Journal of Maxillofacial & Oral Surgery最新文献

Background and aim: Therapeutic surgical exposure and placing a bracket on the impacted tooth is an approach which involves both maxillofacial surgeon and an orthodontist. The prime requirement is complete hemostasis and isolation which sometimes is difficult to achieve. This study was conducted to evaluate the efficacy of topical application of Tranexamic acid (TA) intra-operatively to facilitate this Procedure. Time, duration from exposure of the crown of the impacted tooth to bonding of brackets, allergic reactions, intra-operative blood loss, surgeon's perception and patient's comfort were the criteria's which were evaluated.

Method: This prospective observational study had two groups, for which 10 patients selected with impacted teeth. In first group topical application of TA soaked gauze pieces were used, and in second group normal saline soaked gauze pieces were used as control.

Results: Statistically significant results were achieved for experimental group in terms of Intra operative time duration and intra operative blood loss which inferenced that better isolation was achieved with the local use of Tranexamic acid, Surgeon's perception was good which inferenced that Surgeon was more comfortable in experimental group, Also Patients were more comfortable and postoperative wound healing was better in experimental group and no adverse reactions were reported in any group.

Conclusion: Topical use of tranexamic acid achieved better results for therapeutic surgical exposure showing good isolation for bonding the brackets. This technique is very cost effective, easy to apply with no adverse effects. With additional use of hemostatic agent topically; reduction in time duration, less bond failure, uneventful healing and improved patient's and surgeon's satisfaction is achieved.

Purpose: The purpose of this randomized clinical trial is to compare the efficacy of Tisseel (fibrin glue) with Surgicel as a hemostatic agent in cleft palate surgery.

Methods: This prospective randomized clinical trial consists of 22 patients consenting to the study, and they were randomly allocated to Surgicel (Group 1) and Tisseel (fibrin glue-Group 2), with 11 patients in each. It was a parallel-group clinical trial with balanced randomization (1:1). Patients reported to Meenakshi cleft and craniofacial center for cleft palate surgery were included in this study. The primary outcome measures of this study were to assess the bleeding (intraoperative-bleeding scale) and healing in periodic intervals (healing chart).

Results: This study includes 22 patients, of which 8 were bilateral cleft palate and 14 were unilateral cleft palate. The maximum width of the cleft at the level of hard and soft palate recorded was 1.5 cm and 1.8 cm, respectively. On comparing the bleeding scales among the two groups, the differences were said to be statistically significant (p = 0.011). There were 2 reported cases of palatal fistula in Surgicel group I in the 9th and 13th month of follow-up. Our study occurrence of palatal fistula ranged 4.5% in the Surgicel group and 0% in the Tisseel group.

Conclusion: By comparing bleeding and wound healing in primary palate repair defects, the Tisseel group patients significantly showed better results compared to the Surgicel group. The tolerance to Tisseel was also evident by the way of reduced inflammation and less complications in that group.

Background and objectives: To evaluate the role of Neutrophil-Lymphocyte Ratio (NLR) and Platelet-Lymphocyte Ratio (PLR) in comparison with C-reactive protein (CRP) and Erythrocyte Sedimentation Rate (ESR) in mandibular odontogenic space infection cases.

Materials and methods: 50 patients with mandibular odontogenic space infections who fulfilled the inclusion criteria were selected. The clinical parameters such as blood pressure, pulse rate, respiratory rate, oxygen saturation level, fever, swelling, trismus, dysphagia and dyspnoea were evaluated throughout the length of hospital stay. The blood parameters such as CRP, ESR, Absolute Neutrophil Count, Absolute Lymphocyte Count and Platelet count were evaluated upon admission to hospital and were compared with the values obtained on 2nd and 5th post operative days. The NLR, PLR were derived and compared with CRP and ESR values on the day of admission, 2nd and 5th post-operative day.

Results: The results showed statistically significant differences (p > 0.05) in the values of CRP during the hospital stay of pre-admission day, 2nd and 5th post-operative day. No statistically significant differences were found in the values of NLR, PLR and ESR and on the comparison between NLR and CRP and between PLR and ESR.

Conclusion and interpretation: Among the biomarkers, CRP is a better primary biomarker and ESR is a better secondary bio-marker which are more reliable as changes in their values over the span of pre-admission day to 5th POD is more significant than other biomarkers. CRP and ESR should be incorporated as monitoring tools for managing patients with mandibular fascial space infections of odontogenic origin.

Maxillary osteomyelitis following dengue infection, unaccompanied by additional comorbidities, is a rare but significant clinical entity. We present the first documented case of such a condition in a 22-year-old male who, following recovery from dengue, presented with loose teeth, difficulty chewing, and pus discharge from the upper front jaw area. A comprehensive diagnostic approach, including detailed medical and dental history, clinical examination, radiographic assessment, and incisional biopsy, confirmed the diagnosis of maxillary osteomyelitis. Surgical intervention comprising sequestrectomy and debridement was done under general anaesthesia with histopathological reconfirmation of osteomyelitis. Subsequent provision of a prosthesis facilitated functional and aesthetic restoration for the patient. A 2-year follow-up revealed no recurrence of disease, underscoring the efficacy of the management approach. This case highlights the importance of recognizing uncommon presentations of osteomyelitis post-dengue, enabling timely intervention and favourable outcomes. Such cases serve as valuable learning experiences, emphasizing the necessity of vigilance in diagnosing and managing rare clinical conditions to optimize patient care.

Congenital anomalies involving the epiglottis are an uncommon occurrence and are seldom reported as isolated anomalies. Bifid epiglottis, by itself, is also a rare occurrence. Trifid epiglottis has only been reported once in literature to the best of our knowledge. Epiglottic anomalies are observed commonly as part of a syndrome or a sequence, mostly in association with facial dysmorphic features, cleft lip and palate, polydactyly, and skeletal abnormalities among others. We report to you the case of a 10 year-old child having a triad of clinical features consisting of a trifid epiglottis, and a median cleft lip with associated polydactyly.

Background: BSSO is a technically sensitive procedure, especially in terms of causing iatrogenic damage to the inferior alveolar nerve (Roychoudhury et al. in J Oral Biol Craniofac Res 5(2):65-68, 2015 and Agbaje et al. in Int J Oral Maxillofac Surg 44(4):447-451, 2015) and obtaining a desired sagittal split of mandible.

Objective: Split Spider Splint (SSS) is a newly designed digital surgical guide based on tracking the course of inferior alveolar nerve and intraoperatively helps to make precise osteotomy cuts. This technical note describes the design concept and clinical application of this surgical Splint/ Guide.

Introduction: Undergraduates pursuing dentistry choose from nine specialties to further theireducation and career path. Oral Surgery is the specialty which forms a bridge between medicine and dentistry. Do they get adequate insight into this subject to make an informed decision on pursuing this field? What inspires them to choose this path?

Aim: To analyze the attitude and reason among students pursuing Bachelor's degree in dentistry and general dental practitioners towards choosing Oral and Maxillofacial Surgery (OMFS) as a post-graduation specialization.

Materials and methods: An online questionnaire was circulated among final year dental students, interns and general dental practitioners from all over India. It consisted of 3 sections which emphasized on their interest towards pursuing post-graduation, their attitude towards OMFS as a specialty and a career option.

Results: A total of 1145 responses were obtained through the survey, it was observed that majority (86%) of participants were interested to pursue MDS. 66% selected OMFS as their first choice in pursuing post-graduation. It was also noted that out of 87% of total female participants in the study 62.9% of them were interested in OMFS.

Discussion: Previous studies have shown that students voluntarily chose OMFS as a specialization. In our study the major reasons to pursue OMFS by participants was deep interest towards this subject, financial benefit and to gain knowledge and clinical experience.

Conclusion: OMFS had a positive impact and an exposure at an under-graduate level inspired participants to pursue this subject as a specialization and considering it as a career option.

Aim: To evaluate and compare the postoperative scarring with nasolabial flap reconstruction using silicone gel versus silicone gel sheet.

Materials and methods: This was an in vivo comparative study carried out in the Department of Oral and Maxillofacial Surgery. 10 patients who fit into the inclusion criteria were selected. The surgical procedure was carried out as per the standard protocol. The fishbowl method was used to allocate groups, group A where silicone gel application was prescribed and group B where silicone gel sheets were applied. On postoperative day 10, sutures were removed and the modality was advised as per the study protocol. In group A, silicone gel application was prescribed twice daily for 3 months. In group B, silicone gel sheet application was prescribed for 4 hours on day 1, increasing it by 2 hours a day till 1 week and then 24 hourly until 3 months. The patients were evaluated by a second investigator every 2 weeks until 3 months and at the end of 6 months. The healing of scars was evaluated as per the Vancouver Scar Scale.

Results: Silicone gel showed superior results than silicone gel sheet statistically in terms of pigmentation, vascularity, height and pliability (p<0.05).

Conclusion: In our study, we found an appreciable difference in the healing of scars in both groups. Although both methods aid in better healing of nasolabial scars, silicone gel offers better healing and is well tolerated by the patients.