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For bite injuries on face, immediate primary wound repair after meticulous wound debridement and irrigation with sufficient volume added by antibiotic prophylaxis gives good cosmetic results with minimum risk of infection. Depending upon type of attack and age of victims, psychiatric or social counseling may also be required.

Objective To assess the incidence of dentigerous cystic changes in the follicles of radiographically normal impacted mandibular third molars. Methods One hundred and thirteen follicles obtained after surgical removal of impacted mandibular third molars with radiolucency of less than 2.5 mm in the radiograph were sent for histopathologic evaluation to evaluate pathologic changes. Results The incidence of dentigerous cystic changes observed was 15.9%, that is, 18 out of 113 patients (51 males and 62 females), with the maximum incidence of cystic changes seen in the follicular space size of 0.5 mm. The mean age of the patients included was 27.8 ± 8.1. The most common indication for extraction among the patients in this study was recurrent pericoronitis (95%). There were no statistically significant differences in occurrence of cystic changes based on age, gender, angulation, relation to ramus, depth, side of impaction, and follicle size (P > 0.05). Conclusion Dental follicles obtained from surgically removed impacted mandibular third molars should be submitted for histopathologic examination irrespective of the radiographic size of the follicle.

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Objective. To compare the effect of sutureless versus multiple sutures technique on postoperative variables such as pain, swelling, and trismus after surgical removal of the third molar in Nepalese subpopulation. Materials and Methods. Forty-eight patients were equally grouped into multiple sutures (group 1) and sutureless (group 2) groups using a computer-generated random table. The same operator performed all the surgical procedures. Postoperative variables such as pain, swelling, and trismus were measured by a single concealed observer using a 10 cm Numerical Rating Scale (NRS), flexible plastic measuring tape, and vernier caliper preoperatively and on 1st, 2nd, and 7th postoperative days. Results. This study showed significantly more swelling measured from the gonion to lateral canthus in group 1 than in group 2 on all postoperative periods (P<0.05). The mean NRS score was significantly higher in group 1 on the 1st postoperative day (P=0.01). Though mean duration of surgery, swelling as measured from tragus to commissure, trismus, NRS score except on the 1st postoperative day, total number of analgesics consumed, and complications were noted more in the multiple sutures group, the difference was not statistically significant. Conclusion. Our results support the use of sutureless technique after third molar surgery to minimize postoperative morbidity and the overall operative time and reduce the cost within the Nepalese subpopulation.

Objectives. Oral and maxillofacial surgery is a relatively newer and growing specialty of dentistry in Nepal whose scope is not yet estimated. The objective of this study was to estimate the scope and the factors influencing the scope of oral and maxillofacial surgery in Nepal. Study Design. In this cross-sectional study, all the oral and maxillofacial surgeons who were registered in the Nepalese Association of Oral and Maxillofacial Surgeons (NAOMS) were included (purposive sampling). The structured questionnaires were distributed to them, the collected data were entered in Microsoft excel 2010, and variables were analyzed using descriptive statistics (percentage) by SPSS 16.0. Results. Out of 46 questionnaires distributed, 35 were responded and returned (response rate = 76%). Majority of participants (77.1%) were in 30–39 years of age group. Male to female ratio was 4 : 1. More than half (68.6%) of the participants had practice experience of <5 years, and none had practice experience of >20 years. The ratio of the surgeons practiced in Medical/Dental Teaching Hospital to those in Government Hospital was 3 : 1. Sixteen (45.7%) participants practiced in Capital Valley and none in Far-Western Development Region. Traumatology was practiced by thirty-four (97.1%) participants although only twenty-three (65.7%) participants had primary interest in it. Each of oncology, orthognathic surgery, implantology, and cleft lip/palate surgery was performed by <8% of the participants. Common factors influencing the practice were inadequate training (71.4%) and insufficient facilities/infrastructures (45.7%). Conclusion. The scope of oral and maxillofacial surgery is limited in Nepal, and oncology, implantology, cleft lip/palate, and orthognathic surgery have received little attention.

Background: Mandibular fracture is one of the most common fractures of the maxillofacial region. The pattern of mandibular fractures varies from country to country and these variations can be due to social, cultural, and environmental factors. Objectives: This study was conducted to evaluate the etiology, incidence and pattern of mandibular fractures in western region of Nepal, reported at Nepalgunj Medical College Teaching Hospital. Methodology: A prospective study of 130 patients with mandibular fractures was conducted in Department of Dentistry, Nepalgunj Medical College Teaching Hospital from November 2013 to November 2014. These patients were examined both using clinical and radiographic parameters for mandibular fracture. Data concerning age, gender, causes of fracture and sites of fracture were analyzed. Result: Out of 130 patients, 104(80%) were male patients and 26(20%) were female patients. Most common age group was between 21-30 years. Most common cause of mandibular fracture was road traffic accidents accounting for 66(50.77%) cases followed by fall injury in 30(23.08%) cases. Most common site involved was parasymphysis 46(30.47%) followed by angle 27(17.89%). Road traffic accidents due to alcohol consumption 40(68.97%) was the leading cause followed by assault 10(17.24%) and fall 8(13.79%). Conclusion: Mandibular fractures are more frequent in male than female with higher frequency in 21-30 years age group. The most commonly fractured site was the parasymphysis. Road traffic accidents were the most common etiology and significantly associated with alcoholism.

Background: We aimed to find out the causative bacteria involved in oral and maxillofacial infections, and to evaluate the antibiotic susceptibility by pus culture and sensitivity test. Methods: This prospective observational study conducted over a one- year period enrolled all 41 consecutive patients with features of oral and maxillofacial infections visiting the oral and maxillofacial surgery clinic at the university hospital of B. P. Koirala Institute of Health Sciences. Pus was collected on a sterile syringe and sent to the microbiology laboratory. Pus samples were inoculated in 5% sheep blood agar and MacConkey agar and incubated at 37°C for 48 hours. Identification of the bacterial colony was done by gram staining and different biochemical tests. Antibiotic susceptibility tests were done by disc diffusion method on Mueller-Hinton agar as per CLSI guidelines. Results: Out of 41 patients, 22 were male and 19 were female patients. The average age of the patients was 41.63 years. Odontogenic infection (17, 41.46%) was found to be the most common. Submandibular space (15, 36.59%) was the most common fascial space involved. The most common organism cultured was Enterococcus faecalis (13, 31.71%). The antibiotic susceptibility pattern of the isolates showed that 50% of the cultured organisms (n = 8) were resistant to Penicillin; five of them were Enterococcus faecalis and three were Staphylococcus aureus. Conclusion: We found that Enterococcus faecalis as the common organism causing oral and maxillofacial infections with high resistance to Penicillin.