Shakil Ahmed Nagori

Immediate autotransplantation of third molars: an experience of 57 cases

OBJECTIVE We present our experience of success with immediate third molar transplants in young individuals while secondarily assessing factors predicting failure. STUDY DESIGN A total of 57 cases of third molar transplant with both open and closed apices were studied in individuals aged 15 to 25 years. Factors influencing prognosis were analyzed by univariate and multivariate analysis. RESULTS The replaced teeth included 17 maxillary molars (29.8%) and 40 mandibular molars (70.2%). After a follow-up of 19.9 ± 2.8 months, 49 cases (86%) were successful; 7 (12.3%) cases failed owing to root resorption, and 1 (1.7%) failed owing to infection. Pulp revascularization was seen in all successful cases with open apices. Proximal grinding of donor tooth was significantly associated with failure (odds ratio, 12.5; P = .025). CONCLUSIONS Autogenous third molar transplant is an excellent and viable treatment modality. By using proper case selection and minimizing damage to the donor tooth root, high success rates can be achieved.

Evaluating success of autotransplantation of embedded/impacted third molars harvested using piezosurgery: a pilot study.

Abstract Objective. To evaluate the success of autogenous transplantation of embedded/impacted third molars harvested using piezosurgery. Materials and methods. This prospective pilot study enrolled 20 healthy patients with non-restorable first/second molars and a caries-free retrievable embedded/impacted third molar. Piezosurgery was used for removing inter-radicular bone at the recipient socket as well as for bone removal around the donor teeth. Results. After an average follow-up of 16.4 months (SD = 1.9), 18 cases were successful with formation of periodontal ligament around the teeth. One tooth was lost due to infection at 1 month. One patient was lost to follow-up. There was no root resorption or ankylosis in any of the cases. In six donor teeth with complete root formation, root canal treatment was carried out. All the remaining teeth responded positively with vitality testing. Conclusion. Piezosurgery is an effective device if embedded/impacted third molars are to be harvested for successful autogenous transplantation.

Management of maxillofacial trauma in emergency: An update of challenges and controversies

Trauma management has evolved significantly in the past few decades thereby reducing mortality in the golden hour. However, challenges remain, and one such area is maxillofacial injuries in a polytrauma patient. Severe injuries to the maxillofacial region can complicate the early management of a trauma patient owing to the regions proximity to the brain, cervical spine, and airway. The usual techniques of airway breathing and circulation (ABC) management are often modified or supplemented with other methods in case of maxillofacial injuries. Such modifications have their own challenges and pitfalls in an already difficult situation.

Traumatic bone cyst of the mandible in Langer-Giedion syndrome: a case report

IntroductionLanger-Giedion syndrome (trichorhinophalangeal syndrome type II) is an extremely rare disorder characterized by dysmorphic facial features, multiple exostoses, mental retardation and digit deformities. We report the first case of any maxillofacial pathology in such a syndromic patient.Case presentationA 22-year-old Indian woman with mild intellectual disability presented with malaligned teeth. Routine radiographic screening demonstrated a large multilocular lesion in her right mandible. She had peculiar features such as short stature, short limbs, brachydactyly, and dysmorphic facial characters, which prompted us to evaluate her further. After findings of multiple bony exostoses she was diagnosed with Langer-Giedion syndrome. On surgical exploration of her right mandibular lesion an empty cavity was found suggestive of traumatic bone cyst. The lesion healed completely after 1 year without loss of vitality of any teeth.ConclusionsAlthough diagnosis and management of any maxillofacial pathology can be challenging in syndromic patients, our report suggests a possible correlation between traumatic bone cyst and Langer-Giedion syndrome. Clinicians should routinely screen these patients for any undetected maxillofacial pathology. In future cases of this syndrome, one should consider the possibility of traumatic bone cyst which may not require aggressive surgical management.

Odontogenic infection and pachymeningitis of the cavernous sinus

Hypertrophic pachymeningitis is a rare inflammatory process that causes thickening of the dura mater. Most cases are idiopathic, but it can result from many inflammatory and infective conditions. We present a case of pachymeningitis of the cavernous sinus, the aetiology of which may have been dental.

Is splint therapy required after arthrocentesis to improve outcome in the management of temporomandibular joint disorders? A systematic review and meta-analysis

OBJECTIVE The aim of this systematic review was to assess the efficacy of splint therapy in improving outcomes after arthrocentesis for the management of temporomandibular joint disorders. STUDY DESIGN A comprehensive electronic search was conducted to search for randomized control trials, controlled clinical trials, and retrospective studies comparing arthrocentesis and splint therapy with arthrocentesis alone. RESULTS Six studies were included in this review. There was no statistical significant difference in pain reduction with or without the use of splint after arthrocentesis at 1 month (fixed: weighted mean difference [WMD] = -0.01; 95% confidence interval [CI] -0.46 to 0.44; P = .96; I2 = 0%) and 6 months (fixed: WMD = -0.08; 95% CI -0.27 to 0.42; P = .66; I2 = 0%). Similarly, no difference was seen in improvement in maximal mouth opening at 1 month (fixed: WMD = -0.16; 95% CI -1.75 to 1.42; P = .84; I2 = 44%), and 6 months (fixed: WMD = -0.83; 95% CI -0.52 to 2.18; P = .23; I2 = 0%). CONCLUSIONS Within the limitation of this review, there is some evidence that splint therapy may not improve outcomes after arthrocentesis. There is a need for well-designed RCTs evaluating the additional benefit of splint therapy after arthrocentesis for managing temporomandibular joint disorders.

Neurosensory disturbance after bilateral sagittal split osteotomy: A retrospective study.

AIM To retrospectively evaluate neurosensory disturbance (NSD) after bilateral sagittal split osteotomy (BSSO). MATERIAL AND METHODS A retrospective review was carried out to assess inferior alveolar nerve function in patients treated by BSSO from 2010 to 2013. All patients included in the study were assessed using objective (cotton swabs and pin prick testing) and subjective testing (questionnaire) for inferior alveolar nerve function after a minimum of 1 year of follow-up. Medical records of the patients were used to assess the incidence of NSD in the immediate post-operative period. RESULTS 15 patients (30 sides) had undergone BSSO during the specified time period. On subjective testing, NSD was reported in 22 operated sides (73.3%) in the immediate post-operative period, while 4 operated sides (13.3%) reported persistent NSD. On objective testing, immediate post-operative NSD was seen in 20 operated sides (66.7%). After a minimum of 1 year follow-up, recovery was seen in 18 operated sides while persistent NSD was seen in 2 operated sides (6.7%). CONCLUSION NSD of the inferior alveolar nerve is a common complication after BSSO in the immediate post-operative period. However in a long term, nerve function usually recovers.