ABSTRACT
Introduction: Traditionally, sutures have been widely used to close intraoral wounds. Various alternatives have been developed amongst which newer tissue adhesives such as N-butyl-2-cyanoacrylate having accepted clinical properties are gaining popularity. The primary purpose of the present study is to evaluate the efficacy of N-butyl-2-cyanoacrylate for intraoral attached mucosal wound closure following alveoloplasty. Materials and Methods: In this prospective split-mouth study, 25 patients requiring alveoloplasty in either maxillary or mandibular arch bilaterally with a total of 50 sites were divided into two equal groups, namely silk suture (Group 1) and cyanoacrylate (Group 2). Each patient was evaluated on the first, third, seventh, 14th and 21st post-operative days. Parameters evaluated were time taken to close incision and to achieve haemostasis, pain, oedema, post-operative wound healing, patient discomfort and possible complications. Results: Time taken to close incision, time taken to achieve haemostasis, post-operative pain and oedema were found to be less in Group 2. Wound healing too was found to be better in Group 2. There was one case of adhesive peel off on the first post-operative day which was managed by reapplying the tissue adhesive. The incidence of wound dehiscence and wound infection was observed more in Group 1 on the third post-operative day. Suture breakage (16%) and adhesive dislodgement (8%) were reported on the seventh post-operative day. Discussion: The use of cyanoacrylates' inherent benefits, such as improved wound seal off in attached mucosa, quick polymerisation and bacteriostatic characteristics can be beneficial when performing minor oral surgical procedures on elderly, young and mentally challenged patients.
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Objectives: Mandible is an integral part of masticatory system, and it is expected that it's fracture will have a significant impact on occlusal forces, range of motion, muscle activity levels, and occlusion. The main objective of this study was to compare the efficacy of 3-dimensional (3D) miniplate and conventional miniplates for fixation of anterior mandibular fractures on the basis of bite force as a main parameter. Methods: 66 patients having isolated anterior mandibular fractures were randomized into two groups equally: Conventional miniplates and 3D miniplates. The bite force at incisor, canine, and molar regions was measured preoperatively and postoperatively at weekly intervals until the sixth week, and the mean bite force as well as changes in mean bite force were compared between two groups. Results: An increase in bite force was noted at each subsequent follow up in both the groups across all sites. Statistically significant difference was found in mean bite force values between both the groups during mid-follow up period. The difference in changes in the mean bite force too was observed to be statistically significant during the mid to late follow up period. Interpretation & conclusion: Bite force is a reliable parameter to assess restoration of masticatory efficiency following open reduction and internal fixation (ORIF). 3D miniplates when used in anterior mandibular fractures management are efficient enough to withstand masticatory forces throughout the healing process, providing better stability of fractured segments against torsional forces during immediate post-operative period.
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Objective: To explore the efficacy of ultrasonography as an additional diagnostic tool in superficial odontogenic fascial space infections of maxillofacial region and modifying the treatment plan when needed. Materials and Methods: Forty patients with superficial fascial space infections underwent a detailed clinical, plain radiological and ultrasonographic examination. Based on the ultrasonographic findings, final diagnosis was made and compared with clinical findings. Patients diagnosed with cellulitis were given medical line of treatment, and those with abscess were subjected to incision and drainage along with standard general supportive care and removal of etiologic agent. Results: In this study, out of 40 patients (male = 22, female = 18), clinical diagnosis of cellulitis was made in 26 cases (65%) and abscess in 14 (35.0%). On USG examination, cellulitis was present in 21 cases (52.5%), while abscess in 19 (47.5%). Final diagnosis of cellulitis was made in 13 (59.1%) males and 12(66.7%) females, while abscess was confirmed in 9 (40.9%) male and 6 (33.3%) female patients. The results showed that sensitivity of the clinical examination alone was 64% with 33% specificity, and for USG, sensitivity was 84% with specificity of 100%. Conclusion: The adjuvant role of ultrasonography in the diagnosis and timely management of superficial fascial space infections is promising owing to its accessibility, relative safety, repeatability and cost-effectiveness.
ABSTRACT
INTRODUCTION: Recently, initiation and enhancement of extraction socket healing has been amplified by platelet concentrates, whereas the positive role of Sticky bone has been focused on maintaining alveolar bone dimensions. This study aimed to determine the effectiveness of Sticky Bone for socket grafting of mandibular third molars (M3Ms) in terms of soft- and hard-tissue healing. MATERIALS AND METHODS: This split-mouth prospective trial constituted prophylactic removal of M3Ms with Sticky bone grafted in the study site as a primary predictor variable. Patients underwent 3 months of mandatory follow-up where pain, swelling, interincisal mouth opening, and gingival healing were measured on the 3rd, 7th, and 14th day using the Numeric Rating Scale, anatomic landmarks, steel metric ruler, and criteria given by Landry et al. respectively. Radiological healing was calculated based on the height of the socket, Kelly's Index, and histogram values immediately after the procedure at 1 week, 1 month, and 3 months, respectively. Statistical comparison was made using Paired t-test. P < 0.05 was considered significant. RESULTS: Forty-seven patients (mean 26.83 ± 6.58 years) demonstrated significantly lesser pain, swelling, and better gingival healing at the study site on multiple periods of follow-up. Rapid bone formation with superior density, lesser alveolar resorption, earlier bone blending, and trabecular formation were noticed on the study site with a significant difference at all time intervals. DISCUSSION: Sticky bone was chosen as the graft owing to advantages such as simple preparation, convenient handling characteristics, safety, evident postoperative patient comfort, better retention of the clot, enhanced soft-tissue healing, absence of infection, and decreased osseous deformation as compared to the control site. This study validated the role of Sticky bone as an indispensable component of regenerative therapy in the orofacial osseous tissues as it was an ideal biologic graft with fibrin rich structure. CONCLUSION: This study validated the role of Sticky bone as an indispensable component of regenerative therapy in the orofacial osseous tissues as it was an ideal biologic graft with fibrin rich structure.
