Manjunath Rai | Rajiv Gandhi University of Health Sciences (original) (raw)
Papers by Manjunath Rai
Comminuted zygomatico complex fracture has challenged the diagnostic and operative skill of surge... more Comminuted zygomatico complex fracture has challenged the diagnostic and operative skill of surgeons throughout the decade. A variety of methods have been used over the years for the management of zygomatico complex fracture and each has its own advantage and disadvantages. Antral packing with gauze or a balloon can be used occasionally in much comminuted fractures particularly with anterior antral wall communication.
Journal of Maxillofacial and Oral Surgery, 2020
Distraction Osteogenesis and bone transport have been used to reconstruct bone loss defect by all... more Distraction Osteogenesis and bone transport have been used to reconstruct bone loss defect by allowing new bone to form in the gap. Transport Distraction Osteogenesis (TDO) can be best explained as a creation of bone and soft tissue to fill a defect by moving a disk of bone and formation of new tissues behind it until the disk docks the receiving host bone [1]. Plate-guided bone transport has been successfully described in the literature to treat bone loss defect in mandible. The transport disk is then advanced 1.0 mm per day to span the discontinuity defect [2]. A custom-made indigenous device made in Chennai was used for transport distraction. A single vector distraction was performed regenerating new bone till ramus. The standard technique of segmental resection and TDO challenge has been to maintain the correct vector during the distraction process by maintaining the direction, height and bucco-lingual tilt. Conventional technique of distraction is plate-guided distractor device...
Clinicians frequently come across patients with Trigeminal Neuralgia (TN) in their daily practice... more Clinicians frequently come across patients with Trigeminal Neuralgia (TN) in their daily practice. Most frequently pain is the leading symptom of TN. Sometimes it is caused by other diseases. In everyday clinical practice, it is important to diagnose and treat TN properly. Several issues regarding diagnosis, pharmacological treatment and surgical treatment of TN are still unsettled. This article provides an overview of clinical practice, diagnostic procedure and treatment strategy for TN and also reinforces the importance of programs that alert patients and health professionals about TN and the sequelae of iatrogenic procedures that guide patients to the proper treatment and that contribute to an improved understanding of this excruciatingly painful condition. Significance and reliability of Ginwalla’s technique of peripheral neurectomy is also highlighted.
Every profession is governed by a set of rules and regulations, and the same applies to the field... more Every profession is governed by a set of rules and regulations, and the same applies to the field of maxillofacial surgery. The young surgeon must therefore be aware of what legal requirements he/she must fulfil while practising the profession. Maxillofacial surgery is a challenging field that straddles both medicine and surgery, and therefore surgeons must be very aware of the legal scope of this field. Record keeping such as the informed consent and procedure notes are important legal requirements and must be maintained to provide legal proof of service and respect patient’s rights Maxillofacial surgeons play an important role as expert witnesses in cases of violence that have affected the head and neck region. In addition to all these legal requirements, the maxillofacial surgeon is also extremely vulnerable to civil or criminal litigation in the form of negligence. Surgeons must be aware of their duties and rights. They must also be familiar with legal issues like negligence and...
Journal of Maxillofacial and Oral Surgery
IOSR Journal of Dental and Medical Sciences
Several extraction techniques exist for extraction of upper premolar teeth, but proper selection ... more Several extraction techniques exist for extraction of upper premolar teeth, but proper selection of an appropriate instrument and technique requires understanding of the impact of manipulating the basic principles of extraction for individual cases. We recommend the below mentioned technique for extraction of upper premolar teeth, hence making extraction a doctor and patient friendly procedure.
Journal of Maxillofacial and Oral Surgery
This study was undertaken to compare micromarsupialization and modified micromarsupialization for... more This study was undertaken to compare micromarsupialization and modified micromarsupialization for the management of mucoceles. A prospective randomized clinical study was done on thirty patients having mucocele on lower lip. In Group A (n = 15), micromarsupialization and in Group B (n = 15), modified micromarsupialization technique was used. The outcome variables were duration of surgery, intraoperative pain, postoperative pain, healing and recurrence. t test and p values were used to compare the age, duration of lesion, duration of treatment and time taken for healing. The results were expressed as mean with SD. Statistical significance was established at the p ≤ 0.05 level. Analysis of pain (intraoperative, on 3rd, 7th day), intraoperative bleeding and recurrence was done using Fischer's exact test (p = 0.875, NS). The average duration of treatment for Group A was 4.10 ± 0.39 min and for Group B was 5.33 ± 0.2 min. The difference was found to be statistically highly significant (p value ≤0.000). The observed power was 1.000. The difference in the intraoperative and postoperative pain on 3rd and 7th day was not found to be significant as per Fischer's exact test. The mean time taken for healing of the surgical site in Group A was 7.47 ± 0.64 days and in Group B was 9.87 ± 1.88 days, and the difference was found to be highly significant. The observed power was 0.995. Modified micromarsupialization appears to be a safe technique for the management of mucoceles. However, in comparison with micromarsupialization, it has a higher operating and healing time.
Case Reports in Dentistry, 2016
Fibrous dysplasia (FD) is a condition characterized by excessive proliferation of bone forming me... more Fibrous dysplasia (FD) is a condition characterized by excessive proliferation of bone forming mesenchymal cells which can affect one bone (monostotic type) or multiple bones (polyostotic type). It is predominantly noticed in adolescents and young adults. Fibrous dysplasia affecting the jaws is an uncommon condition. The most commonly affected facial bone is the maxilla, with facial asymmetry being the chief complaint. The lesion in many instances is confused with ossifying fibroma (OF). Diagnosis of these two lesions has to be done based on clinical, radiographic, and microscopic findings. Here, we present a case of fibrous dysplasia of maxilla in a nine-year-old boy mimicking juvenile ossifying fibroma.
International Journal of Oral and Maxillofacial Surgery, 2007
International Journal of Oral and Maxillofacial Surgery, 2007
Journal of Oral and Maxillofacial Surgery, 2011
Journal of Maxillofacial and Oral Surgery
Introduction TMJ ankylosis is a condition which results in partial to complete inability to open ... more Introduction TMJ ankylosis is a condition which results in partial to complete inability to open the mouth due to fusion of head of condyle and glenoid fossa. Case Report A 28 year old man reported to our department with a complaint of inability to open mouth since 13 years. On basis of clinical examination, radiographs and CT scans, he was diagnosed with complete bilateral bony TMJ ankylosis. The treatment plan included bilateral condylectomy with coronoidectomy through a combination of endaural and rhytidectomy incision and interpositional grafting with temporalis myofascial flap. Reconstruction of the TMJ was done with specially designed stainless steel partial condylar prosthesis. Extended genioplasty was done to advance the chin. Post-operative early physiotherapy was initiated with a custom made oral physiotherapy device. Complete oral rehabilitation was done with fixed partial dentures, and patient is on regular follow up. Results Patient had mouth opening of 29 mm and also had a satisfactory esthetic appearence.
Journal of Maxillofacial and Oral Surgery
Teratomas are neoplasm composed of three germinal layers of the embryo that form tissues not norm... more Teratomas are neoplasm composed of three germinal layers of the embryo that form tissues not normally found in the organ in which they arise. These are most common in the sacrococcygeal region and are rare in the head and neck, which account for less than 6%. An unusual case of facial teratoma in a new born, managed successfully is described here with postoperative follow up of 2 years without any recurrence.
Journal of Oral and Maxillofacial Surgery, 2009
Sialolithiasis accounts for more than 50% of the salivary gland diseases, with an estimated 12 of... more Sialolithiasis accounts for more than 50% of the salivary gland diseases, with an estimated 12 of 1,000 persons in the adult population being affected every year. 1 Most salivary calculi (80%-95%) occur in the submandibular gland, whereas 5% to 20% are found in the parotid gland. The sublingual gland and minor salivary glands are rarely (1%-2%) affected. 2 Male patients are affected twice as much as female patients. Multiple calculi in the submandibular gland are rare, as is simultaneous lithiasis in more than 1 salivary system. 4 Radiopacity is not a feature in 40% of parotid and 20% of submandibular stones; therefore sialography or other imaging techniques (computed tomography scan, ultrasound) may be required to locate them. 3 Clinically, the stones are round or ovoid, rough or smooth, and of a yellowish color. They consist of mainly calcium phosphate with small amounts of carbonates in the form of hydroxyapatite, as well as smaller amounts of magnesium, potassium, and ammonia. 5 Submandibular stones are composed of 82% inorganic and 18% organic material, whereas parotid stones are composed of 49% inorganic and 51% organic material. Sialoliths commonly measure between 5 and 10 mm in size, and all stones over 10 mm can be reported as sialoliths of unusual size. 6 Giant sialoliths measuring more than 35 mm are rare, with only around 16 cases published in the literature. Ninety-four percent of the giant sialoliths reported were in the submandibular gland. We report a case of a sialolith in the submandibular duct measuring 72 mm in length and weighing 45.8 g, highlighting the management aspects of this giant sialolith with minimal glandular dysfunction.
Comminuted zygomatico complex fracture has challenged the diagnostic and operative skill of surge... more Comminuted zygomatico complex fracture has challenged the diagnostic and operative skill of surgeons throughout the decade. A variety of methods have been used over the years for the management of zygomatico complex fracture and each has its own advantage and disadvantages. Antral packing with gauze or a balloon can be used occasionally in much comminuted fractures particularly with anterior antral wall communication.
Journal of Maxillofacial and Oral Surgery, 2020
Distraction Osteogenesis and bone transport have been used to reconstruct bone loss defect by all... more Distraction Osteogenesis and bone transport have been used to reconstruct bone loss defect by allowing new bone to form in the gap. Transport Distraction Osteogenesis (TDO) can be best explained as a creation of bone and soft tissue to fill a defect by moving a disk of bone and formation of new tissues behind it until the disk docks the receiving host bone [1]. Plate-guided bone transport has been successfully described in the literature to treat bone loss defect in mandible. The transport disk is then advanced 1.0 mm per day to span the discontinuity defect [2]. A custom-made indigenous device made in Chennai was used for transport distraction. A single vector distraction was performed regenerating new bone till ramus. The standard technique of segmental resection and TDO challenge has been to maintain the correct vector during the distraction process by maintaining the direction, height and bucco-lingual tilt. Conventional technique of distraction is plate-guided distractor device...
Clinicians frequently come across patients with Trigeminal Neuralgia (TN) in their daily practice... more Clinicians frequently come across patients with Trigeminal Neuralgia (TN) in their daily practice. Most frequently pain is the leading symptom of TN. Sometimes it is caused by other diseases. In everyday clinical practice, it is important to diagnose and treat TN properly. Several issues regarding diagnosis, pharmacological treatment and surgical treatment of TN are still unsettled. This article provides an overview of clinical practice, diagnostic procedure and treatment strategy for TN and also reinforces the importance of programs that alert patients and health professionals about TN and the sequelae of iatrogenic procedures that guide patients to the proper treatment and that contribute to an improved understanding of this excruciatingly painful condition. Significance and reliability of Ginwalla’s technique of peripheral neurectomy is also highlighted.
Every profession is governed by a set of rules and regulations, and the same applies to the field... more Every profession is governed by a set of rules and regulations, and the same applies to the field of maxillofacial surgery. The young surgeon must therefore be aware of what legal requirements he/she must fulfil while practising the profession. Maxillofacial surgery is a challenging field that straddles both medicine and surgery, and therefore surgeons must be very aware of the legal scope of this field. Record keeping such as the informed consent and procedure notes are important legal requirements and must be maintained to provide legal proof of service and respect patient’s rights Maxillofacial surgeons play an important role as expert witnesses in cases of violence that have affected the head and neck region. In addition to all these legal requirements, the maxillofacial surgeon is also extremely vulnerable to civil or criminal litigation in the form of negligence. Surgeons must be aware of their duties and rights. They must also be familiar with legal issues like negligence and...
Journal of Maxillofacial and Oral Surgery
IOSR Journal of Dental and Medical Sciences
Several extraction techniques exist for extraction of upper premolar teeth, but proper selection ... more Several extraction techniques exist for extraction of upper premolar teeth, but proper selection of an appropriate instrument and technique requires understanding of the impact of manipulating the basic principles of extraction for individual cases. We recommend the below mentioned technique for extraction of upper premolar teeth, hence making extraction a doctor and patient friendly procedure.
Journal of Maxillofacial and Oral Surgery
This study was undertaken to compare micromarsupialization and modified micromarsupialization for... more This study was undertaken to compare micromarsupialization and modified micromarsupialization for the management of mucoceles. A prospective randomized clinical study was done on thirty patients having mucocele on lower lip. In Group A (n = 15), micromarsupialization and in Group B (n = 15), modified micromarsupialization technique was used. The outcome variables were duration of surgery, intraoperative pain, postoperative pain, healing and recurrence. t test and p values were used to compare the age, duration of lesion, duration of treatment and time taken for healing. The results were expressed as mean with SD. Statistical significance was established at the p ≤ 0.05 level. Analysis of pain (intraoperative, on 3rd, 7th day), intraoperative bleeding and recurrence was done using Fischer's exact test (p = 0.875, NS). The average duration of treatment for Group A was 4.10 ± 0.39 min and for Group B was 5.33 ± 0.2 min. The difference was found to be statistically highly significant (p value ≤0.000). The observed power was 1.000. The difference in the intraoperative and postoperative pain on 3rd and 7th day was not found to be significant as per Fischer's exact test. The mean time taken for healing of the surgical site in Group A was 7.47 ± 0.64 days and in Group B was 9.87 ± 1.88 days, and the difference was found to be highly significant. The observed power was 0.995. Modified micromarsupialization appears to be a safe technique for the management of mucoceles. However, in comparison with micromarsupialization, it has a higher operating and healing time.
Case Reports in Dentistry, 2016
Fibrous dysplasia (FD) is a condition characterized by excessive proliferation of bone forming me... more Fibrous dysplasia (FD) is a condition characterized by excessive proliferation of bone forming mesenchymal cells which can affect one bone (monostotic type) or multiple bones (polyostotic type). It is predominantly noticed in adolescents and young adults. Fibrous dysplasia affecting the jaws is an uncommon condition. The most commonly affected facial bone is the maxilla, with facial asymmetry being the chief complaint. The lesion in many instances is confused with ossifying fibroma (OF). Diagnosis of these two lesions has to be done based on clinical, radiographic, and microscopic findings. Here, we present a case of fibrous dysplasia of maxilla in a nine-year-old boy mimicking juvenile ossifying fibroma.
International Journal of Oral and Maxillofacial Surgery, 2007
International Journal of Oral and Maxillofacial Surgery, 2007
Journal of Oral and Maxillofacial Surgery, 2011
Journal of Maxillofacial and Oral Surgery
Introduction TMJ ankylosis is a condition which results in partial to complete inability to open ... more Introduction TMJ ankylosis is a condition which results in partial to complete inability to open the mouth due to fusion of head of condyle and glenoid fossa. Case Report A 28 year old man reported to our department with a complaint of inability to open mouth since 13 years. On basis of clinical examination, radiographs and CT scans, he was diagnosed with complete bilateral bony TMJ ankylosis. The treatment plan included bilateral condylectomy with coronoidectomy through a combination of endaural and rhytidectomy incision and interpositional grafting with temporalis myofascial flap. Reconstruction of the TMJ was done with specially designed stainless steel partial condylar prosthesis. Extended genioplasty was done to advance the chin. Post-operative early physiotherapy was initiated with a custom made oral physiotherapy device. Complete oral rehabilitation was done with fixed partial dentures, and patient is on regular follow up. Results Patient had mouth opening of 29 mm and also had a satisfactory esthetic appearence.
Journal of Maxillofacial and Oral Surgery
Teratomas are neoplasm composed of three germinal layers of the embryo that form tissues not norm... more Teratomas are neoplasm composed of three germinal layers of the embryo that form tissues not normally found in the organ in which they arise. These are most common in the sacrococcygeal region and are rare in the head and neck, which account for less than 6%. An unusual case of facial teratoma in a new born, managed successfully is described here with postoperative follow up of 2 years without any recurrence.
Journal of Oral and Maxillofacial Surgery, 2009
Sialolithiasis accounts for more than 50% of the salivary gland diseases, with an estimated 12 of... more Sialolithiasis accounts for more than 50% of the salivary gland diseases, with an estimated 12 of 1,000 persons in the adult population being affected every year. 1 Most salivary calculi (80%-95%) occur in the submandibular gland, whereas 5% to 20% are found in the parotid gland. The sublingual gland and minor salivary glands are rarely (1%-2%) affected. 2 Male patients are affected twice as much as female patients. Multiple calculi in the submandibular gland are rare, as is simultaneous lithiasis in more than 1 salivary system. 4 Radiopacity is not a feature in 40% of parotid and 20% of submandibular stones; therefore sialography or other imaging techniques (computed tomography scan, ultrasound) may be required to locate them. 3 Clinically, the stones are round or ovoid, rough or smooth, and of a yellowish color. They consist of mainly calcium phosphate with small amounts of carbonates in the form of hydroxyapatite, as well as smaller amounts of magnesium, potassium, and ammonia. 5 Submandibular stones are composed of 82% inorganic and 18% organic material, whereas parotid stones are composed of 49% inorganic and 51% organic material. Sialoliths commonly measure between 5 and 10 mm in size, and all stones over 10 mm can be reported as sialoliths of unusual size. 6 Giant sialoliths measuring more than 35 mm are rare, with only around 16 cases published in the literature. Ninety-four percent of the giant sialoliths reported were in the submandibular gland. We report a case of a sialolith in the submandibular duct measuring 72 mm in length and weighing 45.8 g, highlighting the management aspects of this giant sialolith with minimal glandular dysfunction.