Comparative Analysis of Radiosurgery and Scalpel Blade Surgery in Impacted Mandibular Third Molar Incisions: a Clinical Trial.

AIMS: This study aims to compare the outcome of radiosurgically assisted incision technique with the conventional scalpel blade technique in impacted mandibular third molar incisions. METHODS: On 100 patients (50 patients each in GROUP R and GROUP S) with impacted mandibular third molar, incisions were given using radio surgical and scalpel technique, respectively. Impacted third molars were classified according to Winter's classification. Two types of incisions (Ward's and modified Ward's) were performed. Results were evaluated considering various parameters like surgical ease, field of surgery, odour, bleeding, discomfort/pain, post-operative analgesic intake and healing in both groups. RESULTS: In our study, mean age of patient was 25.30 years, 54% were females and 46% males; mesioangular was the most common type of impaction, and the average length of incision was 3.105 ± 0.546 cm. There was a significant statistical difference (p < 0.01) in the five measure moments (field of surgery, surgical ease, intra-operative bleeding, odour and post-operative analgesic intake at 3-5th day) between the impacted molars operated with scalpel and the ones done with radiosurgery. There was statistically insignificant difference in pain/discomfort, healing and post-operative analgesic intake at 1st and 7-10th day. CONCLUSIONS: Radiosurgery was very effective in providing clear field of surgery, surgical ease and created less intra-operative bleeding than scalpel blade surgery making day to day minor oral surgery less stress full and productive.

Orocutaneous Fistula or Traumatic Infectious Skin Lesion: A Diagnostic Dilemma.

Orocutaneous fistula (OCF) (of dental origin) is an uncommon but well-described condition in the literature. These are often misdiagnosed by physicians and dentists. Careful selection of investigating modality is important in case of diagnostically challenging cases. A 19-year-old female came with a complaint of a lesion on the chin reported with h/o trauma with the impact on chin presented as diagnostic dilemma because of unusual case history and clinical examination. Commonly used radiographic investigations like IOPA and orthopantomograph did not resolve the dilemma whereas advanced imaging modality like CT scan, 3D volume imaging, and contrast enhanced CT played an important role in the diagnosis of OCF and selecting the treatment plan.

Maxillary adenomatoid odontogenic tumor associated with a premolar.

The adenomatoid odontogenic tumor (AOT) represents 3-7% of all odontogenic tumors, and over 750 cases have been reported in the literature. This lesion was formerly considered to be a variant of the ameloblastoma and was designated as adenoameloblastoma. These lesions may infrequently produce dentinoid material and rarely enamel matrix. Consequently, the WHO (2005) classification of odontogenic lesions considered this process to represent a mixed odontogenic neoplasm. We present a case of a 12-year-old female patient with an AOT of diameter 5 cm × 5 cm located in the anterolateral region of the maxilla in association with an impacted premolar tooth. The rarity of AOT, association of this lesion with regards to maxillary premolar, the exaggerated size at presentation, the eruption of the displaced canine postoperatively and uneventful healing of the bony defect without adjunctive therapy makes this case unique.

CT Scan as an Essential Tool in Diagnosis of Non-radiopaque Sialoliths.

Sialolithiasis is the second most common disease of the salivary glands and the main cause of salivary gland obstruction. Diagnosis of calculi/sialoliths can be made by means of an elaborate history, precise clinical examination and radiographic support. But all sialoliths do not present with predictable signs and symptoms and radiographic appearance. Sialoliths have a variety of manifestations and they may or may not be radiopaque. Non-radiopaque sialoliths are difficult to diagnose radiographically. Although newer techniques like CBCT, CT virtual sialandoscopy and established techniques like sialography, xeroradiography can be useful in selected cases. A regular CT scan is an excellent tool in the diagnosis of a non-radiopaque sialolith and associated salivary gland changes. CT scan should be considered as an important tool of imaging for diagnosis, treatment planning and follow-up of all cases of sialoliths and associated pathologies of the salivary gland.

The syndromic multiple odontogenic keratocyst in siblings: A familial study.

PURPOSE: Our aim is to demonstrate the importance of postoperative assessment and highlight the need for a lifetime follow-up of the patient and the siblings in cases of Nevoid Basal Cell Carcinoma Syndrome (NBCCS). MATERIALS AND METHODS: Three siblings out of which two were of syndromic multiple odontogenic keratocysts, with multiple basal cell nevae were followed-up for manifestations of NBCCS from year 2001 till date. Two of the patients were treated for multiple bilateral odontogenic keratocysts (OKCs). Familial occurrence of the syndromic multiple odontogenic keratocysts was studied. RESULT: Although NBCCS is associated with multiple OKCs, it does not imply that a patient should have more than one cyst at a given point in time, rather it refers to the lifetime history of the patient. Early diagnosis will often make it possible to use conservative therapies rather than complex treatments. CONCLUSION: Recognition of the syndrome permits early treatment in other but possibly asymptomatic relatives. Close attention of the family and past medical history and physical examination will alert the clinician to its presence, allowing for appropriate genetic counseling and serial screening for the development of malignancies and other complications besides OKCs.