Juvenile ossifying fibroma (JOF) is a rare fibro-osseous neoplasm that arises within the craniofacial bones in individuals under 15 years of age, and these lesions are usually benign and tend to grow slowly. The psammomatous type of juvenile ossifying fibroma (PsJOF) mainly involves the bones of the orbit and paranasal sinuses, whereas the trabecular type commonly involves the jaws. We are presenting a case of PsJOF of ramus of mandible in a 7-years-old boy, which is an uncommon condition, and histologically showed predominantly a cellular connective tissue stroma, composed of numerous spindle-shaped cells arranged in fascicular storiform pattern. In between these irregular strands of trabeculae with plump osteoblast, spheroidal ossicles with basophilic in center and eosinophilic in periphery resembling psammoma-like bodies are noticed.

Background In Oral and Maxillofacial Surgery, the majority of the condylar fractures are treated by closed reduction with generally satisfactory long term results. But in such cases of closed reduction, patient will be uncomfortable owing to long term application of inter maxillary fixation (IMF). Where as, Disadvantages of extra oral open reduction and fixation of condylar fracture includes facial nerve damage, facial scars etc. which are surely eliminated by the intraoral reduction and rigid fixation. Aims and Objectives The present study was conducted to determine the efficacy of reduction and fixation of low sub-condylar fractures through intra-oral approach. Methodology In this study, ten patients with low sub-condylar fracture, reported to department of Oral and Maxillofacial Surgery. P.M.N.M. Dental College and Hospital Bagalkot were included. These patients were treated by open reduction and internal fixation through intra-oral approach. All the patients were evaluated post-operatively for mouth opening, occlusion and mandibular deviation with regular radiographic examination for 6 weeks. Results All operated patients followed for 6 weeks, maximum mouth opening was more than 40 mm in seven patients (range from 40 to 50 mm) and less than 40 mm in three patients. Occlusion was satisfactory in all and none of the patients showed deviation of mandible on mouth opening. Statistical analysis showed that postoperative mouth opening was significant ('t' value = 7.88, 'P' = (0.000) \ 0.05) and the test result was significant (S) at 5% level of significance. Statistical analysis of deviation of mouth opening was nonsignificant ['t' value = 1.96, 'P' value (0.081), 0.05]. For occlusion standard photographs were obtained at sixth week and found minor occlusal corrections in two patients are treated by elastic traction for few days. Discussion and Conclusion Open reduction with internal fixation through intraoral approach has proved to be safe for early function and also effective by avoiding the patient discomfort due to long term intermaxillary fixation, psychological effect, facial nerve damage, facial scar and weight loss.

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A 40-years-old male patient reported to our department with a chief complaint of persistent palatal fluid discharge and large depressed forehead defect. He gave a history of trauma 20 months back due to head on collision to electric pole and underwent surgery twice for open reduction and fixation of facial skeletal fractures. After 9 months of surgery again a third surgery was performed for the removal of frontal bone due to infection and osteomyelitis at the same site. Extra-oral examination revealed a large fronto-cranial defect extending from superior border of frontal bone to supra-orbital margins bilaterally in length, and from frontal right lateral to frontal left lateral side in width, measuring 8.0 cm in length, 10.5 cm in width and 1.5 to 2.0 cm in depth. Intra-oral sinus fluid discharge was from left posterior palatal region. Preoperative CT was taken and reconstruction of fronto-cranial defect was successfully performed with bone cement. Alloplastic implant reconstruction achieved an excellent esthetic result without any complications.

Pediatric mandibular fracture needs special consideration by clinicians. The management of pediatric mandibular fracture differs from that in adults considering the presence of tooth germs and the potential for mandibular growth. One of the most common forms of conservative management for pediatric mandibular fractures is the use of cap splint along with circummandibular wiring. The conventional workflow prior to performing surgery with this technique is impression taking and dental model fabrication. Additionally, it is also recommended that mock surgery should be performed to achieve proper reduction before acrylic splint fabrication. However, these procedures are effortful and time consuming when performed under general anesthesia during surgery and require additional sedation if performed prior to surgery. The aim of this case report is to describe a simpler preoperative digital workflow for the treatment of pediatric mandibular fractures, in which closed reduction is achieved with a three-dimensional printed cap splint stabilized with circummandibular wiring under general anesthesia.