Actinomycosis is an infrequent chronic infection regarded as the most misdiagnosed disease by experienced clinicians. The Office of Rare Diseases at the National Institute of Health has also listed this disease as a “rare disease.” This article presents a case report of actinomycosis of the alveolus with unusual clinical features but a successful resolution. It also states the importance of biopsy of deceptive inflammatory lesions that do not respond or recur after conventional treatment modalities.

Introduction The use of intermaxillary fixation (IMF) in the treatment of faciomaxillary fractures is the key factor for reduction and immobilization. Various techniques of IMF have been described in the past and recently IMF screws have been introduced. This technique has various advantages, including ease of use, less time consumption, less trauma to the surrounding soft tissues, and relatively reduced risk of needle stick injury. This study evaluates the efficacy of IMF screws over arch bar IMF before definitive fixation of facial fractures. Materials and methods This study is a randomized clinical study. Study population consists of 20 patients with mandibular fractures requiring IMF with open reduction and reported to Department of Oral Surgery, Modern Dental College and Research Centre, Indore, Madhya Pradesh, India between September 2012 and April 2015. Two groups were formed with 10 patients in each group. In the first group, IMF was achieved using the Erich's arch bar and wires. In the second group, IMF was achieved using self-tapping IMF screw. The patients were assessed for various parameters, such as the time required in minutes for the IMF stability of fixation, postoperative occlusion, postoperative pain, periodontal health, oral hygiene, and incidence of needle stick injury. Results All the cases had stable IMF in both groups. At the end of 14th day, overall oral hygiene was poor in group I and good in group II, significant statistically (p = 0.031). Iatrogenic injury to tooth was absent in group I and present in 1 case in group II, not significant statistically (p = 0.305). Average time taken for the IMF in group I was 74.9 minutes, with the range of 58 to 88 minutes, and in group II was 16.1 minutes, with the range of 11 to 22 minutes, which is highly significant statistically (p = 0.001). Needle stick injuries were taken as positive if glove perforation was present and these were reported in four cases in group I, whereas in group II, no case had incidence of needle stick injuries, which shows significant statistically (p = 0.025). Conclusion After this study, we can conclude that IMF selftapping screw is a proven useful technique of IMF. Intermaxillary fixation is a safe and less time-consuming method but with various shortcomings and complications, which the surgeon must be aware of while providing treatment. Clinical significance: How to cite this article Barodiya A, Thukral R, Agrawal SM, Chouhan AS, Singh S, Loksh Y. Self-tapping Intermaxillary Fixation Screw: An Alternative to Arch Bar. J Contemp Dent Pract 2017;18(2):147-151.

We designed a prospective study with the objective to evaluate the efficacy, indications and our experience of submental intubation in different types of maxillofacial surgeries. From May 2008 to August 2010, 23 patients with different conditions were intubated by submental route of tracheal intubation and patients were evaluated on different parameters during and after surgery to find its efficacy, indications and utilization in maxillofacial surgeries. All the patients were managed well with this technique of intubation with no significant difference in intubation and extubation time. We did not face any uneventful complication. There was only one reported complication that is rupture of the bulb of cuffed flexometallic tube but was managed well by changing tube. We found skull base access surgery as a new indication for submental intubation. The submental route for endotracheal intubation may be utilized as an alternative to blind nasal intubation or tracheostomy in the surgical management of patients involving complex maxillofacial surgeries. We hypothesized that the submental intubation should not be used where long term ventilation support is needed. We did a technique modification to deliver the endotracheal tube out from the submental region to avoid pilot cuff damage. Our study proposes that skull base access surgery is a safe and potential indication for submental intubation. In our experience submental intubation is a simple, secure and effective procedure for operative airway control in major maxillofacial surgeries.

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Patients with schizophrenia had high dental caries, periodontal disease and unmet dental prosthetic needs. Severity of the schizophrenic and EPS was associated with poor oral health. Efforts need to be focused on strengthening the evidence of its association with oral health indicators through further studies including cohort investigations.