ABSTRACT
This article presents a clinical case of a central giant cell granuloma (CGCG) resembling a periapical lesion of endodontic origin. A 39-year-old, otherwise healthy male patient was referred to the department of oral and maxillofacial surgery for its diagnosis and subsequent management. The patient presented with an asymptomatic, progressively increasing intraoral swelling associated with the mandibular left para-symphysis region. On radiographic evaluation, a unilocular radiolucent lesion involving 33-34 teeth was noted. An incisional biopsy presented a giant cell lesion, following which surgical curettage was done. Histopathological examination was in accordance with the diagnosis of CGCG. Therefore, it is imperative for clinicians to accurately diagnose and rule out similarly presenting lesions.
ABSTRACT
In todays era dental implant has become the dependable therapeutic treatment for the replacement of missing teeth. The success of dental implants depends not only on osteointegration of the implant but also on the surrounding hard and soft tissue. Presurgical evaluation of alveolar ridge width and height is of paramount important for implant placement. There are several methods to evaluate the alveolar ridge width and height such as ridge mapping and CBCT. This study included 30 sites from 8 patients in the age ranging from 30 to 65 years. A stent was prepared and the width of the alveolar ridge was estimated employing the following techniques: Group I: Measurement of alveolar ridge width on cone-beam computed tomography (CBCT) method, group II: Measurement of alveolar ridge width by ridge mapping technique, group III: Measurement of alveolar ridge width by surgical exposure. The minimum value for ridge mapping with caliper is 2 and maximum value is 9 with mean 4.5667 ± 1.63335 with standard error 0.29821. The minimum value for Cone beam computed tomography (CBCT) is 1.80 and maximum value is 9.30 with mean 4.6233 ± 1.67119 with standard error 0.30512. The minimum value for direct intrasurgical measurement with caliper is 2 and maximum value is 9 with mean 4.2000 ± 1.58441 with standard error 0.28927. Cone beam computed tomography could also be used to measure the ridge width accurately. Apart from measurement of alveolar ridge dimensions it had multiple other uses and thus can be advised as per requirement of the clinician.
ABSTRACT
Aims and Objectives: To compare the efficacy of platelet rich plasma (PRP) and platelet rich fibrin (PRF) in bone regeneration after removal of impacted bilateral third molars. Materials and Methods: The study was carried out as an open clinical trial on 20 patients chosen from the ones referred to the department of Oral & Maxillofacial Surgery for surgical removal of bilateral mandibular third molar. Patients were prepared for surgical procedure, Inferior alveolar nerve block given using 2% lignocaine hydrochloride with 1:2,00,000 adrenaline. Third molar were removed by flap reflection and bone drilling. Finally, PRF in lower left mandibular third molar region and PRP in lower right mandibular third molar region was inserted and wound closure was done. Cone bean computer tomography (CBCT) was made on 1st postoperative day and 4 months after surgery to evaluate alveolar bone height and density. Result: Alveolar bone height and bone density at post-operative 1st day and 4 months were compared between PRP and PRF group. The bone density and bone volume were analyzed, and there was no significant difference between bone density in PRP and PRF at day 1 and 4th month. Conclusion: As per our study and evaluation, in our postoperative follow up there was no statistically significant differences in bone regeneration by placement of PRP and PRF in extracted socket of third molar. Thus, with this study we can conclude that PRF, would be a good option to Oral and Maxillofacial Surgeons in the near future due to ease of extraction.
ABSTRACT
Benign osseous tumors of mesodermal origin that are included within the group of fibro-osseous lesions include cemento-ossifying fibromas (COFs). The fibrocellular component of these diseases originates from the periodontal ligament, which deposits bone and cementum encased in fibrous tissue. It typically appears in the mandible and presents as a solitary, nonaggressive, slowly developing, asymptomatic, expansile lesion, rarely occurring in the maxilla. The only intervention that proved to be successful in producing excellent outcomes and that may be regarded as a final therapeutic option is the complete surgical removal of COFs. Presenting herein is a case report describing a painless and expansile mass in the left mandibular region, histopathologically diagnosed as COF.
ABSTRACT
The current study is designed to evaluate the efficacy of pre-operative prophylactic antibiotic for prevention of bacteremia after surgical removal of impacted mandibular third molar SRIMTM. The study was carried out as an open clinical trial. Fifty patients who fulfilled the criteria were included. Twenty five randomly selected patients (study group) were administered two grams oral dose of amoxicillin trihydrate, one hour prior to the procedure. Twenty five patients (control group) were not administered any antibiotic prior to the procedure. All patients underwent surgical removal of impacted mandibular third molar through intraoral approach under local anesthesia. Blood culture for detection of aerobic and anaerobic micro-organisms was done for all 50 patients. Eleven out of the twenty five patients (44%) in the control group showed positive growth, including mixed growth (aerobic and anaerobic). Seven patients showed purely anaerobic, 2 patients purely aerobic and two mixed growth. In the study (antibiotic) group, 7 out of the 25 patients (28%) showed positive growth, including mixed growth. Three patients showed purely anaerobic, 2 patients purely aerobic and 2 mixed type of growth. The study suggests that the judicious use of antibiotic prophylaxis, in conjunction with optimal oral health care serves to minimize the adverse effects of antibiotic therapy; and at the same time reduce the significant morbidity and mortality associated with systemic infections that might occur due to bacteremia resulting from surgical procedures of the oral cavity.
ABSTRACT
Fractures of the abutment screw are an extremely dreadful and taxing experience even for experienced clinicians. Retrieval of fractured screw segments due to excessive torque and improperly placed implants pose a great challenge to the clinician. The authors present a case wherein the fractured abutment screw was retrieved successfully with the help of an intraoral plastic mixing tip of light body putty material. The intraoral plastic mixing tips are a more readily available, cost-effective, and feasible alternative to other means of screw retrieval like ultrasonic scalers, endodontic files, and screw retrieval kits.
Subject(s)
Bone Screws , Dental Abutments , Bone Screws/adverse effects , Torque , Dental Prosthesis, Implant-Supported , UltrasonicsABSTRACT
Obstructive sleep apnoea (OSA) is identified as repetitive and intermittent upper airway collapse or narrowing during sleep. Skeletal advancement through maxillomandibular surgery remains the most effective surgical treatment for OSA but is radical with certain relapse rate. Distraction Osteogenesis of mandible is a single-jaw surgical treatment alternative to bi-jaw surgeries having lesser complications. This case report describes successful management of a 46-year-old patient who reported with a chief complain of obstruction in breathing while sleeping since one year. Obstructive Sleep Apnoea (OSA) secondary to a retrognathic mandible was the final diagnosis, which was successfully treated by Distraction Osteogenesis (DO) of the mandible. The case showed enhancement in airway by 13mm and marked forward movement of Point-B (SNB increased by 6 degrees). The Epworth Sleepiness Scale value decreased from 19mm to 8 mm indicating substantial increase in the airway with stable results after 18 months of follow-up (elimination of symptoms and subsequent sound sleep). Distraction osteogenesis is an effective and reliable method to treat obstructive sleep apnoea secondary to retrognathic mandible.
ABSTRACT
Rationale: Complications arising from the extraction of an over-retained deciduous tooth root are an extremely rare event in a dental office, just like liver clots post-extraction of teeth. Patient Concern: The patient reported to the department on the third post-operative day following extraction of a deciduous root stump, complaining of swelling with respect to the extraction site and inability to open his mouth completely. Diagnosis: An unusual presentation of a 'currant blood clot' also commonly known as 'liver clot' was noted in the extraction site. Treatment: An excisional biopsy of the mass was done under local anaesthesia and the sample was sent for histopathological analysis. Suspecting an underlying haematological condition, the patient was further referred to the Department of General Medicine at the institute for opinion and further investigations. Outcome: The blood investigations and subsequent peripheral blood smear analysis and bone marrow aspirate biopsy confirmed that the patient was a case of undiagnosed chronic myeloid leukaemia in the chronic phase. Take-away Lessons: Proper knowledge of possible complications and the reasons behind the same can prove beneficial for the overall health of the patient.
ABSTRACT
Rationale: The successful utilisation of three dimensional (3D) techniques in engineering a titanium patient specific implant (PSI) for a patient who underwent hemimaxillectomy following post COVID mucormycosis infection. Patient Concerns: Issues related to problems associated with resection following mucormycosis, such as occlusal function, aesthetics and facial asymmetry. Diagnosis: The patient affected by mucormycosis was left with Aramany class 1 and Cordeiro type II sub total maxillectomy defect. Treatment: The patient was operated for mucormycosis followed by reconstruction with patient specific implant. Outcome: Positive clinical outcomes, including improved facial symmetry, function and psychological well being with immediate replacement of the teeth, the benefits of which far outweigh the traditional approach. Take away Lessons: The advances in the use of PSI by integration of 3D printing and computer aided design computer aided manufacturing (CAD-CAM) technology for extensive and challenging defects in the maxillofacial region have been highlighted in this case report.
ABSTRACT
Introduction: Local anaesthesia (LA) is the usual drug used in dentistry to reduce intraoperative pain. The efficacy of lignocaine is improved by adding adrenaline as a vasoconstrictor. Adrenaline decreases the systemic absorption of LA and reduces blood loss during the surgical procedure. The study was conducted to observe the effect of adrenaline on blood glucose concentration in patients undergoing tooth extraction. Materials and Methods: The study was conducted on 100 patients needing multiple teeth extraction. On the first appointment, extraction was done using lignocaine without adrenaline (plain), and for the second appointment, extraction was done using lignocaine with adrenaline (1:200,000). Serial blood glucose estimations were carried out at identical intervals on both occasions. Results: Significant difference in blood glucose level was noted when the patients received lignocaine with adrenaline before administration and after 10 min/20 min intervals (P < 0.05). Discussion: Constant vigilance and prudence are recommended while using lignocaine with adrenaline in patients suffering from diabetes mellitus.
ABSTRACT
Lip carcinoma is a common cancer of the head and neck region and it more commonly affects the lower lip (>90%). Out of all the carcinomas affecting the lower lip, squamous cell carcinoma accounts for 95% of the patients. Reconstruction of lower lip is a challenging task, as it requires taking into consideration the restoration of function as well as aesthetics. In this study, a patient for whom successful reconstruction of lower lip defect was done using the Karapandzic flap was presented.
Subject(s)
Carcinoma, Squamous Cell/surgery , Lip Neoplasms/surgery , Plastic Surgery Procedures/methods , Surgical Flaps , Esthetics, Dental , Humans , Male , Middle AgedABSTRACT
PURPOSE: This research aims to study the effects of low-dose aspirin on bleeding after exodontia and to compare statistically and analyze perioperative blood loss during exodontia in patients on aspirin therapy and healthy patients and also to discuss the various measures if required necessary for controlling postoperative bleeding in simple and uncomplicated exodontia. MATERIALS AND METHODS: The study included 100 patients, ranging in age from 30 to 60 years. The patients were divided into two groups, a test group consisting of 50 patients who were on a daily dose of 75-150 mg of aspirin and a control group consisting of 50 patients not on any antiplatelet therapy. All extraction procedures were performed on outpatient basis. Patients were operated under local anesthesia. Post-extraction sockets were checked for bleeding immediately (30 min) and followed up at 24, 48, and 72 h, and 1 week, after the procedure. RESULTS: Amount of intraoperative blood loss was similar in both test and control groups, and there was no excessive postoperative bleeding in any case. Out of 100 patients, only three patients of test group and two patients of control group required level II hemostatic measures and two patients of test group needed level III measures. CONCLUSION: We could reach a conclusion and recommend that patients on long-term low-dose aspirin (75-150 mg) need not to discontinue their aspirin dose prior to routine exodontia and can be carried out safely with enhanced local hemostatic measures, if required.
ABSTRACT
PURPOSE: To assess efficacy of C-reactive protein levels as monitoring tools for patients with fascial space infections of odontogenic origin. MATERIAL AND METHOD: A randomized prospective study was conducted on 20 patients suffering from fascial space infection of odontogenic origin, in the department of Oral and Maxillofacial Surgery Bharati Vidyapeeth dental college and hospital, Pune, Patients between 18 and 60 years of age of both the sexes were selected. All patients were treated and observed by the same surgeon. Patient's venous blood sample was collected pre-operatively and on 2nd and 5th post-operative days for evaluation of WBC count and C-reactive protein (CRP). All patients were encouraged for strict follow-up protocol. RESULT: Where the results of WBC count and CRP when compared it was seen that the mean values of WBC were normal in 15 cases and abnormal in 5 cases on day 0, day 2 and day 5; whereas the mean values of CRP were abnormal on day 0 and day 2 and were within normal limit on day 5 in all cases. CONCLUSION: The findings of this prospective analysis indicate that White blood cells and C-reactive protein are effective markers for determining severity of infection, efficacy of treatment regime for patients with fascial space infections of odontogenic origin. Thus the markers also help in making treatment of patients with fascial space infections of odontogenic origin more cost effective and they also help protecting patients from side effects of excess drugs usage. Thus we conclude that CRP should be incorporated as monitoring tools for managing patients with fascial space infections of odontogenic origin.
ABSTRACT
AIM: The aim of the study is to evaluate the prognostic value of ß2-m as a biochemical parameter for the diagnosis and prognosis of oral squamous cell carcinoma (SCC). MATERIALS AND METHODS: The study included 60 patients (15 oral SCC, 15 leukoplakia, 15 individuals exposed to various carcinogens and without oral cancerous or precancerous lesions, 15 healthy individuals). The levels of ß2-m were estimated using chemi-luminescent immunometric assay on Immulite fully automated machine. Statistical analysis of the data was done using Tuckey's test, ANOVA and independent sample t test. RESULTS: Results showed that ß2-m was increased in individuals exposed to carcinogens without precancerous and cancerous lesion. CONCLUSION: Serum ß2-m can be used as a better indicator and can give an early indication of malignant change and therefore malignancy can be detected at an early and treatable stage.
ABSTRACT
As dentistry continues to go "digital," the field has seen a phenomenal increase in the use of digital imaging in dental practice. Complex impacted mesiodens present potential treatment complications and sometimes possible patient morbidity. Objectives of diagnostic imaging are to aid in diagnosis, decision making, and enhance treatment outcomes. As cases become more complex, sophisticated multiplane imaging methods allowing for a three-dimensional view are more likely to meet these objectives as opposed to traditional two-dimensional radiography. The clinical report elucidates with the help of an illustrative patient how cone beam computed tomography imaging can assist the surgeon during surgical treatment planning, risk assessment, and treatment outcomes of impacted mesiodens.
Subject(s)
Cone-Beam Computed Tomography , Tooth, Impacted/diagnostic imaging , Tooth, Supernumerary/diagnostic imaging , Adolescent , Humans , Imaging, Three-Dimensional , Incidental Findings , Male , Radiography, Panoramic , Tooth, Impacted/surgery , Tooth, Supernumerary/surgeryABSTRACT
Cranial defects occur most commonly as a sequelae to trauma, the incidence being as high as 70%. The successful management of a case of trauma in an emergency situation requires quick evacuation of the hematoma, repair of the dura, and the scalp but not necessarily the integrity of the calvarial segment as an immediate measure. So the reconstruction of the calvarial defect in these cases is mostly carried out as a secondary procedure. Various materials are used for reconstruction of cranial defects, polymethyl methacrylate (PMMA) resin being one of them. In this article, we report a case which was successfully treated by PMMA resin in combination with a titanium mesh for reconstruction of the cranial defect as a secondary procedure.
ABSTRACT
Surgical management of advanced oral submucous fibrosis (OSMF) using bilateral inferiorly based nasolabial flaps is becoming increasingly popular. However no comprehensive analysis of delayed complications using this technique is available in the literature. The authors have conducted a retrospective study to examine the delayed complications of bilateral inferiorly based nasolabial flaps used in advanced oral submucous fibrosis at their institute along with a detailed review of literature on the subject. Thirty-two patients from January 2004 to December 2015 with OSMF and an interincisal distance less than 15 mm were included. All patients were treated with bilateral inferiorly based nasolabial flaps for correction of the restricted mouth opening. All patients had postoperative physiotherapy and were followed up for a minimum period of 6 months. All complaints of patients during the follow up phase were included in this study. In this series, complications such as partial necrosis, intra-oral hair growth, unacceptable extra-oral scar, wound dehiscence, orocutaneous fistula, and pincushioning effect were observed. Numerous complications can occur with the use of nasolabial flaps for the management of advanced oral submucous fibrosis. Although most complications are of inconsequential nature the surgeon must observe due diligence when using this flap.