Occlusal Discrepancies Research Articles

New Avenue for Treatment of Dentinal Hypersensitivity Assisted with Tekscan a Diagnostic Tool

ABSTRACT Background: Occlusion is dynamic and plays an important role in the functioning of the stomatognathic system. Disturbance in one of the components of the stomatognathic system may result in hypersensitivity of teeth, orofacial pain, migraine, and temporomandibular joint (TMJ) disorders. Coronoplasty done using articulating paper is the conventional method for occlusal corrections. T-scan is a computerized occlusal analysis system that overcomes the limitations of articulating paper. Methods: Patients with Myofacial pain dysfunction syndrome (MPDS) having dentinal hypersensitivity were taken into consideration. The case series included three cases. A joint vibratory analysis (JVA) is performed using a JVA device to rule out any TMJ disorders. T-scan-assisted coronoplasty is performed. Patients are asked to score for dentinal hypersensitivity on the VAS scale pre and postoperative. Results: Occlusion and disocclusion time is reduced along with hyperactivity of the muscles after T-scan-assisted coronoplasty. There is a reduction in dentinal hypersensitivity postoperative. Conclusion: T-scan quantifies the forces and hence proved a boon in the field of dentistry. The present case series highlights coronoplasty assisted with a T-scan for diagnosis and treatment planning of hypersensitivity of teeth; hence it is the future of dentistry. Practical Implications: T-scan is a device that is assisted with electromyography. It projects the forces of mastication at every contact point of maxillary and mandibular teeth and reveals muscular hyperactivity. It can be used in MPDS patients with dental hypersensitivity due to occlusal discrepancy as it can guide elective coronoplasty relieving pain and dentinal hypersensitivity.

Malocclusion: Prevalence and Determinants among Adolescents of Karachi, Pakistan.

The aim of this study was to determine the prevalence of malocclusion and its associated demographic and clinical factors in young adolescents (13-15 years) of Karachi, Pakistan. An epidemiological survey included 500 young adolescents of registered schools, madrassas (Islamic education system), and shop workers of Gulshan-e-Iqbal Town. It was a cross-sectional analytical study design. Multistage random sampling technique was used to enroll participants. The pattern of occlusion was recorded with other related features using Angle's classification. Health status was recorded through World Health Organization-guided indices (decayed, missing, and filled permanent teeth [DMFT], community periodontal index of treatment needs [CPITN], and body mass index [BMI]). The information, thus, obtained was analyzed through SPSS using the chi-squared test and regression models. Forty four percent of the participants were female, while overall estimated prevalence of malocclusion in young adolescents of Karachi was 57.4%. After adjustments, participants going to any kind of education system had less malocclusion in comparison to those who were not going to any education system (adjusted odds ratio [aOR] = 0.305, 95% confidence interval [CI] = 0.12-0.73); mother's education especially higher level (aOR = 2.02, 95% CI = 1.08-3.75) and presence of periodontal disease (aOR = 1.57, 95% CI = 1.06-2.33) were significantly associated with malocclusion. This study showed that the class I malocclusion is prevalent in the local community. Demographic factors like gender, age, self-reported ethnicity, and BMI did not show any significant role. Education or knowledge of parents and young adolescents does play an influential role in decreasing malocclusion. Young adolescents, who are more prone to oral health problems at an early age, would have more chances to develop occlusal discrepancies.

Analysis of the impact of various finish line designs and occlusal morphologies on the accuracy of digital impressions

Background/purposeRecent advancements in dental technology has led clinicians to convert from traditional methods to digital workflows. The purpose of this study was to analyze the effect of various finish line designs and occlusal morphologies on the accuracy of digital impressions. Materials and methodsSix maxillary molar crown preparations were designed by using a digital sculpting software program. The samples differed in finish line design and occlusal surface morphology. Three different finish line designs (shoulder, chamfer, and shoulder with internal round angle) and two different occlusal morphologies (sharp and rounded) were used, giving six groups. Using three different intraoral scanners, each group was scanned and compared with a reference scan obtained from an industrial scanner. The accuracy of each scan was studied, and the data were statistically analyzed. ResultsA total of 180 scans were acquired by utilizing three different intraoral scanners. The reference scan was compared with the scans from each group and overall differences (marginal, axial, and occlusal) were assessed. A crown preparation with a chamfer finish line showed the lowest marginal discrepancy of 13.2 ± 4.18 μm while preparation with a shoulder finish line reported the highest discrepancy of 34.8 ± 7.9 μm (P < 0.05). Also, the occlusal discrepancies of the samples with rounded and sharp occlusal morphologies were 12.55 ± 3.09 μm and 19.13 ± 2.3 μm, respectively (P < 0.05). ConclusionIt has been suggested that chamfer finish line design and rounded occlusal anatomy may produce more accurate digital impression for single crown restorations.

Application of a Multi-Layer Perceptron in Preoperative Screening for Orthognathic Surgery.

Orthognathic surgery is used to treat moderate to severe occlusal discrepancies. Examinations and measurements for preoperative screening are essential procedures. A careful analysis is needed to decide whether cases require orthognathic surgery. This study developed screening software using a multi-layer perceptron to determine whether orthognathic surgery is required. In total, 538 digital lateral cephalometric radiographs were retrospectively collected from a hospital data system. The input data consisted of seven cephalometric variables. All cephalograms were analyzed by the Detectron2 detection and segmentation algorithms. A keypoint region-based convolutional neural network (R-CNN) was used for object detection, and an artificial neural network (ANN) was used for classification. This novel neural network decision support system was created and validated using Keras software. The output data are shown as a number from 0 to 1, with cases requiring orthognathic surgery being indicated by a number approaching 1. The screening software demonstrated a diagnostic agreement of 96.3% with specialists regarding the requirement for orthognathic surgery. A confusion matrix showed that only 2 out of 54 cases were misdiagnosed (accuracy = 0.963, sensitivity = 1, precision = 0.93, F-value = 0.963, area under the curve = 0.96). Orthognathic surgery screening with a keypoint R-CNN for object detection and an ANN for classification showed 96.3% diagnostic agreement in this study.

Epidemiology, Pattern, and Management of Midsagittal and Parasagittal Palatal Fractures through Placement of Intra-arch Wire

Aim: The aim of this prospective study was to evaluate the epidemiology, pattern, and concomitant injuries associated with midsagittal and parasagittal palatal fractures and to assess the postoperative complications associated with treatment by placement of intra-arch wiring for their management. Materials and Methods: A prospective study was carried out on 22 patients of maxillofacial trauma who were diagnosed with midsagittal or parasagittal palatal fractures and were treated by placement of intra-arch wires during August 2020 to January 2022 in the Department of Dentistry, Shyam Shah Medical College Rewa. All the cases were treated with open reduction/closed reduction for the management of concomitant injury. Results: Out of a total of 31 cases diagnosed with palatal fractures during the study duration, the most common palatal fractures were parasagittal (41.93%) and sagittal fractures (29.03%), which met the inclusion criterion of the study (n = 22). Sagittal and parasagittal fractures of the palate were commonly seen in males with a male-to-female ratio of 10:1. The mean age of occurrence was 32.04 ± 11.29 years. The mean duration of surgery was 7.9 ± 2.28 min. Occlusal discrepancy requiring an orthodontic intervention for correction was seen in 1 (4.54%) patient. In 3 (13.63%) patients, occlusal discrepancy was managed by prolonging the duration of intermaxillary fixation. Conclusion: Intra-arch wiring is a simple, cost-effective, and quick method for the management of midsagittal and parasagittal fractures of palatal fractures. It eliminates the need of a second surgery for the removal of plates that are placed in open reduction of palatal fractures.

Prevalence of Temporomandibular Joint Pain among Patients who Reported to Dental OPD at a Tertiary Hospital in Pondicherry, India: A Cross-sectional Study

Introduction: Temporomandibular Joint Disorder (TMJD) is a debilitating condition that affects the quality of a person’s life. However, its aetiology remains controversial. Understanding the signs and symptoms associated with this condition is crucial for better comprehension. Determining the prevalence of TMJD can emphasise the importance of routine Temporomandibular Joint (TMJ) examinations and the implementation of preventive measures. Aim: To determine the prevalence of TMJ pain among patients who reported to the dental Outpatient Department (OPD) between January 2015 and December 2019. Additionally, the study sought to identify potential predisposing factors for TMJ pain. Materials and Methods: A cross-sectional study was conducted in the Dental Department at Pondicherry Institute of Medical Sciences, Pondicherry, India. The study duration was six months, from December 2021 to May 2022. The study was done by examining the medical records of all patients who reported TMJ pain during the specified period. A total of 32,094 patients’ records were reviewed, and 322 patients reported pain in the TMJ region. The patients’ reported signs and symptoms were extracted from their case records and evaluated. Pearson’s Chi-square/Fisher’s-exact test was utilised to determine associations between the factors. Results: The mean age of the participants was 35.4±13.2 years. Out of the 32,094 patients who attended the dental OPD, 327 (1.02%; 95% CI: 0.91-1.13) reported TMJ pain. Among these patients, 207 (63.3%) were females. Joint sounds were the most common symptom, observed in 243 (74.3%) patients, followed by emotional stress or tension, reported by 205 (62.7%) patients. Most symptoms were more prevalent in females than males. Parafunctional habits and stress/tension showed a statistically significant association (p&lt;0.001) with male gender. Additionally, occlusal variation, joint sound, missing teeth, chewing with one side, parafunctional habits, and stress showed associations with age. Conclusion: The TMJ pain was more frequently reported by women than men in the studied population. The most common symptoms reported were pain and joint sounds. The highest number of patients fell within the 30 years-55 years age group. Although the prevalence identified was 1.02%, routine TMJ examination should be conducted as a standard part of oral and maxillofacial examinations to identify any predisposing factors that may lead to TMJD in the future.

Evaluation of two different occlusal patterns on single posterior implant-supported crowns: A 12-month prospective study of occlusal analysis

Statement of problemAccording to the concept of implant-protected occlusion, light occlusion and late contact could prevent implants from occlusal overload. However, clinical data demonstrating how light occlusion differs from normal occlusion are lacking. PurposeThe purpose of this prospective clinical study was to characterize the occlusal variation of single posterior implant-supported crowns with or without light occlusion. Material and methodsParticipants with a single missing posterior maxillary or mandibular molar who were to receive implant-supported zirconia ceramic crowns were enrolled. The participants were divided into a light occlusion group, in which a 12-μm articulating film could be removed from the implant-supported crown and opposing natural teeth under the intercuspal position, and a normal occlusion group, in which the articulating film could not be removed. All participants underwent occlusal examinations using the T-scan III system, answered a satisfaction questionnaire using a visual analog scale (VAS), and received regular follow-ups. The participants were evaluated at 0.5, 3, 6, and 12 months after implant-supported crown delivery. The relative occlusal force of the implant-supported crowns, mesial teeth, control teeth (corresponding natural tooth on the dentition contralateral to each implant), and the occlusal contact time of implant-supported crowns were recorded. Moreover, the asymmetry index of the occlusal force and the VAS score were calculated. Two independent-sample tests were used to compare the 2 groups. The Wilcoxon rank sum and Mann‒Whitney tests were used to compare nonnormally distributed data (α=.001). ResultsFifty study participants with a mean ±standard deviation age of 36.97 ±7.34 years (23 men and 27 women aged 20 to 50 years) were followed for 0.5 to 12 months. No obvious complications of overloading were observed in either group. The mean ±standard deviation of the relative occlusal force of implant-supported crowns in the light occlusion group (from 4.91 ±3.52% to 10.34 ±4.35%) was always lower than that in the normal occlusion group (from 10.45 ±4.32% to 18.15 ±4.80%), while the mean ±standard deviation of the occlusal contact time in the light occlusion group (from 0.38 ±0.26 seconds to 0.10 ±0.07 seconds) was significantly later than that in the normal occlusion group (from 0.12 ±0.08 seconds to 0.04 ±0.02 seconds) (P<.001). The value of the asymmetry index of occlusal force remained within the normal range (10%). The VAS score in the normal occlusion group was significantly higher than that in the light occlusion group (P<.001). ConclusionsProviding light occlusion to reduce occlusal force and delay the contact time was not stable over time. The relative occlusal force and occlusal contact time showed a similar development trend in both groups, and no obvious signs of occlusal overloading were observed in this study. Long-term follow-up is necessary for implant-supported prostheses because of the continuous increase in occlusal force.

Conservative orthodontic and multidisciplinary approaches for patients with cleidocranial dysplasia in late adolescence or young adulthood

This case series describes conservative orthodontic and multidisciplinary approaches for treating two patients diagnosed with cleidocranial dysplasia in late adolescence and young adulthood. Most of the impacted permanent teeth erupted spontaneously within 3 to 4 years after surgical extraction of the deciduous and supernumerary teeth. The remaining unerupted permanent teeth were facilitated with traction or extracted followed by implantation or restoration. Repositioning of the maxilla and mandible via orthognathic surgery was also applied to correct skeletal and occlusal discrepancies and lead to satisfying results.

Management of atypical occlusal discrepancy after condylar resection: A clinical report

This clinical report describes the prosthetic management of occlusion for a patient who had received condylar resection as part of cancer treatment. Previous reports have identified that patients with unrepaired segmental resection of the mandible experienced a frontal plane rotation of the mandible toward the nonsurgical side. In contrast, because of preservation of temporomandibular muscles and their attachments, the mandible rotated toward the surgical side, and occlusal contacts were limited to a pair of molars on that side. Manual manipulation and instructions for muscular stretching and massages were provided to reduce muscular tension. A mandibular guidance prosthesis was fabricated and gradually adjusted to guide the mandible progressively toward a normal position. These treatments helped improve general comfort, mastication, occlusion, and the gradual rotation of the mandible toward a normal position.

Prevalence of temporomandibular disorders and its association with malocclusion in children: A transversal study.

This study investigated the prevalence of temporomandibular disorders (TMDs) in a sample of children and adolescents and evaluated the correlation with occlusal variables. TMD signs and symptoms were recorded in 411 subjects (age range 7–15 years), divided into two groups: 214 subjects treated in Chieti (Italy) CG group and 197 in Murcia (Spain) MG group. Once the Angle dental class was identified, it was recorded if there were signs and symptoms of temporomandibular disorders (TMDs) and occlusal interferences. The percentages of signs and symptoms were compared to determine the differences among the groups for TMDs, bruxism, joint sounds, deviation during the opening, reduced opening/lateral/protrusive movements, malocclusions, and myofascial pain. There is no statistically significant difference between the two groups (χ2 = 1.057, p > 0.05). Subjects with Angle Class I (37.37%), deep bite (43.43%), and increased overjet (41.41%) showed a higher prevalence of TMD symptoms.

Role of Distraction Osteogenesis in the Management of Postankylotic Deformity.

Distraction osteogenesis (DO) has evolved in maxillofacial surgery and gained popularity due to the limitations of orthognathic surgery in gross asymmetry cases. The primary aim of the paper was to determine if the use of DO for the management of severe deformities of the mandible secondary to temporomandibular joint ankylosis can achieve optimal results, with or without genioplasty, based on cephalometric norms. The secondary aim of this study was to evaluate the complications associated with DO in this group of patients. Six patients with postankylotic deformity were included. Both internal and external devices were used for an average mandibular corpus lengthening of 15mm with adjunctive procedure genioplasty. All patients had excellent outcome in terms of profile, functional occlusion, and mouth opening without deviation. Two patients had primary genioplasty showed excellent compliance and 2 as secondary at the time of device removal. Complications noted were, difficulty in vector control during distraction, paresthesia, occlusal discrepancy, scarring, and relapse of 2 to 3mm. Preorthodontics and postorthodontics were done in all patients to settle the occlusion, which was stable after 2-year follow-up. Case series shows such gross deformities pose a greater challenge due to undergrowth, gross midline shift, and discrepancy between soft and hard tissue growth pattern and the desired results can be achieved by precise planning. Genioplasty at the time of device placement has definitive positive effect on patient compliance. Though orthognathic surgery has a definitive role in minor deformity, whereas in gross deformities DO with precise planning using 3-dimensional model and vector controlled technique offers excellent outcome.

Linear Dimensional Change in Acrylic Denture Teeth Positions Factored by Different Processing Techniques and Occlusal Forms: An In Vitro Study

The current literature lacks substantial evidence for the effect of denture base processing techniques and posterior denture tooth forms on denture tooth shifts due to denture base resin polymerization. The aim of this study was to evaluate the combined effect of PMMA-based denture processing techniques (compression packing and injection molding) and posterior tooth forms (semi-anatomic and non-anatomic) on the linear dimensional shift of denture teeth following denture processing in both horizontal and vertical dimensions. Two different complete denture fabrication techniques were used to prepare forty ideal maxillary complete dentures using two different types of posterior tooth forms. The used fabrication techniques were conventional heat polymerized compression packing and injection molding. The posterior tooth forms used in the current study were non-anatomic tooth (0 degrees) and semi-anatomic tooth forms (approximately 20 degrees). Initial linear measurements (vertical and horizontal) were taken from pre-specified points for the central incisor and first molar. Specimens were randomly divided into four groups (n = 10), and denture processing was performed using the two techniques. Final linear measurements were recorded. The linear change in dimension for all six parameters was calculated by deducting the after values from the before values. Since the discrepancies were both positive and negative in magnitude, the absolute value of the difference was taken for further analysis. This value represents the dimensional change. T-tests were used to compare the mean dimensional changes. Furthermore, the mean dimensional changes for all the six parameters were compared using a two-way analysis of variance. The alpha error was set at 5%, and a p-value of less than 0.05 was considered statistically significant. The injection molding technique showed significantly fewer tooth movements in both the vertical and horizontal measurements as compared to the conventional compression packing technique. The non-anatomic tooth showed significantly fewer changes in tooth movement as compared to semi-anatomic teeth in both the compression and injection techniques. This study can guide the selection of a proper processing technique for a particular posterior tooth form, thus minimizing occlusal discrepancies and reducing occlusal corrections during laboratory and clinical remount procedures.

Influence of restorative materials on occlusal and internal adaptation of CAD-CAM inlays

Aim: To evaluate the occlusal and internal marginal adaptation of inlay restorations made of different materials, using CAD-CAM. Methods: Preparations were made for MOD inlays of one-third intercuspal width and 4 mm depth in 30 third human molars. The teeth were restored using CAD-CAM materials (n=10) of nanoceramic resin (Lava Ultimate), polymer-infiltrated ceramic network (VITA ENAMIC), or lithium disilicate glass-ceramic (IPS e.max CAD). The specimens were cemented with dual resin cement and sectioned at the center of the restoration, after which the two halves were evaluated, and photographed The occlusal and internal discrepancy (μm) was determined at five points: cavosurface angle of the occlusal-facial wall (CA-O); center of the facial wall (FW); faciopulpal angle (FPA); center of the pulpal wall (PW); and center of the lingual wall (LW). The data were submitted to the Kruskal-Wallis and the Dunn tests (α=0.05). Results: No difference was observed among the materials regarding the occlusal discrepancy at the CA-O, FPA, or PW internal points. The e.max CAD measurement at FW showed larger internal discrepancy than that of Lava (p=0.02). The internal discrepancy at LW was greater for e.max CAD than VITA ENAMIC (p=0.02). Conclusion: Lithium disilicate glass-ceramic presented greater internal discrepancy in relation to the surrounding walls of the inlay preparations.

Versatility of various 3D non locking miniplates in treatment of mandibular fractures

Context: The optimal management of mandibular fractures continues to evolve. Fractures of mandible predispose the patients to structural, functional and aesthetic compromise if not treated. The current understanding of the biomechanics and fracture healing of the mandible has influenced the modern approach to the open reduction and internal fixation of these fractures. These help us to evaluate shortcomings of compression plates and 2D miniplates leading to development of 3D plates. Aims: To evaluate the versatility and efficacy and complication of 3 different varieties of 3D non locking plates–2x2 and 2x3 and delta plates in the treatment of mandibular fractures at different sites.Materials and Methods: A total of 86 patients of mandibular fractures were managed by open reduction and internal fixation utilizing total 114 three dimensional plates (109 non locking 3D plates (2X2,3X2) and 5 delta plates) were used for fractures of the mandible including symphysis, parasymphysis, body, angle, ramus and condyle over a period of 3 years.Results: The use of 3D plates provided semi-rigid fixation of fractured fragments with no immediate post-operative mobility. Immediate and subsequent postoperative clinical and radiographic evaluation was carried out at 15 days, 1 month, 3 months and 6 months. Post-operative complications observed were post-operative neurosensory deficit in 3 patients, occlusal discrepancy in 3 patients, wound dehiscence in 2 patient, plate exposure in 1 patient and parotid fistula in 1 patient which accounted for 8.6% of total patients. None of the patient suffered from Infection, segmental mobility, paraesthesia. Malunion, non-union. All these were treated successfully with definitive measures.Conclusion: The 3D mini-plate system is a versatile and efficient method for fixation of mandibular fractures. Delta plates are efficient method for reduction and fixation of subcondylar fracture. The only contraindication for 3D plates is their use in mental foramen region (where distance between mental foramen and inferior border is less than 1.5cm).

The Effect of Various Cementing Agents on Occlusal Discrepancy Using an Intra-Oral Scanner: An In Vivo Study

A marginal fit of all-ceramic crowns is a prerequisite for the long-term clinical success of a dental restoration. Few in vivo studies have investigated the effect of the film thickness of various luting agents on vertical discrepancy. This in vivo study evaluated the influence of three luting cements on the occlusal vertical discrepancy of milled crowns using a complete digital workflow. Forty-three patients treated in a students’ clinic in Tel-Aviv University with 45 single posterior digitally prepared monolithic crowns were included in the study. The crowns were randomly divided into three groups using different resin luting agents: self-adhesive resin cement, resin-modified glass ionomer cement and adhesive resin cement. The crowns were intra-orally scanned before and after cementation. The two standard tessellation language (STL) files for each crown were superimposed using digital software, and between four and six measurements were made at the occlusal surface to demonstrate the occlusal and marginal discrepancies. One-way ANOVA (α = 0.05) was used. The vertical occlusal discrepancy ranged from 2 to 38 μm. The mean vertical discrepancy values were (µm): self-adhesive resin = 12.93 ± 4.74, resin-modified glass ionomer = 19.05 ± 4.60 and adhesive resin = 13.69 ± 5.17. There were significant differences between resin-modified and self-adhesive cement groups (p = 0.004), and between resin-modified and adhesive resin cement groups (p = 0.013). Distal marginal ridge measurements were significantly different between resin-modified glass ionomer cement and self-adhesive resin cement group (p &lt; 0.001) and the adhesive resin cement group (p = 0.021). There were no significant differences between the discrepancy values at the two measurement points in the self-adhesive cement group (p = 0.377), nor the resin-modified glass ionomer group (p = 0.388), or the adhesive resin cement group (p = 0.905). The cementation procedure with various resin cements results in occlusal vertical discrepancies within standard clinical acceptability. Resin-modified glass ionomer cement produced more vertical discrepancy than adhesive and self-adhesive resin cements did.

Hypothetical Model of How a Clinical Remount Procedure Benefits Patients with Existing Dentures: A Narrative Literature Review.

The clinical remount procedure, which involves remounting the dentures on an articulator with interocclusal records, can effectively reduce occlusal discrepancies. This procedure can be applied not only to new dentures but also to those already in service; however, research in this field is still scarce. This narrative review aims to establish a hypothetical mechanism and possible indications and contraindications for this technique as a basis for further research. Current studies have revealed a high prevalence of malocclusion in delivered dentures. Performing a clinical remount on these existing dentures would enhance the oral function of the denture wearer and would enable effective and accurate correction of the accumulated errors in the jaw relationship in a stable working environment. This technique should be performed if a patient has poor masticatory function or occlusion-related complaints. However, performing a clinical remount on dentures with an excessive anterior–posterior discrepancy between the centric relation and the maximal intercuspal position or on dentures with extremely low occlusal vertical dimension, is considered less effective. The clinical remount procedure remains an essential skill both for fabricating quality dentures and maintaining those already in service.

Comparison of Outcome of Conventional Miniplates Versus 3-D Miniplates for Reduction of Mandibular Fractures

Background: Mandibular fracture, also known as fracture of the jaw, is a sudden discontinuity through the mandibular bone. In the treatment of un-favorable mandibular angle fractures, 3D plating system was analogous to double miniplates Osteosynthesis. Over the last century, the indicators for closed vs. open reduction have shifted considerably. Objective: To compare the outcome of conventional miniplates versus 3-D miniplates for reduction of mandibular fractures Material &amp; Methods Study Design: It was randomized control trial Setting: Department of Oral &amp; Maxillofacial Surgery, Mayo Hospital, Lahore Duration: 6 months i.e. from 24-04-2017 to 24-10-2017 Data collection: 70 mandibular fracture patients were enrolled. The patients were split into two groups. Group A is treated with 3D plates technique and group B treated with conventional mini plate technique. After surgery patients were evaluated for plate failure or and at 1 month for occlusal discrepancy. All the data was entered and put in SPSS version 21. Results: In this study the mean age of the group A patients was 29.29±1.802 years whereas the mean value of age in group B patients was 35.69±11.65 years, male/female ratio of the patients was 1.05:1. Plate was successfully inserted in 100% patients by 3D mini-plate technique. The occlusal discrepancy was noted in 8(11.43%) patients (p-value=0.005). Conclusion: 3-D mini-plates for reduction of mandibular fractures is significantly more efficacious than to conventional mini-plates method Keywords: 3-D mini-plates, Conventional, Mandibular Fractures,

A cyst-like erosion in the mandibular condyle associated with malocclusion and its healing process in an 8-year-old patient: A case report

The etiology of temporomandibular joint disorders (TMDs) is multifactorial. Occlusal discrepancy is one of the predisposing factors for TMD development. This case report describes the healing process of a cyst-like erosion in the superior aspect of the condyle with pain attributable to occlusal discrepancy. The patient was an 8-year-old boy who presented with a posterior crossbite and pain in his right temporomandibular joint. Pretreatment cone-beam computed tomography revealed a cyst-like erosion in the superior aspect of the right condyle. Splint therapy was performed to determine whether there was a relationship between the posterior crossbite and joint pain using a mandibular stabilization splint. During splint therapy, the pain was relieved, and an occlusal interference appeared on the maxillary left lateral incisor, which was responsible for the lateral shift of the mandible and posterior crossbite. The cone-beam computed tomography images acquired over 2 years showed repair of the affected condyle. As shown in this patient, stabilizing the condylar position is one of the methods to determine the relationship between TMD and occlusion.

Partial Bone Necrosis Following Sagittal Split Ramus Osteotomy: Report of a Complicated Orthognathic Jaw Surgery

Study Design Case Report. Objective To present a case of a previous complicated mandibular orthognathic surgery that aimed to setback the mandible in a female cleft lip and palate (CLP) patient, which led to bone necrosis on one side with subsequent severe mandibular deviation and facial asymmetry. We additionally reviewed the previous reports of similar complications, the pathophysiology and the factors that could lead to this dreadful result. Method A 27-year-old female patient presented with a severe dentofacial deformity secondary to a complicated bilateral sagittal split ramus osteotomy performed five years earlier, which resulted in aseptic bone necrosis on the right side. The patient had marked mandibular deviation, chin and midface retrusion and a pronounced occlusal discrepancy. Imaging demonstrated a bony defect at the right mandibular angle with a superiorly displaced proximal segment. Deviation of the mandible was corrected first by performing vertical ramus subsigmoid osteotomy (RSO) on the left side. The right bone defect was then reconstructed with a reconstruction plate and bone grafting. Maxillary and chin advancement was performed at a second stage. Results On follow-up, the patient shows a significant improvement in facial esthetics and mandibular symmetry and is currently under orthodontic management to enhance the occlusal relationship. Conclusion Bone necrosis is a rare but dreaded problem in orthognathic surgery. Minimizing the musculo-periosteal dissection and competent execution of the bone osteotomy is substantially effective in reducing the risk of bone ischemia and necrosis.

Evaluation of postoperative complications following management of mandibular fractures with open reduction &amp; internal fixation under regional anaesthesia

Aim: To assess the rate of postoperative complications and its association with respect to aetiology, gender, age, time lapse between injury and commencement of treatment, history of substance abuse, number and location of the fractures in mandibular fracture patients treated with open reduction and internal fixation (ORIF) under regional anaesthesia. Materials and method: All patients fulfilling the selection criteria with mandible fracture reporting to our institution, from March 2017 to August 2021, were included in the study and were divided into three groups based on anatomic site involved. Patient’s records were analysed for deriving complications that occurred during the postoperative period of ORIF andassociation with different variables. The values were subjected to Chi-square tests. Results: Out of 160 study population, patients with combined Para symphysis involving angle (Group C) were reported with the highest number of complications such as minor occlusal discrepancies (20.4%), surgical site infection (4.1%), wound dehiscence and paraesthesia (4.1%) as compared to fractures involving symphysis &amp; para symphysis region (Group A and Group B respectively). Conclusion: The most common postoperative complication in this study was surgical site infection which can be managed effectively with local wound care, antibiotics and can be prevented with aseptic technique.