Adarsh Kudva

Rare case of giant unicystic ameloblastoma: Luminal variant

Abstract Objective and importance: Ameloblastoma is a locally aggressive benign tumor, commonly occurring in the mandible. While giant ameloblastoma of multicystic or plexiform variant have been reported, the authors report a rare case of giant unicystic ameloblastoma of luminal variant, which was treated by compartmental resection and planned for delayed reconstruction. Clinical presentation: A 46 year old male patient reported to the oral surgery out-patient department with a swelling of the left side mandible region of 2 years duration. He had undergone ayurvedic treatment for the same with no improvement. The size of the lesion on presenting was approximately 9 × 12 cm. Intervention: Compartmental resection with plan for secondary reconstruction, after adequate follow up period. Conclusion: While conservative management is being explored as a treatment option for unicystic ameloblastoma, resection is still the standard of care regardless of the histopathological subtype for giant lesions.

Platelet-rich fibrin combined with synthetic nanocrystalline hydroxy apatite granules in the management of radicular cyst

Radicular cysts are inflammatory jaw cysts confined to the apices of teeth with infected and necrotic pulp. They arise from the epithelial residues in the periodontal ligament as a result of inflammation, following the death of pulp. The treatment of such lesions vary with regard to their sizes; the small cystic lesions heal after an endodontic therapy, but larger lesions, may require additional treatment. Apical surgery for radicular cysts generally involves apical root resection and sealing with endodontic material. This case report, describes the treatment of a cyst related to the maxillary central and lateral incisors using platelet rich fibrin along with synthetic nanocrystalline hydroxyapatite granules for the regeneration of lost tissues. A follow-up evaluation at 6 months and 1-year revealed a significant radiographic bone fill with satisfactory healing at the surgical site.

Rehabilitation of orbital defect with silicone orbital prosthesis retained by dental implants

Orbital defects can result from cancer, birth anomalies, or trauma leading to an onslaught of problems in the function and psyche of the patient. These defects are restored by surgical reconstruction and followed by placement of orbital prosthesis for cosmetic makeup. The use of dental implants in retaining orbital prosthesis improves patient acceptance of the prosthesis owing to better retention and stability than conventional adhesive retained prosthesis. This case report describes a custom-made magnetic retentive assembly anchored by a dental implant which offers the orbital prosthesis the simplicity of self-alignment and ease of use.

Hybrid ameloblastoma: An Amalgam of Rare and Conventional Ameloblastoma

Ameloblastoma is a common benign odontogenic tumor with multiple histologic types. This case report describes an unusual type of ameloblastoma called “Hybrid Ameloblastoma” with features of both follicular and desmoplastic ameloblastoma in a 50-year-old female. This is a very rare form of ameloblastoma as <30 cases have been reported so far in literature. Though this rare form of ameloblastoma is only a histologic variant, it poses a great challenge to diagnosticians and thus to surgeons as there will be mismatch of biopsy reports at different sites in the same tumor thereby changing the treatment plan. This case report is one such example of diverse presentation of this ameloblastoma with conflicting histopathological diagnosis at initial biopsy and on surgical excision.

Magnet and Semi Precision Attachment in an Implant Retained Partial Denture for the Rehabilitation of an Irradiated Marginal Mandibulectomy Patient: A Case Report

Surgical treatment of malignancies in the oral cavity (mandible, tongue, floor of the mouth, alveolus, buccal sulcus) often results in an unfavourable anatomic condition for prosthodontic rehabilitation. Hence, maxillofacial prosthetic rehabilitation becomes a mightier task when resection is accompanied by radiation therapy. In selected cases, implant therapy comes to rescue. The following report throws light on the case of prosthetic rehabilitation of a patient who underwent right marginal mandibulectomy and right partial glossectomy, with the aid of a single implant, semi precision attachment and magnet supported partial denture.

Regrafting of Nipple Areolar Complex During Pectoralis Major Myocutaneous Flap Reconstruction

Pectoralis major myocutaneous flap is one of the most popular reconstructive methods employed in head and neck reconstruction.cosmesis and symmetry are important components of any surgery. Here we report a simple and effective method to restore cosmesis and symmetry.

A LINGUOVERTED IMPACTED TOOTH WITH OROCUTANEOUS FISTULA – A RARE CASE REPORT

The orocutaneous fistulous tract of odontogenic origin is often a diagnostic challenge, due to its rare manifestation and absence of dental signs and symptoms. The odontogenic cutaneous fistula is often misdiagnosed as a superficial skin lesion of non-odontogenic origin delaying the treatment. The diagnosis and treatment must be precise and swift to improve the clinical outcome and minimize the complications. This article presents a rare case of odontogenic keratocyst involving a linguoverted impacted third molar presenting as orocutaneous fistula. The patient was initially treated with empirical antibiotic therapy with no resolution of the cutaneous fistula and thickening of the skin around the sinus opening resulting in cosmetic deformity. Once the fistula was attributed to the underlying odontogenic cyst, treatment was done by cyst enucleation along with the extraction of tooth and fistula excision. The purpose of the paper is to emphasize the importance of early and accurate diagnosis and prompt management of the orocutaneous fistula due to the odontogenic origin.

Recurrent Ameloblastoma: A Surgical Challenge

Ameloblastoma is locally aggressive benign odontogenic tumour with increased risk of recurrence rate. The choice of treatment depends on the histologic subtype. Radical therapy is the recommended modality for solid ameloblastomas. The possibilities of recurrence even after enbloc resection are still high. The author presents two case reports of recurrent ameloblastomas postradical resection. First case describes the recurrence of ameloblastoma in the bone graft which was used for reconstruction, and the second case depicts recurrence in the infratemporal fossa. Intraoperative radiography of the frozen section of the soft tissue margin plays an important role in the holistic management of these lesions.

Subcuticular Suture Technique: Alternative to Frost Suture to Prevent Ectropion After Transcutaneous Incision of Lower Eyelid

IntroductionAn ectropion is a complication that can arise from reconstruction in the infraorbital region. Often, this complication occurs despite proper positioning of the lower lid at the time of closure. Various transcutaneous approaches to orbit skeleton have investigated in view of complication arising from them. A subtarsal approach with a postoperative Frost suture gives an advantage to reduce the occurrence of ectropion especially after treatment of orbital floor fractures.Material and methodsThis case describes a method of subcuticular suturing technique for subtarsal incision of lower lid which can be used to support the lid during healing period, thus decreasing the rate of ectropion.ConclusionThe technique described here is an alterative method for frost suturing with certain advantages.

Unique Magnetic Attachment Designed for a Solitary Dental Implant Retaining Silicone Nose Prosthesis

Midfacial defects are enormous defects that result from cancer treatment that rarely are corrected by surgical reconstruction alone; they generally require a facial prosthesis to restore function and appearance. Surgical reconstruction may be viable for few defects, which are done with different flaps. But for the total nasal resection, prosthetic option would be more feasible. Nasal cartilaginous anatomy is complex due to the varying contours. Therefore it may be difficult for the surgeon to reconstruct the entire nose. This clinical report describes the rehabilitation of a large mid-facial nose defect with a dental implant retained nasal prosthesis. The patient had adenocystic carcinoma of the medial maxillary wall extending to the nose.