National journal of maxillofacial surgery最新文献

Aim: To compare the impact of submucosal dexamethasone (4 mg) administered after the onset of local anesthesia on postoperative discomfort after third molar surgery and compare the parameters with a control group that did not receive the drug.

Methods: A total of 60 patients indicated for surgical removal of impacted mandibular third molars (mesioangular, Class II or III, and position B or C) were randomly divided into two groups of 30 patients each. After the onset of local anesthesia, the first group (Group A) received a submucosal injection of 4 mg dexamethasone adjacent to the surgical site, and the control group (Group B) received no drug. Pain, swelling, and trismus were recorded at follow-up visits on the 1^st, 2^nd, and 7^th postoperative days. Assessment of postoperative discomfort was performed by evaluating responses through a modified postoperative symptom severity scale questionnaire, which was administered to the patients on the 7^th postoperative day.

Results: The difference in subjective pain values and the mean number of analgesics consumed was not significant between the groups. The difference in postoperative swelling was statistically significant on the 1^st, 2^nd (P < 0.0001), and 7^th postoperative days (P = 0.0152). The difference in postoperative trismus was highly significant on 1^st and 2^nd postoperative days (P < 0.0001). The difference in the mean total quality of life (QOL) score, Eating, Appearance, Daily activity subscale (P < 0.0001), and Social Isolation subscale (P = 0.0002) was statistically significant between both groups.

Conclusion: It was found that the administration of submucosal dexamethasone resulted in significantly lesser postoperative swelling and trismus and better QOL outcomes.

Introduction: Maxillofacial injuries in children and adolescents always present a challenge due to the peculiar facial anatomy in children. This study aimed to determine the characteristics and pattern of traumatic maxillofacial injuries in children and adolescents reported to outpatient departments of two tertiary care health centers.

Materials and methods: Present study had a retrospective design, and the hospital records of all children and adolescent patients aged between 0 and 18 years, who had undergone maxillofacial fractures and were admitted for the same to two tertiary care health centers between January 2012 and May 2022 were reviewed.

Results: 77 patients suffered maxillofacial trauma with 115 fractures. The leading cause of maxillofacial trauma in the study was found to be road traffic accidents (RTA) followed by falls and sports-related injuries. Maxillofacial trauma was observed more in boys than girls, with an M: F ratio of 3.8:1. Out of 77 patients in the present study, more than half (51.9%) suffered maxillofacial trauma involving the lower one-third of the face, followed by the middle third (45.5%) and upper third (2.6%). A total of 11 patients (14.2%) were treated within 24 hr of sustaining injury. The majority of the patients, (n = 68; 88.3%) underwent open reduction and rigid internal fixation (ORIF), while 9 patients (11.7%) underwent closed reduction.

Conclusions: Pediatric maxillofacial trauma was mainly attributed to road traffic accidents. Lower one-third of faces were more commonly affected and an increasing trend of maxillofacial trauma was observed with age.

Introduction: Cosmesis is the primary concern for the patient undergoing facial surgery and there are numbers of well proven materials that are available such as adhesive tapes, subcuticular suture, skin adhesive or glue to achieve better cosmesis. The objective of our study was to assess the surgical outcome of sutureless skin closures using Octyl-2-cyanoacrylate (Dermabond™) versus Steri-Strip™.

Method: The present prospective study was conducted in 20 patients. Patients were divided into two groups. After subcutaneous closure of wounds, either Dermabond™ or Steri-Strip™ was placed. The patients were assessed for wound complication (erythema, tenderness, dehiscence or any discharge), scar hypertrophy and cosmetic appearance also time consumed in surgical skin closure was evaluated. Wound assessment, scar hypertrophy and cosmetic appearance were assessed by using Chi-square test. Time closure was assessed by using Mann-whitney U test.

Result: Twenty patients belonging to all age group were included in study. Ten patients undergone closure with Dermabond™ and ten with Steri-Strips™. Assessment of wound complications, cosmetic appearance and scar hypertrophy was done. There was no significant difference found between both the groups, but 2 patients had fair cosmetic outcomes at one month and 1 patient had fair scar hypertrophy at 6 month. However, excellent cosmetic outcome in terms of scar hypertrophy at 6 month was significantly more among group II.

Conclusion: Octyl-2-cyanoacrylate (Dermabond™) and Steri-Strip™ provide similar outcomes in terms of wound complications. Cosmetic outcomes in terms of scar hypertrophy with steri-strip wound closure seem to be better and more economical.

Aim: To assess and compare the outcomes of the cutaneous neck dissection incisions taken by Colorado microdissection needle, surgical blade and cutting electrocautery in patients with oral squamous cell carcinoma.

Materials and methods: A prospective, randomized control, comparative study was carried out on 21 patients. These patients were divided into 3 groups containing 7 patients in each group. The intra operative and post operative outcomes were evaluated. Statistical analysis was done by using descriptive and inferential statistics using Chisquare test, Fisher's Exact Test, one way ANOVA and multiple comparison Tukey Test and software used in the analysis were SPSS 27.0 version and GraphPad Prism 7.0 version and P < 0.05 is considered as level of significance.

Results: The time taken for placing cutaneous skin incision and blood loss was more in the surgical blade group as compared to the Colorado microdissection needle and electrocautery. Statistically no significant difference between the three group while comparing the cutaneous neck incision healing and post operative scar formation.

Conclusion: This study proves the superiority of the Colorado microdissection needle in terms of time taken and blood loss with similar aesthetic outcome in terms of cutaneous wound healing and post operative scar formation when compared to surgical blade and cutting electrocautery.

Congenital nasal pyriform aperture stenosis is a newly defined clinical entity that causes nasal airway obstruction in neonates due to the narrowing of the pyriform aperture, which is the narrowest and most anterior portion of the nasal airway. As newborns are obligate nasal breathers except when crying, a child with bilateral nasal pyriform aperture obstruction presents as an acute airway emergency, resulting in apnea and cyanosis. This entity should be kept in the differential diagnosis of any neonate or infant presenting with signs and symptoms of upper airway obstruction.

Introduction: Pelvis, long bones, and skull are good indicators of sexual dimorphism. In the skull, the supraorbital region is considered a highly sexually dimorphic part. Thus, the present study aimed to analyze the sexual dimorphism of Brazilian adult dry skulls using conventional and geometric morphometry.

Materials and methods: Conventional morphometry was performed on 179 skulls, through the analysis of six linear measurements. For geometric morphometry, 89 skulls (right side) were selected and seven landmarks were considered. Generalized procrustes analysis, principal component analysis, and linear discriminant analysis were then carried out.

Results: All linear measurements presented differences between both sexes. Geometric morphometry showed that 77.05% of the sample variation could be explained by the first three principal components. Moreover, considering the centroid size, there was a difference in shape between the sexes. Geometric morphometry classified sex correctly in 77.32% of the skulls and conventional morphometry from 60.89% to 73.74%.

Conclusions: According to the analyses, the supraorbital region presents significant sexual dimorphism in Brazilian adult dry skulls. Moreover, it can be analyzed efficiently by both conventional and geometric morphometry, although the latter seems to be slightly more accurate.

Aim: Aim of this study was to evaluate the presence of antilingula and its relationship with mandibular foramen.

Materials and methods: In this study, a total of 50 specimens of dry human hemi-mandibles were studied to analyze the presence and relationship of antilingula to mandibular foramen. A 1-mm fissure bur was used to drill a hole perpendicular to bone from the deepest aspect of the concavity at the center of the mandibular foramen from the medial to lateral side, the drill perforated both the medial and lateral cortex of the mandible. The distance from the antilingula to hole was measured and recorded in both antero-posterior and supero-inferior planes. The data were collected and put to statistical analysis.

Results: From this study, it was concluded that the antilingula was present in 90% (n = 45) of mandibles and was absent in 10% (n = 5) of mandibles. Antero-posteriorly, the antilingula was present anterior to mandibular foramen in 22.2% (n = 10) of mandibles, posteriorly in 57.7% (n = 26) of mandibles, and there was complete concordance in 20% (n = 9) of mandibles. The supero-inferior relation shows that antilingula was present superior to mandibular foramen in 97.8% (n = 44) of mandibles, and it was present inferiorly in 2.20 (n = 1) of mandibles.

Conclusion: Although vertical ramus osteotomy is not a commonly used procedure in these days. From our study, it was concluded that antilingula was present as an elevation in 90% of cases on the lateral ramus border and the mandibular foramen is present inferior and anterior to the antilingula.

Calcium sulphate (plaster of Paris) has been used since 1892 to fill bone defects and as a good bone graft substitute. Calcium sulphate is an osteoconductive, inorganic substance. Following 75 years, many other authors reported variable and a better result in grafting of bone defects and in several cases of immediate and delayed dental implants for good osseointegrations, with no complications attributed to the calcium sulphate. Early results were variable, because of its conflicting crystalline structure, purity, and quality of the calcium sulphate. Apart from this, calcium sulphate also shows predictable resorption rate in vivo, presence of minimal trace elements and extremely uniform crystalline structure. Calcium sulphate is a bio-inert material and get resorbed over a period of weeks and fibrovascular tissue takes its place which eventually allows neovascularization and bone formation within the area. Use During the conventional surgical treatment addition of calcium sulphate as a bone graft of in case of placement of dental implants and pathological bony defects it improves the clinical outcome. Calcium sulphate also act as a barrier and filling material for the treatment of "through and through" bony lesions. Use of calcium sulphate as a bone graft substitute avoids the complications and morbidity associated with autograft like infection, second surgery.

Oral mucormycosis mainly involves the maxilla, although it can also affect other areas of the oral cavity. Mucormycosis infection involving the maxilla spreads rapidly leading to the palatal perforation and necrosis of the bone, which eventually leads to intraoral communication between the oral and nasal cavities leading to difficulty in speech, deglutition, and mastication. Although surgical reconstruction is the best treatment modality, reconstruction of large defects still remains questionable, so prosthodontic rehabilitation of such patients restores normal functioning, enhances aesthetics, and boosts the confidence of the patient. This case presentation describes the amalgam of both conventional and digital techniques to bring out an economical and effective possible treatment modality for the rehabilitation of such patients. This case report entails the usage of a digitally fabricated precision attachment retained definitive prosthesis as a simple and effective approach to restore the acquired maxillary defect following mucormycosis.

Background: In Modern dentistry, the implant is the most popular and desirable management of tooth loss. Traditionally two stage (submerged) or one-stage (non-submerged) system has been added by many investigators. In the present study we evaluated the crestal bone loss during osseointegration phase among the three groups (i.e. submerged implants, non-submerged implants with anatomical healing abutment and non- submerged implants with esthetic healing abutment).

Material and methods: 10 subjects with 30 implants, were enrolled in the study. Subjects were randomized in three groups i.e., group 1 submerged (n=10), group 2 non-submerged with anatomical healing abutment (n=10), group 3 non submerged with esthetic healing abutments (n=10). Intraoral periapical radiograph (IOPA), IMAGE J software and CBCT were used to evaluate the crestal bone loss around each implant at baseline, 1 and 3 months after implant placement.

Results: Crestal bone loss at the end of the 3months (osseointegration phase) was lowest in the submerged group (0.18+-0.06mm) followed by non-submerged esthetic group (0.21+-0.03mm) but it was statistically insignificant. Maximum amount of bone loss was observed in non-submerged anatomical abutment group (0.34+-0.03mm) which was highly significant.

Conclusion: It can be concluded that submerged implants technique is a better option in comparison to non-submerged implant technique in terms of radiographical performance during initial phases of osseointegration.