Purpose To compare the efficacy, advantages and disadvantages of the use of preoperative injection of methylprednisolone into masseter muscle versus gluteal muscle to minimize postoperative swelling after the surgical removal of lower third molar. Materials and Methods A prospective randomized study was planned comprising of 10 subjects, undergoing elective surgery for bilateral impacted lower third molar removal with similar severity index. The subjects were randomly assigned into two groups-group I who received intrabuccal masseteric injection and group II who received gluteal injection of 40 mg of methylprednisolone after inferior alveolar nerve and long buccal nerve block (prior to the surgical removal of the impacted lower third molars). We evaluated the postoperative pain, trismus, swelling, advantages and disadvantages of the injection techniques. Statistical analysis was done using student t test. Results Ten patients of mean age 27 ± 6 years were selected for the study including six males and four females. The mean age was 27 years (SD 6). The differences in measurements of preoperative and postoperative pain, swelling and mouth opening between group I and group II were not statistically significant. Conclusion The study evidently proves that there is no statistically significant difference between the intrabuccal approach of masseteric injection and gluteal injection of methylprednisolone in terms of pain, swelling and trismus following surgical removal of impacted lower third molars. However, the intrabuccal approach of masseteric injection was found to be more convenient when compared to gluteal injection, for the surgeon as well as the patient. It also has an additional advantage of being a painless steroidal injection on an anesthetized injection site.

The bilateral sagittal split osteotomy (BSSO) of mandible has been used extensively for the correction of skeletal deformities of the mandible since it was first described by Trauner and Obwegeser.1 Over the past 40 years, it has undergone numerous modifications and improvements. 2-4There are several studies on skeletal stability after BSSO of mandible with wire fixation, fixation either using bicortical screws or miniplates and monocortical screws, although not even one technique has yet been demonstrated to eliminate relapse completely. 5 This study assesses the postoperative stability of bilateral sagittal split advancement and setback osteotomy using miniplates and monocortical screws. Material and MethodsA total of 10 patients underwent BSSO depending upon the deformity present with or without additional osteotomies. Keywords► BSSO ► mandible osteotomy ► orthognathic surgery ► skeletal stability AbstractThe purpose of this study was to evaluate intraorally placed mini plates and monocortical screws in terms of postoperative skeletal stability after bilateral sagittal split advancement and setback osteotomy of the mandible. Ten patients were included in this study with five requiring advancement (group I) and five requiring setback of the mandible (group II). Bell and Epker modified surgical technique was followed for all the patients. All the patients underwent pre-and postsurgical orthodontics. Cephalometric radiographs were taken preoperatively, immediate, 3, 6, and 12 months postoperatively. Cephalometric tracings were performed by one individual examiner using a modified burstone analysis. Statistical analysis was performed using the student paired t-test. In advancement patients, SNB (sella, Nasion, B point) angle showed relapse at 12th month postoperative period which was statistically significant (2.4 degrees). No changes were observed in anterior facial height, posterior facial height, Frankfort-mandibular incisor angle (FmiA), and overjet during the follow-up period. In setback patients, posterior facial height (p < 0.05), angles between the lower incisors and mandibular plane and pogonion had a statistically significant change position of 1.4 mm (paired t-test, p ¼ 0.03). The SNB angle, anterior facial height, interincisal angle, and FmiA remained constant (0.8-1.2 degrees) during the follow-up period. In advancement cases, the relapse was seen from the third month postoperative period but in setback cases, the relapse was noted from the sixth month onward and the skeletal relapse in these cases were noticed cephalometrically.

This technical report describes a simple and innovative surgical technique for supra-alar sidewall region constriction and supra-alar crease attenuation by cinching technique through intraoral approach.

This is a very rare case report of a multiple odontome involving the upper jaws, lower jaws and an extragnathic site. A thirty seven year-old male complained of missing teeth in his left upper and lower jaw since childhood. Radiographic examination revealed multiple calcified teeth like structures in the left side of the patient's maxilla, mandible and mastoid region of skull base. We arrived at the diagnosis of compound odontome. Patient was otherwise systemically normal and with good health. He underwent surgical enucleation of the jaw odontome while the extragnathic odontome was left under observation. This rare case report proves that the embryonic dental cells might migrate to the primordium of the Rathke's pouch and further might be carried towards the site of the developing cranial base region.