A Comparative Study of Platelet-Rich Fibrin and Platelet-Rich Fibrin with Hydroxyapatite to Promote Healing of Impacted Mandibular Third Molar Socket.

Aim: The purpose of this study was to compare the efficacy of platelet-rich fibrin (PRF) and platelet-rich fibrin (PRF) with hydroxyapatite (HA) on postoperative pain, swelling, soft tissue healing and osseous regeneration in mandibular third molar extraction socket in human patient. Materials and Methods: This prospective study included total 40 patients who reported to the Department of Oral and Maxillofacial Surgery (OMFS), Teerthanker Mahaveer Dental College and Research Centre (TMDC&RC), Moradabad (U.P.). Twenty patients each in both the groups of PRF and PRF with HA were included for the management of impacted mandibular 3rd molar extraction sockets and were evaluated for effectiveness. Evaluation was done on the basis of following parameters pain and swelling at time interval of 1st, 3rd, 7th day, soft tissue healing at time interval of 3rd, 7th, 14th day and osseous regeneration at time intervals of 1st, 3rd, 6th month postoperatively. Results: Pain and swelling were less in the PRF with HA group when compared to PRF group. Soft tissue healing was better in the PRF with HA group compared to the PRF group. The result of the study shows rapid bone regeneration in the extraction socket treated with the PRF with HA group when compared with the PRF group. Also there was less postoperative discomfort in the PRF with HA-treated group. Conclusion: PRF a mitogenic promoter together with a bone graft forms a scaffolding, promotes early healing thus being creating beneficial for the patient and is also economic.

Clinical evaluation of Class II and Class III gingival recession defects of maxillary posterior teeth treated with pedicled buccal fat pad: A pilot study.

BACKGROUND: Buccal fat pad (BFP) is a specialized vascular tissue adequately present in buccal space and is close to the maxillary posterior quadrant. The aim of this clinical study was to evaluate the utility of pedicled BFP (PBFP) in the treatment of Class II and III gingival recession. MATERIALS AND METHODS: Ten systemically healthy patients with age ranging from 35 to 55 years with Class II and Class III gingival recession in the maxillary molars were selected. Before the surgical phase, patients were enrolled in a strict maintenance program including oral hygiene instructions and scaling and root planing. A horizontal incision of 1-1.5 cm was made in the buccal sulcus of the maxillary molar region; buccinator muscle was separated bluntly to expose the BFP. The fat was then teased out from its bed and spread to cover defects adequately. It was then secured and sutured without tension. Clinical parameters such as probing depth, recession width, recession length (RL), and width of keratinized gingiva were recorded at baseline and at 6 months postoperatively, and weekly assessment was done at 1 week, 2 weeks, 3 weeks, and after 4 weeks for observations during the postoperative healing. RESULTS: Treated recession defects healed successfully without any significant postoperative complications. Decreased gingival recession horizontal width values from 4.65 ± 0.4327 to 0.94 ± 1.350 and RL from 6.4 ± 1.075 to 0.7 ± 0.6750 were observed postoperatively (P < 0.05). Percentage of root coverage average was 89.3%. There was a statistically significant decrease in the width and depth of recession. CONCLUSION: Pedicled buccal fat showed promising results as the treatment modality in the management of Class II and Class III gingival recession of maxillary posterior teeth.

Adolescent Mandibular Central Odontoameloblastoma: A Rare Case Report.

Odontoameloblastoma is a rare odontogenic tumour, characterised by simultaneous occurrence of an ameloblastoma and a compound or complex odontoma in the same tumoral mass. The tumour is seen in first three decades and affects mandible or maxilla equally, commonly found posterior to the canines. The management is similar to unicystic ameloblastoma and odontoma excision. A long term follow up is a must to observe the recurrence. Here we present a rare case of odontoameloblastoma in a 17 year old male, presenting as an asymptomatic anterior mandibular swelling with chief complaint of missing lower front teeth.

Non-traumatic Occulomotor Nerve Palsy: A Rare Case Report and Discussion on Etiopathogenesis.

The ghost of the past has emerged as the horror of today. The fear of weakness/loss of eyesight following extraction is a common thinking amongst the orthodox people of Indian subcontinent. Occulomotor nerve paralysis following dental extraction is a rare complication. Although these ophthalmic complications in routine practice are rare, some time they do occur and pose difficulty to explain. Occulomotor nerve palsy is amongst the rare reported cases of ocular complication. Here we report a case of spontaneous recovery of occulomotor nerve palsy in an elderly diabetic patient and brief discussion on its etiopathogenesis.

Determination of mesiodistal width of maxillary anterior teeth using inner canthal distance.

BACKGROUND: Selection of appropriately sized maxillary anterior teeth is one of the important aspects of complete denture prosthodontics. In the past several methods have been proposed, but little consensus on an effective method for anterior teeth selection has been reached. Inner canthal distance is one of the reliable anatomic dimension that may provide a valid approach to anterior teeth selection. This study was aimed to ascertain the co-relation between inner canthal distance (ICD) and combined mesiodistal width of maxillary anterior teeth. METHOD: This study was conducted in Army Dental Centre (R & R) Delhi Cantonment between Aug 2006 to Mar 2008. Eight hundred dentate Indian subjects of four different ethnic group; Such as Rajputs, Marathas, Sikh and Tamilian. 100 males and 100 females from each race under the age group of 18-30 years formed the subjects of study. The ICD and mesio-distal width of maxillary anteriors were measured using Digital Vernier Caliper. The Data obtained was statistically analyzed. RESULTS: A consistent ratio of 1.61 was found between ICD and combined mesiodistal width of maxillary anteriors in all four ethnic group. The mean value showed no statistically significant difference between sex. The variation in the ratio between the ethnic groups was negligible. CONCLUSION: The findings of the study indicated that, to select the combined mesiodistal width of maxillary anterior teeth, ICD of the required patient should be multiplied by 1.61. This ratio was consistent with all the four ethnic groups irrespective of sex.

Prospective study of treatment outcome of implant retained mandibular overdenture: Two years follow-up.

AIMS: The aim of this study is to evaluate the treatment outcome of immediately loaded Implants in the interforaminal region of anterior mandible. MATERIALS AND METHODS: A total of 15 completely edentulous patients aged between 50 and 70 years were selected satisfying certain inclusion and exclusion criteria. Two implants were placed in 33 and 43 region (B and D location) and the implants were loaded immediately by mandibular overdenture retained with O-ring attachments. The implants were evaluated for various clinical parameters at 6 months, 1 year, 1.5 years, and 2 years intervals after initial placement. RESULTS: There was increased marginal bone loss around implants during the 1(st) year after that the bone loss was insignificant. Clinical stability of immediately loaded implants was lower initially for 6 months, but improved by the end of 1(st) year. Survival rate for immediately loaded implants was 96.6% at the end of the period of study. CONCLUSION: Immediate loading of interforaminal mandibular implants demonstrated a highly acceptable clinical success at the end of 2 years. However, initially the marginal bone level and clinical stability were significantly lower which showed improvement with time.

Current Concepts in Restoring Acquired Cranial Defects.

Restoring acquired cranial defects has been in vogue for long, and the reconstructive techniques continue to evolve. Over the decades various techniques and materials are employed in rehabilitating cranial defects. Advances in bioengineering, custom templates and Rapid prototyping technology has given greater impetus in restoring larger cranial defects. With the variety of options available it will be very crucial in deciding the best possible technique and material to rehabilitate patients with cranial defects.

Comparative evaluation of pre-emptive analgesic efficacy of intramuscular ketorolac versus tramadol following third molar surgery.

Pre-emptive analgesia aims at preventing the central nervous system from reaching a hyper-excitable state known as central sensitization, in which it responds excessively to afferent inputs. The clinical implication would be more effective pain management, thereby reducing post-operative pain and analgesic requirements. This study aimed at investigating the existence of pre-emptive analgesia and to compare the pre-emptive analgesic efficacy of im ketorolac [NSAID] versus tramadol [SYNTHETIC OPIOD] for post-operative pain management following third molar surgery. Fifty patients under the age group of 16-25 years with asymptomatic, symmetrically impacted mandibular third molars were equally divided into 2 groups and underwent third molar surgery under local anesthesia. Ketorolac 30 mg and tramadol 50 mg were used in the study group, while sodium chloride 0.9 % was used in the control group. Study parameters included pain intensity scores for 12 post-operative hours, time to 1st rescue analgesia, total number of analgesics consumed during the 5 post-operative days and patients' self assessment of efficacy of the surgery with regardsto no pain. Statistically, the data are presented as the mean values with their standard deviations and a 95 % confidence interval [p is significant, if p < 0.05] for the mean are applicable. Incidences of adverse events like pain on injection of the study drug, local reactions, nausea and vomiting were noted. Patients in the study group significantly performed better than the control group in terms of all the parameters; while among the study group, ketorolac fared better than tramadol. All the drug related complications were mild and did not require any intervention. Pre-operative ketorolac or tramadol in comparison to placebo resulted in a significantly better post-operative pain management. However as against tramadol, ketorolac is a better choice as a pre-emptive analgesic agent for the post-operative pain management following third molar surgery.

Setbacks of bio-resorbable plates and screws in the management of condylar fractures: our experience.

PURPOSE: Fractures of the condyle can be managed by open or by closed reduction. This study was designed to mention the complications of the bio-resorbable material we had experienced while using them in the management of condylar fractures. METHODS: Fifteen (11 men and four women) patients with subcondylar fractures were included in the study. Resorbable poly-l-lactide plates and screws were used for the fracture fixation. Patients were followed up clinically and radiographically for a period of 2 years. RESULTS: Seven patients had a satisfactory reduction following the placement of bio-resorbable plates. Three patients had developed a swelling in the pre-auricular region, extending till the angle. Two patients had a screw breakage whereby leading to malunion and three other patients had bone resorption, at the fractured site that was appreciated radiographically. CONCLUSION: Inspite of the advantages of these materials, certain complications has been experienced in our study with regard to the resorption and degradation of the material which has been mentioned and explained in our article.