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National Journal of Maxillofacial Surgery
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   2013| January-June  | Volume 4 | Issue 1  
    Online since September 7, 2013

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Advances in dental local anesthesia techniques and devices: An update
Payal Saxena, Saurabh K Gupta, Vilas Newaskar, Anil Chandra
January-June 2013, 4(1):19-24
DOI:10.4103/0975-5950.117873  PMID:24163548
Although local anesthesia remains the backbone of pain control in dentistry, researches are going to seek new and better means of managing the pain. Most of the researches are focused on improvement in the area of anesthetic agents, delivery devices and technique involved. Newer technologies have been developed that can assist the dentist in providing enhanced pain relief with reduced injection pain and fewer adverse effects. This overview will enlighten the practicing dentists regarding newer devices and methods of rendering pain control comparing these with the earlier used ones on the basis of research and clinical studies available.
  10 11,248 2,857
Buccinator-based myomucosal flaps in intraoral reconstruction: A review and new classification
Amin Rahpeyma, Saeedeh Khajehahmadi
January-June 2013, 4(1):25-32
DOI:10.4103/0975-5950.117875  PMID:24163549
The buccinator-based myomucosal flaps are axial pattern flaps that are suitable in reconstruction of medium sized oral soft tissue defects; they are rich in blood supply, have appropriate thickness and considerable mucosal paddle, and they can secrete saliva. The present study describes surgical anatomy and blood supply of these flaps and demonstrates all possible modifications of these flaps (9 modifications). Many terms (> 10) have been used to refer to buccinator-based myomucosal flaps in the literatures. This report introduces a new classification system mainly based on the remaining attachments of buccinator muscle after flap elevation in pedicle variants and axial blood supply orientation in island variants.
  10 8,531 925
Application of PRF in surgical management of periapical lesions
Smita Singh, Arunendra Singh, Sourav Singh, Rashmi Singh
January-June 2013, 4(1):94-99
DOI:10.4103/0975-5950.117825  PMID:24163562
Aims and Objectives: Platelet rich fibrin is widely used in stimulation and acceleration of soft tissue and bone healing because of local and continuous delivery of growth factors and proteins, mimicking the needs of the physiological wound healing and reparative tissue processes. This article will serve to introduce a second generation platelet concentrate, platelet-rich fibrin (PRF). Materials and Methods: Fifteen cases are presented in which conventional endodontic therapy failed to resolve the problem and periapical root-end surgery was required. Results: At the end of six months, all patients showed complete bone regeneration. Conclusion: Production of a dense, cross-linked, physically robust PRF made of intact platelets and fibrin by high-speed centrifugation in the absence of exogenous thrombin, yields an ideal scaffold for use in tissue repair.
  9 3,051 841
Cone beam computed tomography in oral implants
Jyoti Gupta, Syed Parveez Ali
January-June 2013, 4(1):2-6
DOI:10.4103/0975-5950.117811  PMID:24163545
Cone beam computed tomography (CBCT) scanners for the oral and maxillofacial region were pioneered in the late 1990s independently by Arai et al. in Japan and Mozzo et al. CBCT has a lower dose of radiation, minimal metal artifacts, reduced costs, easier accessibility, and easier handling than multislice computed tomography (MSCT); however, the latter is still considered a better choice for the analysis of bone density using a Hounsfield unit (HU) scale. Oral implants require localized area of oral and maxillofacial area for radiation exposure; so, CBCT is an ideal choice. CBCT scans help in the planning of oral implants; they enable measurement of the distance between the alveolar crest and mandibular canal to avoid impingement of inferior alveolar nerve, avoid perforation of the mandibular posterior lingual undercut, and assess the density and quality of bone, and help in planning of the oral implant in the maxilla with special attention to the nasopalatine canal and maxillary sinus. Hence, CBCT reduces the overall exposure to radiation.
  8 4,664 1,392
Odontogenic myxoma
Suchitra Gupta, Neeraj Grover, Ajit Kadam, Shally Gupta, Kunal Sah, JD Sunitha
January-June 2013, 4(1):81-83
DOI:10.4103/0975-5950.117879  PMID:24163558
Odontogenic myxoma is a rare intraosseous neoplasm, which is benign but locally aggressive. It rarely appears in any bone other than the jaws. It is considered to be derived from the mesenchymal portion of the tooth germ. Clinically, it is a slow-growing, expansile, painless, non-metastasizing, central tumor of jaws, chiefly the mandible. Here we report the case of a typical odontogenic myxoma in a 26-year-old female patient, which had acquired large dimensions and involved the entire left half of the mandible including the ramus, resulting in a gross facial deformity, within a span of one and a half years.
  7 3,524 480
Small cell neuroendocrine carcinoma of the paranasal sinus
Arvind Krishnamurthy, Poornima Ravi, R Vijayalakshmi, Urmila Majhi
January-June 2013, 4(1):111-113
DOI:10.4103/0975-5950.117818  PMID:24163566
Small cell neuroendocrine carcinoma (SNEC) is an uncommon tumor. This tumor usually occurs in the lungs, the extra-pulmonary form accounts for only about 4% of all cases. Primary SNEC of the paranasal sinuses is extremely rare; only about 76 cases have been reported in literature. Unfortunately due to the rarity of this neoplasm, there are no specific recommendations pertaining to the management, treatment options are generally extrapolated from similar tumors of pulmonary origin. While Surgery was used in the past, upfront chemoradiation now seems to be evolving as the treatment of choice. We report a case of sinonasal SNEC who had undergone definitive concurrent chemoradiation and is currently disease-free for close to 2 years. The clinical presentation, imaging studies, histopathological diagnosis with immunohistochemistry correlation, management protocols, and a brief review of literature of this rare tumor is discussed.
  6 2,517 345
Obturator prosthesis for hemimaxillectomy patients
Mayank Singh, Akshay Bhushan, Narendra Kumar, Sharad Chand
January-June 2013, 4(1):117-120
DOI:10.4103/0975-5950.117814  PMID:24163568
Rehabilitation of hemimaxillectomy patients can be challenging. The most common problem with prosthetic treatment in such patients is in getting adequate retention, stability, and support. The size and location of the defect usually influences the amount of impairment and difficulty in prosthetic rehabilitation. The obturator prosthesis is commonly used as an effective means for rehabilitating hemimaxillectomy cases. In cases of large maxillary defects, movement of the obturator prosthesis is inevitable and requires a form of indirect retention to limit the rotation of the prosthesis. The goal of prosthodontics is rehabilitation of missing oral and extraoral structures along with restoration of the normal functions of mastication, speech, swallowing, appearance, and so on. Malignancies are common in the oral region, which are treated through surgical intervention. Surgical intervention creates communication between the oral cavity, nasal cavity, and maxillary sinus. In such cases, it is very difficult for the patient to perform various normal functions like mastication, swallowing, speaking, and so on. Prosthodontic rehabilitation with obturator prosthesis restores the missing structures and acts as a barrier between the communication among the various cavities.
  6 3,504 735
Osteogenic potential of cissus qudrangularis assessed with osteopontin expression
Nimisha Singh, Vibha Singh, RK Singh, AB Pant, US Pal, Laxman R Malkunje, Gagan Mehta
January-June 2013, 4(1):52-56
DOI:10.4103/0975-5950.117884  PMID:24163553
Purpose: Fracture healing involves complex processes of cell and tissue proliferation and differentiation. Many factors are involved, including growth factors, inflammatory cytokines, antioxidants, bone breakdown (osteoclast) and bone building (osteoblast) cells, hormones, amino acids, and uncounted nutrients. We studied the osteogenic potential of Cissus quadrangularis (CQ), a plant that has been customarily used in the Indian subcontinent to hasten the process of healing in bone fractures. Materials and Methods: Total of 60 patients (age, 20-35 years) of mandible fracture was divided in two groups. Patients of group 1 were given capsules of CQ and fracture healing was assessed with osteopontin expression during treatment. Group 2 was control group. Results: Clinical and radiological analysis in our study was suggestive of better healing of fractures in group 1. All the samples of group 1 examined for osteopontin expression using western blot analysis and flow cytometry showed significant levels of expression of osteopontin protein and CD4+ T cells expressing osteopontin, respectively. Conclusion: We conclude that CQ accelerates fracture healing and also causes early remodeling of fracture callus.
  5 3,121 603
Tissue response to titanium implant using scanning electron microscope
Vijay P Nautiyal, Ankur Mittal, Amit Agarwal, Anupam Pandey
January-June 2013, 4(1):7-12
DOI:10.4103/0975-5950.117815  PMID:24163546
Most of the surgeons now use titanium miniplates because of its biocompatibility and corrosion resistant properties; studies have shown that these titanium particles are released in the surrounding tissues causing tissue necrosis and if these implants are placed for a long period, the adverse effect of these implants are more severe. It therefore necessitates a study to find out whether these titanium particles are released into surrounding tissues from titanium miniplates used for maxillofacial fractures so that we could use these implants, that is, bone plates and screws with more confidence.
  5 3,881 462
Blast injury face: An exemplified review of management
Vijay Kumar, Arun Kumar Singh, Parmod Kumar, Yogesh Ramdas Shenoy, Anoop K Verma, Ateesh Jayram Borole, Veerendra Prasad
January-June 2013, 4(1):33-39
DOI:10.4103/0975-5950.117878  PMID:24163550
Facial injuries are extremely common due to increased incidence of vehicular and industrial trauma and warfare injuries. But isolated injury to the face due to low voltage cells exploding is rare. In blast injury, the force can cause massive soft tissue injury, along with injury to facial fractures and damage to adnexa. Facial injury is not life threatening unless associated with other injuries of the skull and airway. The major risks to airway in facial trauma are due to anatomic alteration of patient's airway through bony and soft tissue disruption and increased chances of aspiration. The past several decades have seen a rapid growth in the range of procedures available for reconstructive purposes. However, the essential preliminary management is a must and needs to be structured. The patient, a 10-year-old boy, was joining three pencil batteries in series and twisting the wire with his teeth when one battery exploded causing severe injuries to midface and mandibular region. After stabilization, the patient was taken up for surgery. A cap splint with zygomatic suspension was done for the maxilla, and wiring of residual mandibular segments with lining and skin cover provided by a deltopectoral flap was done. Reconstructive surgeries for reconstruction of the upper lip and maintenance of oral continence were planned for the future. The present case stresses the importance of educating the masses about unsafe handling of low voltage devices, management of airway, massive soft tissue injury, along with facial fractures and damage to adnexa.
  5 7,479 892
Congenital cheek teratoma with temporo-mandibular joint ankylosis managed with ultra-thin silicone sheet interpositional arthroplasty
Ankur Bhatnagar, Vinay Kumar Verma, Vishal Purohit
January-June 2013, 4(1):114-116
DOI:10.4103/0975-5950.117817  PMID:24163567
Primary cheek teratomas are rare with < 5 reported cases. None had associated temporo mandibular joint ankylosis (TMJA). The fundamental aim in the treatment of TMJA is the successful surgical resection of ankylotic bone, prevention of recurrence, and aesthetic improvement by ensuring functional occlusion. Early treatment is necessary to promote proper growth and function of mandible and to facilitate the positive psychological development of child. Inter-positional arthroplasty with ultra-thin silicone sheet was performed. Advantages include short operative time, less foreign material in the joint space leading to negligible foreign body reactions and least chances of implant extrusion. Instead of excising a large bony segment, a thin silicone sheet was interposed and then sutured ensuring preservation of mandibular height. Aggressive post-operative physiotherapy with custom made dynamic jaw exerciser was used to prevent recurrence.
  3 1,633 198
Distraction osteogenesis for management of obstructive sleep apnea secondary to TMJ ankylosis
Amit Gaur, Gaurav Singh, Madan Mishra, KS Srivatsan, Vaibhav Sachdev
January-June 2013, 4(1):104-106
DOI:10.4103/0975-5950.117820  PMID:24163564
Mandibular retrognathism due to temporomandibular joint (TMJ) ankylosis is one of the important contributing factors to the obstructive sleep apnea(OSA). Such patients suffer from number of apneic or hyponeic events during sleep, snoring, daytime sleepiness, fatigue, inability to concentrate, irritability. At the same time facial asymmetry due TMJ ankylosis lead to a progressive lack of confidence. Distraction osteogenesis is a less invasive surgical technique in the management of OSA, secondary to TMJ ankylosis. This modality not only treats the OSA but also corrects the facial asymmetry at the same time, and the results have been gratifying.
  3 1,681 339
Giant aneurysmal bone cyst of the mandible: A case report and review of literature
Gaurav Bharadwaj, Neeraj Singh, Amit Gupta, Anand K Sajjan
January-June 2013, 4(1):107-110
DOI:10.4103/0975-5950.117819  PMID:24163565
Aneurysmal bone cysts are rare benign lesions of bone tissue. They are composed of vascular spaces blood-filled and surrounded by fibrous tissue septa. They are considered as pseudo cysts because of lack of epithelial lining. Here, we describe a giant case of ABC in 12-year-old female child having a massive swelling over the right side of the mandible treated with segmental resection and reconstruction with a reconstruction plate. Case is also discussed with the review of literature.
  3 5,162 494
A case of extensive left-sided facial atrophy of Romberg
Rajesh Verma, Hari Ram, Mani Gupta, Mukund R Vidhate
January-June 2013, 4(1):77-80
DOI:10.4103/0975-5950.117881  PMID:24163557
Progressive facial atrophy or Parry-Romberg syndrome is characterized by slowly progressive facial atrophy involving skin, subcutaneous tissue, cartilage and bony structures. Apart from facial atrophy, it can be associated with diverse clinical manifestations including headache, partial seizures, trigeminal neuralgia, cerebral hemiatrophy and ocular abnormalities. The exact etiology is unknown although sympathetic system dysfunction, autoimmune disorders, focal scleroderma, trauma and genetic factors have been postulated. We hereby report a patient having marked left-sided facial atrophy and wasting of the tongue. Such an extensive wasting is not previously reported in the literature.
  3 2,547 298
Non-syndromic odontogenic keratocysts: A rare case report
Raghavendra S Kurdekar, Jeevan Prakash, AS Rana, Puneet Kalra
January-June 2013, 4(1):90-93
DOI:10.4103/0975-5950.117874  PMID:24163561
Odontogenic keratocysts are very well documented in the literature. Multiple odontogenic keratocysts (OKCs) are one of the most frequent features of nevoid basal cell carcinoma syndrome (NBCCS). It is linked with mutation in the PTCH gene (human homolog of the drosophila segment polarity gene, "patched",). Partial expression of the gene may result in occurrence of only multiple recurring OKC without any associated systemic findings. A rare case of multiple odontogenic keratocysts unassociated with any syndrome is reported, so as to add to the growing number of such cases in the literature. The possibility of this case being a partial expression of the Gorlin-Goltz syndrome is discussed.
  3 3,646 384
Unilocular radiolucencies of anterior mandible in young patients: A 10 year retrospective study
Sujata Mohanty, Ujjwal Gulati, Akshat Mediratta, Sujoy Ghosh
January-June 2013, 4(1):66-72
DOI:10.4103/0975-5950.117885  PMID:24163555
Introduction: Mandibular anterior region is an uncommon site for occurrence of intrabony pathologies. Unilocular presentation of a lesion is again less common than multilocular appearance. Demographically, most lesions occur in middle to elderly age group. The study is designed to review the pathologies manifesting a combination of these rare demographic and radiological criteria. Materials and Methods: A retrospective analysis of patients with anterior unilocular radiolucencies of mandible in young patients was done. Records of past 10 years were searched. There were a total of 17 patients. Their clinical history and radiographs were reviewed from the case files and correlated with histopathological examination of the lesion. Results: Nine different pathologies constituted the sample size of 17. A wide array of lesions was found to manifest similar signs and symptoms and radiographic findings namely ameloblastoma (three), adenomatoid odontogenic tumor (AOT, four), odontogenic keratocyst (OKC, three), ossifying fibroma (OF, two), idiopathic bone cavity (IBC, one), dentigerous cyst (DC, one), radicular cyst (RC, one), central giant cell granuloma (CGCG, one), and calcifying odontogenic cyst (COC, one). Conclusion: Anterior mandible is a rare site for occurrence of intrabony pathologies. Majority of patients are females. Lesions acquire large size before they are detected. Growth occurs more in length than in width. Root resorption is not uncommon and root displacement is almost a consistent feature.
  3 9,105 568
Evaluation of the efficacy of AgNOR as a proliferative marker in oral leukoplakia: A morphometric analysis
Kavita Nitish Garg, Vineet Raj, Shaleen Chandra
January-June 2013, 4(1):40-45
DOI:10.4103/0975-5950.117880  PMID:24163551
Background: Silver stainable nucleolar organizer regions (AgNORs) are replicatory markers which may have a place in objectively characterizing dysplasia. Materials and Methods: A study of various morphometric parameters related to AgNORs was performed in basal and parabasal layers of normal human oral epithelium, nondysplastic leukoplakia, and dysplastic leukoplakia employing photomicrographs of silver stained paraffin embedded sections using image analysis, to assess the usefulness of these parameters in distinguishing dysplastic leukoplakia from nondysplastic oral leukoplakia. Results: Out of various mean AgNOR related parameters, AgNOR count, area, perimeter, and proportion were found to be higher in dysplastic leukoplakia as compared to nondysplastic leukoplakia. On statistical analysis, AgNOR count showed statistically significant differentiation between dysplastic and nondysplastic leukoplakia. While other parameters can distinguish normal oral epithelium from dysplastic and nondysplastic leukoplakia. Conclusion: To conclude, the AgNOR count is the most appropriate marker to differentiate between dysplastic and nondysplastic leukoplakia.
  3 1,915 352
Evaluation of stress patterns in bone around dental implant for different abutment angulations under axial and oblique loading: A finite element analysis
Rohit Bahuguna, Bhargavi Anand, Dheeraj Kumar, Himanshu Aeran, Vishal Anand, Minkle Gulati
January-June 2013, 4(1):46-51
DOI:10.4103/0975-5950.117882  PMID:24163552
Introduction: The replacement of missing anterior teeth presents peculiar challenges to the Prosthodontist. Implants are increasingly gaining favour for the same. The morphology of existing bone in the premaxilla often dictates that implants are placed at angles that are difficult to restore with conventional abutments. However, the angulated abutments might transfer unfavourable forces to the implant or bone, thereby compromising the prognosis of the treatment. Because, it is difficult to assess the generated forces clinically, a finite element analysis was chosen for the present study as it is useful tool in estimating stress distribution in the contact area of the implant with the bone. Materials and Methods: In this study, the frontal region of the maxilla was modelled with a cortical layer 1.5 mm thick containing an inner cancellous core. The implant was cylindrical, round ended, with length 13 mm and diameter 4.1 mm. The abutment was modelled as 7 mm in height with a 5 degree occlusal taper. The different abutment angulations used were 0°, 10°, 15° and 20°. The amount of loads used were 100, 125, 150, 175 and 200 N axially, and 50 N in oblique direction, to approximate the kind of loads seen in clinical situations. Result: It was seen that, as the abutment angulation changes from 0° to 20° both the compressive as well as tensile stresses increased; but, it is within the tolerance limit of the bone. Conclusion: It seems reasonably safe to use angled abutments in anterior implant supported prostheses, in the maxillary arch.
  3 2,470 656
Median facial dysplasia: A rare craniofacial syndrome and the surgical management of associated cleft lip
Rakesh Sharma, Sriram Krishnan, US Pal, Mahesh Verma
January-June 2013, 4(1):84-86
DOI:10.4103/0975-5950.117877  PMID:24163559
Median facial dysplasia (MFD) is a distinct and unique disorder of the craniofacial region that is characteristic of deficient mid facial structures with the addition of a unilateral or bilateral cleft lip with or without a cleft palate. A cleft lip which is associated with MFD whether it is unilateral or bilateral does not represent a typical cleft lip and poses some challenges in reconstruction. The management of such cleft lip has been rarely discussed in previous literatures; the main obstacle comes in identifying the anatomical landmarks to establish an esthetic reconstruction of the lip. However, reasonably good result can be achieved when the adjacent and distant anatomical structures are correlated to aid the reconstruction.
  2 2,021 232
Cleft palate lateral synechia syndrome
Deborah Sybil, Alok Sagtani
January-June 2013, 4(1):87-89
DOI:10.4103/0975-5950.117876  PMID:24163560
Cleft lip and palate are the most common congenital craniofacial anomaly in humans. The presence of oral synechia along with cleft palate is a rare syndrome. We encountered one case that had a cleft palate accompanied by congenital oral synechia due to a membranous adhesion between the floor of the mouth and the free margin of the cleft palate.
  2 2,261 254
Sialoblastoma: A literature review from 1966-2011
Kanaram Choudhary, Swagatika Panda, VT Beena, R Rajeev, R Sivakumar, Satish Krishanan
January-June 2013, 4(1):13-18
DOI:10.4103/0975-5950.117821  PMID:24163547
Sialoblastoma is a rare congenital tumour of the salivary glands arising mainly from the parotid gland. It is usually diagnosed at birth or shortly thereafter with a significant variability in histological appearance and clinical course. In extensive search of PubMed indexed journals, we got 46 cases of "sialobalstoma/embryoma/congenital basal adenoma", with one case was of German literature and three additional cases of adult sialobalstoma. This article has extensively reviewed the clinical, histopathological and immunohistochemical features, Magnetic resonance imaging (MRI) and Computerized Tomography (CT) findings, treatment and prognosis.
  2 2,965 465
Appearance can be deceptive: Dentigerous cyst crossing the midline
Rahul Paul, Geeta Paul, Ruchika K Prasad, Shilpa Singh, Nitin Agarwal, Abhishek Sinha
January-June 2013, 4(1):100-103
DOI:10.4103/0975-5950.117823  PMID:24163563
Dentigerous cyst is a developmental odontogenic cyst, which develops by accumulation of fluid between reduced enamel epithelium and the tooth crown of an unerupted tooth. Dentigerous cysts are usually solitary, slow growing, asymptomatic lesions that are incidentally found during routine radiographs They most frequently involve the mandibular third molar followed in order of frequency by the maxillary canine, mandibular second pre-molar and maxillary third molar. Occasionally, these cysts become painful when infected causing swelling and erythema. The cyst is usually small, however, when large, results in the expansion and thinning of the cortex leading to pathological fracture. Radiographic features are specific to the lesion characterized by a well-defined radiolucency circumscribed by a sclerotic border, associated with the crown of an impacted or unerupted tooth. Dentigerous cysts are treated most commonly by enucleation, Marsupialization and decompression of cyst by fenestration. The criteria for selecting the treatment modality is based on the age, size, location, stage of root development, position of the involved tooth and relation of the lesion to the adjacent tooth and vital structure. The prognosis is an excellent when the cyst is enucleated and recurrence is rare. In this article, we present a case of a Dentigerous cyst in an 80-year-old man in the anterior aspect of the mandible enveloping an impacted canine and crossing the midline but with no clinical expansion or discomfort.
  1 2,085 368
Let's learn to self-introspect
Neelam N Andrade
January-June 2013, 4(1):1-1
DOI:10.4103/0975-5950.117808  PMID:24163544
  - 1,688 329
Multiple paranasal sinus involvement from a metastatic follicular carcinoma thyroid
Arvind Krishnamurthy, Vijayalakshmi Ramshankar
January-June 2013, 4(1):121-122
DOI:10.4103/0975-5950.117809  PMID:24163569
  - 1,447 163
Practical draining technique using Foley catheter for maxillofacial spatial infections
Gökhan Göçmen, Altan Varol, Kamil Göker
January-June 2013, 4(1):122-123
DOI:10.4103/0975-5950.117812  PMID:24163570
  - 800 99
Positive outcomes of naso alveolar moulding in bilateral cleft lip and palate patient
Kamlesh Singh, Deepak Kumar, Kriti Singh, Jasmeet Singh
January-June 2013, 4(1):123-124
DOI:10.4103/0975-5950.117813  PMID:24163571
  - 1,543 338
Relevance of anterior mandibular body ostectomy in mandibular prognathism
Pankaj Bansal, Virender Singh, SC Anand, Sumidha Bansal
January-June 2013, 4(1):57-65
DOI:10.4103/0975-5950.117886  PMID:24163554
Purpose: We tried to find out the relevance of anterior mandibular body ostectomy in deformities of the mandible specially prognathism, which is primarily limited to anterior part only. Patients and Methods: Ten patients with skeletal deformity along with malocclusion, which was limited to anterior body of mandible were selected. Selected patients had proper molar interdigitation (even if class 3) and in general had anterior crossbite (except one). All patients had crossed their growth spurts and had no hormonal influence on facial deformity. Specific protocol, including cephelometric analysis cephalometry for orthognathic surgery, prediction tracing and model surgeries were devised. Pre and post-surgical orthodontics and body ostectomy were performed in all patients along with 18-month post-op follow-up. Results: There was significant reduction in prognathism and horizontal dysplasia in all ten patients. Anterior crossbite as well as axis of incisiors over mandibular plane was corrected in all patients due to decrease in length of mandibular body. All patients showed decreased facial height and better lip competence with intact posterior occlusion and no (negligible or transient) sensory loss. Conclusions: Our study could confirm that people whose deformity is limited to the anterior part of mandible with reasonable occlusion posteriorly can get satisfactory cosmetic and functional results through body ostectomy alone rather than going for surgical procedure in the ramal area, which is liable to cause sensory and occlusal disturbances.
  - 2,847 365
Natal and neonatal teeth among cleft lip and palate infants
Manjushree Kadam, Dinesh Kadam, Sanath Bhandary, Rajesh Y Hukkeri
January-June 2013, 4(1):73-76
DOI:10.4103/0975-5950.117883  PMID:24163556
Objective: Natal/neonatal teeth are reported to be more common among clefts and congenital anomalies. Data exclusively among clefts is sparse. The aim was to evaluate prevalence of natal teeth among cleft lip and palate neonates and review the causes, presentation, associated anomalies, complications and management. Materials and Methods: Out of 641operated patients, records of 151 infants with cleft lip and palate with less than three months of age presented to the department of plastic and reconstructive surgery from 2005 to 2011 were reviewed. Out of which 107 were unilateral complete lip and palate (ULCP), 15 bilateral cleft lip and isolated cleft palate constituted 29. Results: Three patients among the studied records showed neonatal teeth. Two had paired central mandibular incisor teeth along with associated other anomalies and one had a single maxillary neonatal tooth. All were present in unilateral cleft lip and none of the bilateral or isolated cleft palate infants showed neonatal teeth. The overall incidence of neonatal teeth was 1.98% and 2.8% in unilateral Cleft lip. Conclusion: Our study supports the incidence of 2% natal teeth among UCLP. Involvement of mandibular central incisors in contrast to the notion that maxillary alveolus is more commonly affected suggest that it is not only the anatomical disturbance but also all those possible common multifactorial etiological factors contributing to the congenital anomalies as such. Natal/neonatal teeth are rather under-diagnosed and reported than a rare phenomenon and the prevalence is higher in certain population. Riga-Fede disease unlikely to be seen in clefts with neonatal teeth due to anatomical factors. The extraction of non mobile tooth if necessary can be done during the primary surgery for the cleft lip.
  - 3,212 427