TMDs have a multifactorial etiology varying from bruxism, psychological illness and traumatic injuries from mastication, extreme mouth opening, or faulty dental restorations. The present case study highlights the importance of right diagnosis of the patients problem as this forms the foundation to formulate a comprehensive treatment plan which further ensures the right solution to the stated patient problem along with long term maintenance of healthy stomatognathic system. An hard occlusal splint has been indirectly fabricated on the semiadjustable articulator. Occlusal splint used in treatment of TMDs is designed to provide even and balanced Occlusal contacts without forcefully altering the mandibular rest position or permanently altering the dentition. One case of fabrication of mandibular occlusal splint and its therapeutic role is discussed in this case report. The splint successfully relieved the patient TMD signs and symptoms, when used over four months.

BACKGROUND: Endodontically treated teeth are structurally more susceptible to root fractures. Proper tooth restorations with digitally fabricated or fibre post following endodontic therapy is essential to restore function and esthetics. OBJECTIVE: The aim of this in vitro study is to evaluate the fracture load of digitally fabricated and prefabricated fibre posts in endodontically treated teeth. METHODS: Sixty extracted human single rooted teeth were selected. The crowns were sectioned at the cement-enamel junction to standardize the remaining root length at 15 mm from the apices. Cleaning, shaping and obturation was done using conventional step back technique to an ISO K-file size 40. The roots were divided into two groups of 30 samples each: Group S: teeth reinforced with digitally fabricated posts; Group F: teeth reinforced with fibre posts. Each group was further divided into three subgroups (S7, S9, S12, F7, F9, F12) based on lengths 7, 9 and 12 mm at which the posts were cemented. Composite resin core was fabricated and prepared to receive a complete metal crown. Universal testing machine was used to measure the compressive load required to fracture the teeth. RESULTS: The highest fracture resistance of 1532N was observed with fibre posts at 12 mm of post space length followed by digitally fabricated post 1398N at 12 mm, but the difference was not statistically significant. CONCLUSION: The highest fracture resistance was observed in the teeth restored with fibre posts with 12 mm length and the lowest with digitally fabricated post with 7 mm length. As the length of post increases irrespective of type of post fracture resistance increased.

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Road side accidents was the most common cause (55percent) followed by assault (11percent) and agricultural (9percent), incidences. Audiological assessment showed 39 patients having hearing loss (28 conductive, 7mixed and 4 sensory neural). Temporal bone fractures were in 17 cases (14 longitudinal; 3 transverse). Laceration of pinna and external auditory canal was present in 13 patients. 2 cases were having pre-auricular and post -auricular abrasions. The rupture of tympanic membrane was found in 15 cases and csf otorrohea in 3cases. The facial nerve damage or injury was found in 6 patients (3 longitudinal fractures; 2 transverse fractures; one patient had partial paralysis due to fracture of lateral orbital wall with mandible) whereas two patients had mastoid tenderness. MATERIALS AND METHODS: The study was conducted at ENT department of AVBRH Sawangi (Meghe), Wardha about 100 cases of head injuries admitted in surgical ward of AVBRH Sawangi (meghe), Wardha. Detailed clinical history would be taken and E.N.T examination was done and recorded on a performa (Annexure1). A detailed neurological examination in each case including the cranial nerve functions, gait tests and appropriate cerebeller function tests were taken. All the conscious patients was subjected to Tuning fork tests and pure tone auditory and impedence auditory whether indicated. Radiological investigation of each patient were reviewed and finally the findings obtained was compiled.

Cauterisation of 144 ear perforations (Right and Left) with 20 percent TCA (Trichloracetic acid) was tried in patients having 2 to 6mm perforations. Perforations were dry for 3 weeks-3 months or more. 30 patients were having traumatic perforations such as slap on face, blast injuries or associated with head injuries. Most of the patients were having perforations due to inflammation. Few of them had recent attack of otitis media which were effectively treated by suitable antibiotics, antihistamines and subsequently taken for cauterization of perforation. Site of perforation was mostly on the anteroinferior quadrant, next the inferior quadrants. Still less number in the entire four quadrant, least no. in P. S. quadrant. Traumatic perforations were irregular in shape varying from 2-6mm in size and were elliptical in shape. Hearing loss ranged from 15dB-45dB (Depending upon size and site of perforation). Main presenting symptoms in inflammation cases were intermittent discharge as well as deafness. In traumatic case history of pain and deafness was the main symptom. We did wait for 1 month in traumatic cases to achieve spontaneous closure. In inflammatory cases cautery was considered first line of treatment. It has to be done several times at 10 days interval. Most of the times closure of perforation was achieved with 3 attempts, inflammatory cases 5 th or 6 th attempt. In one case as many as 23 attempts. In 6 cases of perforation after partial take of graft in myringoplasty occurred after 3 months cauterization was attempted and we got closure in 5 of them. In one case re myringoplasty had to be done.