Abstract Introduction: The rehabilitation of localised vertical ridge deficiency in posterior jaws often requires short implants to avoid invasive grafting. However, the influence of implant dimensions on the transition from primary to secondary stability remains a subject of investigation. This study aimed to evaluate and compare the effect of short-wide implants (5.0 mm diameter and 8.0 mm length) versus standard-length implants (4.2 mm diameter and 10.0 mm length) on primary and secondary stability at various time intervals using resonance frequency analysis (RFA). Materials and Methods: Twenty-two implants were placed in healed molar sites (Test group: Short-Wide Implants; Control group: Standard-length Implants). Stability was measured using the Implant Stability Quotient (ISQ) via RFA (Osstell) at placement, 3 weeks, 3 months and 9 months. Data were analysed using Student’s t -test and Repeated Measures analysis of variance ( P < 0.05). Results: In the test group, the mean ISQ increased progressively from 60.10 ± 18.41 (baseline) to 80.70 ± 2.63 (9 months). In contrast, the control group exhibited a significant stability dip at 3 weeks (49.56 ± 12.18) compared to its baseline (56.00 ± 18.12), followed by an increase to 75.89 ± 9.29 at 9 months. The test group showed significantly higher stability than the control at 3 weeks ( P = 0.001) and 9 months ( P = 0.043). Conclusion: Short-wide implants appeared to exhibit a more favourable stability pattern during the observation period; however, larger studies are required to confirm these findings.
Abstract Introduction: Faciomaxillary trauma represents a major surgical workload in tertiary referral centres and poses significant airway challenges due to fracture complexity, oedema, haemorrhage and trismus. Long-term data integrating epidemiology, operative workload and airway strategies remain limited. Materials and Methods: A retrospective audit of operative faciomaxillary trauma cases managed over 19 years was conducted. Demographic variables, fracture patterns, operative procedures, airway techniques and operative workload distribution were analysed. A risk-stratified airway management algorithm was derived. Results: A total of 1266 operative trauma cases were included. Mandibular fractures constituted the largest subgroup, followed by zygomaticomaxillary complex and midface fractures. Nasotracheal intubation was the most frequently employed airway technique, while submental intubation was selectively utilised for complex injuries. The proposed algorithm stratified patients into low-, moderate- and high-risk airway categories. Discussion: This long-term audit highlights evolving trauma patterns, operative burden and airway management strategies. The proposed airway-risk algorithm offers a practical approach for airway planning in resource-variable tertiary-care settings.
Abstract Introduction: Pain, being an unpleasant emotional experience, has been the focus of all treatments since time immemorial. The administration of palatal anaesthesia is rated as one of the most painful injections in dentistry. The aim of the present study was to validate whether 4% articaine hydrochloride (HCl) administered unaided as a single buccal infiltration in maxillary therapeutic extraction provided commendatory anaesthesia as compared to buccal and palatal injection for the procedure. Materials and Methods: In total, 80 patients for the removal of bilateral permanent maxillary premolars teeth enrolled in the study. About 0.8 mL of 4% articaine HCl was injected into the buccal vestibule of the tooth; tooth extraction was performed in the experimental side. A similar method with the addition of a 0.4 mL palatal injection was performed on the control side. All patients completed a 10-mm Visual Analogue Scale (VAS), 5-point Faces Pain Rating Scale for parameters such as pain during buccal injection, palatal injection, buccal and palatal flap elevation and tooth extraction. Results: The VAS scores for therapeutic extraction of maxillary premolars showed no significant difference between the two groups during extraction ( P > 0.05). Most patients described both procedures as ‘bearable’ and no patient requested an additional palatal injection to ensure comfortable extraction. Conclusion: The routine use of a palatal injection for the therapeutic extraction of maxillary premolar may not be required when Articaine/HCl is used as the local anaesthetic.
Abstract Rationale: To restore oral function and facial aesthetics in a stroke patient with prolonged inability to close the jaws. Patient Concerns: A 50-year-old African female stroke survivor presented with a 9-month history of inability to achieve jaw closure, accompanied by persistent drooling, significant functional impairment and aesthetic concerns. Diagnosis: Chronic bilateral anterior temporomandibular joint (TMJ) dislocation. Treatment: Following failed manual reduction attempts, surgical reduction was performed under general anaesthesia. Bilateral sub-mandibular incisions allowed exposure of the mandibular angles. A clamshell bone reduction forceps with speed-lock was applied and used to deliver controlled traction, repositioning the condyles into the glenoid fossae. Outcomes: At 3 months, normal jaw closure, improved occlusion and restoration of oral competence were achieved, with residual anterior open bite. Take-away Lessons: Use of clamshell bone-holding/reduction forceps with a locking mechanism can be adopted in the reduction of chronic TMJ dislocation.
Abstract Introduction: Impacted maxillary canines (IMCs) are common eruption disturbances associated with incisor root resorption. Panoramic radiography (PR) is routinely used for initial assessment, but its reliability in localising IMCs is limited. Cone beam computed tomography (CBCT) provides accurate three-dimensional localisation. This study aimed to assess the reliability of panoramic sector localisation in evaluating IMCs and associated root resorption using CBCT. Materials and Methods: This retrospective study evaluated imaging records of 92 patients aged ≥13 years with unilateral IMCs. Sector localisation was performed on PR using Lindauer et al .’s criteria, and CBCT was used to assess position and adjacent incisor root resorption. Data were analysed using descriptive statistics, Chi-square test and Cohen’s kappa test ( P < 0.05). Results: Sector III was the most common location (40.2%). A significant association was found between sector localisation on PR and CBCT position ( P < 0.001), with palatal impactions mainly in Sectors III and IV. Root resorption was more frequent in lateral incisors, particularly in Sectors II and III. Inter- and intra-observer reliability analyses demonstrated substantial agreement, with a Cohen’s kappa value of κ =0.78 ( P < 0.001). Conclusion: Panoramic sector analysis showed good reliability with CBCT in predicting canine position. While PR remains a useful screening tool, CBCT offers superior diagnostic accuracy for three-dimensional localisation and detection of early root resorption, thereby aiding in optimal treatment planning.
