Only Paring Down as Treatment Modality for Fibrous Dysplasia: Case Series.

Fibrous dysplasia is a condition in which normal medullary bone is gradually replaced by an abnormal fibrous connective tissue proliferation and there is arrest of bone development in the woven stage with failure to mature to lamellar bone. The resultant fibroosseous tissue is poorly formed and structurally inadequate and weaker than the original bone. Various treatment modalities including medicinal and surgical treatment have been proposed for this lesion, in this case series we share our experience with paring down for such lesion and found it effective and efficient method of treating fibrous dysplasia. Facial symmetry, esthetics, and function were achieved in all the cases.

Post-traumatic-Zygomaticocoronoid Ankylosis: A Rare Clinical Case Report.

Fusion of the zygomatic bone to the coronoid process of the mandible is a rare phenomenon reported in the literature and commonly called as zygomaticocoronoid ankylosis. It can be sequel of trauma or infection in the midfacial region, mimicking a wide range of problems including the common temporomandibular joint ankylosis and dysfunction. Maxillofacial trauma involving the displaced fracture of zygoma can obstruct the movement of coronoid and if not treated can cause ankylosis between both bones. It is very diffi cult to identify zygomaticocoronoid ankylosis on conventional radiographs and requires the through clinical and advanced radiological evaluation like cone-beam computed tomographic (CBCT) to diagnose it. CBCT can be a great help to identify the size and extension of ankylotic mass and decide the approach to remove it. Zygomaticocoronoid ankylosis can be approached intraorally by Keen’s incision, and extraorally through a hemicoronal approach we have approached intraorally. Here, we present surgical management of post-traumatic zygomaticocoronoid ankylosis in 42-year-old male patient who had trismus for 18 years.

Management of Large Mandibular Ameloblastoma Crossing Midline: Reconstructed by Bilateral Iliac Crest Graft: A Rare Entity.

Ameloblastoma is a true neoplasm of odontogenic epithelial origin. It is the second most common odontogenic neoplasm. It’s incidence approximately 1% of all oral tumors and 18% of all odontogenic tumors. More than 80% of cases of ameloblastoma occur in mandible. The ameloblastoma occurs in three variants solid or multicystic, unicystic, and peripheral. A painless expansion of the jaws is the most common clinical presentation. The correct diagnosis can be easily made with the help of plain X-rays and tissue biopsy. The standard management of ameloblastoma is marginal resection but sometimes a large tumor requires complete resection of affected part. Untreated tumors may lead to tremendous facial disfigurement, a severe malocclusion and pathological fractures of the jaw. Here we present a case of a young man with the chief complaint of facial asymmetry. The orthopantomogram of the patient was showing a multilocular radiolucency with Buccal and lingual cortical expansion. A diagnosis was made on the basis of the biopsy as multicystic ameloblastoma, and resection of the mandible was carried out. The mandibular primary reconstruction was done with avascular bilateral iliac crest bone graft. Long term prognosis showed satisfactory healing and good facial esthetics.

Interpositional Arthroplasty with Temporomyofascial Flap to Correct TMJ Reankylosis in Child: A Case Report.

Temporomandibular joint ankylosis (TMA) is a highly distressing condition in which the temporomandibular joint (TMJ) is replaced by scar tissue. Most frequently reported complications after surgical treatment are limited mouth opening and re-ankylosis. Reankylosis happens due to inadequate bone removal, lack of sufficient interpositional material, fibrous tissue adhesions and elongation of coronoid process and regrowth of bone in the sigmoid notch area. In gap arthroplasty treatment chances to recurrence is 53% than interpositional arthroplasy. We treated a case of right sided TMJ reankylosis by interpositional arthroplasty with temporomyofacial flap and physiotherapy was started 3 days after surgery and maintained for 6 months. In 2 years follow-up, no signs of recurrence and maximum mouth opening 45 mm were observed. The success in preventing reankylosis after TMJ interpositional arthroplasty with temporomyofacial flap is relatively better than gap arthroplasty alone.