Titanium lag screw osteosynthesis in the management of mandibular fractures

Aims and objectives: To evaluate the efficiency of titanium lag screws in the management of oblique and sagittally displaced mandibular fractures. Also to analyze various complications encountered through this technique. Materials and methods: Twenty cases presenting with mandibular oblique, sagittaly displaced mandibular fractures requiring were selected in our study. Titanium lag screws were placed such that their axes bisect the angle between a perpendicular drawn to the fracture line and perpendicular to the bone surface. Postoperative follow up was done for 3to 9 months Results: Majority of the fractures (10) were parasymphysis fractures, 3 with associated fractures. Intermaxillary fixation was used in two of these cases as the fracture fragments were severely displaced (Table1). In two patients, a single lag screw combined with a small conventional miniplate and a bone graft was used, due to loss of bone along the inferior border of the mandible in the fractured site. Two lag screws were used in severely displaced symphysis fractures and when two fracture sites were seen. Adequate rigidity and stability of fractured segments was achieved in all the cases. Conclusion : Titanium lag screw fixation was found to have good rigidity, stability, economic and less time consuming in certain type of mandibular fractures, though there exists few contraindications regarding its usage. It is definitely a technique sensitive procedure, requiring strict adherence to the principle if lag screw placement and adequate knowledge about internal anatomy of the mandible

Anterior Segmental Distraction Osteogenesis in the Hypoplastic Cleft Maxilla : Report of five cases

Orthognathic surgery and distraction osteogenesis play a prime role in the correction of maxillary hypoplasia in patients with cleft lip and palate (CLP). Advancement of the anterior maxilla alone without interfering with the velopharyngeal sphincter may be advantageous in cleft patients, who more commonly have speech deficits and dental crowding. We present a case series of anterior maxillary segmental distraction for maxillary hypoplasia in 5 CLP patients with a one-year follow-up. A custom-made tooth-borne distraction device with a hyrax screw positioned anteroposteriorly was used. The evaluation comprised of hard and soft tissue analysis and speech assessment. A stable occlusion with positive overjet and correction of dental-crowding without extraction was achieved at one year post-distraction. Facial profile and lip support improved. There was no deterioration in speech

Building automation pipeline for diagnostic classification of sporadic odontogenic keratocysts and non-keratocysts using whole-slide images

The microscopic diagnostic differentiation of odontogenic cysts from other cysts is intricate and may cause perplexity for both clinicians and pathologists. Of particular interest is the odontogenic keratocyst (OKC), a developmental cyst with unique histopathological and clinical characteristics. Nevertheless, what distinguishes this cyst is its aggressive nature and high tendency for recurrence. Clinicians encounter challenges in dealing with this frequently encountered jaw lesion, as there is no consensus on surgical treatment. Therefore, the accurate and early diagnosis of such cysts will benefit clinicians in terms of treatment management and spare subjects from the mental agony of suffering from aggressive OKCs, which impact their quality of life. The objective of this research is to develop an automated OKC diagnostic system that can function as a decision support tool for pathologists, whether they are working locally or remotely. This system will provide them with additional data and insights to enhance their decision-making abilities. This research aims to provide an automation pipeline to classify whole-slide images of OKCs and non-keratocysts (non-KCs: dentigerous and radicular cysts). OKC diagnosis and prognosis using the histopathological analysis of tissues using whole-slide images (WSIs) with a deep-learning approach is an emerging research area. WSIs have the unique advantage of magnifying tissues with high resolution without losing information. The contribution of this research is a novel, deep-learning-based, and efficient algorithm that reduces the trainable parameters and, in turn, the memory footprint. This is achieved using principal component analysis (PCA) and the ReliefF feature selection algorithm (ReliefF) in a convolutional neural network (CNN) named P-C-ReliefF. The proposed model reduces the trainable parameters compared to standard CNN, achieving 97% classification accuracy

Recurrent bilateral cystic hygroma of the submandibular space in an adult patient

Cystic hygroma is an uncommon type of benign neoplasm of lymphangioma commonly seen in children, rarely reported in adults. Most of the cases occur in head and neck region. The etiology and pathogenesis of this entity are still unclear. Clinically, they present as painless, soft, compressible, progressively enlarging mass. Various treatment methods have been described, but surgery remains the treatment of choice. Incomplete excision results in recurrence. We present a unique case of bilateral submandibular area cystic hygroma in an adult female patient with a history of recurrence twice

Evaluation of bone regeneration in extracted tooth sockets using simvastatin – A split-mouth study

Introduction: Tooth extraction is followed by alveolar bone resorption, making rehabilitation difficult. Various materials such as autografts and xenografts have been used, but they have their own limitations. Studies have showed that “Statins” like simvastatin used for lowering cholesterol levels also increase the expression of bone morphogenetic protein 2 which has an important role in osteoblast differentiation and mineralization. This facilitates the further rehabilitation of the patient after tooth extraction. The study was conducted to evaluate bone regeneration in extracted tooth socket using simvastatin. Materials and Methods: A randomized control trial split-mouth study was done in patients of 18–65 years' age group. A total of 31 patients requiring bilateral extractions were selected without any gender bias. Simvastatin with gelatin sponge was placed in extracted socket on study side and normal extraction done was done on the control side. The patients were followed up for a period of 6 months. The clinical parameters of pain and swelling were assessed on the 1st and 3rd day. The radiographic parameter was assessed on the 1st postextraction day, 1st month, 3rd month, and 6th month subsequently. The data were subjected to the statistical analysis. Results: Pain was assessed using the Visual Analog Scale; swelling was assessed using the paired sample t-test. Initially, pain and swelling more on the study side as compared to control side which subsided later. The bone density was evaluated on the 1st day, 1st month, 3rd month, and 6th month postoperatively using the independent sample t-test. They showed early bone formation on the study side as compared to the control side, which was statistically significant between the study and control groups. Conclusions: Simvastatin can be used in extracted sockets as it causes early bone formation