Managing a grossly comminuted and infected mandibular fracture using a maxillary extra-oral distractor as stabilizing agent: A clinical case report.

Facial fracture management dates as early as Hippocratic era. Comminuted mandibular fractures are one of the challenging clinical condition requiring high surgical expertise to achieve a good functional and esthetic outcome. In presence of infection and other facial fractures managing comminuted mandibular fracture becomes more challenging. Here we present a case of grossly comminuted and infected mandibular fracture with delayed presentation managed by using maxillary distractor as stabilizing agent. Using a maxillary distractor for managing a fractured mandible has been seldom reported in literature. Current case report gives idea to practicing clinician about the possibility of treatment beyond the established principles.

Prognostic value of toll-like receptor 4 and nuclear factor-κBp65 in oral squamous cell carcinoma patients.

OBJECTIVE: To investigate toll-like receptor 4 (TLR4) and nuclear factor-κBp65 (NF-κBp65) expression in oral squamous cell carcinoma (OSCC) tissues and the effects of their expression on the outcomes in patients with OSCC. STUDY DESIGN: TLR4 and NF-κBp65 expression was assessed in 110 patients with OSCC and in 32 normal oral mucosal samples using immunohistochemistry. Correlations between their expression and clinicopathologic parameters, including disease-free survival, disease-specific survival, and overall survival, were analyzed. RESULTS: High TLR4/NF-κBp65 expression was increased in OSCC tissues compared with normal oral mucosal tissues (all P < .05). High cytoplasmic TLR4 and NF-κBp65 expression was significantly correlated with the primary tumor stage, pN stage, differentiation, invasion depth, and pTNM stage (all P < .05). Cytoplasmic TLR4 expression was associated with NF-κBp65 expression in OSCC (all P < .05). Univariate analysis revealed that high cytoplasmic TLR4 and nuclear NF-κBp65 expression was significantly associated with lower disease-free survival, disease-specific survival, and overall survival rates (all P < .001). Further, multivariate analyses identified high cytoplasmic TLR4 and nuclear NF-κBp65 expression as independent prognostic factors (all P < .05). CONCLUSIONS: The current findings suggest that the TLR4/NF-κBp65 signaling pathway is associated with survival of patients with OSCC and that it may serve as a potential therapeutic target.