Ramen Sinha - Academia.edu (original) (raw)
Papers by Ramen Sinha
Journal of Maxillofacial and Oral Surgery, 2017
Journal of Maxillofacial and Oral Surgery, 2021
The aim of this study is to clinically and radiographically evaluate the stability of parasymphys... more The aim of this study is to clinically and radiographically evaluate the stability of parasymphysis fracture managed with lag screws, miniplates and 3D miniplates. Ninety- eight patients diagnosed with parasymphysis fracture were treated using lag screws in group 1, two 4-hole miniplates in group 2 and 3D miniplates in group 3. Intraoperative stability and duration of fixation was assessed. Postoperative clinical evaluation was done at 1 week, 1 month, 3rd month, 6th month and 1 year for complications and oral function. Radiological evaluation was done at 3rd and 6th month. Only 92 patients were considered for statistical analysis since 6 patients were lost during follow-up. Road traffic accident (65.3%) was the primary cause of mandibular fractures. Postoperative pain score showed a statistically significant difference after 1 week and 1 month duration (P value < 0.001). ANOVA test showed VAS was significantly higher at pre-op followed by 1st day and 1 week, but no significant difference after 3 months in all groups. Radiographic analysis did not show significant difference in approximation of fracture segment among 3 groups after 6 months (P-value = 0.117). Chewing efficiency at 6 months and occlusion by surgeon evaluation at 3 months showed a significant difference (P value < 0.001). Lag screw fixation was technique-sensitive, relatively inexpensive and was less time consuming method when compared to miniplates and 3D plates. Lag screws and 3D plates are superior in reducing the incidence of complications and better in oblique or sagitally displaced mandibular fractures.
Journal of Maxillofacial and Oral Surgery, 2020
Journal of Dental Research and Review, 2019
Aim: The aim of this study was to evaluate the efficacy and reliability of fracture management in... more Aim: The aim of this study was to evaluate the efficacy and reliability of fracture management in the anterior mandible using miniplates (MPs), lag screws (LSs), three-dimensional (3D) plates, and Herbert screws. Materials and Methods: The study consists of forty patients randomly divided into four groups of ten, undergoing open reduction internal fixation of anterior mandible fractures using MPs, LSs, 3D plates, or Herbert screw. All the patients were evaluated for stability of fracture fragments, duration of procedure, requirement of maxillomandibular fixation, and other associated complications. Results: The results of this study showed that each fixation device has its own merits and demerits. The rectangular plates achieved good stability, but its placement and adaptation was challenging in certain clinical scenarios when the anterior mandibular height was less, especially in females and in situations where the fracture line was in close proximity to the mental foramen. The placement of LS and Herbert screw was technique sensitive but did achieve good initial stability in addition to shortening the procedure time. The MPs were more versatile but required more operating time and hardware for the management of the anterior mandibular fractures. Conclusion: All of these modalities were able to achieve satisfactory final outcome. The rigid fixation techniques achieved similar results with less hardware and required lesser times. The MP fixation techniques, on the other hand, are more versatile and less technique sensitive.
Annals of Maxillofacial Surgery, 2019
Background: Recently, oral and maxillofacial surgeons are favoring three-dimensional (3D) minipla... more Background: Recently, oral and maxillofacial surgeons are favoring three-dimensional (3D) miniplates to treat mandibular fractures. Aims: The aim of the study is to evaluate the efficacy of 3D-miniplates over standard miniplates in the management of mandibular parasymphysis fracture. Materials and Methods: Forty patients with mandibular parasymphysis fractures were divided into two groups of 20 patients each. Group I patients underwent osteosynthesis of mandibular fracture by noncompression, unicortical, and stainless steel 3D miniplates, and Group II patients underwent osteosynthesis by noncompression, unicortical, and stainless steel Champy's miniplates. All the patients were followed up 6 months' postoperatively, evaluating occlusion, mobility of fracture segment, pain, wound dehiscence, neurological deficit, and infection. Statistical Analysis Used: The data were analyzed by SPSS for windows (version 17) statistical package (SPSS Inc., Chicago, IL, USA). Chi-square test was carried out to determine the statistical difference between the groups. Results: Mobility of the fractured site was evaluated postoperatively after 2 weeks, and it was found that mobility was absent in all the cases of Group I and 36 (80%) cases in Group II. There was significant difference in the mean visual analog scale scores among the Group I and II when compared from preoperative to 4-week follow-up. In Group II, two patients showed wound dehiscence. After 2 weeks, infection was seen in two patients of Group II. Conclusion: 3D plates in mandibular parasymphysis fractures give dimensional stability and carry low morbidity and infection rates.
Journal of Oral Biology and Craniofacial Research, 2019
Journal of Maxillofacial and Oral Surgery, 2017
Journal of Pierre Fauchard Academy (India Section), 2018
The most important aspect of impacted mandibular third molar surgery or in complicated exodontia ... more The most important aspect of impacted mandibular third molar surgery or in complicated exodontia is removal of roots. Based on our clinical experience, we modified the cryer elevator and compared with normal cryer elevator during surgical removal of roots in bilateral symmetrical impacted mandibular third molars. Therefore, a randomised single blind clinical trial was designed to analyze the efficacy of modified cryer elevator. Thirty-six patients with bilateral identical impacted lower third molars requiring surgical removal, under local anaesthesia, were included. A standard surgical protocol was followed. Roots were removed using Cryer elevator on one side and modified cryer elevator on the other. The ease of the removal of roots (easy, moderate and difficult) and time interval from the start of buccal guttering until removal of roots out of the socket were noted. The difference in ease of removal of roots (p =0.03) and duration (p<0.001) was statistically significant between the two elevators. We conclude use of modified cryer elevator is effective in surgical extraction of impacted mandibular third molars.
Journal of Maxillofacial and Oral Surgery, 2017
The British journal of oral & maxillofacial surgery, Jan 22, 2017
Journal of Maxillofacial and Oral Surgery, 2016
International Journal Of Medical Science And Clinical Invention, 2016
Indian Journal of Oral Sciences, 2015
Juvenile psammomatoid ossifying fibroma (JPOF) is a rare fibro-osseous neoplasm in young children... more Juvenile psammomatoid ossifying fibroma (JPOF) is a rare fibro-osseous neoplasm in young children which is locally aggressive, spreads quickly and has a very high recurrence rate. Early detection and complete excision are essential. It generally occurs in extragnathic craniofacial bones such as periorbital, frontal, and ethmoid bones. Jaw bones are rarely involved. Here, we report a case of JPOF of the maxilla in a 16-year-old female patient. Complete surgical excision along with removal of the first premolar was done. It was initially thought to be Fibro-osseous lesions which were provisionally diagnosed as juvenile ossifying fibroma clinically and radiographically but confirmed histopathologically as JPOF. Definitive diagnosis and treatment of such lesions depend on the collective correlation of clinical, radiographic, and histopathological features.
Medical Journal Armed Forces India, 2014
British Journal of Oral and Maxillofacial Surgery, 2019
Giant cell lesions is a broad term encompassing a wide range of lesions that are biologically and... more Giant cell lesions is a broad term encompassing a wide range of lesions that are biologically and morphologically diverse with an uncertain aetiology, whether it is a benign tumour, reactive lesion, inflammatory lesion or a self-healing lesion is ill understood. Their relation to each other also is not very clearly defined as they differ in their clinical and radiographic characteristics and their only similarity is in the histologic finding of non-neoplastic osteoclast like giant cells of different lineage. Owing to this fact their exact diagnosis continues to be one of the most obscure making them a dilemma, leaving many questions regarding their treatment and prognosis unanswered. Here we present a case of Central Giant Cell Tumor that was misdiagnosed as fibrous dysplasia that lead to an elusive treatment plan.
Journal of Oral and Maxillofacial Surgery
Dynamic stability of the temporomandibular joint (TMJ) is the characteristic of the joint to achi... more Dynamic stability of the temporomandibular joint (TMJ) is the characteristic of the joint to achieve normal function by harmonious, balanced, synchronized interactions of the various functional subunits of the stomatognathic system. The aim of this study was to evaluate changes in the mechanics and dynamics of the TMJ during recovery from surgical treatment of an isolated condylar fracture. This is a prospective cohort study involving 30 patients who underwent open reduction and internal fixation for an isolated unilateral condylar fracture and were clinically asymptomatic at 6 months after surgery. The dynamics of the TMJ were assessed by bite-force analysis, both static and dynamic, to assess masticatory efficiency. Surface electromyography was recorded to assess changes in muscle dynamics. Joint vibration analysis was performed to evaluate the internal functioning of the TMJ. All the assessments were carried out bilaterally to allow comparison of the injured and uninjured joints, and the data were analyzed with the paired t test and independent-samples t test. Statistical significance was considered at P < .05. The study included 18 male and 12 female patients aged between 20 and 40 years. Bite-force analyses showed significantly higher bite forces on the uninjured side at 6 months after surgery. Similarly, surface electromyography analysis showed increased muscle activity on the affected side pointing toward some compensatory hyperactivity in the masticatory muscles. Joint vibration analysis showed that there was increased friction during function in both the injured and uninjured joints. The observations in this study suggest that residual imbalances are present in the TMJ at 6 months after open reduction and internal fixation of condylar fractures. Therefore, long-term studies are required to establish a complete timeline of adaptive changes occurring in the TMJ after condylar fractures, especially in comparison with other treatment modalities.
Indian Journal of Contemporary Dentistry, 2016
Journal of Indian Orthodontic Society, 2015
Journal of Maxillofacial and Oral Surgery, 2011
Journal of Maxillofacial and Oral Surgery, 2017
Journal of Maxillofacial and Oral Surgery, 2021
The aim of this study is to clinically and radiographically evaluate the stability of parasymphys... more The aim of this study is to clinically and radiographically evaluate the stability of parasymphysis fracture managed with lag screws, miniplates and 3D miniplates. Ninety- eight patients diagnosed with parasymphysis fracture were treated using lag screws in group 1, two 4-hole miniplates in group 2 and 3D miniplates in group 3. Intraoperative stability and duration of fixation was assessed. Postoperative clinical evaluation was done at 1 week, 1 month, 3rd month, 6th month and 1 year for complications and oral function. Radiological evaluation was done at 3rd and 6th month. Only 92 patients were considered for statistical analysis since 6 patients were lost during follow-up. Road traffic accident (65.3%) was the primary cause of mandibular fractures. Postoperative pain score showed a statistically significant difference after 1 week and 1 month duration (P value < 0.001). ANOVA test showed VAS was significantly higher at pre-op followed by 1st day and 1 week, but no significant difference after 3 months in all groups. Radiographic analysis did not show significant difference in approximation of fracture segment among 3 groups after 6 months (P-value = 0.117). Chewing efficiency at 6 months and occlusion by surgeon evaluation at 3 months showed a significant difference (P value < 0.001). Lag screw fixation was technique-sensitive, relatively inexpensive and was less time consuming method when compared to miniplates and 3D plates. Lag screws and 3D plates are superior in reducing the incidence of complications and better in oblique or sagitally displaced mandibular fractures.
Journal of Maxillofacial and Oral Surgery, 2020
Journal of Dental Research and Review, 2019
Aim: The aim of this study was to evaluate the efficacy and reliability of fracture management in... more Aim: The aim of this study was to evaluate the efficacy and reliability of fracture management in the anterior mandible using miniplates (MPs), lag screws (LSs), three-dimensional (3D) plates, and Herbert screws. Materials and Methods: The study consists of forty patients randomly divided into four groups of ten, undergoing open reduction internal fixation of anterior mandible fractures using MPs, LSs, 3D plates, or Herbert screw. All the patients were evaluated for stability of fracture fragments, duration of procedure, requirement of maxillomandibular fixation, and other associated complications. Results: The results of this study showed that each fixation device has its own merits and demerits. The rectangular plates achieved good stability, but its placement and adaptation was challenging in certain clinical scenarios when the anterior mandibular height was less, especially in females and in situations where the fracture line was in close proximity to the mental foramen. The placement of LS and Herbert screw was technique sensitive but did achieve good initial stability in addition to shortening the procedure time. The MPs were more versatile but required more operating time and hardware for the management of the anterior mandibular fractures. Conclusion: All of these modalities were able to achieve satisfactory final outcome. The rigid fixation techniques achieved similar results with less hardware and required lesser times. The MP fixation techniques, on the other hand, are more versatile and less technique sensitive.
Annals of Maxillofacial Surgery, 2019
Background: Recently, oral and maxillofacial surgeons are favoring three-dimensional (3D) minipla... more Background: Recently, oral and maxillofacial surgeons are favoring three-dimensional (3D) miniplates to treat mandibular fractures. Aims: The aim of the study is to evaluate the efficacy of 3D-miniplates over standard miniplates in the management of mandibular parasymphysis fracture. Materials and Methods: Forty patients with mandibular parasymphysis fractures were divided into two groups of 20 patients each. Group I patients underwent osteosynthesis of mandibular fracture by noncompression, unicortical, and stainless steel 3D miniplates, and Group II patients underwent osteosynthesis by noncompression, unicortical, and stainless steel Champy's miniplates. All the patients were followed up 6 months' postoperatively, evaluating occlusion, mobility of fracture segment, pain, wound dehiscence, neurological deficit, and infection. Statistical Analysis Used: The data were analyzed by SPSS for windows (version 17) statistical package (SPSS Inc., Chicago, IL, USA). Chi-square test was carried out to determine the statistical difference between the groups. Results: Mobility of the fractured site was evaluated postoperatively after 2 weeks, and it was found that mobility was absent in all the cases of Group I and 36 (80%) cases in Group II. There was significant difference in the mean visual analog scale scores among the Group I and II when compared from preoperative to 4-week follow-up. In Group II, two patients showed wound dehiscence. After 2 weeks, infection was seen in two patients of Group II. Conclusion: 3D plates in mandibular parasymphysis fractures give dimensional stability and carry low morbidity and infection rates.
Journal of Oral Biology and Craniofacial Research, 2019
Journal of Maxillofacial and Oral Surgery, 2017
Journal of Pierre Fauchard Academy (India Section), 2018
The most important aspect of impacted mandibular third molar surgery or in complicated exodontia ... more The most important aspect of impacted mandibular third molar surgery or in complicated exodontia is removal of roots. Based on our clinical experience, we modified the cryer elevator and compared with normal cryer elevator during surgical removal of roots in bilateral symmetrical impacted mandibular third molars. Therefore, a randomised single blind clinical trial was designed to analyze the efficacy of modified cryer elevator. Thirty-six patients with bilateral identical impacted lower third molars requiring surgical removal, under local anaesthesia, were included. A standard surgical protocol was followed. Roots were removed using Cryer elevator on one side and modified cryer elevator on the other. The ease of the removal of roots (easy, moderate and difficult) and time interval from the start of buccal guttering until removal of roots out of the socket were noted. The difference in ease of removal of roots (p =0.03) and duration (p<0.001) was statistically significant between the two elevators. We conclude use of modified cryer elevator is effective in surgical extraction of impacted mandibular third molars.
Journal of Maxillofacial and Oral Surgery, 2017
The British journal of oral & maxillofacial surgery, Jan 22, 2017
Journal of Maxillofacial and Oral Surgery, 2016
International Journal Of Medical Science And Clinical Invention, 2016
Indian Journal of Oral Sciences, 2015
Juvenile psammomatoid ossifying fibroma (JPOF) is a rare fibro-osseous neoplasm in young children... more Juvenile psammomatoid ossifying fibroma (JPOF) is a rare fibro-osseous neoplasm in young children which is locally aggressive, spreads quickly and has a very high recurrence rate. Early detection and complete excision are essential. It generally occurs in extragnathic craniofacial bones such as periorbital, frontal, and ethmoid bones. Jaw bones are rarely involved. Here, we report a case of JPOF of the maxilla in a 16-year-old female patient. Complete surgical excision along with removal of the first premolar was done. It was initially thought to be Fibro-osseous lesions which were provisionally diagnosed as juvenile ossifying fibroma clinically and radiographically but confirmed histopathologically as JPOF. Definitive diagnosis and treatment of such lesions depend on the collective correlation of clinical, radiographic, and histopathological features.
Medical Journal Armed Forces India, 2014
British Journal of Oral and Maxillofacial Surgery, 2019
Giant cell lesions is a broad term encompassing a wide range of lesions that are biologically and... more Giant cell lesions is a broad term encompassing a wide range of lesions that are biologically and morphologically diverse with an uncertain aetiology, whether it is a benign tumour, reactive lesion, inflammatory lesion or a self-healing lesion is ill understood. Their relation to each other also is not very clearly defined as they differ in their clinical and radiographic characteristics and their only similarity is in the histologic finding of non-neoplastic osteoclast like giant cells of different lineage. Owing to this fact their exact diagnosis continues to be one of the most obscure making them a dilemma, leaving many questions regarding their treatment and prognosis unanswered. Here we present a case of Central Giant Cell Tumor that was misdiagnosed as fibrous dysplasia that lead to an elusive treatment plan.
Journal of Oral and Maxillofacial Surgery
Dynamic stability of the temporomandibular joint (TMJ) is the characteristic of the joint to achi... more Dynamic stability of the temporomandibular joint (TMJ) is the characteristic of the joint to achieve normal function by harmonious, balanced, synchronized interactions of the various functional subunits of the stomatognathic system. The aim of this study was to evaluate changes in the mechanics and dynamics of the TMJ during recovery from surgical treatment of an isolated condylar fracture. This is a prospective cohort study involving 30 patients who underwent open reduction and internal fixation for an isolated unilateral condylar fracture and were clinically asymptomatic at 6 months after surgery. The dynamics of the TMJ were assessed by bite-force analysis, both static and dynamic, to assess masticatory efficiency. Surface electromyography was recorded to assess changes in muscle dynamics. Joint vibration analysis was performed to evaluate the internal functioning of the TMJ. All the assessments were carried out bilaterally to allow comparison of the injured and uninjured joints, and the data were analyzed with the paired t test and independent-samples t test. Statistical significance was considered at P < .05. The study included 18 male and 12 female patients aged between 20 and 40 years. Bite-force analyses showed significantly higher bite forces on the uninjured side at 6 months after surgery. Similarly, surface electromyography analysis showed increased muscle activity on the affected side pointing toward some compensatory hyperactivity in the masticatory muscles. Joint vibration analysis showed that there was increased friction during function in both the injured and uninjured joints. The observations in this study suggest that residual imbalances are present in the TMJ at 6 months after open reduction and internal fixation of condylar fractures. Therefore, long-term studies are required to establish a complete timeline of adaptive changes occurring in the TMJ after condylar fractures, especially in comparison with other treatment modalities.
Indian Journal of Contemporary Dentistry, 2016
Journal of Indian Orthodontic Society, 2015
Journal of Maxillofacial and Oral Surgery, 2011