Three-dimensional Locking Plate and Conventional Miniplates in the Treatment of Mandibular Anterior Fractures.

CONTEXT: Three-dimensional (3D) locking plates has been designed with the hypothesis that this will overcome the disadvantages of both the systems and also advantages of both systems will be combined for the management of mandibular fractures. AIMS: The purpose of this study was to evaluate the efficacy of 2-mm 3D locking miniplate in the management of anterior mandibular fracture and to compare it with Champy's miniplate. SETTINGS AND DESIGN: A prospective, randomized, clinical trial was carried out in thirty patients who were divided equally in two groups. SUBJECTS AND METHODS: Group I and Group II patients were treated with 2-mm 3D locking plates and 2-mm standard miniplates, respectively. They were evaluated according to the outcomes of the study, that is, working time, wound dehiscence, infection, segmental mobility, postoperative occlusion, need for postoperative intermaxillary fixation (IMF), and radiological evaluation of reduction and fixation. STATISTICAL ANALYSIS USED: Student's t-test and Mann-Whitney test were used to compare the two systems. The data were analyzed using Statistical Package for the Social Science version 14.0. The P value was taken as significant when <0.05 (confidence interval of 95% was taken). RESULTS: The mean duration of procedure for Group I was found to be 49.33 min, whereas for Group II was 59.67 min. There was significantly greater pain on day 1 and at 1 week in Group II patients. 6.7% (n = 1) of both groups showed incidence of infection. Postoperative stability was adequate in most cases except in one patient (n = 1) of 3D locking system, which was revealed as postoperative occlusal disharmony, unsatisfactory radiological reduction of the fracture fragments, and the segmental mobility. There was no incidence of wound dehiscence, tooth damage, and nerve damage in either group. CONCLUSIONS: The result of the study can conclude that there is no major difference between both systems in terms of treatment outcome.

Comparison of intermaxillary fixation screw versus eyelet interdental wiring for intermaxillary fixation in minimally displaced mandibular fracture: a randomized clinical study.

PURPOSE: The aim of the present randomized study was to evaluate the efficacy of intermaxillary fixation screw (IMFS) versus eyelet interdental wiring for intermaxillary fixation (IMF) in minimally displaced mandibular fractures. MATERIALS AND METHODS: A total of 50 patients with a minimally displaced mandibular fracture were enrolled, with 25 patients randomly selected for each group. In group I (study group, n = 25), the patients were treated using IMFS, and in group II (control group, n = 25), they received eyelet interdental wiring. Both techniques were assessed for the following parameters: time required for placement and removal of each type of IMF technique, time required for placement of IMF wires, postoperative occlusion, stability of the IMF wire, local anesthesia requirement during removal of each fixation type, oral hygiene status, glove perforation rate, and complications associated with both techniques. The collected data were analyzed using Student's unpaired t test or χ2 test. P < .05 was considered significant and the Statistical Package for Social Sciences software, version 10, was used for analysis. RESULTS: The average time required for placement in groups I and II was 17.56 and 35.08 minutes, respectively (P = .000). The time required for placement of the IMF wire in group I was 2.1 minutes and in group II was 6 minutes. The oral hygiene status was assessed, and the mean plaque index score for groups I and II was 1.44 and 2.12, respectively (P = .00). The glove perforation rate was much less in group I than in group II. Finally, the most common complication in both groups was mucosal growth. CONCLUSIONS: The results established the supremacy of IMFS compared with eyelet interdental wiring. Thus, we have concluded that IMFS, in the present scenario, is a safe and time-saving technique. IMFS is a cost-effective, straightforward, and viable alternative to cumbersome eyelet interdental and other wiring techniques for providing IMF, with satisfactory occlusion during closed reduction or intraoperative open reduction internal fixation of fractures. In addition, oral hygiene can be maintained, and the glove perforation rate was very low using IMFS. The relatively small sample size and limited follow-up period were the study limitations.

Transmylohyoid orotracheal intubation: case series and review.

STUDY OBJECTIVE: To evaluate the outcome of airway management in patients with complex maxillofacial fracture by submental intubation, time required for intubation, accidental extubation, and postoperative complications. DESIGN: Retrospective study. SETTING: University-affiliated hospital. MEASUREMENTS: The medical records of the 10 patients who underwent submental intubation from December 2008 to June 2011 were reviewed. MAIN RESULTS: At the end of the procedure, all 10 patients were extubated without any complications. Postoperatively, only one patient presented with superficial infection of the submental wound. CONCLUSIONS: Submental endotracheal intubation is a simple technique with very low morbidity, and may be used as an alternative to tracheostomy in selected cases of maxillofacial trauma.

Submental orotracheal intubation: Our experience and review.

INTRODUCTION: In maxillofacial injuries, a choice has often to be made between different ways of intubation when surgical access to fractured nasal bone and simultaneous establishment of occlusion are required. We report our experience with submental intubation in the airway management of complex maxillofacial trauma patients. AIMS: To evaluate the outcome of airway management in patients with complex maxillofacial fracture by submental intubation, time required for intubation, accidental extubation, postoperative complications, and to discuss indications, contraindications, advantages and disadvantages of submental intubation. SETTINGS AND DESIGN: A retrospective study is designed. MATERIALS AND METHODS: The medical records of seven patients who underwent submental intubation from December 2008 to June 2010 were reviewed and no statistical analysis was used. RESULTS: At the end of the procedure all seven patients were extubated without any complications. Postoperatively only one patient presented with superficial infection of the submental wound. CONCLUSIONS: Submental endotracheal intubation is a simple technique with very low morbidity and can be used as an alternative to tracheostomy in selected cases of maxillofacial trauma.

Ramsay-Hunt syndrome complicating osteonecrosis of edentulous maxilla and mandible: report of a rare case.

Review of literature revealed atleast 30 cases of post herpes zoster osteonecrosis of maxilla or mandible. To our knowledge this is a first reported case of Ramsay-Hunt syndrome with post herpetic neuralgia and post herpes zoster osteonecrosis of edentulous maxilla and mandible. We have briefly reviewed the pathophysiology and management of post herpes zoster osteonecrosis and post herpetic neuralgia.

Concrescence: report of rare complication.

Concrescence is an uncommon developmental anomaly that may influence exodontia as well as periodontal, endodontic, orthodontic and even prosthodontic diagnosis and treatment planning. Unexpected complications arising from this condition may lead to legal complications. To minimize risk and adverse outcome of treatment, consideration should be given to recognizing this condition and, possibly, modifying treatment planning. This article presents an unsuspected case of concrescence with a review of the literature.

Scapholunate dislocation: a rare occupational hazard.

Dentists and their assistants are at risk of physical injuries during dental operations. The most common injuries are musculoskeletal. The need to work in a fixed working position using continuous repetitive movements can predispose dentists to wrist ache, lower backache, and neckache. We encountered a rare case of scapholunate dislocation with ligamentous injury, an unusual complication of extraction of teeth.