The study aims to assess the efficacy of using collagen membrane in the treatment of distal periodontal defects of mandibular second molars following the removal of mesioangularly or horizontally impacted mandibular third molars surgically. Forty sites in twenty patients with bilaterally impacted mandibular third molars (mesioangular or horizontal) were considered for the study. In 20 test sites (Group A), after surgical removal of the mandibular third molar, a resorbable collagen membrane barrier was placed on the distal aspect of the mandibular second molar to cover the post-surgical bone defect. In the other control 20 sites (Group B), the same surgical procedure was repeated without placing any membrane barrier. The clinical parameters recorded were Oral Hygiene Index Simplified (OHI-S), Probing pocket depth (PPD), Clinical attachment level (CAL), and radiographic assessment of alveolar bone level (ABL). OHI-S score of most of the patients was observed to be satisfactory. Group A was observed to achieve a statistically significant reduction in PPD, CAL, and ABL gain compared to Group B. The improvements indicated that the use of collagen membrane facilitates early wound stabilization and promotes primary closure of the defect. This recovery is achieved through its unique property to assist fibrinogenesis over osteoconduction. Further longitudinal studies are needed to confirm the present findings.

Introduction: Dental anxiety, often a result of fear or lack of information, leads to many adults avoiding dental treatment. It is crucial for dental practitioners to assess patients’ anxiety levels for quality care and post-operative recovery. The study aimed to compare patient perceptions of pain, anxiety, stress levels and satisfaction with clinical outcomes in surgical extractions of impacted mandibular third molars, using the Visual Analogue Scale and Amsterdam Pre-operative Anxiety and Information Scale. Methods and Materials: This prospective, clinical, comparative study was performed from June 2017 to February 2020. The study sample enclosed 60 patients – 30 males and 30 females of age ranging from 18 to 51 years. The parameter was assessed and measured for both groups and compared for the results and statistical analysis. Results: The study used IBM SPSS Statistics 16.0 for statistical analysis. Comparisons were made between groups for maximal mouth opening, extra-oral swelling, anxiety scale, pain perception and dental visit satisfaction. Intra-group comparisons were made using repeated measure analysis of variance and Bonferroni’s post hoc test. Dental visit satisfaction was also compared. Statistical significance was determined at a P < 0.05. Discussion: The study found that patient satisfaction was similar for both groups, but female patients experienced higher anxiety and swelling scores compared to male patients. The results suggest that surgeons should educate patients about surgical procedures and related complications.

Severe atrophy of the posterior maxilla poses a significant challenge for conventional implant placement due to insufficient bone height and density. Traditional solutions such as bone grafting or sinus lift procedures extend treatment time, increase patient morbidity, and are associated with varying degrees of success. Zygomatic implants have emerged as a predictable, graft-free alternative by anchoring in the dense zygomatic bone, bypassing the atrophic posterior maxilla altogether. However, they are biomechanically stressed, and their long-term success depends heavily on appropriate prosthetic support and load distribution. This study aimed to evaluate the clinical efficacy and added stability of combining bilateral zygomatic implants with conventional anterior implants in patients with severely atrophic maxillae. A total of five patients (three males and two females), aged 23 to 65 years, with CBCT-confirmed posterior maxillary atrophy (residual ridge height ≤6 mm), were selected for this prospective study. Each patient received two zygomatic implants (length 40 to 55 mm) placed bilaterally using the extra-sinus technique, along with two to four conventional implants in the anterior maxilla. Implant stability was assessed using Resonance Frequency Analysis (RFA) at implant placement, two weeks, two months, six months, and twelve months. All implants were immediately loaded with a provisional fixed prosthesis. The results demonstrated high primary stability for both zygomatic and conventional implants, with mean initial ISQ values of 72 ± 3 and 68 ± 4, respectively. These values remained above the accepted threshold for osseointegration throughout the 12-month follow-up. No implant failures or major complications were reported. One patient required minor prosthetic adjustment. Patient-reported outcomes indicated satisfaction with esthetics, function, and comfort. The study concluded that additional anterior conventional implants provide supplemental support and biomechanical stability to zygomatic implants, enhancing the overall success of rehabilitation in severely atrophic maxillae.

Rationale: Low-flow vascular malformations (LFVMs) of the orofacial region are rare congenital vascular anomalies caused by aberrant development of venous and lymphatic channels, leading to slow or stagnant blood flow. This report highlights the successful management of LFVMs of buccal mucosa using ultrasound-guided bleomycin sclerotherapy. Patient Concerns: A 37-year-old female presented with a 5-year history of progressive, painless swelling of the left buccal mucosa. Diagnosis: Clinical and radiological evaluation, including computed tomography (CT) angiography, confirmed a LFVM supplied by the left facial artery with venous drainage into the retromandibular vein. Treatment: The patient underwent three weekly sessions of ultrasound-guided intralesional bleomycin sclerotherapy (15 IU in 10 mL sterile water). Outcomes: One-year follow-up CT angiography showed minimal residual tissue with no recurrence and a 70% reduction in lesion size was noted. Take-away Lessons: Ultrasound-guided bleomycin sclerotherapy is a safe, minimally invasive and effective treatment for LFVM in cosmetically sensitive facial regions.