Kumar Nilesh

Krishna Institute Of Medical Sciences University | KIMS · Oral and Maxillofacial Surgery

Background Internal derangement (ID) of temporomandibular joint (TMJ) is a common temporomandibular disorder (TMD) which causes hypomobility of the joint. Minimally invasive treatment modality like arthrocentesis is used as first-line of management having low morbidity and high efficacy. This prospective randomized comparative study was carried to...

Introduction: The study is aimed to evaluate the effectiveness of low-level laser therapy (LLLT) in the control of pain, swelling, and trismus after the surgical removal of impacted mandibular third molars. Materials and methods: A prospective study was conducted on thirty patients requiring surgical removal of the impacted mandibular third mola...

Although application of three-dimensional (3D) printing in oral and maxillofacial surgery (OMFS) was first reported almost 30 years back, reduction in its manufacturing cost and availability of affordable 3D printing devices have popularized its use over the past few years. The 3D-printed objects include anatomical models, occlusal splints, drillin...

Schwannomas are rare benign tumors arising from Schwann cells of the nerve sheath. Although the head-and-neck region accounts for a large percentage of extracranial schwannomas, those located within the orbit are infrequent. This paper presents an extremely rare case of orbital schwannoma arising from the terminal branch of abducens nerve in a 37-y...

Background: The photobiomodulation (PBM) therapy has been applied in various fields. Its use in implant dentistry has been proven through various animal, in vitro, and recently also clinical studies. However, the cumulative data of its effect around dental implants in patients is limited. Objectives: The purpose of the present study was to evalu...

Background: Posttraumatic facial scars are not only unaesthetic but also have a negative sociopsychological impact. Surgeons constantly try to achieve the most aesthetic scar by various suturing methods. The tensile forces acting on the edges of the wound during healing are a major factor in determining the final appearance of a scar. Aim: Injec...

The purpose of the research was to compare and assess the efficacy of autologous Platelet-rich fibrin (PRF) as well as gelatin sponges in patients receiving continuous single or dual antiplatelet treatment in preventing hemorrhagic complications after tooth extraction. Methods: In order to achieve haemostasis, one excision site was implanted with A...

Introduction: In India, the most frequent surgical emergency is perforation peritonitis. Despite improvements in surgical methods, antimicrobial therapy, and critical care support, peritonitis treatment remains a very demanding, challenging, and complicated task. The highest dependability on the Risks' assessment is achieved by MPI, enabling the in...

Introduction: Despite extensive research and development, potentially malignant disorders (PMDs) of the oral cavity and oral cancer remain a serious concern. Diet and immunity have been identified as important modifiable factors in such diseases. Materials and methods: A total of 20 patients and 10 healthy individuals, aged 30-60 years, were cho...

Arteriovenous malformations (AVMs) are rare congenital disorders of vascular morphogenesis. These lesions are characterised by high vascular flow with risk of severe bleeding from accidental trauma or surgical manipulation. Although infrequent, potentially life-threatening and fatal oral bleeding has been reported during extraction of tooth associa...

Background. The present study aimed to assess the effect of botulinum toxin type A (BTX-A) for the management of gummy smile and evaluate its stability after administrating BTX-A clinically and using electromyography. Methods. The investigators designed and implemented a prospective clinical study on 10 patients with a gummy smile. Patients with di...

Introduction: Dexmedetomidine is a selective alpha-2 adrenoceptor agonist. It is conventionally used as a sedative in the intensive care unit. However, recently, the application of dexmedetomidine as an adjuvant to a local anesthetic agent has been studied. The present study intends to evaluate the effectiveness of dexmedetomidine as an adjuvant t...

Background Osteomyelitis of the jawbone is mostly secondary to radiation exposure or bone remodelling drugs, with the mandible being commonly involved. Maxillary osteomyelitis risk is low owing to its high vascularity. This study was undertaken to evaluate risk factors, presentation, management and outcomes of maxillary osteomyelitis caused due to...

Dry socket or alveolar osteitis is one of the most common complication following tooth extraction. Patients usually reports of pain, which typically starts on third or fourth postoperative day and responds to simple irrigation and placement of zinc oxide eugenol (ZOE) pack, which provides an obtundent effect. The pack should be loosely kept in the...

Masseter hypertrophy (MH) is an uncommon disorder which can cause both aesthetic and functional problems. The most common aetiological factors associated with MH are habit of chewing gum, clenching and/or bruxism. The treatment of MH includes conservative management as well as surgical resection of the enlarged muscle and/or bone. Injection of botu...

Mucormycosis is an aggressive and deadly fungal infection, which is invariably associated with an immunocompromised patient. Mucormycosis in the head and neck region presents as skeletal necrosis, with or without soft tissue involvement. Early identification and treatment with combination of surgical debridement and parenteral antifungal therapy is...

Ossifying fibroma (OF) is a rare, benign, fibro-osseous lesion of the jawbone characterised by replacement of the normal bone with fibrous tissue. The fibrous tissue shows varying amount of calcified structures resembling bone and/or cementum. The central variant of OF is rare, and shows predilection for mandible among the jawbone. Although it is c...

Aim The purpose of this paper is to describe different acquired conditions necessitating lip reconstruction and present our ten-years’ experience in managing the same at a tertiary care hospital. Materials and methods Data of patients undergoing reconstruction of acquired lip defects from January 2009 to December 2019 were analyzed for demographic...

Oral mucosa exhibit clinical manifestations of a variety of systemic conditions and can serve as an indicator of overall health of an individual. Various systemic conditions like autoimmune, endocrine and haematological disorders can present with oral mucosal lesions, which can serve as an important diagnostic feature. These oral lesions can vary f...

Central giant cell granuloma (CGCG) is an expansile osteolytic lesion of the jawbone. Conventional treatment of CGCG is surgical and vary from simple curettage to more aggressive resection of the jaw. However, surgical management is associated with drawbacks including requirement of hospitalisation and general anaesthesia, damage to vital anatomic...

Sinonasal inverted schneiderian papilloma (ISP) is a rare tumour, which almost exclusively arises from the mucosa lining, the nasal cavity and the paranasal sinuses. The tumour in its early stages presents as an asymptomatic mass, which may be discovered during routine examination. Large lesions usually measure a few millimetres to centimetres in s...

Background. Alveolar bone remodeling after tooth loss results in reduced ridge dimensions in horizontaland vertical planes. To prevent this, various authors have proposed different ridge preservationtechniques. A collagen plug is a novel material that has shown promising results in preserving thealveolar bone. PRP has also yielded favorable outcome...

Osteopetrosis (OP), also known as marble bone disease is an extremely rare inherited skeletal disorder, characterised by abnormal functioning of the osteoclasts that results in incremental bone deposition with lack of normal bone remodelling. This leads to the formation of hard and brittle bone can readily fracture. The compromised quality of marro...

This paper reports a novel, minimally invasive, simple technique for the treatment of a displaced dentoalveolar fracture using a vacuum-formed splint in a 12-year-old pediatric patient. Vacuum formed splints have been reliable treatment options with limited morbidity and discomfort compared to other traditionally used procedures.

Osteomas are bone tumours arising from the cortical or medullary bones of craniofacial skeleton. Involvement of frontal bone and paranasal sinuses is more frequent than jaw bones. Jaw osteomas are slow growing benign lesions, which are usually asymptomatic or present as painless swelling. Those involving mandibular condyle are relatively rare and r...

Background. This study evaluated the viability of platelet-rich plasma for enhancement of osseous and associated soft tissue healing around single-piece implants, subjected to immediate loading and to compare it with a control site not treated with PRP. Methods. Twenty completely edentulous patients were selected and 2 one-piece implants with O-ba...

Background. Surgical removal of mandibular third molars results in pain, swelling and bony defects, causing prolonged postoperative recovery. The growth factors present in platelet-rich plasma (PRP) can accelerate the healing, thereby shortening postoperative recovery period. This study was undertaken to evaluate the role of PRP in postoperative so...

Mucormycosis is a rare, fulminant, rapidly spreading fungal infection, which usually affects patient with underlying immune deficiency. If not managed promptly, the disease is characterized by progressive necrosis and is often fatal. A review of English literature shows that only fourteen cases of mucormycosis have been reported after tooth extract...

Traumatic bone cysts (TBCs) are uncommon intraosseous lesions, classified as pseudocysts because they lack an epithelial membrane lining. The etiology of a pseudo-cyst has not been determined. Various hypotheses have been put forward to explain its pathogenesis, of which the traumatic-hemorrhagic theory is the most commonly accepted. Minor trauma,...

Fibrous dysplasia is a benign bone disease first described by Lichtenstein in 1938. It is characterized by progressive replacement of normal bone with fibro-osseous connective tissue. When the disease involves craniofacial skeleton, it results in significant disfigurement and other functional problems. This paper reports a case of large craniofacia...

Fibrous dysplasia is a benign bone disease first described by Lichtenstein in 1938. It is characterized by progressive replacement of normal bone with fibro-osseous connective tissue. When the disease involves craniofacial skeleton, it results in significant disfigurement and other functional problems. This paper reports a case of large craniofacia...

Background This study was conducted to evaluate the functional outcome and MRI findings of arthrocentsis followed by autologous blood injection (ABI) into the joint space for management of chronic recurrent TMJ dislocation. Material and Methods Total ten patients with bilateral chronic recurrent condylar dislocation were included in the study. Art...

Dental anomalies affecting the teeth are relatively common. Simultaneous occurrence of multiple dental abnormalities in a single tooth is uncommon and relatively rare. One such abnormality routinely encountered in dental clinics is the talon cusp. It is also referred to as dens evaginatus, characterized by the presence of an accessory cusp-like str...

Gorlin-Goltz syndrome (GGS) is a rare autosomal dominant disorder. The disease shows multiple organ involvement with variable clinical presentation. Thus a multidisciplinary approach is required for its prompt clinical diagnosis and management of this condition. This paper highlights a case of GGS presenting in a young male patient with cranial, fa...

Neurofibroma is a rare, benign, neurogenic tumour which may present as multiple lesions as a part of neurofibromatosis syndrome or as a solitary mass. This paper reports a case of large solitary neurofibroma of face in a young female patient. Clinical presentation, imaging characteristics and management of the pathology has been described in detail...

Introduction: Oral cavity is colonised by numerous microorganisms that form a biofilm on the acrylic resin. Hence, routine hygiene is essential to prevent oral mucosal inflammation and lesions. Knowledge of appropriate disinfecting agents for acrylic resins is crucial in this context. Aim: To compare and evaluate the effectiveness of four commercia...

Oral focal mucinosis (OFM) is a rare connective tissue disorder characterized by myxoid degeneration of submucosal connective tissue. It usually presents as gingival or mucosal overgrowth. Due to its uncommon occurrence and lack of pathognomonic clinical or radiological features, diagnosis mainly relies on histopathological evaluation. The paper re...

This review discusses giant cell lesion with main focus on central giant cell granuloma of jaw. Review of the lesion with regard to its nomenclature, pathogenesis and its clinical, radiological & histopathological features is presented. Surgical therapy along with recently reported conservative management protocol is discussed in detail.

Osteomas are benign bone tumors which arise from the cortex or medulla of craniofacial and jaw bones. They are usually asymptomatic or present as slow-growing painless masses. Larger lesions may present with aesthetic (facial asymmetry) and functional disturbances (jaw deviation, difficulty in breathing, pain, and sensory deficits). This paper high...

Usually ear related pain that presents in ENT clinic is pretty straightforward to diagnose and treat. But sometimes specialist see patients that are in pain that feels like it’s in their ear, but it’s actually not. The most essential component of a diagnosis is getting a clear history and doing clinical examination. If all regular tests fail to dia...

Usually ear related pain that presents in ENT clinic is pretty straightforward to diagnose and treat. But sometimes specialist see patients that are in pain that feels like it’s in their ear, but it’s actually not. The most essential component of a diagnosis is getting a clear history and doing clinical examination. If all regular tests fail to dia...

Platelet concentrates (PC), also known as platelet gel or plasma rich in growth factors is supra physiological concentrate of platelet in plasma, derived from autologous blood after its centrifugation. It has dynamic wherein fibrin sealants were used for haemostasis and tissue closure. Subsequently it evolved into platelet rich plasma (1 the genera...

This study was conducted to evaluate and compare the hemodynamic changes associated with intraoral injection of 4% articaine with 1: 100,000 epinephrine and 2% lidocaine with 1:200,000 epinephrine in patients undergoing dental extraction. A prospective observational study was carried out in patients undergoing tooth extraction. Local anesthesia was...

Background: This paper reports a case of large dentigerous cyst of maxilla in a ten year old male child. The cyst involved the entire maxillary sinus and was in close proximity to lateral nasal wall and orbital floor. The lesion caused significant displacement of tooth germs, with the permanent maxillary canine displaced below the orbital floor. Co...

Introduction: Presence of numerous minor salivary gland tissues in the posterior part of hard palate increases the possibility of occurrence of salivary gland neoplasms in this area of oral cavity. Minor salivary gland tumor accounts for about 15% of all the salivary gland neoplasm, of which mucoepidermoid carcinoma accounts to about 35.9%. Case re...

Nasopalatine duct cyst is a non-odontogenic developmental cyst typically located in the maxillary midline between the tooth roots of central incisors. Unlike radicular cyst which is also associated with tooth roots, nasopalatine duct cysts are infrequent and can often be misdiagnosed as periapical lesion or cyst. This paper reports a case of nasopa...

Osteogenesis Imperfecta (OI) is a heterogeneous group of autosomal dominant and recessive inherited disorders of type I collagen metabolism. Clinical features of OI include multiple bone fractures, muscle weakness, joint laxity, skeletal deformities, blue sclerae, hearing loss, and dentinogenesis imperfecta. This report presents a challenging case...

Extracranial schwannomas are rare in the oral cavity, accounting for only 1% of all tumors of this type. This article presents a case study of a schwannoma arising from the mylohyoid nerve that presented as a large nodular swelling in the floor of the mouth extending into the submandibular space.

Introduction: Keratocystic Odontogenic tumor (KCOT) is a odontogenic neoplasm of jaw which has high recurrence potential. Case Report: This paper reports a case of KCOT in left hemimandible with buccal and lingual cortical perforations. The case was treated by segmental resection with disarticulation and reconstructed with avascular fibula graft. P...

Solitary central osteomas of jaw are extremely rare lesions with only few previously documented cases. This paper reports a case of large solitary central osteoma involving mandible symphysis- parasymphysis region in an elderly female patient. A brief review of similar cases reported in the literature is also provided in this paper. Key words:Oste...

Introduction: Oral squamous cell carcinoma (SCC) is a malignant neoplasm, originating from the oral epithelium. Incidence and mortality rates for oral SCC may vary depending on personal habits, socioeconomic characteristics, environmental factors and quality of health care facilitates available in the geographical location. Case Report: This paper...

Preservation of tooth/roots for proprioception is widely known and accepted by the dental profession. Overdentures especially in mandibular ridge plays a crucial role in enhanced retention, thus satisfying the patient. Magnets have been widely used for this purpose, but the tedious laboratory techniques limit its use. Recently, developed magnetic s...

Cementoblastoma is a rare neoplasm, representing <1% of all odontogenic tumors. It usually occurs in the posterior mandible and is associated with roots of a mandibular first molar or second premolar. This paper presents a rare case of cementoblastoma in the maxillary posterior region involving the maxillary sinus, in a young female patient. The cl...

Ranula is a salivary gland cyst which typically present as localized superficial swelling over the floor of mouth. Complex or plunging ranulas develop when the mucus extravasation extends through or around the mylohyoid muscle, deeper into the neck, and present with neck lump along with or without swelling over floor of mouth. We report a case of l...

Principle of every onco-surgery is to attain tumor free specimen margins. Development of high resolution imaging and navigational systems based on high-resolution computed tomography or magnetic resonance imaging with microscope-based navigation, allows excellent evaluation of surgical margins intra-operatively. However these systems are very expen...

Lateral wall of orbit is formed by orbital process of zygomatic bone anteriorly and the greater wing of the sphenoid posteriorly. It is strongest among other orbital walls and is protected by thick lateral orbital rim. Fracture of the lateral orbital wall is uncommon, and is seen in cases of severe facial trauma, when forceful impact is directed ov...

Mucormycosis is a rare opportunistic fungal infection that commonly affects patients who are immuno-compromised. It invariably presents as an acute spreading infection, with very poor prognosis if not treated promptly. We report a case of mucormycosis in immuno-competent elderly patient, presenting as oro-antral communication. Patient’s history, cl...

Congenital absence of one or more salivary gland(s) is a rare disorder. Such patient may present first to a dental surgeon with oral complaints of xerostomia, burning sensation, difficulty in eating and extensive dental dimeneralization resulting in rampant caries. This paper reports a case of non-syndromic non-familial congenital bilateral submand...

Extra-cranial schwannomas although common in head and neck region are very rarely seen originating from the infra-orbital nerve. We report a case of schwannoma arising from infra-orbital nerve in a 40-year-old male patient. The case presented as an isolated, asymptomatic, slow growing sub-cutaneous nodular swelling over left side of mid-face. On ul...

A mucocele is a common pathological lesion involving the minor salivary glands. It usually presents as an asymptomatic small superficial swelling over the lower labial mucosa. However, uncommon variants of oral mucoceles sometimes occur. Such lesions may be difficult to diagnose due to their unusual size and atypical clinical presentation. This art...

Periapical cyst is a slow growing dental cyst, which is discove­ red on routine intraoral radiograph or cause localized intra­ osseous jaw swelling. It is typically found at root apex of the involved tooth and is discovered on routine radiography. This paper reports a rare presentation of periapical cyst. The cyst was localized in the premaxillary...

Aim: The Objective of this project was to evaluate Knowledge, pattern and rationality of antimicrobial prescription by general dental practitioners of Karad taluka of Satara district of Maharashtra. Material and method: This study was an anonymous, questionnaire-based survey undertaken for private dental practitioners in both government & private s...

Radicular cystsare common odontogenic cyst of jaw bone which invariably presents as well-defined radiolucency around the apex of the involved tooth. It is diagnosed on routine radiography or causes a slow growing swelling, limited to apical region of a tooth. Radicular cyst presenting as unusually large maxillary lesions is uncommon. This paper rep...

Purpose: The aim of the study was to evaluate the use of submental route of intubation for maxillofacial trauma patient, in whom oral and nasal routes of intubation were contraindicated. Achieving a secure airway is of utmost importance in patients under general anesthesia. The two most common methods of airway management (intubation) in such patie...

Periapical cyst is a slow growing dental cyst, which is discove­ red on routine intraoral radiograph or cause localized intra­ osseous jaw swelling. It is typically found at root apex of the involved tooth and is discovered on routine radiography. This paper reports a rare presentation of periapical cyst. The cyst was localized in the premaxillary...

Brown tumour [BT] is an uncommon, non neoplastic complication of Hyperparathyroidism [HPT]. Skeletal changes are the main consequences of this endocrine condition. HPT manifest in three categories. Primary HPT is due to hyperfunction of one or more parathyroid gland, causing an increase of parathyroid hormone secretion resulting in hypercalcemia. S...

Although nasopharyngeal carcinoma (NPC) is a common tumor of head and neck region, its incidence is quite low in younger age group. It shows variable presentation depending on stage at which the diagnosis is made. Growth of the lesion in naso- pharynx usually present with nasal obstruction, epistaxis and nasal discharge. Extension of the primary le...

Although nasopharyngeal carcinoma (NPC) is a common tumor of head and neck region, its incidence is quite low in younger age group. It shows variable presentation depending on stage at which the diagnosis is made. Growth of the lesion in naso-pharynx usually present with nasal obstruction, epistaxis and nasal discharge. Extension of the primary les...

Congenital muscular torticollis (CMT) is a rare congenital musculoskeletal disorder characterized by unilateral shortening of the sternocleidomastoid muscle (SCM). It presents in newborn infants or young children with reported incidence ranging from 0.3% to 2%. Owing to effective shortening of SCM on the involved side there is ipsilateral head tilt...

Objective: The present study was undertaken to access the level of knowledge and attitude of patients toward implant treatment as an option for replacement of missing teeth. Materials and methods: An epidemiological study was conducted among 440 subjects who attended the OPD of two Departments (Prosthodontics and Oral and Maxillofacial Surgery)....

Odontogenic keratocyst (OKC) is a cyst of tooth origin with an aggressive clinical behavior including a high recurrence rate. OKC was first described by Phillipsen in 1956. It is one of the most aggressive odontogenic cysts of the oral cavity. OKC is known for its tendency to invade the adjacent tissues including bone. It shows rapid growth and may...

Intermaxillary fixation (IMF) is used for management of jaw fracture. Some of the commonly used technique of IMF include arch bar and various dental wirings. However IMF may not be efficiently attained in patients who are edentulous, partially dentulous or have compromised dentition using these traditional techniques. The purpose of this article is...