Condylar Osteochondroma: A Rare Case Report.

Osteochondroma (OC) is an uncommon reason for the mandibular condyle to grow excessively. Usually unilateral, it can impact the entire mandible, the condyle and ramus, or just the condyle. It is a bony projection covered in cartilage that protrudes from the damaged bone's exterior. Condylar OC are more prevalent as a result of endochondral ossification-related development. The most notable characteristic is the gradual asymmetry of the face over time. Clinical symptoms of the patient include pain, asymmetry, malocclusion, partial or total hearing loss, trismus, and hypomobility of the TMJ. We report a case of 40-year-old male patient complaining of reduced mouth opening since last 10 years. Clinical examination revealed gross facial asymmetry, hard swelling over right TMJ, jaw deviation towards left side, restricted mouth opening of 3 mm and deranged occlusion. An irregular radiopaque mass was seen over the right condylar region in OPG. A large, hyperdense mass that obliterated the sigmoid notch and extended medially to the right condyle was visible on CT scans. Using a pre-auricular Alkayat-Bramley technique, the mass was surgically removed. Occlusal corrections and jaw physiotherapy were then administered. On follow up, deviation was corrected and adequate mouth opening was achieved.

Comparative Evaluation of Efficacy of Physics Forceps versus Conventional Forceps in Orthodontic Extractions: A Prospective Randomized Split Mouth Study.

INTRODUCTION: Tooth extraction is one of the most commonly performed procedures in dentistry. It is usually a traumatic procedure often resulting in immediate destruction and loss of alveolar bone and surrounding soft tissues. Various instruments have been described to perform atraumatic extractions which can prevent damage to the paradental structures. Recently developed physics forceps is one of the instruments which is claimed to perform atraumatic extractions. AIM: The aim of the present study was to compare the efficacy of physics forceps with conventional forceps in terms of operating time, prevention of marginal bone loss & soft tissue loss, postoperative pain and postoperative complications following bilateral premolar extractions for orthodontic purpose. MATERIALS AND METHODS: In this prospective split-mouth study, outcomes of the 2 groups (n = 42 premolars) requiring extraction of premolars for orthodontic treatment purpose using Physics forceps and Conventional forceps were compared. Clinical outcomes in form of time taken, loss of buccal soft tissue and buccal cortical plate based on extraction defect classification system, postoperative pain and other complication associated with extraction were recorded and compared. RESULTS: Statistically significant reduction in the operating time was noted in physics forceps group. Marginal bone loss and soft tissue loss was also significantly lesser in physics forceps group when compared to conventional forceps group. However, there was no statistically significant difference in severity of postoperative pain between both groups. CONCLUSION: The results of the present study suggest that physics forceps was more efficient in reducing operating time and prevention of marginal bone loss & soft tissue loss when compared to conventional forceps in orthodontically indicated premolar extractions.

Orthokeratinized Odontogenic Cyst (OOC) of Condylar Head: A Rare Entity.

Orthokeratinized odontogenic cyst (OOC) is a rare developmental jaw cyst, considered as distinct entity from odontogenic keratocysts as it exhibits a less aggressive behaviour and a very low rate of recurrence. Most commonly occurs in mandibular molar and ramus region, rarely seen in maxilla and mandibular premolar area. But till now never reported in condyle, this article describes a case of OOC involving the mandibular condylar head in a 41-year-old male. The initial clinical diagnosis was given as TMD based on the clinical features, but radiographic evaluation revealed osteolytic lesion in right side condylar head. Condylotomy was performed and the specimen was sent for histopathological examination. A definite diagnosis of OOC was made by histopathological examination of the biopsy specimen. We report a rare entity in this article with its management.

Comparative analysis of local anesthesia with 2 different concentrations of adrenaline: a randomized and single blind study.

BACKGROUND: Local anesthetic agents are more commonly used in dentistry to have painless procedure during surgical intervention in bone and soft tissue. There are many local anesthetic agents available with the wide selection of vaso-constrictive agents that improve the clinical efficacy and the duration of local anesthesia. Most commonly lignocaine with adrenaline is used in various concentrations. Systemically adrenaline like drugs can cause a number of cardiovascular disturbances while most are short lived, permanent injury or even death may follow in drug induced ventricular fibrillation, myocardial infarction or cerebro-vascular accidents. This study compared the efficacy and cardiovascular effects with the use of 2% lignocaine with two different concentrations. MATERIALS AND METHODS: Forty patients underwent extractions of mandibular bilateral teeth using 2% lignocaine with two different concentrations - one with 1:80000 and the other with 1:200000. RESULTS: There was no significant difference in the efficacy and duration with the 2% lignocaine with 2 different concentrations. 2% lignocaine with 1:80000 adrenaline concentration has significantly increased the heart rate and blood pressure especially systolic compared with the lignocaine with 1:200000. CONCLUSION: Though 2% lignocaine with 1:80000 is widely used in India, 1:200000 adrenaline concentrations do not much affect the cardiovascular parameters. So it is recommended to use 2% lignocaine with 1:200000 for cardiac patients.

Ameloblastomatous CCOT: A Case Report of a Rare Variant of CCOT with a Review of the Literature on Its Diverse Histopathologic Presentation.

Calcifying odontogenic cyst is considered as a rare lesion and accounts for 1% of jaw cysts. It represents a heterogeneous group of lesions which exhibit a variety of clinicopathologic and behavioral features. It has been categorized as cyst and neoplasm. Even after several classification and subclassification, COC remains an enigma. WHO classification 2005 has reclassified the lesion as calcifying cystic odontogenic tumor (CCOT). Ameloblastomatous COC is a rare variant which is not much described in the literature. This report describes one such case which was large multicystic, involved the coronoid and condylar process of the mandible, and treated by subhemimandibulectomy. The case was recurrence free even after 1 year of followup.