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The objective of this work is to integrate structural optimization and reliability concepts into mini-plate fixation strategy used in symphysis mandibular fractures. The structural reliability levels are next estimated when considering a single failure mode and multiple failure modes. A 3-dimensional finite element model is developed in order to evaluate the ability of reducing the negative effect due to the stabilization of the fracture. Topology optimization process is considered in the conceptual design stage to predict possible fixation layouts. In the detailed design stage, suitable mini-plates are selected taking into account the resulting topology and different anatomical considerations. Several muscle forces are considered in order to obtain realistic predictions. Since some muscles can be cut or harmed during the surgery and cannot operate at its maximum capacity, there is a strong motivation to introduce the loading uncertainties in order to obtain reliable designs. The structural reliability is carried out for a single failure mode and multiple failure modes. The different results are validated with a clinical case of a male patient with symphysis fracture. In this case while use of the upper plate fixation with four holes, only two screws were applied to protect adjacent vital structure. This behavior does not affect the stability of the fracture. The proposed strategy to optimize bone plates leads to fewer complications and second surgeries, less patient discomfort, and shorter time of healing.

Removal of mandibular third molars surgically is one of the most frequently performed oral surgical procedures which are often accompanied with post-operative pain, swelling and trismus. Despite general progress in pain management, moderate to severe acute post-operative pain after removal of lower third molars remains a problem. Fentanyl is an extremely effective drug in the treatment of severe chronic pain such as cancer pain and post-operative pains which acts by increasing patient’s tolerance to pain. Fentanyl Transdermal System (FTS) is a rectangular transdermal patch which contains high concentration of fentanyl, a potent short-acting Schedule II opiate. In this study the efficacy of transdermal fentanyl for management of post-operative pain after impacted mandibular 3rd molar surgery is evaluated. 20 patients within the age group of 18–40 years with asymptomatic impacted mandibular third molars were equally divided into 2 groups as group A & group B which underwent surgery in Local Anaesthesia. In every patient one side belonged to group A and other side belonged to group B. 50 μg FTS was applied in group A while placebo patch was applied in group B. Patients in group A performed significantly better than group B in terms of mean pain intensity scores assessed by VAS and VRS along with minimum need of post-operative rescue analgesics. It was found that FTS resulted in significantly better pain relief, longer pain-free intervals, and lesser post-operative analgesic consumption.

Among the bewildering variety of neoplasms occurring in the head and neck region, few are unique to the oral cavity which are quite challenging to diagnose. Due to the rarity of these tumours, it is the practicing oral pathologists’ accountability to confirm some of these neoplasms with or without special investigative modalities to rule out the differential diagnosis histopathologically. One in the group of such tumour prevails haemangiopericytoma aka. solitary fibrous tumour (HPC/SFT). The management of these tumours is purely histopathologically driven, since the surgical procedure is dependent on the histological diagnosis. This neoplasm is histologically very difficult to confirm as benign or malignant without the use of immunohistochemical markers. We report such a rare case of a 54-year-old female patient, histopathologically confirmed diagnosis of HPC/SFT with CD34 positivity for documentation in the literature.

The normal range of linear nasal parameters varies greatly amongst different ethnicities and races. The objectives of this study were to measure them for north-east Indian population which has not been studied and to compare this data with the Oriental, Caucasian and Indian parameters available in literature. This cross-sectional study was carried out in 150 young adults from north-east India. Surface landmarks were marked and standard photographs were taken. Thirteen linear characteristics were measured directly while 3 parameters were calculated from photographs using computer software. Fourteen of the 16 linear measurements were greater in males than females and differences in 8 of them were statistically significant. The nasal lengths of north-east Indians were greater than rest of the Indians but smaller than most Caucasians and Orientals. Nasal protrusion was least and columella was shortest in the study population. The north-east Indian nose is dissimilar to that of rest of the country as well as Caucasians and Orientals. Hence, the data from this study needs to be kept in mind while performing aesthetic rhinoplasty on this group to preserve their ethnicity.

Penetrating Cranio-Maxillofacial trauma obscuring the clear view of the face in addition to an impediment to emergency airway management has been a rare occurrence in the archives of emergency trauma. A four-year-old girl reported to the emergency following a lunch box sharp rim penetrating wound to her left supraorbital region, limiting the access and clear view of her face. CT scan ruled out the serious orbital injury, but clearly revealed the piercing of the brain matter in the frontal region. The toddler’s golden hour of primary management was spent in the darkness with the lunch box covering her entire face, obstructing the basic intubation methods required for primary airway management. Interpretation of the radiological investigations necessitated the multiple collaboration of the neurosurgery and maxillofacial surgeons, planning a systematic recovery of the foreign body without any major complications. Follow-up period was uneventful with no neurological and major cosmetic deficits.

The concept of ‘fibro-osseous lesions’ of bone evolved over the last several decades to include two major entities: fibrous dysplasia and ossifying fibroma as well as the other less common lesions such as florid osseous dysplasia, periapical dysplasia, focal sclerosing osteomyelitis, proliferative periostitis of garrie and ostitis deformans. The cemento-ossifying fibroma is a central neoplasm of bone as well as periodontium which has caused considerable controversy because of confusion of terminology and criteria of diagnosis. The cemento-ossifying fibroma is odontogenic in origin where as ossifying fibroma of bony origin. This article reports a case of an 11-year-old male who came to us with the history of swelling at the maxillary anterior region causing difficulty in closing of mouth as well as mastication.

The aim of this study was to clinically evaluate the outcomes of pterygoid disjunction (PD) carried out as the primary treatment modality for reducing disc displacement type of internal derangement (ID) of temporomandibular joint (TMJ) refractory to conservative management and arthrocentesis. 59 PD were carried out in 33 patients. In 26 cases procedure was done bilaterally and in 7 cases unilaterally as per the presentation from 2008 to 2010. Three patients were lost to follow up. Using the Helkimo Anamnestic and Clinical Dysfunction Indices cases were evaluated pre and postoperatively after 1 year. All 30 cases showed improvement. After 1 year follow up 6 cases were in Dio and 22 cases were in DiI and 2 cases were in DiII of clinical dysfunction index. From which we can co-relate that post surgically all the patients were benefited by this procedure. PD as a primary surgical option significantly reduces pain and improves function in the refractory cases of reducing disc displacement type of ID of TMJ.