Research Article
Retromandibular Approach to Treat Mandibular Subcondylar and High Ramus Fracture
Abdullah Al Faruq, Md. Mohibullah, Md. Khadamul Islam, Md. Mukhlachur Rahman, Md. Azizur Rahman, Md. Zahir Abedin, Hasan Ali
Middle East Research Journal of Dentistry; 59-63.
https://doi.org/10.36348/merjd.2025.v05i06.001
Objective: The retromandibular approach for open reduction and internal fixation (ORIF) of mandibular subcondylar and high ramus fractures has gained attention for its direct access and cosmetic advantages. This study aims to evaluate the efficacy, complications, and functional outcomes associated with this surgical technique. Methods: A prospective study was conducted involving 32 patients with unilateral or bilateral subcondylar fractures who underwent ORIF via the retromandibular transparotid approach between January 2017 and December 2024. Demographic data, etiology, surgical details, and postoperative outcomes—including complications such as facial nerve palsy, salivary fistula, malocclusion, and scar appearance—were systematically recorded and analyzed. Results: The mean age of the patients was 23.93 years, with a male predominance (90.63%). Road traffic accidents (93.75%) were the leading cause of injury. A 2 cm retromandibular incision provided sufficient access in most cases, with minimal extension required for complex fractures. No cases of facial nerve palsy, Frey's syndrome, or unacceptable scarring were observed. Postoperative complications included transient salivary fistula in three patients (9.37%) and malocclusion in two (6.25%), both of which resolved with conservative management. All patients achieved satisfactory fracture healing and functional recovery at follow-up. Conclusion: The retromandibular transparotid approach is a safe, effective, and cosmetically favorable technique for the management of subcondylar and high ramus fractures. It offers direct visualization of the fracture site, minimizes the risk of facial nerve injury, and results in minimal complications when performed with meticulous surgical technique. This approach is highly recommended for selected cases in maxillofacial trauma surgery.
Research Article
Evaluation of Tensile Strength of Nanohybrid Composite Resin- An in Vitro Study
Hasan Ali, Md. Khadamul Islam, Kazi Hossain Mahmud, Fouad Al Hasnat, Md Zahir Abedin, Md Shafiul Alam, Md Mohibullah
Middle East Research Journal of Dentistry; 64-67.
https://doi.org/10.36348/merjd.2025.v05i06.002
Objective: This in vitro study aimed to comparatively evaluate the tensile strength of a nanohybrid composite resin versus a conventional microfilled composite resin. Materials and Methods: Sixty cylindrical specimens (n=30 per group) were fabricated using a standardized protocol. The materials investigated comprised a nanohybrid composite (Filtek™ Z250 XR) and a conventional microfilled composite (Durafill VS). Specimens were prepared using a polytetrafluoroethylene mold with dimensions of 4 mm in diameter and 6 mm in height. A critical methodological refinement involved calibrating the light-curing unit to maintain a consistent intensity of 800 mW/cm² and introducing a 24-hour hydration period in distilled water at 37°C to better approximate the oral environment. Polymerization was performed through glass slides for 40 seconds per surface. Tensile strength was determined using a universal testing machine at a crosshead speed of 1 mm/min. Statistical analysis was performed using Student's t-test with a significance threshold of p < 0.05. Results: The nanohybrid composite exhibited a significantly greater mean tensile strength (12.32 ± 3.02 MPa) compared to the microfilled composite (7.72 ± 2.64 MPa). The observed difference was statistically significant (p < 0.001). Conclusion: Within the limitations of this in vitro investigation, the nanohybrid composite demonstrated markedly superior tensile strength performance relative to the conventional microfilled composite. These findings suggest potential mechanical advantages for the nanohybrid material in stress-bearing applications such as Class II restorations, though clinical validation through longitudinal studies remains necessary.
Research Article
Comparison Between Tub and Box Shaped Tooth Preparation of Fiber Reinforced Composite Fixed Partial Denture Replacing First Molar Tooth
Md. Khadamul Islam, Md. Mahbubur Rahman, Md. Mohibullah, Md. Mukhlachur Rahman, Fouad Al Hasanat, Hasan Ali
Middle East Research Journal of Dentistry; 68-73.
https://doi.org/10.36348/merjd.2025.v05i06.003
Background: Fiber-reinforced composite (FRC) fixed partial dentures (FPDs) offer a cost-effective, minimally invasive, and less technique-sensitive alternative for replacing missing teeth. Among the commonly used designs, box-shaped and tub-shaped tooth preparations are frequently applied to restore posterior teeth. Identifying the more effective design can enhance the clinical success of FRC FPDs. Objective: This study aimed to compare the fracture strength and bending behavior of box-shaped and tub-shaped tooth preparations in FRC FPDs replacing a first molar. Materials and Methods: This in vitro experimental comparative study was conducted in the Department of Prosthodontics, BMU, over six months. Extracted premolar and molar teeth were mounted in polymethyl methacrylate resin blocks with an 11 mm edentulous span to simulate clinical conditions. Eighteen specimens were divided equally into two groups: box-shaped and tub-shaped preparations. After tooth preparation, impressions were taken, casts poured, and FRC FPDs fabricated and cemented. All specimens were stored in distilled water for 24 hours before testing. Fracture strength and bending amounts were measured using a universal testing machine, and fracture sites were evaluated radiographically. Results: The box-shaped preparation demonstrated significantly higher fracture strength (509.67 ± 24.02 N) than the tub-shaped preparation (449.56 ± 46.09 N) (p = 0.003). Bending amounts were also greater in the box-shaped group (1.24 ± 0.20 mm) than in the tub-shaped group (0.87 ± 0.25 mm) (p = 0.003). Most fractures occurred in the veneering material with no significant difference between groups (p > 0.99). Conclusion: Box-shaped tooth preparation provides superior strength and flexibility and may be preferred for FRC FPDs replacing first molars.
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