Background:Mandibular fractures contribute to a substantial proportion worldwide. Various variables related to mandibular fractures such as demographics, etiology, pattern of fracture, and treatment have been studied, but fewer reports on their correlations are published. Hence, this study attempts to understand these factors which can be useful for setting up clinical and research priorities.Aim:The purpose of this retrospective study is to establish a correlation between different factors associated with mandibular fractures.Materials and Methods:A database of 277 patients between July 2011 and October 2018 with mandibular fractures was retrospectively retrieved. Information on age, gender, etiology, pattern of fracture, and treatment done was obtained, tabulated, and analyzed statistically. Entities such as age and gender, age and cause, gender and cause, site of fracture and cause, site of fracture and side, site of fracture and treatment done, and site of fracture and gender were correlated.Statistical Analysis Used:Descriptive and analytical statistics were calculated using the SPSS version 20 using Chi-square tests which include Pearson's Chi-square and likelihood ratio.Results:In a total of 277 patients, a statistically significant correlation was found between age and the etiologic agent, site and side of fracture, and site of fracture and the treatment done with value of P < 0.05.Conclusion:A definite correlation between multitude of overlooked relevant co-factors has been studied which can provide an operating surgeon, a valuable impetus to be more vigilant in terms of medicolegal record maintenance, diagnosis, and possible clinical strategy for the treatment of mandibular fractures.
Introduction: Recently, initiation and enhancement of extraction socket healing has been amplified by platelet concentrates, whereas the positive role of Sticky bone has been focused on maintaining alveolar bone dimensions. This study aimed to determine the effectiveness of Sticky Bone for socket grafting of mandibular third molars (M3Ms) in terms of soft- and hard-tissue healing. Materials and Methods: This split-mouth prospective trial constituted prophylactic removal of M3Ms with Sticky bone grafted in the study site as a primary predictor variable. Patients underwent 3 months of mandatory follow-up where pain, swelling, interincisal mouth opening, and gingival healing were measured on the 3 rd , 7 th , and 14 th day using the Numeric Rating Scale, anatomic landmarks, steel metric ruler, and criteria given by Landry et al . respectively. Radiological healing was calculated based on the height of the socket, Kelly's Index, and histogram values immediately after the procedure at 1 week, 1 month, and 3 months, respectively. Statistical comparison was made using Paired t -test. P < 0.05 was considered significant. Results: Forty-seven patients (mean 26.83 ± 6.58 years) demonstrated significantly lesser pain, swelling, and better gingival healing at the study site on multiple periods of follow-up. Rapid bone formation with superior density, lesser alveolar resorption, earlier bone blending, and trabecular formation were noticed on the study site with a significant difference at all time intervals. Discussion: Sticky bone was chosen as the graft owing to advantages such as simple preparation, convenient handling characteristics, safety, evident postoperative patient comfort, better retention of the clot, enhanced soft-tissue healing, absence of infection, and decreased osseous deformation as compared to the control site. This study validated the role of Sticky bone as an indispensable component of regenerative therapy in the orofacial osseous tissues as it was an ideal biologic graft with fibrin rich structure. Conclusion: This study validated the role of Sticky bone as an indispensable component of regenerative therapy in the orofacial osseous tissues as it was an ideal biologic graft with fibrin rich structure.
Objective To explore the efficacy of ultrasonography as an additional diagnostic tool in superficial odontogenic fascial space infections of maxillofacial region and modifying the treatment plan when needed. Materials and Methods Forty patients with superficial fascial space infections underwent a detailed clinical, plain radiological and ultrasonographic examination. Based on the ultrasonographic findings, final diagnosis was made and compared with clinical findings. Patients diagnosed with cellulitis were given medical line of treatment, and those with abscess were subjected to incision and drainage along with standard general supportive care and removal of etiologic agent.Results In this study, out of 40 patients (male = 22, female = 18), clinical diagnosis of cellulitis was made in 26 cases (65%) and abscess in 14 (35.0%). On USG examination, cellulitis was present in 21 cases (52.5%), while abscess in 19 (47.5%). Final diagnosis of cellulitis was made in 13 (59.1%) males and 12(66.7%) females, while abscess was confirmed in 9 (40.9%) male and 6 (33.3%) female patients. The results showed that sensitivity of the clinical examination alone was 64% with 33% specificity, and for USG, sensitivity was 84% with specificity of 100%. Conclusion The adjuvant role of ultrasonography in the diagnosis and timely management of superficial fascial space infections is promising owing to its accessibility, relative safety, repeatability and cost-effectiveness.
Oral Submucous Fibrosis is a premalignant condition affecting a considerable population around the world. The surge in the use of arecanut and tobacco products has led to monumental rise in young patients complaining of trismus and inability to eat. Although, the condition can be effectively managed through surgery followed by physiotherapy, its incessant subclinical progression often restores the intraoral fibrosis once physiotherapy is discontinued, most commonly due to pain. In this respect, it was intriguing to notice many such patients eliciting an elongated styloid process which may be consequent to activation of Transforming Growth Factor-beta due to chronic trauma or inflammation. This growth factor is also involved in marked deposition of collagen forming intraoral fibrous bands. Hence, if a definite association can be delineated between the two conditions, through radiographic examination on an orthopantomogram, clinicians can be alerted to diagnose an elongated styloid process whenever a case of oral submucous fibrosis presents in the clinical practice. This simple yet significant protocol shall eliminate a prominent cause of pain during mouth opening exercises thus making the chances of treatment failure negligible.
<p class="abstract">Oral submucous fibrosis is a widespread, premalignant disorder causing severe difficulty in mastication and speech. With high rate of malignant conversion, it demands aggressive surgical therapy followed by mandatory long-term physiotherapy. An elongated styloid process, if present, could pose a strong hindrance to movement of mandible, leading to complete relapse of trismus in such cases. The purpose of this report is to elaborate on such co-existence in patients having oral submucous fibrosis using digital orthopantomogram. 3 patients suspected to have an elongated styloid process were referred to maxillofacial surgical unit and diagnosed with grade 4A oral submucous fibrosis. Digital orthopantomogram revealed elongated styloid process which was measured using the C. S. imaging software 7.0.3. Consequently, patients were operated by a team of maxillofacial surgeons and otolaryngologists to relieve trismus and tonsillo-styloidectomy respectively. The measured lengths of the styloid process on digital orthopantomogram were considered elongated, if exceeding the normal length of 30 mm. The measured lengths of the styloid process were found to be at 52.7 mm, 50.1 mm and 57 mm on the right side and 51 mm, 46.8 mm and 37 mm on left side respectively in our cases. These elongated styloid processes observed in all three cases of submucous fibrosis indicates that progressive fibrosis may exert significant influence on the ossification of styloid complex. Hence, a routine preoperative screening in all patients of oral submucous fibrosis is imminent to avoid postoperative failure, pain or discomfort to the patient owing to an elongated styloid process. </p>
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