Modern trends in modeling of extra-oral defects.

Maxillofacial prostheses are usually fabricated on the basis of conventional impressions and techniques. The extent to which the prosthesis reproduces normal facial morphology depends on the clinical judgment and skill of the individual fabricating the prosthesis. Recently, as a result of advances in technology, various computer-aided design and manufacturing techniques have been successfully introduced for the automated fabrication of maxillofacial prostheses. These systems are able to provide more consistently accurate reproduction of facial morphology.

A comparative study to evaluate the discrepancy in condylar guidance values between two commercially available arcon and non-arcon articulators: A clinical study.

Aim: The purpose of this study was comparative evaluation of sagittal condylar values of arcon and non-arcon articulators with cephalometric readings and to determine the amount of discrepancy in sagittal condylar guidance values between arcon and non-arcon articulators using same protrusive record. Materials and Methods: Twenty subjects in the age group of 19-35 years, free from temporomandibular joint dysfunction, and occlusal disharmony, with healthy dentition participated in the study. Hanau H2 (non-arcon type) and Hanau Wide-Vue (arcon type) articulators were programmed for sagittal condylar guidance values using the same protrusive record made in polysiloxane bite registration material with edge to edge degree of protrusion. The resultant values for both the articulators on either side were compared with values obtained from tracing of digital lateral cephalogram using Kodak Dental imaging Window software 6.6.3.0-C program. The tabulated data were subjected to statistical analysis, ANOVA (Fishers 'F' test) for group comparison, Tukey's HSD test for inter-comparison, student's unpaired 't' test for intra-group comparison, and level of significance (P) was calculated using the same. Results: The mean sagittal condylar guidance values of the three different groups were found to be very highly significant (P=0.001) and highly significant (P=0.002) on the right and left sides respectively. There was a very highly significant difference (P=0.001) and highly significant difference (P=0.003) between the arcon and non-arcon group on the right and left side respectively. No significant difference was found between the arcon and cephalometric group (P=0.284 right, P=0.853 left) and a statistically significant difference was found between the non-arcon and cephalometric group (P=0.049 right, P=0.015 left). On intragroup comparison there was no statistically significant difference in sagittal condylar values on the right and left sides. Conclusion: The mean difference in the sagittal condylar guidance values obtained from non-arcon and arcon articulators shows a low level of reproducibility, and no significant difference found in mean sagittal condylar values obtained from arcon articulator and cephalometric tracings indicates replication of sagittal condylar guidance value from image of articular eminence.

Prosthetic rehabilitation of large nasal septal defect with an intranasal stent: A clinical report.

Nasal septal perforation is a common complication of many nasal diseases such as congenital, infectious, trauma, and iatrogenic, and rarely may occur as a complication of systemic diseases, etc. The symptoms of uncorrected nasal septal perforations include crusting, epistaxis, difficulty in breathing, nasal twang in speech, postnasal discharge, foul-smelling, rhinorrhea, and hyposmia. Large nasal defects cannot be closed by hard acrylic resin nasal septal obturators because of the problems in access and path of insertion. However, obturation can be achieved by fabrication of a nasal stent that engages one of the nasal cavities. This clinical report describes prosthetic management of a patient with large nasal septal defect following septal surgery complication with an intranasal heat-processed acrylic resin stent. The stent is rendered patent for comfortable breathing, improves speech, is esthetically acceptable, dense and hygienic. These nasal stents indirectly separate the two nasal cavities with effective obturation of large nasal septal defects.

Comparison of lambdoid suture closure by X-Ray and CT scan in two states of India.

In the present study, herewith comparison is done for closure of squamous suture of skull of living individuals from Punjab and Rajasthan. The cases studied in Punjab are 100 individuals between the age group of 45 years to 70 years with age interval of five years and twenty cases from each age group were studied who were CT scanned for closure of squamous suture at Rajindra Hospital Patiala (Punjab). In Rajasthan (SMS Hospital Jaipur), X-ray examination of 100 individuals was done having age group 40 years to 70 years with age interval of ten years in male and female separately for squamous suture closure and accordingly the squamous suture is divided into 2 parts-(1) Upper half(½), (2)Lower half (½). In both studies, squamous suture is studied ectocranially. It is seen that endocranially suture closure will not give reliable results and sometimes endocranially sutures remain unfused for whole life. No differences in right or left side of squamous suture have been reported by Todd and Lyon. Occasionally there is considerable sclerosis and condensation along the various sutures, particularly sagittal, squamous and coronal suture.

An unusual case of penetrating ocular trauma with metallic spoon.

Ocular trauma is an important cause of vision loss. The agents incriminated in such injuries are diverse. We present a case of ocular trauma with a metallic spoon causing deep laceration of lid and temple region with sclerocorneal laceration. After assessment of the general condition and stabilization of the systemic parameters the operative procedure was undertaken on elective basis. Though the final visual outcome was not rewarding due to the severity of the injury, any potential hemostatic catastrophe was averted.

Correlation of CT scan with postmortem findings of acute head trauma cases at SMS Hospital, Jaipur.

Epidemiological information is of great importance in the allocation of resources for the treatment and in formulating policy designed to reduce the incidence, morbidity and mortality of head injuries. In our country much epidemiological data regarding head injuries are not available, hard to find or inaccurate. The reasons for this are several there is no centrally run health care system in the country and head injury cases are managed by a wide variety of Government, Municipal and Private hospitals. The National Health Statistics compiled in the vital statistics in our country give incomplete information regarding head injuries while it is possible to determine mortality from cancer or heart diseases or number of other illness from vital statistics but same is not true for head injuries. Accidental deaths are catalogued as to etiology (for example, death from falls, motor vehicle etc.) and there is no information available as to the part of the body injured. The present study is an attempt to analyse epidemiological aspects of acute head trauma and evaluate the correlation of finding by various diagnostic modalities.

Age assessment from radiological cranial suture closure in fourth to seventh decades (A Jaipur based study).

Reasonably a correct estimation of age in important in Legal, Medical, Social and Administrative matters i.e. regularization of temporary employee, retirement from service or superannuation, re-employment in services, settlement of pension cases, distribution of old age pension, potency certification, for relaxation in imprisonment on the grounds of old age and good behavior of a prisoner, to provide senior citizen benefits etc. In the dead person the age estimation at the time of autopsy is done to help the Investigating Officer. In India and other countries the task of scientific confirmation of disputed age issue of civil and criminal nature is the domain of Forensic Expert. This study is done to determine the age of individual in the fourth decade to seventh decades by correlating radiological finding of various views of skull along with the other physical findings. Maximum Number of cases was in the age group of 51-55 yrs (17%). Female to male ratio was 1:2.2, 66% cases were urban and 34% were rural, 72% Hindu and 73% were from Middle class.

Heat induced morphological changes in the brain.

In severe conflagration the terminal state of the body often does not reflect the condition at the time of death. Some-times death might have occurred before any heat reaches the body and the death might have been caused by inhalation of smoke. It is difficult or rather impossible for the forensic expert to determine the extent of ante-mortem damage caused by flames. The classical distinction of “red flare or vital reaction” are usually absent in such cases. Destruction of the victim by fire is one of the oldest methods used by murderers to conceal their crime, and hence every death by burning require the most meticulous medico-legal scrutiny. Here we report an unusual cases of heat induced morphological changes in brain in a 60 years male, who was addicted to alcohol and smoking and found burnt on his bed in a locked room from inside. Typical vital reaction was not appreciable anywhere on the body so as to frame the opinion in favour in ante-mortem burns but on of dissection of skull certain unusual gross pathological finding was observed which helped in framing the opinion in favour of “Death due to accidental antemortem flame burns”.

Fracture of the temporal bone: A tomographic v/s autopsy study.

The present study was conducted in the Department of Forensic Medicine & Toxicology, SMS Medical College Jaipur (Raj), in the period from December 15, 2001 to April 4, 2002. With the aim to find out the correlation of X-ray (Skull), CT scan (Head), surgical intervention findings with the autopsy findings in the cases of acute Head trauma. Total of 140 cases of acute head trauma were selected irrespective of age, sex, religion caste etc. who had been admitted in Neurosurgery dep’t. And X-ray, CT scan head and /or surgical intervention had been done, subsequently died & autopsy was performed. X- ray skull gave batter information on fracture of skull than CT Scan, particularly when the fracture is located on the vault or base of skull and is of linear variety. [1] Twenty seven cases of fracture of the temporal bone were specially studied, out of these 140 cases. All these cases had the features of triad, indicating of fracture of petrous part of temporal bone i.e. CSF Otorrhoea 14(51.1%), 7th nerve palsy 9(33.3%), serve middle ear bleeding 18(66.6%) & conducting hearing loss 5(85%). The plain X-ray demonstrated the fracture of temporal bone in 21 cases (79%) and the CT Scan demonstrated their in 24 cases (88%) Longitudinal fractures are common in 18 cases (66%) and procedure of choice for their demonstration is lateral tomography, Transverse fracture alone was uncommon (2 cases) and can only be demonstrated in anterior posterior tomographic projections and is usually associated with occipital fractures. CT Scan Examination give better information in detection of fracture of temporal bone as well as the type of fracture [2] which is essential for planning the surgical intervention or treating the patient conservatively in order to avoid the complications like, persistent CSF otorrhoea, posterior meningitis or even death.