The department of Oral and Maxillofacial Surgery, Dhaka Dental College Hospital is a busy centre for specialized maxillofacial services in Bangladesh. A good number of patients with a wide range of oral and maxillofacial surgical conditions are managed here. Maxillofacial injury and oral cancer are the two most common conditions encountered here.
Ossifying fibroma is a benign neoplasm of bone and often considered a type of fibro-osseous lesion. It can affect both the mandible and the maxilla, particularly the mandible. Radiologically it presents as a mixed radiodense and radiolucent lesion that is well demarcated from normal bone and histopathologically it consists of highly cellular, fibrous tissue that contains varying amounts of calcified tissue resembling bone, cementum or both. The treatment consists in completely removing the lesion with curettage, surgical excision or en-block resection, depending on the size and location of the lesion. The aim of this study is to analyse the clinicopathological characteristics of ossifying fibroma and provide a proper management system. Materials and methods - The prospective study was performed in the Department of Oral & Maxillofacial surgery, Dhaka Dental College and Hospital, Dhaka, Bangladesh, from a period of January 2015 to January 2019. All patients were selected for this study based on clinical, radiological and histopathological confirmation of ossifying fibroma. The management of each case and follow-up data were documented. Result and observations - A total number of 25 patients of ossifying fibroma were selected for this study. The mean age of ossifying fibroma were 30.35 years with an age range 12 to 57 years. Female17 (57%) represented the majority of the affected patients and more common in the mandible (60%).The radiographic appearances of ossifying fibroma presented 17(68%) mixed type and 18(72%) well-defined borders. Bone expansion 19(76%), tooth displacement 09(36%) and root resorption 10(40%) were observed in ossifying fibroma. Surgical resection, enucleation and curettage were treatment of choice in ossifying fibroma. Conclusion - Ossifying fibroma occurs more commonly in women in the 2nd to 4th decade of life and presents a painless bony swelling and deformity in mandible and maxilla. Frequently it shows as a mixed radiographic image that is well demarcated from normal bone. The treatment consists in completely removing the lesion with curettage, surgical excision or en-block resection, depending on the size and location of the lesion in ossifying fibroma. Update Dent. Coll. j: 2019; 9 (2): 7-12
Mandible is the second most commonly fractured bone after nasal bone, though it is the largest and strongest facial bone. Fractures of the mandible can involve only one site or can often involve multiple anatomic sites. It account for 36% to 59% of all maxillofacial fracture. The large variability in reported prevalence is due to a variety of contributing factors such as gender, age, environment, and socio-economic status of patient, as well as the mechanism of the injury. The most favorable site of fracture (in descending order) in mandible is the body, angle, condylar region, symphysis, and coronoid process. The descriptive type of cross sectional retrospective study was undertaken to determine the epidemiological & clinical profile of patients presented with fractures of mandible and their different methods of treatment modalities. Four hundred and thirty five patients with mandible fractures were treated during the year 2014-2015. A review of patient’s record was conducted. Data regarding age, gender, cause of fracture, anatomic site and treatment modalities were reviewed. There was higher prevalence in male (3.9:1), with occurrence peak between 21-30 years. The principal causes of fracture in this study were RTA (Road Traffic Accidents) representing 54.02% followed by physical assault 17.24%, Fall, Sports injury, Blow by heavy objects, Tube well injury & others which includes Tire blast injury, Gunshot injury, Iatrogenic cause, Pathological fracture, Boat handle injury, Penetrating injury by metal etc. The most injured sites were in parasymphysis (26.31%) followed by angle of mandible 17.89% then symphysis, condyle, body of mandible, dentoalveolar, ramus, coronoid process of mandible. Most patients (70.11%) of mandible fractures were treated by closed reduction (arch bar, arch bars with intermaxillary fixation IMF, eyelet wiring & lateral compression plate) & 21.83% of patients were treated with open reduction (miniplates fixation. 3D plate fixation) .Only 8.05% patients were managed by conservative approach. This study reflects patterns of mandible fracture within the community and discuss various methods of mandible fracture management in the department of Maxillofacial casualty in Dhaka Dental college hospital. It is hoped that information presented here will be useful to the government agencies and health care professionals involved in planning future programs of prevention & treatment of mandible fracture.J Bangladesh Coll Phys Surg 2018; 36(3): 107-111
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