Iatrogenic Mandibular Ramus Fracture Following Surgical Removal of Impacted Third Molar.

Surgical removal of an impacted tooth is considered to be one of the most frequently performed minor oral surgical procedures due to the plethora of indications associated with it. Like any other surgical intervention, the surgical removal of impacted third molars is also associated with numerous complications. Lot of emphasis has been laid to prevent the complications associated with the surgical removal of impacted third molars. However, at times in spite of delivering the utmost caution, complications occur as a consequence of surgical removal of impacted third molars. We report a rare case in which iatrogenic mandibular ramus fracture occurred in an attempt to surgically removal of an impacted third molar.

Efficacy of palonosetron in the management of postoperative nausea vomiting in oral and maxillofacial surgery.

Objective: The objective is to evaluate the efficacy of prophylactic single intravenous dose of palonosetron in the management of postoperative nausea and vomiting (PONV) following oral and maxillofacial surgical interventions performed through an intraoral approach under general anesthesia (GA). Materials and Methods: A prospective study was conducted on 100 subjects who underwent intraoral surgical procedures for the management of maxillofacial trauma, pathology, dentofacial anomalies, and deformities under GA. All subjects received a prophylactic single intravenous dose of 0.075 mg palonosetron along with premedication. Predisposing factors for PONV such as patient age, gender, Apfel risk score, history of motion sickness, smoking, type of procedure, and administration of postoperative opioids were taken into consideration. All the patients were monitored for PONV for the 1st 24 h postoperatively (PO). First, at an interval of 30 min for 1st 4 h and then at every 2 h interval for next 8 h followed by monitoring every 6 h interval till 24 h. Time and frequency of rescue medication were noted. Results: Seventy-nine percentage subjects did not have PONV. 15% subjects had a single episode of vomiting PO which could be attributed to multiple intra oral surgical sites performed as well as longer duration of exposure to anesthetic agents in addition to providing opioid analgesics for the management of postoperative pain. Only 6% subjects needed rescue antiemetic drug. Palonosetron did not show any significant changes in cardiac status and serum profile. Conclusion: Palonosetron is effective in the management of PONV for maxillofacial surgical procedures performed through an intraoral approach under GA.

Comparative Evaluation of Conventional Miniplates, Three-Dimensional Miniplates and Lag Screws for Internal Fixation of Parasymphysis Fracture of Mandible-A Double-Blind Randomized Clinical Study.

Purpose: The aim of this study is to clinically and radiographically evaluate the stability of parasymphysis fracture managed with lag screws, miniplates and 3D miniplates. Materials and Method: Ninety- eight patients diagnosed with parasymphysis fracture were treated using lag screws in group 1, two 4-hole miniplates in group 2 and 3D miniplates in group 3. Intraoperative stability and duration of fixation was assessed. Postoperative clinical evaluation was done at 1 week, 1 month, 3rd month, 6th month and 1 year for complications and oral function. Radiological evaluation was done at 3rd and 6th month. Only 92 patients were considered for statistical analysis since 6 patients were lost during follow-up. Results: Road traffic accident (65.3%) was the primary cause of mandibular fractures. Postoperative pain score showed a statistically significant difference after 1 week and 1 month duration (P value < 0.001). ANOVA test showed VAS was significantly higher at pre-op followed by 1st day and 1 week, but no significant difference after 3 months in all groups. Radiographic analysis did not show significant difference in approximation of fracture segment among 3 groups after 6 months (P-value = 0.117). Chewing efficiency at 6 months and occlusion by surgeon evaluation at 3 months showed a significant difference (P value < 0.001). Conclusion: Lag screw fixation was technique-sensitive, relatively inexpensive and was less time consuming method when compared to miniplates and 3D plates. Lag screws and 3D plates are superior in reducing the incidence of complications and better in oblique or sagitally displaced mandibular fractures. Supplementary Information: The online version contains supplementary material available at 10.1007/s12663-021-01647-5.

Mandibular Fracture Patterns in a Rural Setup: A 7-Year Retrospective Study.

Aim: This study is designed to outline the probable patterns of mandibular fracture based on patient demographics and mechanism of injury in a rural setup. Materials and Methods: The data from the record section in our unit belonging to patients who sustained fractures in the maxillofacial skeleton and were treated in our unit between the period June 2012-May 2019 were collected and analyzed. The variables analyzed for the study were etiology, gender, age, and type of fracture. All cases were treated by open reduction and rigid internal fixation. Results: A total of 224 patients with maxillofacial fractures were diagnosed, of which 195 were male and 29 were female. The ages ranged from 7 to 70 years. Road traffic accidents are noted to be the most common cause of mandibular fractures. The maximum cases were in the age group of 21-30 years with 85 (38%) patients. In a total of 224 patients, there were 278 mandibular fractures. The maximum incidence of fractures was in the mandibular parasymphysis region with 90 fractures accounting for 32.3% of the mandibular fractures. Males were more susceptible to mandibular fractures. Majority of them sustained mandibular fracture at more than one anatomical area. Conclusion: It can be concluded that mandibular fractures are seen predominantly in the second and third decades of life due to road traffic accidents with high-speed vehicles and lack of protective safety accessories. Mandible when it fractured, it usually involved more than one anatomical location.

Evaluation of Changes in the Pharyngeal Airway Space as a Sequele to Mandibular Advancement Surgery: A Cephalometric Study.

PURPOSE: To evaluate effect of mandibular advancement on pharyngeal airway space using lateral cephalogram. MATERIALS AND METHODS: Twenty patients who were diagnosed with class II skeletal malocclusion and underwent surgical intervention for the correction of their dentofacial deformity following orthodontic treatment were included. The soft tissue changes in the pharyngeal space were brought about by the surgical intervention, and the changes that had occurred in increasing the airway were evaluated by using cephalogram. RESULTS: The results of this study showed that following mandibular advancement surgery, the pharyngeal airway space increased along with an increase in the length and thickness of the uvula with a reduction in the angulation. All the changes remained stable in the late postoperative phase. CONCLUSION: Patients who underwent mandibular advancement showed a significant increase in the pharyngeal airway space and that remained stable during the evaluation period. As a consequence, mandibular advancement seems to be the most stable surgical movement in relation to airway dimensional gains.

Multiple radiolucencies in the mandible: A diagnostic dilemma.

Diagnosis and treatment planning of maxillofacial pathologies is an art. It requires careful evaluation and correlation of clinical presentation and radiologic investigations. When the pathology concerned is an intraosseous lesion, the radiographic findings assume a significantly more important role. While carrying out the radiographic assessment, we rely on typical findings regarding the number, location, and appearance of radiolucent areas which point towards certain types of pathologies. Whenever these findings are atypical or at variance with the clinical presentation, it creates a diagnostic dilemma for the clinician. We report a case of a 34-year-old man who presented with a simple clinical history but multiple radiolucencies on the radiograph.

Outcome of Odontogenic Infections in Rural Setup: Our Experience in Management.

PURPOSE: This study was intended to evaluate the various predisposing factors and to assess the causative microorganisms responsible for fascial space infections. MATERIALS AND METHODS: A total of 124 patients who reported with an orofacial space infection of odontogenic origin were included. Following thorough evaluation, using a disposable syringe, pus sample was obtained and sent for culture and sensitivity test. Offending teeth were extracted under antibiotic coverage, and incision and drainage was done as and when indicated. RESULTS: The results of this study show that submandibular space (34.6%) is the frequently involved fascial space. Majority of the patients are in the second and third decade of life (46.7%). Staphylococcus species (43.7%) is the most commonly isolated microorganism. Majority of the subject gives a history of hot fomentation (64.5%). Penicillin remains to be the drug of choice. Extraction of the offending tooth under antibiotic coverage and incision and drainage as indicated remains to be treatment option when the scenario is tackled in the initial stages. CONCLUSION: Since the study was conducted in a semi-urban/rural setup, poor oral hygiene and lack of awareness for the dental health in addition to the delay in reporting to the clinician may have been the causes for the development of such fascial space infections from a small carious tooth.

Ergonomics among Oral and Maxillofacial Surgeons in the Indian States of Telangana and Andhra Pradesh - An Evaluative Study.

INTRODUCTION: This study is designed to evaluate the work-related musculoskeletal disorders among oral and maxillofacial surgeons in the states of Telangana and Andhra Pradesh. MATERIALS AND METHODS: This study was conducted to disclose the incidence, location, and intensity of musculoskeletal pain among oral and maxillofacial surgeons in the states of Telangana and Andhra Pradesh. A questionnaire study was designed. One hundred and fifty-six oral and maxillofacial surgeons participated in the survey working in different centers of Telangana and Andhra Pradesh. Demographic information, type of professional practice, duration of working hours, and posture of working were collected. If occupation-induced musculoskeletal pain was present, its location, intensity, and the preventive measure employed were noted. RESULTS: It was observed that majority of the oral and maxillofacial surgeons were practicing exclusive oral and maxillofacial surgical practice, and they employ both sitting and standing postures to carry out their professional work. Lack of availability of a well-qualified/trained assistant in addition to the lack of sophisticated equipment was noted to be the cause for occupation-induced musculoskeletal disorders. Majority of the participants have lower back pain with a visual analog scale score of 4. The pain occurred more often in younger individuals. It was believed by most of the participants that a good physical exercise in the morning helps prevent such occupation-induced musculoskeletal disorders. DISCUSSION: Oral and maxillofacial surgeons due to their unique work are more prone to muscle imbalances, and hence, ergonomic interventions are essential to maintain optimal health during the course of their professional career.

Adenoid squamous cell carcinoma of upper lip, a rare variant of squamous cell carcinoma: A case report.

Adenoid squamous cell carcinoma (ASCC) is a variant of squamous cell carcinoma. As this variant is rare it is difficult to distinguish it from other variants of squamous cell carcinoma. It commonly originates in the head and neck region as these parts are highly exposed to the sunlight. There are very few cases reported in the literature. Here we report a case in a 30-year-old male who reported with a nodular lesion over the upper lip with no unusual signs, which was confirmed as adenoid squamous cell carcinoma after various histopathological tests.

Welcome the "new kid on the block" into the family: artificial intelligence in oral and maxillofacial surgery.

Recent decades have witnessed the genesis and progressive application of intelligent machines and computer programs that have the ability to process information and execute cognitive functions similar to those of human logic and reasoning such as problem solving and decision making. That is artificial intelligence (AI) in a nutshell as envisioned by John McCarthy, "the father of AI". Healthcare has welcomed AI, giving rise to collaborations such as the Moorfields Eye Hospital and Google's DeepMind division in the screening and predicting of retinal disease. The use of AI by the maxillofacial surgical fraternity is, however, limited. We wish to highlight the fact that surgeons are uniquely positioned to help drive these innovations rather than passively waiting for the technology to become useful.

Metabolic response to maxillofacial trauma revisited: A retrospective study.

PURPOSE: Management of a trauma patient aims at stabilization or resuscitation and revival from critical condition resulting from various sequences of systemic pathophysiological responses in the body. Hematological changes are the first signs reflecting the homeostasis mechanisms starting in the body after injury. The aim of the current study is to evaluate the physiological changes following maxillofacial trauma and extrapolate the findings to understand the posttrauma responses. PATIENTS AND METHOD: This is a retrospective study involving 192 subjects divided into two groups, trauma group and control group. In both the groups, baseline vitals and complete blood picture were recorded for comparison. In trauma group, the recordings were made within 24 h after maxillofacial injury. RESULTS: All the parameters were analyzed using SPSS version 18. Independent sample t-test was used to assess the nature of data distribution and statistical significance was considered only at P value < 0.05. On comparison of complete blood picture mean values of hemoglobin (13.63 vs 12.18), RBC count (4.51 vs 4.10), WBC count (8835.48 vs 8336.56) were seen to be higher in trauma patients compared to control subjects. The mean bleeding times are almost equal (2.35 vs 2.47) but the clotting times (5.42 vs 5.26), random blood glucose (94.78 vs 90.13), and blood urea (27.14 vs 26.30) were marginally higher in trauma group but were statistically insignificant. The mean value of serum creatinine (0.84 vs 0.80) was comparatively higher in trauma patients and was statistically significant. Study of vitals revealed that mean systolic blood pressures were almost equal (120.65 vs 121.08) in both the groups. The mean diastolic blood pressures (79.46 vs 88.49) and oxygen saturation (93.73 vs 98.86) in trauma patients are comparatively reduced. The mean values of temperature (99.30 vs 98.50) and pulse rate (102.38 vs 97.14) were on relatively higher side in trauma group compared with control group. SUMMARY AND CONCLUSION: Using basic blood parameters and vitals in the present study, the compensatory mechanisms happening in the body after maxillofacial trauma can be seen. These changes although significant on side by side comparison can still fall within the normal physiological range provided by various diagnostic setups. Hence, the need for maxillofacial surgeon to be sensitive to minor variations in these aspects to ensure safety of the patient cannot be overemphasized.

A comparative clinical study on physiotherapy outcomes with wooden tongue depressors versus Heister jaw opener in oral submucous fibrosis patients.

OBJECTIVE: The aim of this study was to compare mouth opening exercise outcomes with wooden tongue depressors (WTDs) versus Heister jaw opener (HJO) in improving mouth opening after reconstruction of the surgical defect with buccal fat pad (BFP) in oral submucous fibrosis (OSF) patients. MATERIALS AND METHODS: Fifty consecutive patients were divided randomly into two groups (25 patients in each group) corresponding to postoperative physiotherapy with WTDs (group 1) and HJO (group 2) respectively. Groups 1 and 2 were evaluated for maximum interincisal distance at 3, 6 and 12 months of follow up. In groups 1 and 2, mouth opening differed substantially at all periods of follow up from preoperative values. RESULTS: The increase in mouth opening was greater in group 2 at 3 (P = 0.003) and 6 (P = 0.010) month follow up visit respectively. No relevant difference was observed in mouth opening between groups 1 and 2 at 12 months (P = 0.066). The mean increase in mouth opening at 12 months compared with the preoperative value was 22.2 mm in group 1 and 25 mm in group 2. CONCLUSION: We conclude both WTDs and HJO are effective in improving postoperative mouth opening in OSF surgical patients.

Three-Dimensional Miniplate: For the Management of Mandibular Parasymphysis Fractures.

BACKGROUND: Recently, oral and maxillofacial surgeons are favoring three-dimensional (3D) miniplates to treat mandibular fractures. AIMS: The aim of the study is to evaluate the efficacy of 3D-miniplates over standard miniplates in the management of mandibular parasymphysis fracture. MATERIALS AND METHODS: Forty patients with mandibular parasymphysis fractures were divided into two groups of 20 patients each. Group I patients underwent osteosynthesis of mandibular fracture by noncompression, unicortical, and stainless steel 3D miniplates, and Group II patients underwent osteosynthesis by noncompression, unicortical, and stainless steel Champy's miniplates. All the patients were followed up 6 months' postoperatively, evaluating occlusion, mobility of fracture segment, pain, wound dehiscence, neurological deficit, and infection. STATISTICAL ANALYSIS USED: The data were analyzed by SPSS for windows (version 17) statistical package (SPSS Inc., Chicago, IL, USA). Chi-square test was carried out to determine the statistical difference between the groups. RESULTS: Mobility of the fractured site was evaluated postoperatively after 2 weeks, and it was found that mobility was absent in all the cases of Group I and 36 (80%) cases in Group II. There was significant difference in the mean visual analog scale scores among the Group I and II when compared from preoperative to 4-week follow-up. In Group II, two patients showed wound dehiscence. After 2 weeks, infection was seen in two patients of Group II. CONCLUSION: 3D plates in mandibular parasymphysis fractures give dimensional stability and carry low morbidity and infection rates.

Dynamic Stability Assessment of the Temporomandibular Joint as a Sequela of Open Reduction and Internal Fixation of Unilateral Condylar Fracture.

PURPOSE: Dynamic stability of the temporomandibular joint (TMJ) is the characteristic of the joint to achieve normal function by harmonious, balanced, synchronized interactions of the various functional subunits of the stomatognathic system. The aim of this study was to evaluate changes in the mechanics and dynamics of the TMJ during recovery from surgical treatment of an isolated condylar fracture. PATIENTS AND METHODS: This is a prospective cohort study involving 30 patients who underwent open reduction and internal fixation for an isolated unilateral condylar fracture and were clinically asymptomatic at 6 months after surgery. The dynamics of the TMJ were assessed by bite-force analysis, both static and dynamic, to assess masticatory efficiency. Surface electromyography was recorded to assess changes in muscle dynamics. Joint vibration analysis was performed to evaluate the internal functioning of the TMJ. All the assessments were carried out bilaterally to allow comparison of the injured and uninjured joints, and the data were analyzed with the paired t test and independent-samples t test. Statistical significance was considered at P < .05. RESULTS: The study included 18 male and 12 female patients aged between 20 and 40 years. Bite-force analyses showed significantly higher bite forces on the uninjured side at 6 months after surgery. Similarly, surface electromyography analysis showed increased muscle activity on the affected side pointing toward some compensatory hyperactivity in the masticatory muscles. Joint vibration analysis showed that there was increased friction during function in both the injured and uninjured joints. CONCLUSIONS: The observations in this study suggest that residual imbalances are present in the TMJ at 6 months after open reduction and internal fixation of condylar fractures. Therefore, long-term studies are required to establish a complete timeline of adaptive changes occurring in the TMJ after condylar fractures, especially in comparison with other treatment modalities.

Pre-emptive Diclofenac Versus Ketoprofen as a Transdermal Drug Delivery System: How They Face.

AIM: To compare the analgesic efficacy of Diclofenac vis-a-vis Ketoprofen transdermal patch, in the management of immediate post-operative pain following orthognathic procedures. MATERIAL AND METHOD: A prospective, double-blinded, randomised controlled study was conducted among 50 subjects, between 2012 and 2015. These patients were diagnosed clinically and cephalometrically as skeletal and dental class II malocclusion and underwent bi-jaw surgical procedure. In total, 25 Diclofenac and 25 Ketoprofen transdermal patches, sealed in envelopes and numbered, were administered to subjects. The patches used, contained 100 mg of either Diclofenac or Ketoprofen and administered by a nurse prior to induction. Duration of analgesia, severity of pain using Visual Analog Scale, necessity of rescue analgesia (spontaneous pain > 5 on a 10-cm scale) and any other adverse effect associated with the drug were evaluated. RESULTS: Mean duration of analgesia was significantly higher in the Ketoprofen group (20 h), compared to Diclofenac group (13 h) (p = 0.001). Rescue analgesia was required in 12% of subjects who received Diclofenac patch, compared to 4% in Ketoprofen group. None of the subjects showed any allergic reactions. CONCLUSION: The study was designed to evaluate the efficacy of transdermal patch in reduction of post-operative pain in subjects undergoing bi-jaw surgeries. Subjects in both groups were comfortable and returned to early function. However, Ketoprofen transdermal patch had an edge over the Diclofenac transdermal patch with respect to analgesic efficacy.

What Surgical Education the Speciality Offers? Perception of Role of Oral and Maxillofacial Surgery by 1200 Healthcare Professionals, Students and the General Public in Hyderabad, India.

AIM: To investigate the perception of Oral and maxillofacial surgery by healthcare professionals, students and general public. MATERIALS AND METHODS: A questionnaire form was created that listed ten clinical situations, and given by hand to 1200 individuals, divided into six groups: group 1, medical professionals; group 2, Specialties of dentistry; group 3, general dentists; group 4, medical students; group 5, dental students; and group 6, general public, each comprising 200 individuals. Respondents were asked to indicate who they would expect to treat them if they had one of the specified conditions listed in the questionnaire. We present the results and current awareness levels of this simple questionnaire. The present study addresses the common issue raised by many authors, 'What surgical education the speciality offers?' especially to medical professionals, medical students and general public to enhance an appropriate referral. RESULTS: Most of the respondents in groups 2, 3 and 5 agreed that specific conditions listed in the questionnaire were within the domain of oral and maxillofacial surgery, but such response was not seen in groups 1, 4 and 6 (p < 0.001). An overall awareness level of oral and maxillofacial surgery was found to be 50.2%. CONCLUSION: The onus of creating and improving the awareness and perception of our specialty lies on oral and maxillofacial surgeon. Unified efforts at individual as well as global level will help achieve this goal.

Musculoskeletal Changes as a Sequel to Advancement Genioplasty: A Long-Term Cephalometric Prospective Study.

AIMS: The aim of this study was to evaluate cephalometrically the stability of hard tissues and soft tissue changes of advancement genioplasty 2 years after surgery. METHODS: A prospective study was conducted which comprised of 25 patients, who underwent advancement genioplasty alone with no other orthognathic surgical procedures. Immediate pre-operative, 6 months postoperative, and 2 years postoperative lateral cephalograms were compiled and assessed. RESULTS: The mean surgical advancement planned was around 8 mm. Six months post-surgery, the relapse rate was 15% of the surgical advancement which was considerably reduced in the following 18 months to 7%. The ratio of soft tissue to bony advancement at pogonion was 0.9:1. There are significant alterations in the soft tissue profile in terms of decrease in the soft tissue thickness, facial convexity angle, deepened mentolabial sulcus and minimal increase in the lower lip height. CONCLUSION: Advancement genioplasty was considered as a relatively stable procedure, if adequate muscular pedicle and internal rigid fixation were maintained. The present study was of 2 years, and we can expect further changes in the hard and soft tissues, which are clinically irrelevant.

Retrograde intubation through nasal route in patients with limited mouth opening undergoing oral and maxillofacial surgery.

BACKGROUND: Patients with limited mouth opening (LMO) often associated with difficult intubation. Retrograde intubation is an alternative technique of establishing definitive airway in these patients when blind nasal intubation fails and fiberoptic bronchoscope is not available. We tested the retrograde intubation through nasal route in patients with LMO less than 2 cm. MATERIALS AND METHODS: The procedure was performed with some modification with regard to retrograde guide on 18 patients requiring maxillofacial surgical procedures to increase mouth opening. Indications for this technique were mandibular fracture (n = 6), oral submucous fibrosis (OSMF; n = 6), temporomandibular joint (TMJ) ankylosis (n = 4) and internal derangement of TMJ (n = 2). All patients were assessed for preoperative interincisal opening; during intubation through specific parameters and; also postoperative findings were observed. RESULTS: Mean time taken for successful intubation was 5.6 min ± 1.66. One patient had subcutaneous emphysema which was managed conservatively. Postoperatively, four patients had sore throat which resolved in few days. No other complications were encountered. CONCLUSION: In conclusion, retrograde nasotracheal intubation is an effective and useful technique for airway control in patients with LMO and with only a small risk potential.

Protocol for Antibiotic Administration in Mandibular Trauma: A Prospective Clinical Trial.

PURPOSE: The purpose of this study is to determine the necessity and/or effectiveness of antibiotics in cases with maxillofacial trauma and emphasise the administration of antibiotics in maxillofacial fractures indicated for open reduction and rigid internal fixation (ORIF). MATERIALS AND METHODS: This study is a single blind, prospective, randomized clinical trial composed of subjects who presented with non-comminuted, linear fractures of the mandible and were treated by ORIF via an intraoral approach. One hundred and forty-four subjects (2011-2015) who belonged to the above entities were randomly categorized into 2 groups of 72 each, on lottery method. Patients in Group A were administered a 5 day course of antibiotic (1 day IV antibiotics followed by 4 days oral) while patients in Group B received a 1 day course of IV antibiotic (1 dose post op). Both the groups were followed up on the 1st day, 3rd day, 1st week, 1st month, 3rd month post operatively and were evaluated for pain, swelling, infection, fever, spontaneous wound dehiscence, purulent discharge and any other adverse effects. RESULTS: Post operative infection when measured clinically and radiographically was comparatively higher in Group B. Out of 72 patients in both the groups, 5 patients each in Group A and Group B reported with wound dehiscence, 9 patients in both groups developed pyrexia. CONCLUSION: Though the post operative infection was slightly more in Group B compared to Group A, 1 day antibiotic regimen was found to be equally effective when compared to 5 day regimen and helps in reducing the after effects, superinfection and antibiotic resistance. It has better patient compliance and is cost effective.

Clinical and MRI Evaluation of Orthodontic Mini-Screws for Disc Repositioning in Internal Derangement of TMJ: A Prospective Study.

PURPOSE: The purpose of this study was to assess the efficacy of orthodontic mini-screws as a modified suture anchor for disc repositioning in cases of internal derangement of the temporomandibular joint. PATIENTS AND METHODS: A prospective evaluation of ten patients was undertaken for a period of 6 months using this modified approach from Jan 2014 to Jun 2016. Symptomatic patients with clinical and MRI features suggestive of internal derangement of TMJ and willing to undergo surgical repositioning of articular disc to alleviate symptoms of temporomandibular dysfunction were taken up for the study. Post-operatively, functional outcomes were assessed in terms of reduction in pain, joint movement and absence of joint noise and clicking sounds. Post-operative MRI was used to assess the disc position and morphological changes in the disc and arthritic changes in the condyle. RESULTS: All patients underwent a surgical repositioning of the anteriorly displaced disc by the modified orthodontic suture anchor. Patients were post-surgically followed up at intervals of 1, 3 and 6 months. Immediate complications in terms of pain, restriction of functional motion and transient facial nerve palsy were noted. Late complications include temporal nerve palsy in one case. All patients experienced significant improvement with good functional outcomes and stable repositioning of disc was noticed at the end of 6 months. CONCLUSION: The modified disc repositioning using an orthodontic screw via a mini preauricular approach provided a good functional outcome in all patients as assessed over a period of 6 months. However, the long-term functional sequel of the procedure and changes in the articular disc needs to be assessed.