Aims and Objectives: The aim of the present study was to compare closed treatment with open reduction internal fixation (ORIF) for subcondylar and condylar neck fractures. Materials and Methods: This randomized prospective study was conducted on thirty patients who visited the Department of Oral and Maxillofacial Surgery, Government Dental College, Srinagar, with condylar fractures. All fractures were displaced; either angulated between 10° and 45° and the ascending ramus was shortened by >2 mm to <15 mm. Patients were divided into two groups after satisfying the inclusion and exclusion criteria – Group I (closed treatment) and Group II (open reduction) (15 implants in each group). In Group I, patients were treated by mandibulo-maxillary fixation using arch bar and elastics for 4 weeks, and in Group II, patients were treated by ORIF using two 1.5-mm miniplates. Follow-up was done at 1 month, 3 months, and 6 months. Our postoperative evaluation included five parameters – maximal interincisal opening, protrusion, lateral excursion on fractured and nonfractured sides, anatomical reduction, and pain and malocclusion. Nonparametric data were compared for statistical significance with Chi square test and parametric data with an independent sample's t-test (P < 0.05). Results: Correct anatomical position of the fragments was achieved significantly more accurately in the operative group in contrast to the closed treatment group. Regarding mouth opening/lateral excursion on fractured and nonfractured sides/protrusion, significant (P < 0.05) differences were observed between both groups (open 39.73/7.50/8.17/7.87 mm vs. closed 36.87/6.07/7.23/7.13 mm). Pain also revealed significant (P = 0.025) difference with less pain in the operative treatment group. Conclusion: Both treatment options for condylar fractures of the mandible yielded acceptable results. However, operative treatment was superior in all objective and subjective functional parameters except occlusion.

Introduction: Surgical removal of impacted mandibular third molars is one of the most commonly performed dentoalveolar surgeries by dental surgeons around the globe. It is known to be associated with clinically significant postoperative morbidity including swelling, pain, trismus, fever, and infection. In addition, the residual bony defect takes 7 months to 1 year to gradually fill with bone and to reossify. Aims and Objective: (1) To carry out a prospective study to evaluate differences in soft tissue healing and bony regeneration of impacted mandibular third molar extraction sites, with and without the incorporation of autologous platelet-rich fibrin (PRF) within the surgical wounds. (2) To also compare the incidence of short- and long-term posttreatment complications in both cases. Materials and Methods: Sixty patients were randomly inducted into two groups, consisting of 30 patients each. The first group, which served as the study group, consisted of patients in whom fresh autologous PRF were placed within the extraction site immediately following the surgical removal of the impacted mandibular third molar, before suturing of the mucoperiosteal flap. The second group, which served as the control froup, included those patients in whom the mucoperiosteal flaps were closed without incorporation of PRF within site.Both groups were evaluated and compared for postoperative pain, swelling, trismus, soft tissue healing, as well as bone fill of the extraction socket. Results: It was found that the study group in which autologous PRF had been incorporated into the operative site exhibited quick and complication-free soft tissue healing as well as a much quicker reossification and bone fill of the extraction socket, as compared to the control group in which no PRF was used. Conclusion: Incorporation of PRF within extraction sockets of impacted third molars proved to be beneficial for patients, yielding a quicker postoperative recovery with fewer complications such as postoperative swelling and edema, pain, and trismus; better overall postoperative results in terms of faster soft tissue healing as well as an earlier bony regeneration.

Purpose: To put an algorithmic approach for the treatment of condylar fractures according to the condition of occlusion. Patients and Methods: This study had been carried out between May 2016 and April 2017. Forty patients were included (6 females and 34 males) with their ages ranged between 3 and 60 years. Patients were managed through two approaches as follows: maxillomandibular fixation (MMF) only regimen and MMF with open reduction and internal fixation regimen. The operated cases were 12 with bilateral condylar/subcondylar fractures, and the rest were unilateral 28 cases. Results: Data were assessed demographically, time lapse before the intervention, surgically, functionally, and radiologically. In general, there were no significant differences between closed and open methods. Conclusion: Retromandibular approach was convenient for internal fixation of condylar fracture with a good outcome. In our work, there were no significant differences between closed and open methods in the treatment of condylar fractures.

Context and Aim: In today's world of advanced dentistry, there are various aspects of restorative, esthetic, and surgical processes. Healing of an extraction socket comprises of bone as well as soft-tissue remodeling with maximum dimensional changes occurring during the first 3 months. Platelet-rich fibrin (PRF) was first developed in France as a therapeutic alternative to platelet-rich plasma to overcome many of its limitations. The present study was planned to evaluate and compare wound healing and bone regeneration in extraction sockets with and without PRF. Materials and Methods: The present study was carried out on 30 patients selected from the outpatient department over a period of 2½ years starting from May 2013 undergoing extraction of maxillary or mandibular teeth simultaneously to conduct a split-mouth study. The research protocol was approved by the Institutional Ethics Committee governing the use of human subjects in clinical experimentation. Statistical Analysis Used: Descriptive and analytical statistics were calculated using Statistical Package for Social Sciences version 19. Chi-square test was used to assess wound healing score in the two groups while paired t-test was used to compare the bone density in the socket and periapical regions at different time intervals, and unpaired t-test was used for the intergroup comparisons. P < 0.05 was considered to be significant while P < 0.001 was considered highly significant. Results: Patients in PRF group had better healing index when compared to without PRF group. Use of PRF showed a comparable increase in bone density too. Conclusion: An appreciable wound healing and bone regeneration was seen in the experimental group when compared to the control sites where no PRF was used substantiating the use of PRF as an inexpensive autologous material for socket preservation and future rehabilitation. The present study, also, showed that minimal operator expertise was required to conduct the procedure of PRF preparation and grafting when compared to bone harvesting from distant sites. The shorter duration between extractions and further rehabilitation obviates the need for a second procedure.

Context: Laser tissue bonding (LTB) is believed to have certain advantages over conventional sutures such as fluid-tight closure and minimal scarring and fibrosis. Aim: The aim of the present study was to evaluate the bond strength of laser tissue welding and laser tissue soldering in mucosal and vascular repair. Materials and Methods: A total of 85 samples of bovine oral mucosa and 85 bovine aortas were bonded using a CO₂laser and different laser powers. Human serum albumin was used as solder. The breaking load for mucosal samples and the bursting pressure for aorta samples were evaluated. Few specimens were evaluated histologically for thermal damage and other microscopic changes. Statistical Methods: Two-way ANOVA was performed as the data were normally distributed and analyzed for significant differences between the groups. This was followed by Simple Main effects (Tuckey's post hoc test) to determine the individual variation between groups and also the significant differences within the groups. Results: Significantly higher values of breaking load (44.2 ± 3.03 g) and bursting pressure (70.8 ± 12.33 mmHg) were noted when 50% albumin was used. When reinforcing sutures were given the bond strength was further increased (68.0 ± 4.0 g for breaking load) (108.0 ± 12.56 mmHg for bursting pressure). Microscopically, a bridge of solder coagulum formed across the wound. Thermal damage was restricted to the top layers only although it did extend much more laterally adjacent to the wound edges. Few areas of vacuolization and carbonization were seen. Conclusion: LTB seems to be a promising new method of wound closure and warrants further evaluation in the form of in vivo and clinical studies.

Purpose: Knowledge of anthropometric measurements of the external ear is important as variations exist based on gender, age and ethnicity. This study has derived anthropometric data pertaining to the external ear in the Maharashtrian population. Materials and Methods: Nine variables of the external ear were measured in 505 Maharashtrian adults (aged 18–64 years) using photoanthropometric methods. Results: Descriptive data and the left-right symmetry for the study population were obtained. Conclusion: These data have applications in screening for or monitoring diseases, otoplastic surgery, forensics, industrial design, apparel design and ergonomics.

Facial paralysis can be a devastating consequence resulting from blunt and penetrating trauma to the head and neck, as well as surgical injury, either accidental or due to involvement by tumor. In addition, the etiology can be attributed to a variety of other causes, ranging from infectious to metabolic, and is frequently idiopathic in nature. The incidence of facial nerve injury during temporomandibular joint (TMJ) surgeries varies among surgeons. There are many factors that could contribute to the injury of the temporal and zygomatic branches of the facial nerve. These nerves lie in a confluence of superficial fascia, temporalis fascia, and periosteum and may be injured by any dissection technique that attempts to violate the integrity of these regions. Excessive or heavy-handed retraction causes compression and/or stretching of nerve fibers resulting in neuropraxia. The facial nerve then enters the parotid gland, where the main trunk branches into the upper and lower divisions at the pes anserinus. The nerve further divides into five main branches: the temporal, zygomatic, buccal, marginal mandibular, and cervical. The temporal branch lies within the superficial muscular aponeurotic system at the level of the zygomatic arch. In this paper, we evaluate the facial nerve function based on the House–Brackmann grading index after the preauricular approach for the treatment of condylar fractures, pathologies, and TMJ ankylosis cases. The nerve functional regeneration postfacial nerve injury has been evaluated and reported in this retrospective study.

Introduction: The Frontoethmoidal encephalomeningocele (FEEM) is a congenital neural tube anomaly, with herniation of intracranial material such as the brain and leptomeninges through a defect of the dura and anterior skull base at the junction of the frontal and ethmoidal bones. It may result not only in neural defects, sensorimotor deficits, neurological morbidities, visual impairment, impaired nasal function, and a potential risk of intracranial infection, but also in significant craniofacial disfigurement with complex deformities in the frontal, orbital, and nasal regions. Materials and Method: The standard two-staged surgical protocol comprises of the first stage performed by a neurosurgeon, which aims at correcting the neural defect by a formal craniotomy; then the second stage performed by a craniomaxillofacial or plastic and reconstructive surgeon, to correct craniofacial hard and soft tissue deformities. The case discussed was managed using a modified intracranial-transcranial single stage approach, achieving both the desired objectives. Results and Conclusion: This protocol elucidates the importance and value of teamwork between the Neurosurgeon and Craniomaxillofacial surgeon, in comprehensively and efficiently managing small to moderately sized FEEMs, assuring their complete elimination, satisfactory defect closure, effective functional treatment as well as esthetic correction and reconstruction of the attendant craniofacial deformities by means of a single-stage definitive surgical approach.

Aim: The aim is to study the assessment of feasibility of medial sural artery perforator (MSAP) free flap for head and neck reconstruction at our center. Materials and Methods: Oral cancer patients with squamous cell carcinoma of the tongue, buccal mucosa, and floor of mouth cancer attending our center were reconstructed using MSAP flap after oncologic resection. Handheld 8 MHz Doppler was used to identify the perforator preoperatively. Results: We reconstructed 10 patients using MSAP flap. The flap was designed according to defect and donor site was primarily closed in all cases. Excellent results were seen in nine patients reconstructed with MSAP flap without any postoperative complication. Flap failure occurred in one patient due to venous thrombosis. The thickness of flap ranged from 4 to 8 mm. The vascular pedicle length ranged from 9 to 13 cm. Conclusion: The MSAP flap is appropriate for medium-sized oral defect reconstruction, with a long pedicle of matching caliber, adequate tissue volume, and minimal donor-site morbidity which makes it comparable to other microvascular free flaps such as radial artery free flap (RAFF) and anterolateral thigh flap.

Background: Radial forearm free flap with all its present day modifications is the workhorse of soft tissue reconstruction in head & neck. Although there are several advantages, it requires the sacrifice of a major artery of forearm. There are several modifications of harvesting a forearm flap based on perforator principles. A clear understanding of vascular anatomy of individual perforators relative to its vascular territory & flow characteristics is essential for both flap harvest & design. The purpose of this cadaveric observational anatomical study was to determine the location, size & vascular territory of the radial artery cutaneous perforators. Materials and Methods: 12 fresh human cadavers & 24 cadaveric forearms were dissected to determine the total number, location, size & vascular territory of radial artery adipo-fascio cutaneous perforator. The cutaneous territory of distally dominant perforators was analyzed using methylene blue injections & three-dimensional computed tomographic angiogram. Results: In the 12 fresh human cadavers & 24 forearm specimens, a total of 222 perforators were dissected for an average of 18.5 radial artery perforators per forearm. Of the total 222 perforators dissected 118 were smaller than 0.5mm in diameter (53.15%) these were not clinically significant. 104 perforators were greater than 0.5mm in diameter (46.84%) these were clinically significant. Of the 222 radial artery perforators dissected, 127 perforators (57.20%) were radially distributed & 95 perforators (42.79%) had ulnar distribution. A total of 90 perforators (40.54%) were identified on distal side (Radial styloid) & 132 perforators (59.45%) were identified on proximal side (Lateral epicondyle). Mean number of perforators on radial side was 10.6 & 7.9 on ulnar side, a comparison of both using student t paired test gives a P value of 0.006, which was statistically significant. Comparison of mean number of perforators on the distal side was 7.5 & proximal side was 11.0, Student Paired t test gives a P value of 0.003, which was statistically significant. Comparison of mean Diameter of perforators between the Distal side (1.11) & Proximal side (0.86) using Student Paired t test gives a P value of 0.01 which was statistically significant. A chi square test was done to compare mean diameter of perforators on distal side, which were more than 1mm (80%) & less than 1mm (20%) & on proximal side more than 1mm (35.6%) & less than 1mm (64.4%). Chi square value of 42.406 was obtained, degree of freedom value was 1& P value of <0.001 was achieved which was found to be highly significant. Methylene blue injections into the proximal part of radial artery demonstrated clusters both in proximal & distal forearm & also cutaneous territory of flap. Three- dimensional computed tomographic angiography reveals a network of linking vessels found to communicate between adjacent perforators & running parallel to radial artery. Large network of linking vessels could be found between fascia & dermis, which also explains the ability to harvest forearm flap at the supra-fascial level. Conclusion: Increase in knowledge of vascular territory of radial artery perforators with regards to numbers, size, location, and cutaneous territory can lead to expanded use of radial forearm flap based on either distal or proximal perforator alone, without sacrificing the radial artery.

Context: Three-dimensional (3D) locking plates has been designed with the hypothesis that this will overcome the disadvantages of both the systems and also advantages of both systems will be combined for the management of mandibular fractures. Aims: The purpose of this study was to evaluate the efficacy of 2-mm 3D locking miniplate in the management of anterior mandibular fracture and to compare it with Champy's miniplate. Settings and Design: A prospective, randomized, clinical trial was carried out in thirty patients who were divided equally in two groups. Subjects and Methods: Group I and Group II patients were treated with 2-mm 3D locking plates and 2-mm standard miniplates, respectively. They were evaluated according to the outcomes of the study, that is, working time, wound dehiscence, infection, segmental mobility, postoperative occlusion, need for postoperative intermaxillary fixation (IMF), and radiological evaluation of reduction and fixation. Statistical Analysis Used: Student's t-test and Mann–Whitney test were used to compare the two systems. The data were analyzed using Statistical Package for the Social Science version 14.0. The P value was taken as significant when <0.05 (confidence interval of 95% was taken). Results: The mean duration of procedure for Group I was found to be 49.33 min, whereas for Group II was 59.67 min. There was significantly greater pain on day 1 and at 1 week in Group II patients. 6.7% (n = 1) of both groups showed incidence of infection. Postoperative stability was adequate in most cases except in one patient (n = 1) of 3D locking system, which was revealed as postoperative occlusal disharmony, unsatisfactory radiological reduction of the fracture fragments, and the segmental mobility. There was no incidence of wound dehiscence, tooth damage, and nerve damage in either group. Conclusions: The result of the study can conclude that there is no major difference between both systems in terms of treatment outcome.

Aim: The aim of this study was to give an insight into the retrospective analysis of a number of maxillofacial trauma cases reported to our institute and research center. Materials and Methods: The data for this study was obtained from the medical records and outpatient prescription slips of cases treated at the Oral and Maxillofacial Surgery Department from 2010 to 2016. Etiology, age, gender, pattern of fracture, and surgical treatment modalities undertaken in these patients were recorded. Results: A total of 353 maxillofacial trauma patients with mean age of 40 years, treated at our institute were evaluated from 2010 to 2016. Mandible was the most commonly fractured bone with parasymphysis as the most frequent site. Majority of victims were males (male:female ratio of 4:1) and also in the third decade of life. This study showed that 73% patients were treated by open reduction and internal fixation (ORIF), 25.8% by intermaxillary fixation (IMF) and Stabilization of fracture mandible with acrylic splint and circummandibular wiring was done in 0.8% pediatric patients. Conclusion: It was concluded that road traffic accidents were reported as the leading cause of maxillofacial fractures followed by assault, falls, and familial dispute. Maxillofacial surgeons as health care providers must continue their 'face it' campaign to decrease the incidence of road traffic accidents. Open reduction and internal fixation remains the gold standard treatment modality.

Introduction: A retrospective analysis was done on patients who had undergone unilateral temporomandibular joint reconstruction using alloplastic temporomandibular prostheses. Aim: The study wished to highlight patient perceptions after surgery; specifically relating to pain, function, and aesthetics. Material and Method: Twenty three patients were assessed using a visual analogue scale (VAS) for pain, ability to eat, quality of life and scar appraisal. Results: Patients Vas scores were favourable for all parameters save for scar appreciation. Conclusion: Total temporomandibular alloplastic joint replacement is a viable treatment option, with generally positive surgical outcomes for patients.

Background: Skull base is difficult to approach surgically due to its complex anatomy. A number of procedures that is endoscopic, microscopic, and open approaches have been used. The maxillary swing approach provides a wide exposure to the surgeon for better oncological clearance. Patients and Methods: A total of 62 patients with varied etiologies involving the skull base region were operated with maxillary swing procedure over a period of 15 years from 2001 to 2016 in plastic surgery department at a single institution. Results: There was no recurrence in the follow-up period. One patient had palatal fistula and one patient had mild nasal mucosal atrophy. None of the patients had malocclusion in the postoperative period. The minimum follow-up period was 24 months. Conclusion: Maxillary swing procedure provides excellent exposure to skull base, and most of the tumors involving this region can be effectively excised with minimal morbidity to the patient.

Background: In the recent past, there have been inconsistent reports of India witnessing a decreasing trend in the incidence of orofacial clefts (OFC). To date, little comprehensive evidence has been published. To identify the prevalence, associated burden in terms of epidemiological parameters and to estimate the “unmet” OFC treatment needs, the present study was undertaken. Materials and Methods: Using the Global Burden of Diseases 2016 approach and its assumptions, an attempt was made to estimate the prevalence to quantify the burden of OFC in India as disability-adjusted life years (DALYs), years of life lost (YLL), and years lived with disability (YLD) as well as death due to OFC. The results from such an approach are presented. Using previous estimates of “unmet” OFC treatment needs, an attempt was made to estimate the current volume of “unmet” OFC treatment needs. Results: In the present study, it was estimated that a total of 0.033% of all Indian population suffers from OFC. In 2016, the estimated prevalence rate/100,000 was 33.27 for males, 31.01 for females, and 32.18 combined for both genders. It was estimated that for all ages, the DALYs lost were 2.05 for 100,000 males, 2.66 for females and 2.34 for both sexes. The OFC birth prevalence model revealed that the birth prevalence (as a proportion) in 2016 in India showed an odds ratio of 0.48 (1.56–1.65) and fixed factor of nonrecording 0.83 (0.15–6.63), underreporting 0.97 (0.88–1), gender 1.09 (1.02–1.16), chromosomal diagnoses included 1.22 (1.22–1.22), and stillbirth 1.22 (1.22–1.22). The total unmet cleft treatment need was estimated at 79,430 or 18.76% of the total Indian cleft population with OFC. Conclusions: Within the constraints of the mathematical modeling and based on all available surveys, literature, and reported data, the overall birth prevalence and the prevalence of OFC in India are presented. Till reliable data emerges, the present estimates could serve as a robust estimate of the prevalence and burden of OFC in India. The present enterprise highlights the need for well-designed, high-quality Pan-India, community-based, observational studies to accurately estimate the burden of OFC in India.

This article analyses published prior article regarding the questions: is the study setup correct (true) and if comparable cases are evaluated for the compared methods. Futhermore the content, the pictures, the tables, the graphs and the pictures legends of the article and statistics are analysed for truth, relevance and applicability. We investigate furthermore if this article addresses all relevant questions regarding bias, the study groups, the evaluation of the outcomes and the evaluation of patient parameters such as burden of the treatment. As a result of the analysis, we state that the analysed article is misleading and it does not provide valuable information regarding decision making for other healthcare professionals in the dental implant field.

Introduction: Ameloblastomatous calcifying odontogenic cyst (COC) is an extremely rare histopathologic variant of COC, an odontogenic cyst of the jaws. It needs to be differentiated from closely associated variant ameloblastoma ex COC that is entitled to a more aggressive form of surgical management. Aim: The aim of this paper is to present a case of ameloblastomatous COC of the right mandibular angle region with review of literature describing this rare entity. The paper also highlights the requirement of including this lesion in differential diagnosis of various jaw lesions. Materials and Methods: Google search, Wikipedia, ScienceDirect, MEDLINE, the Cochrane library, and PubMed were used extensively to search and collect all reported cases of ameloblastomatous COC using keywords such as ameloblastomatous COC, COC, maxilla, mandible, and gorlin cyst ameloblastic proliferation. Results: To the best of our knowledge, a total of twenty one cases of ameloblastomatous COC have been reported in the literature in the maxilla-mandibular region and we represent the twenty second case in a 20-year-old female patient along with the review. Conclusion: Ameloblastomatous COC – a subtype of COC needs to be differentiated from true ameloblastoma arising from COC as it warrants a conservative form of surgical management unlike other neoplastic variants of COC. Owing to scarcity of data of this lesion in literature, more reporting of such cases is required to shed light on its behavior.

The poly-L-lactic acid mini-plate system accomplished rapid development. However, the system still has a variety of problems. One such problem is the breakage of screws. In this technical report, we develop the temporary fixing screws made from stainless with hexagon steel that exhibit a hexagonal head and thread part that also features a tapping function.

True intrusion is one of the difficult and complex goals to achieve which requires clinical judgment, skills, and experience. Intrusion requires less force level than other tooth movement, but it requires delicacy since the entire stress is concentrated in the apex of the root. Although true intrusion alone is not challenging, eliminating the adverse effect while intruding requires tedious skills of the clinician. A 17-year-old male patient with Class I malocclusion with open bite has a prominent maxillary cortical bone. He had a convex profile with an unpleasant smile. To reduce the bulkiness of cortical bone and to intrude the upper anterior, so the decision was made to perform corticotomy.

Neurofibromatosis type 1 (NF1) was first described in 1882 as a hamartomatous disorder of neural crest derivation. We present the imaging of a 65-year-old woman with NF1. Computed tomography revealed that there were three major findings presented: skeletal deformity, an area of fat (probably related to mesodermal dysplasia), and benign neoplasm within the masticator space. Moreover, masticatory muscles were hypoplastic.

Pleomorphic adenoma (PA) is a benign tumor of the salivary glands commonly seen in the parotid and submandibular salivary glands. Rarely, it is seen in the minor salivary glands located at lips, palate, and other parts of the upper aerodigestive tract. We report a case of an unusually large PA of the hard palate in a female patient involving left maxillary sinus and nasal cavity. After excising, the tumor with adequate clinical margins (1 cm), a large postsurgical defect was managed by the use of obturator and it gradually healed by secondary intention in about 6-month period. The unique feature in our case was that in spite of the long duration of the tumor (30 years), it did not undergo malignant transformation.

This case report analyzes the clinical and radiographic features of odontogenic infection with underlying pathology. Systematic approach leads to narrow the differential diagnosis on the basis of exclusion. This results in correct diagnosis, proper treatment, and avoiding unnecessary treatment. This case report highlighted an unusual case of odontogenic infection involving adjacent fascial spaces with underlying pathology which was mimicking a cyst, tumor, and odontome. Systematic approach helped us achieve accurate diagnosis, treatment, and avoiding complications.

It has been very aptly quoted, “Variety is the spice of life”; and so variations exist in all forms and kinds good or bad, and for the worst or the best! Mother nature in all her glory and beauty has been very generous, but what when she fails to provide? It is this very character of nature that gives us variations which sometimes manifest in a cruel way on the human body and gives us the eponym of syndromes. Dandy–Walker malformation is an abnormality of the central nervous system, which leads to hydrocephalus and is associated with other abnormalities. Neurologic symptoms are the norm in afflicted patients due to the inherent nature of the disease in that it affects the very center of human function-the brain. This article brings to you a very unique, challenging and rare case of a young patient with this debilitating disorder who was also affected with giant cell lesions of the maxilla and mandible along with cherubism. It highlights the unpredictable course and progression of the disease in a child and our unique protocol employed for the management of the same. It adds providence and a new perspective to the still ambiguous nature of this disorder and the unprecedented maxillofacial anomalies, i.e., giant cell lesions and Cherubism associated with the same.

Sebaceous glands are reported to be normally located in the oral region in the vermilion of the upper lip and on the buccal mucosa. They are small yellowish bodies located immediately beneath the mucosa, and although numerous pathologies of these tissues have been described, very few clinical reports have been made. Pathologies such as ectopic location, hyperplasia, adenomas, carcinomas, and cysts have been described. If an excretory duct suffers a dilatation which does not regress of its own accord, it may originate a cyst. The purpose of this clinical report is to describe a free sebaceous cyst located in the upper lip.

The most common causes of parotid duct lesions are injuries with sharp instruments. Late alterations after such lesions lead to esthetic defects and complicates the treatment. This case report presents an alternative surgical technique for late reparation of the parotid duct. A 31-year-old male patient was admitted with a history of physical aggression by a glass bottle, resulting in cutting injuries in face and drainage of extraoral transparent fluid from the buccinatory region lesion Antibiotic therapy was initiated immediately, and the surgery was performed nine days after the incident. The repair of the parotid duct lesion was achieved adapting a venous catheter that was passed through the distal portion of the duct from the oral orifice. The proximal segment of the duct was cannulated, the lacerated ends of the duct were approximated on the device and sutured with prolipopylene thread. At the 14-day post-operative return, the saliva was draining through the catheter, and then it was removed. Patients with cutaneous lesions in the buccinatory region require a thorough examination to identify injuries to the parotid duct. The surgical treatment using the presented alternative surgical technique was an effective and cheaper option when compared to other alternatives and showed no complications.

Malignant lymphomas are about 5% of all malignant tumors. Extranodal non-Hodgkin's lymphomas (NHLs) are found in 26% of these cases. Lymphomas of the head-and-neck area occur in 2%–3% of all malignancies, with 28% with an extranodal manifestation. Extranodal NHLs in the oral cavity are usually found in the maxilla, and rarely in the mandible. Their symptoms and clinical manifestation have no pathognomonic features; therefore, the expression of this uncommon entity can be diagnosed with an odontogenic inflammatory process, leading to a misdiagnosis. Delay in the decision for a biopsy, and adequate treatment for the patient directly impairs the prognosis of this neoplasm. This study reports a case of a patient with discomfort in the right mandible and paresthesia of the right lower lip and chin without any dental focus. After performing further diagnostic examinations including a subsequent biopsy, the final diagnosis was a diffuse large B-cell lymphoma (DLBCL). Intraosseous DLBCLs are uncommon in the daily clinical routine, but emphasize the need for careful examination by the clinicians also considering the differential diagnosis of sensory neuropathy. Neurological symptoms with no apparent cause should raise the suspicion of malignancy until the opposite is proven.

Juvenile ossifying fibroma is a rare benign fibroosseous tumor which involves maxilla more than mandible. It usually occurs in children below 15 years of age. This article reports a case occurring in the mandible with the surgical treatment followed by us.

Hemangiopericytomas (HPCs)/Solitary fibrous tumor are rare neoplasms of vascular origin that occur in head-and-neck region. These tumors arise from capillary pericytes and are difficult to distinguish from other tumors of vascular origin. HPC, initially described by Stout and Murray in 1942, usually occur in the fifth decade of life and account for 3%–5% of all soft-tissue sarcomas and 1% of all vascular tumors. The tumors usually occur in limbs, pelvis, or head-and-neck region; 15%–30% of all HPCs occur in head and neck. We report a case of HPC located in the right buccal area of a 60-year-old man.

Temporomandibular jaw dislocation is an uncontrolled anterior movement of the condyle beyond the articular eminence. It can occur mostly in young adults, and the symptoms are mouth opening disturbance, preauricular skin depression, tense masticatory muscles, and pain. The main purpose of the eminectomy procedure is removal of a part of the articular eminence to maintain free movement of the condyle. The surgical procedure may be performed by conventional surgery or piezosurgery. The present case report describes the management of a recurrent mandibular dislocation in a 28-year-old patient who had also treated conservatively with autologous blood injection. In this report, bilateral eminectomy was performed by piezosurgery to provide soft-tissue protection, precise cut, and optimal view of the surgical area. The management technique is discussed within the current literature.

Temporomandibular joint ankylosis may be true or false. Most commonly, trauma and inflammatory conditions lead to this condition. Zygomatico-coronoid ankylosis is a rare extra-articular (false) form of ankylosis of the jaw. This condition may follow treated or untreated midface fractures. Coronoid process locking may be overlooked because attention is generally focused on temporomandibular joint. A review of literature has reported 16 cases of this disorder. The true incidence of this condition may be even higher. In this paper, we present an unusual case of posttraumatic bony ankylosis of the right coronoid process of the mandible with the zygomatic arch in a 30-year-old male. This bony ankylosis was produced by a mass of heterotopic bone formed, following inadequate treatment of midfacial fracture. Extra-oral ostectomy of the ankylotic mass followed by immediate postsurgical aggressive physiotherapy produced good long-term functional outcome.

Temporomandibular joint (TMJ) ankylosis is fusion or a bony union of the head of the condyle and the glenoid fossa by bony or fibrotic tissues. Due to the immobility of the TMJ, all mandibular movements get affected. Treatment goals are to allow nearly normal TMJ movements, restore symmetry of the face and occlusion, and promote growth and correction of deformity in children. The surgical techniques used to treat TMJ ankylosis are a gap or interpositional arthroplasty, joint reconstruction, and distraction osteogenesis. Appropriate interposition materials include autogenous tissues, allogeneic tissues, and alloplastic and xenograft tissues. This report presents the treatment of a patient with a diagnosis of TMJ ankylosis, who had failed surgery. Interpositional autogenous dermis-fat graft was used to manage TMJ ankylosis of the right side. The technique is discussed within the current literature.

Penetrating facial injuries are potentially dangerous and may require emergency management because of the presence of vital structures in the face, and it may be life-threatening especially when the injury involves airway, major blood vessels, spinal cord, and cervical spines. Penetrating injuries of the facial region can occur due to missile injuries, blast injuries, motor vehicle accidents, and accidental fall on sharp objects. However, injury to face caused by the shattering of a protective helmet itself is extremely rare. Primary management is targeted to deal with life-threatening conditions and stabilize the patient followed by subsequent care in a well-equipped setting. We present a case of a 30-year-old male, who suffered extensive soft and hard tissue injury of the maxillofacial region due to shattering of a protective helmet causing a ballistic effect.

Mandibular fractures represent approximately two-thirds of all maxillofacial fractures (nearly 70%), out of which fractures of mandibular ramus represent 3.09% which is considered to be a rare fracture site. They occur alone or in combination with other facial bone fractures resulting in loss of function and disfigurement. The pattern of mandibular fractures varies with geographic location, physical activity, social, cultural, and environmental factors. The main causes of mandibular fracture are road traffic accidents, interpersonal violence, falls, sports injuries, industrial trauma, and pathological fractures. In this clinical case, the authors describe a vertical ramal fracture extending from subsigmoid region to inferior border of angle of the mandible combined with symphysis fracture which was surgically operated through open reduction and internal fixation by extraoral approach.