Introduction: The treatment of subcondylar mandible fractures is a topic of debate and can be variable even though these fractures are commonly seen. The present study aimed at evaluation of various treatment modalities for unilateral condylar fracture in adults. Materials and Methods: Thirty patients with unilateral condylar fractures between the age of 18 and 60 years were evaluated. Treatment protocol included closed reduction for 15 patients and open reduction for 15 patients. Results: Assessment was done functionally for maximum interincisal mouth opening, deviation on maximum interincisal mouth opening, occlusion and facial nerve function, and radiologically for ramus height shortening. In general, there were no statistically significant differences between closed and open methods. Discussion: Both the treatment options for condylar fractures of the mandible yielded acceptable results. Closed treatment appears to be a safe and appropriate modality for most unilateral condylar fractures. Although the open group, in general, showed similar outcomes, this treatment should be reserved for limited indications. The present study has confirmed that both treatment options can yield acceptable results. On clinical examination, there was no significant difference in mouth opening measures, the incidence of occlusal disturbances or in the degree of pain perception.

Subcondylar fractures contribute about 19-29% amongst all the mandibular fractures worldwide, yet the treatment paradigm remains slightly controversial. Subcondylar fractures are pivotal in maxillofacial surgery for diverse reasons, as they can result in number of complications, whether treated or not. Initial clinical outcomes may appear pragmatic but complications such as pain, restrictions of jaw movements, muscle spasm, mandibular deviation, malocclusion, and facial asymmetry may become apparent. Fracture of tympanic part, mandibular fossa of temporal bone, may or may not be escorted by dislocation of condylar segment into middle cranial fossa, damage to blood vessels, arteriovenous fistula are some additional complications. Choosing right surgical strategy is a for minimising postoperative complications management of subcondylar fractures and it should be taken in account that, perioperative, functional, and patient-reported outcomes. The majority of studies that have been published describe the use submandibular, retromandibular, or preauricular incisions have drawbacks such as poor visibility, accessibility, and the potential to harm facial nerve and complications related to the parotid gland. Hereby, the authors present a case report of left subcondylar fracture in a 55-year-old, male patient, where a modified percutaneous approach was taken, to access the fracture, and aid in adequate reduction and proper fixation without any postoperative complications. In this approach, parotid gland is bypassed and masseter muscle fibres are excised to reach the fractured site at subcondylar region. It is small, straight forward, elementary, safe, reliable and scarless approach for the management of subcondylar fractures that ensures adequate exposure of the fractured site, osteosynthesis and minimal potential postoperative complications.

Review Article IntroductIonChronic periodontitis is an inflammatory disease which is characterized by a progressive gingival inflammatory response to bacterial dental plaque. It leads to clinical attachment loss, pocket formation, alveolar bone loss, increased tooth mobility, and finally the tooth loss. [1] This condition is characterized by increased secretion of inflammatory mediators such as cytokines and chemokines in the periodontal environment. [2] Saliva can also reveal the systemic health as well as the oral health to some extent. Whole saliva may also show the presence of periodontal disease and evidence indicates that the level of some cytokines increases in the saliva of patients with periodontitis. Assessment of the composition of saliva may provide valuable information about biochemical markers for the assessment of periodontal diseases. [1] Periostin is a hemophilic, secretory protein from the fasciclin I family. It influences cell matrix interactions, cell functions, tissue remodeling, wound repair, and type I collagen fibrillogenesis in periodontal ligament (PDL). It is induced by Transforming growth factor-β (TGF-β) and modulates matrix-cell interactions relevant to connective tissue repair. [2] Periostin serves as a necessary protein for the integrity, development, and maturity of the tissue and it is believed to play a key role in balancing and regulating homeostasis of the PDL. Expression of periostin is induced by the tumor growth factor (TGF)-β and bone morphogenetic protein-2 (BMP). It regulates collagen I fibrillogenesis in PDL and reinforces the cross-linking of collagen which improves the mechanical properties of connective tissue of PDL. [1] Periostin is an extracellular matrix (ECM) protein belonging to the fasciclin family. [3] It plays a supporting role in cell adhesion, proliferation, survival, and fibrillogenesis in all four components of the periodontium, namely, the PDL, bone, cementum, and gingiva. [13][14][15][16][17] HIstoryPeriostin was named in 1999 as a newly discovered factor for matricellular proteins. [6,18] Periostin is a 90 kDa glutamatecontaining secreted matricellular protein. It has 811 amino acids with EMI domain at one end of the chain followed by 4 FAS-1 domains and a carboxyl-terminal domain (Figure 1). There is a C-terminal sequence at the other end of the Background: Periostin is a matricellular protein highly expressed in periosteum, periodontal ligament and is essential for tissue integrity and maturation. It plays a role in collagen fibrillogenesis and is downregulated in periodontal disease. The goal of periodontal regenerative therapy is to predictably restore the tooth's supporting periodontal tissues and form a new connective tissue attachment of periodontal ligament (PDL) fibers and new alveolar bone. Periostin might play a pivotal part in regeneration of the PDL and alveolar bone following periodontal surgery. Recently, several studies have suggested that periostin may be an important regulator of periodontal tissue formation by promoting collagen fi...

Review Article IntroductIonChronic periodontitis is an inflammatory disease which is characterized by a progressive gingival inflammatory response to bacterial dental plaque. It leads to clinical attachment loss, pocket formation, alveolar bone loss, increased tooth mobility, and finally the tooth loss. [1] This condition is characterized by increased secretion of inflammatory mediators such as cytokines and chemokines in the periodontal environment. [2] Saliva can also reveal the systemic health as well as the oral health to some extent. Whole saliva may also show the presence of periodontal disease and evidence indicates that the level of some cytokines increases in the saliva of patients with periodontitis. Assessment of the composition of saliva may provide valuable information about biochemical markers for the assessment of periodontal diseases. [1] Periostin is a hemophilic, secretory protein from the fasciclin I family. It influences cell matrix interactions, cell functions, tissue remodeling, wound repair, and type I collagen fibrillogenesis in periodontal ligament (PDL). It is induced by Transforming growth factor-β (TGF-β) and modulates matrix-cell interactions relevant to connective tissue repair. [2] Periostin serves as a necessary protein for the integrity, development, and maturity of the tissue and it is believed to play a key role in balancing and regulating homeostasis of the PDL. Expression of periostin is induced by the tumor growth factor (TGF)-β and bone morphogenetic protein-2 (BMP). It regulates collagen I fibrillogenesis in PDL and reinforces the cross-linking of collagen which improves the mechanical properties of connective tissue of PDL. [1] Periostin is an extracellular matrix (ECM) protein belonging to the fasciclin family. [3] It plays a supporting role in cell adhesion, proliferation, survival, and fibrillogenesis in all four components of the periodontium, namely, the PDL, bone, cementum, and gingiva. [13][14][15][16][17] HIstoryPeriostin was named in 1999 as a newly discovered factor for matricellular proteins. [6,18] Periostin is a 90 kDa glutamatecontaining secreted matricellular protein. It has 811 amino acids with EMI domain at one end of the chain followed by 4 FAS-1 domains and a carboxyl-terminal domain (Figure 1). There is a C-terminal sequence at the other end of the Background: Periostin is a matricellular protein highly expressed in periosteum, periodontal ligament and is essential for tissue integrity and maturation. It plays a role in collagen fibrillogenesis and is downregulated in periodontal disease. The goal of periodontal regenerative therapy is to predictably restore the tooth's supporting periodontal tissues and form a new connective tissue attachment of periodontal ligament (PDL) fibers and new alveolar bone. Periostin might play a pivotal part in regeneration of the PDL and alveolar bone following periodontal surgery. Recently, several studies have suggested that periostin may be an important regulator of periodontal tissue formation by promoting collagen fi...

AIM: Aim of the study is to evaluate efficacy and compare the surgical outcome of buccal fat pad and nasolabial flap in increasing postoperative mouth opening in reconstruction of the defect created after excision of fibrous bands in surgically treated cases of OSMF. Materials and Methods: this study included 10 patients who came in our department at karnavati school of dentistry between the years 2017 and 2020, out of which 5 patients underwent closure of surgical defect using buccal fat pad (Group I) and 5 patients underwent closure of surgical defect using nasolabial flap (Group II). Clinically proven cases of OSMF with mouth opening no more than 20 mm were included in this study. Mouth opening of patients were documented preoperatively, intraoperatively and at 6 months of follow up. Results were tabulated and were analysed by paired t test. Results: in group I and II, there was substantial difference in mouth opening at all periods of follow-up. At 1 month follow-up, mean mouth opening was 29.4 mm in group 2 compared with 28.25 mm in group I.