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Introduction: The reconstitution of form and function after maxillofacial tumor resection or traumatic bony defects is a challenge when considering reconstructive options. The reconstructive options will depend upon whether the tissues to be replaced included bone alone or both bone and soft tissue (composite resection). Methodology: This study was carried out on nine patients who with benign tumors or cysts of the mandible that required segmental resection. Mandibular reconstruction using mandibular transport distraction osteogenesis was performed for all the cases. Depending on whether the condyle was spared or sacrificed, the type of mandibular transport distractor either fixed on the remnant condyle-ramus unit or had a condylar component replacing the resected condyles. Depending on the location of the defect, transport distraction was carried our anterior to posterior or posterior to anterior. Results: A total of nine cases of benign mandibular pathologies were operated. Segmental resection with condylar preservation was carried out in seven cases, segmental resection with condylar resection was carried out in two cases. In cases with condylar resection, the reconstruction plate of the distractor device had a condylar component. Anterior to posterior transport distraction was carried out in seven cases, and posterior to anterior transport distraction carried out in two cases. The amount of distracted bone ranged from 38 to 46 mm. Conclusion: Mandibular transport distraction osteogenesis offers a modality of reconstruction where the patient's native host bone is osteotomized and gradually distracted to induce the formation of regenerated osseous structure and soft tissue. Being cost-effective, not requiring a steep learning curve/long operative time, and not technically demanding as vascularized bone grafts/flaps, it is feasible in the Indian setup as a practical reconstructive option for benign jaw tumors.
RESUMO
INTRODUCTION: Owing to the anatomical basis established on the detailed course, distribution and innervations of buccal nerve in the literature, we believe that an effective and extensive buccal nerve block could be achieved when the nerve is anesthetized proximal to its branching point which relates to anteromedial aspect of ramus (retromolar fossa). Though several techniques of inferior alveolar nerve block (IANB) including few single-penetration approaches were already well reviewed and practiced, pitfalls remained in terms of achieving adequate retromolar soft tissue anesthesia, as well as undermining the very importance of contacting the bone and the orientation of the bevel. We propose a simplified single-penetration technique aligning almost similar to conventional technique and its well-adopted landmarks, but still obviating the need for a separate penetration for long buccal nerve anesthesia. AIM: To study the efficacy of a simplified single-penetration technique for mandibular anesthesia. OBJECTIVES: To study the adequacy of the simplified IANB technique in minimizing the number of penetrations required to achieve buccal nerve anesthesia decreasing patient's pain and discomfort when IANB is performed and the ease of adaptability across the operators. MATERIALS: A 25-gauge 42-mm needle, local anesthesia with adrenaline-2% lignocaine HCl (1:80,000), 2.5-ml syringe, observation form. METHOD: Study 1-A sample size of 120 cases, in oral surgery department of our college, with 60 patients in Group I (control) where patients received anesthesia through conventional IANB and 60 patients in Group II (experimental) where patients received anesthesia through simplified IANB. Both the groups are again subdivided into group A (single operator) and group B (multiple operators). Study 2-20 bilateral mandibular impacted third molar in oral surgery department of our college, with right side (control-conventional technique) and left side (experimental-simplified single-penetration technique). VAS data are recorded in the excel sheet. RESULTS: The success rate of the simplified technique is quite comparable to the conventional groups. The mean pain and discomfort score in simplified technique was 3.08 which is relatively lower when compared to mean value in conventional technique which was 6.88. The difference was statistically significant. CONCLUSION: Simplified technique minimizes the number of penetrations, which substantially decreases patient's pain and discomfort levels not only during injection, but also during surgical procedures on mandibular posterior region because of extensive and profound buccal nerve territorial anesthesia.
RESUMO
OBJECTIVE: This study was undertaken to assess the level knowledge and experience about CPR among oral and maxillofacial surgeons. MATERIALS AND METHODS: In a cross-sectional study, a total of 96 professionals (31-PGs, 65-MDS staff) were surveyed using a self-administered structured questionnaire pretested through a pilot survey. The data was analyzed using the SPSS version 15.0. The Student's t-test and ANOVA test were used as test of significance. The level of significance was set at p ≤ 0.05. RESULTS: In the present study, 78% of oral surgeons had received training about CPR but only 52.0% have proper practical knowledge of performing it. As there were some cases due to CPA in dental practice even then half of the participants take history of patients regarding this. A significant difference was found according to designation with PGs having lower mean scores. A positive linear correlation was found between years of experience and knowledge about CPR (Pearson's correlation, r = 0.613, p = 0.00). CLINICAL SIGNIFICANCE: The present findings showed that practical knowledge of performing CPR is still low and half of them still do not take history regarding this. So there is need for more knowledge about CPR through CDE programs.
