The Jaw & Face Academy

a bilateral neck dissection for advanced oral cancer — a reminder of the precision, planning, and multidisciplinary approach required in head and neck oncology.There is an urgent need for more trained surgeons in this field to meet the growing burden of oral cancer, especially in developing regions.Training, mentorship, and hands-on exposure remain key to improving outcomes and saving lives.

Media coverage of our recent camp at Sindh government hospital paretabad

Retaining a 3rd molar (wisdom tooth) in the line of a mandibular fracture during Open Reduction and Internal Fixation (ORIF) is a debated decision. The choice depends on several factors, but here are the key reasons to retain the impacted tooth:
1. Stability of the Fracture Site
• The 3rd molar may act as a buttress, preventing further
displacement of fracture segments.
Removing it may destabilize the fracture, increasing
mobility and delaying healing.
2. Risk of Further Bone Loss
Extracting the tooth may create a bone defect, leading to
a weakened mandible.
It may increase the risk of nonunion or malunion due to
inadequate bone support.
3. Preservation of Blood Supply
The 3rd molar area is close to the inferior alveolar
neurovascular bundle.
Removing the tooth may compromise vascularity,
delaying healing and increasing the risk of osteomyelitis.
4. Risk of Surgical Trauma & Complications
Extraction in the presence of a fracture increases the risk
of latrogenic fracture worsening Soft tissue trauma
Injury to adjacent structures (IAN, lingual nerve)
5. Infection Risk May Be Low
• If the tooth is not infected and shows no signs of
periapical pathology, it may be left in place.
Post-op antibiotics and proper oral hygiene can prevent
secondary infection.
6. Future Treatment Considerations
Once the fracture heals, the tooth can be electively
removed under controlled conditions.
Immediate extraction with a fracture may complicate the
bone healing process.

Jaw & Face Academy

Lingual Nerve in Relation to the Submandibular Gland and Duct

Understanding the course of the lingual nerve in relation to the submandibular gland and duct is essential for safe surgical intervention in the floor of the mouth.
• The lingual nerve originates deep to the mandibular ramus and runs anterior to the inferior alveolar nerve.
• As it approaches the submandibular gland, the nerve loops around the submandibular duct, first running superficial and then passing deep to the duct.
• Injury to the lingual nerve can result in loss of general sensation and taste in the anterior two-thirds of the tongue due to disruption of the chorda tympani.

Surgical Consideration
Precise identification of the lingual nerve is crucial when performing submandibular gland excision or duct stone removal to avoid sensory deficits.