Background/Aims Angle fractures represent the largest percentage of mandibular fractures. They pose as a unique entity because of their codependent morphological dynamic factors, rendering the understanding of the mechanism, and treatment challenging. The aim of this study was to analyze the association between the mandibular gonial angle and the risk of mandibular angle fracture while highlighting its clinical relevance. Materials and Methods A retrospective analysis of radiographs of patients treated for mandibular fractures was done. The factors studied were as follows: the presence of a high gonial angle and an impacted third molar. The outcome was mandibular angle fracture. The gonial angle was measured using Planmeca Digital Software 3.7.0.R. Status of the third molar was also noted. Data obtained were analyzed using SPSS 22 (IBM Corp, Armonk, NY). Results The sample comprised 70 mandibular fractures (32 angle fractures and 38 non‐angle fractures). The mean gonial angle in the angle fracture group was 128.5 ± 5.4º which was 10.2° larger than in the non‐angle group (mean 118.5 ± 4.4º; P = 0.0001). Patients with a high gonial angle were 8.7 times more likely to sustain an angle fracture than those with normal or low gonial angles. A statistically significant relationship between the presence of impacted third molar and patients sustaining mandibular angle fractures was noted (P = 0.0001). Conclusion Subjects with a high gonial angle and an impacted third molar are at an increased risk for mandibular angle fracture due to direct and indirect morphological factors.

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Background Chronic recurrent forms of osteomyelitis of the mandible with their morbid clinical course have long been considered a challenge to maxillofacial surgeons in terms of both diagnosis and treatment. Various classifications and treatments have been established through the ages to define and manage the inflammatory symptoms occurring in adults and children. This paper discusses two such entities occurring in an adult and a child, highlighting the diagnostic and treatment challenges of recurrent osteomyelitis. Methods A thorough workup which included clinical, radiographic, blood investigations was done, followed by administration of antibiotics and anti‐inflammatory with or without surgical debridement/adjuvant therapies. Correlation of our findings and treatment plan was done with evidence‐based literature and practice. Results Complete resolution of symptoms with radiographic evidence was achieved in both the cases. In the recurrence period, long‐term steroids, NSAIDs, antibiotics resulted in better outcomes. Conclusion The evidence‐based protocol for osteomyelitis stresses on short inpatient stays predicated on efficient literature. Thorough clinical and radiographic evaluation with aggressive medical management and surgical intervention when necessary can result in longer symptom‐free periods. Thus understanding the disease, recurrence pattern and response to therapy is essential.

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Aim:A severely atrophied maxilla presents serious limitations for conventional implant placement and the reconstruction of which requires extensive surgical treatments. This original article presents an overview of this evidence-based technique used for maxillary rehabilitation. Background: Growing patients' needs to regain proper oral function with limited surgical effort presents a challenge to the surgeon for implant placement in harmony with the planned prosthesis. Different techniques and protocols have been put forward through the ages to improve implant survival, osseointegration, and quality of life. A new technique-Tall Tilted Pin Hole Immediate Loading (TTPHIL-ALL TILT™ technique)utilizes angulated long bicortical tapered implants placed in a flapless way in immediate loading with screw-retained prosthetic solutions. Technique: TTPHIL-ALL TILT™ technique involves flapless subcrestal bicortical placement of a total of six tall threaded tilted implants engaging the nasal cortex and the pterygoid pillars, rigidly splinted maintaining adequate anteroposterior spread, achieving proper primary stability, fit for immediate loading. Screw-retained prosthetic solutions are provided with the elimination of distal cantilever. Conclusion: The TTPHIL-ALL TILT™ technique can facilitate surgical rehabilitation of patients with maxillary resorption, as an alternative to other graft less and grafting procedures. Clinical significance: TTPHIL-ALL TILT™ technique provides a graftless solution for the challenging resorbed maxillary edentulous ridges. By following this protocol, primary stability is achieved which gives way for immediate loading satisfying the patient's functional and aesthetic needs.