Comprehensive Management of Pediatric Orbital Fractures: A Case Series and Review of Literature.

Orbital fractures in the pediatric population are rare. A trapdoor fracture is a special anatomic type of orbital fracture associated with herniation of orbital contents and entrapment of extraocular muscles entrapment with no signs of any soft tissue trauma. A delay in diagnosis can lead to a life-threatening condition known as oculocardiac reflex, characterized by nausea, vomiting, bradycardia, and syncope. Many authors recommend early surgical intervention, but some patients may delay for various reasons. We hereby represent three cases of orbital fracture to prevent long-term persistent diplopia. Depending on the case scenario, two cases were operated on in which an autogenous iliac cortical graft was placed in one patient to prevent postoperative herniation of orbital content, and in one patient, only release of entrapped muscles was done. One patient was managed conservatively with a regular follow-up visit.

Super-selective Embolisation and Surgical Excision of the Facial Arteriovenous Malformation.

Vascular anomalies broadly include vascular tumours and malformations. Arteriovenous malformations (AVM), though rare in the oral and maxillofacial regions, can present with swelling, facial asymmetry, ulceration, and bleeding tendencies, which can be life-threatening. Thus, to minimise the associated life-threatening consequences, prompt and appropriate diagnosis of the lesion is necessitated. The management of the AVM is a therapeutic challenge for maxillofacial surgeons; however, technological advances in interventional radiology have gained a foothold. Super-selective embolisation of the feeder vessels with subsequent resection of the lesion is the most widely accepted approach for management. The present report describes a unique case of a facial AVM managed through a trans-oral approach without any post-operative sequelae.

Primary Tubercular Osteomyelitis Affecting the Mandibular Condyle - A Case Report.

Rationale: Primary orofacial tuberculosis (TB) accounts for <3% of all cases of TB. TB of the mandibular condyle is often misdiagnosed owing to its rarity. Patient Concerns: This report presents a 19-year-old female who presented with a painful swelling over the right preauricular region. The radiographic evaluation suggested a diagnosis of suppurative osteomyelitis of the condyle. Diagnosis: Clinically, the aetiology of the swelling was considered as infective. The histopathological examination of the resected specimen showed tuberculous granuloma and the polymerase chain reaction came positive.This confirms the diagnosis of tubercular osteomyelitis. Mantoux test and sputum acid-fast bacilli were found to be negative. Treatment: The patient was subjected to sequestrectomy with high condylectomy and systemic multidrug antitubercular regimen for 6 months. Outcomes: There was a resolution of infection postoperatively with subsequent regeneration of healthy bone. Take-away Lessons: Early identification and prompt diagnosis is imperative for better treatment outcomes.

Comparative assessment of corticotomy facilitated rapid canine retraction using piezo versus bur: A randomized clinical study.

PURPOSE: The leading concern of orthodontic patients is prolonged treatment with fixed appliances and demand speedy treatment from the orthodontists. Piezocision is a relatively innovative, safe and reliable technique of corticotomy in the domain of surgically-accelerated orthodontic treatment. Our aim was to compare the efficiency of piezo corticotomy (piezocision) and conventional bur in rapid orthodontic tooth movement (OTM). SUBJECTS AND METHOD: The study employed a randomized, double-blind, split-mouth design. 24 subjects with Class II div 1 malocclusion were randomly assigned to the two interventions, viz; piezo and bur group. The primary parameters evaluated were the rate and amount of tooth movement and total treatment time required for canine retraction. Additionally, the duration of surgery and postoperative complications were also evaluated. OBSERVATIONS AND RESULTS: Rate and amount of tooth movement were significantly higher with reduction in total treatment time in piezo compared to bur group. The duration of surgery was significantly longer in piezo group with no significant difference observed in post-operative complications. CONCLUSION: Piezo-guided corticotomy was effective in providing rapid OTM with profound reduction in total treatment time and may be proposed as a suitable adjuvant to conventional corticotomy having comparable post-operative complications.

Actinomycotic Osteomyelitis of the Mandible - A Rare Case Report.

Actinomycetes are a relatively sporadic cause of infection of the head-and-neck region and their appearance is usually uncharacteristic, and hence pose a challenge for the diagnosis. The present article intends to exhibit this rarity afflicting mandible and highlight its management. The present report describes a case of a 55-year-old countryside female who presented with pain and swelling affecting the left side of the mandible. Orthopantomograph and cone-beam computed tomography imaging showed multiple ill-defined radiolucencies and perforations of the buccal and lingual cortical plates. Fine-needle aspiration microbiology was used to ascertain the microbial organism and the patient was treated with amoxicillin + clavulanic acid with curettage of the infected site. The patient responded well to prompt systemic antibiotics and local surgical measures with complete resolution of the infection and spontaneous bone regeneration. Although rare actinomycosis of the mandible is curable and should be included in the differential diagnosis of osteomyelitis of the jaw. Early and accurate diagnosis and prompt intervention confirm better outcomes.