Evaluation of Neurosensory Changes in the Infraorbital Nerve following Zygomatic Fractures.

PURPOSE: To evaluate the incidence and recovery of persistent sensory disturbances of the infraorbital (IO) nerve after isolated zygomatic complex fractures with various treatment methods. METHODS AND RESULTS: The study was inclusive of isolated unilateral zygomatic complex fractures and fractures of IO rim .Tests performed were Pin prick and Electrical detection threshold test. The evaluation was done preoperatively, after 1 month and after 6 months of surgery. The results suggested that neurosensory disturbance was present in all the patients with zygomatic complex fractures. At 1 month post-operatively some sensory deficit was present in all the patients on the affected side. After 6 months all the patients showed near to normal improvement comparable to normal side. CONCLUSION: Study shows that earlier the surgical intervention, more the recovery of the nerve injury is appreciable during the 1 and 6  months follow up period.

Autologous platelet rich plasma after third molar surgery: a comparative study.

PURPOSE: This study is an attempt to evaluate the use of autologous platelet rich plasma (PRP) to promote wound healing and osseous regeneration in human third molar extraction sockets. MATERIALS AND METHOD: PRP was prepared after two centrifugation and the gelling agent used was freshly prepared 10% calcium chloride.PRP gel was placed in one of the extracted sockets of bilateral impacted mandibular third molars. IOPA Xrays were used to evaluate the wound dehiscence, probing depth, bone density & alveolar bone level after 1st, 2nd and 7th day and 3rd & 6th month respectively. RESULTS: On evaluation, it was found that PRP grafted sockets showed dehiscence in 8% cases. The decrease in alveolar bone level was highly significant in PRP grafted sockets in 3rd and 6th month post operatively. There was significant difference between pre-operative density of adjacent bone and bone formed in extraction sockets at 3rd and 6th month in PRP grafted sockets. There was significant reduction in probing depth from initial period to 3 and 6 months in both the groups, but PRP grafted sockets showed greater decrease in probing depth. CONCLUSION: PRP is an inexpensive and widely available modality to minimize postoperative complication and enhance both hard and soft tissue healing potentials. This autologous product eliminates concern about immunogenic reaction and disease transmission. Its beneficial outcomes in dental clinic, including decrease in bleeding and rapid wound healing hold promise for further procedures.PRP is thus a new application in tissue engineering and developing area for clinician and researchers.

Myositis ossificans circumscripta involving bilateral masticatory muscles.

Myositis ossificans (MO), as its name implies, is ossification and bone formation within a muscle. Pathogenesis is not all clear, but trauma is universally recognized as a trigger event. Myositis ossificans can be divided into 2 classifications: MO progressiva and MO traumatica. When it affects the muscles of mastication, it causes severe trismus. This rare disorder and its limited treatment options can potentially have debilitating effects to the patient's normal oral functioning and health. A computed tomographic scan and panoramic radiographs are essential diagnostic aids for evaluating conditions such as MO. Myositis ossificans can be one of the causes of extra-articular temporomandibular joint ankylosis. Surgical excision of the ossification is the main treatment modality. This is a case report of a patient who developed MO of the muscles of mastication.

Gunshot injury in the neck with an atypical bullet trajectory.

Gunshot injuries are on a rise in both developed and developing countries, the reason for this may be increased access to firearms. Gunshot injuries to the neck and maxillofacial region are associated with high morbidity and mortality due to the complex anatomy and presence of various vital structures in this region. It is indeed a rare finding that a bullet's trajectory passes through the neck region and does not damage any vital structures. We present one such case of gunshot injury to the neck.

Preoperative intravenous tramadol versus diclofenac for preventing postoperative pain after third molar surgery: a comparative study.

PURPOSE: The purpose of this study was to compare the analgesic efficacy of a single-dose of preoperative intravenous tramadol versus diclofenac in preventing pain after third molar surgery. MATERIALS AND METHODS: Fifty patients undergoing elective third molar surgery were randomly assigned into one of the two groups (25 in each group): Group 1 received diclofenac 75 mg, and Group 2 received tramadol 50 mg intravenously preoperatively before the surgery. After injection of the study drugs, the impacted third molars were removed under local anesthetic agent. RESULTS: The difference in postoperative pain was assessed by four primary end-points: pain intensity as measured by a 100 mm visual analogue scale hourly for 12 h, median time to rescue analgesic, postoperative acetaminophen consumption, and patient's global assessment. Throughout the 12 h investigation period, patients reported significantly lower pain intensity scores in the diclofenac versus tramadol group (P = 0.0001, Mann-Whitney U-test). Patients also reported significantly longer median time to rescue analgesic (10 vs. 8 h, P < 0.05, Student t test), lesser postoperative acetaminophen consumption (P < 0.05, Student t test) for the diclofenac versus tramadol group. CONCLUSION: Preoperative intravenous diclofenac 75 mg is more effective than tramadol 50 mg in the prevention of postoperative dental pain.

Multiple supernumerary teeth and odontoma in the maxilla: A case report.

Most supernumerary impacted teeth are located in the anterior maxillary region. They are classified according to their form and location. Their presence may give rise to a variety of clinical problems. The detection of supernumerary teeth is best achieved by thorough clinical and radiographic examination. Their management should form part of a comprehensive treatment plan. This article presents an overview of the diagnostic problems associated with multiple supernumerary impacted teeth and includes a discussion of the classification, diagnosis, and management of this difficult clinical entity.

Classifying odontogenic keratocysts as benign cystic neoplasms: a molecular insight into its aggressiveness.

OBJECTIVE: The present study was conducted with the aim to evaluate the expression of p53 in Odontogenic Keratocyst (OKC) and Ameloblastoma to correlate with the aggressiveness of these lesions. MATERIAL AND METHODS: Immunohistochemical (IHC) staining was performed using anti-p53 antibody in eighteen cases each of OKC and ameloblastoma. RESULTS: p53 positivity was seen in all the cases of OKCs and ameloblastomas. p53 positive cells were seen predominantly in the suprabasal cell layer of OKC and in the peripheral pre-ameloblast like cells in ameloblastoma. Total p53 count was significantly higher in ameloblastoma as compared to OKC. But the intensely stained p53 cell count showed no statistically significant difference between the two lesions. CONCLUSION: The high p53 expression in OKC when compared with ameloblastoma, acknowledges OKC as an aggressive lesion and hence a more aggressive treatment modality is recommended.

Keratocystic odontogenic tumor: a review.

The odontogenic keratocyst is a very well known odontogenic cyst. There are many types of cysts of the jaws, but what makes the odontogenic keratocyst unusual are its characteristic histopathological and clinical features, including potentially aggressive behaviour, high recurrence rate, and an association with the nevoid basal cell carcinoma syndrome. The characteristic histologic feature i.e. the presence of parakeratin, is unique amongst all the different inflammatory and developmental cysts that occur in the jaws. Many treatment modalities have been advocated for its treatment, but none in particular has been regarded as the best treatment option. The 2005 WHO classification now uses the term 'keratocystic odontogenic tumor'. We present a review of treatment modalities of the KCOT.