ABSTRACT
Purpose: The aim of this study was to elucidate the efficiency of BTX-A injections as an alternative approach in patients with excessive gingival display and to observe the patient's satisfaction in order to obtain cosmetically promising results. Materials and Methods: Fifteen patients of whom ten female and five male with different types of gummy smiles such as anterior (53%), posterior (7%) and mixed (40%) reported to the Department of Oral and Maxillofacial Surgery at Thai Moogambigai Dental College and Hospital, Chennai, Tamil Nadu from December 2018 to October 2019 those who were willing to undergo corrections using Botulinum Toxin Type A (BTX-A) were selected for the present study using various inclusion and exclusion criteria. The patients were injected with BTX-A on Yonsei triangle accordingly. The clinical evaluation and patient satisfaction evaluation were carried out. Results: A significant decrease in the gingival exposure of about 3.5 ± 1 mm at 2 weeks after injection was observed and it lasted for 4 months. It was also noted that there was no difference in the measurement of gingival display on maximum smile for postinjection during 5th and 6th month when compared with preinjection measurements. This study confirms that the efficacy of BTX A injection lasted for 4 months and then gradually reduced resulting in reversal of gingival display during maximum smile. Conclusion: The authors conclude that in the cosmetic correction of gummy smile by BTX-A, it is important to identify the type of smile and the main muscles involved, so that the correct injection technique can be used. It also confirms that BTX-A is a novel, competent, risk-free and minimally invasive nonsurgical therapy that can extensively improve smile aesthetics.
ABSTRACT
OBJECTIVES: To evaluate the effects of topical hemocoagulase on intra-oral extraction sockets and impact on the healing process as well as to produce a clinico-histological healing score. STUDY DESIGN: This prospective study compared two extraction sites in each subject. One site received topical hemocoagulase while other site did not receive it. Both the sites were chosen in the same patient and extraction was done at separate intervals. The biopsy was done on a random basis with the pathologist being blinded to the study. Clinical evaluation was done on days 7, 14 and 21. Biopsy was done either on days 7 or 14 for the case as well as for the control. A clinical as well as histological score was developed and the healing was assessed. Statistical analysis was done using Wilcoxon signed rank test and p value ≤ 0.05 was considered significant and z-score was also calculated. RESULTS: The clinical score did not show any statistical significance. The histological total score on day 14 and combined overall analysis of days 7 and 14 showed statistical significance. There was an increased incidence (n = 4) of osteoid formation in the hemocoagulase group on day 14. CONCLUSION: The application of hemocoagulase may improve and accelerates the process of wound healing in extraction sockets.
ABSTRACT
Condylar fracture is the second most common site in the mandibular fractures. Motor vehicle accident and fall are the major causes of such fractures. Because of the anatomical weakness of the condyle and the shape of the condylar head the antero-medial dislocation of the condyle is common. Open reduction and closed reduction is always debatable. The open reduction will bring back the normal function much earlier than closed reduction. Medially dislocated condylar fracture fragments are always managed with open method. In superior or high condylar fractures,exact reduction with conventional open reduction can be difficult due to the limited surgical and visual fields. In such cases extracorporeal fixation of condyle using vertical ramus osteotomy may be better choice to achieve perfect alignment and absolute maintaince of vertical height of the ramus and facial symmetry. We here present a case of extracorporeal fixation of unilateral left high condylar fracture.
ABSTRACT
Extra oral approach for removal of the lower third molar is uncommon. This case report illustrates an example of removal of lower third molar by extra-oral approach preserving the inferior dental nerve.
