CBCT Evaluation of Unilateral Accessory Mental Foramina: Under Reported Anatomic Variant in Children

ABSTRACT: The following manuscript presents two paediatric cases with incidental finding of unilateral accessory mental foramina. Both the cases illustrate CBCT evaluation of a unilateral accessory foramina on the left side of the mandible, one of which, is a 12-year-old baby girl with pre-diagnosed medical history of precocious puberty and oral findings of supernumerary teeth and the other is an 8-year-old boy with oral bifurcation cyst. The not so frequent presence of additional foramina and canals in the mandible are frequently undervalued in clinical procedures and to our knowledge has not yet been reported in paediatric cases in the literature so far. In these case reports, authors attempt to document a rare and first of its type ever reported anatomic variant of mandible in paediatric patients in the whole literature.

RESUMEN: El manuscrito presenta dos casos pediátricos con hallazgo incidental de forámenes mentonianos accesorios unilaterales. Ambos casos se refieren a la evaluación CBCT de un foramen accesorio unilateral en el lado izquierdo de la mandíbula, uno de los cuales era una niña de 12 años con antecedentes medicos prediagnosticados de pubertad precoz y hallazgos orales de dientes supernumerarios y el otro un niño de 8 años con quiste de bifurcación bucal. La presencia no tan frecuente de forámenes y canales adicionales en la mandíbula se subestima con frecuencia en los procedimientos clínicos y, hasta donde sabemos, aún no se ha informado en casos pediátricos en la literatura hasta el momento. En esta serie de casos, los autores intentan documentar una variante anatómica rara y primera de su tipo de la mandíbula en pacientes pediátricos en toda la literatura.

Sub Periosteal and Intra Ethmoidal Displacement of Gutta Percha Cone Following Endodontic Intervention of Maxillary First Molar

ABSTRACT: Foreign bodies in the ethmoid sinus are uncommon, and endodontic gutta percha displacement is even more rare. We present and discuss a case of displacement of gutta percha into the ethmoid sinus following root canal intervention of a maxillary first molar which presumably migrated through the maxillary sinus. There have been reports on the displacement of tooth roots or implants into the maxillary sinus. However, we know of only one such report on the migration of a gutta-percha point into the ethmoid sinus.

RESUMEN: Los cuerpos extraños en el seno etmoidal son infrecuentes y el desplazamiento de la gutapercha endodóntica es aún más raro. Presentamos y analizamos un caso de desplazamiento de la gutapercha hacia el seno etmoidal después de la intervención del conducto radicular de un primer molar superior que se presume migró a través del seno maxilar. A pesar de que existen informes sobre el desplazamiento de raíces dentales o implantes hacia el seno maxilar, solo conocemos un informe de este tipo sobre la migración de un punto de gutapercha hacia el seno etmoidal.

An unusual clinical vignette of oro-pharyngeal discomfort: Pterygoid Hamulus syndrome.

BACKGROUND: A straightforward clinical reasoning is always difficult in patients with persistent orofacial pain with vague symptoms. Craniofacial pain or Orofacial pain can have a mixture of causes ranging from neurogenic, myogenic, and psychogenic factors intertwined amidst the intricate anatomy with a high vascular network. This plethora of uncertainty blurs the judgment for such patients to whom we provide care. We hereby present a case of a 17 year old female with vague pain on talking, chewing and even swallowing when initially examined; this chronic orofacial pain often worsened her quality of life. The aim of this manuscript is to present a case of Pterygoid Hamulus syndrome that was misdiagnosed as glossopharyngeal and myofascial neuralgia. METHODS: The condition was managed by surgical excision of the elongated pterygoid hamulus, following a recurrence of her symptoms. RESULTS: The patient was relieved of pain only after the surgical excision of the elongated hamulus. CONCLUSIONS: The surgery was decided upon only after conservative management had not provided much relief and the manuscript also discusses the ambiguous composite pain referral pattern in Pterygoid Hamulus syndrome.

Open Treatment of Mandibular Condyle by Direct Transparotid Approach: Our Experience.

The fractures of the mandibular condyle are commonly encountered in maxillofacial surgical practice. The controversies to open or not to open are still ongoing. We have used both techniques, to successfully manage our patients. Open treatment of condyle fracture with or without dislocation is technically challenging. We used a "Direct Transparotid" approach in treating 13 condyle fractures over a period of 4 years. The patients were evaluated for facial nerve injury, salivary fistula, scar, function, and occlusion over a period of 12 months. There were no major complications with acceptable scar, both intraoperatively and postoperatively. The script aims at presenting our experience of direct transparotid approach surgical technique.

Efficacious use of a Calgigraf Ag foam dressing in complete healing of a difficult-to-heal, long-standing ulcer of osteoradionecrosis.

A number of dressings containing silver have been recently introduced into the wound care market as increased resistance to antibiotics has become a problem in treating infected wounds. A 54-year-old male, with adenoid cystic carcinoma treated by segmental resection and reconstruction of mandible using reconstruction plate with concomitant radiotherapy, resulted in a deep extraoral nonhealing necrotic, exuding, malodorous, and painful wound. Erythema, eczema, and trophic changes were surrounding the skin. Previous treatment was removal of exposed reconstruction plate and primary closure. Culture samples reported methicillin-resistant Staphylococcus aureus positive and sensitivity to linezolid. Repeated failed attempts to approximate the wound, prompted the use of Calgigraf Ag foam as dressing for the wound. Evidence of new tissue growth and subsequent reduction in wound area and exudate were significant. Chronic nonhealing wounds involving progressive tissue loss give rise to the biggest challenge to wound-care researchers. Despite proper care, some wounds fail to heal in normally and become chronic. The use of ionic silver with negative pressure therapy is safe and effective in difficult nonhealing wounds. This case illustrates the potential benefit of ionic silver combined with negative pressure and moist wound healing as management of a patient with long-standing, nonhealing, and osteoradionecrosis wound. Calgigraf Ag Foam a silver alginate dressing is optimal for maintaining moist environment vital to promote wound healing. It needs less frequent dressing changes with additional benefits such management of excessive exudate minimising malodour and maintaining a moist wound environment.

Foreign body granuloma.

Foreign bodies can penetrate soft tissues through open wounds, lacerations or through accidents iatrogenically. Among the commonly encountered foreign bodies encountered due to trauma are of glass, metal and wood in nature. We report a case of a 32 year old male who reported to our clinic, complaining of a small wound in the right upper cheek region intraorally since 1 month. Patient had a history of road traffic accident (RTA) 6 months back.