Aim: The ameloblastoma is a benign odontogenic tumor of epithelial origin that exhibits a locally aggressive behavior with a high level of recurrence, being believed theoretically to come from dental lamina remains, the enamel organ in development, epithelial cover of odontogenic cysts or from the cells of the basal layer of the oral mucosa. Especially larger, aggressive lesions require a more radical surgical approach resulting in large jaw defects. This paper discusses our experiences in the management of ameloblastoma tumor in 20 such patients. Materials and Methods: A review of 20 cases of ameloblastoma (6 in the maxillary and 14 in the mandibular region) is presented. The lesions were between 4 and 8 cm in diameter. The methods of treatment consisted of radical surgery (i.e., segmental resection) and conservative treatments (i.e., enucleation with bone curettage). Half the cases were treated conservatively and others surgically. Results: Enucleation with curettage was done in 10 cases, out of which six (60%) showed recurrence, whereas one (10%) case in the surgical group showed recurrence. Relatively higher tendencies of recurrence were observed in the cases treated conservatively. The aesthetic and functional outcomes were satisfying in all patients. Conclusion: According to our opinion, radical surgical resection of ameloblastoma is the treatment of choice, followed by the reconstruction of the defects, allowing good functional and aesthetic outcome.

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Aim: To study expression of p53 protein and ki-67 antigen in normal, non-dysplastic, dysplastic, premalignant and malignant lesions of the oral mucosa. Materials and Methods: The standard immunohistochemical method along with MIB-1 and DO-7; DAKO antibodies was used to study the expression of p53 and ki-67 in paraffin-embedded tissue specimens. Results: All samples studied showed positive staining for p53 and ki-67. Only one case each from leukoplakia and oral squamous cell carcinoma (OSCC) groups showed negative staining for ki-67. The staining was confined to basal layer in most of the cases except OSCC in which it was seen in all layers. The intensity of staining was moderate to intense. The percentage of p53-positive cells in normal mucosa was 15-25% which was increased to 95% in malignant mucosa. Statistical analysis revealed that the expression of p53 and ki-67 increases as normal oral mucosa becomes dysplastic and undergoes malignant transformation. Conclusion: These results emphasize the potential use of p53 protein and ki-67 antigen as markers of malignant transformation and carcinogenesis in oral premalignant lesions, conditions and OSCC, respectively; and in future they may serve as prognostic tools in the early detection of malignant transformation in oral premalignant lesions and conditions.

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Oral lichen planus (OLP) is a chronic mucocutaneous disease of uncertain etiopathogenesis. Several factors including stress, genetics, systemic diseases, viruses, dental restorative materials and drugs have been implicated as causative agents. The disease seems to be mediated by an antigen specific mechanism, activating cytotoxic T cells, and non specific mechanisms like mast cell degranulation and matrix metalloproteinase activation. Further clarity on the pathogenesis will aid in modifying therapeutic interventions, thus significantly reducing the morbidity of OLP patients.

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Ameloblastoma is a slow-growing, persistent and locally aggressive neoplasm of epithelial origin accounting for 10% out of 30% of all odontogenic tumors. According to the World Health Organization, ameloblastomas are classified into the following types: conventional, unicystic, and peripheral. Unicystic ameloblastoma (UA) refers to those cystic lesions that show clinical, radiographic, or gross features of a mandibular cyst, but on histologic examination show a typical ameloblastomatous epithelium lining part of the cyst cavity, with or without luminal and/or mural tumor growth. We report a case of young female with a radiolucent lesion in the right posterior mandible. Surgical removal of the lesion was performed, with differential diagnosis of a radicular cyst. However, histopathologic examination revealed UA. The patient was kept under observation and showed signs of local bone regeneration. The purpose of presenting this report of a clinical case of UA previously misdiagnosed as radicular cyst is to emphasize the significance of histopathologic examination of all tissue specimens recovered in surgery even when clinical and radiological finding are innocuous.

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Lymphangiomas are developmental malformations and have a marked predilection for the head and neck region. They are benign proliferation of lymphatic vessels and represents hamartomas of malformed lymphatics. The most common location in the mouth is the dorsum of tongue, followed by lips, buccal mucosa, soft palate, and floor of the mouth. In the tongue, they may present as a localized or a diffused growth which may enlarge to cause macroglossia, impaired speech and difficulty in mastication. These tumors are typically present at birth, but may go unnoticed until after dentition erupts or even after puberty. Presenting here is a case of localized lymphangioma of the tongue in a five year old child and its surgical management.

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Introduction: The superficial veins, especially the external jugular vein (EJV), are increasingly being utilized for cannulation to conduct diagnostic procedures or intravenous therapies. EJV is also used in microsurgical procedures,used as a recipient for the free flaps. Materials and Methods: During routine dissection a variation was observed in the formation of EJV unilaterally on the left side. Result: In the anterior triangle of the neck submandibular vein joined with the anterior jugular vein to form a large venous trunk (V1). Facial vein joined this venous trunk (V1) to form another common channel (V2). The retromandibular vein divided into unusually long anterior and posterior divisions. Anterior division did not join the facial vein but drained into the common channel V2.The posterior division of retromandibular vein also drained into V2 which further continued as EJV and drained into the subclavian vein. Conclusion: The knowledge of variations in the patterns of superficial veins is important for the surgeons to avoid any intraoperative error which might lead to unnecessary bleeding.

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A variety of local and systemic complications can occur during the administration of local anesthesia (LA). Diplopia is one of the very rare complications that follow a posterior superior alveolar (PSA) nerve block. This article describes a very rare case report and the possible mechanisms are discussed in detail. Diplopia is defined as double vision. The patient was administered PSA nerve block for the extraction of the upper right third molar tooth. After the extraction, the patient complained of double vision and not being able to gaze laterally with the right eye. The patient recovered completely after the anesthetic effect. Local and systemic complications do occur during and after administration of local anesthesia. The clinician needs to be aware of the complications and management.

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Probiotics utilize the naturally occurring bacteria to confer health benefits. Traditionally, probiotics have been associated with gut health, and are being mainly utilized for prevention or treatment of gastrointestinal infections and disease; however, recently, several studies have suggested the use of probiotics for oral health purposes. The aim of this review is to understand the potential mechanism of action of probiotic bacteria in the oral cavity and summarize their observed effects with respect to oral health.

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Congenital lingual cystic masses are challenging entities that can be detected prenatally or are discovered in various forms after birth. Foregut duplication cyst of tongue is an extremely rare condition. Here we present the eleventh case in literature on foregut duplication cyst in tongue lined with gastric mucosa. Complete excision was curative with no recurrence on followup.

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Aim: The present study was designed to study the feasibility of single miniplate osteosynthesis in the fracture of angle of mandible. Materials and Methods: in this study 110 patient were included and treated with single miniplate osteosynthesis at upper border along champy's line of osteosynthesis. Results: All the cases were treated successfully, common complications which we have observed in this study, cosmetic disfigurement, delayed union, infection, wound dehiscence and paresthesia. Conclusion: Single miniplate fixation in unfavorable fracture is questionable and hence these fracture require some alternative method (locking plate, etc.) for fixation.

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The administration of supplemental oxygen is an essential element of appropriate management for a wide range of clinical conditions; crossing different medical and surgical specialities. The present review summarizes the role of supportive oxygen therapy in various clinical conditions encountered in our day-to-day practice in the speciality of oral and maxillofacial surgery; including major trauma, shock, sepsis; perioperative and postoperative considerations and in patients with various other medical comorbidities. Regular and judicious use of oxygen as a drug is thus recommended in our day-to-day practice in oral and maxillofacial surgery to reduce the morbidity and improve the prognosis of patients.

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Depressed frontal bone fractures are occasionally seen in maxillofacial trauma patient. If untreated, they look un-esthetic. Although there are numerous options available for correction of these defects, use of bone cement (polymethylmethacrylate or PMMA) is simple and reliable. This is the report of one such case.

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Mandibular nerve block is often performed for diagnostic, therapeutic and anesthetic purposes for surgery involving mandibular region. Advantages of a nerve block include excellent pain relief and avoidance of the side effects associated with the use of opiods or Non-steroidal anti-inflammatory drug (NSAIDs). A patient with maxillo facial trauma was scheduled for open reduction and internal fixation of right parasymphyseal mandibular fracture. The mandibular nerve was approached using the lateral extraoral approach with an 18-gauge i.v. cannula under general anesthesia. He received 4 ml boluses of 0.25% plain bupivacaine for intraoperative analgesia and 12 hourly for 48 h post operatively. VAS scores remained less than 4 through out observation period. The only side effect was numbness of ipsilateral lower jaw line, which subsided after local anesthetic administration was discontinued. Patient was discharged after four days.

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Aims and objectives: To compare the success rate of implant placed immediately in extraction socket vs implant placed delayed in extraction socket. Materials and Methods: The study comprised of 8 patients (6 male and 2 female, aged from 14 to 58 year) for evaluation of implant placement immediately (i.e. Group - A) or delayed (i.e. Group - B) into extraction site, in which at 12 sites implants were placed. Results: The inclusion criteria for implantation was tooth/teeth with one or two degree mobility, root stumps, tooth with failure root canal treatment and extraction sockets. HI-TEC TRX-OP (Life Care) with abutment, non-submerged, tapered at apical 5 mm, sand-blasted & acid etched surfaced implants were used. These are one stage single implants made of commercially pure titanium. The length of implants used was 10 mm and 13 mm and diameter was 3.70 mm and 4.50 mm. The vertical bone dimension was determined by palpation and radiograph (intra-oral periapical, orthopantomograph and dentascan in some patients). Gingival condition, bone condition was examined clinically and radiographically. Discussion: Post-operative evaluation was done under clinical parameters (i.e. Pain (VAS), Swelling, Stability (By Glickman method), Gingival status, Probing depth (By Williams Periodontal probe), Patient's compliance / satisfaction, Complications (If any) and Radiological parameters was (Intra-oral periapical radiograph, orthopantomograph, Dentascan). Conclusion: Overall conclusion drawn from this study was that both the groups are showing similar results but Group-A is slightly better than Group-B

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Cysticercosis is a common disease in developing countries. Labial lesions produced by this parasitic infestation are rare. The most frequently involved oral locations are the tongue, labial or buccal mucosa, and mouth floor. We present here a case report of a 33-year-old-female patient from Maharashtra, who reported to our department with a swelling in the left lower lip, which was diagnosed as cysticercosis on histpathological examination.

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Aims and Objectives: To evaluate the prognostic significance of cyclooxygenase-2 (COX-2) overexpression in oral squamous cell carcinoma (OSCC) patients undergoing chemoradiation therapy. Purpose of the study was to determine whether COX-2 could be used as a diagnostic and prognostic index in OSCC. Materials and Methods: Forty-four patients of SCC were included in the present study and immunohistochemical examination was done for COX-2 expression. Negative and <5% COX-2 positivity were taken as negative expression and ≥5% COX-2 positivity as positive expression group. ≥30% COX-2 positivity was taken as overexpressed group and <30% COX-2 positivity was taken as underexpressed group. All the data were analyzed statistically. Results: COX-2 overexpression in OSCC was found in 15.90% cases. The proportion of COX-2 overexpression was higher in patients with large tumor size than in those with small tumor size. The proportions of COX-2 positive expression cases were higher with cervical lymph node metastasis. Negative COX-2 expression was higher in well-differentiated OSCC and positive expression was higher in moderately differentiated tumors. COX-2 underexpressed cases had better response to chemoradiation therapy as compared to cases with overexpressed COX-2. Conclusion: COX-2 expression in OSCC can be used as a prognostic marker. Studies with large sample size and long-term follow-up are required to find out the exact role and prognostic significance of COX-2 expression in OSCC.

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Background: The management of trauma has evolved greatly over the past many years. Various bone plating systems have been developed to provide stable fixation of mandibular fractures. The introduction of the locking plate/screw system has offered certain advantages over the conventional plating systems. This system does not require intimate adaptation of the miniplates to the underlying bone and has greater stability. This study evaluates the efficacy of locking miniplate/screw system in the treatment of mandibular fractures without maxillomandibular fixation. Materials and Methods: This was a prospective study analyzing 20 patients with undisplaced or minimally displaced mandibular fractures, who reported to Department of Oral and Maxillofacial Surgery, Government Dental College and Research Institute, Bangalore. The selected cases were treated by open reduction and internal fixation using the 2.0 mm locking plate/screw system. Results: Open reduction and internal fixation with the 2.0 mm locking plate/screw system were achieved in all the 20 cases with satisfactory stability of the fracture fragments. The system was found to be reliable and effective intraoperatively. Only two complications were noted in the study. Conclusion: The locking miniplate system was found to be reliable and effective in management of mandibular fractures without postoperative intermaxillary fixation, however further studies with more sample size is required.

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Aim: The present study was aimed at development of the cephalometric norms for orthognathic surgery for the population of eastern Uttar Pradesh in North India. Settings and design: This study was conducted at a dental college. Materials and Methods: The study sample consisted of 50 males and 50 females. Each lateral cephalogram was taken in occlusion and subsequently traced. All reference points, landmarks, and measurements were made according to cephalometrics for orthognathic surgery (COGS) system. Statistical analysis used: The statistical analysis involved calculation of mean and standard deviation for each of the 23 parameters assessed for each subject. The data was subsequently compared with COGS study by using Normal (Z) test. Results: The norms were derived for the purvanchal population of North India and these were found to be quite distinct compared to those obtained from COGS study with respect to specific parameters. Conclusion: Male subjects indicated greater prominence of chin relative to the face, decreased posterior divergence, infraeruption of upper and lower molar as well as lower incisors, decreased total effective length of the maxilla, tendency towards Class III occlusion, and procumbent lower incisors. Female subjects, however, indicated increased anterior cranial base length, greater prominence of chin relative to the face, prognathic maxilla and mandible, increased middle third facial height, infraerupted lower incisors, increased mandibular body length, and procumbent lower incisors.

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Pleomorphic adenoma (PA) is the most common tumor of the benign salivary gland neoplasms, and the most common gland to be involved is the parotid gland. Its occurrence in the submandibular or the sublingual gland is uncommon. We present a case of a histologically proven PA involving the submandiblular gland.

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Oral submucous fibrosis (OSMF) is one of the most commonly found pre-cancerous conditions prevalent in Southeast Asian countries. The treatment method used by most patients is the use of intralesional steroids. With intralesional steroids used commonly, one might come across an unusual ocular complication - central serous chorioretinopathy (CSCR). We report a case of a patient with OSMF who was treated by corticosteroids, subsequent to which he developed CSCR. He was put off steroidal treatment and treated conservatively to which he responded positively.

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Masseter hypertrophy is a rare condition. It is mostly idiopathic with no known cause. It is recognized as an enlargement of one or both masseter muscles. Most patients complain of facial asymmetry; however, symptoms such as trismus, protrusion, and bruxism may also occur. This article reports a case of bilateral masseter hypertrophy with retrognathic mandible in which comprehensive treatment was rendered to the patient by using a combination approach.

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Ossifying fibroma is a rare benign fibro-osseous neoplasm of the jaw characterized by substitution of normal bone by fibrous tissues and newly formed calcified products such as bone, cementum or both. It is a well-demarcated lesion that differentiates it from fibrous dysplasia. This case report describes a rare case of ossifying fibroma arising in the maxilla of an 11-year-old child treated with enucleation. The clinical, radiographical, surgical and histological findings are presented. Controversies regarding the terminology and classification along with the differential diagnosis are discussed and a review is provided of the literature on the subject.

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We report here on rehabilitating a case with mandibular fracture and lower anterior teeth loss. Three double-staged implants were placed in the lower anterior region; in an attempt to rehabilitate the condition of five missing lower teeth, two natural teeth were prepared to act as natural abutments. Teeth implant-supported prosthesis was fabricated. Patient with a right mandibular fracture and loss of lower anterior missing teeth was successfully rehabilitated with teeth implant-supported prosthesis and titanium bony plates.

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