The term Ranula is a Latin word meaning frog. It refers to a bluish translucent cystic lesion in the floor of the mouth resembling the underbelly of a frog. Ranulas can be true cysts occurring due to ductal obstruction of the sublingual gland or a minor salivary gland or a pseudocyst as a result of ductal injury leading to extravasation and accumulation of saliva in the surrounding tissues. Clinically ranulas present as intraoral or plunging ranulas. The prevalence of ranula is 0.2% per 1000 patients Ranulas account for 6% of all salivary gland cysts. Ranulas are more common in children and young adults. However the plunging type occurs most commonly in the later third decade. The diagnosis of plunging ranula is based on a combined clinical,radiographic imaging and histologic findings. The treatment of ranulas have always been controversial.The treatment modalities range from simple marsupialisation to excision of the pseudocyst along with sublingual or submandibular gland excision.The purpose of this paper is to present a rare case of plunging ranula and to highlight the importance of considering plunging ranula in the differential diagnosis of lesions of the neck. Key words:Plunging Ranula,mucus, submandibular gland, transcervical approach.
Schwannomas are benign tumors of neurogenic origin arising from the Schwann cells of peripheral, cranial, and autonomic nerves. Schwannomas in spite of constituting 25-40% of head and neck tumors the percentage of intraoral schwannomas is merely 1%. Among the intraoral schwannoma the occurrence of the variant “ancient schwannoma of the infratemporal fossa with an intraoral presentation is very rare. The purpose of this presentation is to highlight the rarity of this lesion, to stress the importance of an accurate diagnosis and to consider neurogenic lesions in the differential diagnosis of head and neck lesions.
Background:Temporomandibular joint ankylosis is one of the most distressing clinical condition resulting in loss of jaw function and impairment of growth. Ankylosis is a greek word meaning “Stiff Joint”. It is observed that in humans the Sternoclavicular joint and Temporomandibular joint are similar morphologically and histologically as they are the only two synovial joints covered with fibrocartilage. This similarity of the joints have encouraged the surgeons to use SCG as an alternative to costochondral grafts.Aims:The purpose of this article was to evaluate the feasibility of using sternoclavicular graft for TMJ reconstruction in TMJ ankylosis patients and to also assess this technique in restoration of mandibular movement, function and growth of the mandible.Settings and Design:This retrospective study was conducted in 10 patients with unilateral TMJ ankylosiswho had undergone Interpositional arthroplasty with temporalis fascia and reconstruction of ramus condyle unit with sternoclavicular graft.Methods and Material:Ten patients(8 male and 2 female) with unilateral TMJ ankylosis within the growth period were included in the study. Clinical parameters assessed were maximal incisor opening, lateral excursion and protrusive movements.,ramus height,wound infection, donor sitemorbidity, evidence of neurological deficit in both donor and recipient site. Pre and post operative radiographic analysis of graft in relation to glenoid fossa and ramus of mandible was also done and donor site regeneration was also assessed.Statistical Analysis Used:The data were analysed using SPSS version 20 (IBM Corporation, SPPSInc; Chicago, IL, USA). Paired T test was used to compare the pre operative and post operativelaterotrusive, protrusive movements and the height of the ramus of the mandible. Repeated measures ANOVA was used to analyse the mouth opening pre operatively ,immediate post operatively and a after 5- year follow up.Results:The mean post operative mouth opening achieved was 28.9+_7.57mm with reankylosis in two patients. The mean laterotrusive and protrusive movements were 5.2 +_2.82mm and 2.2 +_.78 mm respectively postoperatively on a five year follow up. There was a 6.2 +_2.57mm increase in ramus height. The sternoclavicular graft had integrated and remodelled satisfactorily in eight patients. There was no change in the body length or midline deviation. Regarding the healing of the donor site there was a complete regeneration of clavicle within one year, however there was a incidence of clavicle fracture in one patient. The shoulder movements were normal in all patients.Conclusions:The reconstruction of TMJ with SCG has proved to be successful in this study. With an impressive success rate, the sternoclavicular graft could become a versatile and viable alternative to the surgeons in reconstruction of TMJ as it is relatively simple to carry out with minimal complications and good results.
The canines being the cornerstone of the arch and smile is one of the teeth, which has the longest eruption passage that gets influenced by local and general etiological factors easily. The initial calcification of the crowns starts at 4–5 months of age and proceeds toward eruption about 11–13 years of age with mesiobuccal crown angulation that gets corrected toward occlusion. It gets displaced buccally or palatally or may sometimes get impacted. Early intervention is the best suited to manage canine eruption patterns. Once erupted ectopically, they possess a great challenge in repositioning them back into their correct position. This case report discusses an orthodontic treatment planning and execution to correct a buccally placed canine with an anterior crossbite in an adult.
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