National journal of maxillofacial surgery最新文献

Odontoma is a benign mixed odontogenic tumor. Odontoma is classified into two variants: compound odontoma, which has resemblance to the tooth structure, and complex odontoma, which consists of haphazardly arranged enamel and dentin bearing no resemblance to the tooth structure. The most common site of occurrence of complex odontoma is the posterior aspect of mandible. Surgical excision of the complex odontoma remains the mainstay of treatment, which seldom recurs. Here, we report a series of complex odontoma cases reported to our institute that were managed by surgical excision with no signs of recurrence in subsequent follow-up appointments.

An arteriovenous malformation (AVM) is an infrequent congenital vascular anomaly that can affect the vasculature and involve the endothelium and neighboring cells of any anatomical structure. AVMs are characterized histologically by abnormal AV shunts with atypical interconnecting capillary beds. AVM can cause functional and esthetic issues like face asymmetry, pain, osteolytic changes, and unanticipated hemorrhage or squeeze and tear of the surrounding tissue without causing any symptoms. The literature search yielded limited case reports on AVMs in the facial region. Insufficient diagnosis, limited knowledge, and a lack of literature can lead to severe bleeding and potentially fatal hemorrhagic incidents following dental procedures like tooth extraction, surgery, puncture wounds, or blunt injuries in the affected area. In this manuscript, we report a case of AV malformation involving the left cheek and buccal mucosa region in a 37-year-old male patient who reported uncontrolled bleeding after trauma. This report highlights the management of AV malformation in an emergency by facial artery ligation and surgical excision.

Background and purpose: The zygomatic arch is important to maintain facial projection as well as width. Hence, restitution of its form by open reduction and internal fixation (ORIF) is indicated following its fracture, in certain clinical scenarios. The contemporary surgical approaches are cutaneous with associated complications. This observational clinical trial was designed to evaluate intraoral reduction and transbuccal fixation of zygomatic arch fractures.

Materials and method: Six patients requiring ORIF of the zygomatic arch were recruited for the study. The clinical parameters such as pain, swelling, mouth opening, facial nerve function, and scar were assessed in the pre-operative as well as post-operative period. Radiographic assessment of displacement and inter-fragmentary separation were studied on computed tomography (CT) images.

Results: Mean pre-operative mouth opening was increased from 28.33 ± 6.80 to 36.83 ± 1.94 (P value 0.03). Mean pre-operative swelling was decreased from 34.63 ± 5.41 to 29.71 ± 2.73 (P value 0.02). The pain decreased by day 7 in all the patients (P value 0.01). No facial nerve injury (P value 1) or scar formation (P value 0.002) was encountered in our study. The inter-fragmentary separation as assessed by CT analysis revealed satisfactory outcome.

Conclusion: Intraoral open reduction and transbuccal fixation is a simple, effective, and less invasive method to address zygomatic arch fractures with no complications.

Objectives: The objective of this study was to find the prevalence of agenesis of third molar among the younger population of India.

Materials and methods: A cross-sectional study was conducted, and a younger population (13-21 years) born in the twenty-first century were included. Individuals who required an orthopantomogram, for any reason, were recruited in the study.

Results: A total number of 850 orthopantomograms were studied, and 298 (35.05%) individuals showed the agenesis of at least 1 or more third molars. The most common pattern of agenesis was the missing of both maxillary third molars, followed by the agenesis of all third molars. The frequency of agenesis was 18 >28 >48 >38. The study showed a significant predilection in the maxilla as compared to the mandible. There was no statistically significant gender predilection for agenesis of third molar.

Conclusion: The prevalence of third molar agenesis is increasing rapidly with time, with no significant gender predilection and changing trends of patterns of agenesis.

Context: Human dental pulp stem cells (hDPSC) derived from dental pulp in conducive environment activated by chemicals can enhance chondrogenic cells for future animal model temporomandibular joint model.

Aim: The study aims at evaluating the chemicals preconditioning (curcumin and rapamycin) efficacy toward chondrogenic proliferation of human dental pulp stem cells.

Settings and design: The in vitro study model with 10 premolar teeth extirpated pulp was processed under sterile chemical conditions. The cells viability was checked with calorimetric assay for adipogenic and chondrogenic, osteogenic lineages. The viability of the cells and the concentration of curcumin (CU) and rapamycin (RP) required for cell differentiation toward chondrogenic lineage were assessed.

Material and methods: The hDPSC was evaluated after explant long-term cultivation with characterization and chemical conditioning with dimethyl sulfoxide (DMSO) as control. MTT assay was used for cytotoxicity evaluation, cell viability, and proliferation. The dose optimization was observed with RP and CU. Chondrogenic proliferation was assessed with standard staining method of 0.1% Safranin O and 0.1% Alcian blue.

Statistical design: The flow cytometry analysis revealed good results for CD 90 compared to others. The intergroup analysis was done by ANOVA, and intragroup analysis was done by Post hoc Tukey's test. The intragroup analysis showed P value < 0.05 for RP in comparison between the various preconditioning agents CU and RP. The dosage of 10 µg/ml RP was considered statistically significant.

Results: The flow cytometer analysis revealed good results for CD 90 compared to other surface markers. The dosage of 10 µg/ml RP was having good chondrogenic cell proliferation. The intragroup analysis showed P value < 0.05 for RP in comparison between the various preconditioning agents CU and RP. The calorimetric assay (MTT) quantitative analysis of the chondrogenic cells with Safranin O stain the standard deviation (SD = 0.017 for rapamycin), Alcian blue (SD = 0.49 for RP) in comparison to DMSO (control) and CU.

Conclusion: RP activates mTOR pathway and hence stabilizes the stem cell maintenance of human dental pulp stem cell and the dose quantified can be used for future animal temporomandibular joint animal model.

Angiosarcomas are rare, accounting for only 1-2% of sarcomas in the head and neck region. We present an extremely rare case of primary non-radiation-induced angiosarcoma of the parotid with epithelioid morphology which required a tertiary center second opinion for its histological characteristics. We discuss the presentation, imaging, diagnosis, characteristics, and pathway of this case. As parotid lumps are common, a surgical sieve is required to rule out other possible conditions. Early correct diagnosis is crucial in conditions such as angiosarcomas due to their quick metastatic potential.

Background: Radiotherapy is considered an essential treatment modality in cancers, especially head and neck cancers. Radiotherapy can be given as a definitive, supportive, or adjuvant therapy for various cancers. Radiation damage is an avoidable complication in many patients, after or during radiotherapy. It may be either dose-related, duration-related, or frequency-related. The effects of radiation damage are mainly caused by ischemic necrosis, and once settled it is difficult to manage due to the low vascularity of the affected area.

Aim: To find out the effectiveness of hyperbaric oxygen therapy (HBOT) in the management of radiation damage in the head and neck region.

Materials and methods: Retrospective data of patients attending the HBOT clinic for postradiotherapy changes were recorded in an Excel sheet and analyzed in this study. Statistical analysis was done.

Result: Our study showed that HBOT is effective in postradiation trismus, xerostomia, discharge, foul smell, discharging sinus, etc., However, it was not found to be significant in the closure of fistula with exposed bone.

Conclusion: HBOT is an effective adjunct modality for the management of postradiation changes in the head and neck region.

Objectives: To determine age- and sex-related changes in mastoid air cells volume in orthodontic malocclusions (class 1, class 2, class 3) in cone beam computed tomography (CBCT), morphometric analysis, and age prediction on the basis of mastoid air cells.

Methods: In total, 150 3D CBCT scans of study subjects having class 1, class 2, and class 3 malocclusions have been analyzed retrospectively for the estimation of volume of mastoid air cells by Dolphin imaging software V11.9, and measurement data of volumes have been recorded and analyzed using SPSS software 24.v.

Results: The volume of mastoid air cells was highest in age group of 14-28 years which was statistically not significant (P value >.05). The volume of mastoid air cells in the right side of cranium is greater than mastoid air cells in the left side. The mastoid air cell volume was higher in males than females. The volume of mastoid air cells (right side) was highest in class II malocclusion (2404.53 ± 1737.50 mm³) followed by class III and was least in class I malocclusion (1842.09 ± 1263.78 mm³). However, the volume of mastoid air cells in the left side was highest in class III malocclusion (2368.03 ± 1853.00 mm³) followed by class II and was least in class I (1920.52 ± 1285.34 mm³).

Conclusions: The volume of mastoid air cells varies in different class of orthodontic malocclusions. The mastoid air cells volume is higher in males than females. On the basis of mastoid air cells volume, we are able to predict the age, sex, and class of orthodontic malocclusion.

Background: Chronic periodontitis is a multifactorial disease that causes the supporting tissues around the teeth to become inflamed and destroyed, which further causes tooth mobility and eventual tooth loss. The enzyme alkaline phosphatase (ALP), which is involved in bone resorption and gingival inflammation, is an important biomarker. The current study's objective is to compare the serum, gingival crevicular fluid (GCF), and salivary levels of ALP in individuals with chronic periodontitis before and after nonsurgical periodontal therapy.

Materials and methods: On the basis of clinical and radiographic examinations, 72 participants were split into two groups: Group I (healthy individuals) and Group II (chronic periodontitis patients). All patients who were in an aseptic condition had their serum, GCF, and unstimulated saliva taken, and samples were then tested for ALP levels using ALP kit.

Results: The difference in salivary, serum, and GCF ALP levels between the control group (23.44 ± 4.76, 58.88 ± 8.29, and 776.76 ± 121.91) and the study group (105.66 ± 16.33, 102.38 ± 4.43, and 1,825.77 ± 275.12) was found to be statistically significant with P < 0.001. The difference in salivary, serum, and GCF ALP levels from baseline (105.66 ± 16.33, 102.38 ± 4.43, and 1,825.77 ± 275.12) to postoperative (49.54 ± 5.69, 83.46 ± 4.22, and 1,148.38 ± 129.01) was found to be statistically significant with P < 0.001. The results demonstrated that patients with chronic periodontitis have considerably higher levels of serum, GCF, and salivary ALP than healthy individuals.

Conclusion: Salivary and GCF ALP can thus be used as a key inflammatory diagnostic biomarker in periodontal diseases.