Background:Facial injuries in children always present a challenge in respect of their diagnosis and management. Since these children are of a growing age every care should be taken so that later the overall growth pattern of the facial skeleton in these children is not jeopardized.Purpose:To access the most feasible method for the management of facial injuries in children without hampering the facial growth.Materials and Methods:Sixty child patients with facial trauma were selected randomly for this study. On the basis of examination and investigations a suitable management approach involving rest and observation, open or closed reduction and immobilization, trans-osseous (TO) wiring, mini bone plate fixation, splinting and replantation, elevation and fixation of zygoma, etc. were carried out.Results and Conclusion:In our study fall was the predominant cause for most of the facial injuries in children. There was a 1.09% incidence of facial injuries in children up to 16 years of age amongst the total patients. The age-wise distribution of the fracture amongst groups (I, II and III) was found to be 26.67%, 51.67% and 21.67% respectively. Male to female patient ratio was 3:1. The majority of the cases of facial injuries were seen in Group II patients (6-11 years) i.e. 51.67%. The mandibular fracture was found to be the most common fracture (0.60%) followed by dentoalveolar (0.27%), mandibular + midface (0.07) and midface (0.02%) fractures. Most of the mandibular fractures were found in the parasymphysis region. Simple fracture seems to be commonest in the mandible. Most of the mandibular and midface fractures in children were amenable to conservative therapies except a few which required surgical intervention.
Ameloblastoma or adamantinoma is the rarest of the three forms of tumor of the odontogenic type. They are benign, locally aggressive neoplasms arising from ameloblasts, which typically occur at the angle of the mandible, and are often associated with an un-erupted tooth and must, therefore, be differentiated from a dentigerous cyst which will be centered on the crown. When in the maxilla (less common), they are located in the premolar region, and can extend up in the maxillary sinus. Ameloblastoma is reported to constitute about 1-3% of tumors and cysts of the jaws. The tumor is by far more common in the mandible than in the maxilla and shows predilection for various parts of the mandible in different racial groups. The relative frequency of the mandible to maxilla is reported as varying from 80-20% to 99-1%. Here, we are representing a case of ameloblastoma of anterior mandible which was considered as a rare site of occurrence.
Aim:To compare the efficacy of buccal fat pad (BFP) graft with sandwich graft (hydroxyapatite crystals embedded within collagen sheath) in closure of oroantral defects.Materials and Methods:A 2-year prospective study was conducted; 20 patients were included in the study were divided into two groups having 10 patients in each. Group I patients underwent surgical closure of oroantral fistula with sandwich graft and Group II patients with buccal pad of fat.Results:In Group I, the mean pain scores were 7.60 ± 0.84, 3.90 ± 1.10, 2.30 ± 1.16, 1.10 ± 0.99 and 0.40 ± 0.70 at immediate post-op., 1, 3, 6 and 12 week time intervals, respectively, whereas in Group II these were 7.30 ± 0.67, 3.50 ± 0.53, 1.70 ± 0.48, 1.00 ± 0.47 and 0.30 ± 0.48, respectively, at the corresponding time intervals. In Group I, swelling was seen to be present in 10 (100%), 7 (70%), 2 (20%) and nil (0%) patients at 1, 3, 6 and 12 weeks, respectively, whereas in Group II, it was seen to be present in 10 (100%), 10 (100%), 2 (20%) and nil (0%) patients at the corresponding time intervals. At 1 week, infection was seen to be present in 1 (10%) patient of Group I and 2 (20%) patients of Group II. At 3 and 6 weeks, infection was seen to be present in 1 (10%) patient of Group I and none of the patients of group II. No radiologic evidence of bone formation was seen in either group up to 1 week. At 3 week interval, there were 6 (60%) patients in Group I and nil (0%) in Group II showing bone formation, thus showing a statistically significant difference between the two groups. By 6 week time interval, radiologic evidence of bone formation was seen in 9 (90%) patients of Group I but in no patients of Group II, thereby showing a statistically very highly significant (P < 0.001) difference between the two groups. In Group I, in 1 (10%) patient, graft was rejected by first week; however, no further graft rejection took place. In Group II, no case of graft rejection was reported.Conclusions:The sandwich graft technique yielded a more promising closure of oroantral communication by provision of a more biologically apt base in terms of regeneration of lost bone structure at the floor of the maxillary sinus
Introduction: The World Health Organization in 1971 first classified fibro-osseous lesions (FOLs) as cementum forming tumors of jaws as ossifying fibroma (OF), cement-osseous dysplasia, and fibrous dysplasia. Various theories have been put forward regarding the origin of cemento-ossifying fibroma (COF) but current interests are oriented toward traumatic and developmental etiologies. The COFs are a slow-growing osteoexpansile tumor which grows to a considerable size. The tumor usually arises from tooth bearing and periodontal ligament region basically of odontogenic origin. Background: An inordinate, bony hard swelling, present united in both the jaws showing radiopaque-radiolucent mass, corticated margins, with expansion of buccal as well as lingual cortex gives a delusional image for the provisional diagnosis for surgeon, particularly to decide the surgical approach. These traits showing similarity with FOLs, more particularly cemento-OF, owing to its odontogenic or periodontal origin. Case Report: In this case, a 42-year-old female presented with abovementioned features was first taken for biopsy and then planned for simultaneous surgical resection of pathology for both jaws, from an intraoral approach giving a scar-free result. Preclusion of immediate complications was dealt with reconstruction of mandible with 2.5-mm titanium reconstruction plate. Conclusion: The diagnosis of cement-OF is based on clinical-radiographic-histopathologic evaluation. If remain untreated, these tumor can grow up to an average size of 80 mm, therefore, demanding an early surgical intervention. In our case, intraoral approach leads to almost no residual fibrosed tissue. The patient is further being planned for rehabilitation with either free fibula graft or 3-dimensional mandibular prosthesis.
Augmentation of the floor of the maxillary sinus is an extremely important technique for posterior site development in the maxilla prior to implant placement. A number of techniques have been suggested and used in the past to deal with membrane perforations such as suturing the membrane, application of fibrin sealants oxidized regenerated cellulose and collagen membranes. The most important aspect of sinus grafting is the integrity of the sinus membrane solely to confine the graft. If membrane tears are not taken care of, graft material can extravasate into the antrum and block the ostium. The fast-resorbing membranes are not good enough to form bone as their integrity is lost before woven bone forms. The novel technique demonstrates the use of a slow-resorbing membrane not only for perforations, but even in circumstances where the sinus is devoid of a membrane, thus bypassing the waiting period for schnederian membrane regeneration prior to grafting.
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