Comparative evaluation of different osteosynthesis modalities with respect to lingual splaying in mandibular interforaminal fractures using CBCT: A prospective study.

Introduction: The management of interforaminal fracture can prove to be challenging because of its unique anatomy and muscular forces. Often, lingual splaying has been found either postoperatively or even during the procedures in such fractures and can be challenging when it comes to managing them. Various modalities such as miniplates, lag screws, and three-dimensional (3D) miniplates have been utilized to manage these fractures. This article compares these three modalities in the management of lingual splaying. Material and Methods: Thirty patients were allotted randomly to either of the aforementioned modalities randomly in this prospective study. The patients were operated and followed up for the period of 6 months. Results: It was found that no significant difference exists between the modalities in terms of reduction in lingual splay. Conclusion: All three modalities have different ventures to offer. A larger sample size study may be warranted to elucidate the obtained results.

A comparative study on efficacy of immediate and delayed placement of cylindrical and tapered dental implants: A clinical prospective study.

Introduction: The study deals with improving the understanding of implant design in various situations. Materials and Method: 40 implants were placed out of which 20 were tapered and rest were cylindrical. These were further divided into immediate and delayed settings. The patients were followed upto 6 months and the results were compiled. Result: Statistically significant difference were found between tapered and cylindrical implants in terms of quality of osseointegration and maintenance of crestal bone height. Conclusion: It has been gathered from the study that while delayed placement suggests waiting time period varying between 3 and 6 months, it offers a predictable procedure in terms of visibility, good implant-bone contact, and closure all of which, promote a better outcome for dental implant therapy. Immediate implant placement solution is very viable in reducing the time period involved in dental implant therapy. Apart from few to minimum contraindications, it can be predictably performed.

Trigeminocardiac reflex during maxillary third molar extraction: Our experience.

Trigeminocardiac reflex (TCR) is a cascade of physiological response secondary to the stimulation of any of the sensory divisions of the trigeminal nerve, which is the largest cranial nerve and provides sensory supply to the face, scalp, mucosa of the nose, and mouth. This response usually presents as a triad including bradycardia, apnea, and gastric motility changes. On the another side, transient loss of consciousness or vasovagal syncope, a well-known phenomenon in dentomaxillofacial surgery with its pathophysiology fully elucidated, is thought to be mediated by TCR and sometimes termed as dentocardiac reflex. Thus, it is imperative to know about TCR and its association with routine dental and maxillofacial surgery procedures. It can potentially happen during any minor or major oral surgical procedures ranging from simple third molar extractions, soft tissue surgeries, root canal treatments, or management of maxillofacial fractures. This paper presents two case reports demonstrating TCR which presented during maxillary third molar extraction and author(s) own experience in managing the same.

Comparison between 3D delta plate and conventional miniplate in treatment of condylar fracture: A randomised clinical trial.

The aim of the study was to conduct a randomized clinical trial comparing the efficacy of standard non-compression miniplate and 3-dimensional (3D) titanium plate in the open reduction internal fixation (ORIF) of the mandibular condylar fractures. Patients who underwent open reduction of mandibular condylar fracture were recruited for the study. The patients satisfying the inclusion criteria were randomly assigned to two groups in a 1:1 ratio. Group A comprised patients treated using conventional miniplates, and Group B comprised patients treated using 3D Delta Plate. Informed consent was provided. All the patients underwent ORIF under GA via retromandibular approach. The sample size was set at 20 participants, with 10 participants in each group who were randomly allocated. Our study showed that patients in Group A had a significant statistical difference operating time (141.20 ± 2.59 min) than that of Group B (117.2 ± 9.63 min). Mouth opening was significantly greater in the 3rd-month follow-up in Group B (mean = 42.40 ± 1.82) compared to Group A (mean = 35.80 ± 1.30). Biting efficiency in Group B was observed to be clinically and statistically better compared to Group A (P = 0.012). Wound dehiscence was managed efficiently by judicious use of antibiotics and wounds were free of any signs of infections or discharge in the consecutive follow-ups. No plate removal was required in either group. Patients treated with 3D delta plates have superior outcomes with regard to operation time, mouth opening, and biting efficiency compared with miniplates. Hence, it can be concluded that the triangular shape of the 3D Delta plate allows the stress distribution to be superior and multidimensional, leading to better post-operative stability, faster healing, and reduced complications.

Efficacy of Microplates versus Miniplates in the Management of Maxillofacial Fractures.

INTRODUCTION: Increased facial trauma has led to advances in techniques of internal fixation, improvements in plating system, refinements in exposure of facial skeleton fueling the rapid use of internal fixation for the management of facial fractures. Evaluating 40 patients with confirmed midfacial (Le Fort I and II) and mandibular fractures, this study presents the efficacy of microplate in comparison with miniplate in terms of load bearing capacity, stability at the fracture site and postoperative palpability. OBJECTIVES: To evaluate the efficacy of microplates in comparison with miniplates in maxillofacial trauma. MATERIALS AND METHODS: Study sample consists 40 subjects, 20 each in two groups clinically and radiographically diagnosed with Group 1 (maxillary) and Group 2 (mandibular fractures) which were subdivided into 10 each treated with miniplate and microplate respectively. Postoperatively, stability of fracture, bite force, need for postop MMF, pain, infection, wound dehiscence, mouth opening, occlusion and palpability was noted. All cases have been evaluated clinically for various parameters for minimum of 3 months to assess any postoperative complications. RESULTS: We found microplates are stable enough and have adequate load bearing capacity. Due to close adaptability and less hardware, postoperative palpability is less but larger sample study with long term follow up is necessary to conclude its efficacy in load bearing fracture sites.

Efficacy of hybrid implants in oral and maxillofacial surgery: A clinical prospective study.

AIM: The present study was aimed to evaluate the efficacy of hybrid implants in replacement of missing teeth in either jaw. MATERIALS AND METHODS: Twenty hybrid implants were placed in maxilla and mandible and the implants were assessed for pain,implant exposure, mobility, infection and wound dehiscence at first, third and sixth month postoperatively. RESULTS: According to our study the statistical data showed that all the parameters which were seen clinically were nonsignificant. CONCLUSION: Hybrid implants being a new option in this field, our study provides a platform for further research with larger sample size with longer follow ups to be judgemental on their efficacy.

Efficacy of two-point fixation in the management of zygomatic complex fractures - A prospective clinical study.

INTRODUCTION: Anatomic disfigurement caused by zygomatic fracture warrants intervention tore establish facial symmetry. It is most predictably restored to pre morbid condition by ORIF. AIM: To evaluate the efficacy of 2 point fixation in Zygomaticomaxillary complex fractures. MATERIAL AND METHOD: 20 patients with established ZMC fractures were operated using two point fixation method and followed up for upto 3 months. RESULTS: 2 point fixation revealed satisfactory functional and esthetic results. CONCLUSION: 2 point fixation offers efficient outcome as compared to other modalities of management of ZMC.

Implant Survival between Endo-osseous Dental Implants in Immediate Loading, Delayed Loading, and Basal Immediate Loading Dental Implants a 3-Year Follow-up.

INTRODUCTION: With introduction of the term "ossteointegration of dental implant" by Branemark, advancement in implantology from 1957 to 2017 has come a long way with modification in implant type and in loading time. This study aims to evaluate the survival of endo-osseous immediate loading (IL) implant and basal IL implants in atrophic jaws with objective to compare implant survival in atrophic jaws for full mouth rehabilitation between endo-osseous IL versus endo-osseous delayed loading (DL) versus basal IL during 3-year follow-up. MATERIALS AND METHODS: Fifty-two (34 endo-osseous and 18 basal) implants were placed in 4 patients requiring full mouth rehabilitation in atrophic jaws. Case 1: Endo-osseous DL implants in upper and lower arch, Case 2: Endo-osseous IL implants in upper and lower arch, Case 3: Basal IL implant in upper and lower arch, and Case 4: Endo-osseous DL in upper arch and basal IL implant in the lower arch. Intraoperative evaluation was done on the basis of pain (visual analog scale [VAS]), operative time, and initial primary implant stability. Postoperative evaluation was done on pain (VAS), infection, radiographically successful implant (orthopantomogram), and patient satisfaction (Grade 0-10). RESULTS: All cases showed satisfactory results but more amount of intra- and post-operative pain was felt with immediate basal implants. CONCLUSION: We believe that clinicians should comply with patient requests, and for this reason, we agree with some authors to use minimally invasive techniques and to avoid when possible esthetic or functional problems associated with the use of removable prosthesis after teeth extractions.

A clinical prospective randomized comparative study on ostyeosynthesis of mandibular anterior fractures following open reduction using lag screws and miniplates.

INTRODUCTION: The aim of the present study was to compare fixation of mandibular anterior fractures following open reduction using lag screws or miniplates. MATERIALS AND METHODS: This prospective study was conducted on 20 patients diagnosed with cases of displaced mandibular anterior fractures treated with open reduction and internal fixation. The patients were then randomly allocated to either of two groups - Group A: two 2.5 mm stainless steel lag screws were placed in 10 patients. Group B: two 2.5 mm miniplates were placed in 10 patients for the fixation of fractures. Subsequent follow-up was done on the 1st day, 1st, 4th, and 36th week postoperatively. During every follow-up, patient was assessed clinically for infection, malocclusion, loosening of plate/screw, malunion/nonunion, and masticatory efficiency. Radiographs (orthopantogram) were taken preoperative, 1st, 4th, and 36th postoperative week to compare the osteosynthesis between the two groups. Pain was objectively measured using a visual analog scale. The data collected was subjected to unpaired t-test and paired t-test for statistical analysis. RESULT: It was found that lag screw placement was rapid in comparison of miniplate placement. 3rd month postoperative assessment revealed Lag screw group to have better biting efficiency, and better bone healing which was statistically significant when compared with miniplate group. CONCULSION: Our study suggests that lag screw osteosynthesis can be advocated as a valid treatment modality in the management of mandibular symphysis and parasymphysis fractures.

"Are we similar to caucasians": orthognathic surgery for north indians.

PRIMARY AIM: To establish the cephalometric standards for hard and soft tissues of the facial skeleton for north Indian population. METHODS: The sample comprised of lateral cephalograms taken in natural head position of 100 participants (50 men, 50 women). The cephalograms were traced, analyzed and interpreted using the landmarks and values given by Burstone's analysis for hard tissue and Legan and Burstone analysis for soft tissue respectively. The Student's t test, standard deviation and mean deviation were calculated to compare between the groups. RESULTS: Statistically significant results were found in various parameters between intra and inter group comparison. CONCLUSION: The results obtained in the north Indian population can be used as cephalometric norms for orthognathic surgery.