Oral Dirofilariasis-a Rare Case Report from South India.

Human dirofilariasis is a mosquito-borne/zoonotic nematode parasitic infestation caused by the genus Dirofilaria. From the forty isolated species of dirofilariasis, six are known to cause human infections. Intraoral occurrence is rare. We are reporting a case of oral dirofilariasis from Kerala, South India, with the view of acquainting Keralite dental professionals and Oral and Maxillofacial surgeons with the possibility of the parasitic infection in case of recurrent swellings and when the patient hails from a tropical climate and region where animal husbandry is the mainstay of livelihood.

Incidence of inferior alveolar nerve sensory deficit and intra-operative nerve encounters after advancement of retrognathic mandible - A cross-sectional survey study.

Aims and Objectives: The aim of the current cross-sectional study was to conduct a survey among the oral and maxillofacial surgeons of South India regarding their experiences of incidence of inferior alveolar nerve (IAN) neurosensory deficit after bilateral sagittal split osteotomy (BSSO) for correction of mandibular retrognathism and to assess the intra-operative nerve encounters and its effect on the inferior alveolar neurosensory deficit (NSD), 6 months post-operatively. Materials and Methods: A self-administered questionnaire (SAQ) was prepared using Google Forms (Google Inc.) and sent to the prospective participants through various social media outlets such as Facebook, WhatsApp groups etc., of the maxillofacial surgery specialty for a period of 3 months. SAQ from surgeons with more than 5 years of experience in orthognathic surgery were included. Results: The incidence of NSD post-BSSO advancement surgery from 859 cases after 6 months was 15.1% (130). After splitting the mandible, the IAN was seen in the proximal fragment in 472 sites and needed dissection. The nerve was transected and neurorrhaphy was carried out in 26 sites. A Chi-square test was used to analyse the qualitative variables. The IAN was not visible post-osteotomy in 140 sites and in the distal fragment in 1080 sites. These groups had decreased incidence of NSD. The NSD was significantly higher in cases where the nerve was transected and sutured, P value <0.001 as compared with the other nerve status, followed by the nerve in the proximal fragment needing dissection. Conclusion: The IAN status intra-operatively can be assumed to have a significant role in persisting NSD.

Single-insertion technique for anesthetizing the inferior alveolar nerve, lingual nerve, and long buccal nerve for extraction of mandibular first and second molars: a prospective study.

OBJECTIVES: Appropriate and accurate local anesthetic (LA) techniques are indispensable in the field of oral and maxillofacial surgery to obtain a satisfactory outcome for both the operating surgeon and the patient. When used alone, the inferior alveolar nerve block (IANB) technique requires supplemental injections like long buccal nerve block for extraction of mandibular molars leading to multiple traumatic experiences for the patient. The aim of this study was to anesthetize the inferior alveolar, lingual, and long buccal nerves with single-needle penetration requiring a minimal skillset such as administering a conventional IANB through introduction of the Benny Joseph technique for extraction of mandibular molars. MATERIALS AND METHODS: This was a prospective study conducted in the Department of Oral and Maxillofacial Surgery, Kunhitharuvai Memorial Charitable Trust (KMCT) Dental College, Calicut, India. The duration of the study was 6 months, from June to November 2017, with a maximum sample size of 616 cases. The LA solution was 2% lignocaine with 1:100,000 adrenaline. The patients were selected from a population in the range of 20 to 40 years of age who reported to the outpatient department for routine dental extraction of normally positioned mandibular right or left first or second molars. RESULTS: Of the 616 patients, 42 patients (6.8%) required re-anesthetization, a success rate of 93.2%. There were no complications such as hematoma formation, trismus, positive aspiration, and nerve injuries. None of the cases required re-anesthetization in the perioperative period. CONCLUSION: The Benny Joseph technique can be employed and is effective compared with conventional IANB techniques by reducing trauma to the patient and also requires less technique sensitivity.

Modified Palatal Flap with a Tissue Bridge in the Closure of the Oroantral Fistulae: A Prospective Study.

INTRODUCTION: An oroantral fistula is by definition 'An abnormal communication between the oral cavity and the maxillary sinus.' AIM OF THE STUDY: The aim of this study is to describe the acute and chronic OAFs and to evaluate the efficiency of the modified palatal flaps with tissue bridge in the closure of both acute and chronic OAFs of small to medium size. METHODOLOGY: The study sample was derived from a population of patients from January 2013 to 2018 with the complaint of pain and discharge through the socket. RESULT: The results of this series support the view that the use of modified palatal flap with tissue bridge is a reliable flap for the repair of both acute and chronic oroantral fistulae. CONCLUSION: The ease of mobilization, superior blood supply and minimal donor site morbidity make it an ideal flap and a reliable alternative when other techniques fail.

Comparison of the efficacy of amoxicillin-clavulanic acid with metronidazole to azithromycin with metronidazole after surgical removal of impacted lower third molar to prevent infection.

OBJECTIVES: The goal of the study was to investigate the clinical effects of amoxicillin-clavulanic acid (500+125 mg) with metronidazole 400 mg administered three times daily (Group I) versus azithromycin 500 mg administered once daily and with metronidazole 400 mg three times daily (Group II) for the prevention of postoperative infection following mandibular third molar surgical removal. MATERIALS AND METHODS: The study design was a single-center prospective study. Patients who reported to the Department of Oral and Maxillofacial Surgery between February 2015 and January 2017 for removal of mandibular third molar were screened, and 108 patients were chosen. One surgeon carried out all procedures. Patients were prescribed antibiotics until the two groups contained a similar number of cases. RESULTS: Our data showed that Group II had fewer incidences of surgical site infection, but with no statistical significance. CONCLUSION: Although both treatments are used routinely after removal of the mandibular third molar, neither is significantly better than the other.

Surgical Correction of TMJ Bilateral Dislocation with Eminectomy and Capsulorrhaphy as an Adjuvant: Case Reports.

INTRODUCTION: Anterior excessive movement of the temporomandibular joint (TMJ) is a condition which reduces the quality of life of a person to great extent with the patient always living in the fear of inherent dislocation. Dislocation of the temporomandibular joint represents 3% of all reported joint dislocations. CASE REPORT: In this article, we discuss about two cases where the patients with chronic TMJ dislocation were treated with eminectomy and capsulorrhaphy. Both the patients were reviewed over a period of 1 year and did not show any recurrence of the condition with satisfactory controlled increase in mouth opening. CONCLUSION: The combination has proved to be useful for the better neuromuscular control and psychological aspect, i.e., the fear of dislocation. Future of the technique combination lies in further prospective studies.

Postoperative alar base symmetry in complete unilateral cleft lip and palate:A prospective study.

In the evolution of cleft lip repair, there have been continuous attempts to minimize local trauma and to improve lip and nasal appearances. In order to obtain an aesthetically balanced development of midface, the primary surgical correction of the nasolabial area is of paramount importance. In this study, the importance of a back-cut extending cephalically above the inferior turbinate at the mucocutaneous junction which elevates the nostril floor on the cleft side for the purpose of achieving symmetry of the alar bases are analyzed by pre and postoperative photographic anthropometry. This study comprised of fifty cases of the unilateral complete cleft lip. At the time of surgery, the patient age ranged from 3-9 months. The surgeries, performed by a single surgeon, employed the standard Millard technique, incorporating Mohler modifications of lip repair. Anthropometric analysis revealed that the preoperative mean difference between the normal side and the cleft side was 0.2056 with a standard deviation of 0.133. In the postoperative analysis, the mean difference was reduced to 0.0174 with a standard deviation of 0.141. The paired t-test showed that the p-value is <0.001, indicating high statistical significance. To conclude, in complete unilateral cleft lip and palate, the geometrically placed nasal back-cut incision has a definite role in the correction of the alar base symmetry during primary surgery.

Benign Spindle Cell Tumour of Mandible and Points of Modification in Reconstruction with Nonvascularised Iliac Crest Graft.

Benign fibrous histiocytoma (BFH) is a rare spindle cell tumor occurring in the jaw. It is a benign lesion composed of spindle shaped fibroblasts arranged in a storiform pattern. Literature shows that there are less than hundred reported cases of BFH worldwide and only six reported cases in the mandible. In this article, we are reporting a rare case of BFH in mandible and novel points of modification in reconstruction with nonvascularised iliac crest graft .

Submental intubation: alternative short-term airway management in maxillofacial trauma.

OBJECTIVES: To assess submental route intubation as an alternative technique to a tracheostomy in the management of the airway in cranio-maxillofacial trauma, along with an assessment of its morbidity and complications. MATERIALS AND METHODS: Submental intubation was performed in 17 patients who had maxillofacial panfacial trauma and management was done under general anesthesia during a period of one year from 2013 to 2014 at Departments of Oral and Maxillofacial Surgery and Dentistry, the Malankara Orthodox Syrian Church Medical College, Kochi, India. RESULTS: In all 17 cases, the technique of submental intubation was found to be simple and reliable. Hypertrophic scars were noted in three cases, orocutaneous fistula and mucocele in one case each. All these complications were managed comfortably without significant morbidity to the patient. CONCLUSION: Submental intubation is a good technique that can be used regularly in the management of the airway in cranio-maxillofacial trauma, but with some manageable complications.

Sinonasal sarcoidosis of the maxillary sinus and infraorbital nerve: a case report.

Sinonasal sarcoidosis in the head and neck region is infrequent. Its occurrence can be either isolated in combination with other systems. The literature reveals that the occurrence of sinonasal sarcoidosis without lung involvement is rare. In general, sarcoidosis is a chronic non-caseating granulomatous disease of unknown origin, often identified after biopsy. In this article, we report on a benign tumor of the face that produced a diagnostic dilemma, necessitating refinement of the surgical access and in toto removal of the benign tumor.

Extreme oral myiasis.

Extreme oral myiasis is a rare condition, mostly affecting bedridden patients whose oral health care measures are neglected. Single stage manual removal of the maggots along with the necrotic tissue, debridement, and suturing under general anesthesia is the most effective way to treat the condition. Preventive measures are also equally important to eliminate the cause and recurrence. 

Penile replantation.

Penile amputation is rare and hence the paucity of experience and publication. We present our case of self-inflicted penile amputation, which was successfully managed with microsurgical replantation, with relevant literature review.

Lingual frenectomy using multiple series Z-plasty.

The tongue is an important structure for speech, mastication and deglutition. Avulsion of a portion of tongue can significantly limit the range of motion thereby impairing its functions. This is the case report of a traumatically amputated tongue which was reconstructed to fulfill its function effectively. Z-plasty is one of the most commonly used soft tissue corrective procedures in plastic surgery. Here we describe the use of a modification of the Z-plasty-multiple series Z-plasty for a tongue frenectomy.