Mucormycosis is a modern-day lifestyle disease that has burst into the health-care scenario. It is an opportunistic fungal infection that proliferates into the immunocompromised host by invasion of the fungus into the paranasal sinuses, thereby invading the palate, maxilla, and orbit. Left untreated it invades the cranial components such as cavernous sinus, skull base, and brain. Mucormycosis invades blood vessels, making these infections highly angioinvasive. We reviewed 45 cases of mucormycois of the head-and-neck region from 2010 to 2020 on the basis of electronic search peer-reviewed journals in Medline (PubMed) database. Presenting symptoms, risk factors, history of extraction, and treatment were tabulated and the data were analyzed. The mean age of patients was 53.8 years. 73.93% of patients had diabetes mellitus, 13.63% of patients had no immunocompromised state, and 8.74% of patients had other medical disorders. About 34.78% of cases had a history of extraction prior to manifestation of symptoms. Mucormycosis remains difficult to treat disease with a high mortality rate. At present, the triad of clinician's awareness, appropriate antifungal therapy, and aggressive surgical intervention represents treatment protocols against the disease.
Introduction:Ameloblastomatous calcifying odontogenic cyst (COC) is an extremely rare histopathologic variant of COC, an odontogenic cyst of the jaws. It needs to be differentiated from closely associated variant ameloblastoma ex COC that is entitled to a more aggressive form of surgical management.Aim:The aim of this paper is to present a case of ameloblastomatous COC of the right mandibular angle region with review of literature describing this rare entity. The paper also highlights the requirement of including this lesion in differential diagnosis of various jaw lesions.Materials and Methods:Google search, Wikipedia, ScienceDirect, MEDLINE, the Cochrane library, and PubMed were used extensively to search and collect all reported cases of ameloblastomatous COC using keywords such as ameloblastomatous COC, COC, maxilla, mandible, and gorlin cyst ameloblastic proliferation.Results:To the best of our knowledge, a total of twenty one cases of ameloblastomatous COC have been reported in the literature in the maxilla-mandibular region and we represent the twenty second case in a 20-year-old female patient along with the review.Conclusion:Ameloblastomatous COC – a subtype of COC needs to be differentiated from true ameloblastoma arising from COC as it warrants a conservative form of surgical management unlike other neoplastic variants of COC. Owing to scarcity of data of this lesion in literature, more reporting of such cases is required to shed light on its behavior.
Introduction: Plasma derivatives have been practiced a lot in orthopedics, burns, and sport medicine. Microneedling (MN) with platelet-rich plasma (PRP) therapy has been proven to improve the micro-circulation and thus improve hair growth. The role of concentrated growth factor (CGF) for hair growth has not been mentioned anywhere in the literature for hair growth which we tried to prove in our article by comparing it with various other studies. Materials and Methods: This is a retrospective randomized study involving 20 male patients whose ages ranged from 21 years to 56 years. PRP was prepared using the dual-spin method and injected after activation; post-MN, CGF gel was applied topically. Four sessions were performed, and a follow-up was done after 6 months. Statistical analysis was done using the Statistical Package for the Social Sciences software version 21 for Windows (SPSS, IBM Corp, Armonk, NY, USA). Paired t -test was used for the various comparisons. Results: Hair loss reduced by the end of the first month. At the end of 6 months, postfirst session, microscopic examination showed statistically significant difference in the hair count compared to those during the baseline. Discussion: PRP having platelet-derived growth factor and vascular endothelial growth factor acts on stem cells in the follicles, stimulating the development of new follicles and promoting neovascularization. CGF helps stimulating cell proliferation and matrix remodeling due to numerous growth factors in a concentrated form. Thus, this therapy combined helps to boost the hair growth in a very significant way. Summary: This study provides the preliminary evidence of efficacy of PRP along with MN and CGF in treating androgenetic alopecia by promoting angiogenesis along with vascularization and promotes hair follicles to enter and extend the anagen phase. Most of the results obtained show improved results with this therapy. A larger case study for the same can further be done for a stronger recommendation of the use of CGF for hair growth therapy further.
Rationale: Chondrosarcoma, although being a rare entity in jaws, may turn fatal if left untreated or inadequately excised. Prognosis in terms of 5-year survival rate ranges from 90% for Grade I, 81% for Grade II and 43% for Grade III respectively. Patient Concerns: A 35-year-old male patient reported with a gradually progressive hard painless growth over right maxillary molar region. His main concern was removal of pathology without long-term morbidity. Diagnosis: Computed tomography revealed ill-defined mass with internal calcification involving posterior half of upper right alveolus. Treatment and Outcomes: Mandatory biopsy suggested benign chondroma, however wide excision and infrastructural maxillectomy revealed Grade II chondrosarcoma. Take-away Lessons: Complex anatomy of maxilla renders surgical excision of chondrosarcomas with histological clear margins, a daunting task. Due to misdiagnosis of preoperative biopsy, suboptimal excision of malignant mass may lead to local recurrence and occasional distant metastasis. This necessitates further therapy and long term follow up, with occasional poor patient compliance.
The aim of the evaluative study was to compare the efficacy of standard conservative treatment and the open reduction internal fixation (ORIF) using the delta titanium plates in the mandibular subcondylar fractures in adults. Patients who diagnosed with mandibular subcondylar fracture in the department from January 2018 up to September 2019 were recruited into the study. The patients satisfying the inclusion criteria were randomly assigned to two groups in a 1:1 ratio (10 in each group). Group A comprised patients treated using delta titanium plates through open reduction and internal fixation and Group B comprised patients treated with closed reduction. Informed consent was taken for all the patients. All the patients of Group A underwent ORIF under GA via retromandibular approach. Pain was significantly higher in 1 and 3 month follow up in group B compared to group A. Comparison of mouth opening in both the groups show statistically significant difference at 3 and 6 month compared to baseline mouth opening. Deviation was more prevalent at 1 and 3 month follow up in group B compared to group A. Presence of mandibular deviation at 1, 3 and 6 month was statistically insignificant for both the groups.Our experience with 3D stable delta plate provides better treatment outcomes in terms of easy adaptation to the anatomy of the fracture site, better 3D stability and functional osteosynthesis.
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