Necrotizing sialometaplasia (NS) is a benign, self-limiting inflammatory reaction of salivary gland tissue which may mimic squamous cell carcinoma or mucoepidermoid carcinoma, both clinically and histologically, that creates diagnostic dilemma leading to unwarranted aggressive surgery. Most commonly affected site is the minor salivary glands of the palate. The pathogenesis is unknown but is believed to be due to ischemia of vasculature supplying the salivary gland lobules. A simple incisional biopsy is required to confirm the histological diagnosis and to rule out more serious disease processes. It is a self-limiting disease process and requires no treatment. It will be prudent to do repeat biopsy in case if the lesion does not heal within 3 months.

The aim of this study was to document the pattern and incidence of mandibular fractures occurring in rural population, at Rural Dental College and Hospital, Maharashtra, India. A retrospective analysis of patient records and radiographs for the 5-year period from January 2003 to December 2007 was conducted. Data were identified and analyzed based on age group, gender distribution, anatomic location, and cause of injury. A total of 324 patients with 486 injuries were reviewed, males formed 80.9% and females 19.1% of the studied population, with peak incidence occurring in the 21-30 years age group. The most common fractures site was parasymphysis (39.3%). The etiology of mandibular fractures was road traffic accidents (42.9%), followed by falls (25.9%), assaults and interpersonal violence (20.7%), and animal injuries (10.5%). Our results exhibit that road traffic accidents remain the major cause of mandibular trauma and animal injuries being found exclusively in rural population. There is a variation of incidence and pattern of maxillofacial trauma from region to region.

Ectopic eruption of a tooth within the dentate region of the jaws is often noticed in clinical practice and is well documented in the literature. But the ectopic eruption into the non dentate region is rare and scantly documented. The maxillary sinus is one such a non dentate region, apart from nasal septum, mandibular condyle, coronoid process and the palate, to accommodate such ectopic eruptions of teeth. Due to its rarity and lack of consensus over its management, the incidence deserves to be added to the literature and discussed. Early surgical intervention for removal of ectopic tooth along with enucleation of the associated cyst, if any, is the treatment of choice.

This study aims to retrospectively analyze the incidence and pattern of cranio-maxillofacial injuries in the developing world in a hope to emphasize on authorities the need of improvising infrastructural facilities, medical and other. Hospital medical records with available radiographs of 6,872 patients treated for cranio-maxillofacial injuries at major trauma centres in Pune, India over a 22 year period (from July 1989 to June 2010) were reviewed. Relevant data pertaining to patients' age, sex, cause of injury, sites of injury, associated injuries, anaesthesia, various treatment modalities and complications were recorded and analyzed statistically. A total of 6,872 patients sustained maxillofacial injuries of which 5,936 (86.4 %) were caused by road traffic accidents (RTA), followed by fall in 608 cases. Distribution pattern of sex revealed male predominance (M:F-2.5:1) and the third decade age group (2,416) sustained maximum cranio-maxillofacial injuries. Of 12,503 cranio-maxillofacial sites involved, mandible (6,456) predominated, while there was middle third involvement in 5,024 cases. Most of the patients (4,856) were treated with open reduction and internal fixation without maxillo-mandibular fixation and complications were noted in 320 patients. In comparison to similar recent studies reported in the literature, our findings show that RTA remains the most common cause of cranio-maxillofacial injuries with male preponderance. Also RTA remains the major preventable etiological factor of cranio-maxillofacial injuries, which should prompt authorities to take "Herculean effort" to implement rules and educate people.

Iatrogenic origin of neurosensory dysfunction is a distressing sequel to the surgical removal of impacted mandibular third molars, which is frequently overlooked. According to various surveys, the rate of neurologic complications related to the surgical removal of impacted mandibular third molars varies between 0.5% and 1% for permanent damage and 5% and 7% involving temporary damage. Prevention always stands as the best modality to avoid patient's discomfort and lawsuits by sophisticated consumerism.Preoperative assessment of the topographic relationship of the impacted mandibular third molar to the inferior alveolar canal has been performed by different imaging modalities. However, none of the imaging techniques give cent percent information. The best available imaging modality in time and resources should be adopted by the surgeon to avoid complications and lawsuits. Orthopantomography has often been cited as the imaging modality of choice before surgical removal of impacted mandibular third molar. However, it depicts a two-dimensional view of an intricate three-dimensional anatomic relationship and also fails to accurately project the buccolingual relation between the tooth and the inferior alveolar canal. The current study was designed to evaluate the potential advantages of spiral computed tomography and compare its efficacy as a presurgical planning tool with orthopantomography in patients with impacted mandibular third molars showing proximity to the inferior alveolar canal on an orthopantomogram.

Objective To compare the efficacy of cyanoacrylate (tissue glue) placement after surgical removal of impacted mandibular third molars. Materials and Methods Thirty patients with bilaterally impacted mandibular third molars were studied in this controlled clinical trial. One side closure after surgical removal of third molar was done with conventional sutures and other side with cyanoacrylate. Results The data analysis showed that postoperative bleeding with cyanoacrylate method was less significant than with suturing on the first and second day after surgery. There was no significant difference in the severity of pain between the two methods. Conclusion This study suggested that the efficacy of both, cyanoacrylate and suturing in wound closure were similar in the severity of pain, but use of cyanoacrylate showed better hemostasis.

No abstract

Despite many advances in internal fixation, angle fracture remains among the most difficult and unpredictable fracture to treat compared with those of other areas of the mandible. Large number of studies on mandibular angle fracture treatment attests to the fact that no single approach has been shown to be ideal, and that treatment of mandibular angle fractures remains conceptually controversial, with a bothersome complication rate. During the past decade, significant attention has been placed on variety of plate fixations for mandibular angle fractures.1-14 Fixation using miniplates has been shown to simplify surgery and reduce surgical morbidity, but failed to surpass the predictability of rigid fixation. 15-18Although there have been several studies on linear and curvilinear plates for mandibular fracture fixation, only a few reports on the use of low profile three-dimensional (3D) strut or mesh plates are reported in the literature. 1,6 In fact, majority of studies on 3D strut plates are in vitro biomechanical studies. The geometry of 3D strut plate conceptually allows for an increased number of screws, stability in 3D, and resistance against torque forces while maintaining a low profile and malleability. The 2.0-mm titanium 3D curved angle strut plate allows for almost no movement at the superior and inferior borders with manual torsional and bending forces, as opposed to when a single linear plate is applied to the superior border area. When only one linear plate is placed at the superior border, torsional and bending forces usually cause movement along the axis of the plate with buccal-lingual splaying and gap formation at the inferior border, respectively. Because the Keywords ► angle fracture ► mandibular angle ► rigid fixation ► 3D plates ► curved strut plate AbstractThe aim of the study was to evaluate the efficacy and complication rate with use of 2.0-mm titanium three-dimensional (3D) curved angle strut plate for mandibular angle fractures. Twenty cases requiring internal fixation of the mandibular angle by 2.0-mm titanium 3D curved angle strut plates were evaluated. Postoperative clinical and radiological analyses were done on 1st, 2nd, 4th, and 6th weeks, which included wound healing, transmitted movements, difficulty in function and occlusion, and neurosensory changes, if any. Reasonable level of success in terms of immediate jaw function was noted in all cases. Transient inferior alveolar nerve dysfunction was observed in three cases, which recovered gradually in 2 months, and surgical site infection was observed in two cases, which resolved with appropriate course of antibiotics and wound care. Fixation of mandibular angle fractures with a 2.0-mm titanium 3D curved angle strut plate is predictable, expeditious, and has less complication rate.