Patient-Specific Plates for Genioplasty: A Case Report.

A 20-year-old male patient presented with a retruded chin and crowding of the upper front tooth region. The patient's problem list included skeletal class II malocclusion, retruded chin, and shallow mentolabial sulcus. A treatment plan was curated using clinical examination, cephalometric analysis, and 3D measurements, which included the advancement genioplasty of 5 mm. Osteotomy cut was planned digitally by computer-aided surgical simulation technology (Dolphin Software, Dolphin Imaging Systems, California, USA) and then transferred to Geomagic Software (3D Systems, North Carolina, USA) where patient-specific plates were designed. The patient-specific plates were 3D printed using selective laser melting. Intraoperatively, the osteotomy cut was given using a surgical guide, and an advancement of 5 mm was performed, fixing the segments using patient-specific plates. The outcome was compared with the curated treatment plan to assess accuracy. The primary objective of the case report is to provide a digital method of the treatment plan and surgical accuracy in genioplasty using patient-specific plates.

Quality of Life: determinant of success of head and neck cancer therapy in the battle of survival vs. rehabilitation.

BACKGOUND: Surgical treatment for cancers in the oral and maxillofacial region significantly impacts a patient's physical, social, functional, and psychological well-being, which can in-turn affect the Quality of Life (QoL) negatively. The goal of our study was to assess the Quality of Life (QoL) of patients who underwent surgery in our hospital, and we attempted to extrapolate the data which could in the future help improve the QoL of other patients who undergo similar treatments. METHODS: This was a retrospective study, including patients who have been treated for oral cancer in the last few years in the institute. The standard EORTC Questionnaires QLQ C-30 (version 3.0) and QLQ H and N-35 (version 1.0) were used in this study. RESULTS: GHS scores were lower in patients with T3 stage tumor than in patients with T1 stage tumor. Patients who underwent surgery along with radiotherapy and those who underwent surgery, radiotherapy, and chemotherapy showed a substantial difference in their GHS and FS ratings when their treatment options were compared. Patients who had undergone surgery, radiation, and chemotherapy had higher scores on the symptom scale and QoL H&N-35 than patients who had just undergone surgery and radiotherapy There was no statistically significant difference in the scores, pertaining to the location, age, gender and stage of the tumor but when the comparison was made on the basis of treatment modality chosen, there was a significant difference in the scores. CONCLUSIONS: The aim of any treatment is to improve the Quality of Life. The EORTC questionnaires QLQ 30 and QLQ H and N-35 proved to be very appropriate instruments to evaluate QoL in patients with oral cancer. Assessment of QoL should always receive adequate attention in treatment planning and rehabilitation. Choice of treatment modality plays a significant role in QoL of patients treated for oral cancer. Henceforth, any treatment modality should be selected not only with a curative intent but also with the goal of improving the Quality of Life as this ultimately decides the success of the therapy from the patient's perspective.

Comparative Extraction and Bioactive Potential of the Leaf Extracts of Azadirachta indica for Combatting Postoperative Head and Neck Infections: An In Vitro Study.

INTRODUCTION: Surgical site infections (SSIs) following head and neck cancer surgery are very common postoperative sequelae. Delayed wound healing leads to a poor aesthetic outcome, delay in restarting oral intake, and delay in getting or starting adjuvant therapy. Antibiotic resistance is on the rise necessitating studies that use alternatives to combat the rising antibiotic resistance. Many plant compounds have been studied to explore the possibility. Neem (Azadirachta indica), a high medicinal value plant, possesses a vast array of phytocompounds, which are broadly grouped into isoprenoids and non-isoprenoids. These phytocompounds are crucial for its anti-inflammatory, antioxidant, antimicrobial, antipyretic, and various other pharmacological activities. MATERIALS AND METHODS: In this study, we examined the impact of the extraction solvents on the bioactive potential of neem. Neem leaf samples were extracted with water and ethanol; followed by their biological activities like extraction yield, antioxidant, antimicrobial, and cytotoxicity studies were performed. The extraction yield was found to be higher in the ethanolic extract than in the aqueous extract, which also corroborates with increased antioxidant and antibacterial activity. Both the aqueous and ethanolic extracts of neem exhibited antibacterial activities against dental biofilm-producing pathogens like Staphylococcus aureus, Streptococcus mutans, Pseudomonas aeruginosa, and Escherichia coli. Results: Extraction yield was higher in the ethanolic extract of neem. Antioxidant activity was found to be higher in the ethanolic extract than in the aqueous extract. Neem extract has no toxicity, which was observed through hemolytic and zebrafish embryo toxicity assays. The ethanolic extract of neem was shown to be more effective against the Gram-positive and Gram-negative drug-resistant bacterial pathogen Discussion and conclusion: Thus, the utilization of neem extracts is certainly useful in controlling pathogenic bacterial growth in clinical applications. Further, a detailed mechanism of action of neem extract in bacterial growth inhibition at the molecular level is warranted to utilize their potential in disease management.

A Prospective Study to Assess the Efficacy of 4% Articaine, 0.5% Bupivacaine and 2% Lignocaine using a Single Buccal Supraperiosteal Injection for Maxillary Tooth Extraction.

INTRODUCTION: The aim of this study was to demonstrate if articaine hydrochloride administered alone as a single buccal infiltration in maxillary tooth extraction can provide adequate palatal anesthesia as compared to buccal and palatal injection using lidocaine and bupivacaine. MATERIALS AND METHODS: A prospective double-blinded trial was conducted on 150 patients who required maxillary tooth extraction. The patients were divided into three different groups consisting of 50 patients each. Each group was administered with 4% articaine into buccal vestibular mucosa of the tooth to be extracted, 2% lignocaine and 0.5% bupivacaine was injected into buccal and palatal side of the tooth to be extracted, respectively. Following the tooth extraction, all patients were asked to complete a 10-score Visual Analog Scale (VAS) and 5-score facial pain scale (FPS) to assess the pain on extraction. RESULTS: According to the VAS and FPS scores, the pain on extraction between buccal infiltration of articaine and the routine buccal and palatal infiltration of lignocaine was statistically significant. CONCLUSION: The routine use of a palatal injection for extraction of maxillary teeth may not be required when articaine is used as a local anesthetic solution.