National journal of maxillofacial surgery最新文献

Aim: To evaluate and compare analgesic effect of transdermal Diclofenac patch and oral Diclofenac tablet post-orthodontic extraction.

Materials and method: This study was carried out by the Department of Oral and Maxillofacial Surgery, K M Shah Dental College and Hospital. Thirty-two young pre-orthodontic patients requiring bilateral maxillary and mandibular first premolar extractions were selected for the study. The right maxillary and mandibular first premolars were extracted first and 50 mg oral Diclofenac sodium tablets were prescribed to be taken thrice a day for three days. In the next appointment, the contralateral first premolars were extracted and a 100-mg transdermal Diclofenac patch was applied once a day for three days. Pain relief and pain intensity with both the Diclofenac formulations were recorded for each of the three postoperative days using 5-point verbal pain intensity and pain relief score charts. The patients were evaluated on the day of extraction, one day after extraction and two days after extraction.

Results: Statistical analyses revealed that there was a gradual increase in pain relief scores and a gradual decrease in pain intensity scores with the use of oral Diclofenac tablets as well as with the transdermal patch. However, patients reported that they were more comfortable using the transdermal patch particularly due to the once-a-day application and lesser frequency of systemic adverse effects.

Conclusion: Transdermal Diclofenac patch provides as potent analgesia as the oral Diclofenac tablets with the added advantage of better patient compliance and may be used for routine post-extraction analgesia.

Objectives: Titanium (Ti) has been used as the main biomaterial for implant devices reason being good physical-chemical properties and favorable biocompatibility with host tissues. However, on exposure to the external environment for example the oral cavity, implants show biofilm formation and microbial adhesion that leads to infection. The objective of this in vitro study was to investigate the influence of tantalum thin-film coating on microbial adherence on CP titanium grade 4 and Ti6Al4V grade 5 alloy against S. aureus and C. albicans.

Material and method: CP titanium Grade 4 and Ti-based alloy Grade 5 (control samples) and tantalum-coated Cp titanium Grade 4 and Ti-based alloy Grade 5 (test samples). Samples were tested for adhesion of S. aureus and C. albicans. The quantity and metabolic activity of biofilm obtained was measured by CV assay and MTT assay. Statistical analysis was performed. Biofilm structure was visualized with a scanning electron microscope.

Results: Statistically significant results were obtained for C. albicans and S. aureus biofilm formation evaluated at 48 h for the amount of bacterial and fungal growth on coated (test) samples as compared to uncoated (control) samples for both CPTi grade 4 group as well as grade 5 Ti alloy. SEM images further confirmed these results.

Conclusion: This study concluded that surface modification of dental implant material (CPTi grade 4 group and grade 5 Ti alloy) with tantalum can influence the growth of Staphylococcus aureus and Candida albicans. Tantalum coated Titanium surface has shown a significant reduction in growth of these pathogens indicating enhanced antimicrobial activity.

Objectives: The aim of this work is to evaluate the possibility that the three-dimensional (3D) reconstruction of a cone beam computed tomography (CBCT) scan may facilitate the technical planning of the surgical extraction of third molars, whose roots are located in proximity of or in contact with the inferior alveolar nerve.

Materials and methods: This article describes the planning process and the extraction of a lower third molar with the inferior alveolar nerve (IAN) entrapped through its roots using the 3D reconstruction of a CBCT scan.

Results: After-surgery clinical examinations showed normal healing of the surgical wound and no neurological symptoms.

Conclusions: The 3D reprocessing of a CBCT allows the construction of a computer-aided design model to investigate the spatial relationships between the wisdom tooth and the IAN. This method makes it possible to reconstruct a virtual model to preview the tooth and its spatial relationships, simplifying the mental processes of reworking and analyzing the existing relationships in the area, an important aid, especially in cases that are difficult to diagnose with a first-level examination. Indeed, it helps in reducing the risk of intra-operative injury to the nerve during extraction procedures.

Introduction: Head and neck cancer ablation results in challenging defects with complex reconstructive needs. The type of reconstruction depends on the nature, site, and size of the defect. Facial artery Musculomucosal (FAMM) flap reconstruction has emerged as a versatile option in a variety of small and medium-sized oral and oropharyngeal defects. We describe our experience reconstructing 12 intraoral defects with FAMM flap following resection for benign or malignant disease, with some having their surgery during the early Covid 19 pandemic.

Materials and methods: We examined patient demographics, diagnosis, site, TNM staging, type of FAMM flap, associated functional/cosmetic outcomes, oncological resection margins and adjuvant treatment.

Results: Most patients (75%) had Squamous cell carcinoma, with the palate (41.6%) being the most common site. Inferiorly based FAMM flaps (91.7%) were used in the majority. Clinically, T1 and T2 tumours (91.7%) were the most common. 91.7% had resumed normal dietary function; 83.4% had fully intelligible speech as assessed by the speech and language therapist; and 91.7% had aesthetically pleasing outcomes. 81.8% had clear resection margins. Two patients developed small residual oroantral fistulae requiring repair.

Conclusion: The FAMM flap is a reliable option for reconstructing small to medium-sized oral defects with several advantages and excellent functional and cosmetic outcomes.

Purpose: To understand the viewpoint of the patients who already underwent corrective jaw surgery in order to ascertain whether the clinicians are justified pertaining to their diagnosis and treatment planning of patients with dentofacial deformities.

Materials and method: In order to conduct this study, a predetermined questionnaire was designed to comprehend the thought process of patients who were already subjected to corrective jaw surgery in various surgical centers belonging to various states of south India. One hundred and thirty-six patients were enrolled in the survey. Demographic information, educational qualification, primary reason for undergoing corrective jaw surgery, whether they were convinced with the surgical treatment plan offered to them by the clinician following thorough evaluation, whether they were willing to proceed with a staged surgical treatment plan if offered, and whether they prefer a simple chair-side facial analysis which is time-consuming yet effective or advanced and sophisticated technology that can predict the surgical outcome were evaluated.

Results: It was observed that among the patients who underwent corrective jaw surgery, nearly 62% had both esthetic and functional concerns, while 27% had esthetic concerns and only 11% had functional concerns. The patients with esthetic concerns primarily had apprehensions pertaining to their lips and chin region followed by the jaws, while the functional concerns were primarily with regard to difficulty in chewing. It was observed that 77% of the patients with dentofacial deformity were willing for a staged surgical treatment plan for an optimal clinical outcome. Only 58% of patients felt that the investigations performed on them were sufficient to provide a proper treatment plan and an optimal clinical outcome, while 36% were unaware. It was noticed that 68% of the patients preferred a simple chair-side facial analysis over an advanced and sophisticated technology that can predict the clinical outcome.

Conclusion: On the basis of the inferences obtained from this study, it is wise to recommend that all the esthetic units of the face need to be taken into account while assessing the esthetics of a human face and not merely the relationships of the jaws. It can now be concluded based on the results obtained from this study that when one accomplishes a corrective jaw surgery purely constructed on the norms of the cephalometric analysis and data obtained from three-dimensional (3D) software solutions, it can inevitably fail to address few imperfections of the face. Therefore, for the diagnosis and planning treatment of dentofacial deformity patients, cephalometric analysis and 3D software solutions can only be used as an adjunctive diagnostic tools and clinical judgment needs to be given greater emphasis.

Aim: The aim of this study was to evaluate and compare the management of abrasions of the maxillofacial region by chitosan and hydrocolloid dressing materials.

Materials and methods: The study was carried out by the Department of Maxillofacial Surgery, KMSDCH. The sample size of the study was 70 patients which were divided into two groups: Group A was the Chitosan group and Group B was Hydrocolloid Dressing. The abrasion site was cleaned, and the dressing was given. The parameters of assessment were the rate of wound healing and Bates-Jensen Wound Assessment.

Results: The rates of wound healing for chitosan and hydrocolloid were 9 days and 14 days, respectively. The Bates-Jensen Scores for Wound Assessment for chitosan and hydrocolloid were similar.

Conclusion: The chitosan dressing showed a faster rate of wound healing than hydrocolloid-based dressing.

Pediatric patients with missing tooth pose a challenge to a dental clinician for the effective, functional, esthetic, and durable restoration and rehabilitation. There is a range of various prosthetic treatment options for such a dental condition, such as removable or fixed prosthesis. However, these prostheses are not much clinically effective, efficient, and durable and show low compliance, particularly in pediatric patients. In recent decades, dental implants have emerged as a boon for dentistry. Implants are superior in terms of functions, esthetics, durability, and compliance in adult patients than removable or fixed prosthesis. However, literature reveals that implants in pediatric patients (adolescents) have certain limitations/drawbacks, particularly dental occlusion problems (i.e., infraocclusion), which are due to the active growth phase of the bone and ankylosis of the implant. It is imperative to address the dental occlusion-related problems of implants in growing pediatric patients for achieving clinical success in adulthood phase when growth of the maxillofacial region ceases. Hence, this comprehensive and critical review has been conducted with the aim to explore the dental literature about the possible solutions (approaches/techniques) for the effective management of implant failure in growing pediatric patients. This review article will aid dental professionals including implantologists and pediatric dentists to consider the use of dental implants in adolescent pediatric patients for prosthetic rehabilitation. This article aims to review the relevant literature and highlight the possible ways (techniques) to manage the manifestations of implant failure after growth cessation.

Introduction: Cleft lip and palate (CLP) is one of the most common congenital malformations occurring in the craniofacial region. Causes of CLP can be attributed to the genetics and environmental factors. Potential advantages of prenatal diagnosis of oral cleft include psycho-social preparation, opportunity for parent education, planned neonatal care, anticipation on possible feeding problems, and increased reproductive awareness. Dermatoglyphic analysis and cheiloscopic analysis are now beginning to prove themselves as an extremely useful tool for preliminary investigations into conditions with a suspected genetic basis.

Materials and methods: The study consisted of two groups of 45 parents and siblings each of cleft lip with/without palate, CL (P)-affected children (group A) and normal children (group B). The study aimed to evaluate the inheritance of cleft lip and palate in North Indian patients using dermatoglyphics and cheiloscopy. Prints of all ten fingers were taken by the Ink method and recorded on white paper. Lip patterns were obtained by direct photography of the subjects in the natural head position.

Results: Increased inter-digital asymmetry (with an increased score) was seen in mothers and fathers of group A. The loop pattern was seen more in the mothers, fathers, and siblings of group A. The Type O pattern was seen only in group A in only the fathers and mothers.

Conclusion: A highly significant correlation was observed in finger prints and lip patterns in parents with CL (P)-affected children and hence can prove to be an extremely useful screening tool for CL(P) and other associated genetic anomalies.

Introduction: The study aimed to evaluate the role of I-PRF in treating temporomandibular joint (TMJ) internal derangements with the primary objective being improvement in maximum interincisal opening and Helkimo clinical dysfunction score (HCDS), and secondary objective as identifying any side effects.

Material and methods: The study involved 34 patients with MRI confirmed TMJ internal derangements (Wilkes 3-5). Injectable platelet-rich fibrin injected into TMJ (maximum 2 ml), one injection every week for 3 weeks. Total 3 injections were given to each affected TMJ. After total 3 injections, the patients were assessed for maximum interincisal opening, Helkimo Clinical Dysfunction Score (Range of movement, TMJ function, muscle pain, TMJ pain, pain on movement of mandible), and complications on 10^th day, 1 month, and 3 months postoperatively as the dependant variable. The results obtained were tabulated and compared with the inferential analysis.

Results: Statistically significant differences were observed with respect to maximum interincisal opening and Helkimo Clinical Dysfunction Score at the end of 10^th day, 1 month, and 3 months postoperatively. No major complications were reported during the study; 11 patients had transient edema immediately following I-PRF injections which resolved itself, 1 patient had an episode of syncope during the 2^nd injection and 4 patients had transient facial nerve palsy during auriculotemporal nerve block which again resolved on itself.

Conclusion: Our study also agreed with the previous literature and concluded that injectable platelet-rich fibrin has significant clinical efficacy in improving Helkimo clinical dysfunction score and maximum interincisal opening in patients suffering from internal derangements. Hence, it can be a potent treatment modality for patients with internal disk derangements.