Double jaw surgery – a modified surgical approach to treat skeletal class II

@#Patients with mandibular deficiency and skeletal class II malocclusions exhibit a wide spectrum of esthetic, cephalometric, and occlusal characteristics. The structure of chin determines facial attractiveness and is directly linked to a quality of life. Correction of dentoalveolar protrusion of maxilla is done by anterior maxillary subapical osteotomy by which anterior segment can be moved superiorly or inferiorly and posteriorly as indicated. Augmentation genioplasty is advocated to improve the overall facial esthetics of patient with mandibular deficiency. In skeletal class II malocclusions cases best results are obtained with double jaw surgery combined with the orthodontic treatment. This is a case report of skeletal class II malocclusion with mandibular deficiency and protruded maxilla in 22 year old female patient who was treated surgically by anterior maxillary subapical osteotomy and augmentation genioplasty along with the orthodontic treatment

Rhinoscleroma of nose extruding into oral cavity.

Rhinoscleroma (RS) is a rare chronic granulomatous disease of the upper airways affecting nasal cavity, nasopharynx, and paranasal sinuses. Klebsiella rhinoscleromatis is the causative agent of this infection and Mikulicz cells are specific to this lesion. RS is commonly seen in poorer regions such as Central Africa, South America, Middle East, India and Indonesia. It is predominantly found in rural areas and people with poor socio-economic conditions. Most patients present with chronic rhinitis, sneezing, headache and deviated nasal septum similar to current case. An association with oral cavity has not been reported previously, as per authors' knowledge. This report describes a rare case of RS of nasal cavity extending into the oral cavity.

Brown tumour of posterior maxilla associated with polydactyly, syndactyly and cardiac anomalies: a unique case report.

Brown tumour [BT] is an uncommon, non neoplastic complication of Hyperparathyroidism [HPT]. Skeletal changes are the main consequences of this endocrine condition. HPT manifest in three categories. Primary HPT is due to hyperfunction of one or more parathyroid gland, causing an increase of parathyroid hormone secretion resulting in hypercalcemia. Secondary HPT occurs due to chronic renal failure, decreased vitamin D production or with hypocalcemia. Tertiary HPT occurs when the parathyroid activity turns autonomous and excessive, leading to hypercalcemia. BT occurs frequently in the mandible than the maxilla. They are more common in women aged over 50y and majority of BT are asymptomatic. Radiographically, it appears as well defined radioluceny. The gross specimen usually shows a brown or reddish-brown colour. We report a relatively rare combination of maxillary posterior BT as a clinical manifestation of secondary HPT due to vitamin D deficiency with polydactyly, syndactyly and cardiac anomalies.