Massive Infected Dentigerous Cyst in a Young Child.

Dentigerous cysts are odontogenic cysts that form on the crown of an unerupted or partially erupted tooth. They are specifically anchored to the cementoenamel junction. Dentigerous cysts are known to rarely involve impacted deciduous teeth. Because of this rarity, this article reports a unique case of a five-year-old female patient who developed a dentigerous cyst in relation to a developing permanent left mandibular first molar tooth with its surgical treatment and histopathological features.

Tru-cut needle biopsy: A novel approach in the diagnosis of solid oral pathologies.

Nowadays, new biopsy techniques such as fine and wide needles are now employed instead of invasive biopsy techniques. Compared to open biopsy, true-cut needle biopsy has a number of advantages. It's quick and simple to do, can be done in an outpatient department, avoids incisions into previously irradiated skin, and has few risks. In order to examine malignant and benign tumours, there had been a debate in the past century on the utilisation and efficiency of tru-cut biopsy over Fine needle aspiration cytology (FNAC) and surgical biopsy in solid tumours. A non-odontogenic tumour that occurs in jaws, also classified as a fibro-osseous lesion of the jaw, is Cemento-Ossifying Fibroma. Clinically, these lesions occur as gradually growing, reaching an enormous size if not treated. In this article, a case of cemento-ossifying fibroma noticed in the maxilla with facial swelling is discussed and the diagnosis was done using a tru-cut needle biopsy.

Validation of Modified Hertel Exophthalmometer.

STUDY DESIGN: This is a correlation study. OBJECTIVE: The objective was to obtain normative values from modified Hertel exophthalmometer, to compare difference in values between modified and standard Hertel exophthalmometer and to statistically analyze for correlation. METHODS: The study to validate the modification done to Hertel exophthalmometer was performed at the Department of Oral and Maxillofacial Surgery at our institute. Informed consent was obtained from patients; measurement in 100 volunteers was made with Hertel and modified Hertel exophthalmometer by a single observer, and the measurements taken by the 2 devices were tabulated along with variables such as age and gender. Data were collected and statistical analysis was performed to compare and correlate the values between standard and modified exophthalmometer. Differences of ocular protrusion values in gender and age were also calculated. RESULTS: There has been no statistically significant difference in the normative data between standard Hertel and modified Hertel exophthalmometer and in relation to age and gender. CONCLUSIONS: The modification of the Hertel exophthalmometer is validated and can also be used for relative exophthalmometry to assess the need for treatment and to evaluate the globe position and orbital volume intraoperatively. The proposed modification of the instrument allows it to be used in cases when one of the lateral orbital walls is fractured or displaced due to trauma.

Reliability of Modified Hertels Exophthalmometer as an Intraoperative Tool for Assessment of Relative Globe Position in Orbital/Zygomatic Fracture.

INTRODUCTION: Axial globe position assessment is commonly carried out with Hertels Exophthalmometer. Hertels requires an intact lateral orbital rim for its placement, which is often fractured in zygomatic fractures. Hence, to overcome this problem, we have modified the instrument for its application in zygomatic/orbital fractures. Reliability of this Modified Hertels Exopthalmometer has been already validated in normal healthy patients. Therefore, the aim of this study is to assess the efficacy of the Modified Hertels Exophthalmometer in pateints with zygomatic/orbital fracture. MATERIALS AND METHODS: This is a prospective study carried out between April 2015 and October 2017, including 20 patients with a mean age of 34 years. Enophthalmos was measured using Modified Hertels in patients with unilateral orbital/zygomatic fracture indicated for surgical intervention by a single observer. The data was collected and statistically analyzed. Paired sample t-test was done to compare the preoperative exophthalmometer reading with readings at different time points. RESULTS: A statistically significant difference was noted (P = 0.031) among the variables of Modified Hertels. We believe this instrument to be of practical use in the assessment of enophthalmos/exophthalmos in patients with lateral orbital trauma, surgery or disease and also precludes the use of rim-based exophthalmometry and other modifications of same.

The Involvement of Temporomandibular Joint in Psoriatic Arthritis: A Report of a Rare Case.

Psoriatic arthritis (PsA) is a chronic inflammatory condition affecting psoriatic patients. Its clinical manifestations in patients can vary over time, advancing from one joint to the next with an intermittent pattern of exacerbation and remission. The condition shares similar manifestations with rheumatoid arthritis (RA), ankylosing spondylitis, and reactive arthritis; hence, a comprehensive examination is required for a proper diagnosis and management. It is associated with an increased risk of comorbidities affecting patients' well-being. There have been few incidences of involvement extending to the temporomandibular joint (TMJ), but a proper record needs to be maintained to evaluate its part in PsA. In this report, we present a case of PsA in which the patient complained of ear pain and was discovered to have early alterations in the TMJ.

A Rare Incidence of Metachronous Neurovascular Lesions in a Child.

Neurofibroma is an uncommon benign tumor arising from nerve sheath fibroblasts. The diagnosis of solitary lesions becomes difficult in patients who do not have any family history of neurofibroma. An intra-oral solitary neurofibroma comprises 6.5% of reported cases of neurofibroma. Few cases of intraosseous solitary neurofibroma have been published as per literature. Treatment-surgical resection of tumor has an excellent prognosis with extreme rare malignant transformation which is more commonly seen in neurofibromatosis. A periodic follow-up is necessary in solitary tumors to rule out syndromic cases. Leiomyoma is a benign tumor of smooth muscle origin, which is usually diagnosed in the gastrointestinal tract, uterus, and skin. The most effective treatment for solid, vascular, and epithelioid angioleiomyomas is surgical resection along with tumor capsule. Here we report an uncommon occurrence of multiple benign tumors in a pediatric patient.

Use of C-Arm to Assess Reduction of Zygomatic Complex Fractures: A Comparative Study.

The aim of this study was to analyze the use of C-arm and its significance in accurate reduction of zygomaticomaxillary complex (ZMC) fractures. Orbital volume is used as parameter to compared pre- and postoperative volumes of injured orbit. Differences in orbital volume calculated in cases done with intraoperative imaging and in controls treated without the use of intraoperative imaging were evaluated using Student t-test. C-arm is definitively an effective tool in the armamentarium of oral and maxillofacial surgery in assessment of reduction of ZMC fracture.

"Histiocytosis X" - A Rare Case Report.

Histiocytosis X is an idiopathic disease, characterized by a disorder of the reticulo-endothelial system in the human body. Histopathological studies carried out right from the 1800s have seen a significant similarity in the pathologic process of different stages in particular clinical syndromes showing proliferation of mature histiocytes. It was then modified by Lichenstein in 1953 as "Histiocytosis X". The exact aetiology is unknown; hence, the name "Histiocytosis X". The disease classically presents with three syndromes namely Eosinophilic granuloma, Letterer-Siwe disease and Hand-Schuller-Christian disease. These syndromes present with a spectrum of clinical manifestations with histiocytic proliferation in the granulomatous lesion. The disease is neither familial nor hereditary, nor does it have any microbiological pathologic origin. This disease can be conservatively managed by antibiotics and steroids or surgical curettage with radiotherapy. We report a five-year-old male child who was incidentally diagnosed to have Histiocytosis X. This patient was managed with a moderate surgical procedure with total avoidance of radiotherapy. An adequate follow-up of this patient shows total regression of the lesion and good bone healing.

Finite element analysis comparison of plate designs in managing fractures involving the mental foramen.

Introduction The aim of the study was to propose an ideal plating design for fractures running through the mental foramen. Methods The study compared three plating designs-two four-hole miniplates, 2 × 2-hole three-dimensional (3D) plate, and modified 2 × 2-hole 3D plate (posterior strut removed)-using finite element analysis. Von Mises stresses generated around the plates and bone were measured, as well as the mobility that is generated between the fracture fragments by applying muscle forces to generate bite force in one test and applying a force of 500 N over the premolars and first molar region in the second test. Results Von Mises stress in bone with miniplates measured 9.24 MPa in test 1 and 131.99 MPa in test 2. The stress with unmodified 3D plates measured 34.9 MPa in test 1 and150.03 MPa in test 2. The stress with modified 3D plates measured 24.98 MPa in test 1 and 150.59 MPa in test 2. Von Mises stress on the plates and screws measured 28.23 MPa, 95.97 MPa, 72.93 MPa in test 1 and 458.63 MPa, 779.01 MPa, 742.39 MPa in test 2 on miniplates, unmodified 3D plates, and modified 3D plates, respectively. The fracture mobility generated in the model with miniplates measured 0.001 mm in test 1 and 0.01 mm in test 2 and 0.007 mm and 0.02 mm in the model with unmodified 3D plates in test 1 and in test 2, respectively. In the model with modified 3D plates, the value was 0.001 mm and 0.01 mm in tests 1 and 2, respectively. Conclusion The ideal plate design is the two-plate technique with minimal stress generation on the bone and the hardware. The modified 3D plate has adequate strength to be used in the region but needs to be studied in detail.