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OBJECTIVE: The objective of the study was to compare standard Ward's incision and comma-shaped incision and its influence on postoperative complications in surgical removal of impacted mandibular third molar. MATERIALS AND METHODS: This was a prospective study. Fifty individuals divided into two groups with impacted mandibular third molars were recruited for the study. Twenty-five individuals were allocated to each group: a standard Ward's incision was made in Group A and a comma incision was made in Group B to reflect the mucoperiosteal flap, after which the common steps for removal of impacted third molars were followed. The postoperative parameters were recorded immediately on the postoperative days 1, 3, and 7. OBSERVATION AND RESULTS: The pain scores which were recorded on days 1, 3, and 7 in the surgical area with comma incisions were found to be significantly lower as compared to the pain scores in the area where standard incisions were made. Similarly, swelling was lesser with comma incision than with standard Ward's incision. There was a significant difference in mouth opening between the two incisions on day 1, but no significance was seen on days 3 and 7. All of these findings showed significant statistical differences. SUMMARY AND CONCLUSIONS: The results of the study showed that the new comma-shaped incision design was preferable over the conventional method (Ward's incision), considering the lesser degree of postoperative complications.
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OBJECTIVES: This study aimed to evaluate the effect of clinical factors on the outcome of arthrocentesis in the treatment of temporomandibular joint (TMJ) internal derangement. MATERIALS AND METHODS: Fifty patients with TMJ internal derangement underwent arthrocentesis using ringer's lactate. The present study evaluated the contribution of the clinical variables of age, time since onset, visual analogue scale (VAS) pain level, and range of motion (ROM) on the outcomes of TMJ arthrocentesis: age (≤25 years, >25 and ≤40 years, >40 and ≤60 years), VAS pain level (≤5, >5 and ≤7, >7 and ≤10), and ROM (<25 and ≥25 mm). Odds ratios (ORs) were used to describe the proportional benefit of each variable the on successful outcome of arthrocentesis. For the OR to be clinically relevant or even clinically noticeable, we assumed that the OR would need to be larger than 2. RESULTS: Mean preoperative pain score was 6.49±1.560 and at 6 months postoperative was 0.46±1.147 with an average decrease of pain score 6 (P<0.001). The mean preoperactive maximum mouth opening was 26.14±4.969 mm and mean maximum mouth opening at 6-month inerval was 38.92±3.392 mm. The mean increase in the mouth opening was a mean difference of 12.78 mm (P<0.001). Logistic regression showed that the maximum benefit occurred in patients aged <25 years (OR, 12.01; P=0.012), a VAS pain level of >7 (OR, 11.25; P=0.039), and a maximum vertical opening of <25 mm (OR, 7.70; P=0.038). CONCLUSION: Lavage of the superior joint space with ringer's lactate resulted in significant reduction in pain and improvement in mouth opening. Patients with a greater inflammatory component and younger patients benefitted more from arthrocentesis. Evaluation of these clinical variables helped in predictive modelling, which may provide clinicians with the opportunity to identify "at-benefit" patients early and initiate specific treatment.
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The management of parotid fistulae has been unsatisfactory in the past, and numerous methods of treatment with varying success and morbidity have been described. A case of parotid fistula caused by damage to glandular elements during a transparotid approach for a subcondylar fracture reduction is reported. This paper presents a simple but effective and conservative method of treating this complication with the use of hot hypertonic saline.
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BACKGROUND: Assess clinicopathological features of patients with keratocystic odontogenic tumor (KCOT) associated with Gorlin-Goltz syndrome in our institution from 2004 to 2015. METHOD: After histopathological analyses of KCOT related to Gorlin-Goltz syndrome, 7 patients were assessed. These patients presented a total of 15 primary and 2 recurrent KCOT. RESULTS: All patients presented a multiple KCOT, and 13 lesions were located in mandible (77%) and 4 (23%) in maxilla. Most of the tumors presented a unilocular pattern (71%) and had tooth association (88%). Four patients (57%) were in the age group of 10-19 years and three patients (43%) were in the age group of 20-29 years. There were four male and three female patients. CONCLUSION: KCOT is a frequent manifestation of Gorlin-Goltz syndrome and can be its first sign, mainly in young patients. The four patients presented with two lesions (57%) and three lesions in three patients (43%).
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Angiofibroma is a rare, highly vascular nonencapsulated tumor, which is locally invasive. A rare case of angiofibroma of the mandible in a 16-year-old female patient is reported here. The lesion was excised along with surgical removal of right mandibular third molar tooth. Patient was followed up for 1 year without any recurrence.
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PURPOSE: This study was designed to investigate the efficacy of arthrocentesis on mouth opening and pain in the treatment of temporomandibular joint (TMJ) internal derangement patients. MATERIALS AND METHODS: Fifteen males and 25 females aged between 18 and 37 years comprised the study material in the department of oral and maxillofacial surgery at Govt Dental College Srinagar (India). The patients' complaints were limited mouth opening and TMJ pain. Arthrocentesis was performed under aseptic conditions. Clinical evaluation of the patients was done before the procedure, and 1 week and 4 months post-operatively. Intensity of TMJ pain and maximal mouth opening were recorded at each follow-up visit. RESULTS: There was significant improvement in mouth opening and reduction in pain scores in the post-operative period. CONCLUSIONS: Arthrocentesis is a simple and safe procedure for patients of internal derangement with closed lock for improving mouth opening and decreasing pain.
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Schwannoma (also known as neurilemmoma, peripheral glioma and peripheral nerve sheath tumor) is a common, histologically distinctive, benign, usually encapsulated, peripheral nerve tumor of Schwann cell origin. Schwannomas can appear anywhere in the body, but are more frequently reported in the head and neck with an incidence of 25-48% in maxillofacial region. Resorption of bones due to schwannoma is rarely noticed in maxillofacial region. We hereby present a case report of schwannoma in a 35-year-old female, causing resorption of zygomatic arch along with review of literature.
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OBJECTIVE: Bears are strong and agile wild animals that defend themselves, their young ones and their territory, if they feel threatened. Conflicts between humans and bears are common in bear-prevalent areas of the world. Our valley, which is surrounded all around by forests, is a habitat for black bears (U. thiabetanus) only. Maulings inflicted by these black bears are catastrophic events and such attacks have increased considerably in the recent past due to merciless deforestation. The rising incidences of such attacks, especially in maxillofacial region, have urged our department to undertake a study of such attacks and injuries. MATERIALS AND METHODS: The present study is both a retrospective and prospective study of 200 patients of bear maulings who were admitted and treated in the Department of OMFS, Govt. Dental College, Srinagar, from January 2005 to October 2009. RESULTS: Majority of the patients were from villages. Most of them belonged to fourth decade and majority was males. Black bears only were involved in all the encounters. Claws, paws and combination of both, were the used for attack. In majority of cases, no defense was used for the termination of attack. All the patients had soft tissue injury, deep lacerations, facial viscera, eyes, salivary glands and facial nerve commonly involved.