Introduction: Oral rehabilitation using implants is rapidly replacing tooth supported prostheses. The success of implants is largely dependent on the quality and quantity of alveolar bone. In this study, we assessed the location of limiting anatomical structures and the amount of alveolar bone available for implant placement. Materials and Method: Six hundred digital panoramic radiographs (300 males and 300 females) of dentate patients aged between 15-60 years were selected from the archives. The radiographs were subdivided into 3 groups with age interval of 15 years. Then the location of mental foramen, anterior loop, mandibular canal and maxillary sinus was determined. The amount of bone available was measured in both maxilla and mandible in the premolar and molar regions. Results: The mental foramen was most commonly located at the apex of the second premolar in both the genders. The anterior loop was more readily visible in the younger age group. The amount of bone available in the premolar and molar region of the mandible is nearly the same, while more bone is available in the premolar region of the maxilla. Conclusion: The location and morphology of anatomical structures of the jaws vary not only in different populations but also within the same population. The amount of bone available also showed variations in the same population and in the same individual on the right and left sides. The limiting anatomical structures govern the amount of bone available for possible implant placement.

Background: Of the occupational hazards experienced by dental professional worldwide, work-related musculoskeletal disorders (WRMSDs) are quite common. Research in the past has recognized that musculoskeletal disorders in dentistry contribute considerably to sick leave, reduced productivity, and dentist attrition. Considering the magnitude of these disorders, an attempt has been made to determine the prevalence and associated factors of various WRMSD. Aim: The aim of this study was to investigate the prevalence of self-reported, work-related musculoskeletal problems regarding the perception of pain, over the preceding 12 months and also to identify associated factors which might influence pain among dentists. Subjects and Methods: A self-administered questionnaire was personally handed over to a select sample of practicing dentists in Visakhapatnam, Andhra Pradesh. The survey was performed using the Nordic Musculoskeletal Questionnaire. Results: This study revealed musculoskeletal pain with a frequency of 56% in the neck, 39% in the hand, 32% in the lower back, and 18% in the shoulder regions. Chi-square test showed a significant association between pain in the neck and gender, age, height, and weight (P < 0.05). Pain in lower back was associated with gender, body mass index (BMI), height, and experience (P < 0.05). Pain in the hand was only related to the experience of the dentist (P < 0.05). Conclusion: Within the limits of the study, the prevalence of WRMSD among dentists in Visakhapatnam, especially involving the neck, hand, lower back, and shoulders, is high. Gender, age, height, and weight, BMI and experience were found to be related with musculoskeletal pain.

Context: Tobacco abuse is a well-known risk factor for potentially malignant disorders as well as oral squamous cell carcinoma. Factors that influence tobacco-exposed individuals developing a malignancy may include the combination of total tobacco exposure and genetic susceptibility. Aim: This study was undertaken to determine the prevalence of the glutathione S-transferase M1 (GSTM1) null polymorphism in oral leukoplakia and oral squamous cell carcinoma patients in South Indian population. Settings and Design: This case-control study was conducted in hospital setting on South Indian population. Materials and Methods: About 280 subjects with history of tobacco use, oral leukoplakia, oral squamous cell carcinoma were included in this study. Three milliliter of blood was collected and transported under cold cycle and taken for evaluation of GSTM1 null polymorphism using multiplex polymerase chain reaction. Results and Discussion: On comparing the prevalence of GSTM1 null polymorphism among the group with subjects with habits and no oral lesions, oral leukoplakia, and oral squamous cell carcinoma, it was observed that there was a statistically significant association between GSTM1 null polymorphism and the different groups (P < 0.01). Conclusion: The lack of GSTM1 activity would make the oral tissues more susceptible to action of tobacco carcinogens and to the development of a high-grade level of dysplasia in oral leukoplakia and thereby increases the susceptibility of lesion to undergo malignant changes.

Aim: To find the correlation between nasal airway volume and the craniofacial morphology using cone beam computed tomography (CBCT). Materials and Methods: This study consisted of preorthodontic anonymized CBCT scans of 34 healthy adults in the age span of 18-28 years. The volume was calculated using Dolphin 3D ^R software 11.5 version using semiautomatic segmentation method to calculate nasal volume after determining the nasal airway boundary. The subjects were grouped according to sagittal skeletal relation, craniofacial width, facial index, and facial form. Results: There was statistically significant correlation between nasal volume and craniofacial width (P = 0.009). Conclusion: Nasal volume was correlated only with width of the face and not with width/length ratio of face that could have affected the nasal volume.

Background: Plaque-associated gingivitis is a prevalent disease and research in its treatment using herbal agents must be encouraged to verify which would be a useful addition to the current range or chemotherapeutic treatment options. Aims: The aim of this study was to evaluate the clinical effect of a mouth rinse containing 10% Anacardium occidentale (AO) Linn., a typical plant commonly found in the Northeast Region of Brazil, on the reduction of plaque and gingivitis in comparison to a gold-standard chemotherapeutic agent. Materials and Methods: Thirty normosystemic adult volunteers of both genders, who had a minimum of twenty natural teeth, aging between 18 and 32 years, were enrolled in this crossover, controlled, examiner-blind clinical study. They were randomly allocated into three groups: 10% AO Linn. (n = 10); 0.12% chlorhexidine digluconate (CLX, n = 10); or placebo (PB, n = 10). All volunteers were instructed to brush their teeth with a fluoridated dentifrice two times a day (12/12 h) and to rinse for 1 min with one of the mouthwashes (AO, CLX, or PB) 30 min after tooth brushing for 1 month. Plaque index (PLI) and gingival bleeding index (BLI) were recorded on days 0 and 30. Nonparametric Kruskal-Wallis and Wilcoxon tests (α = 0.05) were performed to evaluate statistical differences among groups. Results: There was a significant reduction (P < 0.05) on plaque and gingivitis at day 30 just in CLX ([PLI = 0.47 ± 0.16; -30%]; [BLI = 0.15 ± 0.09; -55.8%]) and AO ([PLI = 0.49 ± 0.21; -31%]; [BLI = 0.13 ± 0.10; -56.6%]) groups, but no statistically significant difference was observed among them (P > 0.05). Conclusion: Mouthwash containing 10% AO was effective as an antiplaque and antigingivitis agent, in a similar manner that 0.12% CLX.

Context: This study compared digital two-dimensional (2D) lateral cephalograms and cone-beam computed tomography (CBCT) total and half-skull images for the reliability of cephalometric measurements. Aims: (1) To compare the accuracy of cephalometric measurements and reproducibility between the digital and CBCT cephalograms in the Indian population. (2) To compare interobserver variability in landmark identification through their cephalometric measurements by comparing different imaging modalities (CBCT total skull, CBCT half-skull, and conventional lateral cephalogram). (3) To further compare half-skull with the total skull synthesized CBCT and digital cephalograms in the same regard. Materials and Methods: Thirty patients, who had consented with orthodontic treatment, participated in the study. Informed consent was obtained from the patient before the radiographic procedures. 2D digital lateral cephalograms and their corresponding CBCT scans were taken and imported in DICOM format to OnDemand 3D software. Twenty-three landmarks were identified by 3 observers and 9 linear and 14 angular measurements were digitally traced. The values were sent for statistical analysis using ANOVA to check the interobserver reliability between the imaging modalities. Statistical Analysis Used: ANOVA, Student's t-test, and post hoc test were used for the statistical analysis. Results: The interobserver reliability was high between the modalities. CBCT total skull received an overall intraclass correlation coefficient (ICC) value of 0.76. The ICC value for the CBCT half-skull was 0.79 and for the digital cephalograms it was 0.80. The reliability for CBCT total skull was marginally less when compared to the CBCT half-skull and digital cephalograms, but more for the mid-sagittal measurements. Digital cephalograms showed the most variation with measurements of the mandibular plane when compared to CBCT. Conclusions: CBCT has the potential to be used for cephalometrics, especially the half-skull images, but further studies are required to prove whether CBCT total skull images can be used. 2D cephalometry, however, still does remain as the mainstay of orthodontic diagnosis and treatment planning and cannot be easily replaced by three-dimensional cephalometry.

Background: Dental charting is the basis of treatment in dentistry. It should be recorded to know the presence of healthy or diseased, for communication purpose with the colleagues and also used for reference purpose. The three commonly used systems are universal system, Federae Dentale Internationale numbering system (FDI) system, and Palmer/Zsigmondy system. Although these systems are in practice there are lot of confusions in referring a tooth which leads to mismanagement which eventually terminates the clinician-patient relationship. Hence, a growing need of a new system to make dental charting simple, easy, and to avoid confusions is always present. Molar, incisor, canine, Akram, premolar (MICAP) a tooth numbering system that was introduced by Akram et al. in the year 2011. Aim: To assess the attitude of undergraduate students toward the MICAP system and their preference to use in identification of teeth. Materials and Methods: The undergraduate students who were involved in the study were briefed about the ICPM system through a lecture and demonstration. All the 155 undergraduate dental students were asked to number the teeth of given patients using both FDI and the ICAP system. The attitude of the students towards the new system was assessed using a validated questionnaire. Forty-one percentage of students agreed for the uniqueness of the system, and thirty-six percentage agreed that the system was easy to understand. Forty-six percent of students were unsure about the easiness of usage of MICAP system and 42% of students about the clinical applicability of MICAP system. Conclusion: MICAP system of tooth identification can be followed by the students if the system is included in the curriculum and repeatedly used for routine teeth identification.

Context: Bracket debonding is a common problem during orthodontic treatment. This type of failure is associated to masticatory forces, poor adhesion, and the need for repositioning the piece. Aims: The objective of this work was to compare the shear bond strength of debonded brackets that were reconditioned using different protocols (alumina blasting versus hydrofluoric etching). Settings and Design: This was an in vitro experimental study with 45 stainless steel orthodontic brackets. Subjects and Methods: They were randomly divided into three groups: (1) New brackets (n = 15), (2) brackets reconditioned using 10% hydrofluoric acid for 60 s (n = 15), and (3) brackets reconditioned by aluminum oxide blasting until complete removal of the remaining resin (n = 15). In Groups 2 and 3, the insertion of composite resin proceeded in two stages to simulate a type of bracket failure in which the bonding resin was left at the bracket base. For the shear test, the assembly composed by the metallic support, and specimen was taken to the Instron universal testing machine in which the specimens were loaded using a semicircle-shaped active tip in the region of the bonding interface parallel to the surface of the bracket at a speed of 0.5 mm/min. Statistical Analysis Used: The data were subjected to D'Agostino's normality test to have their distribution checked. Analysis of variance and Tukey's test (P < 0.01) were used to compare the findings between groups. Results: The results indicated that Group 1 (new brackets) showed higher bond strength than that obtained for the group treated with hydrofluoric acid (Group 2, P < 0.01). The bond strength value obtained for the group treated with alumina blasting (Group 3) was statistically similar to those obtained for Groups 1 and 2. Conclusions: The aluminum oxide blasting technique was effective for the reconditioning of orthodontic brackets. Nevertheless, the reconditioning technique using 10% fluoridric acid for 60 s was not efficient for clinical use.

Background: Human C-reactive protein (CRP) has been used in the risk assessment of coronary events. Human saliva mirrors the body's health and well-being and is noninvasive, easy to collect, and ideal for third-world countries as well as for large patient screening. Aims: This study aimed to screen the saliva CRP qualitatively in patients with diabetes (Type 1 and 2) taking in considerations, the diagnostic criteria of metabolic syndrome. Setting and Design: Center for diabetes mellitus, prospective study. Materials and Methods: A total number of 50 Type 2 diabetes (T2D) patients, 25 Type 1 diabetes (T1D) patients, and 25 healthy subjects were recruited from the center for diabetes mellitus. Each patient was assessed clinically, and the anthropometric measures, glycemic status, and lipid profiles were determined. Stimulated salivary flow rate and saliva CRP were determined. Statistical Analysis: All calculations analysis was made using Excel 2003 program for Windows. Results: The results showed that the salivary flow rate in T1D was less than healthy subjects and T2D and CRP was found positive (6 mg/L) in 36% and 56% of patients with T1D and T2D, respectively. Saliva CRP was found to be related to the anthropometric measurement, blood pressure, and glycemic control. Conclusions: We conclude that saliva CRP may be used as a biomarker for metabolic syndrome and its value is obvious in T2D rather than in T1D.

Background: Gestational diabetes mellitus (GDM) is glucose intolerance which begins during pregnancy. Few studies have examined the association between periodontal disease and GDM. Aim: The aim of this study was to assess the association between periodontal disease and GDM. Materials and Methods: The study population comprised ninety patients, out of which thirty were cases and sixty were controls. All cases underwent a laboratory screening test for GDM between 24 and 30 weeks of gestation based on the recommendation of the obstetricians and gynecologists. To assess the periodontal status, a full-mouth periodontal examination assessing the probing depth, periodontal depth, bleeding on probing, clinical attachment level, and gingival recession was performed on all study participants by a single trained examiner. Tests for associations were performed using Chi-square statistics and multivariate logistic regression analysis. Results: None of the periodontitis conditions was found to be a significant predictor of GDM. In GDM patients, 70% of females were having periodontal disease whereas non-GDM patients 77% of patient had periodontal disease. Conclusion: The present study did not show any positive association between periodontal disease and GDM.

Background: Neutrophils are the predominant leukocytes in the periodontium, which prevent infection from periodontal pathogens and subsequent tissue destruction. A potentially destructive role has been elucidated, especially due to elastase enzyme. Controlling its levels might be crucial in minimizing the tissue destruction. Hyaluronan, known to inhibit the release of this enzyme from neutrophils, might be a viable option to treat chronic periodontitis. Aims: The aim of this study is to evaluate and compare the effects of 0.2% hyaluronan gel adjunctive to scaling and root planing on the levels of elastase in gingival crevicular fluid (GCF). Settings and Design: This split-mouth study included eighty (forty experimental and forty control) sites from twenty patients representing both sexes. Materials and Methods: GCF samples were collected from all the eighty sites; simultaneously, clinical periodontal parameters were recorded. Enzyme-linked immunosorbent assay was used to determine the levels of elastase at baseline and 6 weeks after therapy, following mechanical debridement and subsequent subgingival placement of the experimental drug. Statistical Analysis Used: With the aid of statistical software (SPSS Version 13), Student's t-test and Pearson's correlation test were performed. Results: There was a mean reduction in the elastase levels from baseline to 6 weeks after therapy in the experimental group. However, the difference between the groups was not statistically significant. Conclusions: Adjunctive use of hyaluronan following mechanical debridement resulted in comparable reduction in the elastase levels, suggesting that this substance has an inhibitory effect on elastase, and subsequent tissue destruction. Further long-term studies are mandatory to validate the results of this study.

Background: Oral cancer is a major health problem in tobacco users worldwide and is one of the ten most common cancers. India alone accounts for 1/3 ^rd of the world's oral cancer and has a high rate of potentially malignant disorders (PMDs). The most common predisposing factors are smoking, smokeless tobacco, betel nut in quid form (pan), alcohol, spicy food, and sharp broken tooth. There are various tobacco-associated lesions (TALs) which can be diagnosed at very early stage. This study was conducted to rule out association of smoking and smokeless tobacco with occurrence of TALs and its dose-response relationship. Materials and Methods: Total of 60,018 patients attending the Department of Oral Medicine and Radiology from January 2013 to December 2014 with different oral and dental symptoms were screened. Of these, 4795 patients satisfying inclusion and exclusion criteria formed the cohort of the present study. All the patients were informed regarding the study and an informed verbal consent was obtained, following which they were interviewed for tobacco-related habits and examined by the trained dental professionals for the presence of any lesion. Along with patients' demographic details, information regarding the type of habit, duration, and frequency was recorded. Statistical Analysis: Statistical analysis was performed using STATA 13.1 software (STATA 13.1 software by Stata Corp Ltd India Continent) by applying Pearson's Chi-square test with Fisher's exact test, Independent t-test, and ANOVA test. Results: The overall study population showed maximum cases having habit of smokeless tobacco (37.9%) and smoking tobacco (36.5%). The overall prevalence of TALs was found to be 7.98%. Our study found strong relation of duration and frequency of habit with respect to occurrence of the lesions. Conclusion: TALs are often subtle and asymptomatic. Therefore, it is important for the clinician to maintain a high index of suspicion, especially if risk factors such as tobacco habits are present.

Background: Tooth bleaching is, today, one of the most widespread cosmetic treatments in dental practice,  so it is important to determine whether it can interfere with orthodontic bonding or not. Aim: The aim of this study was to assess the in vitro effects of 35% hydrogen peroxide bleaching agent on the shear bond strength of orthodontic brackets. Materials and Methods: Forty-five upper bicuspids were divided into three groups (n = 15). In the control Group (C), the brackets were bonded without previous bleaching treatment. Group 1 (G1) was treated with 35% hydrogen peroxide bleaching agent 24 h before bracket bonding. Group 2 was also bleached, and the brackets were bonded after 30 days. The shear bond strength of the brackets was measured using an EMIC machine, and the results were analyzed by ANOVA. Results: There were no statistically significant differences between the three groups (P > 0.05), with Group C showing a mean bond strength of 9.72 ± 2.63 MPa, G1 of 8.09 ± 2.63 MPa, and G2 of 11.15 ± 4.42 MPa. Conclusion: It was possible to conclude that 35% hydrogen peroxide bleaching agent does not affect the shear strength of orthodontic brackets bonded 24 h and 30 days after bleaching.

Background: The rise in disease incidence, increased resistance of pathogenic bacteria to currently used antibiotics and chemotherapeutics, opportunistic infections in immunocompromised individuals, and financial considerations in developing countries necessitates alternate preventive and treatment strategies for oral diseases. Objective: The objective of the study is to assess the antimicrobial efficacy of triple and quadruple combinations of Acacia nilotica (AN), Murraya koenigii (Linn.) (MKL) Sprengel, Eucalyptus (Euca), and Psidium guajava (PS) on primary plaque colonizers. Materials and Methods: The phytochemicals in four plants were extracted using Soxhlet apparatus. The dried extracts were diluted with dimethyl sulfoxide (DMSO) to prepare stock solutions (100 mg/ml) of each plant. The triple and quadruple combinations were prepared after mixing equal quantities of stock solutions from each plant extracts. The antimicrobial efficacy testing was done on Streptococcus mutans, Streptococcus sanguis, and Streptococcus salivarius using agar well diffusion method. Chlorhexidine of 0.2% composition and DMSO were used as positive and negative controls, respectively. The mean diameter of inhibition zone between different categories was compared using one-way analysis of variance. Results: The combination of AN + MKL Sprengel + Euca + PS produced the highest mean diameter of inhibition zone (23.5 ± 2.17 mm) against S. mutans. The combination of AN + MKL Sprengel + Euca produced the maximum antimicrobial efficacy against S. sanguis (19.83 ± 1.33). Conclusion: All the triple and quadruple combinations of the plant extracts offered antimicrobial benefits either superior or comparable to 0.2% chlorhexidine against S. mutans, S. sanguis, and S. salivarius.

Aims: The aim of this in vitro study was to comparatively evaluate the microshear bond strength (MSBS) of etch-and-rinse and self-etch (ER and SE) bonding systems to dentin pretreated with silver diamine fluoride/potassium iodide (SDF/KI) and nanoleakage at the resin-dentin interface using transmission electron microscope (TEM). Subjects and Methods: Seventy-two dentin slabs of 3 mm thickness were prepared from extracted human permanent third molars and divided into four groups (n = 18) based on the dentin surface treatment as follows: (1) ER adhesive bonding without dentin pretreatment; (2) SDF/KI pretreatment of dentin followed by ER adhesive bonding; (3) SE adhesive bonding without dentin pretreatment; and (4) SDF/KI pretreatment of dentin followed by SE adhesive bonding. Resin composite was built on the dentin slabs to a height of 4 mm incrementally, and dentin-composite beams of approximately 1 mm ² cross-sectional area were prepared. The beams were subjected to MSBS analysis, and the fractured surface was observed under scanning electron microscope to determine the mode of failure. The resin-dentin interface was examined under TEM for evaluation of nanoleakage. Statistical Analysis Used: One-way ANOVA followed by Tukey's post hoc multiple comparison tests. Results: Pretreatment of dentin with SDF/KI increased the MSBS of ER and SE adhesives, though not statistically significant, except between Groups 2 and 3. In all the groups, the predominant mode of failure was adhesive followed by cohesive in resin, mixed and cohesive in dentin. TEM examination of resin-dentin interface showed that pretreatment with 38% SDF/KI reduced nanoleakage regardless of the type of bonding system used. Conclusions: Pretreatment of dentin with SDF/KI minimized nanoleakage at the resin-dentin interface without adversely affecting the bond strength of resin composite to dentin.

Background: Enamel demineralization is an event which is always an integral part of fixed orthodontic treatment due to which fluoride releasing bonding agents are considered to be the most effective but have lower bond strength. Thus, this in vitro study has compared the degree of demineralization and bond strength of conventional and fluoridated bonding agents. Materials and Methods: One hundred and five extracted human premolars divided into Group I evaluated to study demineralization and Group II to evaluate bond strength. Group I was subgrouped into (A, B, C, and D and Group II was subgrouped into A, B, and C (n = 15 in each subgroup). All samples were bonded with metal brackets using Transbond Plus ^TM , Discover LC orthodontic adhesive ^TM , and Transbond XT ^TM ; the first two being fluoride releasing and the third being a conventional bonding composite. Group I samples were followed by sectioning and studied for mean depth of demineralization at the margins of the brackets using polarized microscopy. Group II samples were evaluated only for shear bond strength. Statistical analysis was done using ANOVA and Tukey's multiple comparison tests. Observation and Results: The mean depth of enamel demineralization and standard deviation was compared between subgroups A and C and B and C and the P value obtained was 0.02 in each group, suggestive of a considerably lesser degree of demineralization in fluoride releasing composites compared to conventional composite. Similarly, when shear bond strength was compared between subgroups A and C and B and C the P value obtained was 0.04 and 0.00, respectively. Thus, the shear bond strength of the fluoride releasing composites was lesser than that of the conventional composite but well within the clinically acceptable range. Conclusion: Fluoride releasing composites can be used to avoid demineralization around the brackets.

Introduction: From ancient times, plants with medicinal values are being tested and used in the treatment of various infectious diseases. Aims and Objectives: The present in vitro study was designed to assess the antifungal activity of three commonly available medicinal plants Glycyrrhiza glabra, Ficus religiosa, and Plantago major on inhibiting oral Candida albicans in comparison to standard antifungal agents. Materials and Methods: Bark of G. glabra, stem of F. religiosa, and husk of P. major were collected, crushed into fine powder, and dissolved in 67% ethanol. Extracts were subjected to antifungal efficacy test against oral C. albicans (ATCC 66027) using Kirby-Bauer disc diffusion method. Mean zone of inhibition (ZOI) was measured by HI antibiotic zone scale. One-way ANOVA using Tukey's post hoc and t-test were applied for statistical analysis. Results: G. glabra was found to be most effective among the three with highest mean ZOI measuring 19.8 ± 0.83, 19.4 ± 0.54, and 18.2 ± 1.09 at 24, 48, and 72 h, respectively. Tukey's post hoc test showed statistically nonsignificant difference between antifungal activity of F. religiosa and P. major with itraconazole 10 mcg. Conclusion: G. glabra, F. religiosa, and P. major showed acceptable potency against C. albicans (ATCC 66027) comparable to that of synthetic antifungal agents. However, further studies should be undertaken to affirm the same and test their efficacy in different concentrations and clinical utility.

Odontogenic myxomas are a rare benign odontogenic mesenchymal tumor found exclusively in the tooth-bearing area of the jaw and are usually located centrally in the mandible. Soft tissue localization is rarely seen and is classified as peripheral odontogenic myxoma (POM). POM is slow growing and less aggressive as compared to central myxoma. It has a low recurrence rate, comprises 3-6% of all odontogenic tumors. Only a few cases of POM on maxillary gingiva are reported in the literature. Here, we present an unusual case of primary POM occurring in the gingiva of anterior maxilla in a 14-year-old female patient.

The keratocystic odontogenic tumor (KCOT), formerly known as odontogenic keratocyst, is a benign developmental odontogenic tumor with many distinguishing clinical and histologic features. Hard tissue deposits, which usually take the form of dystrophic calcifications, cartilaginous tissue, or dentinoid, are uncommon findings in the connective tissue capsule of the KCOT. We report a case of a 33-year-old female with KCOT showing osseous tissue and calcified deposits close to its epithelial lining, which is an extremely rare occurrence. A brief review on the reported prevalence of hard tissue deposits in KCOTs and possible mechanisms that has been implicated in mineralization and bone formation has been discussed.

Ballistic injuries of oral and maxillofacial region are usually fatal due to close propinquity with the vital structures. The severity of injury depends on the caliber of the weapon used and distance from which the patient is shot. The preliminary care of facial ballistic wounds strictly adheres to the basics of trauma resuscitation. Early and appropriate surgical management has proved to be influential on the final outcome and esthetic result. Treatment of facial gunshot wounds should be planned and carried out carefully to avoid esthetic complications. It takes even multiple-staged corrections to achieve the targeted functional and esthetic treatment plan. Prevention and control of infection is one of the most important goals to achieve the success of the treatment. Herewith, we present a case of facial gunshot injury with fractures in the orbital floor, medial wall maxillary sinus, and buttress of the zygomatic bone causing deficit, which was successfully managed by surgical reconstruction.