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National Journal of Maxillofacial Surgery
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   2014| July-December  | Volume 5 | Issue 2  
    Online since April 10, 2015

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Undiagnosed pediatric condylar fractures and ankylosis of the temporomandibular joint
Ajoy Roychoudhury
July-December 2014, 5(2):107-108
DOI:10.4103/0975-5950.154807  PMID:25937718
  1,273 9,301 1
Trends in management of myofacial pain
Uma Shanker Pal, Lakshya Kumar, Gagan Mehta, Nimisha Singh, Geeta Singh, Mayank Singh, Hemant Kumar Yadav
July-December 2014, 5(2):109-116
DOI:10.4103/0975-5950.154810  PMID:25937719
We systematically reviewed the myofascial pain publications in the literature. The aim of this article is to review the methods of management and their outcome and factors associated with prognosis. The topics of interest in the diagnostic process are myofascial trigger points electromyography, jaw tracking, joint sound recorder, sonography, and vibratography, exclusion of other orofacial pain and temporomandibular disorders. Management modalities are occlusal therapy, physiotherapy, multidimensional rehabilitation antinociceptive therapy, anti-inflammatory and analgesics, muscle relaxants, stretch, and spray technique, transcutaneous electric nerve stimulation, and in severe cases botulinum toxin may be tried. The disease required interdisciplinary interaction in terms of occlusal therapy, antinociceptive therapy and physiotherapy because management of the disease may be influenced by the specialist primarily treating the patients.
  4,292 3,275 6
Dental care during and after radiotherapy in head and neck cancer
Seema Devi, Nimisha Singh
July-December 2014, 5(2):117-125
DOI:10.4103/0975-5950.154812  PMID:25937720
Head and neck cancer is a major health problem. Oral cancer is increasing in Indian subcontinent mainly due to lack of hygiene, tobacco use, chewing tobacco, smoking, and many other factors. Radiation therapy is the most common form of treatment along with surgery and chemotherapy. There are 2 types of complication that occurs during and after radiotherapy, that occur because of effects on normal tissue. Radiotherapy-induced effects occur on the oral mucosa salivary glands, bone, teeth, and musculature of face and neck. These complications needs special attention for their prevention and treatment, Preradiotherapy evaluation and disease stabilization are necessary in every patient, counseling of patients before during and after radiotherapy is important to help them become aware of several oral complications and their prevention.
  4,844 1,399 12
Penetrating facial injury by a wooden log
Sadanandan Mohan, George Varghese, Sanjay Kumar, Dinesh Pambungal Subramanian
July-December 2014, 5(2):228-231
DOI:10.4103/0975-5950.154844  PMID:25937743
Penetrating facial injuries are potentially dangerous and require emergency management because of the presence of vital structures in the face and it may be life threatening especially when the injury involves airway, major blood vessels, spinal cord and cervical spines. Penetrating injuries of facial region can occur due to missile injuries, blast injuries, accidental fall on sharp objects such as sticks or glass and motor vehicle accidents etc., Indications for immediate surgical management of penetrating neck injuries include airway management and hemodynamic instability according to advanced trauma life support protocol.
  5,182 389 1
A radiological evaluation of marginal bone around dental implants: An in-vivo study
Shikha Nandal, Pankaj Ghalaut, Himanshu Shekhawat
July-December 2014, 5(2):126-137
DOI:10.4103/0975-5950.154813  PMID:25937721
Context: This article presents an original research conducted at Government Dental College, PGIDS, Rohtak. Aims: (1) To evaluate the marginal bone level changes around dental implants based on the radiological examination. (2) To evaluate the relationship of various parameters, i.e., gender, implant length, implant diameter and location of implants on the amount of bone loss around dental implants. Materials and Methods: An in-vivo study was undertaken to evaluate the crestal bone loss on mesial and distal aspect of implants, using standardized intra-oral periapical at the end of 6 months after placing the implants, but before prosthetically loading it. Statistical Analysis Used: Student's unpaired t-test. Results: Bone loss was measured and values were recorded immediately after implant placement and after 6 months. Conclusions : (1) Bone loss on mesial and distal aspects of implants was found to be same after period of 6 months. (2) Bone loss was found to be same in both 13 mm and 10 mm implants on mesial aspect, whereas on distal aspect, it was more in 10 mm implants. (3) Bone loss was found to be same in both 3.5 mm and 4.3 mm diameter implants on both mesial and distal aspects of implants. (4) Bone loss was found to be same in both maxilla and mandible on both mesial and distal aspects of implants. (5) Bone loss was found to be more in females on both mesial as well as distal aspects of implants.
  3,578 1,763 4
Airway management using transmylohyoid oroendotracheal (submental) intubation in maxillofacial trauma
Imran Khan, Deborah Sybil, Anurag Singh, Tarun Aggarwal, Rizwan Khan
July-December 2014, 5(2):138-141
DOI:10.4103/0975-5950.154815  PMID:25937722
Successful management of airway in complex maxillofacial injuries is quite challenging. The complications and the post-operative care associated with tracheotomy makes it an unpopular choice for airway management meant solely for surgery in these patients. A retrospective analysis of 12 patients from June 2008 to December 2011, seeking treatment for pan facial fractures who underwent transmylohyoid oroendotracheal (submental) intubation is discussed here. The stepwise procedure is explained along with problems of intubation in pan facial fractures. The advantages, disadvantages and complications of transmylohyoid intubation are discussed and compared with alternative methods of air way management in such cases. This reliable, safe and easy method of airway management gives sterile surgical field without a change of tube.
  3,455 786 -
Antibiotics in third molar extraction; are they really necessary: A non-inferiority randomized controlled trial
Ankit Arora, Ajoy Roychoudhury, Ongkila Bhutia, Sandeep Pandey, Surender Singh, Bimal K Das
July-December 2014, 5(2):166-171
DOI:10.4103/0975-5950.154821  PMID:25937728
Introduction: Antibiotic resistance is now a serious problem, although it was not so only a few years ago. The need of the hour is to give clear evidence of the efficacy of antibiotic use, or lack thereof, to the surgeon for a procedure as common as mandibular third molar surgery. Aim: This study aimed to evaluate whether postoperative combined amoxicillin and clavulanic acid in mandibular third molar extraction is effective in preventing inflammatory complications. Study and Design: The study was structured as a prospective randomized double-blind placebo-controlled clinical trial. Materials and Methods: A study was designed wherein the 96 units (two bilaterally similar impacted mandibular third molars per head in 48 patients) were randomly assigned to two treatment groups (Group I and Group II). Each patient served as his/her own control. Each patient received 625 mg of combined amoxicillin and clavulanic acid 1 h before surgery. In the case of third molars belonging to Group I, 625 mg of combined amoxicillin and clavulanic acid TDS was continued for 3 days; in Group II, placebo in similar-looking packs was continued for 3 days. The patients were evaluated on the third and seventh postoperative days for signs of clinical infection and for microbial load evaluation. Statistical Analysis: The data between the two groups were statistically analyzed by the two-tailed Fisher's exact test, with a 95% confidence interval. Results: The difference was not statistically significant between the test group and the control group with regard to erythema, dehiscence, swelling, pain, trismus, and infection based on microbial load. The data were statistically significant for alveolar osteitis, with the occurrence of alveolar osteitis (14.58%) in the placebo group. Conclusion: Postoperative antibiotics are recommended only for patients undergoing contaminated, long-duration surgery.
  2,548 778 2
Prevalence of oral cancer and pre-cancerous lesions and the association with numerous risk factors in North India: A hospital based study
Shalini Gupta, Rajender Singh, OP Gupta, Anurag Tripathi
July-December 2014, 5(2):142-148
DOI:10.4103/0975-5950.154816  PMID:25937723
Background: Oral cancer is one of the most common life-threatening diseases all over the world. Developing countries face several challenges to identify and remove potential risk factors. Chewing tobacco/pan masala is considered to be the most potent risk factor for oral precancerous lesions and oral cancer. Objectives: To investigate the relative occurrence of different oral pre-cancerous lesions and oral cancer in North India and to identify the associated risk factors. Materials and Methods: A hospital-based study was conducted and 471 subjects were recruited in the study. The subjects comprised patients with squamous cell carcinoma (n = 85), oral submucous fibrosis (n = 240), leukoplakia (n = 32), lichen planus (n = 15), and controls (n = 99). Statistical analysis of the data was done using Chi-square and regression analysis. Results: A strong correlation was observed between the presence of the chewing habit in all the oral precancerous lesions and oral cancer. Duration of the habit and intensity of habit ware also strongly correlated with the risk of oral precancerous lesions and oral cancer. Other factors such as alcohol and smoking were found to be less important in concern with oral cancer and precancerous lesions.
  2,312 572 4
A rare case of breast carcinoma metastasis to mandible and vertebrae
George Varghese, Surender Pal Singh, LS Sreela
July-December 2014, 5(2):184-187
DOI:10.4103/0975-5950.154832  PMID:25937731
Oral cavity metastases are considered rare and represent approximately 1% of all oral malignancies. Due to their rarity and atypical clinical and radiographic appearance, metastatic lesions are considered a diagnostic challenge. This article presents a rare case of breast carcinoma with metastasis to mandible and vertebrae. A case is presented of a 40-year-old female patient with a history of breast carcinoma which was surgically treated approximately 2 years back. The diagnosis of metastatic breast carcinoma was confirmed by radiographic examination, bone scan and histopathologic findings. She was referred to radiotherapy department since it was not amenable to surgery due to metastasis in vertebrae. A high index of clinical suspicion of metastatic cancer is necessary when evaluating patients who complaint of jaw pain and swelling with a history of non-head and neck carcinoma.
  2,488 313 2
Tuberculous osteomyelitis of the maxilla: A rarest of rare case report
Ramesh Gupta, Meenu Garg, Ajay Kumar Gupta, C Anand
July-December 2014, 5(2):188-191
DOI:10.4103/0975-5950.154833  PMID:25937732
Tuberculosis is a chronic granulomatous systemic infectious disease caused by Mycobacterium tuberculosis. The oral lesions found in tuberculosis are relatively rare and may present as ulcers, erythematous patches, indurated lesions, nodules or as bony jaw lesions. Oral tubercular lesions sometimes present a confusing clinical presentation and can be overlooked. Hence, we document a case of tuberculous osteomyelitis of the maxilla in a 19-year-old female patient, who was initially treated for multiple periodontal dental abscesses, which later proved to be tubercular osteomyelitis of the maxilla. Although it is a rare occurrence, the differential diagnosis of tuberculous osteomyelitis must always be considered when it fails to respond to routine therapy.
  1,977 320 -
Cleidocranial dysplasia
Neeraj Kumar Dhiman, Akhilesh Kumar Singh, Naresh Kumar Sharma, Chandresh Jaiswara
July-December 2014, 5(2):206-208
DOI:10.4103/0975-5950.154838  PMID:25937737
Cleidocranial dysplasia (CCD) is an autosomal dominant disorder resulting in the skeletal and dental abnormalities due to the disturbance in ossification of the bones. Clavicle is the most commonly affected bone. The prevalence of CCD is one in millions of live births. In this report, we present a case of 10-years-old boy showing features of this condition.
  2,020 277 -
Evaluation of microbial flora in orofacial space infections of odontogenic origin
Amod Patankar, Arun Dugal, Rajesh Kshirsagar, Hariram , Vikram Singh, Akshay Mishra
July-December 2014, 5(2):161-165
DOI:10.4103/0975-5950.154820  PMID:25937727
Background: The microbiology of acute dental infections has been in the midst of many researches. Various bacteriological studies show variations in their conclusion. The purpose of our study was to evaluate the microbial flora in orofacial space infections of odontogenic origin, which is essential for appropriate antibiotic selection. Materials and Methods: Thirty-five patients with odontogenic infection causing fascial space involvement were included. Aspirated specimen was transported in nutrient broth and thyoglycollate media within an hour for further culture and sensitivity testing. Result and Conclusion: This study indicates that orofacial odontogenic infections are usually polymicrobial, consisting of a complex mixture of both anaerobes and aerobes.
  1,747 506 2
Prevalence and pattern of mandibular fracture in Central India
Dhananjay Barde, Anupama Mudhol, Ramnik Madan
July-December 2014, 5(2):153-156
DOI:10.4103/0975-5950.154818  PMID:25937725
Introduction: The etiology and pattern of mandibular fracture vary considerably among different study populations. Despite many reports about the incidence, diagnosis and treatment of mandibular fracture there is limited knowledge about the specific type or pattern of mandibular fractures in South Asian countries. This study attempts to delineate predictable patterns of fracture based on patient demographics and mechanism of injury in central part of India. Materials and Methods: The medical records of patients with mandibular fractures treated over a 3 years period were identified and analyzed based on age, sex, mechanism of trauma, seasonal variation, drug/alcohol abuse, number and anatomic location. Results: We reviewed 464 patients having mandibular fractures with age ranging from 7 to 89 years. Male (343, 79%) to female (91, 21%) ratio was 3.7:1, significantly higher for males. The highest incidence (37.5%) of mandibular fractures was in the age group of 21-30 years. The main cause was road traffic accidents (RTAs, 68.8%) followed by falls (16.8%), assaults (11%) and other reasons (3.8%). Parasymphyseal fractures were the most frequent 331 (41.1%), followed by condyle (135) and angle (124) fractures in occurrence. Mandibular angle fractures were found mostly to be associated with assault victims. Conclusion: The mechanism of injury correlates significantly with the anatomic location of fracture and knowledge of these associations should guide the surgeons for appropriate and timely management. Because RTAs are most frequent, good traffic sense needs to be imbibed and developed by the government as well as the public.
  1,836 389 3
Use of indomethacin as an adjuvant to surgery for recurrent temporomandibular joint ankylosis in adults
Krushna Bhatt, Sandeep Pandey, Ongkila Bhutia, Ajoy Roychoudhury
July-December 2014, 5(2):198-201
DOI:10.4103/0975-5950.154836  PMID:25937735
Two cases with multiple recurrences of temporomandibular joint ankylosis and multiple failed interposition/gap arthroplasty procedures are presented here. Heterotopic bone formation was thought to be the reason. Indomethacin prophylaxis for prevention of heterotopic new bone formation at the osteoarthrectomy site was used as an adjuvant to surgery, in dosages of 75 mg/day for six weeks. Indomethacin is used frequently in hip and elbow arthroplasties to prevent heterotopic ossification, but its use in temporomandibular joint is not routine. The presented cases did not develop further recurrence and attained stable mouth opening over two-year follow-up after osteoarthrectomy and oral indomethacin.
  1,874 343 2
Evaluation of soft and hard tissue changes after bimaxillary surgery in class III orthognathic surgery and aesthetic consideration
Mehrangiz Ghassemi, Alireza Ghassemi, Rahman Showkatbakhsh, Syed Sayeed Ahmad, Mohammad Shadab, Ali Modabber, Abdolreza Jamilian
July-December 2014, 5(2):157-160
DOI:10.4103/0975-5950.154819  PMID:25937726
Aims: The aim of this study was to evaluate hard and soft tissue change after bimaxillary surgery in class III patients by focusing on sella, nasion, A point (SNA) and sella, nasion, B point (SNB) angle and aesthetic outcome. Materials and Methods: The sample consisted of 96 skeletal Class III patients (42 women, 54 men) with a mean age of 25 years with standard deviation (SD) of 8.4. The youngest patient was 16-years-old and the oldest 51-years-old at the time of surgery. In total, seven skeletal parameters, eight soft tissue parameters, and two dental parameters were evaluated on the cephalograms. Result: At the beginning of the treatment 49 Patients had SNA between 80° and 84°, 34 had SNA of less than 80° and 13 had SNA of more than 84°. Post surgically, 25 patients had SNA of 78°-84°, 19 had SNA less than 78° and 52 patients had SNA of more than 84°. Out of 96 patients 22 had SNB of 78°-82° before surgery, 16 had less than 78° and 58 had SNA of more than 84°. Postoperatively, we measured SNB of 78°-80° in 42, less than 78° in 18 and of more than 82° in 36 patients. The inclination of the maxilla relative to the cranial base changed from 7.2° (SD = 4)-8° (SD = 5.1) and the mandible changed from 35.7° (SD = 6.6) to 36° (SD = 6.3) postoperatively which was not significant. The distance from upper lip to E-line increased by 2.6 mm (SD = 3.9) after surgery (P < 0.001), while, the lower lip distance to E-line decreased slightly by 0.9 mm (SD = 3.2) (P < 0.01). Nasolabial angle was decreased by 9.5° (SD = 9.4) after surgery (P < 0.001). The nose prominence also decreased from 18.2 mm (SD = 3.5) -16.5 mm (SD = 3.3). Conclusion: Although in many cases we did not have a SNA angle or SNB angle in normal range but a good aesthetic outcome have been observed. Consequently our study showed that soft tissue change and aesthetic aspects should be considered in surgical planning and achieving SNA angle or SNB angle of norm range should not be the only goal. As we could show the advancement of maxilla will result in a better lip and nose profile and this should be considered in treatment planning.
  1,714 461 4
Double mandibular osteotomy with segmental mandibular swing approach to parapharyngeal space
Shouvanik Satpathy, Aniruddha Dam, Mollah Arafat Hossain, Jayanta Chatterjee
July-December 2014, 5(2):213-216
DOI:10.4103/0975-5950.154840  PMID:25937739
Surgical removal of benign tumors of the Parapharyngeal space (PPS) is the treatment of choice. PPS tumors may remain undetected for long periods of time and large tumors in the PPS can extend into the Retropharyngeal Space or into the Infra-Temporal Fossa. Anatomically, the mandible represents a significant obstacle to successful PPS surgery. Except for very small tumors, it is difficult to remove larger tumors from this region without some form of mandibular retraction. The standard mandibular "swing" approach involves splitting of the lower lip and a single parasymphysis osteotomy for retraction of the mandible laterally to expose the PPS. However, the morbidity associated with midline lip split and anesthesia of the hemi-labial region caused by the severing of the mental nerve is an unwanted complication of this approach. In this article, we describe an easier double mandibular osteotomy (Segmental Mandibular Swing Approach) which avoids the morbidity associated with lip splitting or intra-oral mucosal incision but allows excellent exposure of the superior and lateral aspect of PPS for easier removal of large tumors in this region.
  1,542 335 2
A 2-year retrospective analysis of facial injuries in patients treated at department of oral and maxillofacial surgery, IGGDC, Jammu, India
Parveen Lone, Amrit Pal Singh, Indumeet Kour, Misha Kumar
July-December 2014, 5(2):149-152
DOI:10.4103/0975-5950.154817  PMID:25937724
Introduction: The incidence of maxillofacial injuries is on the rise due to motor vehicle accidents and increased incidence of violence in recent times. The aim of this retrospective study was to determine the incidence, etiology, and the pattern of fractures in the maxillofacial region. Materials and Methods: After obtaining permission from the concerned authorities, a predesigned questionnaire was used to collect the necessary data from the department. A retrospective analysis of 787 patients, who suffered trauma and were managed in the Department of Oral and Maxillofacial Surgery, Indira Gandhi Government Dental College (IGGDC), Jammu over a period of 2 years was carried out. Results: Road traffic accident (RTA) was the common cause of maxillofacial injuries. Men sustained more injuries as compared to women. Injuries were most commonly sustained in the age group of 11-40 years, constituting about 76% of all injuries, mandibular fractures were the most common. Conclusion: RTAs were the commonest cause for the maxillofacial injuries.
  1,605 250 1
Modified microdissection electrocautery needle
Virendra Singh, Pramod Kumar
July-December 2014, 5(2):243-244
DOI:10.4103/0975-5950.154849  PMID:25937747
Electrocautery is routinely used in surgical procedures. The commercially available microdissection electrocautery needles are costly. To overcome this disadvantage, we have modified monopolar electrocautery tip to function as well as commercially available systems.
  1,607 222 -
Accessory parotid gland with ectopic fistulous duct - Surgical view: A case report and review of current literature
GD Yadav, Anju Yadav, Jatin Soni, Ghisulal Chaudhary
July-December 2014, 5(2):236-239
DOI:10.4103/0975-5950.154846  PMID:25937745
Accessory parotid glands are a common clinical occurrence and usually drain into the main Stenson's duct by small ductules and thereby, into the buccal cavity. Presence of an accessory parotid gland with an ectopic fistulous duct is a rare occurrence. Clinical findings, imaging studies, biochemical tests, histopathological examination are needed for appropriate surgical management. It is extremely rare case with ectopic fistulous duct in an accessory parotid gland managed surgically by internalization of the duct to open into the buccal mucosa and excision of pre-aural appendages. Further to this, we give a comprehensive review of literature on accessory parotid gland and duct anomalies.
  1,600 206 3
Epithelial-myoepithelial carcinoma of floor of mouth: A case report with cytological, histological and immunohistochemical correlation
Sujata Mohanty, Himani Pathak
July-December 2014, 5(2):195-197
DOI:10.4103/0975-5950.154835  PMID:25937734
A 61-year-old female presented with a 3-year-old swelling in the right floor of mouth. Clinical examination and fine needle aspiration cytology suggested a benign lesion. The mass was excised locally along with the involved sublingual and deep part of submandibular gland and duct. Post-operative histopathological examination revealed features of pleomorphic adenoma. However, on revision of histological sections, features were predominantly of a rare malignancy of the salivary glands, epithelial-myoepithelial carcinoma (EMC), along with focal areas of adenoid cystic carcinoma (Ad CC). The tumor was p-63, s-100 and smooth muscle actin positive but C-kit was negative, which ruled out Ad CC and the possibility of a hybrid carcinoma. The aim of this article is to describe a rare case of EMC in the floor of mouth and the confusing cytological picture that it created.
  1,503 250 3
An unusual case of compound odontome associated with maxillary impacted central incisor
Nadia Khan, Neha Shrivastava, Tarun Vijay Shrivastava, Fahad Mansoor Samadi
July-December 2014, 5(2):192-194
DOI:10.4103/0975-5950.154834  PMID:25937733
Odontomas are the most common type of odontogenic tumor occurring within the jaws and are frequently associated with the retained deciduous teeth interfering with the eruption of permanent teeth. Compound odontomas are usually diagnosed in the anterior portion of the jaws and resemble tooth-like structure. These are usually asymptomatic. Complex odontomas are normally diagnosed in the posterior part of the jaws and consist of a disorganized mass with no morphologic resemblance to a tooth. The present case report of a 16-year-old female is a typical case of compound odontoma in the maxillary anterior region associated with retained deciduous incisor, which also resulted in failure of eruption of the permanent maxillary right central incisor. An intraoral periapical radiograph revealed the presence of a radio-opaque tooth-like structure in the apical region of retained deciduous incisor and an impacted permanent right central incisor whose path of eruption was impeded by the structure. Treatment included the surgical removal of the lesion followed by orthodontic extrusion of the impacted incisor. Follow-up was done for one 1 year and no recurrence was seen.
  1,404 335 2
Immediate reconstruction of palato-maxillary defect following tumor ablation using temporalis myofascial flap
Sunil Yadav, Anita Dhupar, Vikas Dhupar, Francis Akkara, Hitesh C Mittal
July-December 2014, 5(2):232-235
DOI:10.4103/0975-5950.154845  PMID:25937744
The resection of oral cavity tumor and malignancies often causes functional disabilities like deglutition and articulation. Maxillectomy is a very common surgical procedure carried out for the management of benign and malignant tumors of maxilla. Irrespective of the procedure, there is a common end result that is the defect. Several soft tissue flaps can be used for reconstruction of maxillectomy defect. Keeping the parameters of reconstruction in mind it is ideal to reconstruct the maxillary defect with either the free flaps or the regional flaps. Of all regional flaps, the temporalis myofascial flap (TMF) provides a high degree of reliability, vascularity, adequate bulk, and proximity to the defect in the oral and maxillofacial region.
  1,343 278 3
Extensive ossifying fibroma of jaw
Anand Kumar, DS Gupta, Sunit K Jurel, Ruchika Khanna, Manoj Yadav
July-December 2014, 5(2):224-227
DOI:10.4103/0975-5950.154843  PMID:25937742
Ossifying fibroma of bone is a central neoplasm of bone and it is more common in young adult with marked predilection for mandible and also it is more common in female. Lesion is generally asymptomatic until growth produces a noticeable swelling and mild deformity. It presents an extremely variable roentographic appearance depending upon the stage of development. This lesion is composed basically of many delicate interlacing collagen fibers, seldom arranged in discrete bundle, interspersed by large numbers of active, proliferating fibroblasts. The lesion should be excised conservatively. We present a case of huge ossifying fibroma arising from maxilla.
  1,264 270 -
Lateral orbital approach: Gateway to intraorbital lesions
LK Surej Kumar, Moni K Vinod, P Varun Menon
July-December 2014, 5(2):217-220
DOI:10.4103/0975-5950.154841  PMID:25937740
Several approaches to the intraorbital space have been described in the literature. Selection of a proper approach to intraorbital lesions depends on various factors including the location of the tumor, the size of the lesion, and the probable pathology anticipated. The approach should provide a good exposure of intraorbital anatomical structures, allow their functional preservation, and provide good cosmetic results. Intraconal lesions of the orbit usually necessitate transcranial approaches although some intraconal and laterally situated lesions could be removed effectively via lateral orbitotomy. Lateral orbitotomy is a well-known approach for lesions of the lateral orbital cone. In this case report, the lateral orbital approach has been used for exposure of intraorbital lesion, as it is minimally invasive compared to the transcranial approach.
  1,250 272 -
Amelogenin in odontogenic cysts and tumors: An immunohistochemical study
Praveen Anigol, Venkatesh V Kamath, Krishnanand Satelur, Nagaraja Anand, Komali Yerlagudda
July-December 2014, 5(2):172-179
DOI:10.4103/0975-5950.154822  PMID:25937729
Background: Amelogenins are the major enamel proteins that play a major role in the biomineralization and structural organization of enamel. Aberrations of enamel-related proteins are thought to be involved in oncogenesis of odontogenic epithelium. The expression of amelogenin is possibly an indicator of differentiation of epithelial cells in the odontogenic lesions. Aims and Objectives: The present study aimed to observe the expression of amelogenin immunohistochemically in various odontogenic lesions. Materials and Methods: Paraffin sections of 40 odontogenic lesions were stained immunohistochemically with amelogenin antibodies. The positivity, pattern and intensity of expression of the amelogenin antibody were assessed, graded and statistically compared between groups of odontogenic cysts and tumors. Results: Almost all the odontogenic lesions expressed amelogenin in the epithelial component with the exception of an ameloblastic carcinoma. Differing grades of intensity and pattern were seen between the cysts and tumors. Intensity of expression was uniformly prominent in all odontogenic lesions with hard tissue formation. Statistical analysis however did not indicate significant differences between the two groups. Conclusion: The expression of amelogenin antibody is ubiquitous in odontogenic tissues and can be used as a definitive marker for identification of odontogenic epithelium.
  1,158 256 2
Cellular infiltrative angiolipoma of cheek in an infant
Ajoy Kumar Shahi, Hiralal Ash, Kabita Chatterji, Revati Singh
July-December 2014, 5(2):202-205
DOI:10.4103/0975-5950.154837  PMID:25937736
Lipomas represent about 1 to 5% of all neoplasms of the oral cavity most commonly presenting as painless, mobile, soft, round mass. Angiolipoma, spindle cell lipoma, mylelolipoma, chondrolipoma and myxolipoma are histological variants of lipoma arising from fat tissues. Although the angiolipoma is the most common tumour in the trunk and the extrimities of young people, it occurs infrequently in the head and neck region. In this article we present clinical, radiological and histological features of a cellular infiltrative angiolipoma exicised from the buccal mucosa of a 9 months old female child.
  1,158 196 -
Clear cell odontogenic carcinoma of the mandible and temporomandibuar joint with cervical lymph nodal metastasis
Arvind Krishnamurthy, Vijayalakshmi Ramshankar, Urmila Majhi
July-December 2014, 5(2):221-223
DOI:10.4103/0975-5950.154842  PMID:25937741
Clear cell odontogenic carcinoma (CCOC) is a rare aggressive tumor that has the ability to invade locally as well as cause regional and distant metastasis. The etiology of this neoplasm remains poorly understood and the diagnosis of CCOC is done by exclusion of other clear cell tumors. To date, approximately 75 cases of CCOC have been described in the English literature, all involving a single jaw. The majority of cases have been reported to arise from the mandible, the maxilla is less frequently involved, and no case had involvement of the temporomandibuar joint. Lymph node metastasis at initial presentation is reportedly rare (<10%). We describe possibly the first case of CCOC in a 50-year-old woman with involvement of the mandible and the temporomandibuar joint along with cervical lymph nodal metastasis. We share our experiences and challenges in the management of this unusual tumor.
  1,068 245 3
Internal jugular vein thrombosis due to heterozygote methylene tetrahydrofolate reductase (MTHFR) 1298C and Factor V G1691A mutations after a minor trauma
Murat Gumussoy, Ilker B Arslan, Ibrahim Cukurova, Sinan Uluyol
July-December 2014, 5(2):180-183
DOI:10.4103/0975-5950.154824  PMID:25937730
Internal jugular vein thrombosis usually appears in central venous catheterization, distant malignancies, hypercoagulation, infections, or secondary to ovarian hyperstimulation syndrome. A 44-year-old female patient presented to us with sore throat, and pain and swelling on the right side of her neck. She had a history of simple neck trauma 10 days ago. Ultrasonography and computed tomography showed bilateral multiple lymphadenopathies and right internal jugular vein thrombosis. Patient was put on parenteral antibiotherapy and oral anticoagulant treatment. Genomic DNA tests for hypercoagulation revealed methylene tetrahydrofolate reductase 1298C heterozygote mutation and Factor V G1691A (Leiden) mutation. Patient has been under clinical control for 1 year and does not have any complaints. In this article, diagnosis, treatment, and the etiology of internal jugular vein thrombosis, which is a rare and potentially fatal condition, have been discussed through this case.
  1,142 168 -
Gorlin-Goltz syndrome: A series of three cases
Amod P Patankar, Rajesh A Kshirsagar, Arun Dugal, Akshay Mishra, Hari Ram
July-December 2014, 5(2):209-212
DOI:10.4103/0975-5950.154839  PMID:25937738
The Gorlin-Goltz syndrome (GGS) is also known as nevoid basal cell carcinoma syndrome. It is characterized by multiple keratocystic odontogenic tumors (KCOTs) in the jaw, multiple basal cell nevi carcinomas and skeletal abnormities. The syndrome may be diagnosed early by a dentist during the routine radiographic exams in the first decade of life, since the KCOTs are usually one of the first manifestations of the syndrome. This article reports the series of 3 cases, emphasizing its clinical and radiographic manifestations of GGS.
  1,092 217 -
Peripheral osteoma of maxilla: A case report
Namish Batra, Renu Batra, Gaurav Singh, Amit Gaur
July-December 2014, 5(2):240-242
DOI:10.4103/0975-5950.154848  PMID:25937746
Osteoma is a benign osteogenic lesion with a very slow growth, characterized by proliferation of either compact or cancellous bone. Most cases of peripheral osteomas are asymptomatic and produce swelling and asymmetry. Its pathogenesis is unclear but commonly accepted theories propose embryologic, traumatic, or infectious causes. The osteoma may appear in the form of a limited peripheral lesion involving the alveoli or cheek or as a tumoral growth developing inward toward the sinus. Recurrences of osteomas have not been reported in the literature. We report a rare case of maxillary peripheral osteoma with impacted right canine in a 32-year-old female patient.
  1,033 210 -
Osteolipoma of the palate - An unusual presentation
Manas Bajpai, Manish Kumar, Deshant Agarwal, Shyam Agrawal, Sameer Gupta, Malay Kumar
July-December 2014, 5(2):250-251
DOI:10.4103/0975-5950.154856  PMID:25937752
  1,044 197 4
Lower third molars
Parmananad Dhanrajani, Mark Smith
July-December 2014, 5(2):245-246
DOI:10.4103/0975-5950.154851  PMID:25937748
There has always been a debate whether to remove or leave asymptomatic mesioangular impacted lower third molars. The present short communication discusses the merit of prophylactic removal to avoid clinical complications in future and the consequences to second molars.
  932 263 1
Platelet-rich plasma in periodontal defect treatment after extraction of impacted mandibular third molars: Retraction

July-December 2014, 5(2):254-254
DOI:10.4103/0975-5950.154859  PMID:25937754
  919 205 -
Isolated lower lip pits
Osama A Samargandi, Mahmoud Fakiha
July-December 2014, 5(2):247-248
DOI:10.4103/0975-5950.154854  PMID:25937750
  891 165 3
Modified mask ventilation in post rhinoplasty patient
Sukhminderjit Singh Bajwa, Rudrashish Haldar, Jasleen Kaur, Sukhen Samanta
July-December 2014, 5(2):248-249
DOI:10.4103/0975-5950.154855  PMID:25937751
  803 150 -
Hair discharging from the frenulum: Unusual presentation of a lingual dermoid cyst
Archana A Arya, Shridhar V Babanagare, Chetana Naik, Sanjay D Deshmukh
July-December 2014, 5(2):251-253
DOI:10.4103/0975-5950.154858  PMID:25937753
  744 134 1
Mitochondrial C-tract and tobacco exposure in oral precancer cases
Sim Sai Tin, Viroj Wiwanitkit
July-December 2014, 5(2):247-247
DOI:10.4103/0975-5950.154852  PMID:25937749
  673 104 -