Balaji Dental & Craniofacial Hospital

ABSTRACTBackground:Mandibular fractures are among the most frequently encountered maxillofacial injuries, often resulting from road traffic accidents (RTAs), interpersonal violence, and falls. Understanding the patterns, etiology, and demographics of these fractures is crucial for effective prevention and management.Materials and Methods:A retrospective analysis was conducted on 728 patients with mandibular fractures treated at the maxillofacial unit of SIBAR Institute of Dental Sciences from March 2006 to February 2016. Data on demographics, fracture sites, etiology, and contributing factors were collected and analyzed using SPSS.Results:The majority of cases involved males (86.5%), with the highest incidence in the 21-30 years age group (39.7%). RTAs were the leading cause (45.2%), followed by interpersonal violence (25.2%) and falls (13.4%). The parasymphysis was the most common fracture site (41.5%), followed by the angle (33.6%) and condyle (17.1%).Conclusion:Mandibular fractures predominantly affect young males and are largely caused by RTAs. Targeted prevention strategies, stricter traffic laws, and public awareness campaigns are essential to reduce their incidence and associated morbidity.

Abstract Background: Mandibular fractures are among the most common facial skeletal injuries, with patterns influenced by anatomical structure, trauma mechanism, and patient demographics. Accurate preoperative diagnosis is essential for effective management and prevention of complications. Aim: To evaluate the anatomical distribution and percentage of mandibular fractures in patients using preoperative radiographs. Materials and Methods: A retrospective observational study was conducted on 100 patients aged 19–55 years who presented with mandibular fractures at the department of oral and maxillofacial surgery between 2023 and 2025. Preoperative radiographs, including panoramic and posteroanterior views, were reviewed by two independent examiners. Fractures were classified into seven anatomical zones: symphysis, parasymphysis, body, angle, ramus, condyle, and coronoid. Frequency and percentage distributions were calculated, and combined fracture patterns were identified. Results: The mandibular angle was the most commonly fractured site, followed by the parasymphysis and condyle, whereas coronoid and ramus fractures were rare. Combined fractures, particularly angle + parasymphysis, were frequently observed. Patterns correlated with anatomical vulnerability, presence of third molars, and force transmission during trauma. Conclusion: Preoperative radiographs effectively identify mandibular fracture sites and patterns, aiding in accurate diagnosis and surgical planning. Understanding site-specific fracture distribution facilitates management, minimizes complications, and provides insight for preventive strategies. Advanced imaging may further refine classification and improve detection in complex cases.

This book by a team led by Prof. S. R. Prabhu is an impressive and noteworthy contribution to the field of oral diagnostics, particularly oral pathology, delivering an insightful exploration of the pathological processes underlying orofacial disorders. It succeeds in bridging the often wide gap between foundational biomedical science and clinical application, rendering it a critical resource for students, educators, and dental practitioners alike. Structured across nine well-organized sections, written by 57 authors, a mix of global south and north, the book’s strength lies in its comprehensive scope and clarity of presentation. The initial chapters provide a robust grounding in core pathological principles, including cellular pathology and homeostasis. Particularly, noteworthy is the homeostasis—not just as a textbook concept, but as a clinically relevant mechanism integral to understanding disease – for a dental practitioner. The book demystifies complex regulatory systems such as feedback loops, illustrating them through accessible examples like thermoregulation and glucose control, which reinforces the reader’s understanding of how physiological imbalance can influence disease processes. The clinical depth of the book is most evident in its discussion of oral potentially malignant disorders (OPMDs), especially leukoplakia and erythroplakia. These sections go beyond superficial descriptions, offering detailed insights into molecular pathogenesis, histopathological features, and clinical correlations. The inclusion of clinical photographs, histopathology slides, and explanatory diagrams ensures that the content caters to multiple learning styles, enhancing both visual and conceptual comprehension. Importantly, the book equips practitioners with a nuanced understanding of epithelial dysplasia, aiding in diagnosis, risk stratification, and informed management—an essential component of contemporary oral surgical practice. The text also excels in its treatment of developmental pathologies, with particular attention to non-heritable disorders such as cranioectodermal dysplasias. These chapters are remarkably clear in their exposition of complex embryological processes and genetic-environmental interactions. The authors skillfully discuss how disruptions during craniofacial development can result in clinically significant anomalies, a topic of increasing relevance given advancements in prenatal diagnostics and regenerative therapies. What truly distinguishes this work is the seamless integration of basic and clinical sciences. Despite being a multi-authored volume, the editorial oversight is evident in the coherent and uniform narrative voice throughout the text. The editors have ensured that no section feels disjointed, and that readers are consistently guided through a logical progression of topics—from molecular foundations to patient-centred applications. This book is not only conceived as a foundational text for academic learning, but also a practical guide for clinical decision-making. It is poised to become a staple reference for undergraduate and postgraduate dental students, trainee pathologists, and practicing clinicians seeking to sharpen their diagnostic acumen and deepen their understanding of the pathobiological basis of oral and maxillofacial diseases. A truly outstanding academic resource, it delivers both intellectual rigour and clinical relevance, making it a must-have on the bookshelf of anyone invested in the study or practice of oral pathology.

Composites are prone to time-dependent bond degradation. Many measures have been taken to stabilize the bond. This in vitro study aims to evaluate the effect of pretreatment with 1,2,3,4-Butane Tetracarboxylic acid (BTCA) on the micro-tensile bond strength (µTBS) of composite resin to dentine and to compare it with the pretreatment using 2% chlorhexidine (CHX). Permanent molars (40) extracted for periodontal reasons were selected. Dentine surfaces were exposed using a diamond bur, preconditioned with BTCA for the test group (SIGMA-ALDRICH) and with CHX for the control group, followed by the application of self-etch adhesive (GC G-Premio bond) and composite restoration (GC Solare X). Each group was subdivided to be tested as: Group 1A: after 24 hours with BTCA; Group 1B: after 1 month with BTCA; Group 2A: after 24 hours with CHX; Group 2B: after 1 month with CHX. The µTBS was tested using a universal testing machine. The mode of failure was determined using a stereomicroscope and a scanning electron microscope (SEM). BTCA pretreatment was able to preserve the bond slightly better than the control group, though not statistically significant either at 24 hours (P = 0.492) or 1 month (P = 0.181). There was no significant reduction in the µTBS between immediate testing and 1-month storage for both groups (P = 0.213 for acid; P = 0.914 for CHX). The mode of failure was predominantly cohesive for both groups, with fewer adhesive failures. BTCA pre-conditioning is capable of preserving the dentin-composite bond as efficiently as CHX.

The aim was to evaluate the clinical efficacy of intra-nasal vitamin B12 spray compared to oral B12 in the recovery of transient neurosensory disturbances of the lingual nerve post-mandibular third molar surgery. Thirty patients, who experienced paresthesia of the tongue a day after mandibular third molar surgery, participated in this study. They were randomly divided into two groups: Group 1 (intra-nasal vitamin B12 spray) and Group 2 (oral vitamin B12). Clinical neurosensory tests were conducted at various intervals, and the Fisher's exact test was performed for group comparisons based on recovery. Out of the 30 patients (18 females and 12 males) with transient lingual neurosensory disturbances, after third molar extraction, 15 used the intra-nasal vitamin B12 spray, while the other 15 took oral vitamin B12 tablets. Significant recovery was observed in the nasal group compared to the oral group at POD 16 (p = 0.005) and POD 24 (p = 0.003)." Intra-nasal vitamin B12 sprays were found to be conducive adjuvants to treat transient neurosensory disturbances following third molar surgery. Further studies on its routine application post-neurosensory complications are recommended.

Amongst the emerging techniques adapted to oral and maxillofacial surgery is the three-dimensional (3D) bioprinting technology. Very soon, bone grafts harvested from distant anatomical sites, leaving behind scars and compromising donor sites, would be a thing of the past. The dawn of personalised, biocompatible jaw reconstruction is upon us, and the recent explosion of research in this domain hints at a thrilling picture of what’s to come in the near future. Recent studies have demonstrated the potential of 3D bioprinting in creating cartilaginous templates for large bone defect healing. The study by Pitacco et al., revealed that 3D bioprinting could be a viable approach to scale up the engineering of developmentally inspired templates for bone tissue engineering. Their research showed that early hypertrophic templates supported accelerated regeneration in critically sized, load-bearing bone defects. This study demonstrated the remarkable potential of 3D bioprinted cartilaginous templates in regenerating critically sized femoral bone defects in rats. This study, employing human mesenchymal stem cells and fibrin-based bioinks, highlights the feasibility of bioprinting developmentally inspired templates that mimic the natural process of endochondral ossification.[1] Similar successes have been reported in mandibular reconstruction using 3D-printed titanium grid scaffolds, showcasing the efficacy of this technology in promoting osteogenesis within jaw defects. Li et al., fabricated 3D-printing titanium grid scaffolds, which possess sufficient pores and basic biomechanical strength, to facilitate osteogenesis in mandibular segmental defects. Their results demonstrated that these scaffolds could facilitate bone regeneration in large-segment mandibular bone defects.[2] The rapid pace of research in this field is nothing short of exhilarating. With each passing month, discoveries and advancements are unveiled, pushing the boundaries of what was once considered science fiction. The sheer volume of research papers being published speaks volumes about the burgeoning interest and immense potential of 3D bioprinting in jaw reconstruction. This rapid knowledge expansion paves the way for the imminent arrival of the first human case reports, marking a pivotal moment in the history of maxillofacial reconstructive surgery. The ultimate goal of 3D bioprinting – personalised surgical solutions – is no longer a distant dream. Imagine a future where a patient walks into your clinic, their computed tomography scan readily available. Within hours, a custom-designed, bioprinted jawbone scaffold, perfectly mimicking their unique anatomy, may be prepared using their cells (perhaps stem cells). This personalised implant, meticulously crafted layer by layer, promises precise reconstruction, faster healing and minimal donor-site morbidity. Such a scenario, once relegated to the realm of fantasy, is now within the grasp of reality. While we celebrate these advancements, it is crucial to remember that the journey is just beginning. While the outlook is undeniably optimistic, it is crucial to acknowledge that challenges remain. Regulatory hurdles, cost considerations and ethical implications surrounding the use of stem cells must be carefully navigated to ensure safe and equitable access to this technology. The medical community must continue to explore this promising technology, refining techniques and expanding applications to fully harness its potential. Hope the New Year 2024 will usher in such renewed hope and scientific vigour.