- Professor of Oraledit
Study Design A clinical randomized control trial. Objective To compare the efficacy and safety of Hybrid arch bar (HAB) with Erich arch bar (EAB) in fracture management of the mandible. Methods In this randomized clinical trial, 44... more
Study Design A clinical randomized control trial. Objective To compare the efficacy and safety of Hybrid arch bar (HAB) with Erich arch bar (EAB) in fracture management of the mandible. Methods In this randomized clinical trial, 44 patients were divided into 2 groups:- Group 1, N = 23 (EAB group) and Group 2, N = 21 (HAB group). The primary outcome was time taken for the application of arch bar, while the inner and outer glove puncture, operator prick, oral hygiene, arch bar stability, complications of HAB, and cost comparison were secondary outcomes. Results The time taken for the application of arch bar in group 2 was significantly shorter than group 1 (55.66 ± 17.869 min vs 82.04 ± 12.197 min) and the frequency of outer glove puncture was also significantly lesser for group 2 (0 punctures vs 9 punctures). Better oral hygiene was found in group 2. EAB was cost-effective than HAB (Rs 700 ± 239.79 vs Rs 1742.50 ± 257.14). The stability of the arch bar was comparable in both groups. ...
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The aim of this study was to compare the efficacy and safety of transdermal Fentanyl patch with oral Ketorolac for pain management in dry socket patients. Sixty patients who were diagnosed with dry socket (VAS > 40 mm) were recruited... more
The aim of this study was to compare the efficacy and safety of transdermal Fentanyl patch with oral Ketorolac for pain management in dry socket patients. Sixty patients who were diagnosed with dry socket (VAS > 40 mm) were recruited in this prospective randomized controlled trial. Patients were divided into two groups. Group1 (n = 30) Transdermal Fentanyl patch (25mcg/hr) was given and in Group 2 (n = 30) Ketorolac 10 mg Oral tablet was prescribed for pain management. The primary endpoint was the mean pain scores within 72 h evaluated by visual analog scale (VAS). Secondary measures included the safety and tolerability, amount of rescue medication (analgesic and antiemetic) and effectiveness of treatment interventions by Brief Pain Inventory Questionnaire (BPI). The mean VAS pain scores were significantly less in group 1 (Fentanyl) as compared to group 2 (ketorolac) on all follow-up days. Significant difference was noted in the mean amount of rescue analgesic medication. It was 2.16 + 1.53 in group 1 and 8.50 + 3.98 in group 2. Side effects were seen in both the groups. Nausea (46%) and vomiting (43%) were reported in group 1 while headache (36.6%) and epigastric pain (53.3%) in group 2. Thus, transdermal Fentanyl was better in pain control than Ketorolac with less need for rescue analgesic medication in dry socket.
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Various methods have been described for intermaxillary fixation (IMF) for treatment of faciomaxillary injuries. Many studies have been described to evaluate the efficacy of different methods. Hanger plate method has not been commonly... more
Various methods have been described for intermaxillary fixation (IMF) for treatment of faciomaxillary injuries. Many studies have been described to evaluate the efficacy of different methods. Hanger plate method has not been commonly used. The aim of the present study was to compare the advantages and disadvantages of this method over Erich arch bar in mandibular fracture. Sixty patients of only mandibular fracture presenting to trauma center requiring open reduction and internal fixation under general anesthesia were randomly allocated to Group A and Group B comprising thirty patients in each. Group A included patients who received IMF with Erich arch bar. Group B included patients who received IMF with hanger plate method. The two groups were compared for time duration of intermaxillary procedure, total duration of surgery, oral hygiene score, postoperative occlusion, and complications. The average time of intermaxillary procedure, total duration of surgery, and wire prick injurie...
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Introduction A late mandibular fracture after third molar extractions is a very rare complication. The main etiological factors of it are considered to be age greater than 40, male patients, tooth position, and trauma to the mandible. The... more
Introduction A late mandibular fracture after third molar extractions is a very rare complication. The main etiological factors of it are considered to be age greater than 40, male patients, tooth position, and trauma to the mandible. The main features commonly described by the patients are occurrence after few days of extraction with history of crackling due to fracture of mandible and pain on chewing. Material and Method We retrospectively review the treatment chart of mandibular trauma patients and observe cases of fracture mandible angle after third molar surgery. Five patients who reported late mandibular fracture after a third molar extraction were treated either by maxillomandibular fixation (MMF) or by open reduction and internal fixation (ORIF) studied. Results Out of the 5 patients, 3 were treated with ORIF and 2 were treated with MMF. After maximum follow-ups, all healed well without any complications. Conclusion It is observed that all the causative factors should be ass...
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Supplemental Material, sj-pdf-1-cpc-10.1177_10556656211025197 for Comparative Assessment of Autogenous Cancellous Bone Graft and Bovine-Derived Demineralized Bone Matrix for Secondary Alveolar Bone Grafting in Patients With Unilateral... more
Supplemental Material, sj-pdf-1-cpc-10.1177_10556656211025197 for Comparative Assessment of Autogenous Cancellous Bone Graft and Bovine-Derived Demineralized Bone Matrix for Secondary Alveolar Bone Grafting in Patients With Unilateral Cleft Lip and Palate by Vijay Kumar, Vidya Rattan, Sachin Rai, Satinder Pal Singh and Jai Kumar Mahajan in The Cleft Palate-Craniofacial Journal
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Purpose The purpose of this paper is to design and development of a patient-specific implant for zygomatic area of a patient suffering from mucormycosis (fungal infection). The paper describes how integration of computer-aided design... more
Purpose The purpose of this paper is to design and development of a patient-specific implant for zygomatic area of a patient suffering from mucormycosis (fungal infection). The paper describes how integration of computer-aided design (CAD) and 3D printing can be successfully used for developing custom implants for the sites for which readymade optimal solutions are not available. Design/methodology/approach The CT scan data of the patient were used for the generation of a 3D model. The healthy side of skull was mirrored and copied on the infected part, which served as a base for designing the implant. The prototype of the implant was printed using fused deposition modelling before finally printing in Ti6Al4V alloy using direct metal laser sintering process. Findings The custom designed implant fitted well to the patient’s skull during surgery. Proper facial aesthetics were maintained post-surgery. Originality/value The work describes the application of CAD-based image processing sof...
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Dental stem cells (DMSC) have been studied extensively since their early discovery. However, the data regarding osteogenic potential of DMSC with other cell types is sparse and the secretome proteins underlying these differences have not... more
Dental stem cells (DMSC) have been studied extensively since their early discovery. However, the data regarding osteogenic potential of DMSC with other cell types is sparse and the secretome proteins underlying these differences have not been explored. In this study, we have compared the osteogenic and adipogenic potential of DMSC with Bone Marrow Stem cells (BMSC) and reported the contribution of secretome proteins in controlling their differentiation. Osteogenic potential of these stem cells was compared by mineralization assay, alkaline phosphatase (ALP) assay, immunofluorescence of dentine sialo phosphoprotein (DSPP) & qPCR for osteogenic genes. Adipogenic potential was compared by Oil Red O staining and qPCR for PPAR-γ, leptin & adipsin. Proteomic analysis of secretome was performed by employing WATERS nano Lc-MS/MS system. We observed a higher osteogenic potential in DMSC, especially dental pulp stem cells (DPSC) as compared to BMSC population but adipogenic potential was foun...
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Epigenetic modifications have been reported to play an important role in regulating gene expression and these modifications become critical when they have a role in controlling another important layer of epigenetic regulation namely... more
Epigenetic modifications have been reported to play an important role in regulating gene expression and these modifications become critical when they have a role in controlling another important layer of epigenetic regulation namely microRNAs. In the present study, we have identified the microRNAs that may be regulated by promoter DNA methylation and histone acetylation in Human papilloma virus-positive head and neck squamous cell carcinoma. HPV-negative cell line (UPCI:SCC-116) and HPV-16 +ve cell line (UPCI:SCC-090) were treated with methylation inhibitor (5-aza-2'-deoxycytidine, AZA) and acetylation inhibitor (Trichostatin-A, TSA), followed by micro-array analysis. The differentially expressed miRNAs were validated in control (n = 10), HPV-16 +ve (n = 30), and HPV -ve (n = 30) HNC, TCGA (n = 529) tissue samples, and two HPV -ve (SCC116 and Hacat) and two HPV +ve (SCC090 and SiHa) cell lines. Methylation-specific PCR (MSP) and chromatin immunoprecipitation assay (CHIP) were pe...
Research Interests: Molecular Biology, MicroRNA, Biology, Cancer Research, Epigenetics, and 11 moreMedicine, HUMAN PAPILLOMAVIRUS, Humans, DNA methylation, microRNAs, Oral Squamous Cell Carcinoma (OSCC), Carcinogenesis, Molecular and Cellular Biochemistry, Biochemistry and cell biology, Papillomavirus Infections, and Head and neck neoplasms
This prospective study was aimed to determine and quantify the change in mandibular condylar hyperactivity over a period of time by using a fluorine-18 (F) fluoride PET-computed tomography (CT) scan. Sixteen patients (age 19.50±2.58... more
This prospective study was aimed to determine and quantify the change in mandibular condylar hyperactivity over a period of time by using a fluorine-18 (F) fluoride PET-computed tomography (CT) scan. Sixteen patients (age 19.50±2.58 years) with noticeable faciomandibular asymmetry caused by unilateral condylar hyperplasia (UCH) were included in the test group and underwent an F-fluoride PET-CT scan at the beginning of the study (T0); these patients were then followed up for a minimum of 12 months, after which the F-fluoride PET-CT scan was repeated at first follow-up (T1). An age-matched control group consisted of 10 patients with apparently symmetrical faces whose PET-CT scans were acquired for some other medical conditions. Statistical analysis of maximum standardized uptake values (SUVmax) obtained through F-fluoride PET-CT was performed using the paired t-test. Mean SUVmax of the affected condyle at T0 and T1 was 9.18±4.07 and 9.18±3.88, respectively. The mean SUVmax of the cont...
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Cherubism is characterized by hereditary and intraosseous fibrous swellings of the jaws. It presents with bilateral mandibular and maxillary involvement in young individuals. Fine needle aspiration cytologic (FNAC) features have rarely... more
Cherubism is characterized by hereditary and intraosseous fibrous swellings of the jaws. It presents with bilateral mandibular and maxillary involvement in young individuals. Fine needle aspiration cytologic (FNAC) features have rarely been described in the literature; they include smears showing moderate cellularity with spindle cells mixed with multinucleated giant cells of osteoclast type. Therefore, giant cell containing soft tissue and bone lesions are considered in the differential diagnosis. A 13-year-old girl presented with bilateral symmetrical mandibular enlargement and was diagnosed as having cherubism on FNAC. We describe the cytomorphologic features of cherubism along with its differential diagnosis on cytology and emphasize that with clinicoradiologic correlation, a specific diagnosis can be offered for a definitive therapeutic approach.
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Peripheral osteomas of the mandible are uncommon bony tumours. Of those that have been described, the location is normally posterior to the premolars on the lingual surface of the mandible or in the condylar area. This article presents a... more
Peripheral osteomas of the mandible are uncommon bony tumours. Of those that have been described, the location is normally posterior to the premolars on the lingual surface of the mandible or in the condylar area. This article presents a case of an atypical presentation of an osteoma arising from the anterior lingual alveolar cortical plate of the mandible.
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Supplemental Material, sj-docx-1-cpc-10.1177_10556656211025197 for Comparative Assessment of Autogenous Cancellous Bone Graft and Bovine-Derived Demineralized Bone Matrix for Secondary Alveolar Bone Grafting in Patients With Unilateral... more
Supplemental Material, sj-docx-1-cpc-10.1177_10556656211025197 for Comparative Assessment of Autogenous Cancellous Bone Graft and Bovine-Derived Demineralized Bone Matrix for Secondary Alveolar Bone Grafting in Patients With Unilateral Cleft Lip and Palate by Vijay Kumar, Vidya Rattan, Sachin Rai, Satinder Pal Singh and Jai Kumar Mahajan in The Cleft Palate-Craniofacial Journal
Objective: Comparison between bovine-derived demineralized bone matrix (DMBM) and iliac crest graft over long term for secondary alveolar bone grafting (SABG) in patients with unilateral cleft lip and palate (UCLP) in terms of... more
Objective: Comparison between bovine-derived demineralized bone matrix (DMBM) and iliac crest graft over long term for secondary alveolar bone grafting (SABG) in patients with unilateral cleft lip and palate (UCLP) in terms of radiological and clinical outcomes. Design: Prospective, randomized, parallel groups, double-blind, controlled trial. Setting: Unit of Oral and Maxillofacial Surgery, Oral Health Science Centre, Postgraduate Institute of Medical Education & Research, Chandigarh. Participants: Twenty patients with UCLP. Interventions: Patients were allocated into group I (Iliac crest bone graft) and group II (DMBM) for SABG. Outcomes were assessed at 2 weeks, 6 months, and then after mean follow-up period of 63 months. Outcomes Measures: Volumetric analysis of the grafted bone in the alveolar cleft site was done through cone beam computed tomography using Cavalieri principle and modified assessment tool. Clinical assessment was performed in terms of pain, swelling, duration of ...
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There is limited knowledge about masticatory function after the release of temporomandibular joint (TMJ) ankylosis. In this study, masticatory function was evaluated by measuring maximum voluntary bite force (MVBF) and chewing efficiency... more
There is limited knowledge about masticatory function after the release of temporomandibular joint (TMJ) ankylosis. In this study, masticatory function was evaluated by measuring maximum voluntary bite force (MVBF) and chewing efficiency in 30 unilateral TMJ ankylosis patients who were treated with buccal fat pad (BFP) interpositional arthroplasty. Eighteen subjects over 12 years of age were included in study Group A and 12 subjects below 12 years of age in study Group B. Patients in the study groups had completed a minimum follow up of one year after surgery. Control groups C (over 12 years of age, n = 18) and D (under 12 years of age, n = 12) consisted of age, sex, and weight-matched normal subjects. The mean MVBF was measured between occluding molar teeth with a strain gauge transducer. Chewing efficiency was measured with two different coloured chewing gum strips. These were chewed for 5, 10, 20, 30, and 50 strokes. Compared with normal subjects, the study groups (A and B) could generate 64.7% (p = 0.004*) and 89.8% (p = 0.121) of MVBF, respectively. Overall chewing efficiency was 88.7% in Group A and 92.9% in Group B (p = 0.014* and p = 0.138, respectively) when compared with normal subjects. The study has shown that BFP interpositional arthroplasty effectively restores masticatory function.
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Necrotizing fasciitis is a rare rapidly progressive, devastating surgical emergency that results in necrosis of superficial fascia, and subcutaneous tissue. It most commonly affects the abdominal wall, extremities and perineum, while the... more
Necrotizing fasciitis is a rare rapidly progressive, devastating surgical emergency that results in necrosis of superficial fascia, and subcutaneous tissue. It most commonly affects the abdominal wall, extremities and perineum, while the involvement in the head and neck region is relatively rare. Here, we report a successfully treated case of necrotizing fasciitis of the craniofacial region caused by Mucor in an uncontrolled diabetic patient. Early diagnosis, early surgical intervention with radical excision of infected tissue, management of underlying predisposing medical condition and supportive therapy (antimicrobials, rehydration, proper rest and nutrition) can reduce the morbidity and mortality associated with this condition.
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The paper highlights the management of a 4 years old female child who suffered oral and maxillofacial injury due to explosion of a firecracker inside the mouth. How to cite this article Yadav S, Rai S, Rattan V. Management of... more
The paper highlights the management of a 4 years old female child who suffered oral and maxillofacial injury due to explosion of a firecracker inside the mouth. How to cite this article Yadav S, Rai S, Rattan V. Management of Maxillofacial Injury due to Firecracker in a Child. J Postgrad Med Edu Res 2014;48(2):98-99.
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Liver regeneration is a spontaneous process that occurs after liver injury, but acute liver failure is a complex and fatal disease which is difficult to treat. Cell-based therapies are promising alternative therapeutic approach for liver... more
Liver regeneration is a spontaneous process that occurs after liver injury, but acute liver failure is a complex and fatal disease which is difficult to treat. Cell-based therapies are promising alternative therapeutic approach for liver failure and different cell sources have been tested in this regard. We investigated the comparative hepatogenic potential of human bone marrow stem cells (BMSC) with stem cells derived from human dental pulp (DPSC), apical papilla (SCAP) and follicle (DFSC) during this study. Hepatogenic potential of stem cells was assessed by functional assays at both genetic and protein level. We observed higher expression of most of the hepatic markers post differentiation in DPSCs compared to other cell types. LC-MS/MS analysis of stem cell secretome revealed the presence of different proteins related to hepatogenic lineage like growth arrest specific protein 6, oncostatin M, hepatocyte growth factor receptor etc. Interactome and Reactome pathway analysis reveal...
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PURPOSE In the past, both tranexamic acid and dexmedetomidine have been used separately to decrease intraoperative blood loss during orthognathic surgery. However, their combined use in the same setting has never been prospectively... more
PURPOSE In the past, both tranexamic acid and dexmedetomidine have been used separately to decrease intraoperative blood loss during orthognathic surgery. However, their combined use in the same setting has never been prospectively evaluated. The present study was conducted to evaluate the effect of tranexamic acid on operative field visibility and blood loss during orthognathic surgery after dexmedetomidine-induced hypotensive anesthesia. PATIENTS AND METHODS The present prospective, randomized clinical trial included patients who had undergone orthognathic surgery under general anesthesia. The patients were divided into 2 groups. The dexmedetomidine and tranexamic (DT) group received an intravenous bolus of tranexamic acid (15 mg/kg) and intravenous dexmedetomidine (0.25 to 0.7 μg/kg/hr) as maintenance infusion. The dexmedetomidine (DS) group received only intravenous dexmedetomidine at the same dosage. All the patients had received a bolus dose of intravenous dexmedetomidine (1 μg/kg) before the start of anesthesia induction. The operating surgeon rated the quality of the surgical visual field every 15 minutes using the Fromme ordinal scale. Intraoperative blood loss was estimated using the modified gross formula. The operating surgeon's satisfaction was assessed using a Likert scale. Data were analyzed using SPSS, version 22.0 (IBM Corp, Armonk, NY). Kolmogorov-Smirnov tests were used to assess the normality of the measured data, and categorical variables were analyzed using the χ2 or Fischer exact test. RESULTS The study sample included 36 patients, with a mean age of 23.67 ± 11.298 years in the DS group and 20.28 ± 3.286 years in the DT group. Of the patients in the DS and DT groups, 66.66 and 61.11% were male, respectively. No statistically significant differences were found in the baseline characteristics between the 2 treatment groups. The surgeon reported a significantly better surgical visual field in the DT group compared with that in the DS group (P = .001). Also, the intraoperative blood loss significantly less in the DT group (231.11 ± 137.64 mL vs 360.17 ± 187.86 mL; P = .025). CONCLUSIONS Tranexamic acid improved surgical field visibility and reduced intraoperative blood loss when administered in conjunction with dexmedetomidine during orthognathic surgery under controlled hypotensive anesthesia.
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The purpose of the study was to investigate whether open reduction and internal fixation (ORIF) with ultrasound activated resorbable pins (UARPs) is superior to closed treatment of condylar head (CH) fractures. The investigators... more
The purpose of the study was to investigate whether open reduction and internal fixation (ORIF) with ultrasound activated resorbable pins (UARPs) is superior to closed treatment of condylar head (CH) fractures. The investigators hypothesized that fixation with UARPs is superior to closed treatment of CH fracture. It was a prospective pilot study on CH fracture patients. Patients in closed group were managed conservatively with arch bar fixation and elastic guidance. Fixation in open group was done with UARPs. Assessment was done for primary objective of stability of fixation by UARPs and secondary objectives of functional outcome and complications. The study sample included 20 patients (10 in each group). 10 patients (11 joints) in closed group and 9 patients (10 joints) in open group were available for final follow-up. 5 joints showed re-dislocation of fractured segment, 1 joint showed slightly imperfect but adequate fixation and 4 joints showed adequate fixation in open group. In the closed group, displaced fragment was fused with mandible at displaced position in all the joints. All the joints showed resorption of medial condylar head at 3 months follow-up in open group. There was minimal resorption of condyle in closed group. Occlusion was deranged in 3 patients in open group and 1 patient in closed group. MIO, pain scores and lateral excursions were equal in both the groups. The results of the present study rejected the hypothesis that fixation of CH with UARPs was superior than closed treatment. There was resorption of medial CH fragment in open group as compared to closed group.
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The relationship of orthognathic surgery and temporomandibular disorders (TMD) has always been a topic of debate. The results have varied from mild/moderate improvement to actual worsening in some cases. The purpose of this study was to... more
The relationship of orthognathic surgery and temporomandibular disorders (TMD) has always been a topic of debate. The results have varied from mild/moderate improvement to actual worsening in some cases. The purpose of this study was to evaluate the effects of orthognathic surgery on TMD in patients with dentofacial deformities. An observational study was conducted on 56 patients (112 condyles) of patients with dentofacial deformities with age range of 19–35 years who underwent orthognathic surgery. TMD was evaluated using seven types of disorders in diagnostic criteria for TMD (DC/TMD, 2010) pre-operatively and after 6-month follow-up. There was minimal decrease in unassisted mouth opening without pain, maximum unassisted mouth opening and maximum assisted mouth opening after surgery. There was significant improvement in joint sounds and headache in 18 patients. Overall, there was improvement in 29 cases (33.93%), worsening in 8 cases (14.29%) and no change in 19 cases (33.93%). There was high prevalence of TMDs in dentofacial deformity patients. Most of the patients with pre-operative TMD improved with orthognathic surgery, whereas a small percentage of patients who were asymptomatic pre-operatively developed TMD after surgery and in some patients TMD worsened. The risk of developing TMD and worsening of severity conditions is low.
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Zygomatico-orbital (ZMO) fractures pose considerable difficulty in intraoperative assessment during open reduction and internal fixation (ORIF), and this can be attributed to its three-dimensional complex anatomy and articulations. Recent... more
Zygomatico-orbital (ZMO) fractures pose considerable difficulty in intraoperative assessment during open reduction and internal fixation (ORIF), and this can be attributed to its three-dimensional complex anatomy and articulations. Recent advancements in the form of intraoperative imaging and navigation have led to an adequate assessment and correct reduction of these fractures minimizing chances of any revision surgery. The purpose of this study was to evaluate the advantage of intraoperative computerized tomography (CT) scan in the management of ZMO/isolated orbital complex fracture and further to develop a protocol for managing such fractures. Twenty-three cases of ZMO/isolated orbital fractures were managed with ORIF, followed by an intraoperative CT scan. The evaluation was focused on the articulations of the zygoma and orbital wall reconstruction. The score of 0 and 1 was given for inadequate and adequate reduction, respectively. Necessary corrections were performed in case of improper reduction followed by a repeat CT scan if required. The reduction score was statistically correlated with number of incisions. In 8 (35%) out of 23 patients, clinical judgment was inaccurate when radiologically assessed with an intraoperative CT scan. In 6 out of 8 cases, a repeat CT scan was done after revision of reduction. The reduction score improved with additional incision and revision in the second CT scan. Intraoperative CT has an important role in assessing the accuracy of reduction and confirming implant position in ZMO/isolated orbital fractures. This can avoid the need for secondary corrective surgery and postoperative imaging. Intraoperative CT is an important tool to improve surgical outcomes in the management of ZMO orbital fractures.
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Purpose Maxillomandibular fusion (syngnathia) is a rare craniofacial anomaly. It occurs as either fibrous (synechiae) or bony (synostosis) fusion of jaw or fusion of mandible to zygoma, tuberosity, hard palate and temporal bone. There are... more
Purpose Maxillomandibular fusion (syngnathia) is a rare craniofacial anomaly. It occurs as either fibrous (synechiae) or bony (synostosis) fusion of jaw or fusion of mandible to zygoma, tuberosity, hard palate and temporal bone. There are several documentations delineating this condition but owing to its varying presentation, association with both intraoral and extraoral anomalies and syndromes, reviewing it has been as uphill task. The non-unanimous description of cases in the literature and the use of different nomenclatures make it difficult to classify this condition. Methods Extensive search of the literature was done from the year 1936 to 2018 which included a total of 118 cases with 62 cases of bony fusion, 48 cases of fibrous fusion and 8 cases of combined fusion, i.e., fibrous on one site and bony on another side. Results This paper proposes a novel, simple and explicit classification system on the basis of nature of fusing tissues, location and extent, association with syndrome after reviewing the existing literature. Furthermore, this review reports 4 new cases of syngnathia along with their clinical, radiographic features and their management protocol. Conclusions This classification can be generalized to all the cases of syngnathia and can further facilitate in its appropriate diagnosis and treatment plan.
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Three dimensional imaging systems whether in the form of digital models, facial scanning or dolphin software play an important role in proper diagnosis and treatment planning of the orthosurgical cases. This case report highlights... more
Three dimensional imaging systems whether in the form of digital models, facial scanning or dolphin software play an important role in proper diagnosis and treatment planning of the orthosurgical cases. This case report highlights importance of three-dimensional treatment planning in the ortho-surgical management of the patient with skeletal Class III malocclusion involving atypical extraction. On clinical examination, patient had concave profile, prominent chin, deficient midface, flat cheekbone contour and prominent nasal projection. He had Class III molar and canine relation bilaterally with missing 12 (previously extracted), negative overbite and overjet with discordant maxillomandibular midlines. After 3-dimensional digital model set-up for occlusion planning and dolphin simulation for soft tissue prediction, extraction of left maxillary lateral incisor was planned followed by maxillary advancement and mandibular setback surgery and finish the occlusion in Class II molar relationship. After the orthodontic and orthognathic surgical treatment, the skeletal and dental imbalance was corrected, and most of the treatment objectives were achieved and patient was extremely satisfied with his facial profile. The treatment results were stable at the 3 years follow-up.
Research Interests: Orthodontics and Medicine
AimTo highlight the spontaneous regeneration of mandibular segmental defects in young and pediatric cases and to review the literature of this unusual and rare phenomenon.MethodologyTwo case reports of a 17-year old male and a 8-month-old... more
AimTo highlight the spontaneous regeneration of mandibular segmental defects in young and pediatric cases and to review the literature of this unusual and rare phenomenon.MethodologyTwo case reports of a 17-year old male and a 8-month-old infant has been presented who underwent resection of mandible for benign tumors. These two cases have been compared with the existing literature of 61 cases published till date.InferenceSpontaneous regeneration of mandible as a viable reconstructive option is not practically feasible. The consistency and predictability of the phenomenon is questionable. Bone grafting should probably be done immediately in all cases, even in young patients if a delay would interfere with quality of life. In infants and small children though, we propose that immediate reconstruction may be avoided to allow some regeneration at the defect site. If it does not occur, secondary reconstruction may then be considered.
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Purpose Chitosan has been shown to promote wound healing and induce bone formation. The aim of this split-mouth study was to evaluate the effectiveness of chitosan based dressing in wound healing after lower third molar extraction. Method... more
Purpose Chitosan has been shown to promote wound healing and induce bone formation. The aim of this split-mouth study was to evaluate the effectiveness of chitosan based dressing in wound healing after lower third molar extraction. Method Asymptomatic symmetrical mandibular third molars were extracted simultaneously in 27 patients and Chitosan dressing was placed into the extraction socket in the test side. Pain scores were recorded on VAS using a 0 to 10 pain score. Wound healing was compared between right and left side. Radiographic findings were evaluated by observing lamina dura and density of extraction socket. Results Test group had more pain than control at all time intervals and unerupted tooth sites showed mean pain score significantly more than erupted tooth sites. Test group was superior to control in event of wound healing. Healing was significantly better in erupted tooth than unerupted tooth. At second week 12 sites showed better radiographic findings in chitosan treated group compared to 3 sites in the control group. At third month, 14 sites showed improved bone formation in chitosan treated group compared to 4 in control group. None of the unerupted teeth group showed better radiographic finding in test side at 2 week and 3 month compared to erupted teeth group. Conclusion Chitosan is effective in promoting wound healing and early osteogenesis in erupted tooth socket after extraction. We recommend that chitosan dressing should be used in the sockets of erupted tooth after extraction but should be avoided in unerupted or impacted teeth cases.