Browsing by Author "Chandresh Jaiswara"

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Adenoid cystic carcinoma of the floor of the mouth – A rare presentation
(Elsevier B.V., 2016) Chandresh Jaiswara; Neeraj Kumar Dhiman; Akhilesh Kumar Singh; Naresh Kumar Sharma; Vishal Verma; Arun Pandey
Adenoid cystic carcinoma (ACC) is an unusual salivary gland malignancy that remains poorly understood. It is a slow growing but aggressive neoplasm with a tendency for recurrence. It is characterized by the proliferation of ductal (luminal) and myoepithelial cells in cribriform, tubular, solid, and cystic forms. Standard treatment, including surgery with postoperative radiation therapy, has attained reasonable local control rates, but distant metastases do not allow any improvement in the survival rate. The understanding of the molecular mechanisms driving ACC is quite rudimentary. We present a case of a 55-year-old female diagnosed with ACC involving the floor of the mouth with an aim to present the carcinoma's behavior, immunohistocytochemistry, the staining pattern, its treatment, and prognosis. © 2015 Craniofacial Research Foundation
Comparative evaluation of buccal pad of fat with and without bovine collagen membrane in the management of oral submucous fibrosis: A prospective clinical study
(Wolters Kluwer Medknow Publications, 2020) Arun Pandey; Naresh Kumar Sharma; Neeraj Kumar Dhiman; Chandresh Jaiswara; Preeti Tiwari; Akhilesh Kumar Singh; Vishal Verma; Shankar Singh
Background: Oral submucous fibrosis (OSMF) is a chronic, debilitating disease characterized by juxtaepithelial fibrosis. The present study evaluates the efficacy of buccal fat pad (BFP) and bovine collagen membrane as reconstruction options. Materials and Methods: The sample size includes 22 patients between 20 and 60 years, randomly distributed in two groups: Group I in which BFP was used and Group II where BFP with bovine collagen membrane was used after surgical resection of fibrotic bands. The clinical evaluation on postoperative 1st, 3rd, and 5th days and 1st, 2nd, 3rd, 4th, 12th, and 24th weeks subsequently. Results: The mean age in Group I was 27.17 ± 3.157 years and Group II was 37.90 ± 6.657 years. The mean preoperative mouth opening was 9.75 ± 6.717 and 8.90 ± 3.784 mm in Groups I and II, respectively. The mean duration of presenting illness in Group I was ± 2.598 years and in Group II was 8.80 ± 1.989 years. There was no significant difference observed between Groups I and II in relation to reduced mouth opening and duration of symptoms (P > 0.05) except for age. No significant difference was observed between both the groups in relation to preoperative pain, burning sensation, cheek stiffness, mucosal suppleness, postoperative infection, and postoperative pain at days 1 and 5 and 1st week. There was a significant difference observed in postoperative pain among both the groups on the 3rd day and 2nd week. Conclusion: In the present study, both the groups have proved to give better results, as BFP in the form of interposition material showed rapid epithelization and minimum wound contracture. © 2020 National Journal of Maxillofacial Surgery.
Efficacy of arthrocentesis with intra‑articular injection of hyaluronic acid and corticosteroid in the treatment of internal derangement of temporomandibular joint
(Wolters Kluwer Medknow Publications, 2023) Neeraj K. Dhiman; Chandresh Jaiswara; Mehul S. Hirani; Nishtha Chauhan; Arjun D. Mahajan; Aswathi Krishnan
Introduction: Various techniques have been used to treat internal temporomandibular joint derangements (TMJ ID), with arthrocentesis one of the most successful in reducing symptoms and promoting function. In cases of TMJ ID, this research study compares and evaluates the efficacy of arthrocentesis with injections of corticosteroids (CS) or hyaluronic acid (HA). Methods: This prospective randomized, non‑blinded study involving 91 patients with symptoms of TMJ ID treated by arthrocentesis followed by intra articular injection of 1 ml of either corticosteroid (group A) or HA (group B) . Maximum mouth opening, lateral excursive movements, TMJ pain at rest and during function, masticatory efficiency, pre‑treatment functional TMJ limitation and subjective judgment of efficacy of treatment were assessed with millimeter scale. All the parameters measured before the procedure and further followed at 1st week, 1st month, 3rd month and 6th month post‑procedure. Results: Maximum mouth opening post procedure improved significantly in Group B at follow up visits (P < 0.05). Subjects in group B showed significant reduction in pain at rest (P = 0.001) at 1 week and 1 month follow up & increased masticatory efficiency at 6 months (P = 0.042) as compared to that of group A subjects. Conclusion: Injection of HA post‑TMJ arthrocentesis is found be comparatively more effective method of treating TMD IDs with resultant decrease in pain & improved functionality of the jaw. TMJ arthrocentesis along with injection of HA could serve as a possible alternative to treat chronic TMJ pain sufferers who are unresponsive to conservative medical therapies. © 2023 National Journal of Maxillofacial Surgery.
Evaluation of Efficacy of 10% Dextrose Prolotherapy in Management of Temporomandibular Joint Disorders: A Prospective Study
(Springer, 2024) Shankar Singh; Naresh Kumar Sharma; Chandresh Jaiswara; Neeraj Kumar Dhiman; Preeti Tiwari; Janani Anandkumar; Arun Pandey
The aim of this study was to assess the efficacy of 10% dextrose prolotherapy in the management of temporomandibular joint disorder. Thirty patients aged between 18 and 62 years, diagnosed with Temporomandibular Disorders (TMDs) persisting for more than six months and unresponsive to other conservative treatments, were enrolled in the study. Over four subsequent visits, spaced six weeks apart, each patient received injections of 3 ml of 10% dextrose solution into the temporomandibular joint space. Parameters assessed included pain levels, frequency of luxations/dislocations, episodes of locking per month, maximal mouth opening, and clicking, evaluated every six weeks for a duration of three months. All patients exhibited improvements in Temporomandibular Disorders (TMDs), manifested as reduced pain, clicking sounds, locking episodes, and increased maximal mouth opening, following prolotherapy treatment. These improvements were found to be statistically significant (p-value < 0.05). Dextrose prolotherapy is a treatment method with broad applications and should be considered prior to resorting to long-term pharmacotherapy or surgical interventions. The use of 10% dextrose prolotherapy presents a promising treatment modality for temporomandibular joint disorders, as evidenced by its therapeutic benefits. © Association of Otolaryngologists of India 2024.
Evaluation of Transport Distraction Osteogenesis in Maxillofacial Region
(Springer, 2025) Ajit Kumar Vishwakarma; Neeraj Kumar Dhiman; Naresh Kumar Sharma; Chandresh Jaiswara; Preeti Tiwari; Mehul Shashikant Hirani
Introduction: Transport distraction osteogenesis (TDO) is a novel reconstructive modality for mandibular ablative defects, precluding donor site morbidity. Assessing of TDO regenerate that could assist in modifying the distraction strategy for patient specific needs. Materials and Methods: Present study enrolled 17 patients with mandibular defects of size < 12 cm, divided in two groups ≤35 years (A) and > 35 years (B); and assessed the TDO regenerate by clinically examining intra as well as post operatively, using orthopantomogram (OPG), ultrasonography (USG), color Doppler (CD) and cone beam computed tomography (CBCT). Results: Group B had a longer latency period (p = 0.001) and consolidation period (p = 0.002) than group A. Paired sample correlation study of clinical defect and TDO regenerate (p 0.004) indicate that a better length of regenerate is possible with TDO in mandibular defects. OPG, USG and CBCT shown a significant difference in bone mineralization observed within different age groups except for CD. USG representing earlier detection of mineralization than OPG over the consolidation period. Conclusion: Use of TDO for reconstruction of mandibular defects is advantageous as the regenerated bone and soft tissues matches the existing anatomical tissues. Evaluation by USG, OPG and CBCT could aid in providing patient specific protocols for TDO in Maxillofacial region. © The Association of Oral and Maxillofacial Surgeons of India 2024.
Exploring the supremacy of microvascular coupling devices for arterial anastomosis in terms of added expeditiousness, safety concerns: A systematic review
(Elsevier B.V., 2024) Ajit Kumar Vishwakarma; Naresh Kumar Sharma; Neeraj Kumar Dhiman; Shankar Singh; Chandresh Jaiswara; Sadhana Swaraj
Background: Arterial anastomoses are still most commonly performed using orthodox hand sewing technique. Various rationale such as non-pliable, atherosclerotic, thick-walled or irradiated vessels limit the competency of coupler devices for arterial micro-anastomosis. Microvascular coupling devices (MCD) are well known for venous anastomoses but arterial MCD have relatively been less navigated in reported literatures. This review outlines the current applications, troubleshooting, safety and efficiency of arterial MCD in free flaps. Methods: Comprehensive search of electronic databases (PUBMED/MEDLINE) in accordance with PRISMA guideline was performed. Data were extracted and collected in four groups of standardised variables. Results: Out of a total of 263 identified articles, 38 studies were analysed and 16 amidst these were included in final data synthesis. Included studies contained a combined total of 2416 patients who went through 521 arterial and 2460 venous anastomoses using 3 M/Synovis coupling devices. Among all coupled arterial anastomoses, 407 were conducted in head and neck free tissue transfer and 114 were performed in breast reconstruction. The aggregate coupled arterial micro-anastomosis success rate reported was 90.01 % (469/521). Only 9.98 % (52 out of 521) manifested pooled incidence of troubleshooting, thrombosis or flap failure. Conclusion: Microsurgeons are resisting the frequent use of arterial coupling devices owing to inherent arterial characteristics, but with suitable vessel selection, arterial coupling may be a powerful tool and can be executed in safe, expeditious and reliable fashion. This study embellishes collaborative suggestions and troubleshooting issues related to arterial coupling, however further assessment would be required with controlled trials. © 2024 The Authors
Hyena bite: A rare intriguing mode of maxillofacial injury, its management, risks involved, scenarios to avoid
(Wolters Kluwer Medknow Publications, 2024) Arjun Mahajan; Chandresh Jaiswara; Neeraj Kumar Dhiman; Aswathi Krishnan
The striped hyena (Hyaena hyaena) is a rarely spotted carnivore in India listed as Near Threatened (red list) by International Union for Conservation of Nature (IUCN) in 2014. Hyena is considered as scavenger but also executes rare opportunistic attacks on humans. In India, reported cases of hyena attack on humans are very rare, because of remote locations of these attacks majority of which go unreported to higher medical centres. This article describes about the circumstances and management of Hyena inflicted maxillofacial injury in North India, which is as per our knowledge first scientifically documented maxillofacial injury caused by Hyena in Indian subcontinent. © 2024 National Journal of Maxillofacial Surgery | Published by Wolters Kluwer - Medknow.
Long-term follow-up of trigeminal neuralgia patients treated with percutaneous balloon compression technique: A retrospective analysis
(Jaypee Brothers Medical Publishers (P) Ltd, 2016) Suman Yadav; Rajratna M. Sonone; Chandresh Jaiswara; Shipra Bansal; Deepak Singh; Vidhi Chhabra Rathi
Background: Trigeminal neuralgia (TN) refers to sharp, lancinating pain in the areas supplied by trigeminal nerve. Both pharmacological and surgical lines of treatments are available for the treatment of TN. Percutaneous balloon compression (PBC) is one such surgical technique that is usually advocated for the treatment of TN occurring in elderly patients. Hence, we aim to evaluate the follow-up results of the TN patients treated by the PBC technique. Materials and methods: A total of 400 patients were selected for the study who had undergone surgical treatment of TN by percutaneous balloon decompression technique. All the postoperative follow-up records of the patients, clinical history, and complication records of the patients were studied and evaluated. Results: Of all the patients included in the study, 353 patients showed improvement clinically after PBC therapy. Out 400, 180 were males and 220 were females. Postoperative complications of the patients during their follow-up were also recorded and it was observed that the most common complication arising after treatment with this technique included facial numbness, masseter muscle weakness, paresthesia, diplopia, and corneal anesthesia. Conclusion: One of the most common neuralgic pains affecting the face is the pain of TN. Although numerous lines of treatment options are available for its treatment, all these have one or the other drawbacks. From our results, we can conclude that PBC technique offers more advantages than other surgical modalities and, therefore, should be preferred over other techniques of treatment.
Masticatory efficiency of fracture mandible after osteosynthesis with 2 mm conventional and locking miniplates: A comparative study
(Jaypee Brothers Medical Publishers (P) Ltd, 2020) Nitesh Mishra; Aditi Priya; Chandresh Jaiswara; Naresh Kumar Sharma; Neeraj Kumar Dhiman; T. Janani
Aim: To evaluate and compare the effectiveness of locking vs conventional 2.0 mm titanium miniplate in the fixation of mandibular fractures and to compare masticatory efficiency. Materials and methods: In this study, 30 patients were selected and randomly divided into two groups (I and II). Both groups I and II consisted of 15 patients who underwent mandibular osteosynthesis using locking and conventional (non-locking) 2-mm miniplates, respectively. Postoperative follow-up was done at first, second, fourth week, and at third month for radiological and clinical assessment of all the patients. Results: In this study, a statistically insignificant result was found in the following parameters: pain, swelling, paresthesia, infection, hardware failure, and postoperative occlusal bite forces. An increase in bite force is recorded at each follow-up (first, second, fourth week, and at third month) for both the groups. When occlusal bite forces were compared, group I showed greater mean bite force than group II at each follow-up, however, the results were statistically insignificant (p value > 05). Conclusion: This study concludes that both locking and conventional miniplates are equally effective in withstanding masticatory load, with locking plates/screw system having added advantage of higher initial stability and stiffness thereby minimizing the duration of IMF. Locking miniplates system was found to have less infection and hardware failure. Clinical significance: In this study, locking plate group was found to be clinically superior because of ease of handling, higher initial stability, and stiffness, hence minimizing the total duration and had less infection and failure. © 2020, Jaypee Brothers Medical Publishers (P) Ltd. All rights reserved.
Role of procalcitonin, interleukin-6 and interleukin-10 as a predictive marker for the use of perioperative steroid in maxillofacial trauma patients
(Churchill Livingstone, 2024) Preeti Tiwari; Rathindra Nath Bera; Nishtha Chauhan; Chandresh Jaiswara; Ragini Srivastava; Bikram Kumar Gupta
Maxillofacial trauma often brings significant challenges for surgeons in terms of preoperative oedema. Steroids offer oedema reduction, yet potentially increase the risks of postoperative infection. This study explores procalcitonin (PCT), as a marker for bacterial infection risk, and interleukins IL-6 and IL-10, which respectively signify pro-inflammatory and anti-inflammatory responses, as potential indicators of infection and inflammation in these trauma cases and thereby aid in refining perioperative guidelines for the use of steroids. A prospective study was conducted at a tertiary public hospital in India from 2019 to 2022 on patients >18 years with facial trauma. After specific exclusions, patients were randomised into steroid (Group A) and non-steroid (Group B) groups. Various parameters including oedema, PCT, IL-6, and IL-10 levels were measured and analysed using SPSS software. Out of 80 patients, 44 were in Group A and 36 in Group B. Post-24 hours, Group A showed significant oedema reduction, with 25 patients displaying a decline to mild oedema, versus 10 patients in Group B (p = 0.034). However, Group A witnessed a higher infection risk, with 20 patients showing positive wound cultures versus three in Group B. Subgroup analysis revealed a link between higher PCT levels and infections (p = 0.039). Additionally, Group A showed less intraoperative bleeding and reduced operating time. While perioperative steroids mitigate swelling, they might increase postoperative infection risk. Elevated PCT levels indicate potential wound infections, suggesting those patients should avoid perioperative steroids. IL-6 and IL-10 trends during perioperative phases can predict pronounced oedema outcomes. © 2024 The British Association of Oral and Maxillofacial Surgeons
Temporomandibular joint ankylosis: A tertiary center-based epidemiological study
(Wolters Kluwer Medknow Publications, 2021) Nitesh Mishra; Naresh Kumar Sharma; Neeraj Kumar Dhiman; Chandresh Jaiswara; Preeti Tiwari; Akhilesh Kumar Singh
Introduction: Limitation of mouth opening can be caused by bony or fibrous ankylosis of the temporomandibular joint (TMJ) as a sequel to trauma, infection, or autoimmune diseases. The incidence of TMJ ankylosis differs significantly in different parts of the world. The purpose of this study was to analyze the etiological incidence of TMJ ankylosis at our tertiary-level center, which covers a huge population from parts of Bihar and eastern Uttar Pradesh. Materials and Methods: This study was conducted from July 2016 to April 2019, and a total of 1607 children were screened in the duration of 33 months. Participants were included in this study as per the inclusion and exclusion criteria. Results: After screening of the 1607 children, 128 TMJ ankylosis cases were identified. Out of the 128 cases of TMJ ankylosis, 33 cases were bilateral and 95 cases were unilateral (48 left sided and 47 right sided). Most of the patients (83.5%) were in the 10–15-year-old age group (mean age was 12.1 ± 2.83 years). There was a female preponderance, and the male-to-female ratio was 7:10. Overall, the most common cause of ankylosis was found to be childhood trauma. Conclusion: The major etiologic factor of TMJ ankylosis was found to be birth/childhood trauma. TMJ ankylosis cases were detected in significant numbers in this study. This increased prevalence may be due to the lack of knowledge about this pathological entity among the general population and health-care professionals at primary level, which leads to poor initial management. © 2021 National Journal of Maxillofacial Surgery.
The Comparative Evaluation of Novel Second Generation Platelet Rich Fibrin Membrane and Conventional Collagen Membrane as Grafting Materials in Post-Fibrotomy Defects of Oral Submucous Fibrosis Lesions
(Springer, 2025) Arjun D. Mahajan; Neeraj Kumar Dhiman; Chandresh Jaiswara; Monika Bansal; Richik Tripathi
Oral SubmucousFibrosis(OSMF) is a premalignant condition predominantly affecting people of south-east Asian origin. Histologically, progressive submucosal fibrous band formation is a characteristic feature which requires surgical excision in advanced cases. A various grafting materials have been used to cover post-surgical defects such as buccal fat pad, nasolabial flap, platysma flap, and collagen membrane each with different advantages and disadvantages. But in today’s era of tissue engineering Platelet Rich Fibrin (PRF) based on the platelet gel therapeutic concept is gaining popularity in restorative procedures, after its development by Choukroun et al. in 2001. PRF membrane being an autogenous growth factor-rich fibrin biomaterial is compared for efficacy with widely used collagen xenograft. As per our knowledge of the literature, this study is the first comparative analysis between PRF membrane and Collagen membrane as reconstructive materials post fibrotomy of OSMF bands. 30 patients including males and females diagnosed clinically with OSMF were grouped post randomization and post-fibrotomy defects were reconstructed with PRF membrane (Group 1) and Collagen membrane (Group 2). Post-operative pain, edema, epithelization, mucosal suppleness, mouth opening, and patient compliance were noted. Data was statistically analyzed with SPSS® IBM® (version 21) software. PRF membrane group showed significant reduction in pain, rapid recovery from mucosal edema, faster rate of epithelization and improvement in mucosal suppleness. Though trend for mouth opening over the period of follow-up was similar in both groups, patient compliance for post-operative jaw physiotherapy was found to be better with PRF membrane grafted patients. With the only drawback of technique sensitivity PRF membrane is emerging as an excellent option for the reconstruction of soft tissue defects. © Association of Otolaryngologists of India 2025.
The rarest cause of impaction of mandibular third molar – A case report
(Elsevier B.V., 2016) Chandresh Jaiswara; Alka Rani; Neeraj Kumar Dhiman
Mandibular tooth impaction is a very common finding and is usually associated with so many local and systemic causes in which the pathway of tooth eruption is obstructed or misdirected. The local causes are either a local bony lesion or an abnormal position of the adjacent tooth. The case presented here is associated with a very rare cause of impaction, which is the hamartomatus growth of the first and second molars causing the obstruction and leading to the impaction of the adjacent third molar tooth. © 2015 Craniofacial Research Foundation