Actinomycosis is a chronic granulomatous infection caused by Actinomyces species which may involve only soft tissue or bone or the two together. Actinomycotic osteomyelitis of maxilla is relatively rare when compared to mandible. These are normal commensals and become pathogens when they gain entry into tissue layers and bone where they establish and maintain an anaerobic environment with extensive sclerosis and fibrosis. This infection spreads contiguously, frequently ignoring tissue planes and surrounding tissues or organ. The portal of entry may be pulpal, periodontal infection, and so forth which may lead to involvement of adjacent structures as pharynx, larynx, tonsils, and paranasal sinuses and has the propensity to damage extensively. Diagnosis is often delayed and is usually based on histopathology as they are cultured in fewer cases. The chronic clinical course without regional lymphadenopathy may be essential in diagnosis. The management of actinomycotic osteomyelitis is surgical debridement of necrotic tissue combined with antibiotics for 3–6 months. The primary actinomycosis arising within the maxilla with contiguous involvement of paranasal sinus with formation of oroantral fistula is rare. Hence, we present a 50-year-old female patient with chronic sclerosing osteomyelitis of maxilla which presented as oroantral fistula with suppurative and sclerotic features.

Background and Objectives:A major concern of orthodontic patients is treatment time. Reducing the treatment time requires increasing the rate of orthodontic tooth movement. Research has proved that bone resorption is the rate-limiting step in tooth movement. Therefore, any procedure that potentiates osteoclastic activity is capable of increasing the rate of orthodontic tooth movement. Low-level laser has been indicated to have the capability to facilitate the differentiation of the osteoclastic and osteoblastic cells, which are responsible for the bone remodeling process. The purpose of this study was to evaluate whether the low-level laser therapy can accelerate orthodontic tooth movement during en masse retraction.Method:The study was a split-mouth design. The experimental side was exposed to biostimulation using 810 nm gallium-aluminium-arsenide diode laser. A total of 10 irradiations for 10 s per site were given 5 on the buccal side and 5 on the palatal side of the tooth. The total energy density at each application was 10 J with an interappointment gap of 3 weeks. The retraction was carried using a constant force of 150 gm. A digital vernier caliper measurement was used to measure the distance between the contact points of the maxillary canine and second premolar on 1st and 84th day.Results:The rate of orthodontic tooth movement was faster on the experimental side, and the difference between the two sides was statistically significant (P < 0.014).Interpretation and Conclusion:It was concluded that biostimulation carried out using an 810 nm diode laser is capable of increasing the rate of extraction space closure. Hence, it is capable of increasing the rate of orthodontic tooth movement.

Background and Objectives:Orthodontic forces are known to produce mechanical damage and inflammatory mediators such as prostaglandins (PGs) and interleukin (IL)-1, in the periodontium and dental pulp. Low-level laser therapy (LLLT) is a stimulator of the on-going biological process in tissue and found to be effective in modulating cell activity, which is involved in orthodontic tooth movement. Here, a humble effort has been made to study two such cytokines, namely IL-1 β and PG E2 (PGE2) which are partially responsible for bone turnover. The purpose of this study was to compare the changes occurring in the values of IL-1 β and PGE2 in the gingival crevicular fluid (GCF) during en masse retraction with and without LLLT.Methodology:GCF was collected using micropipettes from the distal ends of upper canines. The experimental side was exposed to biostimulation using 810 nm gallium-aluminum-arsenide diode laser and the contralateral side taken as control. A total of 10 irradiations for 10 s per site were given, five on the buccal side and five on the palatal side, to cover the entire periodontal fibers and the alveolar process around the tooth. After 7 days and 21 days of retraction, GCF sample was collected. Quantitative analysis of IL-1 β and PGE2 in the GCF samples was assessed using a commercially available Raybiotech® IL-1 β and Human PGE2.Results:(1) IL-1 β and PGE2 levels showed significant results from baseline to 21 days after LLLT irradiation. (2) LLLT-assisted retraction was significantly faster than conventional retraction.Interpretation and Conclusion:It was concluded from the study that IL-1 β and PGE2 levels peaked after LLLT. The difference in the levels of both cytokines was statistically significant.

Giant cell granuloma (GCG) is an uncommon bony lesion in the head and neck region, most commonly affecting the maxilla and mandible and has a female predilection. The clinical behavior of central GCG ranges from a slowly growing asymptomatic swelling to an aggressive lesion. The clinical, radiological, histological features and management of an aggressive GCG of maxilla in an 18-year-old female patient are described and discussed. It is emphasized that surgery is the traditional and still the most accepted treatment for GCG. Le Fort I osteotomy has been advocated as one of the access osteotomy for the surgical management of aggressive and extensive GCG involving the maxilla. The postoperative morbidity and recurrence have been discussed.

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