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Background: Wound healing consists of sequential overlapping events, namely, hemostasis, inflammation, proliferation and remodelling. Disruption of one or more of these events results in impaired healing of the wound which causes functional, esthetic and emotional burdens in the future. Hemocoagulase is an enzyme derived from snake venom which is widely used for its hemostatic properties. In recent times, it has shown to enhance wound healing and reduce scar formations. The objective of this systematic review is to compare the effectiveness of topical hemocoagulase and placebo/control in postoperative wound healing following dentoalveolar extraction. Methodology: A systematic review was carried out to explore the use of hemocoagulase in wound healing of dental extraction sockets. The Databases of PubMed, Cochrane and Google scholar were searched for the related topics along with a complimentary manual search of all oral surgery journals till December 2020. Results: A total of eleven studies were revealed on data search. After application of inclusion and exclusion criteria based on the filtering process, two clinical trials were included for final appraisal. Of the two clinical trials, one compared topical hemocoagulase with placebo and one clinical trial compared topical hemocoagulase with control. Both trials included patients undergoing bilateral dental extraction.

Introduction: Temporomandibular joint disorder (TMD) is a musculoskeletal disorder characterized by pain, limited mouth opening, joint sounds, mandibular deviation, and chewing disability. Premature contacts may lead to TMD. Role of dental occlusion as an etiological factor for TMD is still controversial. Aim of this study is to analyze the relationship between occlusion time and clinical symptoms of TMD using digital occlusion scan and analysis systems. Methodology: This observational study included patients of any gender, between 18-35yrs of age with TMD but otherwise healthy. Patients with periodontal disease, systemic inflammatory conditions, bruxism and tooth wear, patients undergoing treatment for TMD, orthognathic surgery and orthodontic therapy were excluded from the study. Occlusion and disocclusion time were the parameters assessed. The total sample size of this study was 30. Result: There is significant difference between study and test groups in occlusion and disocclusion time during centric occlusion, disocclusion time in protrusion, right and left lateral excursion. Conclusion: Occlusal interferences may affect the TMJ and can cause TMD.

Third molar removal is the most frequently done procedure. Pain, swelling, trismus, alveolar osteitis are the most common postoperative complications. Few authors have used certain drugs like corticosteroids and proteolytic enzymes in order to reduce the postoperative complications.The aim of this systematic review is to evaluate in an evidence based way, the effectiveness of oral proteolytic enzymes and corticosteroids in controlling postoperative complications following mandibular third molar surgery. The objective of this systematic review is to compare the effectiveness of oral proteolytic enzymes and corticosteroids in preventing postoperative sequelae following mandibular third molar surgery. The Databases of PubMed, Cochrane and Google scholar were searched for the related topics along with a complimentary manual search of all oral surgery journals till December 2020. Four articles were selected based on the inclusion criteria. One among the four clinical trials comparing oral proteolytic enzymes and corticosteroids, they show significant differences proving post-operative swelling and trismus are less in patients receiving oral proteolytic enzymes compared to corticosteroids. In the other three trials patients receiving corticosteroids showed decreased post-operative swelling compared to oral proteolytic enzymes.

Background: The surgical removal of impacted mandibular third molars is one of the most performed Dento-alveolar procedures, associated with varying degrees of postoperative discomfort. Pharmacologic strategies for minimizing the clinical manifestations of surgical injury are therefore, logically directed at blocking the formation or inhibiting the effects of mediators of acute inflammation. NSAIDs are being used very extensively all over the world but their chronic use may lead to side effects such as gastric ulcers and liver kidney damage. Considering these facts, the use of drugs of natural origin with lesser hazards is a positive alternative. Bromelain, Rutoside and Trypsin are known to have a very promising role in relieving inflammation and promote wound healing. Materials and Methods:The study was conducted on 60 patients of either sex between the age group of 18-40 years who required surgical removal of mandibular impacted 3rd molars. Group 1:- comprising 15 patients received the drug combination of bromelain 90mg, trypsin 48mg, rutoside 100mg(Phlogam)for three times a day for three days. Group 2:- comprising 15 patients received diclofenac 50 mg and serratiopeptidase 10 mg(Lyser -D) for three times a day for three days. Measurement of facial swelling, was made pre operatively and on the first, third and seventh postoperative day. Pain was evaluated from the patient's response to visual analogue scale (VAS). Results: Group 2 with Diclofenac and serratiopeptidase (Lyser-D) showed a significant reduction in pain score when compared with Group 1 (Phlogam)at all time intervals. Significant difference was seen in reduction of facial swelling in Group 1 (Phlogam) when compared to Group 2(Lyser -D). Conclusion: Bromelain and other proteolytic enzymes can be considered as an effective alternative to NSAIDs in reducing the postoperative sequelae associated with surgical extraction of third molars and causing less health hazards. Diclofenac offers superior analgesia when compared to Bromelain.

Schwannomas are benign nerve tumors of schwann cell origin. Schwann cells are derived from neural crest and are therefore of neuroectodermal origin. 25-40% of all schwannomas arise in the head and neck region. The most common schwannomas are vagal schwannomas and cervical schwannomas in the head and neck region. Here we present two cases of head and neck schwannomas which were not identified as originating from any major nerve. The first patient had a schwannoma in the infratemporal region which was excised by performing transzygomatic approach, and the second patient had a schwannoma in the left lateral part of the neck which was excised using a cervical crease incision.

Background: Dental anxiety and fear of needle injection is one among the foremost common problems encountered by dental practitioners. This might affect the patient's quality of life. Several methods are suggested to lower the discomfort of local anaesthesia injection during dental procedures. Numbness of injection site is one among the recommended strategies. Materials and Methods: During this Split Mouth design study, a complete of 60 healthy patients between the age of 18 and above were selected and were randomly divided into two equal groups. Sixty participants (120 sites) undergoing prophylactic orthodontic extraction received a five second application of a refrigerant (tetrafluoroethene, sixty sites) and a two minute application of a local anaesthetic (2% percent lidocaine, sixty sites) before an injection of an area anaesthetic solution was administered with a 30 gauge needle. Participants rated the pain they experienced after each injection by employing a 100-millimetre visual analogue scale (VAS). The pain was calculated by measuring the space in millimetres from the no pain end of the scale (VAS scale). Results: The means of visual analogue scales (VAS) for the study and control groups were 42.20 ± 12.70 and 58.40 ± 16.83, respectively; With statistically significant differences between the 2 groups (P < 0.05). Conclusion: The utilization of a precooled refrigerant was simpler compared with lidocaine local anaesthetic in reducing the pain experienced by participants who received inferior alveolar nerve blocks.

Aim: The aim of this study is to explore the prognostic significance and clinicopathological correlations of the Wnt pathway genes in a cohort of surgically treated patients with oral squamous cell carcinoma (OSCC) patients. Settings and Design: A prospective genetic study on patients with OSCC was carried out during the period from July 2014 to January 2016. Informed consent from patients and institutional ethical approval for the study was obtained and the guidelines were strictly followed for collection of samples. Subjects and Methods: Clinical data and mRNA expression analysis of ten genes in the canonical Wnt pathway were evaluated and their relationships with clinical and demographic variables were studied in 58 tissue samples. Wnt-3a, β-catenin, secreted frizzled-related proteins sFRP-1, sFRP-2, sFRP-4, sFRP-5, Wnt inhibitory factor 1, dickkopf-1, c-MYC, and cyclin-D1 from cancer (n = 29) and normal (n = 29) tissue samples were investigated using quantitative reverse transcription-polymerase chain reaction. Statistical Analysis: Descriptive statistics were used to summarize the sample characteristics and clinical variables. If the data were normal, then parametric tests were used; otherwise, nonparametric alternatives were used. All the analyses were carried out using SPSS version 23.0 (IBM SPSS Inc., USA). Results: Expression of sFRP-1, sFRP-2, and sFRP-5 in control samples and expression of c-MYC and cyclin D1 in cancer samples showed statistical significance. Significant expression of Wnt3A was observed among patients who had recurrence and were deceased. Conclusion: Wnt3A, β-catenin, and cyclin D1 are recognized as key components of Wnt/β-catenin signaling. However, in this study, there was no significant expression of all the three genes in OSCC. The proto-oncogene c-MYC showed statistically significant upregulation in cancer tissue samples suggesting that the OSCC among South Indian population is primarily not mediated by the canonical Wnt signaling pathway.

The aim of this retrospective study was to identify the significant risk factors that contribute towards postoperative infection in patients recovering from orthognathic surgery. Retrospective records of 522 patients who underwent orthognathic surgery over 9 year period were evaluated for postoperative infection within 3 months of surgery and after 3 months of surgery. The variables of interest included age, gender, habits like smoking and alcohol consumption and incidence of postoperative infection. The overall infection rate was 4.60%. Patients who underwent bilateral sagittal split osteotomy to advance the mandible had an infection rate of 10.4%. Statistically significant predictor variables (P

BACKGROUND: Orthognathic surgery involves movement of jaws in all three planes, and this being a part of airway complex, displacement of jaws can influence the dimension of airway at all levels. Lefort one osteotomy surgery with superior repositioning is a common procedure done for patients with vertical maxillary excess PURPOSE: The purpose of this study was to evaluate the three-dimensional volumetric changes in airway after lefort one impaction surgery using three-dimensional cone beam computed tomography (3D-CBCT) in patients with vertical maxillary excess (VME). METHODS: A prospective analysis of 15 patients who underwent isolated lefort one impaction surgery was done with pre-operative (T0) and 3-months (T1) post-operative 3D-CBCT scans. Airway was divided into three segments, nasopharyngeal, velopharyngeal and oropharyngeal. Volumetric analysis of all these segments was done before and after surgery. Paired ‘t test’ was used to assess the mean difference in airway volume and area between T0 and T1. One-way ANOVA was used to check the mean percentage difference in airway volume and area among the three segments. RESULTS: The mean percentage of nasopharyngeal volume difference was − 0.6299 ± 0.9146%, velopharyngeal volume difference was − 0.5205 ± 1.107%, oropharyngeal volume difference was − 1.492 ± 2.745%. Though volume and area of pharyngeal airway were decreased after maxillary impaction surgery in all three segments of airway studied, they were not statistically significant. CONCLUSION: Among the three segments of airway studied, oropharyngeal airway volume has shown the highest post-surgical reduction though statistically insignificant. ESS scores were within normal limits. Hence, we are of the opinion that there is lack of evidence to conclude that the patients undergoing lefort one superior repositioning for the treatment of VME might develop significant narrowing of PAS that may predispose the patient to breathing disorders.

Aim of this study was to evaluate the split skin graft held in place with a polyethylene stent for the treatment of oral submucous fibrosis.Fifteen prospective patients diagnosed clinically with oral submucous fibrosis, from June 2011 to 12 December 2012, were recruited for this study. All patients were treated surgically using the same surgical technique of fibrotomy followed by split skin graft along with a polyethylene stent. Preoperative and postoperative mouth opening measurements at 1 week and after a minimum of 6 months were evaluated by measuring the inter incisal distance.Mean follow up was 9.8 months with a minimum of 6 months. Mean preoperative mouth opening was 12.9 mm (6-20 mm). Intraoperatively mean mouth opening was 37.9 mm (36-41 mm). After 1 week mean mouth opening was 35.8 mm (31-40 mm). At 6 months follow up, mean mouth opening was 33 mm (20-40 mm).Fibrotomy followed by split skin graft along with a polyethylene sheet stent and sufficient postoperative physiotherapy is a simple, cost effective and viable treatment modality for oral submucous fibrosis.

Introduction: Hyaluronic acidis known as Sodium hyaluronate or hyaluronan is an essential component of the synovial fluid. It enables the fluid to act as a lubricant, a shock absorber and a filter controlling the movement of cells and large molecules within the joint.The present study presents a case series on the efficacy of hyaluronic acid injections for the treatment of temporomandibular joint pain by providing patient evaluations. Study Design: Thirty-one temporomandibular joints in 23 patients were evaluated in this study. Six males and 17 females aged 18 to 55 years with chief complaints of limited mouth opening, TMJ pain, and clicking sounds in the TMJ. The TMJ was examined clinically and radiographically. Patients were randomly divided into two groups, were one group received only arthrocentesis and the other group received arthrocentesis plus hyaluronic acid. Both the groups contained patients with disc displacement with reduction with closed lock. Results: Descriptive analysis showed improvements which were maintained over time for all the study parameters. Permutation tests evidenced the significance of changes which occurred in many clinical parameters over three months. Differences with baseline levels remained significant at the end of the follow-up period, particularly for the jaw movements, masticatory efficiency, clicking and pain at mastication parameters. Conclusion: Data from the clinical study support findings from studies on other joints, which prove the efficacy of hyaluronic acid after arthrocentesis to reduce symptoms of osteoarthritis and to maintain improvements over time.

Introduction: Correction of Dentofacial deformity or Orthognathic surgery can be described and classified, where the treatment goal is to reposition the maxilla, mandible, or chin for patients who have crossed the age for growth modification and for other dentofacial conditions or orthodontic camouflage. The treatment is projected more from the aesthetic point of view, where patients undergo a dramatic change in the skeletal morphology. However, it is important to consider from the aesthetic and functional point of view for the overall well -being of the patient. Hence, Orthognathic surgery in combination with orthodontic treatment, not only corrects the dentofacial deformity, it also improves occlusal contacts, masticatory efficiency, the electromyographic (EMG) activity of the masticatory muscles and the bite force for the patient. Various studies have identified the problems and changes in occlusal discrepancy following orthognathic surgery. Objective: To compare the bite force and masticatory efficacy before and after orthognathic surgical correction. Selection criteria: All studies and articles that evaluated bite force and masticatory efficiency before and after orthognathic surgical correction were selected for review. Data Collection: The parameters compared in both the groups included, the surgical time was taken, postoperative occlusion, IMF stability, oral -hygiene, intra and postoperative complications. Results: Orthognathic surgery can improve the functional deficits, including those of the bite force, but the improvement may not continue beyond the first year of surgery. Conclusion: An objective analysis of the masticatory efficiency is important in evaluating the success of orthognathic treatment of the jaw deformities.

Aim: The aim of this study was to assess under graduates and post graduates knowledge about post-exposure prophylaxis for Hepatitis B virus and to compare the results obtained from both the groups. Material and Methods: A cross-sectional study was conducted in December 2015 using a self-structured questionnaire to collect information from Saveetha Dental College and Hospital, Chennai. Results: Knowledge, attitude and practice of post graduates is more followed by interns, final years and third years. Conclusion: Based on the results of this survey, authors concluded that there is lack of knowledge about HBV post-exposure prophylaxis among undergraduates and post graduates. Participation in such workshops must be made mandatory for all dental health care providers.[4]

Background: Pain control through the truncal block of the inferior alveolar nerve is one of the locoregional anesthetic techniques most widely used in oral surgery, affording comfort and safety for both the patient and operator when used correctly. Aim: To compare the anesthetic efficacy of both 4% articaine and 2% lignocaine with epinephrine in the truncal block of the inferior alveolar nerve during surgical removal of the impacted mandibular third molars. Materials and Methods: A randomized, double-blind, clinical trial was conducted of 360 patients programmed for the surgical extraction of symmetrical lower third molars in the context of the Master of Oral Surgery and Implantology (Saveetha Dental College, Saveetha University, Chennai, India). Following the obtainment of informed consent, two operators performedsurgery on an extemporaneous basis, using as local anesthetic 4% articaine or 2% lignocaine, with the same concentration of a vasoconstrictor (epinephrine 1:100,000). The study variables for each anesthetic were: Latency (time to action) and duration of anesthetic effect, the need of reanesthetizing the surgical zone, and intraoperative pain intensity measured objectively using the Visual Analog Scale (VAS) and Faces Pain Scale (FPS). Data were analyzed using the Independent t -test and Chi-square test. Results: A statistically significant difference ( P P Conclusion: We conclude that 4% articaine has better anesthetic efficacy as compared to 2% lignocaine. This can be explained based on its different chemical structure, liposolubility, increased protein-binding ability, diffusion in soft tissue, and increased pulpal anesthesia.