Accidental displacement of mandibular third molar roots into the pterygomandibular space.

The surgical removal of impacted third molars is one of the most common procedures performed in both oral surgery and general dentistry. Accidental displacement of the impacted tooth or root fragments to the adjacent anatomical spaces is a rare but serious complication with even life-threatening complications. This case report presents the diagnosis and surgical management of an accidentally displaced right mandibular third molar root via an intraoral approach.

Effects of different mandibular fracture patterns on the stability of miniplate screw fixation in angle mandibular fractures.

The aim of the present study was to evaluate the effects of horizontally favourable and unfavourable mandibular fracture patterns on the fixation stability of titanium plates and screws by simulating chewing forces. Favourable and unfavourable mandibular fractures on 22 sheep hemimandibles were fixed with 4-hole straight titanium plates and 2.0mm×7mm titanium screws according to the Champy technique. Hemimandibles were mounted with a fixation device in a servohydraulic testing unit for compressive testing. Displacement values under 20, 60, 100, 120, 150, 200N, maximum displacements, and maximum forces the model could resist before breakage were recorded and compared. The authors found no statistically significant differences between the groups for the displacement values in the force range 60-200N (60, 100, 120, 150 and 200N). Statistically significant differences for maximum displacement values (displacement values at the breaking forces) between the groups were found (P<0.05). There was no evidence for the need to apply different treatment modalities to mandibular fractures regardless of whether the factures are favourable or not.

The accuracy of computer-assisted surgical planning in soft tissue prediction following orthognathic surgery.

BACKGROUND: The purpose of the present study was to evaluate the accuracy of a computer-assisted imaging system in predicting the soft tissue response following orthognathic surgery. METHODS: The study sample consisted of 11 adult patients with a mean age of 23.5 years. The preoperative and postoperative lateral cephalograms were obtained after orthodontic preparation and immediately before surgery and at least 1 year after surgery. The computer-generated soft tissue image and the actual surgical outcome were compared to evaluate the accuracy of the imaging system. RESULTS: In the sagittal plane, the tip of nose was the most accurate site and the largest difference was shown in the upper lip. The lower lip was noted to be the least accurate and the subnasale the most accurate region in the vertical plane. Predictions were found to be more accurate for the sagittal plane when compared with those for the vertical plane. CONCLUSIONS: Computer-assisted visual treatment objectives was proved to be satisfactory in predicting the soft tissue outcome following orthognathic surgery.

Three siblings with juvenile hyaline fibromatosis.

Juvenile hyaline fibromatosis (JHF) is an extremely rare hereditary genetic disease of autosomal recessive transmission that is characterized by large cutaneous tumors commonly involving the scalp, papulonodular skin lesions, flexural joint contractures, gingival hyperplasia, and osteolytic bone lesions. JHF is usually diagnosed in young infants and in children younger than 5 years, and the lesions characteristic of this disorder consist of fibrous tissue and homogenous amorphous eosinophilic hyaline material. We report the case of a 9-year-old girl with severe gingival hyperplasia, nasal enlargement, mild osteoporosis, and multiple papulonodular skin lesions. Her two brothers (7 and 13 years of age, respectively) were also diagnosed as having JHF. In the patient described in this report, the maintenance of oral hygiene after gingivectomy enabled the continued resolution of gingival hyperplasia, although skin lesions recurred and nasal overgrowth persisted.

A comparison of pre-emptive analgesic efficacy of diflunisal and lornoxicam for postoperative pain management: a prospective, randomized, single-blind, crossover study.

Diflunisal and lornoxicam are currently available non-steroidal anti-inflammatory drugs (NSAIDs) that have been shown to be effective to various degrees in pain relief when administered either pre-emptively or postoperatively. The pre-emptive analgesic efficacy of diflunisal 1000 mg was compared with that of lornoxicam 16 mg in 40 ASA I patients undergoing surgical removal of bilateral impacted third molars. The impacted third molar teeth on one side were removed at the first surgical appointment using one of the two drug regimens being assessed and the teeth on the contralateral side were removed at a second appointment using the alternate drug regimen; all operations were performed by the same surgeon. Acetaminophen up to 2000 mg daily was provided as rescue medication. The postoperative rescue analgesic consumption was recorded and pain scores were evaluated with a visual analogue scale at 2, 4, 6, 12 and 24h postoperatively. No statistically significant differences were found between groups with respect to rescue analgesic consumption and postoperative pain scores. Pre-emptive administration of both NSAIDs proved to be effective in the management of pain following the surgical removal of impacted third molar teeth.