Massive expansile ossifying fibroma of the mandible with osteomyelitis

An ossifying fibroma is a benign odontogenic tumor of mesenchymal origin that belongs to the spectrum of fibro-osseous lesions afflicting the craniofacial complex. Although benign, it can be potentially aggressive, reaching very large sizes. The authors report a rare case of an aggressive ossifying fibroma in the mandible of a 30-year-old male patient that reached gigantic proportions with superimposed osteomyelitis, mimicking a malignancy. Differentiation of ossifying fibroma from other fibro-osseous lesions and benign and malignant neoplasms is important for the correct management of this lesion. Proper radiological evaluation and interpretation aids for arriving at a definitive diagnosis are required. The paper also highlights the radiological features of this entity.     

Comprehensive Survey to Study Awareness,Knowledge and Attitude Towards HIV/AIDS and Hepatitis B Amongst Dental Professionals Working in Rural India

Introduction

Thirty years into the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) pandemic, social and behavioral research on HIV/AIDS remains limited. Data on sexual behavior and AIDS-related knowledge and attitudes are sparse and difficult to compare. The present survey aims primarily towards acquiring unique source of information from health professionals in rural population in order to document AIDS and hepatitis B awareness. The Surveys is an attempt to contain a wealth of data on HIV/AIDS and hepatitis B which until now was not disseminated to rural audience.

Materials and Methods

Pre-formed questionnaire of 45 questions will be given to all dental professionals, practicing in rural sector, willing to participate in study. Instructions will be given regarding filling the questionnaire. All participants requested to complete the questionair with best of their knowledge and without any assistance. Questionnair were completed in front of author and collected back personally.

Conclusions

The outcomes of the present study, it is clear that our efforts in the last two decades in spreading the knowledge about the disease have met with some limited success. The fact that increasing number of cases of HIV/AIDS are being reported from rural parts, there is certainly a need to reorient the ongoing training programmes towards rural population.     

Bisphosphonate Related Osteonecrosis of the Jaw: An Update

Objectives

The aim of this paper is to summarize different diagnostic criteria as well as probable aetiopathogenesis of bisphosphonates related osteonecrosis of the jaw.

Materials and Methods

The electronic search of peer-reviewed journals were performed in MEDLINE (PubMed) database in order to find the relevant articles on bisphosphonates related osteonecrosis of the jaw (BP-related ONJ). The search was restricted to English language articles, published from January 2002 to May 2013. On the basis of these articles, probable aetiopathogenesis and different diagnostic criteria of BP-related ONJ were summarized.

Results

BP-related ONJ is related to the development of avascular necrosis or dead jaw bones. In recent literature many given hypotheses show the aetiopathogenesis and diagnosis of BP-related ONJ which are interlinked and have multifactorial nature. Their diagnosis revolves around four main diagnostic criteria that differentiate it from other conditions which can delay bone healing.

Conclusions

Factors like potency of bisphosphonates, biology of jaw bone, antiangiogenic property of bisphosphonates and soft tissue toxicity in combination with present infection, other drugs, pre-existing pathologies, compromised immune response and dentoalveolar trauma may lead to development of BP-related ONJ.     

Total Alloplastic Temporomandibular Joint Reconstruction for Management of TMJ Ankylosis

Introduction

Temporomandibular joint (TMJ) ankylosis involves the fusion of the mandibular condyle to the glenoid fossa, the skull base. The dilemma with regards to treatment planning whether distraction is done before gap arthroplasty or as a simultaneous procedure or after gap arthroplasty is still a controversy. In an attempt to carry out both the procedures simultaneously there is loss of vector control of the distal segment and the risk of pseudoarthrosis at the osteotomy site. This combined problem could be overcome by the use of total alloplastic joint prosthesis which offers a firm posterior stop for the proximal segment and negates aggressive physiotherapy.

Material and methods

The reference literatures were retrieved from Pub Med and Science Direct database. Three case reports of bilateral recurrent TMJ ankylosis successfully treated with custom made total TMJ by the authors are illustrated.

Conclusion

The purpose of this article is to review the world literature on various alloplastic joints available for TMJ reconstruction and to introduce our indigenous total joint prosthesis in the management of recurrent ankylosis.     

Efficacy of Serum Prealbumin and CRP Levels as Monitoring Tools for Patients with Fascial Space Infections of Odontogenic Origin: A Clinicobiochemical Study

Objectives

Study includes 20 patients with diagnosis of fascial space infections of odontogenic origin to assess efficacy of serum prealbumin and CRP levels as monitoring tools for determining severity of infections, nutritional status, hospital stay and efficacy of treatment.

Methods

Blood samples taken on day 0, 4, and 8 for measuring serum levels of markers. Simultaneously clinical parameters like swelling size, pain etc., were also recorded on day 0, 4, and 8 and appropriate treatment given to each patient. Correlation between markers and parameters was found using regression and paired t test.

Results

Statistical analysis found strong correlation between laboratory values of markers and parameters used to measure severity of infection also. Prealbumin and crp are significant markers for hospital stay (p < 0.01). Prealbumin also found to be a sensitive indicator of nutritional status (p < 0.001).

Interpretation and Conclusion

Prospective analysis indicates prealbumin and crp are effective markers for determining severity of infection, treatment efficacy and hospital stay. Prealbumin is also sensitive marker for nutritional status. Duration of antibiotic usage, intensive unit care, use of nutritional supplements becomes more rationale. Markers also make treatment cost effective and help protecting patients from side effects of excess drug usage.     

Lipoma of the Floor of the Mouth: Report of an Unusually Large Lesion

Lipomas are among the most common benign tumors affecting the human body. However, they are relatively uncommon in the oral cavity. Oral lipomas are likely to affect cheek, tongue, lips, gingiva and rarely the floor of the mouth. We report a case of huge lipoma of the floor of the mouth, associated with difficulty in speech and mastication in a 72-year-old male. The tumor was completely excised and sent for histopathological examination, which confirmed the tumor to be a simple classical lipoma.     

Evaluation of Vertical Bone Gain Following Alveolar Distraction Osteogenesis in the Anterior Edentulous Mandible: A Clinical Study

Aim and Objectives

To calculate the gain in bony height and volume of the distracted upper segment using an extraosseous unidirectional device to improve the retention of the future prosthesis.

Materials and Methods

Ten cases with completely or partially edentulous but severely or considerably resorbed anterior mandibles were managed by vertical alveolar distraction osteogenesis. All the patients were evaluated preoperatively, intraoperatively and post-operatively for various parameters clinically and radiographically i.e. on OPG, lateral cephalogram and on CT scan, at different time intervals. In all cases there was increase in vertical bone height.

Results

The study showed mean vertical bone gain (VBG) on OPG as 8.2 mm. The mean VBG on lateral cephalogram was 8.1 mm. The mean VBG on CT scan at right canine was 8.35 mm, at left canine was 8.2 mm and at midline was 8.27 mm.

Conclusion

Alveolar distraction osteogenesis is a predictable method for restoring alveolar ridges prior to implant placement or prosthesis. Distraction osteogenesis is ideally suited for recreating missing tissue in the anterior esthetic zone by increasing vertical bone height as well as good width and soft tissue growth.