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Introduction:Ankylosis may be defined as the fusion of the articular surfaces with bony or fibrous tissue. The treatment of temporomandibular joint ankylosis poses a significant challenge because of the high incidence of recurrence. A number of interpositional materials have been used including alloplastic materials (acrylic, proplast–teflon, silastic), and autogenous tissues (temporalis muscle flaps, buccal fat pad, dermis, costochondral grafts, metatarsal, fibula, tibia, iliac crest, cranial bone and Sternoclavicular graft SCG and cartilage). Literature suggests that rather than growth centre, we need adaptive centre. SCG is presumed to be a more suitable material for interpositional arthroplasty because Sternoclavicular Joint (SCJ) and TMJ are very similar developmentally, histologically and morphologically throughout the growth period.Material and Method:Patients with TMJ ankylosis (8 males, 2 females) underwent release of the ankylosed joint by the senior author, between June 2013 and Novemeber 2015. The age of the patients ranged from 10 to 19 years. Pre- and post- operative assessment included a thorough history and physical examination to determine the cause of ankylosis, the maximal incisal opening, etiology and type of the ankylosis, recurrence rate.Result:MIO at 6 months follow up was 37.4±2.633 mm (range 32-40 mm), greater than MIO achieved in immediate postoperatively {34.4±2.22 mm (range 30-38 mm). After reconstruction of temporomandibular joint with sternoclavicular graft in the growing child there was a significant increase in the growth of mandible which was stunned due to ankylosis. And the ramal height also increased.Conclusion:The articular reconstruction with alloplastic or autogenous grafts, or gap arthroplasty for the treatment of ankylosis is shown to be efficient in relation to the post-operative maximal incisal opening, recurrence and articular function.

There is dearth of information in the literature regarding the relationship between head injuries and facial trauma in literature. The objective of our study was to study this important relationship. We evaluated 230 patients with maxillofacial trauma and intracranial injury admitted to our hospital, between 2012 and 2017. The rate of head injuries associated with facial trauma was 63 %. The most common associated head injury was concussion, followed by cerebral contusion and skull fractures. Falls were most common mode of injury followed by motor vehicle accidents.This study also revealed that fracture of facial bones in anatomic proximity to the cranium was indicator for an amplified risk of brain injuries.

Shot gun or Pellet gun injuries is quite uncommonly faced emergency nowadays by maxillofacial and neurosurgeons worldwide and has invited a challenges in modern day to day practice of surgeons. For this reason a study was conducted in departments of Maxillofacial and Neurosurgery, Govt Medical College and SMHS hospital, between January 2016 to December 2017. The pattern, severity and outcome of injuries in head/neck and maxillofacial region in patients of shot gun injuries particularly in young population was studied.

Mandibular symphysis and parasymphysis fractures are a common type of injury to facial skeleton. The purpose of this prospective study was to evaluate outcomes for 2 bone plating techniques used in the treatment of mandibular symphysis/ parasymphysis fractures. Thirty patients reporting to the department with mandibular symphysis/parasymphysis fractures were divided into 2 groups (group A and group B). A prospective study was carried out in 30 patients with defined inclusion and exclusion criteria. Patients were followed for 3 months postoperatively for occlusion, distraction of lower border radiologically, paraesthesia, infection, failure of bone plate (plate fracture) and screw loosening, postoperative segmental stability and radiological evaluation of fixation. Fifteen patients were treated by open reduction and single miniplate fixation below apices of teeth with arch bar acting as tension band (Group A) and 15 with conventional titanium miniplates following Champy's rule i.e. Two miniplates (Group B). Distraction of lower border was seen in both groups (as in group A-1 patient and group B-2 patients), which was noticed radiographically at all follow ups. There was no occlusal discrepancy present in both groups after 3 months post operatively. The fracture segments were stable in both groups at all times. Paraesthesia was noticed in both groups, which gradually decreased in 1 month and resolved completely by 3 rd month follow up. The degree of paraesthesia, distraction of lower border, occlusal discrepancy was not statistically significant between the two groups. Infection was noticed in both groups at the end of 2 weeks, which was treated with antibiotics. The result between both the groups was not significant though. Hardware failure (plate fracture and screw loosening) was not found in both groups. Osteosynthesis by both techniques is effective in providing immediate post operative function but the distinct advantage of less hardware has made the use of a single miniplate quite popular in the recent times.

The management of parotid fistulae has been unsatisfactory in the past, and numerous methods of treatment with varying success and morbidity have been described. A case of parotid fistula caused by damage to glandular elements during a transparotid approach for a subcondylar fracture reduction is reported. This paper presents a simple but effective and conservative method of treating this complication with the use of hot hypertonic saline.

Bifid Mandibular Condyle as described in this study is very rare case of condylar anatomy, mostpreferably diagnosedon incidental radiographic examination. It is noticed at any age with male dilection of 3:2 ratio. The etiology and pathogenesis of Bifid Mandibular Condyle though remains controversial and it lacks pathognomic clinical features and proper description as only few case are reported so far. Herein, a study of 5 cases of unilateral bifid condyle in Jammu and Kashmir population is reported.

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