Introduction: The retromolar fossa is a small triangular area posterolateral to 3rd molar region in the mandible. The retromolar fossa often contains the retromolar foramen (RMF) as an anatomical variant. When the RMF is present, the foramen is connected with the mandibular canal (MC) through another canal known as the retromolar canal (RMC). RMC contains neurovascular bundle, which gives additional supply to the mandible. Although few studies have been conducted in past, a lacunae in comprehensive review is lacking. Although, these variations posed challenging situations for the practicing surgeons, they have been quite neglected and not well presented in textbooks. Hence, we made an attempt to provide a comprehensive and consolidated review regarding RMF and RMC. Materials and Methods: The relevant articles were selected by hand search and electronic media (Google scholar, PubMed, Science Direct, Medline, Embase and Cochrane) from 1987 to 2019. All the relevant articles were properly screened and findings were extracted from the articles. Results: There seems to be wide variations in morphology and morphometry of RMF and RMC. Discussion: Detailed knowledge of these anatomical variations is important in surgical procedure involving the retromolar area to protect the patient from complications such as unexpected bleeding, hematoma formation, and nerve damage. Furthermore, its knowledge makes us understand about the failed inferior alveolar nerve block, spread of infection, and metastasis in case of carcinoma. When there is any suspicious alteration in the MC, we suggest more accurate examination technique like CBCT.

To evaluate the efficacy of nasolabial (NL) flap as a grafting technique in the management of oral submucous fibrosis (OSMF). Patients and Methods: A prospective randomized study was conducted including 10 patients who were treated surgically for OSMF. Patients with the chief complaint of long standing difficulty in mouth opening (less than 20mm), pain in relation with the third molars or any non-malignant growth associated with that region were included. Results: This prospective study was carried out to evaluate the use of NL flap as a grafting technique in OSMF cases and observe the surgical outcome in terms of post-surgical mouth opening.1 week postoperative mouth opening ranged from 25mm to 45mm with a mean of 36 mm. However, 15 days, 1 month and 3 months post-operative mouth opening was 32, 34, and 36 mm respectively. Finally the 12 months follow up showed a range from 22 mm to 44 mm with a mean of 34 mm. Conclusion: Cessation of habits, vigorous mouth opening exercises and improvement in nutritional statusis must for better results post-operatively. All the patients showed sustained mouth opening, satisfactory epithelialization, and minimum wound contracture. The NL flap has proven to be a useful and reliable treatment modality.

Introduction: Conventional implants have great limitations in case of atrophic maxillary and mandibular ridges. Ultimately, patients who have severely atrophied jawbones paradoxically receive little or no treatment, as long as conventional implants are considered the device of first choice. Basal implants were developed with the goal to overcome the limitations of conventional implantology, primarily for atrophied ridges or inadequate bone with the protocol of immediate loading. However, studies regarding the rehabilitation followed by placement of screwable basal implants in atrophied ridges are limited. The purpose of the study was to conduct a prospective evaluation for the feasibility of placing strategic basal implants in clinical practice along with its merits and demerits. Materials and Methods: A prospective study was designed to evaluate the protocol of immediate functional loading using the technology of strategic basal implants ® for fixed complete arch prostheses and segmental teeth prostheses. A minimal of 10 patients selected in the age group of 20–80 years were restored with strategic basal implants irrespective of the quality and quantity of cancellous/alveolar bone following immediate functional loading protocols. Results: About 157 various designs of basal implants were placed in 10 patients, out of which four failed with the survival rate of 97.5% of basal implants. Discussion: The new concepts laid by basal implantology eliminate all drawbacks of conventional implantology and should be used as an adjunct to improve the quality of life of our patients. The concept of strategic implantology is innovative but reliable technique for patients in need of permanent rehabilitation.

Evolution in the field of dental implantology made the replacement of missing tooth easy and quick. During initial phase of evolution, there was a need of 3 to 6 months of healing period to get teeth on implants but with advancement of technology and research, immediate replacement of missing teeth without waiting period could become a possibility. To access the efficacy of immediate loading in dental implantology using Hexacone® (IHDE DENTAL - Switzerland) dental implant. The objectives were to evaluate pain, infection, recession, loosening of abutment, fracture of implant/crown, de-cementation, peri-implant radiolucency, and marginal bone loss. Five patients (3 male and 2 female) who needed teeth replacement were included in the study. Among 5 patients, 3 patients needed single tooth replacement and the remaining 2 needed segmental replacement. Out of 7 implants 6 implants were placed in the healed bone and 1 was placed in the extraction socket. In case of healed bone, permanent prosthesis were given on 3 day. In case of extraction site, temporary acrylic crown was given on 2 day, which was replaced by permanent prosthesis after 3 month. These patients were evaluated at 7 day, 1 month, 3 months, 6 months and 12 months clinically and radiographically. Infection, prosthetic problems, peri-apical radiolucency, and implant mobility were not observed and marginal bone loss was observed during follow-up periods. On 6 months follow up, 0.5mm and 0.45mm marginal mean bone loss was observed on mesial and distal aspect respectively whereas the same was 1.24mm and 1.14 mm on 12 months follow-up respectively.The immediate loading for dental implants is a successful procedure that decreases the time for the patients to obtain a final restoration satisfying both esthetical and functional problems. Immediately loaded implants survive equally well in extraction socket. No significant difference was seen in survival when implants were placed in healed bone and extraction socket.

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