Eventuality of Dexamethasone Injected Intra-massetrically on Post Operative Sequel Following the Surgical Extraction of Impacted Mandibular Third Molars: A Prospective Study.

OBJECTIVE: The objective of the study was to compare the efficacy of dexamethasone given intra-massetrically via intra buccal approach on postoperative sequele after surgical extraction of impacted mandibular third molars. METHODOLOGY: Twenty patients, each of who required surgical extraction of a single impacted mandibular third molar under local anesthesia, were randomly set apart to one of the two groups of ten each. The experimental group received dexamethasone 8 mg injected to the masseter muscle intra buccally and the control group did not receive any steroid. Facial swelling and maximal inter-incisal distance were measured by an independent examiner preoperatively, and at 4th h, on the day of surgery, 2 and 7 postoperative days. Pain was measured from the patient's response to a visual analogue scale. RESULTS: Patients were of the age range 18-40 years. Dexamethasone group showed significant reduction in swelling and pain compared with the control group at all intervals. Dexamethasone injected into the masseter muscle via intra buccal approach resulted in significantly less trismus than control on day one postoperatively. CONCLUSION: Dexamethasone 8 mg given intra-massetrically through intra buccal approach is an effective way of minimizing swelling, trismus, and pain following surgical extraction of impacted mandibular third molars. It offers a simple, safe, painless, non-invasive and cost-effective treatment.

A study to evaluate cephalometric hard tissue profile of Tamil population for orthognathic surgery.

The primary aim of this study is to compare, the cephalometric hard tissue profile values and analysis between Tamil and Caucasian population. The study also aims to create a better understanding in the facial proportions of Tamil Nadu population and to have better diagnosis and treatment planning for orthognathic surgery for Tamil population in Tamil Nadu.

A Study on the Influence of the Osteotomy Slope on Bony Changes after Advancement Genioplasty.

INTRODUCTION: The slope of the osteotomy used for the genioplasty dictates the vertical change. The horizontal bony changes after advancement genioplasty are not identical to the intercortical bony changes, because the variety of osteotomy slopes result in different vertical changes. MATERIAL AND METHODOLOGY: Ten of these patients had additional osteotomies as follows: five maxillary, three mandibular and two both maxillary and mandibular. Pre-operative and post-operative (at least 6 months) lateral cephalograms were retrospectively analyzed to assess horizontal and vertical movements of the chin. The following landmarks were used, Hard tissue pogonion (Pog), Occlusal plane (OPL), Menton (Me), Menton plane (MePL). The following parameters were calculated: ΔH = H-H, ΔV = V-V, The ratio between ΔH and ΔV equals tangent α, Calculated α = inverse tangent α . RESULTS: The Mean Horizontal bony movements was 3.75 mm (SD 1.4 mm, range -6 to 15 mm). The Mean Vertical bony movements was 1.4 mm (SD 0.8 mm, range 0.5-2 mm). The Mean Measured Osteotomy slope angle was 82.2 (SD 7.4, range 75-91). The Calculated Mean Slope Angle based on the ΔH/ΔV ratio was 82.3 (SD 7.0, range 74-95). DISCUSSION: The slope of the osteotomy used for the genioplasty dictates the vertical change. The osteotomy slope angle was defined as the angle between the osteotomy and a line perpendicular to the occlusal plane. The measured angle was compared with the calculated angle deduced from the horizontal and vertical genial post-operative changes.

Evaluation of versatility and effectiveness of pedicled buccal fat pad used in the reconstruction of intra oral defects.

INTRODUCTION: The use of buccal fat pad as a grafting source in the closure of intraoral defects has gained popularity in the last quarter of this century. Because of the ease of access and rich blood supply, its use in oral defects is an attractive concept. METHODOLOGY: The study comprised of 8 patients with oral submucous fibrosis, 1 patient with oroantral fistula, 1 patient with verrucous hyperplasia. The acquired oral defects following resection of pathology in the oral cavity, were reconstructed with pedicled buccal fat pad. The Post operative follow up at the intervals of 1st, 7th and 15th day, followed by 1st month, 2nd month and 3rd month was done. RESULTS: The procedure was successful in all the patients. Healing was satisfactory with no breakdown or liquefaction necrosis post operatively. All the patients had definitive colour change at the end of 1st post operative month owing to the epithelialisation. Residual defect was present in one patient diagnosed of verrucous hyperplasia on the 1st and the 7th post operative day which subsequently healed. In 8 patients with oral submucous fibrosis post operative mouth opening was measured in and was observed to be in the range of 12-26 mm on the 1st post operative day and 34-42 mm during 3rd month post operatively. CONCLUSION: The results of this study support the view that the use of buccal fat pad is a simple, convenient and reliable method for the reconstruction of small to medium sized intra oral defects.

Self Tapping Screws v/s Erich Arch Bar for Inter Maxillary Fixation: A Comparative Clinical Study in the Treatment of Mandibular Fractures.

INTRODUCTION AND OBJECTIVE: Numerous methods have been described for achievement of Intermaxillary fixation in the treatment of fractures of facial skeleton. Conventional methods like Erich arch bars and eyelet wires are currently most common methods for achieving intermaxillary fixation (IMF), but they have their own disadvantages. Since 1989, IMF using intraoral self tapping IMF screws has been introduced for treatment of mandibular fractures. The aim of this work was to compare the efficacy, advantages, disadvantages indications and potential complications associated with Erich archbar v/s self tapping IMF screws in the management of mandibular fractures. METHODS: Twenty patients with mandibular fractures, reporting to Department of Oral and Maxillofacial Surgery, The Oxford Dental College, Bangalore were evaluated, to compare the efficacy of two techniques. The parameters considered were, time taken, perforations in the gloves, patient acceptance, oral hygiene, iatrogenic dental injuries, and needle stick injuries during IMF with Erich arch Bar and self tapping IMF screws. RESULTS: The mean time taken for IMF was 8.52 ± 2.7 min with screws as compared to 100 min with Erich arch bars. Mean number of perforations were significantly more in Group II. Oral hygiene status was good in 90% and fair in 10% of Group I and 100% fair in Group II patients. CONCLUSION: Use of self tapping IMF screws for intermaxillary fixation is a valid alternative to conventional Erich arch bars in the treatment of mandibular fractures. Iatrogenic injury to dental roots is the most important problem to this procedure, which can be minimized by careful radiographic evaluation and treatment planning.