Introduction: With little evidence available in the literature, this study tries to clinically determine the efficiency and outcomes of non-surgical management of post-traumatic Zygomaticomaxillary complex (ZMC) fractures. Materials and Methods: One hundred and three patients with post-traumatic isolated ZMC fractures managed conservatively for various reasons were identified. The patients were classified based on the Zingg et al. criteria into Types A, B, and C. We evaluated the resolution of signs and symptoms of six standard parameters over 6 months—persistent pain, restriction in mouth opening, infraorbital nerve (ION) paresthesia, aesthetic deformity, infraorbital step deformity with associated tenderness on palpation, and ophthalmic status. The study variables were then statistically analyzed using Cochran’s Q test with an associated confidence interval of 95%. Results: A six-month follow-up revealed persisting residual deformities for all three groups. However, Type A and Type B showed significant improvement in pain reduction, mouth opening, and infraorbital nerve (ION) paresthesia. No significant improvement was noted in any of the groups for aesthetic deformity, infraorbital step deformity, and ophthalmic status. Type C, which had comminuted fracture patterns, exhibited significant defects in all the parameters. Significant inter-variable relationship between certain paired parameters was also observed. Conclusion: The Type A group is most suited for non-surgical management. Type B with a mono-bloc fracture is a crucial group that demands broader, long-term studies to extract a proper treatment protocol. Type C with severe fracture displacement validates surgical correction.

Objective. To evaluate the profile of patients operated for maxillofacial space infections and associated risk factors for the length of hospital stay. Materials and Methods. We conducted a retrospective study among patients operated for maxillofacial infections at our center from 2010 to 2020. Information collected from the records were age, sex, type and number of spaces involved, clinical signs and symptoms (pain, swelling, toothache, sore throat, otalgia, hoarseness, headache, cough, neck swelling, rancid breath, sialorrhea, gingival swelling, muffled voice, trismus, fever, dysphagia, odynophagia, malaise, lymphadenopathy, dyspnoea, pus discharge), treatment modality, total leukocyte count, evidence of bacterial growth, comorbidities, complications if any and length of hospital stay. Results. A total of 128 medical records were examined, out of which 59 were female. The mean age was 38.59 ± 19.7 and the length of hospital stay was 7.56 ± 3.8 days. The most commonly involved space was submandibular space (46.1%) and the common symptoms reported were swelling (99.2%), pain (86.7%), and trismus (68%). Four patients had complications like necrotizing fasciitis (1.6%), pneumonia (0.8%), and death in one patient (0.8%). Logistic regression showed that patients more than 36 years of age, male sex, evidence of bacterial growth, and diabetics had higher odds of increased hospital stay (>6 days). Multiple logistic regression analysis showed that age ( ; OR: 2.98) and evidence of bacterial culture ( ; OR:6.64) were potential predictors associated with increased hospital stay. Conclusion. Our study showed that the age of the patient and evidence of bacterial culture were potential predictors of prolonged hospital stay among patients operated for maxillofacial space infections.

Introduction: Maxillary reconstruction is often a challenging task for the surgeons because of the complex anatomy. However, with the advances in virtual surgical planning (VSP) and 3D printing technology there is a new avenue for the surgeons which offers a suitable alternative to conventional flap-based reconstructions. Patients and Methods: In this article, we have described 4 case scenarios which were managed with the help of VSP and additive manufacturing technology for complex maxillary reconstruction procedures. Use of the technologies aided the clinician in achieving optimal outcomes with regards to form, function and esthetics. Discussion: Virtual surgical planning (VSP) has gained a lot of impetus in past 1 decade. These aides the surgeon in determining the extent of disease and also carry out the treatment planning. In addition to VSP, the concept of additive manufacturing provides a viable alternative to the conventional reconstruction modalities for maxillary defect rehabilitation. Increased accuracy, rehabilitation of normal anatomical configuration, appropriate dental rehabilitation, decreased intra-operative time and post-operative complications are some of the advantages. In addition, patient-specific implants eliminate the need for a separate donor site. Apart from the treatment of pathologies, they also can be used for reconstruction of post-traumatic defect, where endosteal implant placement is not possible. Conclusion: These modalities show promising results for reconstruction of complex maxillary defects.

Orthognathic surgery entails a high risk of blood ingestion, which causes postoperative nausea and vomiting (PONV). Throat packs are placed to combat this problem. However, the efficacy of throat packs in reducing blood ingestion and PONV is debatable. We aimed to review the existing literature and pool the estimates of the quality of gastric contents, PONV, and throat pain associated with and without the use of throat packs among patients undergoing orthognathic surgery. Globally recognized databases (PubMed, Scopus, Embase, CINAHL, and Web of Science) were searched to identify relevant studies, and 2 randomized controlled trials comprising 84 participants were included. A qualitative analysis of the gastric contents showed that throat packs are not practical barriers against the ingestion of blood during orthognathic surgery. The meta‐analysis revealed that placement of throat packs during orthognathic surgery did not reduce the incidence of PONV ( p value = 1) and caused higher postoperative throat pain ( p value = 0.02). Thus, the current review provides no evidence in favor of throat packs during orthognathic surgery. The role of throat packs in preventing blood ingestion is questionable due to a limited number of studies. They play no significant role in preventing PONV and increase postoperative throat pain.