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Key Clinical Message: Amelogenesis imperfecta (AI) is a rare developmental anomaly characterized by poorly developed or absent tooth enamel, which complicates orthodontic treatment due to weak enamel-bracket bond strength. This case report presents a successful management of AI using fixed orthodontic appliances and prosthodontic rehabilitation. Abstract: Amelogenesis imperfecta (AI) causes enamel defects, complicating oral hygiene, reducing masticatory function and lowering self-esteem. This case report details an 18-year-old female with AI who underwent fixed orthodontic treatment followed by prosthodontic rehabilitation. The multidisciplinary approach restored function and aesthetics, significantly improving her quality of life.

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Microsurgical free flaps have become the first choice for reconstruction of oral and maxillofacial (OMF) defects after tumor resection. Till recently the pectoralis major myocutaneous flap (PMMC) was considered to be the benchmark for OMF reconstruction. This philosophy is changing fast with rapid advancement in reconstructive microsurgery. Years of innovation in reconstructive microsurgery has given us a reasonably good number of excellent flaps. Tremendous work has been put into producing some exceptionally brilliant research articles, sometimes contradicting each other. This has led to the need for clarity in some areas in this field. This article reviews the most common microvascular free flaps (MFF) namely, radial forearm free flap (RFFF), anterolateral thigh flap (ALT) and free fibula flap (FFF) that are commonly used in OMF reconstruction. Since they can cater to almost all sizeable defects we come across after ablative surgery in the OMF region, they can aptly be titled as the workhorses of OMF reconstruction with regard to free flaps.   Key words: Free tissue flaps, oral surgical procedures, microsurgery.

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OBJECTIVES: Patients are usually left in a vulnerable state after an accident. Because of this, they long for a good encounter when they are brought to the hospital. Physical impairment and psychological morbidities are some of the complications that can occur to them. Traditionally, surgeons tend to pay little attention to a patient's emotional and psychological perspective. The aim of this study was to understand the experience of oral and maxillofacial trauma patients due to road traffic accident right from immediate after the accident till the end of definitive treatment. MATERIALS AND METHODS: Phenomenological approach of qualitative study was used to explore these patients' experience. Twenty subjects involved in road traffic accidents without any cognitive impairment aged 18 and above were recruited. Purposive sampling was used to include maximal variation sample regarding age, gender, types of injury, and types of treatment received. Semi-structured and open-ended interview approach was used to obtain in-depth information. RESULTS: Seven themes were identified to describe the patients' response to and experience after meeting with a road traffic accident; they are unreal experiences, emotional responses, need to inform and need for information, need for assistance, their perception toward the maxillofacial injury, their experience on treatment and staff-patient interaction. CONCLUSION: This qualitative study has provided an in-depth understanding of patients experience during maxillofacial trauma and treatment, which otherwise cannot be obtained by the use of surveys and test questions.

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AIM: The study was carried to find a relationship between the postextraction stable landmark, the incisive papilla, and the most labial position of the maxillary central incisor teeth, which occurred in Nepalese population. MATERIALS AND METHODS: Casts of the subjects selected by nonprobability random sampling meeting the inclusion criteria were obtained. Each casts were standardized with respect to the occlusal plane and a photographic technique was used to measure the distance from the tangent of the labial surface of the central incisors to the posterior border of the incisive papilla. The measurements were made using Adobe Photoshop and results were analyzed by using appropriate statistical methods. Most appropriate software (SPSS) for the purpose was used to generate all desired values. RESULTS: The data obtained suggested that the distance from the labial surface of maxillary central incisors to the posterior border of the incisive papilla ranged from 9 to 15.9 mm with a mean of 11.59 mm (SD 1.3). Various other results were also found after evaluation of the arch forms in relation to sex and race. CONCLUSION: Within the limitations of the study, these results suggested that there is a relationship between the maxillary central incisors and the incisive papilla aiding in the anteroposterior positioning of the anterior tooth. The clinical relevance of the study lies in application of the incisive papilla as a starting point in the preliminary location of maxillary incisors and canines during construction of the denture in absence of preextraction records.

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Rhinosporidiosis is a benign chronic granulomatous infection caused by Rhinosporidiosis seeberi (R. seeberi). Rhinosporidiosis is endemic in South Asia, notably in Southern India and Sri Lanka. The common sites of involvement are the nose and nasopharynx followed by ocular tissue. Rhinosporidiosis is also known to involve many rare sites and may become disseminated to ocular in generalized form. Rhinosporidiosis of parotid duct is extremely rare. The case presented here is of 18-year-old male from the nonendemic zone of Nepal with a proliferative mass in the parotid duct. Although rhinosporidiosis was not taken into consideration in the clinical differential diagnosis, eventual histopathological diagnosis confirmed rhinosporidiosis. Thus clinicians should be flexible in the differential diagnosis of proliferative growth in the parotid duct, even in those cases which are from nonendemic areas.

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Attacks by elephants, the largest of the "large animals," produce many fatalities a year. Most attacks are provoked, although rogue elephants are occasionally responsible. Trampling, goring, tossing the individual with the trunk, or crushing with the knees produces the injuries. Injuries from encounters with large animals represent a significant health risk for rural communities. Wild-animal-inflicted maxillofacial injuries are rare, and limited literature is available describing their management. We present a case of severe maxillofacial injuries caused by the attack of a rogue elephant.