Efficacy of Low-Level Laser Therapy in Management of Temporomandibular Joint Pain: A Double Blind and Placebo Controlled Trial.

Background: Stomatognathic system is an interaction of the muscles of mastication, dentition, neural component, and temporomandibular joint. Any dysfunction in this system may lead to temporomandibular disorders (TMDs). Various non-surgical modalities have been employed for treating TMDs. Aim and objectives: The aim of the study was to objectively evaluate the effects of low-level laser therapy (LLLT) in treatment of patients with TMDs. Materials and Methods: Sixty individuals diagnosed with TMDs were divided randomly into two groups (Group I-placebo and Group II -LLLT). A series of 20 sessions of LLLT applied both in closed mouth and maximum mouth opening position were given over a period of 08 weeks. Assessment was done in terms of improvement in mouth opening, pain, clicking, and deviation of mandible. The data collected were analyzed statistically. Results: The results showed improvement in the pain reduction, improvement in the maximum mouth opening, reduction in deviation, and clicking in both groups but better treatment outcome in the low-level laser group. Conclusion: Though conservative measures improved the symptoms in TMD but LLLT has shown better results in comparison with the placebo group. Being non-surgical can be employed in combination with other modes for effectively treating such disorders. Keywords: Pain, Dysfunction, Temporomandibular joint disorders (TMDs), Low-level laser therapy (LLLT).

Unusual Cause for Maxillofacial Injury.

Penetrating facial injuries are potentially dangerous and may require emergency management because of the presence of vital structures in the face, and it may be life-threatening especially when the injury involves airway, major blood vessels, spinal cord, and cervical spines. Penetrating injuries of the facial region can occur due to missile injuries, blast injuries, motor vehicle accidents, and accidental fall on sharp objects. However, injury to face caused by the shattering of a protective helmet itself is extremely rare. Primary management is targeted to deal with life-threatening conditions and stabilize the patient followed by subsequent care in a well-equipped setting. We present a case of a 30-year-old male, who suffered extensive soft and hard tissue injury of the maxillofacial region due to shattering of a protective helmet causing a ballistic effect.

Comparison of ultrasonography with conventional radiography in the diagnosis of zygomatic complex fractures.

PURPOSE: Zygomatic complex fractures have changed in patterns of occurrence, severity, and, more importantly, in the mode of injury. Protection of the globe and maintaining the width of the face are the more important roles of the complex. Diagnosis and treatment planning of such fractures become imperative in the sequencing of repair if and where indicated, especially in the case of isolated zygomatic complex fractures. Exploring the versatility of ultrasonography (US), in diagnosing zygomatic complex fractures in comparison to conventional radiography in a double-blind study, the objective of this study was to evaluate the efficacy of US and to explore the possibility of making US examination a mainstay in the primary diagnosis of such fractures. MATERIAL AND METHOD: The prospective, double-blind study design included 32 patients suspected of having sustained isolated zygomatic complex fractures. The patients underwent US examination and radiographic examination in the form of para-nasal sinus (PNS) and sub-mentovertex (SMV) views for comparison. RESULTS: A sensitivity of 100% was seen in favor of US in the areas of the fronto-zygomatic suture (FZ), arch, infra-orbital, and buttress areas. Statistically significant differences (p < .01) was seen in areas of the arch and buttress region and in the infra-orbital area. CONCLUSION: Although US showed 100% sensitivity in detection of fracture lines at three articulations of the four that make up the zygomatic complex, it lacked in quantifying the amount and degree of displacement of the fractured segments, which hampered accurate treatment planning.

Surgical management of recurrent odontogenic keratocyst.

The odontogenic keratocyst is a distinct entity arising from odontogenic epithelium. The unique histopathological appearance and the propensity for recurrence has made it management controversial in terms of the conservatism to be followed. This article describes the management of a case of recurrent odontogenic keratocyst with an aggressive therapy being adopted due to the nature of the pathology.