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National Journal of Maxillofacial Surgery
 
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   Table of Contents - Current issue
Coverpage
January-June 2016
Volume 7 | Issue 1
Page Nos. 1-111

Online since Monday, December 19, 2016

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EDITORIAL  

Temporomandibular joint disorders Highly accessed article p. 1
Rakesh Kumar Singh
DOI:10.4103/0975-5950.196144  
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REVIEW ARTICLES Top

Role of nutrition in oral and maxillofacial surgery patients Highly accessed article p. 3
V Usha Giridhar
DOI:10.4103/0975-5950.196146  
Diet, nutrition, and dental health are closely related and have multidirectional impacts. Any oral diseases, may it be congenital, infective, traumatic, inflammatory, or neoplastic, affect routine functions of the oral cavity and even after corrective surgeries done to improve may adversely affect the food and fluid intake and further compromises nutritional status. Unlike other general surgeries, the surgeries done in oral and maxillofacial region impairs normal food intake, especially by mouth which is the preferred commonly used route. This oral cavity being harbored by multiple organisms makes it prone to further infection which again hampers the healing. Oral surgeries include the dentoalveolar region for the treatment of fracture or prosthetic reasons, for maxillofacial trauma, orthognathic surgeries, tumors, cleft lip and palate correction, etc., Nutrition plays a major role in the postoperative recovery and healing. Malnutrition in the Oral and Maxillofacial Surgery (OMFS) patients increases the postoperative morbidity and mortality rate. Nutrition in jaw fractures treated with intermaxillary fixation is more compromised. Healing is impaired in malnourished, critically ill, elderly, and patients with prolonged stay in hospital and hence nutrition in the form of enteral, parenteral, and oral sip feeding plays a major role in providing nutritional care. Preoperative nutrition and perioperative nutrition influence the postoperative outcome and hence metabolic and nutritional care is important for the uneventful healing. This article provides a basic review of the role of nutrition in the postoperative outcome of OMFS patients based on the search through articles in journal and internet.
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Botulinum toxin the poison that heals: A brief review p. 10
Shubha Ranjan Dutta, Deepak Passi, Mahinder Singh, Purnima Singh, Sarang Sharma, Abhimanyu Sharma
DOI:10.4103/0975-5950.196133  
Botulinum neurotoxins, causative agents of botulism in humans, are produced by Clostridium botulinum, an anaerobic spore-former Gram-positive bacillus. Botulinum neurotoxin poses a major bioweapon threat because of its extreme potency and lethality; its ease of production, transport, and misuse; and the need for prolonged intensive care among affected persons. This paper aims at discussing botulinum neurotoxin, its structure, mechanism of action, pharmacology, its serotypes and the reasons for wide use of type A, the various indications and contraindications of the use of botulinum neurotoxin and finally the precautions taken when botulinum neurotoxin is used as a treatment approach. We have searched relevant articles on this subject in various medical databases including Google Scholar, PubMed Central, ScienceDirect, Wiley Online Library, Scopus, and Copernicus. The search resulted in more than 2669 articles, out of which a total of 187 were reviewed. However, the review has been further constricted into only 54 articles as has been presented in this manuscript keeping in mind the page limitation and the limitation to the number of references. A single gram of crystalline toxin, evenly dispersed and inhaled, can kill more than one million people. The basis of the phenomenal potency of botulinum toxin (BT) is enzymatic; the toxin is a zinc proteinase that cleaves neuronal vesicle-associated proteins responsible for acetylcholine release into the neuromuscular junction. A fascinating aspect of BT research in recent years has been the development of the most potent toxin into a molecule of significant therapeutic utility. It is the first biological toxin which is licensed for the treatment of human diseases. The present review focuses on both warfare potential as well as medical uses of botulinum neurotoxin.
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Tumor markers: A diagnostic tool p. 17
Madhav Nagpal, Shreya Singh, Pranshu Singh, Pallavi Chauhan, Meesam Abbas Zaidi
DOI:10.4103/0975-5950.196135  
The purpose of this review is to give a brief background to enable the judicious use of widely performed serum cancer markers. The markers could be product of cancerous cell or as response to cancer. They are usually proteins, which are mainly found in blood or urine. These markers may be employed to predict primary or secondary tumor risk. Sometimes, non-cancerous conditions can also cause elevation of some tumor markers to be higher than normal. Besides, not every cancer patient may have raised level of a tumor marker. For these reasons, knowledge about cancer biomarkers has increased tremendously. Awareness for cancer and related tumor markers providing great opportunities for improving the management of cancer patients by enhancing the efficiency of detection and efficacy of treatment.
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ORIGINAL ARTICLES Top

Minimizing complications associated with coronal approach by application of various modifications in surgical technique for treating facial trauma: A prospective study p. 21
V Santosh Kumar, N Koteswara Rao, Kodali Rama Mohan, Leela Krishna, B Srinivasa Prasad, N Ranganadh, Vijaya Lakshmi
DOI:10.4103/0975-5950.196143  
Background: Coronal incision is a popular and versatile surgical approach to the anterior cranial vault and upper and middle third facial skeleton. The flap itself permits widespread exposure of the fractures in this region. The bicoronal flap was first described by Hartley and Kenyon (neurosurgeons) to gain access to the anterior cranium in 1907. It extension as an access flap to the upper and lateral aspect of the face was pioneered by Tessier (1971). Esthetically, it is pleasing as the surgical scar is hidden within the hair. Aims: To evaluate the versatility of coronal incision using various modifications advocated in incision, exposure to fractured site, and closure of flap in treating the upper and middle third facial fractures. Materials and Methods: A total of ten patients diagnosed with upper and middle third facial fractures requiring open reduction and internal fixation/correction of contour defect were selected after preoperative clinical and radiographic (computed tomography scan) evaluation. All the cases were operated by coronal approach to gain the access to the fracture/defect site for reduction/correction of the defect. Advantages and complication are evaluated. Results: Excellent access and anatomical reduction by this approach with least number of complications; if it is performed with healthy knowledge of anatomy of the scalp and temporal region. Certain minimal complications have also been noted using various modifications used in the procedure. Conclusion: Despite of prolonged surgical time for the exposure, it is very advantages in treating upper and middle third facial fractures due to wide access and discreet scar (minimal).
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Role of fixation in posttraumatic nerve injury recovery in displaced mandibular angle fracture p. 29
RK Singh, US Pal, Pranshu Singh, Geeta Singh
DOI:10.4103/0975-5950.196132  
Objective: The objective of this study was to assess the effectiveness of different types of fixation in the enhancement of posttraumatic inferior alveolar nerve (IAN) recovery in displaced mandibular angle fracture and to establish. Patients and Methods: Thirty patients of displaced mandibular angle fracture were treated with preangulated plate and three-dimensional (3D) matrix plate in two groups and were observed during follow-up at 04,06 and 12 weeks along with other parameters. Results: Fifteen patients were treated with preangulated plate and 15 patients with 3D matrix miniplate. There was early nerve recovery in Group A than Group B, with residual paresthesia 20% in Group A and 26.6% in Group B at the end of 12-week follow-up. Conclusion: The displaced mandibular angle fracture with posttraumatic IAN paresthesia treated with preangulated plate has shown evidence of early nerve recovery than those fractures were treated with matrix miniplate. The fracture fragments displaced more than 9 mm have shown poor nerve recovery in both groups.
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Evaluation of maximal mouth opening for healthy Indian children: Percentiles and impact of age, gender, and height p. 33
Shital M Patel, Nehal H Patel, Geet Gunjana A Khaitan, Rashmi S Thanvi, Parth Patel, Rajesh N Joshi
DOI:10.4103/0975-5950.196140  
Background and Aim: Maximal mouth opening (MMO) is used as a marker of masticatory pathology. However, MMO among children varies considerably with their age, height, sex, and race. While accurate percentile of normal mouth opening and relationship with anthropometric measurement are not precisely defined for the Indian population, we designed prospective, observational study to define the percentiles for normal MMO in our children. Methods: A total of 985 children, 560 males and 425 females, in the age range of 5–18 years attending the pediatric clinic in a tertiary care center in Western India were studied. In addition to the basic demographic data, MMO was measured in these children. The children were asked to open their mouth maximally until no further opening was possible. The distance from the incisal edge of the upper incisor teeth to the incisal edge of the lower incisor teeth was measured using a calibrated fiber ruler. Statistical analysis was performed to assess the impact of other anthropometric measures such as age, gender, and height on MMO. Observations: The mean MMO for males was 44.24 (±5.84) mm and for females was 43.5 (±5.19) mm. Age- and height-related percentiles were created for girls and boys separately, showing the 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles from 5 through 18 years of age with 86–185 cm height. Conclusion: The MMO percentile range for different age and height groups is established for the normal children. The mouth opening seems to increase with the age and especially with the height as per the skeletal growth. Height affects mouth opening more than the age.
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A comparative study on evaluation of role of 1.5 mm microplates and 2.0 mm standard miniplates in management of mandibular fractures using bite force as indicator of recommendation p. 39
Syed Sayeed Ahmed, Sajjad Abdur Rehman, Md Kalim Ansari, Abid Ali Khan, Omar Farooq, Arshad Hafeez Khan
DOI:10.4103/0975-5950.196128  
Aims and Objectives: To compare the maximum voluntary bite force generated at different periods during mandibular fracture healing using miniplates and microplates as means of rigid internal fixation. Materials and Methods: Maximum voluntary bite force was recorded in healthy young individuals of different age group from either gender. Patients suffering from symphyseal and parasymphyseal and body fractures were selected and randomly treated using miniplate and microplate osteosynthesis by open reduction and rigid internal fixation. Postoperative bite forces at intervals of 1st, 2nd, 4th, and 6th week were recorded and compared with control group. Observations and Results: It was noticed that bite forces were significantly reduced in the study groups in comparison to control group and at different intervals of treatment. There was a progressive improvement in the bite force with passage of time. There was no statistical significance in the observed bite force in both the study groups at different intervals of assessment. Conclusion: 1.5 mm microplates provide adequate stability comparable to miniplates for the treatment of fractured mandible and should be preferred over miniplates. We further suggest that bite forces should be considered for the assessment of clinical union of bone as well as studies pertaining to selection of hardware for rigid internal fixation.
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A randomized comparative prospective study of platelet-rich plasma, platelet-rich fibrin, and hydroxyapatite as a graft material for mandibular third molar extraction socket healing p. 45
Shubha Ranjan Dutta, Deepak Passi, Purnima Singh, Sarang Sharma, Mahinder Singh, Dhirendra Srivastava
DOI:10.4103/0975-5950.196124  
Aim: The purpose of this study was to compare the efficacy of platelet-rich plasma (PRP), platelet-rich fibrin (PRF), and hydroxyapatite (HA) for reduction of pain and swelling, absence of dry socket, soft tissue healing, and bone regeneration after mandibular third molar extraction in human patients. Materials and Methods: Forty patients requiring extraction of mandibular third molars were randomly grouped as control, PRP, PRF, and HA-treated. The patients were assessed for postoperative pain, swelling, dry socket, and soft tissue healing on the 3rd, 7th, and 14th day of postoperative periods depending on the standard methods. Radiological assessment of the extraction site was done at 1, 2, and 6 months interval to compare the change in bone density in the sockets in control and treated patients. Results: Pain and swelling were less on PRP and PRF site when compared to HA and control site. PRP and PRF site showed better soft tissue healing when compared to HA and control site. Radiographic assessment showed comparatively lesser bone density values in PRP, PRF, and control site at 1, 2, and 6 months than HA site. Conclusion: Our study showed that PRP and PRF are better graft materials than HA regarding pain, swelling, dry socket, and soft tissue healing. Bone regeneration is induced promptly by HA as compared to other graft materials. However, a more elaborate study with a larger number of clinical cases is very much essential to be more conclusive regarding the efficacy of the graft materials.
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Periodontal parameters around implants and natural teeth p. 52
Anjani Kumar Pathak, Kopal Goel, Vijay Shakya, Arunesh Kumar Tiwari
DOI:10.4103/0975-5950.196130  
Introduction: Nowadays, dental implants permit consideration of as one of the most reliable therapeutic modalities during the establishment of any prosthetic treatment plan. In numerous clinical situations, implants can clearly contribute to a notable simplification of therapy, frequently enabling removable prostheses to be avoided, keeping it less invasive with respect to remaining tooth structure. The aim of the present study was to clinically assess the peri-implant and periodontal conditions after the placement of crowns in partially edentulous patients. Materials and Methods: Twenty-five participants with 28 implant supported crowns were recruited in the study. After the insertion of suprastructure, meticulous scaling and root planing were performed on adjacent teeth which served as control. The clinical examination was carried out by a single examiner after placement of crowns at an interval of 1, 3, 6, 9, and 12 months and included the assessment of modified plaque index (mPlI), bleeding score, calculus score, probing pocket depth (PPD), and recession on the four aspects of each implant and adjacent teeth. Results: The mPlI, modified bleeding index (mBlI), calculus score, PPD, and recession decreased from 1 month to 12 months in both implants and in control teeth. The mean mPlI, mBlI, and calculus score were comparatively high in control teeth than implants. PPD was found to be more on implants than in control teeth. Recession was slightly higher in control teeth than implants throughout the study period, but it was not statistically significant. Conclusion: An implant patient must always be enrolled in a supportive therapy program that involves recall visits at regular intervals.
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Aerobic microbiology and culture sensitivity of head and neck space infection of odontogenic origin p. 56
Amit Shah, Vikas Ramola, Vijay Nautiyal
DOI:10.4103/0975-5950.196126  
Context: Head and neck space infections source, age, gender, tooth involved, fascial spaces involved, microbiological study of aerobic flora, and antibiotic susceptibilities. Aims: The aim of the present study is to identify causative aerobic microorganisms responsible for deep fascial spaces of head and neck infections and evaluate the resistance of antibiotics used in the treatment of such. Settings and Design: Prospective study in 100 patients. Materials and Methods: This prospective study was conducted on 100 patients who reported in the outpatient department and fulfilled the inclusion criteria to study aerobic microbiology and antibiotic sensitivity in head and neck space infection of odontogenic origin. Pus sample was obtained either by aspiration or by swab stick from the involved spaces, and culture and sensitivity tests were performed. Statistical Analysis Used: Chi-square test and level of significance. Results: Result showed aerobic Gram-positive isolates were 73% and aerobic Gram-negative isolates were 18%. Nine percent cases showed no growth. Streptococcus viridans was the highest isolate in 47% cases among Gram-positive bacteria, and in Gram-negative, Klebsiella pneumoniae was the highest isolate of total cases 11%. Amoxicillin showed resistance (48.4%) as compared to other antibiotics such as ceftriaxone, carbenicillin, amikacin, and imipenem had significantly higher sensitivity. Conclusions: Amoxicillin with clavulanic acid showed (64.8%) efficacy for all organisms isolated, whereas ceftriaxone showed (82.4%) efficacy and could be used in odontogenic infections for both Gram-positive and Gram-negative microorganisms. Substitution of third generation cephalosporin for amoxicillin in the empirical management of deep fascial space infections can also be used. Carbenicillin, amikacin, and imipenem showed (93.4%) sensitivity against all microorganisms and should be reserved for more severe infection. Newer and broad-spectrum antibiotics are more effective in vitro than older narrow spectrum antibiotics.
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Efficacy of low-level laser therapy in temporomandibular disorders: A systematic review p. 62
Deepankar Shukla, MR Muthusekhar
DOI:10.4103/0975-5950.196127  
Purpose: The aim of this systematic review was to assess the efficacy of low-level laser therapy (LLLT) in patients with temporomandibular disorders (TMDs). Methods: Medline search was done from 1997 to 2011 using search terms appropriate to establishing a relation between LLLT and TMD. Only randomized controlled trials were included in this study. Outcome variables related to pain, muscle tenderness, mandibular movements, and Electromyographic (EMG) activity were considered. Of the 242 articles examined, 13 were finally included in the critical analysis conducted as a part of the present systematic review. Results: Of the 242 titles reviewed, only 13 articles were considered eligible. 7 articles showed significant improvement in the study group, whereas 5 showed no significant improvement between the study and control groups. The primary outcome of most of the studies was pain. Other variables considered were muscle tenderness, mandibular movements; EMG activity was considered. Conclusion: Our results have shown that LLLT seems to be effective in reducing pain in TMD's. It may be a treatment option for patients with an interest in a noninvasive, complementary therapy.
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Prevalence of ocular defects among patients visiting in an institutionalized hospital setting: A cross-sectional study p. 67
Neerja Raj, Mayank Singh, Vineet Raj, Mohd Anwar, Lakshya Kumar
DOI:10.4103/0975-5950.196131  
Purpose: The purpose of this study was to analyze the prevalence of ocular defect among different age groups, gender, side involved, and etiology.Materials and Methods: A retrospective study was conducted among referred ocular defect patients in a dental college in southern part of India over a 5 years period (2008–2012). Information regarding general identification, gender, age, affected side, and etiology was collected. The collected data were analyzed and grouped according to different age groups, gender, side involved, and etiology. Results: The ocular defects were more frequently observed in the young male population (66%).Trauma (46%) and pathogenic (44%) causes were the main reasons over nonspecific (8%) and congenital (2%) reasons. Conclusion: High prevalence of injuries and infections in young adults (mostly males) predominantly causing ocular bulb loss.
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Transoral approach alone in single miniplate osteosynthesis of angle fracture - our experience p. 71
Sunil Yadav, Hitesh Chander Mittal, Vikas Dhupar, Francis Akkara, Akash Sachdeva
DOI:10.4103/0975-5950.196136  
Aim: The aim of this study was to determine the outcome of transoral approach alone to treat the mandibular angle fracture using single 2.0 mm miniplate. Materials and Methods: In this study, 28 patients were included and treated with 2.0 mm single miniplate osteosynthesis at upper border along Champy's line of osteosynthesis using transoral approach alone. Results: All the cases were treated successfully with 2.0 mm single miniplate with common complications such as infection (two cases) and plate exposure (one case) in a total of two cases. Conclusion: Use of single miniplates by transoral approach alone for superior border osteosynthesis is effective and simple approach without need of extra armamentarium.
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The newer aspect of dexmedetomidine use in dentistry: As an additive to local anesthesia, initial experience, and review of literature p. 76
Prashant Kumar, Manju Thepra, Amrish Bhagol, Kannu Priya, Virendra Singh
DOI:10.4103/0975-5950.196137  
Introduction: Despite the availability of a wide variety of pharmacological agents in the field of anesthesia, there has always been a continuous search for newer local anesthetic agents with improved efficacy, potency, and better handling properties. Dexmedetomidine, a selective alpha-2 adrenergic receptor agonist, is an emerging agent for provision of additive local anesthetic effect if used with conventional local anesthetics, which can be implicated in dentistry for performing many minor oral surgical procedures. The present paper reports a pilot study comparing clinical efficacy and potency of this newer emerging drug in combination with lignocaine. Materials and Methods: Ten patients undergoing orthodontic extraction for correction of malocclusion and other dentofacial deformities requiring orthodontic treatment were locally infiltrated with 2% lignocaine plus dexmedetomidine 1μ/ml and 2% lignocaine plus adrenaline in 1:200,000 dilution at two different appointments. The onset of action, duration of action, and pain threshold were assessed. Results: Onset of action was found to be faster with longer duration of action with the newer drug dexmedetomidine and lignocaine combination when compared with combination of lignocaine and adrenaline. Conclusion: The study demonstrated that the combination of dexmedetomidine with lignocaine enhances the local anesthetic potency of lignocaine without significant systemic effects when locally injected into oral mucosa.
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Trends of maxillofacial fractures in the Garhwal Himalayas at Government Medical College, Srinagar, Uttarakhand p. 80
Amit Shah, Vijay Nautiyal, Arti Gupta, Vikas Ramola
DOI:10.4103/0975-5950.196139  
Context: Evaluation of Maxillofacial fractures in hilly region of Garhwal Himalyas and its relation with age, gender, anatomical location, seasonal variation and treatment provided. Aims: The aim of the present study is to analyze the pattern of maxillofacial fractures in the Garhwal Himalayan region of India and to compare the results with similar studies in India and the rest of the world. Settings and Design: This was a prospective study conducted on 102 patients with 128 facial fractures. Materials and Methods: This study was conducted on 102 patients who were admitted for the treatment of maxillofacial fractures in the Department of Dentistry at Government Medical College, Srinagar, Uttarakhand, India. Statistical Analysis Used: All analyses were performed using Chi-square test and level of significance. Results: Peak incidence was noted in the second to fourth decades of life. Male: female ratio was 4:1. Road traffic accident was the main etiology (42.2%), followed by fall (37.2%) and assault (11.8%). Among other etiology of injury, distinguishing feature was bear bite, which was only seen in winters causing 5.9% of total injury. Fall was reported high in females whereas road traffic accident in males. Mandible was fractured in 73.5% of patients while mid-face in 26.5% of patients. Open reduction with internal fixation was the choice of treatment in 60.8% of cases. Nearly 79.4% of patients were treated under local anesthesia. The mean duration of hospitalization was (standard deviation 5.2 days) 5.3 days. Conclusions: Road traffic accidents still remain the main cause of maxillofacial fractures in developing countries such as India. In hilly area, road traffic accident can be minimized by better wide roads with guide walls/parapet, strict law enforcement for overspeed, overload, and to use seat belts while driving, and use of helmet while riding two-wheeler. Open reduction internal fixation remains the first choice of treatment in facial fractures due to early return of function with minimal morbidity and better nutritional status in patients compared to closed reduction.
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CASE REPORTS Top

Postanesthetic ulceration of palate: A rare complication p. 86
Ramesh Gupta, Meenu Garg, Salil Pawah, Ajay Gupta
DOI:10.4103/0975-5950.196142  
The routine dental practice involves various dental procedures which needs the application of local anesthetics. Generally, there are very few complications associated with these procedures. Complications such as tissue necrosis can occur following the rapid injection of local anesthetic solutions. Palate is a favorable site for soft tissue lesions, various factors such as direct effects of the drug, blanching of the tissues during injection, a relatively poor blood supply, and reactivation of the latent forms of herpes can all promote to tissue ischemia and a lesion in the palate.
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Rehabilitation of single finger amputation with customized silicone prosthesis p. 89
Niharika Yadav, Pooran Chand, Sunit Kumar Jurel
DOI:10.4103/0975-5950.196141  
Finger amputations are common in accidents at home, work, and play. Apart from trauma, congenital disease and deformity also leads to finger amputation. This results in loss of function, loss of sensation as well as loss of body image. Finger prosthesis offers psychological support and social acceptance in such cases. This clinical report describes a method to fabricate ring retained silicone finger prosthesis in a patient with partial finger loss.
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Ameloblastic fibroodontoma or complex odontoma: Two faces of the same coin p. 92
Akhilesh Kumar Singh, Indu Bhusan Kar, Niranjan Mishra, Parikshit Sharma
DOI:10.4103/0975-5950.196129  
An ameloblastic fibroodontoma (AFO) is a rare odontogenic tumor of mixed dental tissue origin. It exhibits histological features of ameloblastic fibroma and complex odontoma. AFOs are usually found to be asymptomatic and are most often discovered on routine radiography. Sometimes their presence is suspected due to missing permanent dentition. We report a case of an 18-year-old female patient with missing mandibular molars on the left side associated with a giant complex odontoma. Treatment included surgical excision of the tumor followed by reconstruction with iliac crest graft. Histopathological study revealed it as an AFO, to our surprise.
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Osteomyelitis of zygoma secondary to depressed fracture of parietal bone: Case report of a rare entity p. 96
Ram Rangila
DOI:10.4103/0975-5950.196138  
Osteomyelitis is an inflammatory condition of bone involving the medullary cavity, the Haversian system, and the adjacent cortex. According to literature review osteomyelitis of zygomatic bone secondary to the depressed fracture of the parietal bone never reported. Here we report a case of osteomyelitis of zygomatic bone which develops 3 month after the depressed fracture of parietal bone.
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Hemifacial hypertrophy: Exploring new avenues of treatment modalities p. 100
Santosh Ashok Nandimath, GC Rajkumar, Tulasi Nayak, DP Ashwin, KB Rudresh, R Prashanth
DOI:10.4103/0975-5950.196123  
Congenital hemihyperplasia is a rare developmental disorder characterized by unilateral overgrowth of one or more body parts resulting in marked asymmetry. We are reporting here, a case of true hemifacial hypertrophy in a young female adult highlighting the clinical features and possible treatment options.
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Aspergillosis associated with surgically assisted rapid maxillary expansion p. 105
Erol Cansiz, Emine Akbas, Sabri Cemil Isler
DOI:10.4103/0975-5950.196145  
Surgically assisted rapid palatal expansion (SARPE) is one of the most common orthognathic surgery operations for the treatment of maxillary transverse deficiencies. Although this operation is considered technically simple and has low complication rate, predisposing factors can complicate the postoperative period. In this case report, fistula formation and aspergillosis after SARPE operation were presented.
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TECHNICAL NOTE Top

Novel technique and simple approach for supra-alar region and supra-alar crease correction by supra-alar cinching p. 108
Loganathan Selvaraj
DOI:10.4103/0975-5950.196134  
This technical report describes a simple and innovative surgical technique for supra-alar sidewall region constriction and supra-alar crease attenuation by cinching technique through intraoral approach.
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LETTER TO EDITOR Top

Need to reclassify keratocystic odontogenic tumor into cyst and neoplasm Highly accessed article p. 111
Harkanwal Preet Singh
DOI:10.4103/0975-5950.196125  
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