Incidence of Risk and Complications Associated with Orthodontic Therapeutic Extraction.

BACKGROUND: Extraction in orthodontics are carried out in the cases where there is space deficiency to align the teeth. The elective extraction of first or second premolars has been discussed in the literature for more than 50 years. In the 1940s and 1950s Nance, Dewel and Carey reviewed this as a useful option, and in the 1970s Logan and other leading orthodontists favoured the extraction as choice. It is not always the elective extraction of premolar is a smooth drive for the surgeon as well as to patient. Sometimes the elective extraction of premolar result in complications, which might be due to both anatomical and surgical factors. METHODOLOGY: The study sample consisted of 100 patients referred for one or more orthodontic extractions to the department of oral and maxillofacial surgery were included in this retrospective study at the vivekanandha dental college for women tiruchengode between November 2014 and May 2016. All referrals were from the department of orthodontics. A survey was carried out to record the intraoperative risks and correlated with its morbidity as when occured. All intraoperative morbities were managed appropriately as required. RESULT AND CONCLUSION: Between November 2014 and May 2016, 100 patients had one or more premolar teeth removed by the oral surgeons. The sample size was 100 patients who had a total of 334 premolars removed. The sample's mean age was 11.4+\- 8.4 years, and 57.0% were male. The average number of teeth extracted per patient was 2.34 +\- 1.46, and 73.8% had complete root development. More than 93.4% of subjects had normal root and bone morphology, whereas 35.65% had variations in root forms and bone texture. The intra-operative and post operative complication rates were 7.4% and 1.9%, respectively. Complications were generally minor (91.9%) and were managed nonoperatively on an outpatient basis. There were no case of oral antral communication.

Incidence of Trismus in Transalveolar Extraction of Lower Third Molar.

BACKGROUND: Conventional mandibular third molar removal produces tissue trauma that induces an inflammatory reaction, leading to postoperative sequelae, the most common ones being trismus which influences the patient's quality of life in the postoperative period. Identifying the factors determining trismus after mandibular third molar extraction helps us to evaluate and correlate the incidence of trismus with morphological and surgical factors that are associated with its incidence in the postoperative period. METHODOLOGY: Patients referred to our institution for surgical removal of their impacted lower third molar between November 2014 and February 2015 were the participants of the study. Type of impaction, indication, and level of difficulty based on Pedersen criteria were obtained. Postoperative pain, swelling, and mouth opening (MO) limitations were evaluated at postoperative day (POD) 0, POD1, POD3, POD5, and POD7 and were analyzed. P < 0.05 was considered statistically significant. RESULT AND CONCLUSION: In this study, out of fifty patients, only nine patients had experienced limited MO during postoperative period when the duration of procedure exceeded 30 min. However, it occurred as cumulative of pericoronitis and tooth sectioning done. The postoperative trismus was more significant in disto-angular impaction (P < 0.05) due to postoperative sequelae, swelling and pain.

The role of diagnostic ultrasound as a new diagnostic aid in oral and maxillofacial surgery.

Only very few studies have been done in the past to evaluate the usefulness and limitations of ultrasonography in oral and maxillofacial surgery. This study, though in an embryonic stage, has been done to bring this technique to limelight and to put forth the importance of its use and limitations in the branch of oral surgery. The purpose of this study was to investigate and study the characteristic pattern of the oral tissues on gray scale ultrasonography and to assess the practical applicability of this new diagnostic technique in diagnosing various tissue pathologies in the field of oral and maxillofacial surgery.

The role of three-dimensional computed tomography in the evaluation of temporomandibular joint ankylosis.

AIMS: The aim of the study was to evaluate the role of three-dimensional computed tomography (3D-CT) in the assessment of temporomandibular joint (TMJ) ankylosis and its importance in treatment planning. The objectives of study were to measure and assess the mediolateral extent of ankylosis mass in 3D-CT and to compare the extent with intraoperative assessment. The study was also aimed to measure the coronoid process elongation in 3D-CT and its significance in treatment planning. MATERIALS AND METHODS: This prospective study included 3D-CT evaluation of 11 patients with TMJ ankylosis during the period of February 2006-October 2007. RESULTS: The 3D-CT assessment provided the length of the coronoid process and the relation of vital structures including maxillary artery to the ankylosed mass. Measurement of ankylosed mass also aids in preoperative measurement of the graft required to reconstruct the defect following removal of the ankylosed mass. CONCLUSION: Our study concludes that 3D-CT is a useful tool in the diagnosis and treatment planning of TMJ ankylosis.

Diabetes and periodontal disease.

Diabetes mellitus is a systemic disease characterized by increased blood glucose levels and abnormalities of lipid metabolism due to absence or decreased level of insulin. It affects all the body organs and their functions either directly or indirectly. Every dentist should have a basic understanding of the etiopathogenesis, oral and systemic manifestations of this disease. The periodontal diseases are a consequence of extension of the gingival inflammation into the underlying supporting structures of the periodontium, initiated by the presence of plaque and its products on the surfaces of the teeth and the adjoining structures. The progression of periodontal disease is influenced by variety of factors like microorganisms, host response, systemic background, and genetic makeup of the host. Amongst them, diabetes mellitus tops the list. Diabetes and periodontitis influence the clinical outcome of each other and control of both influences the clinical improvement of each.

Changes in quality of life and impact on patients' perception of esthetics after orthognathic surgery.

OBJECTIVES: The aim of our study is to determine the changes in quality of life and patient's perception of esthetic improvement after anterior maxillary osteotomy. MATERIALS AND METHODS: Our prospective study consisted of 14 patients who had been diagnosed of skeletal orthodontic deformity and underwent anterior maxillary osteotomy, along with orthodontic correction. The quality of life was evaluated using questionnaires based on Oral Health Impact Profile-14 questionnaire (OHIP-14) and a 22-item orthognathic quality of life questionnaire. They were evaluated at baseline pre-surgical, 8 weeks postoperatively, and 24 weeks postoperatively. RESULTS: Our results showed mild improvement in generic health related quality of life immediately following surgery, while condition-specific quality of life and patient's perception of esthetic improvement were noted only at 24 weeks following anterior maxillary osteotomy. CONCLUSION: We conclude that anterior maxillary osteotomy had a positive impact on the quality of life. The improvement in patient's perception of esthetics is seen only 2 months after surgery, while improvements in oral health and function were seen within 2 months following surgery. The acceptance and satisfaction of patient toward surgery was more positive 2 months after surgery.