Osteoradionecrosis (ORN) is a noninfectious, necrotic condition of the bone occurring as a complication of radiotherapy. Most cases occur following trauma or surgical manipulation of the irradiated site. Mandible is the most common bone to be affected following head and neck irradiation. The aim was to develop a successful therapeutic approach for ORN. A spectrum of treatment modalities is practiced for ORN with variable success rate that includes simple irrigation of the affected bone to the partial or complete resection of the jaw bone. In this paper, we present two cases which had successful therapeutic approach for ORN of mandible with autologous bone marrow concentrate stem cells and allogeneic dental pulp stem cells (DPSC) with platelet rich plasma (PRP) following failure of conventional methods. Autologous bone marrow aspirate concentrate (BMAC) was injected around the socket and into the periosteum for one case, and DPSC were mixed with tricalcium phosphate and inserted at the site of the defect in one case. The patient treated with BMAC remained asymptomatic and complete bone remodeling was noticed after 1 year. The extraoral sinus was excised, and healing was uneventful without recurrence in the patient treated with allogeneic DPSC and PRP. Periodic panoramic radiographs revealed an appreciable bone formation from the 2nd month onward. We have successfully treated two cases of ORN with BMAC and DPSC, respectively.

Ameloblastoma is benign odontogenic tumor, which is locally aggressive in behavior. Till date, the treatment of choice is resection and reconstruction using a variety of modalities. Inadequate resection may lead to many complications such as bone deformity and dysfunction. This report is about a 14-year-old male with ameloblastoma treated with autologous dental pulp stem cells (DPSCs) and stromal vascular fraction (SVF) and evidence of bone regeneration. Marsupialization was performed; tooth was extracted and sent for DPSC cultivation. On the day of surgery, SVF was processed from buccal pad of fat, and platelet-rich fibrin (PRF) was prepared from patient's peripheral blood. During the procedure, labial plate resection and curating of tumor lining were done. After which, a mesh packed with SyboGraft T-plug, prepared SVF, DPSCs, and PRF were placed over lingual cortex and pressure dressing was done. After the 1st month of surgery the postoperative course was uneventful, the wound shrinkage led to exposure of mesh in the intraoral region. Removal of exposed mesh was done. The correction surgery with removal of part of mesh and primary closure was achieved with SyboGraft plug, SVF and PRF. Enhanced bone formation was seen in post-operative OPG and CT Scan after 10th month. In this article, we propose an innovative approach to manage these cases by using a combination of autologous DPSC and buccal pad of fat SVF to regenerate a mandibular defect left by the resection of an ameloblastoma with 1.5 year follow-up. We were able to demonstrate bone regeneration using this technique with no recurrence of tumor.

Background: To report in-vitro interaction between ameloblastic cell and dental pulp stem cell. Methods: Dental Pulp stem cells were isolated from extracted pre molars and Ameloblastoma primary culture was obtained from the patient. Direct co-culture study was performed to do morphological sorting with tryphan blue dye exclusion method and transwell co-culture was performed to study anti-proliferative effects. Results: The viability count from transwell co-culture plates revealed that in the control wells the AM has higher proliferation rate than DPSC. However when co-cultured with DPSCs, the proliferation level is arrested and decreased cell count was noted. This was confirmed by Tryphan blue dye exclusion assay also. Conclusion: Result demonstrated that dental pulp stem cell can induce anti-proliferation or anti-tumorigenic activity in ameloblastoma cells. This has helped us in using these cells in the management of ameloblastoma cases.

Aim: Proximal fibular osteotomy (PFO) for osteoarthritis (OA) knee is an emerging concept with good early results. This short-term study aimed to analyze the usefulness of PFO in Indian patients with OA knee with regard to pain relief and correction of deformity. Materials and methods: This study involves a surgical technique where 2 cm of proximal fibular bone is resected, and patient is permitted fullweight-bearing walking as early as possible. Subjective and objective outcome analyses done using Lysholm knee scoring sheet and radiographs, respectively. Minimum follow-up time was 6 months. Results: We had a of total of 20 knees in 18 patients, with average age of 56.1 years. The average visual analog score reduced by 6.8 points, and the average Lysholm knee score improved by an average of 34 points at the end of follow-up. The mean alpha angle correction achieved was 3.738°. The calculation of Pearson's correlation coefficient between the amount of correction of alpha angle and reduction of visual analog scale during the immediate postoperative period was −0.186. Among the 20 knees, we had four cases of weakness of extensor hallucis longus. Conclusion: Through our short-term prospective cohort study, we conclude that PFO helps in improvement of pain and function, in patients suffering from medial compartment OA knee. The effectiveness of proximal tibiofibular joint mechanism in immediate pain relief is evident in our study by subjective and objective means. A proper selection of case with regard to severity and duration of disease and patellofemoral involvement is vital in getting good results. Clinical significance: Proximal fibular osteotomy is an emerging concept in the management of OA of knee and gives the patient, more years, with native knee to walk.