Introduction: There are twelve cranial nerves and seventh one is the Facial cranial nerve, which supplies the muscles of facial expression. It gives of five terminal branches, which form a plexus with in the parotid gland. These branches exhibit variations in their branching pattern. Detection of the main trunk of facial nerve and its branches is important in all surgeries of this area, to avoid any injury that may lead to the loss of function of this nerve. This study has elaborated the branching and communications among the terminal branches of facial nerve in parotid gland. Objectives: To study the anatomical variations in the terminal branching and communicating pattern of the seventh cranial nerve and to observe the division pattern of the facial nerve trunk in parotid area. Study Design: It was carried out at Department of Forensics and Department of Anatomy in King Edward Medical University Lahore. Period: The study commenced in March 2014 after approval of the synopsis by the Advance Studies and Research Board of KEMU and was successfully completed in December 2015. Methodology: Dissection of one hundred hemi-faces in the Departments of Forensic and Anatomy at King Edward Medical University Lahore. Adult cadavers of both sexes were included and with mutilated face were excluded. A Descriptive Cross-sectional type of study. Collected data was analyzed in SPSS 13. Simple frequency/percentages tables and charts were used to presents the outputs. Chi-Square, Student t-test and ANOVA were used. Results: Branching and Communicating Pattern according to occurrence were: Type I, 9%, Type II, 39%, Type III, 20%, Type IV, 25%, Type V, 6%, Type VI, 1%. 95% cases showed bifurcation. Conclusion: Most common branching pattern was Type II (39%), and least common was Type VI (1%). Surgery of Zygomatic region must be done carefully due to complexity of branching in this area.

Objective: To compare the difference in pain perceived by patients undergoing intra-oral local anesthesia withdifferent gauge needles. Study Design: Qausi experimental study. Place and Duration of Study: Oral and Maxillofacial surgery department of Institute of Dentistry, CombinedMilitary Hospital, Lahore Medical College, Lahore, from July 2019 to August 2019. Methodology: One hundred patients were selected by consecutive sampling from the oral surgery OPD clinic.They were divided into two groups A and B randomly. Twenty three gauge needle on a 3cc disposable syringewas used for inferior alveolar nerve block and buccal nerve block for group A and 27 gauge needle on a metaldental syringe was used for the same in group B. Patients gave a verbal pain score, from 0-10 for each injection. Results: One Hundred participants were included in study, 37 (37%) males and 63 (63%) females. Mean painscore for group A for the inferior alveolar nerve block was 4.50 ± 2.1 and group B was 3.86 ± 2. The mean painscore for the buccal nerve block in group A was 4.02 ± 1.7, while that of group B was 3.94 ± 1.8. There was nosignificant difference (p=0.167 & 0.855) in pain perceived by patients undergoing intra oral local anesthesia using needles of different gauges. Conclusion: There is no difference in pain perceived by patients undergoing intra oral local anesthesia usingneedles of different gauges.

Background: Paresthesia is an abnormal dermal sensation with no apparent physical cause. One of the everyday practices in any oral surgery setup is the extraction of the impacted mandibular third molars surgically. Precise measurement of the bone present for support of the implant coronal to the inferior alveolar nerve (IAN) canal is the pertinent way to prevent IAN injuries. Objective: To assess the frequency of paresthesia due to IAN damage after mandibular third molar’s surgical extraction in patients with darkening of root on orthopantomogram. Material & Methods: It was a descriptive case series study which took place in the department of Oral and Maxillofacial Surgery at Sharif Medical and Dental College, Lahore in a time frame of 6 months i.e. from December 2020 till May 2021. After meeting the inclusion/exclusion criteria, 200 patients were made part of the study program. Informed consent and demographic information was recorded. Surgical procedure of all these patients was done. Assessment was done post-operatively first after one week when patient came for suture removal by inquiring about the subjective perception of abnormal feeling or sensation on lower lip and chin area. Patients were then reappointed for a follow-up visit after 1 month as well. Results: Patients’ mean age was 28.05±3.94 years. There were 104 (52%) males and 96 (48%) females in the study population. There were 38 (19%) patients of distoangular impaction, 39 (19.5%) had horizontal impaction, 55 (27.5%) had mesioangular impaction while 68 (34%) had vertical impaction. The IAN paresthesia after 1st month of surgery was found in 13 (6.5%) patients. Conclusion: According to this study, the frequency of paresthesia after 1st month of surgery was 6.5% due to IAN injury after mandibular third molar surgery in patients with darkening of root as observed on orthopantomogram. Keywords: Inferior Alveolar Nerve, Orthopantomogram, Paresthesia, Third Molar Surgery.

Objective: To compare skin staples with prolene for closure of neck dissection incisions in terms of time for wound closure, pain on removal and aesthetic outcome. Study design and setting: Single blinded, prospective clinical study carried out at Sharif Medical and Dental College, Lahore from 19.04.2021 to 18.04.2022. Materials and methods: All healthy (ASA-I/II) patients requiring neck dissection were enrolled in the study. The patients were divided into two groups, incision in group A was closed with 3/0 vicryl and 5/0 prolene while incision in group B was closed using 3/0 vicryl and stainless-steel staples. Results: Total 140 patients were enrolled in the study with 70 patients in each group. In group A, 37 were males and 33 females while in group B, 43 were males and 27 females. The age in group A was 52.69+8.1 years while in group B, the age was 51.93+8.2 years. The mean time for wound closure in group A was 35.2+2.7 minutes while in group B it was 3.5+0.4 minutes. Pain on removal using VAS was 22.1+6.3 in group A while it was 21.8+5.5 in group B. In group A, 23 were excellent, 37 moderate and 10 poor while in group B, 27 were excellent, 38 moderate and 05 poor aesthetically. Overall, the results were statistically significant in terms of time of placement while they were statistically insignificant in terms of pain on removal and aesthetic outcome. Conclusion: The results of the study conclude that staples are a better modality for closing neck incisions after neck dissection as they are quicker to apply and yield similar outcomes as sutures. Keywords: Neck dissection, incision, closure, suturing.