Osteopetrosis is a rare congenital (autosomal type) disorder of the skeletal system. Several variants have been described in the literature with grossly variant prognosis and clinical behaviour. Several reports of intractable osteomyelitis of the jaw bones secondary to osteopetrosis, particularly the mandible, have been published widely. However, there is no published report of the complete mandible sequestrating de novo, in the literature. An overview of this spectrum of sclerotic bone disease, its presentation in the oro-facial region, the diagnostic challenge it poses and the management dilemma it offers to the maxillofacial surgeon is discussed and a protocol for managing this disease effectively is presented. A clinical illustration of the complexities of management of osteopetrosis-induced osteomyelitis of jaw bones is demonstrated with a very rare case in which the entire mandible had sequestrated.

Aim:The cleft lip and palate patients undergo a series of surgical procedures from the time of their birth, wherein the primary cleft lip correction procedure is carried out. The last in the series is rhinoplasty after the maxillary skeletal base has been set right in its dynamics with the mandibular base. The degree of deformity lies in the type of cleft and its accompanying features. The timing of correction at the primary lip closure stage, allowing a repositioning of the lateral nares, the detailed examination of the nose at the time of presentation ascertains the degree of augmentation necessary. Background: The first mention of rhinoplasty dates back to the dates of Shusruta and his disciples who managed to reconstruct parts of the nose and ear, which were sliced as a part of criminal punishment. The Roman encyclopedist published the techniques of reconstruction, followed by the Europeans. By the 11th century, the Arabs converted Shushruta's book into Sanskrit, and this spread to the Western atmosphere. Evidence for a free flap graft and a forehead graft that were adopted and published by Doctors Cruzo and Findlay in 1794 are the first steps to the modern rhinoplasty techniques. Review results: The correction of the nose at the primary surgery of the cleft lip was widely accepted to reduce the gross deformities that would manifest if the small corrections were not made appropriately the first time. The caudal resection of septae was identified as the reason for the growth deformities that happened secondarily. The secondary rhinoplasty was to be performed as a final procedure after the growth phase when all other surgical procedures were done and dealt with leaving an L-shaped strut of the septae at the dorsal, and the caudal end was advocated for a stable result of the septum without any buckling and further deformity. Conclusion:The key to performing a near-perfect procedure lies in the clinical assessment at the time of presurgical presentation.

We are presenting a case with multiple recurring ankylosis, as the child had exhibited the clinical signs and symptoms of an ankylotic right temporomandibular joint. She was operated for the 1st time when she was 6 years old with poor compliance and was reoperated with a distraction unit when she was 10 years old. The research points out to frequent relapses in younger patients operated as they had less compliance relative to the adult ankylotic patients. Henceforth, we dealt with an aggressive approach of planning only on the resection of the mass and if the mouth opening ensues to progress with further correction of the asymmetry and the residual defect. The patient had nil mouth opening and hence was consented for tracheostomy, and fiber-optic intubation was arranged. The aggressive resection of the ankylotic mass was done and the cavity was lined with temporalis myofascial flap. This was followed by aggressive physiotherapy. The patient now has 28 mm of mouth opening and is continuing aggressive physiotherapy for the same. After 6 months of surgery, the patient is planned to undergo corrective jaw surgery for the asymmetry present.