Syngnathia per se is a rare congenital disorder. A literature survey reveals a total of 26 cases of syngnathia in the English literature since 1936, of which only seven cases involved fusion of the ascending ramus of the mandible to the posterior portion of the maxilla and zygomatic complex. The remaining 19 involved fusion of the alveolar ridges of the maxilla and mandible. This is a unique case of fusion of the mandible to the zygomatic complex presenting with a unilateral anophthalmic orbit in an 18-day-old neonate. The use of the term syngnathia has been reviewed and a modification in classification has been suggested.

The cephalometric norms for orthognathic surgery (COGS analysis) are the standard benchmark in cephalometrics for any orthognathic surgical diagnosis and treatment planning. Since the introduction of cephalometrics by Broadbent, numerous studies have been conducted to establish craniofacial norms of different ethnicities. Most of these studies, however, determined craniofacial norms for Caucasian people and may not be applicable to other ethnic groups due to differences in their facial appearance. Therefore, it is essential to study and compare the existing cephalometric parameters between Caucasians and Indians to validate their application during the treatment planning of the orthognathic surgery. This review focuses on studying the cephalometric norms for the North Indian (NI) population and establishing the COGS analysis for the population of North India. The objective is to determine the cephalometric parameters of Angle's dental and skeletal Class I faces for the NI population. The following databases were searched for the present study -PubMed, Ovid MEDLINE, and EMBASE. The initial inclusion criteria comprised studies written in English and quoting cephalometric norms in Indian population. The time period of publications was not determined. The quality features evaluated were sample description, variables analyzed, and how cephalometric standards were evaluated. Initially, 49 articles were retrieved. After removal of the duplicated records and assessing for the eligibility, four articles met the inclusion criteria. These four articles were included in the systematic review. The NI people are characterized by having small cranial base, short facial height, protrusive chin, and more inclination of mandibular incisors in comparison with Caucasians. Due to limited research on the Central Indian cephalometric norms, the Caucasian norms are still referred for the diagnosis and treatment planning of orthognathic surgery for NI population.

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INQICATIONSWbile there are many reasons for autotransplanting teeth, tooth loss as a result of dental caries is the most common indication, especially when mandibular first molars are involved. Firstmolars erupt early and are often heavily restored. Autotransplantation in this situation involves the removal of a third molar which ,may then be transferred to the site of an unrestorable first molar. Other conditions in which transplantation can be considered include tooth agenesis (especially of premolars and lateral incisors), traumatic tooth loss, atopic eruption of canines, root resorption, large endodontic lesions, cervical root jractures, localized juvenile periodontitis as well as other pathologies. Successful transplantation depends on specific requirements of the patient, the donor tooth, and the recipient site. CANDIDATE CRITERIA Patient selection is very important for the success of autotransplantation. Candidates must be in good health, able to follow post-operative instructions, and available for follow-up visits. They should also demonstrate an acceptable level of oral hygiene and be amenable to regular dental care. Most importantly, the patients must have a suitable recipient site and donor tooth. Patient cooperation and comprehension are extremely important to ensure predictable results. RECIPIENT SITECRITERIA The most important criteria for success involving the recipient site is adequacy of bone support. There must be sufficient alveolar bone support in all dimensions with adequate attached keratinized tissue to allow for stabilization of the transplanted tooth. In addition, the recipient site should be free from acute infection and chronic inflammation. DONORTOOTHCRITERIA The donor tooth should be positioned such that extraction will be as atraumatic as possible. Abnormal root morphology, which makes tooth removal exceedingly difficult and may involve tooth sectioning, is contraindicated for this surgery.1 Teeth with either open or closed apices may be donors; however, the most predictable results are obtained with teeth having between one-half to two-thirds completed root development.1-5 Surgical manipulation of teeth with less than one-half root formation may be too traumatic and could compromise further root development, stunting maturation or altering morphology. When root development is greater than two-thirds, the increased length may cause encroachment on vital structures such as the maxillary sinus or the inferior alveolar nerve. Furthermore, a tooth with complete or near complete root formation will generally require root canal therapy, while a tooth with an open apex will remain vital and should continue root development after transplantation. In the latter case, successful transplantation without the need for further endodontic therapy is usually seen. CONCLUSION Although autotransplantation has not been established as a traditional means of replacing a missing tooth, the procedure warrants more consideration. Recent studies clearly demonstrate that autotransplantation of teeth is as su...