Evaluation of Secondary and Late Secondary Alveolar Bone Grafting on 66 Unilateral Cleft Lip and Palate Patients.

OBJECTIVE: The aim of this retrospective study was to evaluate the outcomes of secondary alveolar bone grafting and late secondary alveolar bone grafting in 66 unilateral cleft lip and palate patients. MATERIALS AND METHODS: The total patients were 66 unilateral cleft lip and palate patients, out of which 19 patients underwent secondary alveolar bone grafting and 47 patients underwent late secondary alveolar bone grafting. Autogenous anterior iliac crest cancellous bone graft was harvested and used for grafting the alveolar clefts. Radiographic assessment based on Enemark's scoring according to the marginal bone levels was done on the intraoral periapical radiographs taken 6 months after performing the surgery. RESULTS: Twelve (63%) out of the 19 patients on whom secondary alveolar bone grafting was done achieved score 1 (optimal marginal bone levels), whereas only 12 (25%) out of the 47 patients achieved score 1 amongst the late secondary alveolar bone graftings. Overall results showed, probability, P = .034 (statistically significant). CONCLUSION: This study reaffirmed the fact that alveolar bone grafting when done in preadolescent age group (secondary alveolar bone grafting) gives better results in terms of marginal bony consolidation and maintaining the continuity of the alveolar arch, but the late presentation (late secondary alveolar bone grafting) should not be the refusal criteria for performing the alveolar bone grafting. Although the latter patients may not be rewarded in terms of bony consolidation as much as the preadolescent patients the potential of successful surgery in them still exists in terms of providing a platform for the dental implant placement, improvement in the soft tissue symmetry and aesthetics of the face.

OBJECTIF: La présente étude rétrospective visait à évaluer le résultat des alvéoloplasties secondaires et des alvéoloplasties secondaires tardives chez 66 patients ayant une fente labio-palatine unilatérale. MATÉRIEL ET MÉTHODOLOGIE: Au total, 66 patients ayant une fente labio-palatine unilatérale ont participé à l'étude, dont 19 ont subi une alvéoloplastie secondaire et 47, une alvéoloplastie secondaire tardive. Les plasticiens ont prélevé de l'os spongieux autologue au niveau de la crête iliaque pour le greffer dans la fente alvéolaire. Six mois après l'opération, ils ont attribué un score d'Enemark à la hauteur de l'os marginal d'après leur examen des radiographies périapicales intraorales. RÉSULTATS: Douze des 19 patients (63 %) qui avaient subi une alvéoloplastie secondaire ont obtenu un score de 1 (hauteur optimale de l'os marginal), par rapport à seulement 12 des 47 patients (25 %) qui avaient subi une alvéoloplastie secondaire tardive. Les résultats globaux ont démontré une probabilité p=0,034 (statistiquement significative). CONCLUSION: La présente étude confirme que l'alvéoloplastie réalisée chez des préadolescents (alvéoloplastie secondaire) assure une meilleure consolidation osseuse marginale et la continuité de l'arc alvéolaire, mais une présentation tardive (alvéoloplastie secondaire tardive) ne devrait pas constituer un critère pour refuser l'alvéoloplastie. Même si les patients plus âgés ne profitent pas d'une aussi bonne consolidation osseuse que les préadolescents, il se peut tout de même que l'opération leur fournisse la plateforme nécessaire pour installer l'implant dentaire, améliorer la symétrie des tissus mous et l'esthétisme du visage.

Superolateral dislocation of an intact mandibular condyle into the temporal fossa: case report and literature review.

Temporomandibular joint dislocation refers to the dislodgement of mandibular condyle from the glenoid fossa. Anterior and anteromedial dislocations of the mandibular condyle are frequently reported in the literature, but superolateral dislocation is a rare presentation. This report outlines a case of superolateral dislocation of an intact mandibular condyle that occurred in conjunction with an ipsilateral mandibular parasymphysis fracture. A review of the clinical features of superolateral dislocation of the mandibular condyle and the possible techniques of its reduction ranging from the most conservative means to extensive surgical interventions is presented.

Congenital bilateral syngnathia and tracheoesophageal fistula: A rare presentation.

Congenital syngnathia (CS), first reported by Burket in 1936, is a rare condition, with <50 reported cases and is associated with other conditions and syndromes. CS restricts mouth opening, causing difficulty in feeding, swallowing, and respiration. This report puts forth the clinical findings and management of this challenging condition in association with tracheoesophageal fistula in a neonate.

Bioterrorism: Law Enforcement, Public Health & Role of Oral and Maxillofacial Surgeon in Emergency Preparedness.

INTRODUCTION: The contrived and deliberate use of pathogenic strains of micro-organisms such as bacteria, viruses or their toxins to spread life-threatening diseases on a mass scale with the aim to devastate the population of an area is referred to as 'bioterrorism'. RISK ASSESSMENT: The threat of bioterrorism is higher than ever. It is now a well established fact that the capability to create immense panic and unimaginable fear has allured the terrorists for the despicable use of biological agents for causing terror attacks. Moreover to add to the grievance, this era of biotechnology and nanotechnology has created an easy accessibility to more sophisticated biologic agents apart from the conventional bacteria, viruses and toxins. These biologic weapons can cause large-scale mortality and morbidity in large population and create civil disruption in the shortest possible time. PREPAREDNESS AND MITIGATION: Fight against bioterrorism is a global concern and necessitates that the issue should be criminalized internationally with the assistance of international co-operation and laws in favor of global public health. National public health agencies must also fortify their ability to be able to detect and respond to such biological attacks with better research and training facilities to health professionals, enhanced surveillance and improved diagnostic facilities by evolving an empowered public health system. Public health education and awareness are imperative; people should be made aware of reporting early to health institutions on arousal of signs and symptoms related to suspicious bioterrorist attack. CONCLUSION: Effective bioterrorism planning, prevention and response requires cooperation and collaboration between law enforcement and public health; Oral and maxillofacial surgeons can be successfully integrated into the emergency medical response system. With their education, training, skills and amenities in form of equipments they can augment medical and surgical personnel in early identification and subsequent control of a bioterrorist attack.