Browsing by Author "Farhan Durrani"

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An interdisciplinary approach for reconstruction of worn dentition
(Wolters Kluwer Medknow Publications, 2022) Farhan Durrani; Rakhshinda Nahid; Samidha Pandey; Aishwarya Pandey; Preeti Singh
Complete tooth wear dentition is multifactorial and has challenges with diagnosis and etiology. Their rehabilitation often requires orthognathic surgery, orthodontics, periodontal surgery, and prosthodontic guidelines for occlusion with harmonious facial and dental esthetics. A patient needs a multidisciplinary approach with systematic analysis to formulate evidence-based approach to improve function and esthetics. Contemporary periodontal therapy also encompasses esthetic treatment where needs are frequently associated with changes in tooth size, shape, proportion, and balance that can adversely affect smile appearance. The article provides an evidence-based guideline for reconstruction of a worn dentition. The completed work includes crown lengthening, provisionalization, socket shield technique, oral implants, and gain in lost vertical dimension with occlusion correction and minimally invasive prosthetic restorations. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
Comparative Analysis of Radial Forearm Free Flap and Submental Island Flap in Reconstruction of Post-glossectomy Defects of Oral Squamous Cell Carcinoma and Quality of Life Assessment
(Springer, 2025) Akhilesh Kumar Singh; Arjun D. Mahajan; Janani Anandkumar; Naresh Kumar Sharma; Farhan Durrani; Neeraj Kant Agrawal; Pg G.Naveen Kumar; J. F. Neville
Aim: Reconstruction of tongue defects has always been a challenging aspect of onco-surgery. Although a variety of locoregional and free flaps have been advocated, it still poses a challenge due to its complex function in deglutition and speech articulation. Hence, this study aims at reducing the dilemma of flap selection for better patient outcome. Materials and Methods: Among 16 tongue carcinoma cases, 6 cases were reconstructed using submental island flap (SIF) and 10 using radial forearm free flap (RFFF). These 2 flaps were compared in terms of parameters like intraoperative time, hospital stay, overall survival, pain, cosmesis, and recreation of anatomy, and functions like deglutition and articulation of speech. Patients were followed for oncologic safety and recurrence. Obtained data were statistically analysed using IBM® SPSS®. Result: SIF showed significantly higher activity score (P = 0.001) with reduced flap harvest time (P = 0.014) but showed difficulty in deglutition (P = 0.03) compared to RFFF. It was concluded that in cases of RFFF mobility and functional outcome was superior, but flap harvest time was considerably higher. Overall patient survival rate was better in cases of RFFF in long-term follow-up, but flap survival rate was significantly higher in SIF owing to better vascularity. Conclusion: In highly compromised cases and salvage cases where microvascular flaps are contraindicated, submental flap being a local flap with comparable overall survival rate, better cosmesis hence, serves as a reliable flap for reconstruction of glossectomy defects. © The Association of Oral and Maxillofacial Surgeons of India 2024.
Comparative Analysis of Radial Forearm Free Flap and Submental Island Flap in Reconstruction of Post-glossectomy Defects of Oral Squamous Cell Carcinoma and Quality of Life Assessment
(Springer, 2024) Akhilesh Kumar Singh; Arjun Mahajan; Janani Anandkumar; Naresh Kumar Sharma; Farhan Durrani; Neeraj Kant Agrawal; P. G. Naveen Kumar; J.F. Neville
Aim: Reconstruction of tongue defects has always been a challenging aspect of onco-surgery. Although a variety of locoregional and free flaps have been advocated, it still poses a challenge due to its complex function in deglutition and speech articulation. Hence, this study aims at reducing the dilemma of flap selection for better patient outcome. Materials and Methods: Among 16 tongue carcinoma cases, 6 cases were reconstructed using submental island flap (SIF) and 10 using radial forearm free flap (RFFF). These 2 flaps were compared in terms of parameters like intraoperative time, hospital stay, overall survival, pain, cosmesis, and recreation of anatomy, and functions like deglutition and articulation of speech. Patients were followed for oncologic safety and recurrence. Obtained data were statistically analysed using IBM® SPSS®. Result: SIF showed significantly higher activity score (P = 0.001) with reduced flap harvest time (P = 0.014) but showed difficulty in deglutition (P = 0.03) compared to RFFF. It was concluded that in cases of RFFF mobility and functional outcome was superior, but flap harvest time was considerably higher. Overall patient survival rate was better in cases of RFFF in long-term follow-up, but flap survival rate was significantly higher in SIF owing to better vascularity. Conclusion: In highly compromised cases and salvage cases where microvascular flaps are contraindicated, submental flap being a local flap with comparable overall survival rate, better cosmesis hence, serves as a reliable flap for reconstruction of glossectomy defects. © The Association of Oral and Maxillofacial Surgeons of India 2024.
Comparative evaluation of conventional and socket-shield techniques on maxillary esthetics following immediate implant placement in fresh extraction sockets: A randomized controlled trial
(Wolters Kluwer Medknow Publications, 2024) Farhan Durrani; Aishwarya Pandey; Shweta Ahlawat; Ekta Kumari; S. U. Gokila Vani; Sakshi Agarwal; P. G. Naveen Kumar
Background: Dental implants in fresh extraction sockets of the maxillary esthetic area are technique-sensitive procedures where retaining a buccal root segment can enhance periodontium preservation and esthetics. This study aims to compare marginal bone levels and esthetic outcomes between conventional immediate implant placement and the socket-shield technique in fresh maxillary extraction sockets. Materials and Methods: Twenty-four patients with type 1 extraction sockets were included in this randomized trial and assigned to either conventional immediate implant placement or the socket-shield technique. Implant survival, crestal bone levels, and pink esthetic scores (PES) were evaluated at 8 months (temporary prosthesis), 12 months, and 36 months (final crowns). Results: All implant-supported restorations were successful within the study's observation period. The socket-shield technique showed significantly lower marginal bone loss (e.g. 1.40 ± 0.29 mm vs. 1.70 ± 0.36 mm at 36 months; P = 0.040) and superior PES (e.g., 10.50 ± 0.90 vs. 9.36 ± 0.98 at 36 months; P = 0.008) compared to the conventional technique. However, the technique's complexity underscores the need for expertise and careful execution to optimize tissue preservation in the maxillary esthetic zone. Conclusion: The socket-shield technique better preserves hard and soft tissues around implant-retained prostheses than conventional implant placement in maxillary esthetic regions. Further studies with larger sample sizes and longer follow-up are required to validate these findings. © 2025 Indian Society of Periodontology.
Comparative evaluation of hard and soft tissue parameters by using short implants and standard long implants with sinus lift for prosthetic rehabilitation of posterior maxilla
(Wolters Kluwer Medknow Publications, 2024) Farhan Durrani; S.M. Karthickraj; Fouzia Imran; Shweta Ahlawat; Ekta Kumari; S. U. Gokila Vani
Objective: The objective is to compare and evaluate the hard and soft tissue parameters by using short and standard long implants with sinus lifting in the posterior maxilla. Materials and Methods: Eleven patients with complaints of missing upper back teeth were enrolled in the study for implant-supported rehabilitation and were categorized into two groups: Group long (GL): longer implant (>8 mm) placement, preceded by Sinus Augmentation. Group short (GS): short implant (≤8 mm) placement, without sinus augmentation. The primary outcome measured was cumulative survival rate (CSR) in the compromised partial edentulous posterior maxilla. Secondary outcomes measured were implant stability (IS), marginal bone level alterations (MBL), pocket probing depth (PPD), crown-to-implant ratio, and any complications. Results: The difference in CSR between the groups was not statistically significant (P = 0.317). High stability was achieved immediately after the placement of the implants, in both groups (GS: 64 ± 4.07, GL: 65.58 ± 9.75); this difference in the mean ISQ (IS quotients) values was not found to be statistically significant at implant placement (P = 0.7). The mean MBL reported in the study at the end of 12 months of prosthesis function was - 0.762 ± 0.48 mm and - 0.7 ± 0.34 mm for GS and GL, respectively. The mean PPD measurements in GS and GL groups were 1.917 ± 0.68 mm and 1.833 ± 0.38 mm, respectively, and it was not statistically significant (P = 0.8). Conclusion: Within the limitations of the present study, the obtained results indicate that short implants provided a similar clinical and radiographic performance compared to long implants placed in combination with a sinus augmentation procedure (lateral window) up to 12 months after prosthetic loading. © 2024 Indian Society of Periodontology | Published by Wolters Kluwer - Medknow.
Comparative evaluation of mucin and total protein in periodontal disease before and after nonsurgical periodontal therapy
(Wolters Kluwer Medknow Publications, 2024) J.P. Vishnu; Anju Gautam; Surendra Pratap Mishra; Farhan Durrani; Fouzia Imran; Ekta Kumari
Background: Periodontal ailments cause a quantum leap in the biomarker profile of the saliva. This profile is, in fact, the epiphany of the scale and extent of the disease. Both gingivitis and periodontitis are chronic inflammatory diseases with a step-grade progression. The study aimed to determine the response of the host in these conditions by analyzing concentrations of salivary mucin and total protein activity, before and after nonsurgical periodontal therapy (NSPT). Materials and Methods: Sixty adult subjects were clinically examined and divided into three groups (n = 20) according to the clinical assessment and categorized as Group I (healthy), Group II (gingivitis), and Group III (chronic periodontitis). Whole saliva was collected, and salivary mucin and total protein levels were quantitatively measured at baseline in all the groups and additionally after NSPT in Groups II and III. Results: Levels of mucin and total protein increased in patients with gingivitis and periodontitis. There was a slight decline in mucin levels in periodontitis patients in comparison with the gingivitis group. A positive correlation was found between the respective clinical parameters of both the groups along with their levels of salivary mucin and total protein. It indicated that the response of salivary glands to increase their protective potential caused the change among the groups. Conclusion: Periodontal diseases induce an increase in the levels of mucins and proteins, which is believed as the action of the salivary glands to protect the oral cavity and put off the chaos caused by the microorganisms. © 2024 Indian Society of Periodontology | Published by Wolters Kluwer - Medknow.
Comparison between all-on-four and all-on-six treatment concepts on stress distribution for full-mouth rehabilitation using three-dimensional finite element analysis: A biomechanical study
(Wolters Kluwer Medknow Publications, 2023) Aishwarya Pandey; Farhan Durrani; Sanjay Kumar Rai; Nishant Kumar Singh; Preeti Singh; Rati Verma; Jitendra Kumar
Purpose: The current study intended to provide a comparison of biomechanical behaviors of two different treatment concepts for full-mouth rehabilitation with dental implants placed according to the 'All-on-four' concept and 'All-on-six' concept with analysis of the stress patterns of the implant support system using three-dimensional finite element analysis (FEA). Materials and Methods: The edentulous mandible was treated with two different implant designs. 'All-on-Four' implant placement concept was used in Model 1 with two central axial implants and two distally tilted implants at 17° and in Model 2, 'All-on-Six' concept was applied with six vertically placed implants. Individual vertical and horizontal load of 100 N and oblique load of 141 N at 45° was applied to all implants. To evaluate and compare the results in terms of maximum principal stress, we used FEA. Results: All-on-six showed smaller maximum principal stress values on the cortical bone and implants. However, maximum principal stress values obtained on trabecular bone was smaller in the All-on-four design for vertical and horizontal loading conditions. Conclusions: The All-on-six approach showed more favorable biomechanical behavior. © 2023 Indian Society of Periodontology | Published by Wolters Kluwer - Medknow.
En Block Versus Separate Management of Cervical Nodes in Tongue and Floor of the Mouth Cancers- Is There a Difference? An Analysis of 85 Cases in a Tertiary Care Institute
(Springer, 2022) J.F. Neville; Mandar Tilak; Akhilesh Kumar Singh; Naresh Kumar Sharma; Janani Anand Kumar; Nitesh Mishra; Farhan Durrani
To evaluate difference in local recurrence, regional (neck) recurrence as well as distant metastases between cases operated with en-block excision of primary cancer and neck nodes versus their separate removal, in squamous cell carcinomas of anterior 2/3 of tongue and floor of the mouth. A total 85 patients of cT1-T4a N0-N2b of carcinoma anterior 2/3 of tongue and floor of mouth were evaluated. Amongst these patients 39 cases of in-continuity en-block neck dissection and 46 cases of discontinuous neck dissection were evaluated for post-operative complications as well as oncological outcome for a follow up period of 3 years. Patient population was similar in both groups with tongue cancers being the commonest site and tobacco being the most common addiction. Primary site hematoma was seen more in the in-continuity en-block neck dissection group with a p-value of 0.0276, which was statistically significant. Post-operative oro-cutaneous fistula occurred more in in-continuity enblock neck dissection as compared to discontinuous neck dissection, but the difference was not statistically significant. Local recurrence rate was significantly more in cases of discontinuous neck dissection (19.565) as compared to in-continuity en-block neck dissection (5.12%) with a p-Value 0.0481. A statistically non-significant but higher loco-regional recurrence was observed in cases of discontinuous neck dissection as compared to cases of in-continuity en-block neck dissection (10.56% vs 2.56). In the present study recurrence-free survival RFS 3 year in cases of en-block in-continuity neck dissection (84.06%) cases as compared to discontinuous neck dissection cases (63.04%) with p Value 0.025698. In-continuity en-block in continuity neck dissection has lower loco-regional recurrence and may impact overall distant metastases. Though early postoperative complications are more in in-continuity en-block in continuity neck dissection as compared to discontinuous neck dissection, most are managed conservatively. Further studies with a larger sample size are needed to evaluate its outcome in a comprehensive manner. © 2021, Association of Otolaryngologists of India.
Evaluation and comparison of stress distribution around periodontally compromised mobile teeth splinted with different materials: Three-dimensional finite element analysis
(Wolters Kluwer Medknow Publications, 2019) Farhan Durrani; Arpit Galohda; Sanjay Rai; Nishant Singh; Rati Verma; Dhananjay Yadav; S.M. Karthickraj
Background: Progressive attachment loss around the teeth because of periodontal disease can result in increased tooth mobility. This adversely affects patient's comfort, function, and esthetics. Periodontal splinting helps in accomplishing stability by redistributing the functional and parafunctional forces. There are various materials that have been used for periodontal splinting. Fiber-reinforced composite, composite resin, and metal-reinforced composite are often used as splinting materials for periodontally compromised teeth. In our study, a comparison was done among these materials for their ability to distribute the stresses at different bone levels in mobile lower incisors splinted together with canines. Materials and Methods: Five patients of age group 25-50 years with Grade 2 and 3 mobile incisors having 40% or more bone loss and firm canines with optimal bone support were selected. From the computed tomography scan of each patient, three models were developed demonstrating splinting of mandibular incisors and canines with metal-reinforced composite, fiber-reinforced composite, and composite resin. So in total, 15 models were developed and each one of them was subjected to vertical and transverse loads of 150 N. Pattern of stress distribution was observed in these models using three-dimensional finite element analysis. Results: After splinting, the stress on the canine increased when bone levels around incisors decreased while stress on incisors reduced. Conclusion: Tested splinting materials were successful in stress distribution, and metal-reinforced composite was found to be better than the other splinting materials. © 2019 Indian Journal of Dental Research.
Lateral overlap technique for the treatment of isolated deep Miller Class II/III gingival recession in mandibular anterior teeth: A single-arm interventional study
(Wolters Kluwer Medknow Publications, 2025) Farhan Durrani; Aishwarya Pandey; Kajol Kumari Rajak; Mahendra Rawaji Gawade; Dhanraj Meena
Background: Treating deep isolated mandibular recession defects, especially Miller Class III cases, remains a significant challenge due to factors such as shallow vestibules, muscle pull, reduced keratinized tissue width (KTW), and tooth malposition. Although various techniques have been explored, predictable outcomes with complete root coverage (RC) in such cases are rarely documented in the literature. Materials and Methods: Thirty-two systemically healthy patients (22 males and 12 females) aged 22–36 years, with isolated mandibular recessions measuring 6–11 mm, were treated using the lateral overlap technique (LOT) combined with coronal flap displacement and subepithelial connective tissue grafts. Clinical parameters, including gingival recession depth (GRD), KTW, and probing depth, were evaluated over a 1-year follow-up. Results: Significant improvements were observed: GRD reduced from 5.55 ± 0.89 mm to 0.17 ± 0.16 mm, KTW increased by 3.26 ± 0.37 mm, and the mean percentage of RC was 96.81 ± 2.83. Conclusion: LOT with connective tissue grafting is a reliable and effective approach for managing deep isolated mandibular Miller Class II and III gingival recessions, achieving excellent clinical outcomes. © 2025 Indian Society of Periodontology.
Microsurgical aesthetic treatment of gingival fenestration by a coronally repositioned Partial thickness graft: A case report
(2013) Punit Vaibhav Patel; Naresh Kumar; Farhan Durrani
Gingival fenestration is a rare pathological entity, scarcely described in the literature. The present paper has reported a case of a 22-year-old male patient with a "Gingival fenestration" in the lower left central incisor. The lesion was successfully treated using a coronally positioned partial thickness graft under 4 X magnification, with excellent aesthetic results.
Natural teeth and implant-retained prosthesis in treated periodontitis subjects
(Wolters Kluwer Medknow Publications, 2022) Farhan Durrani; Samidha Pandey; Rakhshinda Nahid; Aishwarya Pandey; Preeti Singh
History of periodontal disease is a risk factor for the development of peri-implantitis. Implant treatment in susceptible patients should be followed by adequate periodontal treatment and stringent supportive programs. The assessment of the patient needs to be carefully evaluated before the procedure for implants. The risk associated with the sites to be treated requires evaluation with regular visits. The completion of treatment will still require committed follow-up visits with checks for pockets, bone loss, and plaque scores around implant-retained prosthesis as well as complete dentition. In our report, we describe in detail the reconstruction of lost dentition with implants in treated periodontitis subjects. The patients are still being followed with regular recall programs. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
One-piece implants: Careful approach for complex rehabilitation
(Wolters Kluwer Medknow Publications, 2021) Farhan Durrani; Rakhshinda Nahisamidha Pandey; Preeti Singh; Aishwarya Pandey
It is understood that one-piece implant design is a stronger concept as there is no connection between implant and abutment. The absence of a microgap can lead to minimal peri-implant bone loss. Furthermore, there is a reduction of mechanical complications such as screw loosening and abutment fractures. These implants can be immediately placed and can be put through instant function because of their high cortical stabilization. This immediate function protocol has advantages over two-stage surgical placement. Other benefits are fewer surgical appointments, reduced treatment time, and minimal trauma. It is suggested that one-piece implant can be an alternative to conventional implants for edentulous arches where there is a resorbed bone in width and height. Initially, one-piece implants were used as transitional or provisional implants. However, because of biological osseointegration, their removal often became difficult. Several manufacturers obtained approval for its use in defined situations. Proper treatment planning avoided comorbidity associated with augmentation procedures and acceptable esthetic result was achieved. © 2021 National Journal of Maxillofacial Surgery.
Palatal bone block: A predictable bone augmentation technique for restricted maxillary defect
(Wolters Kluwer Medknow Publications, 2023) Farhan Durrani; J.P. Vishnu; Aabida Taslim; Fouzia Imran; Ekta Kumari; Aishwarya Pandey
Bone grafting for implant dentistry depends on bone quality, quantity, and biological principles for good outcome. Autogenous bone as donor remains the gold standard among all the available materials. However, it carries unpredictable morbidity and need for different surgical sites. In our report, we describe a simplified approach in bone augmentation for restricted maxillary atrophic defect within the same surgical site as a harvesting site. The method can be an alternative for different intraoral surgical harvesting sites. The patient's left maxillary central incisor before treatment had a large bony defect which was reconstructed though single site approach of augmentation. The implant-supported restoration with healthy periodontium around even after 2 years of review looks promising. The approach can be an alternative for different intraoral surgical sites. © 2023 Wolters Kluwer Medknow Publications. All rights reserved.
Peri-Implant Esthetics in Focus: Comparing Anodized Titanium and Zirconium Dioxide Abutments in a Randomized Clinical Trial
(John Wiley and Sons Inc, 2025) Sakshi Agarwal; Farhan Durrani; Aishwarya Pandey; M. Rashika; Shraddha Shilpi; Dhanraj Meena
Objective: Achieving optimal esthetics remains challenging due to limited comparative evidence between pink-anodized titanium and zirconium dioxide abutments. The objective of this clinical study was to evaluate the optical outcomes of pink-anodized titanium and zirconium dioxide abutments in the esthetic region. Methods: Twenty-two subjects with an edentulous site in the maxillary esthetic region with a tooth present mesially and distally were selected for implant surgery along with hard and soft tissue augmentation. Group A received a pink-anodized titanium abutment with a layered lithium disilicate single crown. Group B received a zirconium dioxide abutment with the same prosthesis material. The contralateral natural tooth served as the control group. Optical outcomes were assessed using a spectrophotometer. The CIELAB color coordinates (Commission Internationale de l'Eclairage) were recorded to calculate ΔE values. Vernier calipers, along with an endodontic file, were used to measure the peri-implant soft tissue thickness. The Pink Esthetic Score (PES) was evaluated using digital images of 22 single-tooth implant crowns to assess the surrounding soft tissue esthetics. Results: Zirconia abutments (Group A) demonstrated superior optical outcomes compared to pink-anodized titanium abutments (Group B). The ΔE values for Group A at the peri-implant soft tissue, coronal, and midfacial crown levels were significantly lower compared to Group B. Soft tissue thickness (STT) increased over time in both groups, with a slight increase in Group B. The Pink Esthetic Score (PES) also improved with recall visits at each evaluation. Conclusion: Zirconia abutments provided superior esthetic outcomes compared to pink-anodized titanium abutments, with significantly lower color differences (ΔE) and higher Pink Esthetic Scores (PES). Although pink-anodized titanium abutments showed increased soft tissue thickening with time, zirconia abutments remained the more favorable option for esthetically demanding cases. Clinical Trials Registry: (CTRI No. CTRI/2024/03/064442). © 2025 Wiley Periodicals LLC.
Periodontal and prosthetic perspective of implant-supported full-arch prostheses with monolithic zirconia and porcelain fused metal restorative materials: A three-year retrospective case series
(Wolters Kluwer Medknow Publications, 2025) Farhan Durrani; Aishwarya Pandey; Rashika Muralisekar; Sakshi Agarwal; Shraddha Shilpi; Kajol Kumari Rajak
Full-mouth implant-supported prosthetic rehabilitation for failing dentition is a complex, multifactorial process influenced by prosthetic materials and peri-implant periodontal health. Traditionally, porcelain-fused-to-metal (PFM) frameworks have ensured functional stability and acceptable esthetics; however, the advent of monolithic zirconia layered with porcelain has introduced enhanced mechanical strength and esthetic appeal. This retrospective case series evaluated the 3-year clinical outcomes of full-arch implant-supported prostheses fabricated using either monolithic zirconia or PFM in edentulous patients, focusing on peri-implant soft-tissue health, marginal bone loss, and prosthetic complications. Ten edentulous patients rehabilitated with full-arch implant-supported prostheses were included and assessed clinically and radiographically for peri-implant tissue health, plaque accumulation, probing depth, bleeding on probing, marginal bone levels, and technical complications over a 3-year follow-up. Both prosthetic materials demonstrated stable peri-implant tissue health and 100% implant survival at the 3-year mark. Monolithic zirconia restorations exhibited reduced plaque accumulation, stable bone levels, and absence of prosthetic complications, whereas the PFM group showed minor technical issues such as porcelain chipping and screw loosening. Within the limitations of this study, both materials proved clinically viable for full-arch implant rehabilitation; however, monolithic zirconia showed a trend toward superior biological and mechanical outcomes. Larger, prospective studies are warranted to validate these preliminary findings. © 2025 Indian Society of Periodontology.
Pink gingival restoration: An acceptable treatment for complex ridge defects
(Wolters Kluwer Medknow Publications, 2022) Farhan Durrani; Aishwarya Pandey; Preeti Singh
Complex implant prosthetic reconstruction poses several challenges. The lost anatomy of periodontium due to trauma or long-standing missing teeth, especially in esthetic area, requires several surgical visits for recovery. The augmentation procedures are technique sensitive and unpredictable and need long commitment from the patient. They are time-consuming and expensive, and patients are often unwilling. The alternative for anatomically deficient partial edentulous sites could be prosthetic gingival restoration. They help in re-establishing natural contours, interproximal papilla, and further eliminating complex procedures. The other advantage is perfect horizontal and vertical transition between the prosthesis and adjacent tissues. This article describes two cases of completed gingival prosthetic prosthesis which corrected the missing architectures around lost teeth. It was well accepted by the patients and can be an alternative for unpredictable regenerative procedures. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
Quality of Life Assessment and Comparative Analysis of Anterolateral Thigh Flap and Pectoralis Major Myo-cutaneous Flap for Reconstruction of Post Excision Defects of Oral Squamous Cell Carcinoma
(Springer, 2024) Arjun Mahajan; Janani Anand Kumar; Akhilesh Kumar Singh; Naresh Kumar Sharma; Farhan Durrani; Neeraj Kant Agrawal; Neville JF
Present study is a comparative evaluation of the financial impact on choice of flap, clinical results as well as post resection quality of life assessment of cancer patients reconstructed with anterolateral thigh(ALT) flap and pectoralis major myo-cutaneous(PMMC) flap. Ethical clearance was obtained from institutional ethical committee. In this non-randomised, prospective study design among 49 oral squamous cell carcinoma cases, 39 cases were reconstructed using PMMC flap and 10 using ALT flap from year 2020 to 2022. These 2 flaps were compared in terms of parameters like time utilised for reconstruction, hospital stay, overall survival and Washington University Quality of Life index(UW-QOL) for head and neck cancer. Patients were followed regularly for post-operative complications. The University of Washington Quality of Life score (UW-QOL) questionnaire, version 4, was completed at six months post-operatively. Obtained data was statistically analysed using IBM® SPSSⓇ. Washington University Quality of Life index scores and esthetics are better with Antero-lateral thigh flap, with less overall post-operative complications. On the other hand Pectoralis myocutaneous flap has less surgical time and more salvage potential. Despite of Antero-lateral thigh flap having Good Washington University Quality of Life index scores, lesser post-operative complications and better esthetics; scale of developing nations is still tipping towards economical, less time consuming and less technique sensitive Pectoralis major myocutaneous flap. © Association of Otolaryngologists of India 2024.
Root submergence in maxillary anterior region: An alternative for unpredictable augmentation
(Wolters Kluwer Medknow Publications, 2025) Farhan Durrani; Aishwarya Pandey; Kajol Kumari Rajak; Dhanraj Meena; Mahendra Rawaji Gawade
Alveolar ridge resorption following tooth extraction is a progressive and inevitable process, particularly critical in the maxillary anterior region where esthetics are paramount. Conventional approaches to restoring hard and soft tissue contours often yield unpredictable results, especially in recreating papillary form and ridge architecture. The root submergence technique (RST), which involves the intentional decoronation and submergence of nonrestorable teeth, aims to preserve the periodontal ligament and maintain surrounding tissue integrity. This case report presents two clinical scenarios in which submerged roots were retained beneath implant-supported fixed prostheses in the anterior maxilla. In both cases, careful case selection and precise execution of RST resulted in preservation of the interdental papilla, stable crestal bone levels, and harmonious soft-tissue profiles over a 1-year follow-up. These outcomes highlight the potential of RST as a biologically driven alternative to extensive ridge augmentation procedures, offering superior esthetic results in challenging anterior prosthetic rehabilitations. © 2025 Indian Society of Periodontology.
Socket shield: An esthetic success?
(Wolters Kluwer Medknow Publications, 2020) Farhan Durrani; Himani Painuly; Akanksha Shukla; Samidha Pandey; Rakhshinda Nahid
Dental implants require adequate bone, three dimensionally, for successful osseointegration. The extraction socket changes in the dimension had been described in several studies. Implant in extraction socket cannot prevent resorption of the surrounding tissues. The bony alterations make oral esthetic implant reconstruction difficult without hard-And soft-Tissue augmentation. Placement of bone substitute material and immediate implant were not able to completely establish an esthetic outcome. A novel technique of retaining the buccal aspect of the tooth root during implant placement has shown preservation of esthetics. Hard and soft tissues were preserved in their original form around the replaced tooth. The retained root on the buccal aspect of an oral implant is observed to have formed cementum and to some aspects of osseointegration with the surrounding tissues. It is called socket-shield technique and if completed meticulously can be an alternative for regenerative materials and soft-Tissue grafting. In our report, we completed 14 cases of the said technique with 5-year follow-up. The results looked promising as none of the cases required guided bone regeneration procedures. This may become the future noninvasive method for the preservation of hard and soft tissues around an oral implant in esthetic areas. © 2020 Indian Society of Periodontology - Published by Wolters Kluwer - Medknow.