Randomized Controlled Trial to Evaluate the Efficacy of Oral Dexamethasone and Intramuscular Dexamethasone in Mandibular Third Molar Surgeries.

INTRODUCTION: Surgical removal of impacted third molar is the most commonly performed dento-alveolar procedure and is associated with post-operative pain, swelling and trismus. AIM: The aim of the study was to compare the efficacy of dexamethasone administered orally with that of dexamethasone administered as an intra-masseteric injection in surgical removal of mandibular third molars. MATERIALS AND METHODS: Sixty patients with impacted mandibular third molars were selected to undergo surgical removal of mandibular third molars. They were divided into three groups of twenty each, viz., Control Group, Group taking Oral dexamethasone and Group taking Intra-masseteric dexamethasone. Evaluation was done over a period of seven days postoperatively to study the effects of the drug in terms of swelling, trismus and pain. RESULTS: ANOVA test was done and comparisons were made. It was found that there was a statistically significant difference with respect to the group taking oral dexamethasone in terms of resolution of trismus. It was also found that there was no statistical significance with respect to reduction in swelling in either of the groups. CONCLUSION: Thus, it can be concluded that the oral route is superior compared to the intramuscular route when administering dexamethasone in surgical removal of mandibular third molars, with respect to drug dosage, bio-availability and resolution of trismus.

Congenital Giant Keratinous Cyst Mimicking Lipoma: Case Report and Review.

Epidermal cysts represent the most common cutaneous cysts. They arise following a localized inflammation of the hair follicle and occasionally after the implantation of the epithelium, following a trauma or surgery. Conventional epidermal cysts are about 5 cm in diameter; however, rare reports of cysts more than 5 cm are reported in the literature and are referred as "Giant epidermal cysts." Epidermal cysts although common, can mimic other common benign lesions in the head and neck area. A thorough clinico-pathologic investigation is needed to diagnose these cutaneous lesions as they differ in their biologic behavior, treatment, and prognosis. We report a case of a giant epidermoid cyst in the scalp area of a young female patient which mimicked lipoma on clinical, as well as cyotological examination. We also present a brief review of epidermal cysts, their histopathological differential diagnosis, and their malignant transformation.

Management of Midline Facial Clefts.

Median or midline facial clefts are rare anomalies of developmental origin, etiology of whose occurrence is still unknown precisely. The most basic presentation of midline facial clefts is in the form of a Median cleft lip which is defined as any congenital vertical cleft through the centre of the upper lip. First described by Bechard in 1823, it is the most common amongst all atypical clefts reported. The incidence is about 1:10,00,000 births. This may occur as a sporadic event or as a part of an inherited sequence of anomalies. It arises embryologically from incomplete fusion of the medial nasal prominences. The authors present a series of eight cases with varying degrees of midline facial clefts. This review article aims to give a broad idea on the various classifications used for further understanding of midline facial clefts and a brief idea about the various surgical management techniques used in the repair of these facial clefts.

Applications of coronoid process as a bone graft in maxillofacial surgery.

The coronoid process can be easily harvested as a donor bone by an intraoral approach during many maxillofacial surgery procedures. The purpose of this study was to evaluate the utility of autogenous coronoid process bone grafts for maxillofacial reconstructive surgery. Twelve patients, who underwent coronoid process grafts for reconstruction of maxillofacial deformities due to trauma, alveolar atrophy, or temporomandibular joint ankylosis, were included in the study. There were 3 orbital defects after extended maxillectomy, 1 blowout fracture of the orbit, 2 cases of reconstruction after temporomandibular joint ankylosis surgery, 1 case of additional chin augmentation following horizontal flip genioplasty, 1 defect of anterior wall of maxilla due to trauma, 2 mandibular defects, and 2 cases of bone augmentation for implants.We recommend the use of coronoid process of the mandible as a source for autogenous bone graft as it can provide sufficient bone in quantity and quality for selected maxillofacial reconstructions.

Accidental injection of sodium hypochlorite instead of local anesthetic in a patient scheduled for endodontic procedure.

We present here a case of tissue destruction and paresthesia following the accidental injection of sodium hypochlorite instead of local anesthetic in a patient scheduled for endodontic procedure. The accident was managed by the local injection of steroid, debridement of necrotic tissue, daily dressings and medications. Wound healing was satisfactory at the end of 1 month. An extra-oral scar and a small area of paresthesia persisted even after 5 years.

Application of 2.0 mm Titanium Plates in Rigid Internal Fixation of Mandibular Angle Fractures.

PURPOSE: The present study aimed to evaluate the efficacy and stability of 2.0 mm Titanium plates in treatment of mandibular angle fractures. MATERIALS AND METHODS: A randomized, prospective study was carried out on 17 patients treated by ORIF with 2.0 mm titanium plates. Operative handling of the plate and clinical stability were qualitatively analyzed. RESULTS: The 2.0 mm plate showed good intra-operative handling and adequate clinical stability with follow up of 6 months showing good soft tissue healing. CONCLUSION: A single 2.0 mm titanium plate provides easy handling and adequate occlusal stability in the post-operative phase as compared to the traditional 2.5 mm plate without post-operative MMF. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s12663-010-0128-2) contains supplementary material, which is available to authorized users.