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INTRODUCTION: Treatment for TMJ Ankylosis aims at restoring joint function, improving the patient's aesthetic appearance and quality of life and preventing re-ankylosis. Mouth opening is achieved by gap arthroplasty with various options of interpositional materials. Ramus-condyle unit (RCU) reconstruction maintains the height of the ramus and prevents secondary occlusal problems. Advancement genioplasty corrects chin deformities as well as increases the posterior airway space (N-PAS) by the forward pull exerted on geniohyoid and genioglossus. MATERIALS AND METHODS: This prospective single-centre study on 43 joints in 25 adult patients with TMJ Ankylosis aimed at providing a single-staged management plan of ankylosis release, RCU reconstruction and extended advancement centering genioplasty. Interpositional arthroplasty was done using temporalis myofascial flap, abdominal dermis fat or buccal fat pad. RCU reconstruction was done either by vertical ramus osteotomy or L osteotomy. OBSERVATIONS AND RESULTS: Follow-up ranged from 12 to 20 months (mean 14.4). Average mouth opening at maximum follow-up was 34.36 mm with re-ankylosis in no case. Cephalometric parameters showed increase in point P to Pog, decrease in N perpendicular to Pog, angle N-A-Pog, Cg-ANS to Cg-Menton, neck-chin angle and labiomental angle. N-PAS increased, and average 50% improvement in AHI was seen in all patients with OSA. Most common complications involved transient paraesthesia of temporal and zygomatic branches of facial nerve. CONCLUSION: Based on the findings of the above study, we propose treatment guidelines for treatment of TMJ ankylosis in adult patients with AHI < 20.

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AIM: The purpose of this study was to evaluate the use of buccal fat pad-derived stem cells (BFPSCs) as a source for full thickness bone defect repair secondary to pathology in maxilla or mandible. METHODS: Fat-derived stem cells were isolated from buccal fat pad, differentiated into osteocytes in osteogenic medium, and seeded onto human bone defects. Autologous buccal fat pad was harvested and BFPSCs cultured within 4-6 weeks. Bone defects secondary to enucleation of pathologic cyst or tumors were reconstructed with osteogenically differentiated fat-derived stem cells. Hematoxylin and eosin staining, immunohistochemical staining for osteocalcin, alkaline phosphatase and genotypic and phenotypic marker analysis, and histomorphometric measurements of new bone were performed. RESULTS: Maxillofacial bone defects were successfully reconstructed by BFPSCs, which after implantation at an in vivo site yielded faster osseous regeneration. BFPSCs were associated with superior bone density formation, better blending of margins with enhanced bone trabecular formation, well-organized and well-vascularized lamellar bone with Haversian channels and osteocytes resulting in superior functional and cosmetic results with better quality of life and with significant decrease in secondary complications. CONCLUSION: Buccal fat pad is an ideal tool in the hands of an oral and maxillofacial surgeon for tissue engineering and clinical use requiring bone tissue growth and repair, secondary to large osseous defects. This study demonstrates the feasibility of reconstructing bony defects with fat-derived stem cells.

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AIMS: The study intends to evaluate the clinical outcome of treating young patients of unicystic ameloblastoma, by various conservative treatment modalities such as marsupialization, enucleation with bone curettage and aid in establishing sound treatment guidelines. MATERIALS AND METHODS: A case series of fifteen patients is presented of unicystic ameloblastoma, who presented to our Department over the past 6 years (2010-2015) and conservative method of treatment elected in all the patients. Also, a methodical literature review of studies discussing treatment of unicystic ameloblastoma in young age group (<20 years) patients over the last 15 years from 2001 to 2015 is added. RESULTS: Faster osseous regeneration after conservative treatment was noted, owing to the young age and growth potential. Over a mean follow-up of 4 years, uneventful secondary healing, no clinical or radiographic evidence of recurrence and no apparent deformity were noted in any of the cases. CONCLUSION: Unicystic ameloblastoma is a benign, locally invasive odontogenic neoplasm of young age which can develop during the stage of tooth formation and hence its early inception and vast proliferation is not uncommon in this age group, due to which it can grow into a huge lesion causing significant morbidity. Conservative surgical management may be a viable option to reduce morbidity and increase the probability of uneventful secondary healing and bone regeneration in the younger population.

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Cystic hygroma is a benign congenital malformation of the lymphatic system that occurs in infant or children younger than 2 years of age. Although cystic hygroma is well recognized in pediatric practice, it seldom presents de novo in adulthood. These are commonly present in head and neck but can be present anywhere. Cystic hygroma is very rare in adults, but it should be considered in the differential diagnosis of adult neck swellings. Patients presenting with a painless, soft, fluctuant, and enlarging neck mass should have a careful history and physical examination along with radiological imaging to assist with diagnosis. Surgical intervention is the treatment of choice for this rare condition. Here, we are reporting a case of cystic hygroma in a 32-year-old male patient in the neck region. The objectives of this case report are to discuss the clinical presentation, diagnosis, histopathological findings and management of this malformation.

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Ameloblastoma is the most common aggressive benign odontogenic tumour of the jaws and has received considerable attention due to its frequency, clinical subtypes and high tendency to infiltrate and recur. There are various types of this tumour and confusion still exists among clinicians as to its correct classification. Multicystic ameloblastoma is the most frequent subtype while unicystic ameloblastoma can be considered a variant of the solid or multicystic subtype. Unicystic ameloblastoma is considered a less aggressive tumour with a variable recurrence rate. However, its frequency is often underestimated. Ameloblastoma is often asymptomatic, presenting as a slowly enlarging facial swelling or an incidental finding on radiograph. It is seen in all age groups but is most commonly diagnosed in the third and fourth decades. We report a case of unusual unicystic ameloblastoma and present its clinical, radiological and full-blown histological changes and treatment modalities, providing new insights into ameloblastomas.

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A glandular odontogenic cyst (GOC) is a developmental cyst that is a clinically rare and histopathologically unusual type of odontogenic cyst. GOCs are now relatively well-known entities; their importance relates to the fact that they exhibit a propensity for recurrence rates from 21% to 55%, similar to odontogenic keratocysts, and may be confused microscopically with central mucoepidermoid carcinoma. Furthermore, some microscopic features of GOCs may also be found in dentigerous, botryoid, radicular and surgical ciliated cysts. The present case report aims to describe a typical case of GOC, throwing light on its epidemiology and origin, as well as on its clinical, radiographic and microscopic features, which may be helpful for diagnosis in problematic cases, long-term follow-up and to determine the most appropriate treatment.

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Gorlin-Goltz syndrome, also known as nevoid basal cell carcinoma syndrome, is caused by genetic alteration produced by a mutation in the 'patched' tumour suppressor gene, and is inherited in a dominant autosomal way. Although sporadic cases have been found, this syndrome has rarely been reported in twin patients. The syndrome is characterised by a wide range of developmental abnormalities and has a predisposition to neoplasms such as multiple pigmented basal cell carcinomas and keratocysts in jaws; it also has other features such as palmar and/or plantar pits and calcification of falx cerebri. Owing to the critical oral and maxillofacial manifestations of this syndrome, it is important to recognise its characteristics in order to make a diagnosis, and to plot early preventive treatment and establish the right genetic evidence. Based on a combination of imaging, clinical and histopathological findings, we present a diagnosed case of Gorlin-Goltz syndrome in 18-year-old twin brothers. All cystic lesions were enucleated and 1 year follow-up showed no recurrence.

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