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Gadre P.K.,Sharad Pawar Dental College and Hospital | Ramanojam S.,Bharati Vidyapeeth Deemed University | Patankar A.,Bharati Vidyapeeth Deemed University | Gadre K.S.,Bharati Vidyapeeth Deemed University
Journal of Craniofacial Surgery | Year: 2011

This retrospective study analyzes the long-term results and complications of mandibular reconstruction with nonvascularized bone grafts (NVBGs) and suggests refinements. A total of 166 patients underwent mandibular ablation and primary reconstruction between June 1990 and August 2009, of which 101 were NVBGs, 27 were vascularized bone grafts, and 38 were with functional plate reconstruction. Eighty-seven of 101 patients undergoing NVBG, having all records and followed up for a minimum of 12 months, were included in this study. The analysis criteria included site of defect, surgical approach, method of graft fixation, bony continuity and stability, presence or absence of infection, aesthetic and functional prosthetic rehabilitation, donor-site morbidity, and clinical and radiological changes in the reconstructed area.The overall success with NVBGs in our study was 77 (88.5%) of 87. We used ilium in 68 cases (78.16%), fibula in 16 cases (18.39%), and rib in 3 cases (3.44%). Ten cases (11.5%) showed complete failure due to infection (7 cases) and resorption (3 cases).Nonvascularized bone grafts could be used judiciously for reconstruction of selective mandibular resection defects where there is not much of soft tissue loss, or where 2-layer watertight closure can be achieved intraorally and extraorally. Where only a single-layer intraoral closure is anticipated, either additional soft tissue should be brought submucosally or there should not be extraoral-intraoral communication even during surgery. Also precise patient selection, surgical planning, and execution with meticulous nursing care are keys to success. Copyright © 2011 by Mutaz B. Habal, MD.

Gondivkar S.M.,Mgvs Kbh Dental College And Hospital | Gadbail A.R.,Sharad Pawar Dental College and Hospital | Chole R.,Peoples Dental Academy | Parikh R.V.,Parikh Hospital
Oral Oncology | Year: 2011

The adenoid cystic carcinoma is a relatively rare epithelial tumor of the major and minor salivary glands, accounting for about 1% of all malignant tumor of the oral and maxillofacial region. Although it presents a widespread age distribution, peak incidence occurs predominantly among women, between the 5th and 6th decades of life. The clinical and pathological findings typical of this tumor include slow growth, perineural invasion, potential local recurrence and distant metastasis. Histopathologically it is composed of basaloid cells with primarily myoepithelial/basal cell differentiation. It presents three patterns, cribriform, tubular and solid; the solid type is related to a poor prognosis contrary to the cribriform type, which has a better prognosis. Surgical excision with wide margins is the treatment of choice, if it metastasizes to lymph nodules, post surgical radiotherapy is recommended. We presented herein the case of a 45 year old female patient who presented a palatal lesion, which was treated with surgery and radiotherapy as an additional treatment. We also described a brief literature review of adenoid cystic carcinoma. © 2011 Elsevier Ltd. All rights reserved.

Daigavane P.S.,Sharad Pawar Dental College and Hospital
Journal of the Indian Society of Pedodontics and Preventive Dentistry | Year: 2011

Management of bilateral cleft lip and palate cases is a challenging task, and if the premaxilla is shifted to either side, it poses a problem for the surgeon to operate and also for the orthodontist to do the orthodontic alignment. The aim of this study was to reposition the shifted premaxilla for better retraction with presurgical infant orthopedics, thus reducing the tissue tension and further scarring which have detrimental effects on maxillary growth. The innovative technique with pre-directional (PD) appliance is easy to fabricate and use and works in this direction. Acrylic, springs, permasoft liner, elastics, retentive tapes. Previous approach for the shifted premaxilla was more focused on the surgical correction. In adults, surgery with osteotomy is the only option, with its own limitations and disadvantages, in repositioning the shifted premaxilla. Thus, PD appliance aids to correct the shifted premaxilla in presurgical molding stage. The premaxilla was thus shifted 5.5 mm to the left side, with premaxilla in facial symmetry, with the PD appliance. Presurgical orthopedics with PD appliance is worth in infants with shifted premaxilla in bilateral clefts cases.

Gondivkar S.M.,Mgvs Kbh Dental College And Hospital | Gadbail A.R.,Sharad Pawar Dental College and Hospital | Chole R.,Peoples Dental Academy | Parikh R.V.,New Radhika Housing Society
Oral Oncology | Year: 2011

Ossifying fibromas are uncommon benign tumors of the craniofacial skeleton thought to originate from the periodontal ligament. Most are small and incidentally diagnosed with routine dental radiographs. With larger lesions, patients may complain of an abnormal bite or an enlarging mass. This tumor involves slow-evolving growth with deforming swelling generally arising in the mandible, with possible early tooth displacement. From the radiological perspective, more than 50% of the lesions exhibit an expansion of the jaws and 53% shows well-defined unilocular radiolucencies and 40% are mixed radiolucent-radiopaque lesions. The lesions exceptionally can be radiopaque. Ossifying fibroma presents several variant histopathological subtypes. The overlapping clinical and histopathological features of these subtypes have led to diagnostic dilemma and confusion. Complete excision of this tumor has become a necessity since it is notorious for recurrence. We present here two cases of ossifying fibroma of the jaws along with insight into the literature review. © 2010 Elsevier Ltd. All rights reserved.

Gondivkar S.M.,K M Shah Dental College and Hospital | Gadbail A.R.,Sharad Pawar Dental College and Hospital
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology | Year: 2010

Gorham-Stout syndrome is a very rare bone condition of unknown etiology. It is characterized by the spontaneous onset of bone resorption. Bones that previously appeared normal begin to resorb, partially or completely. Sometimes only a thin shell of cortical bone remains, and there is usually a little replacement by fibrous tissue. This process can continue for years but may stop spontaneously. Bone loss can occur in one bone or spread to soft tissue and adjacent bones. Although the disease may strike any of the bones of the body, it is more often recognized earlier when the calvarium and/or the mandible are involved. Because of its rarity, the disorder often goes unrecognized, and lack of agreement on how best to treat Gorham-Stout syndrome can delay the provision of treatment. We report the case of a 58-year-old man whose left body and ramus of mandible had disappeared as a result of massive osteolysis. Crown Copyright © 2010.

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