Which Factors Affect Citation Rates in the Oral and Maxillofacial Surgery Literature?

Science.gov (United States)

Cheng, Kristie L; Dodson, Thomas B; Egbert, Mark A; Susarla, Srinivas M

2017-07-01

Citation rate is one of several tools to measure academic productivity. The purposes of this study were to estimate and identify factors associated with citation rates in the oral and maxillofacial surgery (OMS) literature. This was a retrospective longitudinal study of publications in the Journal of Oral and Maxillofacial Surgery (JOMS), International Journal of Oral and Maxillofacial Surgery (IJOMS), and Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology (OOOO) from January through December 2012. The predictor variables were author- and article-specific factors. The outcome variable was the citation rate, defined as the total number of citations for each article over a 4-year period. Descriptive, bivariate, and multiple regression statistics were computed. The authors identified 993 articles published during 2012. The mean number of citations at 4 years after publication was 5.6 ± 5.3 (median, 4). In bivariate analyses, several author- and article-specific factors were associated with citation rates. In a multiple regression model adjusting for potential confounders and effect modifiers, first author H-index, number of authors, journal, OMS focus area, and Oxford level of evidence were significantly associated with citation rate (P ≤ .002). The authors identified 5 factors associated with citation rates in the OMS literature. These factors should be considered in context when evaluating citation-based metrics for OMS. Studies that focus on core OMS procedures (eg, dentoalveolar surgery, dental implant surgery), are published in specialty-specific journals (eg, JOMS or IJOMS), and have higher levels of evidence are more likely to be cited. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Salvage surgery for local failure of oral squamous cell carcinoma

International Nuclear Information System (INIS)

Omura, Ken; Harada, Hiroyuki; Shimamoto, Hiroaki

2003-01-01

Local failure rates following treatment for squamous cell carcinoma of the oral cavity have been reported to be in the range of 25%-48%. This study investigated the pattern of failure for squamous cell carcinoma (SCC) of the oral cavity and evaluated salvage surgery for local recurrent disease. The tumor files of 549 patients undergoing treatment for SCC of the oral cavity between 1980 and 2000 at Chiba Cancer Center Hospital were reviewed. Of 549 patients, 289 were initially treated with radiation therapy for their primary tumor, and 260 with surgery, either with or without radiation therapy. One hundred and sixty-one patients developed failures, yielding a failure rate of 29.3%. The site of recurrent tumor was local in 72 (13.1%) patients, regional in 89 (16.2%) patients, and distant in 5 (0.9%) patients. Local failure developed in 49 (17.0%) patients with radiation therapy and in 23 (8.8%) patients with surgery. Out of these 72 patients with local failure, 41 (56.9%) patients had salvage surgery for their disease. Twenty-five (73.5%) of the 34 patients initially treated with radiation therapy were salvaged with surgery, and 4 (57.1%) of the 7 patients initially treated with surgery were cured with further surgery. For the treatment of patients with local failure, the disease should be diagnosed more carefully than untreated disease. The disease that has recurred after radiation therapy may be more likely to be salvaged by surgery, however, the disease that has developed after surgery may have a limited indication for re-surgery. (author)

Combination of chemotherapy, radiotherapy and surgery in the treatment of oral cancer

International Nuclear Information System (INIS)

Ayyagiri, S.; Gupta, B.D.; Dutta, T.K.

1980-01-01

In locally advanced oral cancer, the main modalities of treatment, e.g. surgery and radiotherapy, most often fail to control the disease when used singly. A combination policy of surgery and radiotherapy achieves adequate control of the disease. In order to improve the results in advanced oral cancer, chemotherapy given prior to and during radiation treatment and judicious combination of surgery offer the best possible approach in the management. The experience in the combination policy in the treatment of oral cancer in Northern India is dealt with. (auth.)

Curriculum Planning for Oral and Maxillofacial Surgery Assistant Program. Final Report.

Science.gov (United States)

Taylor, Mary Ann

This project was conducted to develop a curriculum for dental auxiliary training in the dental specialty field of oral and maxillofacial surgery. Research was conducted to identify the major functions performed by an oral surgery assistant and then to organize these functions into an educational program that would provide adequate didactic and…

Do patients fear undergoing general anesthesia for oral surgery?

Science.gov (United States)

Elmore, Jasmine R; Priest, James H; Laskin, Daniel M

2014-01-01

Many patients undergoing major surgery have more fear of the general anesthesia than the procedure. This appears to be reversed with oral surgery. Therefore, patients need to be as well informed about this aspect as the surgical operation.

Use of antifibrinolytic mouthwash solution in anticoagulated oral surgery patients

OpenAIRE

Dimova, Cena; Evrosimovska, Biljana; Papakoca, Kiro; Georgiev, Zlatko; Angelovska, Bistra; Ristoska, Sonja

2012-01-01

Introduction:The ordinary treatment of anticoagulated patients includes the interruption of anticoagulant therapy for oral surgery interventions to prevent hemorrhage. However, this practice may logically increase the risk of a potentially life-threatening thromboembolism, so this issue is still controversial. The aim of the study was to evaluate the antifibrinolitic mouthwash solution (tranexamic acid) as a local haemostatic modality after oral surgery interventions. Methods:To realize the a...

Prior oral conditions in patients undergoing heart valve surgery.

Science.gov (United States)

Silvestre, Francisco-Javier; Gil-Raga, Irene; Martinez-Herrera, Mayte; Lauritano, Dorina; Silvestre-Rangil, Javier

2017-11-01

Patients scheduled for heart valve surgery should be free of any oral infectious disorders that might pose a risk in the postoperative period. Few studies have been made on the dental conditions of such patients prior to surgery. The present study describes the most frequent prior oral diseases in this population group. A prospective, observational case-control study was designed involving 60 patients (30 with heart valve disease and 30 controls, with a mean age of 71 years in both groups). A dental exploration was carried out, with calculation of the DMFT (decayed, missing and filled teeth) index and recording of the periodontal parameters (plaque index, gingival bleeding index, periodontal pocket depth, and attachment loss). The oral mucosa was also examined, and panoramic X-rays were used to identify possible intrabony lesions. Significant differences in bacterial plaque index were observed between the two groups ( p <0.05), with higher scores in the patients with valve disease. Probing depth and the presence of moderate pockets were also greater in the patients with valve disease than among the controls ( p <0.01). Sixty percent of the patients with valve disease presented periodontitis. Patients scheduled for heart valve surgery should be examined for possible active periodontitis before the operation. Those individuals found to have periodontal disease should receive adequate periodontal treatment before heart surgery. Key words: Valve disease, aortic, mitral, heart surgery, periodontitis.

Current Trend of Antimicrobial Prescription for Oral Implant Surgery Among Dentists in India.

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Datta, Rahul; Grewal, Yasmin; Batth, J S; Singh, Amandeep

2014-12-01

The aim of our study was to evaluate antimicrobial prescription behaviour amongst dentists performing oral implant surgery in India. Dentists performing oral implant surgery from different parts of India were personally approached during various national events such as conferences and academic meetings and information regarding their prescription habits for antimicrobial agents in routine oral implant surgery was collected using a structured questionnaire. Out of a total sample of 332 dentists, 85.5 % prescribed 17 different groups or combinations of antibiotics routinely for oral implant surgery in the normal healthy patient. Majority preferred the peri-operative protocol of drug therapy (72.2 %) with variable and prolonged duration of therapy after surgery, ranging from 3 to 10 days. An antimicrobial mouthwash was routinely prescribed by all the doctors (14.5 %) not in favour of prescribing antimicrobials in a normal healthy patient. Our findings suggest that there is a trend of antimicrobial agent misuse by dentists performing oral implant surgery in India, both in terms of drugs used and the protocols prescribed. The majority of these dentists prescribed a variety of antimicrobial agents for prolonged durations routinely even in the normal, healthy patients.

KNOWLEDGE GAPS IN ORAL AND MAXILLOFACIAL SURGERY

DEFF Research Database (Denmark)

Österberg, Marie; Holmlund, Anders; Sunzel, Bo

2017-01-01

OBJECTIVES: The aim of this study was to evaluate available knowledge and identify knowledge gaps within the field of oral and maxillofacial surgery, by systematically collecting and evaluating systematic reviews. Twelve specific domains were selected: surgical removal of teeth, antibiotic....... However, in all domains, the search revealed a large number of knowledge gaps. Also of concern was the lack of data regarding health economics and ethics. CONCLUSIONS: In conclusion, there is a need for well-conducted clinical research in the fields of oral and maxillofacial surgery........ RESULTS: In all, 1,778 abstracts were identified, of which 200 met the inclusion criteria. Forty-five systematic reviews were assessed as of high to moderate quality. The results disclosed some existing evidence in a few domains, such as surgical removal of teeth and implant survival after sinus lifts...

Smartphone photography in oral and maxillofacial surgery.

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Jamil, F

2016-01-01

An increasing number of staff in oral and maxillofacial surgery (OMFS) departments take clinical photographs with their personal phones. We report the results of a survey on the use of smartphone photography in OMFS departments in the United Kingdom, and highlight the guidelines that govern their use and the associated ethical and medicolegal implications. Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

ON THE NECESSITY OF MINOR ORAL SURGERY PRETREATMENT ORTHODONTICS

Directory of Open Access Journals (Sweden)

Georgeta Zegan

2011-09-01

Full Text Available The aim of the study was to establish the frequency of some minor oral surgery performed on both teeth and on the soft tissues, before any orthodontic treatment. The sample group included 587 patients (240 boys and 347 girls, divided into 3 categories. The data base was created wtih patient records, the statistical analyses being performed with the SPSS 17.0 software for Windows. The frequency of malocclusions with minor oral surgery pretreatment orthodontics was of 24%, out of which the surgical interventions on teeth represented 85.41% (serial extractions – 21.87%, orthodontic extractions – 41.66%, enucleation of third molars – 18.75%, discovery of impacted teeth – 2.08% and teeth enucleation – 1.04% and the surgical interventions on the soft tissues represented 14.59% (labial frenectomy: 12.60%, lingual frenectomy: 1.04% and discovery of pericoronal tissues: 1.04% The minor oral surgery pretreatment orthodontics upon both teeth and soft tissues are not quite frequent, yet they are necessary for a partial preparation of the patient for orthodontic therapy.

Equipment for oral surgery in small animals.

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Reiter, Alexander M

2013-05-01

This article provides an overview of equipment used for oral surgery. Specific instruments and materials used when performing relevant operative procedures are also mentioned in other articles in this issue. Copyright © 2013 Elsevier Inc. All rights reserved.

Compliance with the guide for commissioning oral surgery: an audit and discussion.

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Modgill, O; Shah, A

2017-10-13

Introduction The Guide for commissioning oral surgery and oral medicine published by NHS England (2015) prescribes the level of complexity of oral surgery and oral medicine investigations and procedures to be carried out within NHS services. These are categorised as Level 1, Level 2, Level 3A and Level 3B. An audit was designed to ascertain the level of oral surgery procedures performed by clinicians of varying experience and qualification working in a large oral surgery department within a major teaching hospital.Materials and methods Two audit cycles were conducted on retrospective case notes and radiographic review of 100 patient records undergoing dental extractions within the Department of Oral Surgery at King's College Dental Hospital. The set gold standard was: '100% of Level 1 procedures should be performed by dental undergraduates or discharged back to the referring general dental practitioner'. Data were collected and analysed on a Microsoft Excel spreadsheet. The results of the first audit cycle were presented to all clinicians within the department in a formal meeting, recommendations were made and an action plan implemented prior to undertaking a second cycle.Results The first cycle revealed that 25% of Level 1 procedures met the set gold standard, with Level 2 practitioners performing the majority of Level 1 and Level 2 procedures. The second cycle showed a marked improvement, with 66% of Level 1 procedures meeting the set gold standard.Conclusion Our audit demonstrates that whilst we were able to achieve an improvement with the set gold standard, several barriers still remain to ensure that patients are treated by the appropriate level of clinician in a secondary care setting. We have used this audit as a foundation upon which to discuss the challenges faced in implementation of the commissioning framework within both primary and secondary dental care and strategies to overcome these challenges, which are likely to be encountered in any NHS care

Laser for bone healing after oral surgery: systematic review.

Science.gov (United States)

Noba, Claudio; Mello-Moura, Anna Carolina Volpi; Gimenez, Thais; Tedesco, Tamara Kerber; Moura-Netto, Cacio

2018-04-01

The purpose of this study is to perform a systematic review on the use of lasers in oral surgery for bone healing. Selection of articles was carried out by two evaluators in Pubmed and Web of Science databases for published articles and OpenGray for gray literature. Search strategy was developed based on the PICO Question "Does the use of lasers after oral surgery improve bone healing?". Eligibility criteria were: being on laser; evaluate bone healing; involve oral surgery; do not be about implant, periodontics, orthodontics, osteonecrosis or radiotherapy, nor revisions, clinical cases, etc. Data were collected from each article in a structured spreadsheet and a descriptive analysis was performed. Risk assessment of bias of the articles was carried out through the tool elaborated by the Cochrane collaboration. A total of 827 potentially relevant references were identified. No articles were found in OpenGray. Eleven articles met the eligibility criteria and were included in the systematic review. Most of studies were in vivo and in jaw, being conducted with low-power lasers which were applied immediately after the surgical procedure of extraction. Neoformation and bone density were the outcomes of choice and there was a tendency of increase in bone density, neoformation, regeneration, mineralization, or bone condensation when laser was applied. Regarding the bias risk assessment, studies were not clear in reporting most of the parameters. Low-power laser therapy seems to reduce time of bone healing in oral surgery, although there are no defined protocols and the level of evidence is still considered weak.

Patients` compliance with instructions after oral surgery in Nigeria

African Journals Online (AJOL)

2Department of Dental Surgery, Military Hospital, Port Harcourt, Nigeria. KEY WORDS: ... Objective: To prospectively study the behaviour of oral surgery patients given verbal and written instructions ..... This is intriguing in view of the general belief in the dental .... comply with the antibiotic prescription while the response.

Obtaining consent to oral and maxillofacial surgery.

Science.gov (United States)

Poswillo, D

1989-09-01

The question of whether or not a patient has consented to treatment has recently become significant to all who practise oral and maxillofacial surgery. It is often linked to professional negligence when the outcome differs from the patient's perception or expectation of the operation. Consent may be oral or written, applies to referred patients and all those with physical and mental handicap and religious restrictions. Examples of procedure in discussing consent assist the surgeon to inform without creating fear. Knowledge of the benefits of informed consent and current legal opinion assist the oral and maxillofacial surgeon to avoid the pitfalls of failure to inform.

The role of oral antibiotics prophylaxis in prevention of surgical site infection in colorectal surgery.

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Koullouros, Michalis; Khan, Nadir; Aly, Emad H

2017-01-01

Surgical site infection (SSI) continues to be a challenge in colorectal surgery. Over the years, various modalities have been used in an attempt to reduce SSI risk in elective colorectal surgery, which include mechanical bowel preparation before surgery, oral antibiotics and intravenous antibiotic prophylaxis at induction of surgery. Even though IV antibiotics have become standard practice, there has been a debate on the exact role of oral antibiotics. The primary aim was to identify the role of oral antibiotics in reduction of SSI in elective colorectal surgery. The secondary aim was to explore any potential benefit in the use of mechanical bowel preparation (MBP) in relation to SSI in elective colorectal surgery. Medline, Embase and the Cochrane Library were searched. Any randomised controlled trials (RCTs) or cohort studies after 1980, which investigated the effectiveness of oral antibiotic prophylaxis and/or MBP in preventing SSIs in elective colorectal surgery were included. Twenty-three RCTs and eight cohorts were included. The results indicate a statistically significant advantage in preventing SSIs with the combined usage of oral and systemic antibiotic prophylaxis. Furthermore, our analysis of the cohort studies shows no benefits in the use of MBP in prevention of SSIs. The addition of oral antibiotics to systemic antibiotics could potentially reduce the risk of SSIs in elective colorectal surgery. Additionally, MBP does not seem to provide a clear benefit with regard to SSI prevention.

Human Cadaver Material in Preclinical Oral Surgery.

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Barber, H. Dexter; And Others

1993-01-01

A University of Michigan dental school curriculum for oral surgery that uses human cadaver heads is described. Selection, preparation, and laboratory use of the materials are outlined. Faculty and students have received the sequence well and found it prepared them for clinical rotation. (MSE)

The impact of intraoperative opioid use on survival after oral cancer surgery.

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Patino, Miguel A; Ramirez, Rafael E; Perez, Carlos A; Feng, Lei; Kataria, Pranav; Myers, Jeffrey; Cata, Juan P

2017-11-01

To investigate the impact of opioid use on cancer recurrence after oral cancer surgery. We hypothesized that the amount of opioids administered during oral cancer surgery is an independent predictor of recurrence free survival (RFS) and overall survival (OS). After Institutional Review Board approval, we collected demographic, tumor related, intraoperative and survival data of patients who had oral cancer surgery. Multivariable Cox proportional hazards models were used to determine the impact of important covariates on RFS and OS. 268 patients were included. After adjusting for significant covariates, the amount of opioids administered during surgery was not an independent predictor of RFS (HR: 1.27 [CI 95%, 0.838-1.924], p=0.26). However, we observed an association between opioid consumption and shorter OS (HR=1.77, [CI 95%=0.995-3.149]. p=0.05). High requirements of opioids during surgery increase the risk of recurrence and mortality by 27% and 77%, although the association is not statically significant. Copyright © 2017 Elsevier Ltd. All rights reserved.

Ambulatory oral surgery: 1-year experience with 11 680 patients from Zagreb district, Croatia

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Jokić, Dražen; Macan, Darko; Perić, Berislav; Tadić, Marinka; Biočić, Josip; Đanić, Petar; Brajdić, Davor

2013-01-01

Aim To examine the types and frequencies of oral surgery diagnoses and ambulatory oral surgical treatments during one year period at the Department of Oral Surgery, University Hospital Dubrava in Zagreb, Croatia. Methods Sociodemographic and clinical data on 11 680 ambulatory patients, treated between January 1 and of December 31, 2011 were retrieved from the hospital database using a specific protocol. The obtained data were subsequently analyzed in order to assess the frequency of diagnoses and differences in sex and age. Results The most common ambulatory procedure was tooth extraction (37.67%) and the most common procedure in ambulatory operating room was alveolectomy (57.25%). The test of proportions showed that significantly more extractions (P Zagreb than in patients residing in rural areas. Conclusion The data from this study may be useful for planning of ambulatory oral surgery services, budgeting, and sustaining quality improvement, enhancing oral surgical curricula, training and education of primary health care doctors and oral surgery specialists, and promoting patients’ awareness of the importance of oral health. PMID:23444246

Periodontal surgery improves oral health-related quality of life in chronic periodontitis patients in Asian population.

Science.gov (United States)

Chou, Yu-Hsiang; Yang, Yi-Hsin; Kuo, Hsiao-Ching; Ho, Kun-Yen; Wang, Wen-Chen; Hu, Kai-Fang

2017-10-01

The effect of periodontal surgery on patients' quality of life was investigated. Sixty patients received regenerative surgery or resective osseous surgery. Oral health-related quality of life and health-related quality of life instruments were used to assess the participants' quality of life before surgery and 4 weeks after surgery. Periodontal surgery can improve patients' quality of life by alleviating the physical pain and psychological discomfort. The scores were lower (more favorable) in the regenerative surgery group, and the functional limitations of the regenerative surgery group improved substantially compared with those of the resective osseous surgery group (P = 0.0421). The patients' oral health-related quality of life scores improved significantly after periodontal surgery. Clinicians can take advantage of the positive functional oral health-related quality of life impacts of regenerative surgery. Copyright © 2017. Published by Elsevier Taiwan.

Trans-oral robotic surgery in oropharyngeal carcinoma - A guide for general practitioners and patients.

Science.gov (United States)

Liu, Wendy Sijia; Limmer, Alex; Jabbour, Joe; Clark, Jonathan

Trans-oral robotic surgery (TORS) is emerging as a minimally invasive alternative to open surgery, or trans-oral laser surgery, for the treatment of some head and neck pathologies, particularly oropharyngeal carcinoma, which is rapidly increasing in incidence. In this article we review current evidence regarding the use of TORS in head and neck surgery in a manner relevant to general practice. This information may be used to facilitate discussion with patients. Compared with open surgery or trans-oral laser surgery, TORS has numerous advantages, including no scarring, less blood loss, fewer complications, lower rates of admission to the intensive care unit, and reduced length of hospitalisation. The availability of TORS in Australia is currently limited and, therefore, public awareness about TORS is lacking. Details regarding the role of TORS and reliable, up-to-date, patient-friendly information sources are discussed in this article.

Salvage surgery for radiation failure in oral, oropharyngeal, and hypopharyngeal squamous cell carcinoma

International Nuclear Information System (INIS)

Suzuki, Masahiro; Terada, Akihiro; Ogawa, Tetsuya; Suzuki, Hidenori; Hasegawa, Yasuhisa

2007-01-01

Few reports have covered salvage surgery after radiotherapy, especially with chemotherapy for oral, oropharyngeal, and hypopharyngeal squamous cell carcinoma. The feasibility of salvage surgery is unclear. We analyzed postoperative complications and prognosis after salvage surgery for local recurrence after definitive radiotherapy. Subjects were 37 patients with oral, oropharyngeal, and hypopharyngeal squamous cell carcinoma treated from 1994 to 2003. Of these, 14 (37.8%) had postoperative complications. The complication rate was significantly high in the reconstructive operation group (p=0.031) and the chemotherapy group (p=0.049). The 5-year overall survival rate after salvage surgery was 70.7%. Although there was no significant improvement, the prognosis was good in early-stage groups with primary tumors. We found that salvage surgery after definitive radiotherapy was effective for recurrent oral, oropharyngeal, and hypopharyngeal squamous cell carcinoma. We stress the need to pay attention to postoperative complications in reconstructive operation and chemotherapy groups. (author)

Fear and anxiety in patients undergoing minor oral surgery | Saheeb ...

African Journals Online (AJOL)

Objective: This study was carried out to determine the causes of fear and anxiety in consecutive patients who attended the University of Benin Teaching Hospital for minor oral surgical treatment. Method: All consenting consecutive patients referred for minor oral surgery were studied. Information on all the patients was ...

Publication bias in oral and maxillofacial surgery journals: an observation on published controlled trials.

Science.gov (United States)

Pitak-Arnnop, Poramate; Sader, Robert; Rapidis, Alexander D; Dhanuthai, Kittipong; Bauer, Ute; Herve, Chistian; Hemprich, Alexander

2010-01-01

Publication bias (PB) diminishes the full distribution of research, distorts and discredits the scientific record, and thus compromises evidence-based practice. The objective of this study was to analyse published controlled trials with regard to PB in leading oral and maxillofacial surgery (OMS) journals. All controlled trials published in the International Journal of Oral and Maxillofacial Surgery, Journal of Cranio-Maxillofacial Surgery, Journal of Oral and Maxillofacial Surgery, and British Journal of Oral and Maxillofacial Surgery in 2008 were analysed for a primary outcome, country of authors, sample size, gender of the first author, funding source and location of the study. Of 952 published articles, 53 controlled trials (5.7%) were identified. The OMS journals preferentially published controlled trials with a positive outcome (77.4%) and from high-income countries (73.6%). Single-centred trials (86.8%) with low sample size (njournals should establish measures to eliminate PB to uphold scientific integrity. However, this study was an observation based on the published articles. An analysis of all submitted manuscripts would provide more accurate estimates of PB. Ethical considerations on PB are also discussed.

Osteo-odonto-keratoprosthesis surgery: a combined ocular-oral procedure for ocular blindness.

Science.gov (United States)

Tay, A B G; Tan, D T H; Lye, K W; Theng, J; Parthasarathy, A; Por, Y-M

2007-09-01

The aim of this retrospective study was to describe the oral procedures used in osteo-odonto-keratoprosthesis (OOKP) surgery, and the demographics and oral findings of candidate patients in Singapore. The OOKP procedure utilizes an autologous tooth-bone complex to mount a poly-methylmethacrylate optical cylinder, as an artificial cornea, stabilized by an overlying autologous buccal mucosal graft. Consecutive patients referred over 3 years for dental evaluation prior to OOKP surgery were included. A total of 21 patients underwent oral clinical and radiographic evaluation. The aetiology of blindness included Stevens-Johnson's syndrome (11 cases), chemical burns (9 cases) and multiple failed corneal grafts (1 case). Evaluation revealed that 12 patients were suitable for OOKP surgery, 8 were at risk of complication or failure and 1 had no usable teeth. Fourteen patients have undergone unilateral OOKP Stage 1 surgery successfully. Complications included fracture of a tooth from its lingual bone necessitating the harvesting of a second tooth (1 case), oronasal perforation (1 case), exposure of adjacent roots (5 teeth), lower lip paresthesia (2 cases) and submucosal scar band formation in the buccal mucosal graft donor site (10 cases). Thirteen patients have completed Stage 2 surgery, with attainment of their best possible visual potential following OOKP surgery.

The role of diagnostic ultrasound as a new diagnostic aid in oral and maxillofacial surgery

Directory of Open Access Journals (Sweden)

Siva Subramaniyam Venkataraman

2012-01-01

Full Text Available Only very few studies have been done in the past to evaluate the usefulness and limitations of ultrasonography in oral and maxillofacial surgery. This study, though in an embryonic stage, has been done to bring this technique to limelight and to put forth the importance of its use and limitations in the branch of oral surgery. The purpose of this study was to investigate and study the characteristic pattern of the oral tissues on gray scale ultrasonography and to assess the practical applicability of this new diagnostic technique in diagnosing various tissue pathologies in the field of oral and maxillofacial surgery.

Are You Ready for Emergency Medical Services in Your Oral and Maxillofacial Surgery Office?

Science.gov (United States)

Rayner, Clive; Ragan, Michael R

2018-05-01

Efficient responses to emergencies in the oral and maxillofacial surgery office require preparation, communication, and thorough documentation of the event and response. The concept of team anesthesia is showcased with these efforts. Emergency medical services training and response times vary greatly. The oral and maxillofacial surgery office should be prepared to manage the patient for at least 15 minutes after making the call to 911. Patient outcomes are optimized when providers work together to manage and transport the patient. Oral and maxillofacial surgery offices should develop and rehearse emergency plans and coordinate these protocols with local Emergency medical services teams. Copyright © 2018 Elsevier Inc. All rights reserved.

Regenerative nanotechnology in oral and maxillofacial surgery.

Science.gov (United States)

Shakib, Kaveh; Tan, Aaron; Soskic, Vukic; Seifalian, Alexander M

2014-12-01

Regenerative nanotechnology is at the forefront of medical research, and translational medicine is a challenge to both scientists and clinicians. Although there has been an exponential rise in the volume of research generated about it for both medical and surgical uses, key questions remain about its actual benefits. Nevertheless, some people think that therapeutics based on its principles may form the core of applied research for the future. Here we give an account of its current use in oral and maxillofacial surgery, and implications and challenges for the future. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Comparison of multi-modal early oral nutrition for the tolerance of oral nutrition with conventional care after major abdominal surgery: a prospective, randomized, single-blind trial.

Science.gov (United States)

Sun, Da-Li; Li, Wei-Ming; Li, Shu-Min; Cen, Yun-Yun; Xu, Qing-Wen; Li, Yi-Jun; Sun, Yan-Bo; Qi, Yu-Xing; Lin, Yue-Ying; Yang, Ting; Lu, Qi-Ping; Xu, Peng-Yuan

2017-02-10

Early oral nutrition (EON) has been shown to improve recovery of gastrointestinal function, length of stay and mortality after abdominal surgery; however, early oral nutrition often fails during the first week after surgery. Here, a multi-modal early oral nutrition program is introduced to promote recovery of gastrointestinal function and tolerance of oral nutrition. Consecutive patients scheduled for abdominal surgery were randomized to the multimodal EON group or a group receiving conventional care. The primary endpoint was the time of first defecation. The secondary endpoints were outcomes and the cost-effectiveness ratio in treating infectious complications. The rate of infectious-free patients was regarded as the index of effectiveness. One hundred seven patients were randomly assigned to groups. Baseline characteristics were similar for both groups. In intention-to-treat analysis, the success rate of oral nutrition during the first week after surgery in the multimodal EON group was 44 (83.0%) versus 31 (57.4%) in the conventional care group (P = 0.004). Time to first defecation, time to flatus, recovery time of bowel sounds, and prolonged postoperative ileus were all less in the multimodal EON group (P oral nutrition group (P oral nutrition program was an effective way to improve tolerance of oral nutrition during the first week after surgery, decrease the length of stay and improve cost-effectiveness after abdominal surgery. Registration number: ChiCTR-TRC-14004395 . Registered 15 March 2014.

[Contribution of Perioperative Oral Health Care and Management for Patients who Underwent General Thoracic Surgery].

Science.gov (United States)

Saito, Hajime; Minamiya, Yoshihiro

2016-01-01

Due to the recent advances in radiological diagnostic technology, the role of video-assisted thoracoscopic surgery in thoracic disease has expanded, surgical indication extended to the elderly patients. Cancer patients receiving surgery, radiation therapy and/or chemotherapy may encounter complications in conjunction with the oral cavity such as aspiration pneumonia, surgical site infection and various type of infection. Recently, it is recognized that oral health care management is effective to prevent the postoperative infectious complications, especially pneumonia. Therefore, oral management should be scheduled before start of therapy to prevent these complications as supportive therapy of the cancer treatment. In this background, perioperative oral function management is highlighted in the remuneration for dental treatment revision of 2012,and the importance of oral care has been recognized in generally. In this manuscript, we introduce the several opinions and evidence based on the recent previous reports about the perioperative oral health care and management on thoracic surgery.

The Impact of Orthognathic Surgery on Oral Health-Related Quality of Life

Directory of Open Access Journals (Sweden)

Reza Tabrizi

2013-12-01

Full Text Available Introduction: This study aimed to measure the changes in oral health-related quality of life of the patients, referred to Shahid Chamran Hospital in Shiraz before and after the orthognathic surgery. Methods: This prospective study was performed using the 14-item oral health impact profile (OHIP-14 questionnaire. The questionnaires were given both before and four months after the orthognathic surgery to all the patients referred to Shahid Chamran Hospital of Shiraz between 20th of November 2012 and 20th of February 2013. The patients were asked about their motivation for surgery and the responses were classified as functional, esthetic or a combination of functional and esthetic problems. The data achieved from all the questions before and after the surgery were analyzed using repeated measures test. Results: Twenty eight patients including 10 men and 18 women participated in this study. The mean scores of quality of life after the surgery decreased significantly compared to that before the treatment (P

Reporting of ethical protection in recent oral and maxillofacial surgery research involving human subjects.

Science.gov (United States)

Pitak-Arnnop, P; Sader, R; Hervé, C; Dhanuthai, K; Bertrand, J-Ch; Hemprich, A

2009-07-01

This retrospective observational study investigated the frequency of reporting ethical approval and informed consent in recently published oral and maxillofacial surgery (OMS) research involving human subjects. All research involving human subjects published in the International Journal of Oral and Maxillofacial Surgery, Journal of Oral and Maxillofacial Surgery, British Journal of Oral and Maxillofacial Surgery, and Journal of Cranio-Maxillofacial Surgery during January to June 2005-2007 were analysed for disclosure of ethical approval by a local ethical committee and obtaining informed consent from the subjects. 534 articles were identified; ethical approval was documented in 118 (22%) and individual patient consent in 135 (25%). 355 reports (67%) did not include a statement on ethical approval or informed consent and only 74 reports (14%) disclosed statements of both. Ethical documentation in retrospective and observational studies was scant; 12% of randomised controlled trials and 38% of non-random trials did not report both of ethical protections. Most recent OMS publications involving humans failed to mention ethical review or subjects' consent. Authors must adhere to the international research ethics guidelines and journal instructions, while editors should play a gatekeeper role to protect research participants, uphold scientific integrity and maintain public trust in the experimental process and OMS profession.

Audit of accuracy of clinical coding in oral surgery.

Science.gov (United States)

Naran, S; Hudovsky, A; Antscherl, J; Howells, S; Nouraei, S A R

2014-10-01

We aimed to study the accuracy of clinical coding within oral surgery and to identify ways in which it can be improved. We undertook did a multidisciplinary audit of a sample of 646 day case patients who had had oral surgery procedures between 2011 and 2012. We compared the codes given with their case notes and amended any discrepancies. The accuracy of coding was assessed for primary and secondary diagnoses and procedures, and for health resource groupings (HRGs). The financial impact of coding Subjectivity, Variability and Error (SVE) was assessed by reference to national tariffs. The audit resulted in 122 (19%) changes to primary diagnoses. The codes for primary procedures changed in 224 (35%) cases; 310 (48%) morbidities and complications had been missed, and 266 (41%) secondary procedures had been missed or were incorrect. This led to at least one change of coding in 496 (77%) patients, and to the HRG changes in 348 (54%) patients. The financial impact of this was £114 in lost revenue per patient. There is a high incidence of coding errors in oral surgery because of the large number of day cases, a lack of awareness by clinicians of coding issues, and because clinical coders are not always familiar with the large number of highly specialised abbreviations used. Accuracy of coding can be improved through the use of a well-designed proforma, and standards can be maintained by the use of an ongoing data quality assurance programme. Copyright © 2014. Published by Elsevier Ltd.

Knowledge and Awareness of Medical Practitioners of Jazan City towards Oral and Maxillofacial Surgery as a Specialty.

Science.gov (United States)

Ali, Fareedi Mukram; Al-Iryani, Ghassan M; Namis, Sultan Mohammed; Hezam, Asma Ali; Swaid, Salma Abdu; Alomar, Anas Esam

2018-03-15

In many health services communities the scope of oral and maxillofacial surgery (OMFS) as a discipline is frequently not probably understood. Good awareness towards OMFS among different branches of health services providers is essential for better referral strategies and will be for the benefit of the patient. The cross-sectional study was done using a specially prepared questionnaire distributed randomly to 125 general medical practitioners working in Jazan province. In this questionnaire, there were also some close-ended questions to evaluate awareness regarding a variety of conditions treated by the oral and maxillofacial surgeons. Out of 125 participants, 105 (84%) were aware of the oral and maxillofacial surgery as a speciality branch of dentistry. Only 52 (41.6%) participants were aware of the different treatment modalities coming under the scope of oral and maxillofacial surgery. Also in the referral of cases to the oral and maxillofacial surgeon, 50 (40%) participants referred their oral and maxillofacial region cases to OMS. Tooth removal was the only procedure where most of the medical practitioners knew it is a speciality procedure of the oral and maxillofacial surgeon. For facial fractures, 76 medical practitioners believe it comes under the scope of the orthopaedic surgeon. Similarly, for facial abscesses, 81 and 36 practitioners responded that it is a job of a general surgeon and OMS respectively. There is low awareness toward the scope of oral and maxillofacial surgery in the medical community. Knowledge and awareness of the scope of oral and maxillofacial surgery can improve the success and promptness of delivery of health services.

Application of additive manufacturing in oral and maxillofacial surgery

NARCIS (Netherlands)

Farré-Guasch, E.; Wolff, J.; Helder, M.N.; Schulten, E.A.J.M.; Forouzanfar, T.; Klein-Nulend, J.

2015-01-01

Additive manufacturing is the process of joining materials to create objects from digital 3-dimensional (3D) model data,which is a promising technology in oral andmaxillofacial surgery. The management of lost craniofacial tissues owing to congenital abnormalities, trauma, or cancer treatment poses a

Lasers in oral surgery and implantology

Science.gov (United States)

Vescovi, Paolo

2016-03-01

The usefulness of laser for oral hard tissue procedure such as caries treatment, impacted teeth extraction, periodontal therapy, peri-implantitis management, sinus lifting is reported by several Authors [1]. Conventionally, mechanical rotary instruments and hand instruments are employed for bone surgery. Rotary instruments have better accessibility and cutting efficiency, but there is a risk of excessive heating of bone tissue and caution must be exercised to avoid the bur becoming entangled with surrounding soft tissues and the reflected flap. The main clinical advantages of the lasers are represented by minimal patient discomfort, good recovery with decreased or absent post-operative pain. In the last ten years are described in the international literature great advantages of Laser Surgery and Low Level Laser Therapy (LLLT) performed with different wavelength in addition to traditional surgical techniques to improve bone and soft tissue healing and for pain and infection control.

The analgesic efficacy of intravenous versus oral tramadol for preventing postoperative pain after third molar surgery

NARCIS (Netherlands)

Ong, Cliff K. S.; Lirk, Phillip; Tan, Juliana M. H.; Sow, Belle W. Y.

2005-01-01

The aim of this study was to compare the analgesic efficacy of single-dose preoperative intravenous versus oral tramadol for preventing pain after third molar surgery. Seventy-two patients undergoing elective third molar surgery were randomized to receive either intravenous (n = 36) or oral (n = 36)

Validation of Universal Scale in Oral Surgery (USOS) for Patient’s Psycho-emotional Status Rating

Science.gov (United States)

Pinchasov, Ginnady; Gervickas, Albinas; Sakavicius, Dalius; Juodzbalys, Gintaras

2017-01-01

ABSTRACT Objectives There aren’t any objective methods that may help in standard evaluation of oral surgery patient’s psycho-emotional status. Without any standardized evaluation, two main problems appear: heterogeneity between studies and ineffective patient’s evaluation. Therefore, Universal Scale in Oral Surgery (USOS) for patient’s psycho-emotional status rating has previously been proposed by authors. The aim of present study is to assess the clinical effectivity and validate the Universal Scale in Oral Surgery in case of outpatient tooth extraction for adult healthy patients. Material and Methods Clinical trial to validate the USOS for patient’s psycho-emotional status rating was performed. In total 90 patients, that came for outpatient dental extraction to Lithuanian University of Health Sciences Oral and Maxillofacial Surgery Department ambulatory, were enrolled in clinical trial. Patients filled self-reported questionnaires before the procedure. Operating surgeon rated USOS for patient’s psycho-emotional status rating doctor’s part questionnaire after the procedure. 4 - 6 weeks later all patients were asked to fill USOS for patient’s psycho-emotional status rating questionnaire retrospectively. Results According to the statistical analysis, the final composition of USOS for patient’s psycho-emotional status rating that would fit to reliability coefficient should be composed from 6 patient part questions and 3 general doctor part questions. Conclusions Universal Scale in Oral Surgery for patient’s psycho-emotional status rating is a novel, doctor and patient rated scale which is suitable for clinical and scientific usage. PMID:29435204

A review of computer-aided oral and maxillofacial surgery: planning, simulation and navigation.

Science.gov (United States)

Chen, Xiaojun; Xu, Lu; Sun, Yi; Politis, Constantinus

2016-11-01

Currently, oral and maxillofacial surgery (OMFS) still poses a significant challenge for surgeons due to the anatomic complexity and limited field of view of the oral cavity. With the great development of computer technologies, he computer-aided surgery has been widely used for minimizing the risks and improving the precision of surgery. Areas covered: The major goal of this paper is to provide a comprehensive reference source of current and future development of computer-aided OMFS including surgical planning, simulation and navigation for relevant researchers. Expert commentary: Compared with the traditional OMFS, computer-aided OMFS overcomes the disadvantage that the treatment on the region of anatomically complex maxillofacial depends almost exclusively on the experience of the surgeon.

Influence of Effective Communication by Surgery Students on Their Oral Examination Scores.

Science.gov (United States)

Rowland-Morin, Pamela A.; And Others

1991-01-01

Clinical surgery faculty (n=78) evaluated videotaped simulated surgery student oral examinations. Results showed that regardless of the content of students' responses, evaluators were strongly influenced by how well students communicated. Evaluators preferred a moderate response rate and direct eye contact over a slower response rate and indirect…

Presurgical motivations, self-esteem, and oral health of orthognathic surgery patients.

Science.gov (United States)

Yu, Dedong; Wang, Fang; Wang, Xudong; Fang, Bing; Shen, Steve Guofang

2013-05-01

The aim of this study was to evaluate motivations, self-esteem, and oral health for undergoing orthognathic patients by gender in China before orthognathic surgery. Using a prospective and control study design, 429 subjects in China were collected from December 2010 to May 2011. The patient group consisted of 210 consecutive healthy patients, and 219 young individuals comprised the control group. All the subjects filled out a questionnaire and were assessed by Self-esteem Scale and Oral Health Impact Profile validated for Chinese patients before surgery. To measure the discrepancy, the Student t test was computed. P motivations for orthognathic surgery are to improve facial appearance (83.33%), occlusion (50%), and self-confidence (48.1%). Females expect to improve facial appearance (83.87%), self-confidence (43.55%), and occlusion (41.94%). Males are for the improvement of facial appearance (82.56%), occlusion (63.95%), and self-confidence (54.65%). Self-esteem in the patient group is obviously lower (P self-esteem in female groups (P motivation. Self-confidence has been more frequently mentioned, while headache far less than other countries. (2) Female patients have less self-esteem than females in the control group. (3) Patients' oral health are worse than those in the control group.

Video capsule endoscopy after bariatric and gastric surgery: oral ingestion is associated with satisfactory completion rate.

Science.gov (United States)

Stanich, Peter P; Kleinman, Bryan; Porter, Kyle M; Meyer, Marty M

2015-01-01

To investigate the outcomes of video capsule endoscopy (VCE) performed on patients after bariatric and gastric surgery with a focus on delivery method (oral ingestion or endoscopic placement). There is minimal published data regarding the use of VCE in patients after bariatric and gastric surgery and the optimal delivery method is unknown. Retrospective case series of patients with bariatric or gastric surgery undergoing VCE in a tertiary care center over 3 years. Outcomes of interest were completion of the procedure and bowel transit times. Twenty-three patients met study criteria. They underwent 24 VCE in the study period, with 13/16 (81.3%; 95% CI, 54%-96%) completed to the colon after oral ingestion and 5/8 (62.5%; 95% CI, 24%-91%) completed after endoscopic deployment. The median gastric transit time after oral ingestion was 440) (P=0.48). There were no instances of capsule retention. Oral ingestion of VCE resulted in a satisfactory completion rate with rapid gastric transit after bariatric and gastric surgery. There were no capsule retention events. Given this and the favorable risk and cost profile, oral ingestion should be favored over endoscopic placement in this patient population.

Corticosteroid administration in oral and orthognathic surgery: a systematic review of the literature and meta-analysis

DEFF Research Database (Denmark)

Dan, Anne E B; Thygesen, Torben H; Pinholt, Else M

2010-01-01

was made. The primary predictor variable was CS administration and the outcome variables were edema, pain, and infection. A meta-analysis was performed. The risk of other side effects was evaluated through a simple review. RESULTS: In oral surgery, most clinical trials showed a significant decrease...... toward a neuroregeneration effect, but no statistical analysis could be performed. Regarding the risk of other side effects, in oral surgery, a minimal risk of chronic adrenal suppression was seen; in orthognathic surgery, an elevated risk of avascular osteonecrosis, steroid-induced psychosis......, and adrenal suppression was seen. There were no reports of decreased healing. CONCLUSION: These findings suggest that the administration of CS in oral surgery decreases edema and pain significantly, with no higher risk of infection and with a minimum risk of other side effects....

Oral surgery in the European Union: challenges of diversity in training and practice.

Science.gov (United States)

Nasseripour, M N; Hervé, C; Meningaud, J-P

2017-02-01

At the crossroads of medicine and dentistry, oral surgery with orthodontics are the only recognised dental specialties by the European Union. The goal of our study is to evaluate the current state of oral surgery in Europe from its teaching to its practice, the hypothesis being that a notable diversity persists despite European Union harmonisation process. To understand the impact of this diversity applied to European Union freedom of movement and its ethical implications for the practice of oral surgery, English and French questionnaires were sent by email to universities and organisations delivering authorisation to practise in France, Germany, Spain, Sweden and United Kingdom chosen based upon inclusion and exclusion criteria. An analysis of documents on these organisations' official websites was also conducted. Demographic information was obtained from the aforementioned organisations. The profile of practising oral surgeons is different dependent on the country. The university and hospital trainings conform to European recommendations and span 3-4 years. European Board certification is not required. Continuing education is mandatory only in France, Germany and United Kingdom. As for curricula and scope of practice, no consensus can be derived. There is potential conflict of interest between European Union principles of freedom of movement and protection of all citizens, as member countries do not uniformly apply Directives and recommendations. A new survey of all European Union oral surgery programmes as well as organisations delivering authorisation to practise is necessary to implement across the board harmonisation of training and practice to insure patient safety in light of the migration of European Union practitioners. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Effect of Oral Lactoferrin on Cataract Surgery Induced Dry Eye: A Randomised Controlled Trial.

Science.gov (United States)

Devendra, Jaya; Singh, Sneha

2015-10-01

Cataract surgery is one of the most frequently performed intra-ocular surgeries, of these manual Small Incision Cataract Surgery (SICS) is a time tested technique of cataract removal. Any corneal incisional surgery, including cataract surgery, can induce dry eye postoperatively. Various factors have been implicated, of which oneis the inflammation induced by the surgery. Lactoferrin, a glycoprotein present in tears is said to have anti-inflammatory effects, and promotes cell growth. It has been used orally in patients of immune mediated dry eye to alleviate symptoms. This study was aimed to evaluate the dry eyes induced by manual Small Incision Cataract Surgery, and the effect if any, of oral lactoferrin on the dry eyes. A single centre, prospective randomised controlled trial with a concurrent parallel design. The study was carried out on patients presenting in the OPD of Rohilkhand Medical College hospital for cataract surgery. Sixty four patients of cataract surgery were included in the study. Patients with pre-existing dry eyes, ocular disease or systemic disease predisposing to dry eyes were excluded from the study. The selected patients were assigned into two groups by simple randomisation-Control Group A-32 patients that did not receive oral lactoferrin postoperatively. Group B-32 patients that received oral lactoferrin 350 gm postoperatively from day 1 after SICS. All patients were operated for cataract and their pre and postoperative (on days 7, 14, 30 and 60) dry eye status was assessed using the mean tear film break-up time (tBUT) and Schirmer test 1 (ST 1) as the evaluating parameters. Subjective evaluation of dry eye was done using Ocular Surface Disease Index (OSDI) scoring. Data was analysed for 58 patients, as 6 did not complete the follow up. Unpaired t-test was used to calculate the p-values. There was a statistically significant difference between the tBUT values of the Control and Lactoferrin group from day 14 onwards. The tBUT of control group

Computer-assisted oral and maxillofacial surgery

International Nuclear Information System (INIS)

Hassfeld, S.; Brief, J.; Muehling, J.; Krempien, R.; Mende, U.; Raczkowsky, J.; Muenchenberg, J.; Woern, H.; Giess, H.; Meinzer, H.P.

2000-01-01

Background: Methods from the area of virtual reality are used in oral and maxillofacial surgery for the planning and three-dimensional individual simulation of surgeries. Simulation: In order to simulate complex surgeries with the aid of a computer, the diagnostic image data and especially various imaging modalities (CT, MRT, US) must be arranged in relation to each other, thus enabling rapid switching between the various modalities as well as the viewing of mixed images. Segmenting techniques for the reconstruction of three-dimensional representations of soft-tissue and osseous areas are required. We must develop ergonomic and intuitively useable interaction methods for the surgeon, thus allowing for precise and fast entry of the planned surgical intervention in the planning and simulation phase. Surgery: During the surgical phase, instrument navigation tools offer the surgeon interactive support through operation guidance and control of potential dangers. This feature is already available today. Future intraoperative assistance will take the form of such passive tools for the support of intraoperative orientation as well as so-called tracking systems (semi-active systems) which accompany and support the surgeons' work. The final form are robots which execute specific steps completely autonomously. Discussion: The techniques of virtual reality keep gaining in importance for medical applications. Many applications are still being developed or are still in the form of a prototype. However, it is already clear that developments in this area will have a considerable effect on the surgeon's routine work. (orig.) [de

History of the Oral and Maxillofacial Surgery Residency Program at Universidad el Bosque, Bogotá, Colombia.

Science.gov (United States)

Castro-Núñez, Jaime

2012-01-01

The formal training of oral and maxillofacial surgeons in Colombia started in 1958 at Hospital Sanjos6, thanks to the titanic work of Waldemar Wilhelm, a German-born surgeon who settled in BogotA in 1950. Today there are seven institutions in Colombia that offer residency programs in oral and maxillofacial surgery. The aim of this article is to describe the history of the Oral and Maxillofacial Surgery Residency Program at Universidad El Bosque in Bogota.

Optimal degree of mouth opening for laryngeal mask airway function during oral surgery.

Science.gov (United States)

Sanuki, Takuro; Sugioka, Shingo; Hirokane, Motoko; Son, Hiroki; Uda, Rumiko; Akatsuka, Masafumi; Kotani, Junichiro

2011-04-01

This study was performed to determine the optimal degree of mouth opening in anesthetized patients requiring laryngeal mask airway (LMA) during oral surgery. A single, experienced LMA user inserted the LMA in 15 patients who were scheduled for elective oral surgery. Oropharyngeal leak pressure, intracuff pressure, and fiberoptic assessment of the LMA position were sequentially documented in 5 mouth conditions-opening of 1.4 (neutral position), 2, 3, 4, and 5 cm-and any resulting ventilatory difficulties were recorded. Oropharyngeal leak pressure with the mouth open 4 cm (21.8 ± 3.2 cm H(2)O, P = .025) and 5 cm (27.3 ± 7.2 cm H(2)O, P Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Corrective Jaw Surgery

Science.gov (United States)

... Extractions and Other Oral Surgeries Extractions and Other Oral Surgeries Oral and maxillofacial surgeons surgically treat the soft ... Extractions and Other Oral Surgeries Extractions and Other Oral Surgeries Oral and maxillofacial surgeons surgically treat the soft ...

Application of Additive Manufacturing in Oral and Maxillofacial Surgery.

Science.gov (United States)

Farré-Guasch, Elisabet; Wolff, Jan; Helder, Marco N; Schulten, Engelbert A J M; Forouzanfar, Tim; Klein-Nulend, Jenneke

2015-12-01

Additive manufacturing is the process of joining materials to create objects from digital 3-dimensional (3D) model data, which is a promising technology in oral and maxillofacial surgery. The management of lost craniofacial tissues owing to congenital abnormalities, trauma, or cancer treatment poses a challenge to oral and maxillofacial surgeons. Many strategies have been proposed for the management of such defects, but autogenous bone grafts remain the gold standard for reconstructive bone surgery. Nevertheless, cell-based treatments using adipose stem cells combined with osteoconductive biomaterials or scaffolds have become a promising alternative to autogenous bone grafts. Such treatment protocols often require customized 3D scaffolds that fulfill functional and esthetic requirements, provide adequate blood supply, and meet the load-bearing requirements of the head. Currently, such customized 3D scaffolds are being manufactured using additive manufacturing technology. In this review, 2 of the current and emerging modalities for reconstruction of oral and maxillofacial bone defects are highlighted and discussed, namely human maxillary sinus floor elevation as a valid model to test bone tissue-engineering approaches enabling the application of 1-step surgical procedures and seeding of Good Manufacturing Practice-level adipose stem cells on computer-aided manufactured scaffolds to reconstruct large bone defects in a 2-step surgical procedure, in which cells are expanded ex vivo and seeded on resorbable scaffolds before implantation. Furthermore, imaging-guided tissue-engineering technologies to predetermine the surgical location and to facilitate the manufacturing of custom-made implants that meet the specific patient's demands are discussed. The potential of tissue-engineered constructs designed for the repair of large oral and maxillofacial bone defects in load-bearing situations in a 1-step surgical procedure combining these 2 innovative approaches is

Early and late physical and psychosocial effects of primary surgery in patients with oral and oropharyngeal cancers

DEFF Research Database (Denmark)

Mortensen, Annelise; Jarden, Mary

2016-01-01

The purpose of this systematic review is to explore early and late physical and psychosocial effects of primary surgery for oral and oropharyngeal cancers and to investigate the factors that influence these effects. PubMed, Cinahl, and PsycInfo were searched for studies concerning patients...... diagnosed with oral and oropharyngeal cancers and treated with primary surgery and which followed the treatment trajectory from time of diagnosis to 10 years after surgery; these studies reported the quantitative assessments and qualitative experiences of the patient's physical and psychosocial well...... in this review was 3386; of these, 1996 were treated by surgery alone and 1390 with combined surgery and adjuvant radiation therapy and/or chemotherapy. The studies showed that because of the nature of their disease, patients are negatively affected by the different types of surgical treatment for oral...

Indications for Elective Tracheostomy in Reconstructive Surgery in Patients With Oral Cancer.

Science.gov (United States)

Leiser, Yoav; Barak, Michal; Ghantous, Yasmine; Yehudai, Noam; Abu El-Naaj, Imad

2017-01-01

Oral cancer surgery carries a high risk of upper airway obstruction; yet optimal airway management approach remains controversial. The purpose of the present study was to evaluate the use of tracheostomy in oncological patients undergoing oral cancer surgery with intra oral flap reconstruction. The study cohort included 75 patients with oral cancer, who underwent major intraoral resections and reconstruction with vascularized flaps. Thirty-six percent of the patients received elective tracheostomy (27 patients). Mean hospital stay of the patients with tracheostomy was 28.4 ± 12.5 days compared with 9.7 ± 2.1 days in the nontracheostomy patients. A scoring system rendered from this study suggests that patients with a total scoring at or above 8 should be considered for elective tracheostomy. With appropriate postoperative monitoring, selected patients can be managed without routine elective tracheostomy, yet, patients with comorbidities, mostly elderly patients, which undergo surgical resection and reconstruction in high-risk areas that can result in a bulky flap that pose danger to the postoperative airway, should receive elective tracheostomy.

Corrective Jaw Surgery

Medline Plus

Full Text Available ... Extractions and Other Oral Surgeries Extractions and Other Oral Surgeries Oral and maxillofacial surgeons surgically treat the soft ... Extractions and Other Oral Surgeries Extractions and Other Oral Surgeries Oral and maxillofacial surgeons surgically treat the soft ...

COMPLICATIONS OF ORAL AND MAXILLOFACIAL SURGERY UNDER GENERAL ANESTHESIA IN TUBE-FED CHILDREN: A RETROSPECTIVE ANALYSIS.

Science.gov (United States)

Nguyen, Trang D; Freilich, Marshall M; Macpherson, Bruce A

2016-06-01

To assess morbidity and mortality associated with oral and maxillofacial surgery procedures requiring general anesthesia among children with aspiration tendency requiring enteral feeding. A retrospective chart review was conducted of children surgically treated under general anesthesia by the oral and maxillofacial surgery service at the Hospital for Sick Children in Toronto, Canada. Medical and dental records over a 9-year period (January 1, 2000 to January 1, 2010) were reviewed. Data were collected on demographics, primary illness, coexisting medical conditions, procedures performed, medications administered, type of airway management used, duration of general anesthesia, American Society of Anesthesiologists' physical status classification and adverse events. During the period reviewed, 28 children underwent 35 oral and maxillofacial surgery procedures under general anesthesia. The mean patient age was 12 years (range 4-17 years). No deaths occurred. Of the 35 surgeries, 10 (29%) were associated with at least 1adverse event. Adverse events included 1incident of respiratory distress, 2incidents of fever, 5incidents of bleeding, 1incident of seizure and 4incidents of oxygen saturation below 90% for more than 30s. Children with a history of aspiration tendency that necessitates enteral feeding, who undergo oral and maxillofacial surgery under general anesthesia, are at increased risk of morbidity. Before initiating treatment, the surgeon and parents or guardians of such children should carefully consider these risks compared with the anticipated benefit of surgery.

Student perception of two different simulation techniques in oral and maxillofacial surgery undergraduate training.

Science.gov (United States)

Lund, Bodil; Fors, Uno; Sejersen, Ronny; Sallnäs, Eva-Lotta; Rosén, Annika

2011-10-12

Yearly surveys among the undergraduate students in oral and maxillofacial surgery at Karolinska Institutet have conveyed a wish for increased clinical training, and in particular, in surgical removal of mandibular third molars. Due to lack of resources, this kind of clinical supervision has so far not been possible to implement. One possible solution to this problem might be to introduce simulation into the curriculum. The purpose of this study was to investigate undergraduate students' perception of two different simulation methods for practicing clinical reasoning skills and technical skills in oral and maxillofacial surgery. Forty-seven students participating in the oral and maxillofacial surgery course at Karolinska Institutet during their final year were included. Three different oral surgery patient cases were created in a Virtual Patient (VP) Simulation system (Web-SP) and used for training clinical reasoning. A mandibular third molar surgery simulator with tactile feedback, providing hands on training in the bone removal and tooth sectioning in third molar surgery, was also tested. A seminar was performed using the combination of these two simulators where students' perception of the two different simulation methods was assessed by means of a questionnaire. The response rate was 91.5% (43/47). The students were positive to the VP cases, although they rated their possible improvement of clinical reasoning skills as moderate. The students' perception of improved technical skills after training in the mandibular third molar surgery simulator was rated high. The majority of the students agreed that both simulation techniques should be included in the curriculum and strongly agreed that it was a good idea to use the two simulators in concert. The importance of feedback from the senior experts during simulator training was emphasised. The two tested simulation methods were well accepted and most students agreed that the future curriculum would benefit from

Platelet-rich plasma (PRP) in dental and oral surgery: from the wound healing to bone regeneration.

Science.gov (United States)

Albanese, Antonino; Licata, Maria E; Polizzi, Bianca; Campisi, Giuseppina

2013-06-13

Platelet-rich plasma (PRP) is a new approach to tissue regeneration and it is becoming a valuable adjunct to promote healing in many procedures in dental and oral surgery, especially in aging patients. PRP derives from the centrifugation of the patient's own blood and it contains growth factors that influence wound healing, thereby playing an important role in tissue repairing mechanisms. The use of PRP in surgical practice could have beneficial outcomes, reducing bleeding and enhancing soft tissue healing and bone regeneration. Studies conducted on humans have yielded promising results regarding the application of PRP to many dental and oral surgical procedures (i.e. tooth extractions, periodontal surgery, implant surgery). The use of PRP has also been proposed in the management of bisphosphonate-related osteonecrosis of the jaw (BRONJ) with the aim of enhancing wound healing and bone maturation. The aims of this narrative review are: i) to describe the different uses of PRP in dental surgery (tooth extractions and periodontal surgery) and oral surgery (soft tissues and bone tissue surgery, implant surgery and BRONJ surgery); and ii) to discuss its efficacy, efficiency and risk/benefit ratio. This review suggests that the use of PRP in the alveolar socket after tooth extractions is certainly capable of improving soft tissue healing and positively influencing bone regeneration but the latter effect seems to decrease a few days after the extraction. PRP has produced better results in periodontal therapy in association with other materials than when it is used alone. Promising results have also been obtained in implant surgery, when PRP was used in isolation as a coating material. The combination of necrotic bone curettage and PRP application seem to be encouraging for the treatment of refractory BRONJ, as it has proven successful outcomes with minimal invasivity. Since PRP is free from potential risks for patients, not difficult to obtain and use, it can be employed

Platelet-rich plasma (PRP) in dental and oral surgery: from the wound healing to bone regeneration

Science.gov (United States)

2013-01-01

Platelet-rich plasma (PRP) is a new approach to tissue regeneration and it is becoming a valuable adjunct to promote healing in many procedures in dental and oral surgery, especially in aging patients. PRP derives from the centrifugation of the patient's own blood and it contains growth factors that influence wound healing, thereby playing an important role in tissue repairing mechanisms. The use of PRP in surgical practice could have beneficial outcomes, reducing bleeding and enhancing soft tissue healing and bone regeneration. Studies conducted on humans have yielded promising results regarding the application of PRP to many dental and oral surgical procedures (i.e. tooth extractions, periodontal surgery, implant surgery). The use of PRP has also been proposed in the management of bisphosphonate-related osteonecrosis of the jaw (BRONJ) with the aim of enhancing wound healing and bone maturation. The aims of this narrative review are: i) to describe the different uses of PRP in dental surgery (tooth extractions and periodontal surgery) and oral surgery (soft tissues and bone tissue surgery, implant surgery and BRONJ surgery); and ii) to discuss its efficacy, efficiency and risk/benefit ratio. This review suggests that the use of PRP in the alveolar socket after tooth extractions is certainly capable of improving soft tissue healing and positively influencing bone regeneration but the latter effect seems to decrease a few days after the extraction. PRP has produced better results in periodontal therapy in association with other materials than when it is used alone. Promising results have also been obtained in implant surgery, when PRP was used in isolation as a coating material. The combination of necrotic bone curettage and PRP application seem to be encouraging for the treatment of refractory BRONJ, as it has proven successful outcomes with minimal invasivity. Since PRP is free from potential risks for patients, not difficult to obtain and use, it can be employed

Subsequent publication of oral and maxillofacial surgery meeting abstracts.

Science.gov (United States)

Rodriguez, Joseph L; Laskin, Daniel M

2012-05-01

Previous studies in various medical specialties have shown that fewer than 50% of abstracts presented at meetings are subsequently published. The purpose of the present study was to determine the publication rate of abstracts presented at the annual meetings of the American Association of Oral and Maxillofacial Surgeons. The titles and authors of the abstracts from all oral abstract session presentations and posters by American contributors were collected from the Final Programs of the American Association of Oral and Maxillofacial Surgeons annual meetings for 2006 to 2009. A PubMed search for published articles through December 2010 was then performed using the authors' names, abstract titles, and key words. A total of 311 abstract presentations were done at the 4 annual meetings. Of these, only 85 (24%) were subsequently published. No difference was found between abstracts from oral or poster presentations. Most of the articles were published in the Journal of Oral and Maxillofacial Surgery. Because of deficiencies that can occur in abstracts and the need to disseminate the information they contain, it is important to take the appropriate measures to ensure that full articles are subsequently published. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Early oral feeding after elective abdominal surgery--what are the issues?

DEFF Research Database (Denmark)

Bisgaard, Thue; Kehlet, Henrik

2002-01-01

This review analyzes the literature and the historical concerns (restrictions, traditions, nasogastric tube) and pathophysiologic factors (postoperative ileus, risk of anastomotic dehiscence, nausea and vomiting, loss of appetite) invoked for not instituting early oral feeding after major abdomin...... surgical programs in abdominal surgery provide a rational basis for future studies to investigate and facilitate enforced oral feeding after major abdominal procedures.......This review analyzes the literature and the historical concerns (restrictions, traditions, nasogastric tube) and pathophysiologic factors (postoperative ileus, risk of anastomotic dehiscence, nausea and vomiting, loss of appetite) invoked for not instituting early oral feeding after major abdominal...... procedures. It appears that several factors may promote postoperative oral feeding such as thoracic epidural analgesia, multimodal anti-emetic treatment, opioid-sparing analgesia, selective peripheral opioid antagonists, and enforced oral nutrition. Recent data from multimodal fast-track rehabilitation...

Oral triiodothyronine normalizes triiodothyronine levels after surgery for pediatric congenital heart disease*.

Science.gov (United States)

Marwali, Eva M; Boom, Cindy E; Sakidjan, Indriwanto; Santoso, Anwar; Fakhri, Dicky; Kartini, Ay; Kekalih, Aria; Schwartz, Steven M; Haas, Nikolaus A

2013-09-01

This study was conducted to determine if oral triiodothyronine supplementation could prevent the decrease of serum triiodothyronine levels that commonly occurs after cardiopulmonary bypass for pediatric congenital heart surgery. Secondary objectives included identifying any significant adverse effects of oral triiodothyronine supplementation, including any effects on the thyroid/pituitary axis. Randomized, placebo-controlled, doubleblind clinical trial Operating room and ICU. Infants and children younger than 2 years of age undergoing congenital heart surgery using cardiopulmonary bypass (n = 43). Subjects were assigned to placebo (n = 15, group A) or one of two treatment groups: a low-dose group (group B, n = 14, 0.5 mcg/kg triiodothyronine orally every 24 hr for 3 d) or a high-dose group (group C, n = 14, 0.5 mcg/kg triiodothyronine orally every 12 hr for 3 d). Thyroid hormone, including total and free triiodothyronine levels at predetermined time points, potential side effects indicating hyperthyroidism, indicators of the thyroid-pituitary axis, and clinical endpoints. Oral triiodothyronine supplementation twice-daily maintained serum triiodothyronine levels within normal limits in group C, whereas serum levels progressively declined in groups A and B. A statistically significant difference in triiodothyronine levels between the treatment groups occurred between 18 and 36 hours post cross-clamp release, with the largest difference in serum levels between group C and group A noted at 36 hours post cross-clamp release (total triiodothyronine, 0.71 ± 0.15 [0.34-1.08] ng/mL [p triiodothyronine, 2.56 ± 0.49 [1.33-3.79] pg/mL [p triiodothyronine supplementation at a dose of 0.5 mcg/kg every 12 hours for 3 days can maintain total and free triiodothyronine levels within normal limits after open-heart surgery using cardiopulmonary bypass for congenital heart disease.

Accessibility to editorial information in Oral and Maxillofacial Surgery journals: The authors' point of view.

Science.gov (United States)

Castelo-Baz, Pablo; Leira-Feijoo, Yago; Seoane-Romero, Juan Manuel; Varela-Centelles, Pablo; Seoane, Juan

2015-09-01

To evaluate the accessibility to editorial information in Oral & Maxillofacial Surgery journals. A cross-sectional study using the WOS-Web of Science database in three categories: "Surgery," "Otorhinolaryngology," and "Dentistry, Oral Surgery & Medicine" was designed. Journals were filtered by title and classified under three headings: OMFS specialty; OMFS subspecialty and related sciences; and multidisciplinary journals. Specialty scope (OMFS vs. other); impact factor; path for the manuscript; blinding policy; accessibility to reviewers' criteria; and percentage of acceptance. Only 46 of 330 journals met the inclusion criteria. All OMFS journals provided comprehensive information about the review process, compared to 5 of 27 (18.5%) of Oral Surgery and related sciences periodicals. Most specialty journals do not inform about the blind review mode used (20 of 33; 60.6%). Generally, information about the reviewers' assessment criteria is scarce, but is available from all OMFS journals, which also state the percentage of manuscript acceptance (100% vs. 14.8%). OMFS JCR journals provide adequate information about their editorial process in terms of path for the manuscript, accessibility to reviewers' criteria, and percentage of acceptance. Additional efforts are needed to increase accessibility to information about blinding policy and average time from submission to acceptance. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Impact of orthognathic surgery on oral health-related quality of life in patients with jaw deformities.

Science.gov (United States)

Kurabe, K; Kojima, T; Kato, Y; Saito, I; Kobayashi, T

2016-12-01

The purpose of this study was to clarify the impact of orthognathic surgery on oral health-related quality of life (OHRQOL) in patients with jaw deformities. The subjects were 65 patients (21 males and 44 females) who underwent orthognathic surgery. The mean age of the patients was 23.6 years. Forty-seven patients had skeletal class III malocclusions, eight patients had skeletal class II, and 10 patients had skeletal class I with facial asymmetry and/or open bite. OHRQOL was assessed using the Japanese version of the Oral Health Impact Profile (OHIP-J54) before and 6 months after surgery. While OHIP-J54 scores in the patients before surgery were significantly higher than those in the control subjects, OHIP-J54 scores after surgery were significantly lower than those before surgery. OHIP-J54 scores in older patients were significantly higher than those in younger patients. In conclusion, most patients with jaw deformities have lower OHRQOL than individuals with normal occlusion, and orthognathic surgery has a positive impact on OHRQOL. The determination of OHRQOL in patients with jaw deformities seems to be very useful for understanding the patients' problems and for assessing the extent of changes in terms of patient well-being. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Factors associated to post-operative nausea and vomiting following oral and maxillofacial surgery: a prospective study.

Science.gov (United States)

Albuquerque, Assis Filipe Medeiros; Queiroz, Salomão Israel Monteiro Lourenço; Germano, Adriano Rocha; da Silva, José Sandro Pereira

2017-03-01

This study aims to address and assess possible factors associated with nausea and vomiting (NV) following oral and maxillofacial surgery. A prospective study was carried out in the period from December 2013 to January 2016 targeting all attended cases in that period. For statistical analysis, Pearson chi-square and Fisher tests were used to verify association and ANOVA and Student's t tests to test for significant difference, p was defined as ≤0.05. The sample group consisted of 207 patients with an average age of 33.56 years (±13.23), and 70.5% of subjects were male. Calculations based on the predictive model showed that a female patient with prior history of nausea and vomiting who used opioids and had intra-oral surgical access would have a 96% chance of experiencing a nausea and vomiting episode. Other factors like age, being overweight, anesthesia, surgery duration, and duration of hospital stay also contribute so that these aspects must be paid careful attention prior to surgery to ensure a suitably orientated treatment that will avoid disturbances caused by post-operative nausea and vomiting. The occurrence of post-operative nausea and vomiting after oral and maxillofacial surgery was found to be more higher incidence associated to female patients who used opioids, who had a prior history of NV, whose surgery involved intra-oral access, who were in the second or third decades of their lives, who have above average weight, and who have long anesthesia when undergoing surgery, resulting in a long hospital stays.

The Use of Telemedicine in Oral and Maxillofacial Surgery.

Science.gov (United States)

Wood, Eric W; Strauss, Robert A; Janus, Charles; Carrico, Caroline K

2016-04-01

To determine the perceived utility and demand for the application of telemedicine for improved patient care between nonsurgical dental practitioners (GPs) and oral and maxillofacial surgeons (OMS). Two distinct questionnaires were made, one for GPs and one for OMSs. The GP questionnaire was sent to practicing Virginia Dental Association members on an e-mail list (approximately 2,200). The OMS questionnaire was sent by the Virginia Society of Oral Maxillofacial Surgery to members on an e-mail list (approximately 213). Questionnaires included questions about access to care, benefits of telemedicine consultations, reliability of telemedicine consultations, and perceived barriers against and opportunities for the implementation of telemedicine. The questionnaire was completed by 226 GP and 41 OMS respondents. There was a significant difference among responses of GPs based on practice location: rural patients had a longer average time from referral to OMS consultation (P = .003), rural patients traveled longer distances (P telemedicine, whereas OMS respondents were more neutral. GPs responded they would refer more patients (4.4) if consultations could be performed by telemedicine. OMSs agreed that more referrals would influence their decision to provide telemedicine consultations (51%). Practitioners had neutral perceptions about the reliability of telemedicine. OMS respondents agreed they would implement telemedicine in their practice if it provided equally good consultations as in-office visits. According to the present findings, telemedicine could be an important step in the right direction for overcoming current issues with patient access to care and increasing health care costs. The benefits of telemedicine technology have been documented and will continue to be seen with wider application of its use in other areas of health care such as oral and maxillofacial surgery. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier

Role of plasma-rich fibrin in oral surgery

OpenAIRE

Kumar, K. Retna; Genmorgan, K.; Abdul Rahman, S. M.; Rajan, M. Alaguvel; Kumar, T. Arul; Prasad, V. Srinivas

2016-01-01

Platelet-rich fibrin (PRF) is a fibrin meshwork, in which platelet cytokines, growth factors, and cells are entrapped and discharged after a period and can serve as a resorbable film. PRF is the next generation of platelet concentrates equipped to improve arrangement without biochemical blood handling; PRF is an evolution of the fibrin adhesive, which is widely used in the oral surgery. The guidelines of this innovation depend on concentrating platelets and growth factors in a plasma medium, ...

Gender trends in authorship in oral and maxillofacial surgery literature: A 30-year analysis.

Science.gov (United States)

Nkenke, Emeka; Seemann, Rudolf; Vairaktaris, Elefterios; Schaller, Hans-Günter; Rohde, Maximilian; Stelzle, Florian; Knipfer, Christian

2015-07-01

The aim of the present study was to perform a bibliometric analysis of the gender distribution of first and senior authorships in important oral and maxillofacial journals over the 30-year period from 1980 to 2010. Articles published in three representative oral and maxillofacial surgery journals were selected. The years 1980, 1990, 2000, and 2010 were chosen as representative points in time for article selection. Original research, case reports, technical notes, and reviews were included in the analysis. Case reports and technical notes were pooled in one group. For each article, the gender of the first author as well as that of the senior author was determined, based on the inspection of their first name. The type of article was determined and the country of origin of the article was documented. A total 1412 articles were subjected to the data analysis. A significant increase in female authorship in oral and maxillofacial surgery could be identified over the chosen 30-year period. However, the number of publications by male authors was still significantly higher at all points of time, exceeding those of female authors by at least 3.8 fold in 2010. As there is a trend towards feminization of medicine and dentistry, the results of the present study may serve as the basis for further analysis of the current situation, and the identification of necessary actions to accelerate the closure of the gender gap in publishing in oral and maxillofacial surgery. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Evaluation of scientific production in Oral Surgery in Italy from 1998 to 2012.

Science.gov (United States)

Zizzari, V L; De Carlo, A; Lorusso, F; Tetè, S; Piattelli, A

2014-06-20

Dental research, especially in the field of oral surgery, showed a strong and significant increase during the last years. This was probably determined by the introduction among the clinicians of different therapeutic protocols through biomaterials engineering, and by the large broadcasting of scientific knowledge due to new media such as the internet. The aim of this work was to analyze the scientific production of a sample of Italian Oral Surgeons from 1998 to 2012. The scientific production of 252 Active Members belonging to three associations of Italian Oral Surgery (SIdCO, SIO, SICOI) was examined. The number of authors, the number of publications and the number of citation were quantified for three periods of 5 years each from the first year considered along 15 years. The overall sample was then divided into two groups, Academics and Not Academics, in order to differently assess the scientific production conducted inside or outside the University. Over the years, scientific production increased considerably, with a progression not strictly proportional if compared to the number of authors, especially in the last 5 years. By spearately considering the Academics and the Not Academics authors, the biggest contribution to the scientific production increasingly came from the last 5 years, both in terms of authors' and published papers number. The results reported in this bibliometric analysis show how scientific research increasingly pursued by clinicians in Oral Surgery in the last 15 years.

Mechanical bowel preparation and oral antibiotic prophylaxis in colorectal surgery: Analysis of evidence and narrative review.

Science.gov (United States)

Badia, Josep M; Arroyo-García, Nares

2018-05-14

The role of oral antibiotic prophylaxis and mechanical bowel preparation in colorectal surgery remains controversial. The lack of efficacy of mechanical preparation to improve infection rates, its adverse effects, and multimodal rehabilitation programs have led to a decline in its use. This review aims to evaluate current evidence on antegrade colonic cleansing combined with oral antibiotics for the prevention of surgical site infections. In experimental studies, oral antibiotics decrease the bacterial inoculum, both in the bowel lumen and surgical field. Clinical studies have shown a reduction in infection rates when oral antibiotic prophylaxis is combined with mechanical preparation. Oral antibiotics alone seem to be effective in reducing infection in observational studies, but their effect is inferior to the combined preparation. In conclusion, the combination of oral antibiotics and mechanical preparation should be considered the gold standard for the prophylaxis of postoperative infections in colorectal surgery. Copyright © 2018 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

The utility of mock oral examinations in preparation for the American Board of Surgery certifying examination.

Science.gov (United States)

Higgins, Rana M; Deal, Rebecca A; Rinewalt, Daniel; Hollinger, Edward F; Janssen, Imke; Poirier, Jennifer; Austin, Delores; Rendina, Megan; Francescatti, Amanda; Myers, Jonathan A; Millikan, Keith W; Luu, Minh B

2016-02-01

Determine the utility of mock oral examinations in preparation for the American Board of Surgery certifying examination (ABS CE). Between 2002 and 2012, blinded data were collected on 63 general surgery residents: 4th and 5th-year mock oral examination scores, first-time pass rates on ABS CE, and an online survey. Fifty-seven residents took the 4th-year mock oral examination: 30 (52.6%) passed and 27 (47.4%) failed, with first-time ABS CE pass rates 93.3% and 81.5% (P = .238). Fifty-nine residents took the 5th-year mock oral examination: 28 (47.5%) passed and 31 (52.5%) failed, with first-time ABS CE pass rates 82.1% and 93.5% (P = .240). Thirty-eight responded to the online survey, 77.1% ranked mock oral examinations as very or extremely helpful with ABS CE preparation. Although mock oral examinations and ABS CE passing rates do not directly correlate, residents perceive the mock oral examinations to be helpful. Copyright © 2016 Elsevier Inc. All rights reserved.

Head, Neck, and Oral Cancer

Medline Plus

Full Text Available ... Extractions and Other Oral Surgeries Extractions and Other Oral Surgeries Oral and maxillofacial surgeons surgically treat the soft ... Extractions and Other Oral Surgeries Extractions and Other Oral Surgeries Oral and maxillofacial surgeons surgically treat the soft ...

Early Oral Feeding After Surgery for Upper Gastrointestinal Malignancies: A Prospective Cohort Study

Directory of Open Access Journals (Sweden)

Saeed Shoar

2016-05-01

Full Text Available Objectives: Poor nutritional status following abdominal surgeries for esophageal and gastric cancers remains a major challenge in postoperative care. Our study aimed to investigate the efficacy of starting early oral feeding (EOF in patients undergoing surgical resection of upper gastrointestinal malignancies. Methods: A total of 180 consecutive patients with a diagnosis of esophageal or gastric malignancies undergoing elective surgical resection between January 2008 and February 2011 were enrolled in this prospective cohort study. Seventy-two patients were assigned to the EOF group, and 108 patients received late oral feeding (LOF. Postoperative endpoints were compared between the two groups. Results: Nasogastric tubes were removed from patients on average 3.3±1.6 days after the surgery in the EOF group and 5.2±2.5 days in the LOF group (p 0.050. Conclusions: EOF is safe following esophageal and gastric cancer surgery and results in faster recovery and hospital discharge.

Diode Laser in Minor Oral Surgery: A Case Series of Laser Removal of Different Benign Exophytic Lesions

OpenAIRE

Sotoode, Somaye Mazarei; Azimi, Somayyeh; Taheri, Sayed Alinaghi; Asnaashari, Mohammad; Khalighi, Hamidreza; Rahmani, Somayeh; Jafari, Soudeh; Elmi Rankohi, Zahra

2015-01-01

Introduction: The role of laser in conservative management of oral disease is well established. Laser procedures are common in the fields of oral surgery, implant dentistry, endodontic, and periodontic therapy.

[Orthodontic and oral surgery therapy in cleidocranial dysplasia].

Science.gov (United States)

Balaton, Gergely; Tarján, Ildikó; Balaton, Péter; Barabási, Zoltán; Gyulai Gál, Szabolcs; Nagy, Katalin; Vajó, Zoltán

2007-02-01

A cleidocranial dysplasia is an autosomal dominant inherited condition consisting of generalized skeletal disorder. Associated dental signs are present in 93,5%; failure of tooth eruption with multiple supernumerary teeth, dilaceration of roots, crown germination, microdontia, high arched palate, midface hypoplasia, high gonion angle. The molecular- genetic analysis revealed a missense mutation in the CBFA1 gene located on chromosome 6p21, which is considered to be etiological factor for CCD. Orthodontic and oral surgery therapy of a 13 year-old child with CCD was performed due to aesthetic and functional problems. The supernumerary germs were removed and the teeth were aligned with orthodontic appliances. Temporary functional rehabilitation was solved with partial denture. The presented case and the literature data support the importance of early diagnosis of CCD. The good collaboration of the orthodontic and maxillo-facial surgery specialists help achieve the correct rehabilitation of the patient.

Corrective Jaw Surgery

Medline Plus

Full Text Available ... Oral Surgeries Facial Cosmetic Surgery Facial Injury / Trauma Surgery Obstructive Sleep Apnea (OSA) Oral, Head and Neck Pathology TMJ and Facial Pain Wisdom Teeth Management Procedures Anesthesia Anesthesia Oral and maxillofacial surgeons are ...

Midazolam intravenous conscious sedation in oral surgery. A retrospective study of 372 cases.

Science.gov (United States)

Runes, J; Ström, C

1996-01-01

In 1987 the Swedish Dental Act was amended to allow Swedish dentists who have undergone a specific accreditation course to administer intra-venous sedation. Midazolam is a benzodiazepin derivate with express sedative and hypnotic qualities, powerful amnesia, a short half-life time and few secondary effects. From 1989-1994 midazolam intravenous conscious sedation (ICS) was administered in 372 cases in the Department of Oral and Maxillofacial Surgery, County Hospital, Falun. This study presents data on the 298 patients. Although surgical removal of impacted wisdom teeth predominated, implant surgery, reduction of fractures and correction of anomalies were also carried out. Supplementary sedative premedication was rarely used. Most patients were treated under local anaesthesia. The mean dosage was 10.45 mg (range 1.25-40 mg). Mean dosage/kg was 0.15 mg (range 0.03-0.50 mg). The average duration of anaesthesia was 50 minutes. The average recovery time was 94 minutes. Three hundred and sixty-nine of 372 planned treatments were completed. No serious complications occurred. The patients were co-operative during surgery and were satisfied with the treatment. Compared with full anaesthesia this method required less resources and is a valuable complement in management of anxious patients undergoing oral surgery.

Portfolio: A Comprehensive Method of Assessment for Postgraduates in Oral and Maxillofacial Surgery

OpenAIRE

Kadagad, Poornima; Kotrashetti, S. M.

2012-01-01

Post graduate learning and assessment is an important responsibility of an academic oral and maxillofacial surgeon. The current method of assessment for post graduate training include formative evaluation in the form of seminars, case presentations, log books and infrequently conducted end of year theory exams. End of the course theory and practical examination is a summative evaluation which awards the degree to the student based on grades obtained. Oral and maxillofacial surgery is mainly a...

Oral nutrition or water loading before hip replacement surgery; a randomized clinical trial.

Science.gov (United States)

Ljunggren, Stefan; Hahn, Robert G

2012-07-02

Surgery induces insulin resistance that might be alleviated by a nutritional drink given preoperatively. The authors hypothesized that some of the beneficial effects of the drink could be attributed to the volume component (approximately 1 L) rather than to the nutrients. Sixty patients scheduled for elective total hip replacement under spinal anesthesia were recruited to a clinical trial, and randomly allocated to preoperative fasting, to oral ingestion of tap water, or to oral ingestion of a carbohydrate drink. An intravenous glucose tolerance test calculated glucose clearance and insulin sensitivity on the day before surgery, in the postoperative ward, and on the day after surgery. Other parameters were stress (cortisol in plasma and urine), muscle catabolism (urinary 3-methylhistidine), and wellbeing. Fifty-seven patients completed the study. In the postoperative ward, the glucose clearance and the insulin response had decreased from the previous day by 23% and 36%, respectively. Insulin sensitivity did not decrease until the next morning (-48%) and was due to an increased insulin response (+51%). Cortisol excretion was highest on the day of surgery, while 3-methylhistidine increased 1 day later. Follow-up on the third postoperative day showed an average of 1.5 complications per patient. Wellbeing was better 2 weeks after than before the surgery. None of the measured parameters differed significantly between the study groups. Preoperative ingestion of tap water or a nutritional drink had no statistically significant effect on glucose clearance, insulin sensitivity, postoperative complications, or wellbeing in patients undergoing elective hip surgery.

Primary Surgery vs Radiotherapy for Early Stage Oral Cavity Cancer.

Science.gov (United States)

Ellis, Mark A; Graboyes, Evan M; Wahlquist, Amy E; Neskey, David M; Kaczmar, John M; Schopper, Heather K; Sharma, Anand K; Morgan, Patrick F; Nguyen, Shaun A; Day, Terry A

2018-04-01

Objective The goal of this study is to determine the effect of primary surgery vs radiotherapy (RT) on overall survival (OS) in patients with early stage oral cavity squamous cell carcinoma (OCSCC). In addition, this study attempts to identify factors associated with receiving primary RT. Study Design Retrospective cohort study. Setting National Cancer Database (NCDB, 2004-2013). Subjects and Methods Reviewing the NCDB from 2004 to 2013, patients with early stage I to II OCSCC were identified. Kaplan-Meier estimates of survival, Cox regression analysis, and propensity score matching were used to examine differences in OS between primary surgery and primary RT. Multivariable logistic regression analysis was performed to identify factors associated with primary RT. Results Of the 20,779 patients included in the study, 95.4% (19,823 patients) underwent primary surgery and 4.6% (956 patients) underwent primary RT. After adjusting for covariates, primary RT was associated with an increased risk of mortality (adjusted hazard ratio [aHR], 1.97; 99% confidence interval [CI], 1.74-2.22). On multivariable analysis, factors associated with primary RT included age ≥70 years, black race, Medicaid or Medicare insurance, no insurance, oral cavity subsite other than tongue, clinical stage II disease, low-volume treatment facilities, and earlier treatment year. Conclusion Primary RT for early stage OCSCC is associated with increased mortality. Approximately 5% of patients receive primary RT; however, this percentage is decreasing. Patients at highest risk for receiving primary RT include those who are elderly, black, with public insurance, and treated at low-volume facilities.

Perceptions of Teaching Methods for Preclinical Oral Surgery: A Comparison with Learning Styles.

Science.gov (United States)

Omar, Esam

2017-01-01

Dental extraction is a routine part of clinical dental practice. For this reason, understanding the way how students' extraction knowledge and skills development are important. To date, there is no accredited statement about the most effective method for the teaching of exodontia to dental students. Students have different abilities and preferences regarding how they learn and process information. This is defined as learning style. In this study, the effectiveness of active learning in the teaching of preclinical oral surgery was examined. The personality type of the groups involved in this study was determined, and the possible effect of personality type on learning style was investigated. This study was undertaken over five years from 2011 to 2015. The sample consisted of 115 students and eight staff members. Questionnaires were submitted by 68 students and all eight staff members involved. Three measures were used in the study: The Index of Learning Styles (Felder and Soloman, 1991), the Myers-Briggs Type Indicator (MBTI), and the styles of learning typology (Grasha and Hruska-Riechmann). Findings indicated that demonstration and minimal clinical exposure give students personal validation. Frequent feedback on their work is strongly indicated to build the cognitive, psychomotor, and interpersonal skills needed from preclinical oral surgery courses. Small group cooperative active learning in the form of demonstration and minimal clinical exposure that gives frequent feedback and students' personal validation on their work is strongly indicated to build the skills needed for preclinical oral surgery courses.

Oral and maxillofacial surgery with computer-assisted navigation system.

Science.gov (United States)

Kawachi, Homare; Kawachi, Yasuyuki; Ikeda, Chihaya; Takagi, Ryo; Katakura, Akira; Shibahara, Takahiko

2010-01-01

Intraoperative computer-assisted navigation has gained acceptance in maxillofacial surgery with applications in an increasing number of indications. We adapted a commercially available wireless passive marker system which allows calibration and tracking of virtually every instrument in maxillofacial surgery. Virtual computer-generated anatomical structures are displayed intraoperatively in a semi-immersive head-up display. Continuous observation of the operating field facilitated by computer assistance enables surgical navigation in accordance with the physician's preoperative plans. This case report documents the potential for augmented visualization concepts in surgical resection of tumors in the oral and maxillofacial region. We report a case of T3N2bM0 carcinoma of the maxillary gingival which was surgically resected with the assistance of the Stryker Navigation Cart System. This system was found to be useful in assisting preoperative planning and intraoperative monitoring.

Oral Nutrition as a Form of Pre-Operative Enhancement in Patients Undergoing Surgery for Colorectal Cancer

NARCIS (Netherlands)

Bruns, Emma R.J.; Argillander, Tanja E.; Heuvel, Van Den Baukje; Buskens, Christianne J.; Duijvendijk, Van Peter; Winkels, Renate M.; Kalf, Annette; Zaag, Van Der Edwin S.; Wassenaar, Eelco B.; Bemelman, Willem A.; Munster, Van Barbara C.

2018-01-01

Background: Nutritional status has major impacts on the outcome of surgery, in particular in patients with cancer. The aim of this review was to assess the merit of oral pre-operative nutritional support as a part of prehabilitation in patients undergoing surgery for colorectal cancer. Methods: A

[The clinical effect observation for surgery of nose and pharyngeal auxiliary oral appliance in severe OSAHS].

Science.gov (United States)

Hui, Peilin; Xie, Yuping; Wei, Xiaoquan; Zhao, Lijun; Ma, Wei; Wang, Jinfeng; Ning, Jing; Xu, Chao; Yang, Qian; Kang, Hong

2015-03-01

To investigate the therapeutic effects of oral modified device combined with nasopharyngeal enlargement surgery and evaluate the oral modified device' s adjuvant therapy meaning in severe OSAHS patients after surgery treatment. 46 cases with severe OSAHS were diagnosed by PSG according to AHI and the lowest arterial oxygen saturation (LSaO2). We performed the nasal or pharyngeal cavity expansion surgery for them according to the pathological change part correspondingly. Then all subjects were divided into combined group (n=26) and surgery alone group (n=20) according to their personal willingness. We monitored the PSG for all subjects aftter 2 weeks and 3 months respectively, then we calculate the diversity between the two group or intragroup change on the basis of the AHI, LAT, LSaO2, mean arterial oxygen saturation (MSaO2) and sleep structures recorded by PSG. At the same time, we collected the subjective sensations by questionnaire. The AHI and LAT in combined group were significantly lower and LSaO2 was significantly higher than these in surgery alone group(P0. 05). The N 1% was more shorter and the N2% and N3% were more longer after nasal or pharyngeal operation compared with pre-operative states in both groups(P. 05). The data of PSG also showed that the shallow sleep proportion was more shorter and the slow wave sleep proportion was more longer in combined group compared with surgery alone group. The subjective sensations results also showed significantly alleviated in combined group, such as mental state, daytime sleepiness and physical strength. The efficiency ratio of treatment was 85. 0% and 92. 3% in surgery alone group and combined group respectively. Nasal and pharyngeal cavity enlargement surgery combined with oral modified device is a more effective treatment in patients with severe OSAHS, and it is meaningful for the long-term curative effect of surgery to prevent relapse and improve.

Use of piezosurgery device in management of oral surgery complications: clincal case and clinical experience report.

Science.gov (United States)

Sammartino, G; Riccitiello, F; Trosino, O; Marenzi, G; Cioffi, A; Mortellaro, C

2012-05-01

The root displacement into the maxillary sinus could be a complication of oral surgery in the upper jaw. In these cases, the root removal is needed in order to avoid the occurrence of sinus pathologies. Piezosurgery techniques could assure a safer management of such complications, because of the clear surgical visibility and the selective ability of cut. The aim of this article is to present a case of oral surgery complication (root displacement in the right maxillary sinus), in which piezosurgery technique helped for a correct and safe clinical management, allowing to reduce the soft tissue damage.

Oral nutrition or water loading before hip replacement surgery; a randomized clinical trial

Directory of Open Access Journals (Sweden)

Ljunggren Stefan

2012-07-01

Full Text Available Abstract Background Surgery induces insulin resistance that might be alleviated by a nutritional drink given preoperatively. The authors hypothesized that some of the beneficial effects of the drink could be attributed to the volume component (approximately 1 L rather than to the nutrients. Methods Sixty patients scheduled for elective total hip replacement under spinal anesthesia were recruited to a clinical trial, and randomly allocated to preoperative fasting, to oral ingestion of tap water, or to oral ingestion of a carbohydrate drink. An intravenous glucose tolerance test calculated glucose clearance and insulin sensitivity on the day before surgery, in the postoperative ward, and on the day after surgery. Other parameters were stress (cortisol in plasma and urine, muscle catabolism (urinary 3-methylhistidine, and wellbeing. Results Fifty-seven patients completed the study. In the postoperative ward, the glucose clearance and the insulin response had decreased from the previous day by 23% and 36%, respectively. Insulin sensitivity did not decrease until the next morning (−48% and was due to an increased insulin response (+51%. Cortisol excretion was highest on the day of surgery, while 3-methylhistidine increased 1 day later. Follow-up on the third postoperative day showed an average of 1.5 complications per patient. Wellbeing was better 2 weeks after than before the surgery. None of the measured parameters differed significantly between the study groups. Conclusions Preoperative ingestion of tap water or a nutritional drink had no statistically significant effect on glucose clearance, insulin sensitivity, postoperative complications, or wellbeing in patients undergoing elective hip surgery. Trial registration Registration number: NCT 01211184 (http://www.clinicaltrials.gov

Trends in oral drug bioavailability following bariatric surgery: examining the variable extent of impact on exposure of different drug classes.

Science.gov (United States)

Darwich, Adam S; Henderson, Kathryn; Burgin, Angela; Ward, Nicola; Whittam, Janet; Ammori, Basil J; Ashcroft, Darren M; Rostami-Hodjegan, Amin

2012-11-01

Changes to oral drug bioavailability have been observed post bariatric surgery. However, the magnitude and the direction of changes have not been assessed systematically to provide insights into the parameters governing the observed trends. Understanding these can help with dose adjustments. Analysis of drug characteristics based on a biopharmaceutical classification system is not adequate to explain observed trends in altered oral drug bioavailability following bariatric surgery, although the findings suggest solubility to play an important role. To identify the most commonly prescribed drugs in a bariatric surgery population and to assess existing evidence regarding trends in oral drug bioavailability post bariatric surgery. A retrospective audit was undertaken to document commonly prescribed drugs amongst patients undergoing bariatric surgery in an NHS hospital in the UK and to assess practice for drug administration following bariatric surgery. The available literature was examined for trends relating to drug permeability and solubility with regards to the Biopharmaceutics Classification System (BCS) and main route of elimination. No significant difference in the 'post/pre surgery oral drug exposure ratio' (ppR) was apparent between BCS class I to IV drugs, with regards to dose number (Do) or main route of elimination. Drugs classified as 'solubility limited' displayed an overall reduction as compared with 'freely soluble' compounds, as well as an unaltered and increased ppR. Clinical studies establishing guidelines for commonly prescribed drugs, and the monitoring of drugs exhibiting a narrow therapeutic window or without a readily assessed clinical endpoint, are warranted. Using mechanistically based pharmacokinetic modelling for simulating the multivariate nature of changes in drug exposure may serve as a useful tool in the further understanding of postoperative trends in oral drug exposure and in developing practical clinical guidance. © 2012 The Authors

Perioperative risk factors for postoperative pneumonia after major oral cancer surgery: A retrospective analysis of 331 cases.

Science.gov (United States)

Xu, Jieyun; Hu, Jing; Yu, Pei; Wang, Weiwang; Hu, Xingxue; Hou, Jinsong; Fang, Silian; Liu, Xiqiang

2017-01-01

Postoperative pneumonia (POP) is common and results in prolonged hospital stays, higher costs, increased morbidity and mortality. However, data on the incidence and risk factors of POP after oral and maxillofacial surgery are rare. This study aims to identify perioperative risk factors for POP after major oral cancer (OC) surgery. Perioperative data and patient records of 331 consecutive subjects were analyzed in the period of April 2014 to March 2016. We individually traced each OC patient for a period to discharge from the hospital or 45 days after surgery, whichever occur later. The incidence of POP after major OC surgery with free flap construction or major OC surgery was 11.6% or 4.5%, respectively. Patient-related risk factors for POP were male sex, T stage, N stage, clinical stage and preoperative serum albumin level. Among the investigated procedure-related variables, incision grade, mandibulectomy, free flap reconstruction, tracheotomy, intraoperative blood loss, and the length of the operation were shown to be associated with the development of POP. Postoperative hospital stay was also significantly related to increased incidence of POP. Using a multivariable logistic regression model, we identified male sex, preoperative serum albumin level, operation time and postoperative hospital stay as independent risk factors for POP. Several perioperative risk factors can be identified that are associated with POP. At-risk oral cancer patients should be subjected to intensified postoperative pulmonary care.

Analysis of Survival Rates Following Primary Surgery of 178 Consecutive Patients with Oral Cancer in a Large District General Hospital.

Science.gov (United States)

Stathopoulos, Panagiotis; Smith, William P

2017-06-01

The aim of this study is to present the survival rates in patients treated for oral cancer with primary surgery in a large district general hospital. We discuss the influence of the most significant prognostic factors on survival and compare our results with larger centres specializing in the management of oral cancer. All patients diagnosed with oral cancer from 1995 to 2006 and were treated in the Department had their details entered prospectively onto a computerized database. Demographic details of patients, type of treatment, pathological stage of tumor (TNM), local and regional recurrence rate, overall survival, disease specific survival and incidence of involved margins were recorded and calculated. Of the 178 patients, 96 (54 %) were alive and free of oral cancer 5 years after surgery. Forty-four patients died of oral cancer (24.7 %) but 38 (21.3 %) died of other causes. The overall survival rate after primary surgery in relation to stage was: I 84 %, II 71 %, III 36 % and IV 28 %. As almost half of our patients presented with advanced cancer and had discouraging survival rates, we emphasize the need for early recognition of the disease. Advanced disease signifies difficulty in obtaining clear margins which actually indicates a higher recurrence rate. 25 % of our patients died of oral cancer within 5 years of surgery which highlights the poor prognosis that recurrence carries after treatment. Effective educational campaign with purpose to raise oral cancer awareness and earlier referral may result in improvement of survival.

Dysphagia following tumor surgery in the oral cavity and hypopharynx. An analysis by videofluoroscopy

International Nuclear Information System (INIS)

Oursin, C.; Trabucco, P.; Bongartz, G.; Steinbrich, W.

1998-01-01

Dysphagia is a common complaint following surgical intervention in the oral cavity and hypopharynx, often leading to prolonged postoperative recovery. Videofluoroscopy allows detailed visualization of deglutition, demonstrating the morphology as well as the functional aspects. Therefore, videofluoroscopy provides the basis for further therapeutic management. We discuss the pathology of deglutition in 19 patients recovering from tumor surgery of the oro- and hypopharynx. In most cases the results demonstrated severe impairment of both the oral and pharyngeal phase of deglutition. Our data emphasize the importance of the oral phase of deglutition for preparation and initiation of the following phases. (orig.) [de

Deep vein thrombosis: A rare complication in oral and maxillofacial surgery: A review of two cases

Directory of Open Access Journals (Sweden)

M.R. Ramesh Babu

2013-01-01

Full Text Available Deep vein thrombosis (DVT is caused by obstruction of blood flow of deep veins in upper and lower limb. One of the precipitating factors for DVT is surgery under general anesthesia exceeding 30 min. However, there are very few reports of DVT associated with surgery of oral and maxillofacial region. In this paper we report two cases of DVT involving left ilio-femoropopliteal deep vein in one patient treated for fractured left angle of mandible and left peroneal vein in the other patient treated for oral sub mucous fibrosis. Clinical and color Doppler examination were performed to diagnose the condition and were referred to vascular surgical unit of higher institute for further management. These cases illustrates any surgery of maxillofacial region is not free from risk of DVT, which can cause fatal pulmonary thromboembolism.

Perceptions of Teaching Methods for Preclinical Oral Surgery: A Comparison with Learning Styles

Science.gov (United States)

Omar, Esam

2017-01-01

Purpose: Dental extraction is a routine part of clinical dental practice. For this reason, understanding the way how students’ extraction knowledge and skills development are important. Problem Statement and Objectives: To date, there is no accredited statement about the most effective method for the teaching of exodontia to dental students. Students have different abilities and preferences regarding how they learn and process information. This is defined as learning style. In this study, the effectiveness of active learning in the teaching of preclinical oral surgery was examined. The personality type of the groups involved in this study was determined, and the possible effect of personality type on learning style was investigated. Method: This study was undertaken over five years from 2011 to 2015. The sample consisted of 115 students and eight staff members. Questionnaires were submitted by 68 students and all eight staff members involved. Three measures were used in the study: The Index of Learning Styles (Felder and Soloman, 1991), the Myers-Briggs Type Indicator (MBTI), and the styles of learning typology (Grasha and Hruska-Riechmann). Results and Discussion: Findings indicated that demonstration and minimal clinical exposure give students personal validation. Frequent feedback on their work is strongly indicated to build the cognitive, psychomotor, and interpersonal skills needed from preclinical oral surgery courses. Conclusion: Small group cooperative active learning in the form of demonstration and minimal clinical exposure that gives frequent feedback and students’ personal validation on their work is strongly indicated to build the skills needed for preclinical oral surgery courses. PMID:28357004

Patterns of relapse following surgery and postoperative intensity modulated radiotherapy for oral and oropharyngeal cancer

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Collan, Juhani; Vaalavirta, Leila; Kajanti, Mikael; Tenhunen, Mikko; Saarilahti, Kauko (Dept. of Oncology, Helsinki Univ. Central Hospital, and Univ. of Helsinki, Helsinki (Finland)), E-mail: kauko.saarilahti@hus.fi; Lundberg, Marie; Baeck, Leif; Maekitie, Antti (Dept. of Otorhinolaryngology - Head and Neck Surgery, Helsinki Univ. Central Hospital, and Univ. of Helsinki, Helsinki (Finland))

2011-10-15

Background. To investigate the patterns of relapse following intensity modulated radiotherapy (IMRT) given after radical surgery for oral and oropharyngeal squamous cell cancer. Patients and methods. One hundred and two patients with oral or oropharyngeal cancer were treated with radical surgery followed by IMRT up to a mean total dose of 60 Gy between years 2001 and 2007. Thirty-nine of the patients (%) also received concomitant weekly cisplatin. Forty of the patients had oral and 62 had oropharyngeal cancer. Data on the tumour, patient and treatment factors were collected. Following therapy the patients were followed by clinical examination, endoscopy and MRI/CT at 2- to 3-months interval up to 2 years and thereafter at 6-month intervals. Results. The mean follow-up time of the patients was 55 months (range, 26-106 months). The rate for local tumour control for the whole cohort was 92.2%: 87.5% for oral cancer patients and 96.7% for oropharyngeal cancer patients. The 5-year disease specific survival was 90.2% and 5-year overall survival 84.3%. During the follow-up eight locoregional recurrences were observed, three at the primary tumour site and one at regional nodal site and four at both sites. The mean time to primary tumour recurrence was seven months (range, 2-10 months) and to nodal recurrence seven months (range, 2-12 months). Distant metastasis occurred in six (6%) patients. The factors associated with poor prognosis were the primary tumour size and tumour site with oral cancers having worse outcome. The treatment was well tolerated with no unexpected toxicities. The most frequent late toxicity was dysphagia necessitating permanent PEG in five patients. This was correlated with the advanced primary tumour size and resulting in wide tumour excision and reconstruction. Conclusions. Surgery combined with postoperative radiotherapy given as IMRT results in low level of tumour recurrence

Patterns of relapse following surgery and postoperative intensity modulated radiotherapy for oral and oropharyngeal cancer

International Nuclear Information System (INIS)

Collan, Juhani; Vaalavirta, Leila; Kajanti, Mikael; Tenhunen, Mikko; Saarilahti, Kauko; Lundberg, Marie; Baeck, Leif; Maekitie, Antti

2011-01-01

Background. To investigate the patterns of relapse following intensity modulated radiotherapy (IMRT) given after radical surgery for oral and oropharyngeal squamous cell cancer. Patients and methods. One hundred and two patients with oral or oropharyngeal cancer were treated with radical surgery followed by IMRT up to a mean total dose of 60 Gy between years 2001 and 2007. Thirty-nine of the patients (%) also received concomitant weekly cisplatin. Forty of the patients had oral and 62 had oropharyngeal cancer. Data on the tumour, patient and treatment factors were collected. Following therapy the patients were followed by clinical examination, endoscopy and MRI/CT at 2- to 3-months interval up to 2 years and thereafter at 6-month intervals. Results. The mean follow-up time of the patients was 55 months (range, 26-106 months). The rate for local tumour control for the whole cohort was 92.2%: 87.5% for oral cancer patients and 96.7% for oropharyngeal cancer patients. The 5-year disease specific survival was 90.2% and 5-year overall survival 84.3%. During the follow-up eight locoregional recurrences were observed, three at the primary tumour site and one at regional nodal site and four at both sites. The mean time to primary tumour recurrence was seven months (range, 2-10 months) and to nodal recurrence seven months (range, 2-12 months). Distant metastasis occurred in six (6%) patients. The factors associated with poor prognosis were the primary tumour size and tumour site with oral cancers having worse outcome. The treatment was well tolerated with no unexpected toxicities. The most frequent late toxicity was dysphagia necessitating permanent PEG in five patients. This was correlated with the advanced primary tumour size and resulting in wide tumour excision and reconstruction. Conclusions. Surgery combined with postoperative radiotherapy given as IMRT results in low level of tumour recurrence

Effect of third molar surgery on oral health-related quality of life in the first postoperative week using Dutch version of oral health impact profile-14

NARCIS (Netherlands)

van Wijk, A.; Kieffer, J.M.; Lindeboom, J.H.

2009-01-01

Purpose: The present study investigated the effect of third molar surgery on oral health-related quality of life, related to pain and clinical variables, in the first postoperative week using the Dutch version of the 14-item Oral Health Impact Profile. Materials and Methods: A total of 50 patients,

Development and application of stent-based image guided navigation system for oral and maxillofacial surgery

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Lee, Woo Jin; Kim, Dae Seung [Interdisciplinary Program in Radiation Applied Life Science, Dental Research Institute and BK21, College of Medicine, Seoul National University, Seoul (Korea, Republic of); Yi, Won Jin; Lee, Sam Sun; Choi, Soon Chul; Heo, Min Suk; Huh, Kyung Hoe; Kim, Myung Jin; Lee, Jee Ho [Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul (Korea, Republic of)

2009-09-15

The purpose of this study was to develop a stent-based image guided surgery system and to apply it to oral and maxillofacial surgeries for anatomically complex sites. We devised a patient-specific stent for patient-to-image registration and navigation. Three dimensional positions of the reference probe and the tool probe were tracked by an optical camera system and the relative position of the handpiece drill tip to the reference probe was monitored continuously on the monitor of a PC. Using 8 landmarks for measuring accuracy, the spatial discrepancy between CT image coordinate and physical coordinate was calculated for testing the normality. The accuracy over 8 anatomical landmarks showed an overall mean of 0.56 {+-} 0.16 mm. The developed system was applied to a surgery for a vertical alveolar bone augmentation in right mandibular posterior area and possible interior alveolar nerve injury case of an impacted third molar. The developed system provided continuous monitoring of invisible anatomical structures during operation and 3D information for operation sites. The clinical challenge showed sufficient accuracy and availability of anatomically complex operation sites. The developed system showed sufficient accuracy and availability in oral and maxillofacial surgeries for anatomically complex sites.

Perioperative risk factors for postoperative pneumonia after major oral cancer surgery: A retrospective analysis of 331 cases.

Directory of Open Access Journals (Sweden)

Jieyun Xu

Full Text Available Postoperative pneumonia (POP is common and results in prolonged hospital stays, higher costs, increased morbidity and mortality. However, data on the incidence and risk factors of POP after oral and maxillofacial surgery are rare. This study aims to identify perioperative risk factors for POP after major oral cancer (OC surgery.Perioperative data and patient records of 331 consecutive subjects were analyzed in the period of April 2014 to March 2016. We individually traced each OC patient for a period to discharge from the hospital or 45 days after surgery, whichever occur later.The incidence of POP after major OC surgery with free flap construction or major OC surgery was 11.6% or 4.5%, respectively. Patient-related risk factors for POP were male sex, T stage, N stage, clinical stage and preoperative serum albumin level. Among the investigated procedure-related variables, incision grade, mandibulectomy, free flap reconstruction, tracheotomy, intraoperative blood loss, and the length of the operation were shown to be associated with the development of POP. Postoperative hospital stay was also significantly related to increased incidence of POP. Using a multivariable logistic regression model, we identified male sex, preoperative serum albumin level, operation time and postoperative hospital stay as independent risk factors for POP.Several perioperative risk factors can be identified that are associated with POP. At-risk oral cancer patients should be subjected to intensified postoperative pulmonary care.

Surgical Navigation: A Systematic Review of Indications, Treatments, and Outcomes in Oral and Maxillofacial Surgery.

Science.gov (United States)

Azarmehr, Iman; Stokbro, Kasper; Bell, R Bryan; Thygesen, Torben

2017-09-01

This systematic review investigates the most common indications, treatments, and outcomes of surgical navigation (SN) published from 2010 to 2015. The evolution of SN and its application in oral and maxillofacial surgery have rapidly developed over recent years, and therapeutic indications are discussed. A systematic search in relevant electronic databases, journals, and bibliographies of the included articles was carried out. Clinical studies with 5 or more patients published between 2010 and 2015 were included. Traumatology, orthognathic surgery, cancer and reconstruction surgery, skull-base surgery, and foreign body removal were the areas of interests. The search generated 13 articles dealing with traumatology; 5, 6, 2, and 0 studies were found that dealt with the topics of orthognathic surgery, cancer and reconstruction surgery, skull-base surgery, and foreign body removal, respectively. The average technical system accuracy and intraoperative precision reported were less than 1 mm and 1 to 2 mm, respectively. In general, SN is reported to be a useful tool for surgical planning, execution, evaluation, and research. The largest numbers of studies and patients were identified in the field of traumatology. Treatment of complex orbital fractures was considerably improved by the use of SN compared with traditionally treated control groups. SN seems to be a very promising addition to the surgical toolkit. Planning details of the surgical procedure in a 3-dimensional virtual environment and execution with real-time guidance can significantly improve precision. Among factors to be considered are the financial investments necessary and the learning curve. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. All rights reserved.

Effect of third molar surgery on oral health-related quality of life in the first postoperative week using Dutch version of Oral Health Impact Profile-14

NARCIS (Netherlands)

van Wijk, Arjen; Kieffer, Jacobien M.; Lindeboom, Jerome H.

2009-01-01

The present study investigated the effect of third molar surgery on oral health-related quality of life, related to pain and clinical variables, in the first postoperative week using the Dutch version of the 14-item Oral Health Impact Profile. A total of 50 patients, referred to the Department of

[Contribution of platelet concentrates to oral and maxillo-facial surgery].

Science.gov (United States)

Bettega, G; Schir, E

2012-09-01

We evaluated the clinical contribution of platelet concentrates to oral and maxillo-facial surgery. This bibliographic research was made using the PubMed MeSH database with the following keywords: "platelet rich fibrin" (PRF), "platelet rich plasma" (PRP), "bone", "facial bone", "dental implant", and "blood platelet". The research was made without any date or language limitation since English summaries were available. All summaries were read to evaluate the relevance of the article. Only original articles and case reports were considered. The articles were classified as "in vitro studies", "animal experiments", or "clinical studies". The research was stopped on March 22, 2012. One hundred and sixty-nine articles were validated after excluding irrelevant articles, reviews, technical notes, and articles without English or French summaries. Seventeen were in vitro studies, 61 animal experiments, and 91 clinical studies. One hundred and ten complete articles were read to complete summary data. The data of in vitro studies univocally supports of using platelet concentrates. The data from animal experiment studies was less consensual and the validity of animal models was contested. The disparity of clinical study designs and the lack of rigorous methodology did not allow clearly determining platelet concentrate benefits for oral and maxillo-facial surgery. PRF or PRP clinical benefit has not been clearly demonstrated yet. French regulations relative to their use should be clarified. Copyright © 2012. Published by Elsevier Masson SAS.

Head, Neck, and Oral Cancer

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Full Text Available ... Oral Surgeries Facial Cosmetic Surgery Facial Injury / Trauma Surgery Obstructive Sleep Apnea (OSA) Oral, Head and Neck Pathology TMJ and Facial Pain Wisdom Teeth Management Procedures Anesthesia Anesthesia Oral and maxillofacial surgeons are ...

Management of adult recurrent respiratory papillomatosis with oral acyclovir following micro laryngeal surgery: a case series.

Science.gov (United States)

Chaturvedi, Jagdish; Sreenivas, V; Hemanth, V; Nandakumar, R

2014-01-01

To demonstrate the role of oral acyclovir in monthly regimes after microdebrider assisted excision in 3 patients with adult recurrent respiratory papillomatosis (ARRP). Three patients with ARRP who presented to a tertiary referral hospital in stridor were initially treated with a tracheostomy in order to secure airway. On further evaluation by videolaryngoscopy extensive bilateral laryngeal papillomatosis was noted with history of similar conditions in the past for which they were repeatedly operated. They were admitted and underwent Microlaryngeal surgery and laryngeal microdebrider assisted surgery under general anesthesia. Post operatively a course of oral acyclovir at 800 mg/5 times/day for 5 days was administered. On repeat assessment with videolaryngoscopy at monthly intervals a complete remission of the disease was noted with no residual disease at the end of 1 year in 2 cases. One case had a recurrence. Renal parameters were monitored periodically. It may be concluded that the action of anti viral drugs at regular intervals in addition to a short course of oral steroids lead to rapid recovery and prevented latent virus activation within the laryngo tracheal system hence maintaining long term improvement. This can avoid multiple laryngeal surgeries, repeated respiratory emergencies and risk for malignant transformation in the future thereby reducing morbidity and effect on quality of life.

Comparison of surgical conditions following premedication with oral clonidine versus oral diazepam for endoscopic sinus surgery: A randomized, double-blinded study

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Rohini V Bhat Pai

2016-01-01

Full Text Available Background and Aims: Endoscopic sinus surgery (ESS provides a challenge and an opportunity to the anesthesiologists to prove their mettle and give the surgeons a surgical field which can make their delicate surgery safer,more precise and faster. The aim of the study was to evaluate the surgical field and the rate of blood loss in patients premedicated with oral clonidine versus oral diazepam for endoscopic sinus surgery. Material and Methods: ASA I or II patients who were scheduled to undergo ESS were randomly allocated to group D (n = 30 or group C (n = 30. The patients′ vital parameters, propofol infusion rate, and rate of blood loss were observed and calculated. The surgeon, who was blinded, rated the visibility of the surgical field from grade 0-5. Results: In the clonidine group, the rate of blood loss, the surgical time, propofol infusion rate was found to be statistically lower as compared to the diazepam group. Also a higher number of patients in the clonidine group had a better surgical score (better surgical field than the diazepam group and vice versa. Conclusions: Premedication with clonidine as compared to diazepam, provides a better surgical field with less blood loss in patients undergoing ESS.

Development and application of stent-based image guided navigation system for oral and maxillofacial surgery

International Nuclear Information System (INIS)

Lee, Woo Jin; Kim, Dae Seung; Yi, Won Jin; Lee, Sam Sun; Choi, Soon Chul; Heo, Min Suk; Huh, Kyung Hoe; Kim, Myung Jin; Lee, Jee Ho

2009-01-01

The purpose of this study was to develop a stent-based image guided surgery system and to apply it to oral and maxillofacial surgeries for anatomically complex sites. We devised a patient-specific stent for patient-to-image registration and navigation. Three dimensional positions of the reference probe and the tool probe were tracked by an optical camera system and the relative position of the handpiece drill tip to the reference probe was monitored continuously on the monitor of a PC. Using 8 landmarks for measuring accuracy, the spatial discrepancy between CT image coordinate and physical coordinate was calculated for testing the normality. The accuracy over 8 anatomical landmarks showed an overall mean of 0.56 ± 0.16 mm. The developed system was applied to a surgery for a vertical alveolar bone augmentation in right mandibular posterior area and possible interior alveolar nerve injury case of an impacted third molar. The developed system provided continuous monitoring of invisible anatomical structures during operation and 3D information for operation sites. The clinical challenge showed sufficient accuracy and availability of anatomically complex operation sites. The developed system showed sufficient accuracy and availability in oral and maxillofacial surgeries for anatomically complex sites.

Addressing Gender Discrimination in Oral and Maxillofacial Surgery via the Social Norms Approach.

Science.gov (United States)

Uppgaard, Rachel

2018-03-28

Gender discrimination continues to be a challenge faced by women in oral and maxillofacial surgery. The discrimination itself is perpetrated by a small number of individuals, but it is lack of support and intervention by other surgeons that allows this to continue. The social norms approach is one means to break this cycle: first by identifying misperceptions and then by encouraging individuals to intervene instead of remaining bystanders. To move forward as a specialty, we must actively intervene when discrimination and harassment occur. Copyright © 2018 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Oral surgery in patients under antithrombotic therapy: perioperative bleeding as a significant risk factor for postoperative hemorrhage.

Science.gov (United States)

Rocha, Amanda L; Souza, Alessandra F; Martins, Maria A P; Fraga, Marina G; Travassos, Denise V; Oliveira, Ana C B; Ribeiro, Daniel D; Silva, Tarcília A

2018-01-01

: To investigate perioperative and postoperative bleeding, complications in patients under therapy with anticoagulant or antiplatelet drugs submitted to oral surgery. To evaluate the risk of bleeding and safety for dental surgery, a retrospective chart review was performed. Medical and dental records of patients taking oral antithrombotic drugs undergoing dental surgery between 2010 and 2015 were reviewed. Results were statistically analyzed using Fisher's exact test, t test or the χ test. One hundred and seventy-nine patients underwent 293 surgical procedures. A total of eight cases of perioperative and 12 episodes of postoperative bleeding were documented. The complications were generally managed with local measures and did not require hospitalization. We found significant association of postoperative hemorrhage with increased perioperative bleeding (P = 0.043) and combination of anticoagulant and antiplatelet therapy (P bleeding is 8.8 times bigger than procedures without perioperative bleeding. Dental surgery in patients under antithrombotic therapy might be carried out without altering the regimen because of low risk of perioperative and postoperative bleeding. However, patients with increased perioperative bleeding should be closely followed up because of postoperative complications risk.

The biology of platelet-rich plasma and its application in oral surgery: literature review.

NARCIS (Netherlands)

Nikolidakis, D.; Jansen, J.A.

2008-01-01

Platelet-rich plasma (PRP) is a new approach in tissue regeneration and a developing area for clinicians and researchers. It is used in various surgical fields, including oral and maxillofacial surgery. PRP is prepared from the patient's own blood and contains growth factors that influence wound

Effect of perioperative oral care on prevention of postoperative pneumonia associated with esophageal cancer surgery: A multicenter case-control study with propensity score matching analysis.

Science.gov (United States)

Soutome, Sakiko; Yanamoto, Souichi; Funahara, Madoka; Hasegawa, Takumi; Komori, Takahide; Yamada, Shin-Ichi; Kurita, Hiroshi; Yamauchi, Chika; Shibuya, Yasuyuki; Kojima, Yuka; Nakahara, Hirokazu; Oho, Takahiko; Umeda, Masahiro

2017-08-01

The aim of this study was to investigate the effectiveness of oral care in prevention of postoperative pneumonia associated with esophageal cancer surgery.Postoperative pneumonia is a severe adverse event associated with esophageal cancer surgery. It is thought to be caused by aspiration of oropharyngeal fluid containing pathogens. However, the relationship between oral health status and postoperative pneumonia has not been well investigated.This study included 539 patients with esophageal cancer undergoing surgery at 1 of 7 university hospitals. While 306 patients received perioperative oral care, 233 did not. Various clinical factors as well as occurrence of postoperative pneumonia were retrospectively evaluated. Propensity-score matching was performed to minimize selection biases associated with comparison of retrospective data between the oral care and control groups. Factors related to postoperative pneumonia were analyzed by logistic regression analysis.Of the original 539 patients, 103 (19.1%) experienced postoperative pneumonia. The results of multivariate analysis of the 420 propensity score-matched patients revealed longer operation time, postoperative dysphagia, and lack of oral care intervention to be significantly correlated with postoperative pneumonia.The present findings demonstrate that perioperative oral care can reduce the risk of postoperative pneumonia in patients undergoing esophageal cancer surgery.

Hyperfractionated-accelerated radiotherapy followed by radical surgery in locally advanced tumors of the oral cavity

International Nuclear Information System (INIS)

Hoeller, U.; Biertz, I.; Tribius, S.; Alberti, W.; Flinzberg, S.; Schmelzle, R.

2006-01-01

Purpose: to evaluate the outcome of hyperfractionated-accelerated radiotherapy and subsequent planned primary tumor resection and radical neck dissection in locally advanced tumors of the oral cavity. Patients and Methods: this retrospective analysis evaluates 126 subsequent patients who were treated between 1988 and 1997 for locally advanced tumors of the oral cavity (with extension into the oropharynx in 17 patients), 34 (27%) AJCC stage III and 92 (73%) stage IV. Primary tumor and nodal metastases were irradiated with 1.4 Gy bid to a median total dose of 72.8 Gy (range 58.8-75.6 Gy). Then, planned radical surgery of the primary site according to the initial tumor extent and cervical nodes was performed. Median follow-up of living patients was 6 years (range 1-11 years). Results: 4 weeks after radiotherapy, 14 patients (11%) had complete tumor remission, 92 (73%) partial remission, 15 (12%) no change, and five (4%) progressive disease. Complete resection was achieved in 117 (93%) patients (nine incomplete resections). 5-year locoregional control rate was 62 ± 9%, overall survival 36 ± 9%. Surgery-related morbidity occurred in 42 patients (33%; mainly delayed wound healing and fistulae), overall severe treatment-related morbidity in 46 patients (36%). 24/84 relapse-free patients (29%) required a percutaneous gastrostomy or nasal tube ≥ 1 year after therapy. Conclusion: in this study, the outcome of combined curative radiotherapy and planned surgery of the primary tumor and neck nodes was comparable to reported results of hyperfractionated radiotherapy with or without salvage surgery of the neck nodes with respect to locoregional control and overall survival. Planned surgery carries a substantial risk of morbidity and seems to offer no benefit in comparison to salvage surgery of the neck nodes only. Therefore, salvage surgery is preferred. (orig.)

Oral health-related quality of life in youth receiving cleft-related surgery: self-report and proxy ratings.

Science.gov (United States)

Broder, Hillary L; Wilson-Genderson, Maureen; Sischo, Lacey

2017-04-01

This paper evaluated the impact of cleft-related surgery on the oral health-related quality of life (OHRQoL) of youth with cleft over time. Data were derived from a 5-year, multi-center, prospective, longitudinal study of 1196 youth with cleft lip and/or palate and their caregivers. Eligible youth were between 7.5 and 18.5 years old, spoke English or Spanish, and were non-syndromic. During each observational period, which included baseline, and 1- and 2-year post-baseline follow-up visits, youths and their caregivers completed the Child Oral Health Impact Profile, a validated measure of OHRQoL. Multilevel mixed-effects models were used to analyze the effects of receipt of craniofacial surgery on OHRQoL over time. During the course of this study a total of 516 patients (43 %) received at least one surgery. Youth in the surgery recommendation group had lower self- (β = -2.18, p self- and proxy-rated OHRQoL at baseline. Both surgical and non-surgical youth (β = 3.73, p self-reported OHRQoL for youth postsurgery (β = 1.04, p self- and caregiver-rated OHRQoL when compared to non-surgical youth. Youth who underwent cleft-related surgery had significant incremental improvements in self-rated but not caregiver (proxy)-rated OHRQoL after surgery.

Health-related quality of life outcome for oral cancer survivors after surgery and postoperative radiotherapy

International Nuclear Information System (INIS)

Fang, Fu-Min; Chien, Chih-Yen; Wang, Chong-Jong; Tsai, Wen-Ling; Chiu, Herng-Chia

2004-01-01

Health-related quality of life (HRQL) data are becoming an important supplement to information pertaining to treatment outcome for cancer patients. The purpose of this study was to evaluate the HRQL outcome for oral cancer survivors after surgery plus postoperative radiotherapy (RT) and to investigate the variables associated with their HRQL. Sixty-six oral cancer patients with cancer-free survival after surgery plus postoperative RT of >2 years were enrolled. The Short Form-36 (SF-36) questionnaire in the Taiwan Chinese version was self-reported by all participants at the clinics. The linear regression model was used to analyze the socio-demographic and medical-related variables correlated with the physical component summary (PCS) and mental component summary (MCS) in SF-36. The mean scores of the eight functional domains in the SF-36 were markedly lower for oral cancer survivors compared with the Taiwanese and US norms. Those with older age, lower annual family income, more advanced cancer stage and flap reconstruction had significantly worse PCS, and those with lower annual family income, unemployment and more advanced cancer stage reported significantly worse MCS. This model accounts for 63% of variance in PCS, and 51% in MCS. These results provided patient-reported evidence that oral cancer survivors lived with a worse HRQL compared with the general Taiwanese population. Socio-economic factors and cancer stage were important factors correlated with their HRQL. (authors)

The advantages of carbon dioxide laser applications in paediatric oral surgery. A prospective cohort study.

Science.gov (United States)

Hanna, R; Parker, S

2016-11-01

The aim of this study is to evaluate and demonstrate the advantages of the carbon dioxide laser in paediatric oral surgery patients in terms of less post-operative complications, healing without scaring, functional benefits, positive patient perception and acceptance of the treatment. One hundred fit and healthy paediatric patients (aged 4-15 years) were recruited to undergo laser surgery for different soft tissue conditions. The outcome of these laser treatments was examined. The Wong-Baker Faces Pain Rating Scale was employed to evaluate the pain before, immediately after laser treatment in the clinic and 1 day after post-operatively at home. Post-operative complications and patients' perception and satisfaction were self-reported during a review telephone call the day after treatment. The patients were reviewed 2 weeks after surgery. Laser parameter was 1.62 W, measured by power meter, continuous wave mode with 50 % emission cycle. The beam spot size at the target tissue was 0.8 mm. The pain score pre-operative, during and immediately after laser treatment was rated 0. Whilst the pain score 1 day after surgery was rated between 0 and 2, the healing time was measured over 2 weeks. None of the patients reported post-operative complications after surgery. Patients' perception and acceptance were rated very good. Laser dentistry is a promising field in modern minimally invasive dentistry, which enables provision of better care for children and adolescents. In this cohort study, the use of the carbon dioxide laser therapy offers a desirable, acceptable and minimally invasive technique in the surgical management of soft tissues in paediatric oral surgery with minimal post-operative complications.

Tourniquet-induced cardiovascular responses in anterior cruciate ligament reconstruction surgery under general anesthesia: Effect of preoperative oral amantadine

Directory of Open Access Journals (Sweden)

Ashraf Abd Elmawgood

2015-01-01

Conclusion: Preoperative oral amantadine reduced tourniquet induced hypertension and postoperative analgesic requirements in anterior cruciate ligament reconstruction surgery under general anesthesia.

The Effect of Preoperative Oral Immunonutrition on Complications and Length of Hospital Stay After Elective Surgery for Pancreatic Cancer--A Randomized Controlled Trial

DEFF Research Database (Denmark)

Gade, Josephine; Wilkens, Trine Levring; Hillingsø, Jens

2016-01-01

Major gastrointestinal surgery is associated with immune suppression and a high risk of postoperative complications. The aim of this open, randomized controlled trial was to examine the effect of supplementary per oral immunonutrition (IN) seven days before surgery for pancreatic cancer (PC......) on postoperative complications and length of hospital stay (LOS). Secondary outcomes were the changes in functional capability and body weight (BW). Consecutive patients referred for surgery for diagnosed or plausible PC were included. The patients in the intervention group received supplementary IN (Oral Impact...

Oral Nutrition as a Form of Pre-Operative Enhancement in Patients Undergoing Surgery for Colorectal Cancer: A Systematic Review

NARCIS (Netherlands)

Bruns, Emma R. J.; Argillander, Tanja E.; van den Heuvel, Baukje; Buskens, Christianne J.; van Duijvendijk, Peter; Winkels, Renate M.; Kalf, Annette; van der Zaag, Edwin S.; Wassenaar, Eelco B.; Bemelman, Willem A.; van Munster, Barbara C.

2018-01-01

Background: Nutritional status has major impacts on the outcome of surgery, in particular in patients with cancer. The aim of this review was to assess the merit of oral pre-operative nutritional support as a part of prehabilitation in patients undergoing surgery for colorectal cancer. Methods: A

A randomized prospective study of oral levofloxacin vs intravenous flomoxef prophylaxis in postoperative infection after endoscopic sinus surgery.

Science.gov (United States)

Inoshita, Ayako; Yokoi, Hidenori; Matsumoto, Fumihiko; Yao, Toru; Kawano, Kenji; Furukawa, Masayuki; Ikeda, Katsuhisa

2010-01-01

The clinical efficacy and cost effectiveness of oral antimicrobial prophylaxis with levofloxacin (LVFX) on endoscopic sinus surgery (ESS) was evaluated. Ninety-three patients undergoing ESS were prospectively enrolled in the present study. The patients were randomly divided into 2 groups, LVFX and flomoxef (FMOX). Two hundred milligrams of LVFX was orally given 2 hours before the start of surgery and 6 hours after the end of surgery, which was followed by the administration of 200 mg every 12 hours for 2 days. One gram of FMOX was dissolved in 100 ml of physiological saline and given intravenously at the induction of anesthesia and 6 hours after the end of surgery, followed by infusion twice daily for 2 days. There were no statistically significant differences between 2 groups in terms of age, sex, systemic complications, surgical procedures, the duration of the operation, the length of hospitalization, the amount of blood loss, body temperature, or the number of white blood cells or C-reactive protein. Although no statistical significance was observed in the bacterial resistance between the two antibiotics, LVFX seems to show a low rate of resistance pattern change as compared to FMOX. The present study demonstrated that no patients treated with LVFX or FMOX were afflicted with postsurgical infection. Oral administration of LVFX is a simple, cost-effective and safe alternative to intravenous prophylaxis in ESS based on clinical efficacy and bacteriological study. Copyright 2010 Elsevier Inc. All rights reserved.

Magnitude of Myocutaneous Flaps and Factors Associated With Loss of Volume in Oral Cancer Reconstructive Surgery.

Science.gov (United States)

Sakamoto, Yuki; Yanamoto, Souichi; Ota, Yoshihide; Furudoi, Shungo; Komori, Takahide; Umeda, Masahiro

2016-03-01

Myocutaneous flaps are often used to repair oral and maxillofacial defects after surgery for oral cancer; however, their volume decreases during the postoperative period. To facilitate treatment planning, the authors measured the extent of such postoperative flap volume loss and identified associated factors in patients who underwent oral reconstruction with myocutaneous flaps. The authors designed and performed a retrospective observational study of patients who underwent reconstructive procedures involving rectus abdominal myocutaneous (RAM) or pectoralis major myocutaneous (PMMC) flaps at Tokai University Hospital, Kobe University Hospital, or Nagasaki University Hospital from April 2009 through March 2013. Flap type and other clinical variables were examined as potential predictors of flap loss. The primary outcome was flap loss at 6 months postoperatively. Correlations between each potential predictor and the primary outcome were examined using multiple regression analysis. The subjects were 75 patients whose oral defects were reconstructed with RAM flaps (n = 57) or PMMC flaps (n = 18). RAM flaps exhibited a mean volume shrinkage of 22% at 6 months postoperatively, which was less than the 27.5% displayed by the PMMC flaps, but the difference was not important. Renal failure, previous surgery of the oral region, postoperative radiotherapy, and postoperative serum albumin level were found to be meaningful risk factors for postoperative flap volume loss. The results of this study suggest that larger flaps should be used in patients who possess these risk factors or are scheduled to undergo postoperative radiotherapy. Future studies should examine the utility of postoperative nutritional management for preventing flap volume loss. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Sequential Participation in a Multi-Institutional Mock Oral Examination Is Associated With Improved American Board of Surgery Certifying Examination First-Time Pass Rate.

Science.gov (United States)

Fingeret, Abbey L; Arnell, Tracey; McNelis, John; Statter, Mindy; Dresner, Lisa; Widmann, Warren

We sought to determine whether sequential participation in a multi-institutional mock oral examination affected the likelihood of passing the American Board of Surgery Certifying Examination (ABSCE) in first attempt. Residents from 3 academic medical centers were able to participate in a regional mock oral examination in the fall and spring of their fourth and fifth postgraduate year from 2011 to 2014. Candidate׳s highest composite score of all mock orals attempts was classified as risk for failure, intermediate, or likely to pass. Factors including United States Medical Licensing Examination steps 1, 2, and 3, number of cases logged, American Board of Surgery In-Training Examination performance, American Board of Surgery Qualifying Examination (ABSQE) performance, number of attempts, and performance in the mock orals were assessed to determine factors predictive of passing the ABSCE. A total of 128 mock oral examinations were administered to 88 (71%) of 124 eligible residents. The overall first-time pass rate for the ABSCE was 82%. There was no difference in pass rates between participants and nonparticipants. Of them, 16 (18%) residents were classified as at risk, 47 (53%) as intermediate, and 25 (29%) as likely to pass. ABSCE pass rate for each group was as follows: 36% for at risk, 84% for intermediate, and 96% for likely pass. The following 4 factors were associated with first-time passing of ABSCE on bivariate analysis: mock orals participation in postgraduate year 4 (p = 0.05), sequential participation in mock orals (p = 0.03), ABSQE performance (p = 0.01), and best performance on mock orals (p = 0.001). In multivariable logistic regression, the following 3 factors remained associated with ABSCE passing: ABSQE performance, odds ratio (OR) = 2.9 (95% CI: 1.3-6.1); mock orals best performance, OR = 1.7 (1.2-2.4); and participation in multiple mock oral examinations, OR = 1.4 (1.1-2.7). Performance on a multi-institutional mock oral examination can identify

End Stage Renal Disease: Not a Contraindication for Minor Oral Surgery-Protocol for the Management of Oral Surgery patients with ESRD on Hemodialysis.

Science.gov (United States)

Pendem, Sneha; Lakshmi Narayana, G; Ravi, Poornima

2017-06-01

To describe a safe and effective protocol for the management of patients with end stage renal disease (ESRD) undergoing minor oral surgery. A prospective cohort study was conducted on all patients with ESRD who were referred for dental consultation. A definite protocol was designed in consultation with the nephrologist to minimize the risk of bleeding and wound healing complications during and after the minor surgical procedures. 36 patients consented for the protocol to be followed while 4 patients did not comply with the protocol and in 2 cases the protocol could be followed. The intra operative, post operative bleeding, and the wound healing were assessed in these patients. 36 patients had uneventful extractions as the blood pressure was brought down to pre hypertensive stage following the protocol. 4 patients who did not comply with the protocol had episodes of bleeding in the post operative period. There were two special scenarios where additional precautions had to be taken have been discussed. The wound healing was satisfactory in all these patients. The protocol discussed in this article helps us provide safe minor oral surgical treatment in patients with ESRD.

Review of orthognathic surgery and related papers published in the British Journal of Oral and Maxillofacial Surgery 2011-2012.

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Goodson, Alexander M C; Payne, Karl F B; Tahim, Arpan; Colbert, Serryth; Brennan, Peter A

2015-04-01

This review summarises all orthognathic and related papers published between January 2011 and December 2012 in the British Journal of Oral and Maxillofacial Surgery (BJOMS). A total of 36 articles were published, a high proportion of which (78%) were full-length papers. The remainder consisted of short communications and technical notes. The topics included operative planning and postoperative outcomes, and there was a strong focus on distraction osteogenesis. There were fewer orthognathic articles published in BJOMS than articles on other subspecialties such as trauma or head and neck oncology. Only 8 (29%) of the full-length articles were prospective studies or randomised trials, which highlights a need for well-designed clinical studies in orthognathic research. Copyright © 2013 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

An evaluation of the retromolar space for oral tracheal tube placement for maxillofacial surgery in children.

Science.gov (United States)

Arora, Suman; Rattan, Vidya; Bhardwaj, Neerja

2006-11-01

The eruption of the first and second permanent molar teeth may influence the size of the retromolar space. In this study we evaluated the adequacy of the retromolar space for retromolar intubation and any effect of eruption of the first and second permanent molar teeth on this space in children. Children 3-15 yr of age, undergoing surgery other than facial surgery were included for evaluation of the retromolar space. After standard oral tracheal intubation, the endotracheal tube was shifted to the retromolar space and the mandible was slowly closed to achieve centric occlusion. At the same time, any increase in airway resistance or decrease in oxygen saturation was noted. In the second part of the study, the feasibility of retromolar intubation in pediatric patients undergoing maxillofacial surgery with intraoperative maxillomandibular fixation was assessed. There was enough space for endotracheal tube placement in the retromolar region. The eruption of the first and second permanent molar teeth did not affect intubation. It was possible to achieve centric occlusion in 79 of 80 children with the endotracheal tube positioned in the retromolar space. Retromolar intubation was successfully accomplished in six pediatric patients undergoing maxillomandibular fixation and maxillofacial surgery. The retromolar space can be safely used for intubation in children when intraoperative maxillomandibular fixation, and simultaneous access to the nose and oral cavity are needed.

Hipnosis como complemento en la cirugía oral del adulto mayor Hypnosis as a complement to oral surgery in elderly persons

Directory of Open Access Journals (Sweden)

Elina Muñiz Manzano

2013-03-01

Full Text Available Introducción: el envejecimiento poblacional es un fenómeno mundial y la cirugía oral es compleja en los adultos mayores, por lo que la preparación preoperatoria es de vital importancia para una evolución satisfactoria. Este trabajo tiene como objetivo demostrar la eficacia de la hipnosis en pacientes con temor en la cirugía oral del adulto mayor. Métodos: se realizó un estudio descriptivo, transversal, con muestra de 20 pacientes de 60 años o más, atendidos en la consulta de Cirugía Maxilofacial del Hospital Universitario "Comandante Manuel Fajardo", en el año 2011, donde se analizaron las variables edad, sexo, número de sesiones de hipnosis, antecedentes patológicos, diagnósticos más frecuentes y temor. Resultados: el mayor número de pacientes se encontró entre 60-69 años de edad, (70 % y el menor en 70-79, (30 %. El sexo femenino prevaleció con 70 %. El número de sesiones fue en el grupo de 60-69 con 58, con un promedio total de 4 por pacientes. En los antecedentes patológicos más frecuentes fue la hipertensión arterial en 14 (70 % y le siguió la diabetes tipo II en 2 (10 % En los diagnósticos más frecuentes fue la caries de cuarto grado con 10 (50 % seguido por los dientes parodontósicos con 4 (20 %. El temor se midió en una escala confeccionada, en la que los pacientes con cifras de l0, 8 y 7 se redujeron a 4 y 5. Conclusiones: Se demuestra la efectividad de la terapia de hipnosis para disminuir el temor y realizar la cirugía oral en el adulto mayor.Introduction: population aging is a worldwide phenomenon, and oral surgery is complex in elderly patients. Therefore, preoperative preparation is vital to their satisfactory evolution. The purpose of the present paper is to show the efficacy of hypnosis in elderly patients who fear oral surgery. Methods: a descriptive cross-sectional study was conducted with a sample of 20 patients aged 60 or over, cared for at the maxillofacial surgery service of Comandante Manuel

Outcome and prognostic factors following curative-intent surgery for oral tumours in dogs: 234 cases (2004 to 2014).

Science.gov (United States)

Sarowitz, B N; Davis, G J; Kim, S

2017-03-01

To describe the long-term outcomes and prognostic factors associated with curative-intent surgery for oral tumours in a large series of dogs. Retrospective review of records for dogs with oral tumours treated with curative-intent surgery. Data collected included signalment, weight, surgical procedure, lymph node staging results, computed tomography results, tumour size, histopathology results including margin evaluation, complications, adjunctive therapies, local recurrence or metastasis, date and cause of death and owner satisfaction. Median cause-specific survival was shortest for malignant melanoma (206 days) and osteosarcoma (209 days). Local recurrence rate was highest for fibrosarcoma (54·2%) and distant metastatic rate was highest for malignant melanoma (30%). Curative-intent surgery resulted in complete surgical margins in 85·2% of cases. Results suggest tumour type, completeness of excision, tumour size, and age may affect disease-free interval and cause-specific survival. Fibrosarcoma had a higher risk of recurrence compared to other tumour types. © 2017 British Small Animal Veterinary Association.

Management of Antithrombotic Agents in Oral Surgery Maria Martinez and Dimitrios A. Tsakiris *

Directory of Open Access Journals (Sweden)

Maria Martinez

2015-10-01

Full Text Available Systemic anticoagulation with intravenous or oral anticoagulants and antiplatelet agents is an efficient treatment against thromboembolic or cardiovascular disease. Invasive dental procedures or oral surgery might be associated with bleeding complications if carried out under anticoagulants. Patients on vitamin K antagonists, new direct anticoagulants or antiplatelet agents having dental interventions with low-risk for bleeding do not need interruption of anticoagulation. In case of bleeding complications local hemostatic measures, such as local surgical sutures, fibrin glue, local antifibrinolytic treatment with tranexamic acid, or e-aminocaproic acid suffice to stop bleeding. In patients with high risk of bleeding an individual assessment of the benefit/risk ratio of interrupting anticoagulation should be carried out. Bridging the long-term anticoagulation with short-term anticoagulants should be planned according to national or international guidelines. The introduction of the newer direct oral anticoagulants having more flexible pharmacokinetic properties has facilitated bridging, allowing short-term interruption without increasing the risk of relapsing thrombotic or cardiovascular events.

The effectiveness of systematic perioperative oral hygiene in reduction of postoperative respiratory tract infections after elective thoracic surgery in adults

DEFF Research Database (Denmark)

Pedersen, Preben Ulrich; Larsen, Palle; Håkonsen, Sasja Jul

2016-01-01

to increase patients' risk for nosocomial respiratory tract infection. OBJECTIVES: To identify, appraise and synthesize the best available evidence on the effectiveness of systematic perioperative oral hygiene in the reduction of postoperative respiratory airway infections in adult patients undergoing...... elective thoracic surgery. INCLUSION CRITERIA: Patients over the age of 18 years who had been admitted for elective thoracic surgery, regardless of gender, ethnicity, diagnosis severity, co-morbidity or previous treatment.Perioperative systematic oral hygiene (such as mechanical removal of dental biofilm......% confidence interval [CI] 0.55-0.78) for respiratory tract infections RR 0.48 (95%CI: 0.36-0.65) and for deep surgical site infections RR 0.48 (95%CI 0.27-0.84). CONCLUSIONS: Systematic perioperative oral hygiene reduces postoperative nosocomial, lower respiratory tract infections and surgical site infections...

Portfolio: a comprehensive method of assessment for postgraduates in oral and maxillofacial surgery.

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Kadagad, Poornima; Kotrashetti, S M

2013-03-01

Post graduate learning and assessment is an important responsibility of an academic oral and maxillofacial surgeon. The current method of assessment for post graduate training include formative evaluation in the form of seminars, case presentations, log books and infrequently conducted end of year theory exams. End of the course theory and practical examination is a summative evaluation which awards the degree to the student based on grades obtained. Oral and maxillofacial surgery is mainly a skill based specialty and deliberate practice enhances skill. But the traditional system of assessment of post graduates emphasizes their performance on the summative exam which fails to evaluate the integral picture of the student throughout the course. Emphasis on competency and holistic growth of the post graduate student during training in recent years has lead to research and evaluation of assessment methods to quantify students' progress during training. Portfolio method of assessment has been proposed as a potentially functional method for post graduate evaluation. It is defined as a collection of papers and other forms of evidence that learning has taken place. It allows the collation and integration of evidence on competence and performance from different sources to gain a comprehensive picture of everyday practice. The benefits of portfolio assessment in health professions education are twofold: it's potential to assess performance and its potential to assess outcomes, such as attitudes and professionalism that are difficult to assess using traditional instruments. This paper is an endeavor for the development of portfolio method of assessment for post graduate student in oral and maxillofacial surgery.

Incidence and types of complications after ablative oral cancer surgery with primary microvascular free flap reconstruction

NARCIS (Netherlands)

Lodders, J.N.; Parmar, S.; Stienen, N.-L.M.; Martin, T.J.; Karagozoglu, K.H.; Heymans, M.W.; Nandra, B.; Forouzanfar, T.

2015-01-01

Background: The aims of the study were 1) to evaluate the incidence and types of postoperative complications after ablative oral cancer surgery with primary free flap reconstruction and 2) identify prognostic variables for postoperative complications. Material and Methods: Desired data was retrieved

Incidence and types of complications after ablative oral cancer surgery with primary microvascular free flap reconstruction

NARCIS (Netherlands)

Lodders, J.N.; Parmar, S.; Stienen, N.L.M.; Martin, T.J.; Karagozoglu, K.H.; Heymans, M.W.; Nandra, B.; Forouzanfar, T.

2015-01-01

BACKGROUND: The aims of the study were 1) to evaluate the incidence and types of postoperative complications after ablative oral cancer surgery with primary free flap reconstruction and 2) identify prognostic variables for postoperative complications. MATERIAL AND METHODS: Desired data was retrieved

[Evaluation of flipped classroom teaching model in undergraduates education of oral and maxillofacial surgery].

Science.gov (United States)

Cai, Ming; Cao, Xia; Fang, Xiao; Wang, Xu-dong; Zhang, Li-li; Zheng, Jia-wei; Shen, Guo-fang

2015-12-01

Flipped classroom is a new teaching model which is different from the traditional teaching method. The history and characteristics of flipped classroom teaching model were introduced in this paper. A discussion on how to establish flipped classroom teaching protocol in oral and maxillofacial surgery education was carried out. Curriculum transformation, construction of education model and possible challenges were analyzed and discussed.

Markerless laser registration in image-guided oral and maxillofacial surgery.

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Marmulla, Rüdiger; Lüth, Tim; Mühling, Joachim; Hassfeld, Stefan

2004-07-01

The use of registration markers in computer-assisted surgery is combined with high logistic costs and efforts. Markerless patient registration using laser scan surface registration techniques is a new challenging method. The present study was performed to evaluate the clinical accuracy in finding defined target points within the surgical site after markerless patient registration in image-guided oral and maxillofacial surgery. Twenty consecutive patients with different cranial diseases were scheduled for computer-assisted surgery. Data set alignment between the surgical site and the computed tomography (CT) data set was performed by markerless laser scan surface registration of the patient's face. Intraoral rigidly attached registration markers were used as target points, which had to be detected by an infrared pointer. The Surgical Segment Navigator SSN++ has been used for all procedures. SSN++ is an investigative product based on the SSN system that had previously been developed by the presenting authors with the support of Carl Zeiss (Oberkochen, Germany). SSN++ is connected to a Polaris infrared camera (Northern Digital, Waterloo, Ontario, Canada) and to a Minolta VI 900 3D digitizer (Tokyo, Japan) for high-resolution laser scanning. Minimal differences in shape between the laser scan surface and the surface generated from the CT data set could be detected. Nevertheless, high-resolution laser scan of the skin surface allows for a precise patient registration (mean deviation 1.1 mm, maximum deviation 1.8 mm). Radiation load, logistic costs, and efforts arising from the planning of computer-assisted surgery of the head can be reduced because native (markerless) CT data sets can be used for laser scan-based surface registration.

Prognostic value and importance of surgery combined with postoperative radiotherapy for oral and oropharyngeal cancer

International Nuclear Information System (INIS)

Maciejewski, A.

2001-01-01

The aim of this paper is to evaluate the efficacy of surgery for patients with oral cavity or oropharyngeal cancer, and is impact on the final results of treatment combined with postoperative radiotherapy. Furthermore, predictive and prognostic value of clinical and histopatological postoperative factors were analysed, and estimation of clinical applicability of modified scale for risk of postoperative local and/or nodal recurrence according to Peters was checked. Material includes 218 cases of the advanced oral cavity or oropharyngeal cancer. All data were subdivided into 4 groups depending on treatment strategy. For the analysis of the treatment efficacy (overall and disease-free survival) many predictive and prognostic factors have been considered. Despite of multivariate logistic regression analysis of these factors, the risk of local recurrence was related to the results of combined treatment based on the modified numerical risk scale adapted from Peters. The risk value is the sum of scores given to individual prognostic factors. Time interval between surgery and radiotherapy (TI) and overall treatment time (TTT) have been accounted for the analysis. Generally; optimal results were noted in the group B, where surgery has been combined with postoperative radiotherapy. In case of surgery combined with preoperative radiotherapy (group E) 5-year DFS was 30%, and in the case when radiotherapy was delayed and applied when recurrence after primary surgery has occurred, the 5-year DFS was not higher than 20%. Macro- and microscopic surgical radicalism has been found one of the most important and significant prognostic factors. For positive margins (m+) 5-year DFS significantly decreases to about 20%. Surgical macro- and microradicalism has an important impact (p = 0.013) on the incidence of distant metastases. The scoring system for the recurrence was based on Peters scale. The sum of the risk scores (TRRI+n) for individual prognostic factors allow to allocate

Recovery of dynamic balance after general anesthesia with sevoflurane in short-duration oral surgery.

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Fujisawa, Toshiaki; Miyamoto, Eriko; Takuma, Shigeru; Shibuya, Makiko; Kurozumi, Akihiro; Kimura, Yukifumi; Kamekura, Nobuhito; Fukushima, Kazuaki

2009-01-01

Recovery of dynamic balance, involving adjustment of the center of gravity, is essential for safe discharge on foot after ambulatory anesthesia. The purpose of this study was to assess the recovery of dynamic balance after general anesthesia with sevoflurane, using two computerized dynamic posturographies. Nine hospitalized patients undergoing oral surgery of less than 2 h duration under general anesthesia (air-oxygensevoflurane) were studied. A dynamic balance test, assessing the ability of postural control against unpredictable perturbation stimuli (Stability System; Biodex Medical), a walking analysis test using sheets with foot pressure sensors (Walk Way-MG1000; Anima), and two simple psychomotor function tests were performed before anesthesia (baseline), and 150 and 210 min after the emergence from anesthesia. Only the double-stance phase in the walking analysis test showed a significant difference between baseline and results at 150 min. None of the other variables showed any differences among results at baseline and at 150 and 210 min. The recovery times for dynamic balance and psychomotor function seem to be within 150 min after emergence from general anesthesia with sevoflurane in patients undergoing oral surgery of less than 2-h duration.

Recovery following General Anesthesia with Isoflurane or Enflurane for Outpatient Dentistry and Oral Surgery

OpenAIRE

Valanne, Jukka V.; Korttila, Kari

1988-01-01

Anesthesia was induced in 120 unpremedicated, healthy patients undergoing outpatient dentistry or oral surgery with methohexital, and endotracheal intubation facilitated with succinylcholine. Anesthesia was maintained randomly with either enflurane or isoflurane in nitrous oxide and oxygen (50%) administered in a nonrebreathing circuit using spontaneous respiration. After both enflurane and isoflurane anesthesia, it took 12-13 minutes before the patients were oriented as to time and place. Th...

Adverse effects during the oral glucose tolerance test in post-bariatric surgery patients

OpenAIRE

Andrade,Heliana Fernanda de Albuquerque; Pedrosa,William; Diniz,Maria de Fátima Haueisen Sander; Passos,Valéria Maria Azeredo

2016-01-01

ABSTRACT Objective The oral glucose tolerance test (OGTT) is used in the screening of gestational diabetes, in diagnosis of type 2 diabetes in conjunction with fasting blood glucose and glycated hemoglobin. The aim of this study was to examine the incidence and risk factors of adverse effects of OGTT in patients who underwent bariatric surgery, in addition to proposing standardization for ordering the OGTT in these patients. Subjects and methods This study assessed the incidence of adverse ...

Rapid prototyping modelling in oral and maxillofacial surgery: a two year retrospective study

OpenAIRE

Suomalainen, Anni; Stoor, Patricia; Mesimäki, Karri; Kontio, Risto K.

2015-01-01

Background The use of rapid prototyping (RP) models in medicine to construct bony models is increasing. Material and Methods The aim of the study was to evaluate retrospectively the indication for the use of RP models in oral and maxillofacial surgery at Helsinki University Central Hospital during 2009-2010. Also, the used computed tomography (CT) examination ? multislice CT (MSCT) or cone beam CT (CBCT) - method was evaluated. Results In total 114 RP models were fabricated for 102 patients. ...

[Correlations of plasma concentrations of β-amyloid peptide and S-100β with postoperative cognitive dysfunction in patients undergoing oral and maxillofacial cancer surgery].

Science.gov (United States)

Liang, Bing; Sun, Yuan-Qing; Jiang, Jue; Xu, Hui

2016-12-01

To evaluate the changes of perioperative plasma concentrations of Aβ 1-40 and S-100β to determine the relationship with postoperative cognitive dysfunction in elderly patients undergoing oral and maxillofacial cancer surgeries. One hundred and fifteen patients aged at least 60 years undergoing oral and maxillofacial tumor resection were investigated between May 2014 to December 2014.Neuropsychological tests for detecting postoperative cognitive dysfunction(POCD) were performed one day before surgery and 7 days postoperatively. According to the results of neuropsychological tests on day 7, patients were divided into POCD group and non-POCD group.Plasma values of Aβ 1-40 and S-100β were determined with enzyme linked immunosorbent assay (ELISA) before anesthesia induction, 24 h and 7 days after surgery. The data were analyzed using SPSS 19.0 software package. According to the definition, POCD was present in 37 of 115 (32.3%) patients 1 week after surgery. Compared with pre-anesthesia, S-100β levels in POCD group were significantly increased (Psurgery (Poral and maxillofacial surgeries with general anesthesia. The increasing levels of Aβ 1-40 , S-100β may be associated with the occurence of POCD. Patients with long-lasting operation and high concentrations of Aβ 1-40 and S-100β after surgeries were at a higher risk of POCD. The clinical values of Aβ 1-40 and S-100 as predictive measurements of POCD after oral and maxillofacial cancer surgery appear to be reasonable.

A multiple-dose, double-blind comparison of intramuscularly and orally administered ketorolac tromethamine and Ketogan in patients with pain following orthopaedic surgery

DEFF Research Database (Denmark)

Gebuhr, Peter Henrik; Soelberg, M; Strauss, W

1994-01-01

In this multiple-dose, double-blind study 100 patients with moderate, severe or very severe pain following orthopaedic surgery were randomly assigned to receive ketorolac, a non-steroidal anti-inflammatory drug with potent analgesic properties (10 mg), or the standard regimen of Ketogan (a combin......-mg doses of oral ketorolac are as effective as Ketogan for the treatment of pain following orthopaedic surgery. Ketorolac appears to be better tolerated than Ketogan since significantly fewer patients reported adverse events (P = 0.004) when taking ketorolac.......In this multiple-dose, double-blind study 100 patients with moderate, severe or very severe pain following orthopaedic surgery were randomly assigned to receive ketorolac, a non-steroidal anti-inflammatory drug with potent analgesic properties (10 mg), or the standard regimen of Ketogan (a...... combination product containing the narcotic analgesic, ketobemidone, plus a spasmolytic agent) by intramuscular injection every 1-6 h as needed for pain. When patients were able to tolerate an oral diet and were expected to respond to oral analgesic medication, based on overall pain sensitivity, they were...

Pre-prosthetic surgery: Mandible

Directory of Open Access Journals (Sweden)

Veeramalai Naidu Devaki

2012-01-01

Full Text Available Pre-prosthetic surgery is that part of oral and maxillofacial surgery which restores oral function and facial form. This is concerned with surgical modification of the alveolar process and its surrounding structures to enable the fabrication of a well-fitting, comfortable, and esthetic dental prosthesis. The ultimate goal of pre-prosthetic surgery is to prepare a mouth to receive a dental prosthesis by redesigning and smoothening bony edges.

Choosing academia versus private practice: factors affecting oral maxillofacial surgery residents' career choices.

Science.gov (United States)

Lanzon, Jesse; Edwards, Sean P; Inglehart, Marita R

2012-07-01

This study explored how residents who intend to enter private practice versus academic careers differ in their background and educational characteristics, engagement in different professional activities, professional values, and satisfaction. Survey data were collected from 257 residents in oral and maxillofacial surgery programs in the United States. The responses of the respondents who planned a career in private practice (65%) and who considered academia (35%) were compared with χ(2) and independent-sample t tests. Residents who considered academia were more likely to be women (29% vs 8%; P career compared with residents interested in private practice. Future clinicians placed a higher value on having manageable hours and more time performing outpatient procedures than future educators. These findings showed, first, that the characteristics at the beginning of residency programs that are likely to indicate an increased interest in academic careers are being a woman, from a non-European American background, and having an interest in research. Second, once residents are admitted, different types of surgeries and different types of professional activities tend to appeal to residents who want to practice in private practice settings versus work in academia. Third, residents interested in academia have a relatively lower level of satisfaction compared with residents interested in practicing outside of academia. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Tissue differentiation by diffuse reflectance spectroscopy for automated oral and maxillofacial laser surgery: ex vivo pilot study

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Zam, Azhar; Stelzle, Florian; Tangermann-Gerk, Katja; Adler, Werner; Nkenke, Emeka; Schmidt, Michael; Douplik, Alexandre

2010-02-01

Remote laser surgery lacks of haptic feedback during the laser ablation of tissue. Hence, there is a risk of iatrogenic damage or destruction of anatomical structures like nerves or salivary glands. Diffuse reflectance spectroscopy provides a straightforward and simple approach for optical tissue differentiation. We measured diffuse reflectance from seven various tissue types ex vivo. We applied Linear Discriminant Analysis (LDA) to differentiate the seven tissue types and computed the area under the ROC curve (AUC). Special emphasis was taken on the identification of nerves and salivary glands as the most crucial tissue for maxillofacial surgery. The results show a promise for differentiating tissues as guidance for oral and maxillofacial laser surgery by means of diffuse reflectance.

Open Access Publishing: A Study of Current Practice in Oral and Maxillofacial Surgery Research.

Science.gov (United States)

Tahim, Arpan; Bansal, Hitesh; Goodson, Alexander M C; Payne, Karl F B; Sabharwal, Sanjeeve

2016-12-01

Open access (OA) publication has become an increasingly common route for dissemination of scientific research findings. However, it remains a contentious issue with continued debate as to its impact on the peer-review process and a potential change in the quality of subsequent evidence published. There is little research that looks into OA in oral and maxillofacial surgery. We investigated the OA policy in the 30 relevant journals listed in the Institute for Scientific Information Web of Knowledge journal citation report, comparing bibliometric data and quality of evidence produced in journals offering OA and those with subscription-only policies. 3474 articles were graded for evidence level and the results correlated to journal OA status. 76.7 % of journals offered authors OA services. There was no difference between impact factor, self-citation rate, total citations or quality of evidence between OA and subscription journals. These findings should send clear messages to both clinicians and researchers and should re- assure readers that scientific findings that are disseminated in open access form do not differ in quality to those in subscription-only format. It should reinforce that open access formats are a credible way to display research findings in oral and maxillofacial surgery.

H-classic: a new method to identify classic articles in Implant Dentistry, Periodontics, and Oral Surgery.

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De la Flor-Martínez, Maria; Galindo-Moreno, Pablo; Sánchez-Fernández, Elena; Piattelli, Adriano; Cobo, Manuel Jesus; Herrera-Viedma, Enrique

2016-10-01

The study of classic papers permits analysis of the past, present, and future of a specific area of knowledge. This type of analysis is becoming more frequent and more sophisticated. Our objective was to use the H-classics method, based on the h-index, to analyze classic papers in Implant Dentistry, Periodontics, and Oral Surgery (ID, P, and OS). First, an electronic search of documents related to ID, P, and OS was conducted in journals indexed in Journal Citation Reports (JCR) 2014 within the category 'Dentistry, Oral Surgery & Medicine'. Second, Web of Knowledge databases were searched using Mesh terms related to ID, P, and OS. Finally, the H-classics method was applied to select the classic articles in these disciplines, collecting data on associated research areas, document type, country, institutions, and authors. Of 267,611 documents related to ID, P, and OS retrieved from JCR journals (2014), 248 were selected as H-classics. They were published in 35 journals between 1953 and 2009, most frequently in the Journal of Clinical Periodontology (18.95%), the Journal of Periodontology (18.54%), International Journal of Oral and Maxillofacial Implants (9.27%), and Clinical Oral Implant Research (6.04%). These classic articles derived from the USA in 49.59% of cases and from Europe in 47.58%, while the most frequent host institution was the University of Gothenburg (17.74%) and the most frequent authors were J. Lindhe (10.48%) and S. Socransky (8.06%). The H-classics approach offers an objective method to identify core knowledge in clinical disciplines such as ID, P, and OS. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The Influence of Oral Carbohydrate Solution Intake on Stress Response before Total Hip Replacement Surgery during Epidural and General Anaesthesia.

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Çeliksular, M Cem; Saraçoğlu, Ayten; Yentür, Ercüment

2016-06-01

The effects of oral carbohydrate solutions, ingested 2 h prior to operation, on stress response were studied in patients undergoing general or epidural anaesthesia. The study was performed on 80 ASA I-II adult patients undergoing elective total hip replacement, which were randomized to four groups (n=20). Group G patients undergoing general anaesthesia fasted for 8 h preoperatively; Group GN patients undergoing general anaesthesia drank oral carbohydrate solutions preoperatively; Group E patients undergoing epidural anaesthesia fasted for 8 h and Group EN patients undergoing epidural anaesthesia drank oral carbohydrate solutions preoperatively. Groups GN and EN drank 800 mL of 12.5% oral carbohydrate solution at 24:00 preoperatively and 400 mL 2 h before the operation. Blood samples were taken for measurements of glucose, insulin, cortisol and IL-6 levels. The effect of preoperative oral carbohydrate ingestion on blood glucose levels was not significant. Insulin levels 24 h prior to surgery were similar; however, insulin levels measured just before surgery were 2-3 times higher in groups GN and EN than in groups G and E. Insulin levels at the 24(th) postoperative hour in epidural groups were increased compared to those at basal levels, although general anaesthesia groups showed a decrease. From these measurements, only the change in Group EN was statistically significant (poral carbohydrate nutrition did not reveal a significant effect on surgical stress response.

Ipsilateral Irradiation for Oral and Oropharyngeal Carcinoma Treated With Primary Surgery and Postoperative Radiotherapy

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Vergeer, Marije R.; Doornaert, Patricia; Jonkman, Anja; Kaanders, Johannes H.A.M.; Ende, Piet L.A. van den; Jong, Martin A. de; Leemans, C. Rene; Slotman, Ben J.; Langendijk, Johannes A.

2010-01-01

Purpose: The purpose was to evaluate the contralateral nodal control (CLNC) in postoperative patients with oral and oropharyngeal cancer treated with ipsilateral irradiation of the neck and primary site. Late radiation-induced morbidity was also evaluated. Methods and Materials: The study included 123 patients with well-lateralized squamous cell carcinomas treated with surgery and unilateral postoperative irradiation. Most patients had tumors of the gingiva (41%) or buccal mucosa (21%). The majority of patients underwent surgery of the ipsilateral neck (n = 102 [83%]). The N classification was N0 in 73 cases (59%), N1 or N2a in 23 (19%), and N2b in 27 cases (22%). Results: Contralateral metastases developed in 7 patients (6%). The 5-year actuarial CLNC was 92%. The number of lymph node metastases was the only significant prognostic factor with regard to CLNC. The 5-year CLNC was 99% in N0 cases, 88% in N1 or N2a cases, and 73% in N2b cases (p = 0.008). Borderline significance (p = 0.06) was found for extranodal spread. Successful salvage could be performed in 71% of patients with contralateral metastases. The prevalence of Grade 2 or higher xerostomia was 2.6% at 5 years. Conclusions: Selected patients with oral or oropharyngeal carcinoma treated with primary surgery and postoperative ipsilateral radiotherapy have a very high CLNC with a high probability of successful salvage in case of contralateral metastases. However, bilateral irradiation should be applied in case of multiple lymph node metastases in the ipsilateral neck, particularly in the presence of extranodal spread. The incidence of radiation-induced morbidity is considerably lower as observed after bilateral irradiation.

A randomized controlled trial evaluating early versus traditional oral feeding after colorectal surgery

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Ahmet Dag

2011-01-01

Full Text Available OBJECTIVE: This prospective randomized clinical study was conducted to evaluate the safety and tolerability of early oral feeding after colorectal operations. METHODS: A total of 199 patients underwent colorectal surgery and were randomly assigned to early feeding (n = 99 or a regular diet (n = 100. Patients’ characteristics, diagnoses, surgical procedures, comorbidity, bowel movements, defecation, nasogastric tube reinsertion, time of tolerance of solid diet, complications, and length of hospitalization were assessed. RESULTS: The two groups were similar in terms of gender, age, diagnosis, surgical procedures, and comorbidity. In the early feeding group, 85.9% of patients tolerated the early feeding schedule. Bowel movements (1.7±0.89 vs. 3.27±1.3, defecation (3.4±0.77 vs. 4.38±1.18 and time of tolerance of solid diet (2.48±0.85 vs. 4.77±1.81 were significantly earlier in the early feeding group. There was no change between the groups in terms of nasogastric tube reinsertion, overall complication or anastomotic leakage. Hospitalization (5.55±2.35 vs. 9.0±6.5 was shorter in the early feeding group. CONCLUSIONS: The present study indicated that early oral feeding after elective colorectal surgery was not only well tolerated by patients but also affected the postoperative outcomes positively. Early postoperative feeding is safe and leads to the early recovery of gastrointestinal functions.

Surgery-first orthognathic approach vs traditional orthognathic approach: Oral health-related quality of life assessed with 2 questionnaires.

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Pelo, Sandro; Gasparini, Giulio; Garagiola, Umberto; Cordaro, Massimo; Di Nardo, Francesco; Staderini, Edoardo; Patini, Romeo; de Angelis, Paolo; D'Amato, Giuseppe; Saponaro, Gianmarco; Moro, Alessandro

2017-08-01

The purposes of the study were to investigate and evaluate the differences detected by the patients between the traditional orthognathic approach and the surgery-first one in terms of level of satisfaction and quality of life. A total of 30 patients who underwent orthognathic surgery for correction of malocclusions were selected and included in this study. Fifteen patients were treated with the conventional orthognathic surgery approach, and 15 patients with the surgery-first approach. Variables were assessed through the Orthognathic Quality of Life Questionnaire and the Oral Health Impact Profile questionnaire and analyzed with 2-way repeated-measures analysis of variance. The results showed significant differences in terms of the Orthognathic Quality of Life Questionnaire (P surgery in the surgery-first group and an initial worsening during orthodontic treatment in the traditional approach group followed by postoperative improvement. This study showed that the worsening of the facial profile during the traditional orthognathic surgery approach decompensation phase has a negative impact on the perception of patients' quality of life. Surgeons should consider the possibility of a surgery-first approach to prevent this occurrence. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

PREOPERATIVE ORAL CODEINE EFFECT ON POSTOPERATIVE CAUGH CONTROL IN CATARACT SURGERY

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H SOLTANI NEZHAD

2003-03-01

Full Text Available Introduction: cataract surgery is .one of the most common operation in ophthalmology. Post operative caught can lead to anterior chamber hemmorage and dehiscence of suture so we were going to finding a way to overcome to this problem. Method: This study is a clinical trial one which was done on 150 ASA 1, 2 patient that were over 45 years old age. These patient have cataract surgery under GA in Farabi Hospital of Esfahan medical university. All of the patient were intubated under direct laryngoscopy. Patients that have more of one laryngoscope, difficult intubation, thraceal intubation prolonged more than 15 seconds and those which have opiate addiction. We divided the patients into two 75 patient group by randomized selection. This study is double blind and 30mg codeine phosphate and placebo has given to the patient one hour preoperatively. Heart rate and systolic and diastolic, blood pressure has been recorded preoperatively, three minutes after intubation and three minutes after extubation respectively. Caught has been counted and recorded immediately. Five minutes and 30 minutes after extubation and results in contorol group are compared with the results in another group. Discussion: According to the statistical analysis t-student test, chi-square and non parametric test and Pvalue only changes in heart rate after extubation has been different in two groups and other findings make no difference in two groups. There was not any significant difference between two groups about age, sex, duration of surgery, preoperative mean heart rate and blood pressure. There was not any difference about mean number of coughs between two groups and according to this study oral codeine phosphate has administered preoperatively has not any effect on reducing postoperative caught in patients who have GA and tracheal incubation for cataract surgery.

Surgical site infections among high-risk patients in clean-contaminated head and neck reconstructive surgery: concordance with preoperative oral flora.

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Yang, Ching-Hsiang; Chew, Khong-Yik; Solomkin, Joseph S; Lin, Pao-Yuan; Chiang, Yuan-Cheng; Kuo, Yur-Ren

2013-12-01

Salivary contamination of surgical wounds in clean-contaminated head and neck surgery with free flap reconstruction remains a major cause of infection and leads to significant morbidity. This study investigates the correlation between intraoral flora and surgical site infections (SSIs) among high-risk head and neck cancer patients undergoing resection and free flap reconstruction. One hundred twenty-nine patients were identified as being at high risk for infective complications based on cancer stage, tumor size, comorbid factors, and extent of reconstruction. All patients had intraoral swab cultures before surgery. Patients with culture-confirmed SSI after surgery were chosen for analysis, using the κ index and its 95% confidence interval for concordance analysis. All patients received clindamycin and gentamicin for antibiotic prophylaxis for 5 days. Antibiotic susceptibility testing of all isolates was obtained and analyzed. Thirty-seven patients experienced SSI, or an infection rate of 28.3%, occurring at a mean of 9.3 postoperative days. The overall concordance between oral flora and SSI was fair to moderate (κ index of 0.25), but detailed analysis shows a higher concordance for known and opportunistic pathogens, such as Pseudomonas aeruginosa and Enterococcus faecalis, compared to typical oral commensals. Antibiotic susceptibility tests show rapid and significant increases in resistance to clindamycin, indicating a need for a more effective alternative. Predicting pathogens in SSI using preoperative oral swabs did not demonstrate a good concordance in general for patients undergoing clean-contaminated head and neck surgery, although concordance for certain pathogenic species seem to be higher than for typical intraoral commensals. The rapid development of resistance to clindamycin precludes its use as a prophylactic agent.

Midline submental intubation might be the preferred alternative to oral and nasal intubation in elective oral and craniomaxillofacial surgery when indicated.

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Jin, Huijun; Patil, Pavan Manohar

2015-01-01

No consensus exists to date regarding the best method of controlling the airway for oral or craniomaxillofacial surgery when orotracheal and nasotracheal intubations are unsuccessful or contraindicated. The most commonly used method of tracheostomy has been associated with a high degree of morbidity. Therefore, the present study was conducted to determine the indications, safety, efficacy, time required, drawbacks, complications, and costs of the midline submental intubation (SMI) approach in elective oral and craniomaxillofacial surgical procedures. A retrospective case series study was used to evaluate the surgical, financial, and photographic records of all patients who had undergone oral or craniomaxillofacial operations at Sharda University School of Dental Sciences, Greater Noida, from April 2006 to March 2014. The indications, drawbacks, time required for the procedure, ability to provide a secure airway, intra- and postoperative complications, and additional costs associated with SMI were analyzed. Of the 2,823 patients treated, the present study included 120 patients (97 men and 23 women, aged 19 to 60 years). The average time required for SMI was 10 ± 2 minutes. No episode of intraoperative oxygen desaturation was noted. One intraoperative complication, an injury to the ventral surface of the tongue, was encountered. Two patients developed infection at the skin incision site. No significant additional cost was incurred with the use of SMI. SMI has been successfully used in elective oral and craniomaxillofacial surgical procedures for which oral and nasal intubations were either not indicated or not possible. The advantages include a quick procedure, insignificant complications, the ability to provide a stable airway, and no added costs, making SMI a quick, safe, efficient, and cost-effective alternative in such cases. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

9. Challenges Associated with Learning Oral Diagnostic Sciences, A ...

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Harcourt, Nigeria. 4Department of Oral Maxillofacial Surgery and Oral Pathology, Obafemi Awolowo University, Ile Ife, Nigeria. 5Department of Oral Surgery and Pathology, University of Benin, Benin, Nigeria. Corresponding author: Dr A.O Adisa.

Dental students’ perceptions of undergraduate clinical training in oral and maxillofacial surgery in an integrated curriculum in Saudi Arabia

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Mahmoud Al-Dajani

2015-09-01

Full Text Available Purpose: The aim was to understand dental students’ experiences with oral and maxillofacial surgery (OMS teaching, their confidence levels in performing routine dento-alveolar operations, and the relationship between the students’ confidence level and the number of teeth extracted during the clinical practice. Methods: The survey questionnaire was distributed to 32 students at Aljouf University College of Dentistry, Saudi Arabia during their fourth and fifth year in 2015. Respondents were asked to rate 19 items, which represent a student’s confidence in performing routine surgical interventions, using a four-point Likert scale (1=very little confidence, 4=very confident. A multivariate regression was computed between average confidence and the variables: weekly hours devoted to studying oral and maxillofacial surgery, college grade point average, and the total number of teeth extracted. Results: The response rate was 100%. Students revealed the highest level of confidence in giving local anesthesia (96.9%, understanding extraction indications (93.8%, and performing simple extractions (90.6%. Less confidence was shown with handling difficult extractions (50.0%, extracting molars with separation (50.0% or extracting third molars (56.3%. The average confidence in performing surgical procedures was 2.88 (SD=0.55, ranging from 1.79 to 3.89. A given student’s confidence increased with an increase in the total number of teeth extracted (P=0.003. Conclusion: It reveals a significant impact of undergraduate clinical training on students’ confidence in performing oral and maxillofacial surgery clinical procedures: The more clinical experience the students had, the more confidence they reported.

Management of novel oral anticoagulants in emergency and trauma surgery.

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Pinho-Gomes, Ana-Catarina; Hague, Adam; Ghosh, Jonathan

2016-08-01

The compelling safety, efficacy and predictable effect of novel oral anticoagulants (NOACs) is driving a rapid expansion in their therapeutic indications. Management of the increasing number of patients on those new agents in the setting of emergency or trauma surgery can be challenging and the absence of specific reversal agents has been a matter of concern. This review summarises the key principles that underpin the management of those patients with a particular emphasis on the recent development of specific antidotes. As of 2015, a new line of antidotes, specific for these drugs, are at different stages of their development with their release imminent. However, as NOACs are innately reversible due to their short half-life, the use of reversal agents will probably be restricted to a few exceptional cases. Post-marketing surveillance will be paramount to better clarify the role of these promising drugs. Management of patients on NOACs in the context of emergency or trauma surgery relies on best supportive care in combination with the blood products and/or specific antidotes as required. Familiarity with the new reversal agents is essential but further evidence on their indications, safety and efficacy as well as consensus guidelines are warranted prior to widespread adoption. Copyright © 2016 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Benefits of mock oral examinations in a multi-institutional consortium for board certification in general surgery training.

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Subhas, Gokulakkrishna; Yoo, Stephen; Chang, Yeon-Jeen; Peiper, David; Frikker, Mark J; Bouwman, David L; Silbergleit, Allen; Lloyd, Larry R; Mittal, Vijay K

2009-09-01

The Southeast Michigan Center for Medical Education (SEMCME) is a consortium of teaching hospitals in the Greater Detroit metropolitan area. SEMCME pools its resources for several educational means, including mock oral board examinations. The educational and cost benefits to mock oral examinations on a multi-institutional basis in preparation for the American Board of Surgery (ABS) certifying examination were analyzed. Ten-year multi-institution data from the mock oral examinations were correlated with ABS certifying examination pass rates. Mock oral examination scores were available for 107 of 147 graduates, which included 12 candidates who failed their certifying examination on the first attempt (pass rate = 89%). Four of 31 examinees who had a low score (4.9 or less) in their mock oral exams failed their certifying examination in their first attempt. The cost of running the mock examination was low (approximately $35/resident for 50 residents). When graduates from the last 10 years were surveyed, the majority of respondents believed that the mock oral examination helped in their success and with their preparation for the certifying examination. Thus, the many benefits of administering the examination with the resources of a consortium of hospitals result in the accurate reproduction of real-life testing conditions with reasonable overall costs per resident.

Is There a Role for Oral Antibiotic Preparation Alone Before Colorectal Surgery? ACS-NSQIP Analysis by Coarsened Exact Matching.

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Garfinkle, Richard; Abou-Khalil, Jad; Morin, Nancy; Ghitulescu, Gabriela; Vasilevsky, Carol-Ann; Gordon, Philip; Demian, Marie; Boutros, Marylise

2017-07-01

Recent studies demonstrated reduced postoperative complications using combined mechanical bowel and oral antibiotic preparation before elective colorectal surgery. The aim of this study was to assess the impact of these 2 interventions on surgical site infections, anastomotic leak, ileus, major morbidity, and 30-day mortality in a large cohort of elective colectomies. This is a retrospective comparison of 30-day outcomes using the American College of Surgeons National Surgical Quality Improvement Program colectomy-targeted database with coarsened exact matching. Interventions were performed in hospitals participating in the national surgical database. Adult patients who underwent elective colectomy from 2012 to 2014 were included. Preoperative bowel preparations were evaluated. The primary outcomes measured were surgical site infections, anastomotic leak, postoperative ileus, major morbidity, and 30-day mortality. A total of 40,446 patients were analyzed: 13,219 (32.7%), 13,935 (34.5%), and 1572 (3.9%) in the no-preparation, mechanical bowel preparation alone, and oral antibiotic preparation alone groups, and 11,720 (29.0%) in the combined preparation group. After matching, 9800, 1461, and 8819 patients remained in the mechanical preparation, oral antibiotic preparation, and combined preparation groups for comparison with patients without preparation. On conditional logistic regression of matched patients, oral antibiotic preparation alone was protective of surgical site infection (OR, 0.63; 95% CI, 0.45-0.87), anastomotic leak (OR, 0.60; 95% CI, 0.34-0.97), ileus (OR, 0.79; 95% CI, 0.59-0.98), and major morbidity (OR, 0.73; 95% CI, 0.55-0.96), but not mortality (OR, 0.32; 95% CI, 0.08-1.18), whereas a regimen of combined oral antibiotics and mechanical bowel preparation was protective for all 5 major outcomes. When directly compared with oral antibiotic preparation alone, the combined regimen was not associated with any difference in any of the 5 postoperative

Characterizing scientific production of Italian Oral Surgery professionals through evaluation of bibliometric indices.

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Tetè, Stefano; Zizzari, Vincenzo Luca; De Carlo, Alessandro; Lorusso, Felice; Di Nicola, Marta; Piattelli, Adriano; Gherlone, Enrico; Polimeni, Antonella

2014-01-01

The aim of this study was to characterize the scientific production of Italian Oral Surgery professionals by evaluating different bibliometric indices. The bibliometric evaluation was conducted on the Scopus Database upon all the Active Members joining three important Italian scientific societies in Oral Surgery (SIdCO, SIO, and SICOI). The scientific production was analysed by considering the number of total publications, number of total citations, h-index, and hc-index. Moreover, the overall sample was divided into two groups (Academics and Not Academics), according to the fact the professionals had or not a university position, and then into sub-groups according to the different career lengths. Statistical analyses were performed to compare the scientific productivity amongst groups. For all the considered parameters a lack of homogeneity between groups was reported, and significantly greater mean values were recorded for the Academics compared to the Not Academics Group. Moreover, the h-index values increased more regularly as the career length progressed than the hc-index values, even if the last seemed to be less variable. h- and hc-indices are both stable bibliometric parameters, but as the hc-index values are related not only to the number of citation but also to their age, it seems to be less influenced by the authors' career length. Bibliometric analysis of the scientific production in dentistry may facilitate the recognition of factors that may further enhance research activity and clinical performance and be useful for a comparative assessment of authors or research groups in terms of quality and quantity of the scientific production.

Investigations on the potential of a low power diode pumped Er:YAG laser system for oral surgery

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Stock, Karl; Wurm, Holger; Hausladen, Florian; Wagner, Sophia; Hibst, Raimund

2015-02-01

Flash lamp pumped Er:YAG-lasers are used in clinical practice for dental applications successfully. As an alternative, several diode pumped Er:YAG laser systems (Pantec Engineering AG) become available, with mean laser power of 2W, 15W, and 30W. The aim of the presented study is to investigate the potential of the 2W Er:YAG laser system for oral surgery. At first an appropriate experimental set-up was realized with a beam delivery and both, a focusing unit for non-contact tissue cutting and a fiber tip for tissue cutting in contact mode. In order to produce reproducible cuts, the samples (porcine gingiva) were moved by a computer controlled translation stage. On the fresh samples cutting depth and quality were determined by light microscopy. Afterwards histological sections were prepared and microscopically analyzed regarding cutting depth and thermal damage zone. The experiments show that low laser power ≤ 2W is sufficient to perform efficient oral soft tissue cutting with cut depth up to 2mm (sample movement 2mm/s). The width of the thermal damage zone can be controlled by the irradiation parameters within a range of about 50μm to 110μm. In general, thermal injury is more pronounced using fiber tips in contact mode compared to the focused laser beam. In conclusion the results reveal that even the low power diode pumped Er:YAG laser is an appropriate tool for oral surgery.

Corrective Jaw Surgery

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Full Text Available ... Oral and maxillofacial surgeons. The experts in face, mouth and jaw surgery.™ What We Do Who We ... surgically treat the soft tissues of the face, mouth and gums to improve function, appearance and oral ...

A Randomized Placebo-Controlled Trial of Oral Ramosetron for Prevention of Post Operative Nausea and Vomiting after Intrathecal Morphine in Patients Undergoing Gynecological Surgery.

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Wangnamthip, Suratsawadee; Chinachoti, Thitima; Amornyotin, Somchai; Wongtangman, Karuna; Sukantarat, Numphung; Noitasaeng, Papiroon

2016-05-01

The incidence of postoperative nausea and vomiting (PONV) after intrathecal morphine is high. Ramosetron is a 5-HT₃ antagonist that has been shown to reduce PONV in general anesthesia. The objective of this study was to evaluate the efficacy of Ramosetron in preventing PONV MATERIAL AND METHOD: 165 patients undergoing elective gynecological surgery under spinal anesthesia were randomly allocated to two groups: the Ramosetron group (0.1 mg orally, n = 82), and the placebo group (oral corn starch, n = 83). The incidence of PONV severity of nausea and use of rescue antiemetic during the first 24 hour after surgery were evaluated. The incidence of PONV was significantly lower in the Ramosetron group compared with the placebo group (24.4% vs. 44.6%, number needed to treat (NNT) = 5.0). The severity of nausea was significantly lower in the Ramosetron group compared with the placebo group (20.7% vs. 39.8%, NNT = 6.0) in the 24 hour period. Oral Ramosetron 0.1 mg was more effective than placebo in PONV prevention and reduced the incidence of moderate to severe nausea after intrathecal morphine in the first 24 hour after gynecological surgery.

Diffuse reflectance spectroscopy for optical nerve identification. Preliminary ex vivo results for feedback controlled oral and maxillofacial laser surgery

Science.gov (United States)

Stelzle, Florian; Zam, Azhar; Adler, Werner; Douplik, Alexandre; Tangermann-Gerk, Katja; Nkenke, Emeka; Neukam, Friedrich Wilhelm; Schmidt, Michael

Objective: Laser surgery has many advantages. However, due to a lack of haptic feedback it is accompanied by the risk of iatrogenic nerve damage. The aim of this study was to evaluate the possibilities of optical nerve identification by diffuse reflectance spectroscopy to set the base for a feedback control system to enhance nerve preservation in oral and maxillofacial laser surgery. Materials and Methods: Diffuse reflectance spectra of nerve tissue, skin, mucosa, fat tissue, muscle, cartilage and bone (15120 spectra) of ex vivo pig heads were acquired in the wavelength range of 350-650 nm. Tissue differentiation was performed by principal components analysis (PCA) followed by linear discriminant analysis (LDA). Specificity and sensitivity were calculated by receiver operating characteristic (ROC) analysis and the area under curve (AUC). Results: Nerve tissue could correctly be identified and differed from skin, mucosa, fat tissue, muscle, cartilage and bone in more than 90% of the cases (AUC results) with a specificity of over 78% and a sensitivity of more than 86%. Conclusion: Nerve tissue can be identified by diffuse reflectance spectroscopy with high precision and reliability. The results may set the base for a feedback system to prevent iatrogenic nerve damage performing oral and maxillofacial laser surgery.

Dental student perceptions of oral and maxillofacial surgery as a specialty.

Science.gov (United States)

Jarosz, Krystian F; Ziccardi, Vincent B; Aziz, Shahid R; Sue-Jiang, Shuying

2013-05-01

The specialty of oral and maxillofacial surgery (OMS) encompasses the diagnosis and surgical management of a variety of pathologic, functional, and esthetic conditions of the oral and maxillofacial region. Despite the specialty's prominent role in the field of dentistry, a lack of complete understanding still remains among dental and medical health professionals as to the exact scope and expertise of the oral and maxillofacial surgeon. The present study aimed to analyze a population of dental students' perceptions of OMS as a specialty with respect to treatment rendered, referral patterns, and a general opinion of the specialty as a whole. A survey consisting of 10 multiple-choice questions was compiled and distributed to dental students through an on-line polling service (SurveyMonkey). A total of 5 dental student classes at a single dental school were polled using school-based electronic mail, including the graduating seniors. All answers were kept confidential, and no individual students were identified. The students were not able to retake the survey once completed. The final tallies of the survey results were compiled and submitted for statistical analysis. Statistically significant associations between the year of dental education and student perceptions of OMS were determined. As dental students progress through their undergraduate studies, their perceptions change with regard to the referral of dental implants. Periodontists were found to have statistically significantly greater rates of referral than oral and maxillofacial surgeons from dental students in the fourth year and recent graduates compared with younger dental students from the first, second, and third years for placement of dental implants. Statistically insignificant in terms of a changing dental student perception was the finding that third molar removal was within the domain of the oral and maxillofacial surgeon, as well as the management of cleft lip and palate deformities and mandibular

Which route of antibiotic administration should be used for third molar surgery? A split-mouth study to compare intramuscular and oral intake.

Science.gov (United States)

Crincoli, V; Di Comite, M; Di Bisceglie, M B; Petruzzi, M; Fatone, L; De Biase, C; Tecco, S; Festa, F

2014-01-01

To compare the effectiveness of two different routes of antibiotic administration in preventing septic complications in patients undergoing third molar extraction. Twenty-four healthy patients requiring bilateral surgical removal of impacted mandibular third molars were successfully enrolled for this study. Depth of impaction, angulation, and relationship of the lower third molars with the mandibular branch had to be overlapping on both sides. A split-mouth design was chosen, so each patient underwent both the first and second surgeries, having for each extraction a different antibiotic route of administration. The second extraction was carried out 1 month later. To compare the effects of the two routes of antibiotic administration, inflammatory parameters, such as edema, trismus, pain, fever, dysphagia and lymphadenopathy were evaluated 2 and 7 days after surgery. Side effects of each therapy were evaluated 48 h after surgery. Oral and intramuscular antibiotic therapies overlap in preventing post-operative complications in dental surgery (p>0.05), even if the oral intake, seems to promote the onset of significant gastrointestinal disorders (p=0.003). This study could help dentists in their ordinary practice to choose the right route of antibiotic administration in the third molar surgery. At the same effectiveness, the higher cost and the minor compliance of the patient seem not to justify a routine antibiotic intramuscular therapy, reserving it for patients with gastrointestinal disorders.

Mandibular Reconstruction Using Pectoralis Major Myocutaneous Flap and Titanium Plates after Ablative Surgery for Locally Advanced Tumors of the Oral Cavity

International Nuclear Information System (INIS)

El-Zohairy, M.A.F.; Mostafa, A.; Amin, A.; Abd El-Fattah, H.; Khalifa, Sh.

2009-01-01

The most common indication for mandible resection remains ablative surgery for cancer of the oral cavity and oropharynx. The use of vascularized bone grafts has become state-of-the-art for mandibular reconstruction. However, the high cost of such surgery may not be justified in patients with advanced disease and poor prognosis, or poor performance status. Objective: The purpose of this study was to evaluate outcomes of mandibular reconstruction using titanium plates covered with a pedicled pectoralis major myocutaneous flap after ablative surgery for locally advanced tumors of the oral cavity. Patients and methods: The study involves a total of 33 patients with locally advanced tumors of the oral cavity that were treated over 5 year period (2003-2008) at the National Cancer Institute, Cairo University, Egypt. Mandibular resections were performed for treatment of patients with primary oral cavity tumors invading the mandible followed by mandibular reconstruction using titanium plates covered with a pedicled pectoralis major myocutaneous flap. Results: Of 33 patients, 25 (75.75%) were males and 8 (24.25%) were females. The age ranged from 42 to 70 years (mean 52.3±5.9 years). Tongue cancer was the most common tumor, it affects 17 (51.5%) of the patients, 24 patients received post operative radiation therapy. The flap survival was 100%; partial necrosis of the flap skin was observed in 3 patients. One patient developed wound dehiscence. Oro-cutaneous fistula occurred in 5 patients that closed spontaneously. There were 4 cases of plate failure, one patient experienced plate fracture at 13 months after reconstruction. Three patients developed external plate exposure. All patients achieved good functional and acceptable aesthetic outcome. The overall cause-specific cumulative survival was 72.7% at one year and 56.1% at two years. Conclusions: Titanium plate and pedicled pectoralis major myocutaneous flap is a safe and reliable option for composite mandibular defects

Outbreak of bacterial endocarditis associated with an oral surgery practice: New Jersey public health surveillance, 2013 to 2014.

Science.gov (United States)

Ross, Kathleen M; Mehr, Jason S; Greeley, Rebecca D; Montoya, Lindsay A; Kulkarni, Prathit A; Frontin, Sonya; Weigle, Trevor J; Giles, Helen; Montana, Barbara E

2018-03-01

In October and November 2014, the New Jersey Department of Health received reports of 3 patients who developed Enterococcus faecalis endocarditis after undergoing surgical procedures at the same oral surgery practice in New Jersey. Bacterial endocarditis is an uncommon but life-threatening condition; 3 patients with enterococcal endocarditis associated with a single oral surgery practice is unusual. An investigation was initiated because of the potential ongoing public health risk. Public health officials conducted retrospective surveillance to identify additional patients with endocarditis associated with the practice. They interviewed patients using a standardized questionnaire. An investigative public health team inspected the office environment, interviewed staff, and reviewed medical records. Public health officials identified 15 confirmed patients with enterococcal endocarditis of those patients who underwent procedures from December 2012 through August 2014. Among these patients, 12 (80%) underwent cardiac surgery. One (7%) patient died from complications of endocarditis and subsequent cardiac surgery. Breaches of recommended infection prevention practices were identified that might have resulted in transmission of enterococci during the administration of intravenous sedation, including failure to perform hand hygiene and failure to maintain aseptic technique when performing procedures and handling medications. This investigation highlights the importance of adhering to infection prevention recommendations in dental care settings. No additional patients with endocarditis were identified after infection prevention and control recommendations were implemented. Infection prevention training should be emphasized at all levels of professional dental training. All dental health care personnel establishing intravenous treatment and administering intravenous medications should be trained in safe injection practices. Copyright © 2018 American Dental Association

African Americans in Oral and Maxillofacial Surgery: Factors Affecting Career Choice, Satisfaction, and Practice Patterns.

Science.gov (United States)

Criddle, Thalia-Rae; Gordon, Newton C; Blakey, George; Bell, R Bryan

2017-12-01

There are few data available on the experience of minority surgeons in the field of oral and maxillofacial surgery (OMS). Therefore, the purpose of this study was to 1) explore factors that contribute to African Americans choosing OMS as a career, 2) examine satisfaction among minority oral and maxillofacial surgeons with the residency application and training process, 3) report on practice patterns among minority oral and maxillofacial surgeons, and 4) identify perceived bias for or against minority oral and maxillofacial surgeons in an attempt to aid the efforts of OMS residency organizations to foster diversity. A 19-item survey was sent to 80 OMS practitioners by use of information from the mailing list of the National Society of Oral and Maxillofacial Surgeons, an American Association of Oral and Maxillofacial Surgeons-affiliated organization. All surveys were sent by mail and were followed by a reminder mailing after 8 weeks. Responses returned within 16 weeks were accepted for analysis. Of the 80 mailed surveys, 41 were returned within the 16-week parameter, representing a return rate of 51%. Most of the minority surgeon respondents were married men with a mean age of 60 years who worked as private practitioners. Most respondents practiced on the eastern and western coasts of the United States. Exposure in dental school was the most important factor in selecting OMS as a specialty. Location and prestige were the most important factors in selecting a residency program. Most respondents reported that race did not affect the success of their application to a residency program and did not currently affect the success of their practice. However, 25 to 46% of participants experienced race-related harassment, and 48 to 55% of participants believed there was a bias against African Americans in OMS. Our data suggest that a substantial number of minority oral and maxillofacial surgeons subjectively perceive race-based bias in their career, although it does not

Self-nanoemulsifying drug delivery systems ameliorate the oral delivery of silymarin in rats with Roux-en-Y gastric bypass surgery

Directory of Open Access Journals (Sweden)

Chen CH

2015-03-01

Full Text Available Chun-Han Chen,1,2 Cheng-Chih Chang,1 Tsung-Hsien Shih,2 Ibrahim A Aljuffali,3 Ta-Sen Yeh,4,5 Jia-You Fang6–8 1Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chiayi, 2Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Kweishan, Taoyuan, Taiwan; 3Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; 4Department of Surgery, Chang Gung Memorial Hospital, 5School of Medicine, College of Medicine, 6Pharmaceutics Laboratory, Graduate Institute of Natural Products, 7Chinese Herbal Medicine Research Team, Healthy Aging Research Center, Chang Gung University, 8Research Center for Industry of Human Ecology, Chang Gung University of Science and Technology, Kweishan, Taoyuan, Taiwan Abstract: Roux-en-Y gastric bypass (RYGB is a popular surgery to reduce the body weight of obese patients. Although food intake is restricted by RYGB, drug absorption is also decreased. The purpose of this study was to develop novel self-nanoemulsifying drug delivery systems (SNEDDS for enhancing the oral delivery of silymarin, which has poor water solubility. The SNEDDS were characterized by size, zeta potential, droplet number, and morphology. A technique of RYGB was performed in Sprague-Dawley rats. SNEDDS were administered at a silymarin dose of 600 mg/kg in normal and RYGB rats for comparison with silymarin aqueous suspension and polyethylene glycol (PEG 400 solution. Plasma silibinin, the main active ingredient in silymarin, was chosen for estimating the pharmacokinetic parameters. SNEDDS diluted in simulated gastric fluid exhibited a droplet size of 190 nm with a spherical shape. The nanocarriers promoted silibinin availability via oral ingestion in RYGB rats by 2.5-fold and 1.5-fold compared to the suspension and PEG 400 solution, respectively. A significant double-peak concentration of silibinin was detected for RYGB rats receiving SNEDDS. Fluorescence

Prosthetic Rehabilitation After Fibular Free Flap Surgery of Mandibular Defects in a Patient With Oral Squamous Cell Carcinoma.

Science.gov (United States)

Yoon, Hyung-In

2016-10-01

This report is to present the treatment procedure and clinical considerations of prosthodontic management of a patient who had undergone a partial mandibulectomy and fibular free flap surgery. A 59-year-old man with a squamous cell carcinoma received a partial mandibular resection. Microsurgical reconstruction with a fibular free flap surgery and implant-supported zirconia-fixed prosthesis produced by computer-aided manufacturing led to successful results for the oral rehabilitation of mandibular defects. The implant-supported zirconia-fixed prosthesis can be recommended for use in patients with mandibulectomy and fibular free flaps. Close cooperation between the surgeon and the prosthodontist is mandatory for the satisfaction of the patient.

A retrospective review of outcome and survival following surgery and adjuvant xenogeneic DNA vaccination in 32 dogs with oral malignant melanoma.

Science.gov (United States)

Treggiari, Elisabetta; Grant, Jessica Pauline; North, Susan Margaret

2016-06-01

A xenogeneic DNA vaccination has been licensed for use in dogs with locally controlled stage II and III oral malignant melanoma (OMM). At present, there are limited outcome data for dogs with OMM treated with surgery and immunotherapy. The aim of this study is to retrospectively review the outcome and survival of 32 dogs affected by OMM that were treated with a combination of surgery and the xenogeneic DNA vaccination (with the addition of radiotherapy in some cases) and to determine the influence of surgical margins and delay in receiving vaccination. The overall median survival time (MST) was 335 days (95% CI: 301-540 days), and the overall median progression-free survival (PFS) was 160 days (mean 182 days, 95% CI: 132-232 days). Stage, completeness of surgical margins and delay in administration of the vaccine did not appear to statistically influence survival or PFS, although these results may reflect the low statistical power of the study due to small numbers. Further studies are required to assess whether the addition of any adjuvant treatment to surgery, including immunotherapy, is able to significantly prolong survival in cases of canine oral melanoma.

Evaluation of Laser Speckle Contrast Imaging for the Assessment of Oral Mucosal Blood Flow following Periodontal Plastic Surgery: An Exploratory Study.

Science.gov (United States)

Molnár, Eszter; Molnár, Bálint; Lohinai, Zsolt; Tóth, Zsuzsanna; Benyó, Zoltán; Hricisák, Laszló; Windisch, Péter; Vág, János

2017-01-01

The laser speckle contrast imaging (LSCI) is proved to be a reliable tool in flap monitoring in general surgery; however, it has not been evaluated in oral surgery yet. We applied the LSCI to compare the effect of a xenogeneic collagen matrix (Geistlich Mucograft®) to connective tissue grafts (CTG) on the microcirculation of the modified coronally advanced tunnel technique (MCAT) for gingival recession coverage. Gingival microcirculation and wound fluid were measured before and after surgery for six months at twenty-seven treated teeth. In males, the flap microcirculation was restored within 3 days for both grafts followed by a hyperemic response. During the first 8 days the blood flow was higher at xenogeneic graft comparing to the CTG. In females, the ischemic period lasted for 7-12 days depending on the graft and no hyperemic response was observed. Females had more intense and prolonged wound fluid production. The LSCI method is suitable to capture the microcirculatory effect of the surgical intervention in human oral mucosa. The application of xenogeneic collagen matrices as a CTG substitute does not seem to restrain the recovery of graft bed circulation. Gender may have an effect on postoperative circulation and inflammation.

Glycine does not add to the beneficial effects of perioperative oral immune-enhancing nutrition supplements in high-risk cardiac surgery patients

NARCIS (Netherlands)

Tepaske, Robert; te Velthuis, Henk; Oudemans-van Straaten, Heleen M.; Bossuyt, Patrick M. M.; Schultz, Marcus J.; Eijsman, Leon; Vroom, Margreeth

2007-01-01

Background: Elderly patients and patients with a poor cardiac function have increased morbidity rates when undergoing cardiac surgery. The aim of this study was to determine whether addition of glycine to a standard preoperative oral immune-enhancing nutrition supplement (OIENS) improves outcome.

[Present situation and prospect of enhanced recovery after surgery in pancreatic surgery].

Science.gov (United States)

Feng, Mengyu; Zhang, Taiping; Zhao, Yupei

2017-05-25

Enhanced recovery after surgery is a multimodal perioperative strategy according to the evidence-based medicine and multidisciplinary collaboration, aiming to improve the restoration of functional capacity after surgery by reducing surgical stress, optimal control of pain, early oral diet and early mobilization. Compared with other sub-specialty in general surgery, pancreatic surgery is characterized by complex disease, highly difficult procedure and more postoperative complications. Accordingly, pancreatic surgery shares a slow development in enhanced recovery after surgery. In this review, the feasibility, safety, application progress, prospect and controversy of enhanced recovery after surgery in pancreatic surgery are discussed.

What Surgical Education the Speciality Offers? Perception of Role of Oral and Maxillofacial Surgery by 1200 Healthcare Professionals, Students and the General Public in Hyderabad, India.

Science.gov (United States)

Vadepally, Ashwant Kumar; Sinha, Ramen

2018-06-01

To investigate the perception of Oral and maxillofacial surgery by healthcare professionals, students and general public. A questionnaire form was created that listed ten clinical situations, and given by hand to 1200 individuals, divided into six groups: group 1, medical professionals; group 2, Specialties of dentistry; group 3, general dentists; group 4, medical students; group 5, dental students; and group 6, general public, each comprising 200 individuals. Respondents were asked to indicate who they would expect to treat them if they had one of the specified conditions listed in the questionnaire. We present the results and current awareness levels of this simple questionnaire. The present study addresses the common issue raised by many authors, 'What surgical education the speciality offers?' especially to medical professionals, medical students and general public to enhance an appropriate referral. Most of the respondents in groups 2, 3 and 5 agreed that specific conditions listed in the questionnaire were within the domain of oral and maxillofacial surgery, but such response was not seen in groups 1, 4 and 6 ( p  oral and maxillofacial surgery was found to be 50.2%. The onus of creating and improving the awareness and perception of our specialty lies on oral and maxillofacial surgeon. Unified efforts at individual as well as global level will help achieve this goal.

Future of bone pathology, bone grafting, and osseointegration in oral and maxillofacial surgery: how applying optical advancements can help both fields

Science.gov (United States)

Tandon, Rahul; Herford, Alan S.

2013-03-01

Introduction: In recent years, advances in technology are propelling the field of oral and maxillofacial surgery into new realms. With a relatively thin alveolar mucosa overlying the underlying bone, significant diagnostic and therapeutic advantages are present. However, there remains an enormous gap between advancements in physics, in particular optics, and oral and maxillofacial surgery. Bone Pathology: Improvements in diagnosis, classification, and treatment of the various bone pathologies are still being sought after as advancements in technology continue to progress. Combining the clinical, histological, and pathological characteristics with these advancements, patients with debilitating pathologies may have more promising treatment options and prognosis. Bone Grafting: Defects in the facial bones, in particular the jaws, may be due to a number of reasons: pathology, trauma, infections, congenital deformities, or simply due to atrophy. Bone grafting is commonly employed to correct such defects, and allows new bone formation through tissue regeneration. Osseointegration: Growing use of dental implants has focused attention on osseointegration and its process. Osseointegration refers to the actual process of the direct contact between bone and implant, without an intervening soft tissue layer. The theories proposed regarding this process are many, yet there lacks a clear, unified stance on the actual process and its mechanisms. Further investigation using optical probes could provide that unifying answer. Conclusion: The primary goal of this lecture is to introduce pioneers in the field of optics to the field of oral and maxillofacial surgery. With a brief introduction into the procedures and techniques, we are hopeful to bridge the ever-widening gap between the clinical science and the basic sciences.

The changes of histological malignancy in recurrent squamous cell carcinoma of oral cavity. Comparison between surgery and radiotherapy

International Nuclear Information System (INIS)

Nakazawa, Mitsuhiro; Iwai, Souichi; Tamura, Hiroshi; Moriga, Shigeru; Uekusa, Yasuhiro; Hasina, R.; Sakuda, Masayoshi; Matumura, Tatsushi

1998-01-01

We investigated the difference of histological malignancy between primary lesion and recurrent lesion using malignancy grading system by Lund (Jakobsson) for oral squamous cell carcinomas. Patients were divided into radiation group (20 patients) and surgery group (10 patients). The incidence of patients whose malignancy was increased was 40% in surgery group and 75% in radiation group. The mean points of total malignancy score was increased from 18.8 to 22.0 points (p<0.05) in radiation group while from 18.4 to 18.9 points (ns) in surgery group. In eight factors of grading system, the points of ''appearance'', ''nuclear differentiation'' and ''cellular response'' were significantly increased in radiation group (p<0.05), although there was no significant increase in surgery group. The characteristic changes in recurrent tumor compared with primary tumor were that all four factors for tumor-host relationship became worth in both groups, especially radiation group. It was suggested that resistance of host tissue against tumors was reduced in recurrent tumor and adjacent tissue after initial therapy. (author)

Evaluation of the clinical photographs in the Journal of Oral and Maxillofacial Surgery: from readers' perspectives.

Science.gov (United States)

Wu, Tianfu; Chen, Sulin; Xiong, Xuepeng

2014-03-01

This study was designed to evaluate clinical photographs published in the Journal of Oral and Maxillofacial Surgery (JOMS) and understand the current status of oral and maxillofacial surgery. A total of 1,317 photographs from the JOMS Volume 69 were assessed. These photographs were scored from 1 to 10 for the following parameters: sharpness; depth of field; exposure; composition; color or grayscale; background; position; distortion; label consistency; and white balance. Then, the distributions of scores were analyzed. Each score was compared with the average score. The effects of different subjects; emergency or nonemergency situations; and intraoperative, preoperative, or postoperative conditions on the quality of photographs were analyzed by conducting a nonparametric Kruskal-Wallis test. The total score of each photograph showed a left-skewed distribution, varying from 3 to 10, with an average score of 6.82. Four parameters, including sharpness, depth of field, exposure, and white balance, scored less than the average score. Photographs with an intraoral subject yielded the lowest score, with a significant difference (P photographs taken during a nonemergency situation was significantly higher than that during an emergency situation (6.84 vs 6.03; P Photographs of an intraoperative condition yielded a score significantly lower than those of pre- and postoperative conditions (6.53 vs 7.11 and 6.75, respectively; P photographs (148 of 325) displayed uncovered eyes and 57.1% of specimens (40 of 70) did not appear with a plotting scale. Sharpness, depth of field, exposure, and white balance should be considered to a greater extent than the other parameters when oral and maxillofacial photographs are taken, particularly for intraoral conditions, emergency situations, and intraoperative conditions. Enhanced parameters and protection of a patient's identity may significantly improve the average level of photographic quality. Crown Copyright © 2014. Published by

Treatment of naturally occuring hemangiopericytoma and oral squamous cell carcinoma in dogs using surgery and photodynamic therapy with HPPH as a photosensitizer

Science.gov (United States)

Payne, John T.; McCaw, Dudley L.; Rogers, Kevin J.; Tompson, Robert V.

1995-05-01

Pyropheophorbide-a-hexyl ether (HPPH) is a new photosensitizer for use with photodynamic therapy (PDT) that has shown promise in laboratory animals. PDT, using this drug, is being used to treat canine patients afflicted with hemangiopericytoma and oral squamous cell carcinoma (SCC) at the University of Missouri-Columbia College of Veterinary Medicine. To date, 11 dogs with hemangiopericytoma and 5 dogs with oral SCC have been treated using a combination of surgery and PDT. Thus far, there have been no serious complications attributable to the treatment. Two dogs have had recurrences of the hemangiopericytoma and there have been no recurrences of SCC with a median follow time of 5 months. Both recurrent hemangiopericytomas were in patients with large tumors that had previous surgery. This study is ongoing and no conclusions have been reached; however several observations are noted. It appears that PDT using HPPH is safe is dogs, and may decrease the recurrence rate of Hemangiopericytomas. In dogs with oral SCC, the treatment is effective is causing necrosis and sloughing of the tumor tissue, and recurrences have not been noted on follow-ups up to 6 months.

Towards virtual surgery in oral cancer to predict postoperative oral functions preoperatively

NARCIS (Netherlands)

van Alphen, M.J.A.; Kreeft, A.M.; van der Heijden, Ferdinand; Smeele, L.E.; Balm, A.J.M.; Balm, Alfonsus Jacobus Maria

2013-01-01

Our aim was to develop a dynamic virtual model of the oral cavity and oropharynx so that we could incorporate patient-specific factors into the prediction of functional loss after advanced resections for oral cancer. After a virtual resection, functional consequences can be assessed, and a more

Diode laser surgery versus scalpel surgery in the treatment of fibrous hyperplasia: a randomized clinical trial.

Science.gov (United States)

Amaral, M B F; de Ávila, J M S; Abreu, M H G; Mesquita, R A

2015-11-01

Fibrous hyperplasia is treated by surgical incision using a scalpel, together with removal of the source of chronic trauma. However, scalpel techniques do not provide the haemostasis that is necessary when dealing with highly vascular tissues. Diode laser surgery can be used in the management of oral tissues due to its high absorption by water and haemoglobin, and has provided good results in both periodontal surgery and oral lesions. The aim of the present study was to compare the effects of diode laser surgery to those of the conventional technique in patients with fibrous hyperplasia. A randomized clinical trial was performed in which surgical and postoperative evaluations were analyzed. On comparison of the laser-treated (study group) patients to those treated with a scalpel (control group), significant differences were observed in the duration of surgery and the use of analgesic medications. Over a 3-week period, clinical healing of the postoperative wound was significantly faster in the control group as compared to the study group. In conclusion, diode laser surgery proved to be more effective and less invasive when compared to scalpel surgery in the management of fibrous hyperplasia. However, wound healing proved to be faster when using scalpel surgery. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Outcome following curative-intent surgery for oral melanoma in dogs: 70 cases (1998-2011).

Science.gov (United States)

Tuohy, Joanne L; Selmic, Laura E; Worley, Deanna R; Ehrhart, Nicole P; Withrow, Stephen J

2014-12-01

To evaluate the outcome in terms of progression-free interval (PFI) and overall survival time (ST) after curative-intent resection of oral melanoma in dogs. Retrospective case series. 70 client-owned dogs. An electronic medical record search and review was performed for dogs that underwent curative-intent resection of oral melanoma (May 1, 1998, to December 31, 2011). Information gathered included signalment, oral location of tumor, staging results, type of surgery, type of adjuvant therapy, findings on histologic evaluation, and outcome. 36 (51.4%), 16 (22.9%), 13 (18.6%), and 1 (1.4%) of 70 dogs had tumors classified as stage I, II, III, and IV, respectively; tumor stage could not be determined for 4 (5.7%) dogs because of the lack of tumor size information. Fifty-one (72.9%) dogs had tumors completely excised. Twenty-nine (41.4%) dogs received adjuvant therapy. Median PFI and ST were 508 and 723 days, respectively. Thirty-two (45.7%) dogs had disease progression. Significant associations with PFI or ST were found for administration of adjuvant therapy, presence of metastatic disease at the time of diagnosis, higher tumor stage (III or IV), increased tumor size (> 3 cm), and sexually intact female dogs. Administration of adjuvant treatment was associated with a 130% increased hazard (hazard ratio, 2.3; 95% confidence interval [CI], 1.0 to 5.0) of disease progression; the presence of metastases at the time of diagnosis was associated with a 281% increased hazard (hazard ratio, 3.8; 95% CI, 1.5 to 9.6) of death. Results indicated that dogs with oral melanoma can have a long PFI and ST after resection with wide margins.

Clinical outcomes for T1-2N0-1 oral tongue cancer patients underwent surgery with and without postoperative radiotherapy

International Nuclear Information System (INIS)

Shim, Su Jung; Cha, Jihye; Koom, Woong Sub; Kim, Gwi Eon; Lee, Chang Geol; Choi, Eun Chang; Keum, Ki Chang

2010-01-01

The aim of this study was to assess the results of curative surgery with and without radiotherapy in patients with T 1-2 N 0-1 oral tongue squamous cell carcinoma (OSCC) and to evaluate survival and prognostic factors. Retrospective analysis of 86 patients with T 1-2 N 0-1 OSCC who received surgery between January 2000 and December 2006. Fourteen patients (16.3%) received postoperative radiotherapy (PORT). Patient characteristics, tumor characteristics, treatment modality, failure patterns, and survival rates were analyzed. The median follow-up was 45 months. The five-year overall survival (OS) and disease-free survival (DFS) rates were 80.8% and 80.2%, respectively. Higher tumor grade and invasion depth ≥ 0.5 cm were the significant prognostic factors affecting five-year OS and DFS (OS rate; 65% vs. 91%, p = 0.001 for grade; 66% vs. 92%, p = 0.01 for invasion depth: DFS rate; 69% vs. 88%, p = 0.005 for grade; 66% vs. 92%, p = 0.013 for invasion depth). In the risk group, there was no local failure in patients with postoperative radiotherapy. In T 1-2 N 0-1 OSCC, factors that affected prognosis after primary surgery were higher tumor grade and deep invasion depth over 0.5 cm. Postoperative radiotherapy should be considered in early oral tongue cancer patients with these high-risk pathologic features

Oral and maxillofacial surgery residents have poor understanding of biostatistics.

Science.gov (United States)

Best, Al M; Laskin, Daniel M

2013-01-01

The purpose of this study was to evaluate residents' understanding of biostatistics and interpretation of research results. A questionnaire previously used in internal medicine residents was modified to include oral and maxillofacial surgery (OMS) examples. The survey included sections to identify demographic and educational characteristics of residents, attitudes and confidence, and the primary outcome-knowledge of biostatistics. In 2009 an invitation to the Internet survey was sent to all 106 program directors in the United States, who were requested to forward it to their residents. One hundred twelve residents responded. The percentage of residents who had taken a course in epidemiology was 53%; biostatistics, 49%; and evidence-based dentistry, 65%. Conversely, 10% of OMS residents had taken none of these classes. Across the 6-item test of knowledge of statistical methods, the mean percentage of correct answers was 38% (SD, 22%). Nearly half of the residents (42%) could not correctly identify continuous, ordinal, or nominal variables. Only 21% correctly identified a case-control study, but 79% correctly identified that the purpose of blinding was to reduce bias. Only 46% correctly interpreted a clinically unimportant and statistically nonsignificant result. None of the demographic or experience factors of OMS residents were related to statistical knowledge. Overall, OMS resident knowledge was below that of internal medicine residents (Pbiostatistics and the interpretation of research and are thus unprepared to interpret the results of published clinical research. Residency programs should include effective biostatistical training in their curricula to prepare residents in evidence-based dentistry. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Head, Neck, and Oral Cancer

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Full Text Available ... Oral and maxillofacial surgeons. The experts in face, mouth and jaw surgery.™ What We Do Who We ... surgically treat the soft tissues of the face, mouth and gums to improve function, appearance and oral ...

Dissociated incretin response to oral glucose at 1 year after restrictive vs. malabsorptive bariatric surgery

DEFF Research Database (Denmark)

Guldstrand, M; Ahrén, B; Näslund, E

2009-01-01

AIM: Compare the response to oral glucose of the two incretin hormones, glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) at 1 year after restrictive vs. malabsorptive bariatric surgery. METHODS: Vertical banded gastroplasty (VBG, n = 7) or jejunoileal bypass...... (JIB, n = 5) was performed in 12 women, aged 26-39 years, with severe obesity [body mass index (BMI) 46.6 +/- 2.3 kg/m(2)]. After 1 year, 75 g glucose was administered and plasma levels of glucose, insulin, GIP and GLP-1 were determined regularly during the following 2 h. RESULTS: At 1 year after...

Ethical issues in instructions to authors of journals in oral-craniomaxillofacial/facial plastic surgery and related specialties.

Science.gov (United States)

Pitak-Arnnop, Poramate; Bauer, Ute; Dhanuthai, Kittipong; Brückner, Martin; Herve, Christian; Meningaud, Jean-Paul; Hemprich, Alexander

2010-12-01

Ethical standards of biomedical publications are associated with editorial leadership, such as contents of instructions to authors and journal's mechanisms for research and publication ethics. To compare ethical issues in the guidelines for authors in oral-craniomaxillofacial/facial plastic surgery (OCM-FPS) journals with those in plastic surgery and otorhinolaryngology/head and neck surgery (ORL-HNS) journals, and to evaluate the relationship between journal's impact factor (IF) and ethical issues in the instructions to authors. This study used a cross-sectional study design. The predictor variables were journal's specialty and IF. The outcome variable was the presence of seven ethical issues in the online versions of journal's instructions to authors in October 2009. We included only journals with identifiable IF for 2008, published in English, French, German and Thai. Appropriate descriptive and univariate statistics were computed for all study variables. The level of statistical significance was set at Pjournals: seven OCM-FPS (14.6%), 14 plastic surgery (29.2%) and 27 ORL-HNS (56.2%) journals. Only four journals (8.3%) mentioned all ethical issues in their guidelines for authors. Neither journal's specialty nor IF was linked to completeness of the ethical requirements. The results of this study suggest that ethical issues in the instructions to authors of most IF-indexed journals in OCM-FPS, plastic surgery and ORL-HNS are incomplete, regardless of specialty and IF. There is room for substantial improvement to uphold scientific integrity of these surgical specialties. Copyright © 2010 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Effects of intraoperative administration of carbohydrates during long-duration oral and maxillofacial surgery on the metabolism of carbohydrates, proteins, and lipids.

Science.gov (United States)

Yamamoto, Toru; Yoshida, Mitsuhiro; Watanabe, Seiji; Kawahara, Hiroshi

2015-12-01

Insulin resistance in patients undergoing invasive surgery impairs glucose and lipid metabolism and increases muscle protein catabolism, which may result in delayed recovery and prolonged hospital stay. We examined whether intraoperative administration of carbohydrates during long-duration oral and maxillofacial surgery under general anesthesia affects carbohydrate, proteins, and lipid metabolism and the length of hospital stay. We studied 16 patients with normal liver, kidney, and endocrine functions, and ASA physical status I or II, but without diabetes. Patients were randomly assigned to receive 0.1 g/kg/h of (n = 8) or lactated Ringer's solution (n = 8). Blood was collected before (T0) and 4 h after (T1) the start of surgery. We analyzed the plasma levels of glucose, ketone bodies, 3-methylhistidine (3-MH), and the length of hospital stay. At T0, no statistically significant differences were observed in the levels of glucose, ketone bodies, and 3-MH between the groups. At T1, no statistically significant difference in glucose levels was found between the groups. However, ketone bodies were significantly lower, and the changes in 3-MH levels were significantly less pronounced in the glucose-treated group compared with controls. No significant differences were observed between the groups in terms of length of hospital stay. The administration of low doses of glucose during surgery was safe, did not cause hyperglycemia or hypoglycemia, and inhibited lipid metabolism and protein catabolism. Additional experiments with larger cohorts will be necessary to investigate whether intraoperative management with glucose facilitates postoperative recovery of patients with oral cancer.

Applications of piezoelectric surgery in endodontic surgery: a literature review.

Science.gov (United States)

Abella, Francesc; de Ribot, Joan; Doria, Guillermo; Duran-Sindreu, Fernando; Roig, Miguel

2014-03-01

Piezosurgery (piezoelectric bone surgery) devices were developed to cut bone atraumatically using ultrasonic vibrations and to provide an alternative to the mechanical and electrical instruments used in conventional oral surgery. Indications for piezosurgery are increasing in oral and maxillofacial surgery, as in other disciplines, such as endodontic surgery. Key features of piezosurgery instruments include their ability to selectively cut bone without damaging adjacent soft tissue, to provide a clear operative field, and to cut without generating heat. Although piezosurgery instruments can be used at most stages of endodontic surgery (osteotomy, root-end resection, and root-end preparation), no published data are available on the effect of piezosurgery on the outcomes of endodontic surgery. To our knowledge, no study has evaluated the effect of piezosurgery on root-end resection, and only 1 has investigated root-end morphology after retrograde cavity preparation using piezosurgery. We conducted a search of the PubMed and Cochrane databases using appropriate terms and keywords related to the use and applications of piezoelectric surgery in endodontic surgery. A hand search also was conducted of issues published in the preceding 2 years of several journals. Two independent reviewers obtained and analyzed the full texts of the selected articles. A total of 121 articles published between January 2000 and December 2013 were identified. This review summarizes the operating principles of piezoelectric devices and outlines the applications of piezosurgery in endodontic surgery using clinical examples. Piezosurgery is a promising technical modality with applications in several aspects of endodontic surgery, but further studies are necessary to determine the influence of piezosurgery on root-end resection and root-end preparation. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Clinical evaluations of complete autologous fibrin glue, produced by the CryoSeal® FS system, and polyglycolic acid sheets as wound coverings after oral surgery.

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Kouketsu, Atsumu; Nogami, Shinnosuke; Yamada-Fujiwara, Minami; Nagai, Hirokazu; Yamauchi, Kensuke; Mori, Shiro; Miyashita, Hitoshi; Kawai, Tadashi; Matsui, Aritsune; Kataoka, Yoshihiro; Satomi, Norihisa; Ezoe, Yushi; Abe, Satoko; Takeda, Yuri; Tone, Takeshi; Hirayama, Bunnichi; Kurobane, Tsuyoshi; Tashiro, Kazuki; Yanagisawa, Yuta; Takahashi, Tetsu

2017-09-01

The CryoSeal ® FS System has been recently introduced as an automated device for the production of complete fibrin glue from autologous plasma, rather than from pool allogenic or cattle blood, to prevent viral infection and allergic reaction. We evaluated the effectiveness of complete autologous fibrin glue and polyglycolic acid (PGA) sheet wound coverings in mucosa defect oral surgery. Postoperative pain, scar contracture, ingestion, tongue dyskinesia, and postoperative bleeding were evaluated in 12 patients who underwent oral (including the tongue) mucosa excision, and received a PGA sheet and an autologous fibrin glue covering. They were compared with 12 patients who received a PGA sheet and commercial allogenic fibrin glue. All cases in the complete autologous fibrin glue group demonstrated good wound healing without complications such as local infection or incomplete cure. All evaluated clinical measures in this group were similar or superior to the commercial allogenic fibrin glue group. Coagulation and adhesion quality achieved with this method was comparable to that with a PGA sheet and commercial fibrin glue. Covering oral surgery wounds with complete autologous fibrin glue produced by an automated device was convenient, safe, and reduced the risk of viral infection and allergic reaction associated with conventional techniques. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Changes in biomarkers of hepatic and renal function after prolonged general anesthesia for oral cancer surgery: A cohort comparison between desflurane and sevoflurane

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I-Hua Lin

2013-12-01

Conclusion: Both desflurane and sevoflurane did not cause clinically significant nephrotoxicity but produced a transient deterioration in liver function after prolonged anesthesia for oral cancer surgery. Sevoflurane was associated with a more severe degree of liver damage than desflurane in this study.

Rapid prototyping modelling in oral and maxillofacial surgery: A two year retrospective study.

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Suomalainen, Anni; Stoor, Patricia; Mesimäki, Karri; Kontio, Risto K

2015-12-01

The use of rapid prototyping (RP) models in medicine to construct bony models is increasing. The aim of the study was to evaluate retrospectively the indication for the use of RP models in oral and maxillofacial surgery at Helsinki University Central Hospital during 2009-2010. Also, the used computed tomography (CT) examination - multislice CT (MSCT) or cone beam CT (CBCT) - method was evaluated. In total 114 RP models were fabricated for 102 patients. The mean age of the patients at the time of the production of the model was 50.4 years. The indications for the modelling included malignant lesions (29%), secondary reconstruction (25%), prosthodontic treatment (22%), orthognathic surgery or asymmetry (13%), benign lesions (8%), and TMJ disorders (4%). MSCT examination was used in 92 and CBCT examination in 22 cases. Most of the models (75%) were conventional hard tissue models. Models with colored tumour or other structure(s) of interest were ordered in 24%. Two out of the 114 models were soft tissue models. The main benefit of the models was in treatment planning and in connection with the production of pre-bent plates or custom made implants. The RP models both facilitate and improve treatment planning and intraoperative efficiency. Rapid prototyping, radiology, computed tomography, cone beam computed tomography.

Self-assessment of facial form oral function and psychosocial function before and after orthognathic surgery: A retrospective study

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Narayanan Vinod

2008-01-01

Full Text Available Orthognathic surgery is a well-accepted treatment for patients with skeletal discrepancies. The primary motivation of many patients who seek orthognathic surgery is esthetics and not for correction of functional disability. The treatment is incomplete if the surgeon attempts to correct the physical deformity alone without adequate understanding and regard for the emotional framework. The purpose of this study is aimed at patient′s self-perceptions of facial form oral function and psychosocial function before and after orthognathic surgery. Fifty patients were included in the study, of which 21 were used as control. Twenty-two questions were asked to evaluate the problem in all four areas as mentioned earlier. Each question takes a score from one to five. In group I, the internal consistency of each scale indicates moderate to high internal reliability, ranging from α = 0.71 for general health to α = 0.88 for psychosocial problem. In group II, except for functional problems, the internal consistency of each scale has moderate to high reliability. The psychological wellbeing of an orthognathic surgery patient is enhanced by careful preoperative counseling regarding the expected surgical treatment objectives, the operative course, and the expected postoperative sequelae. Patients who undergo orthognathic surgery readily accept the changes in their postoperative appearance and are satisfied with achieved results.

Clinical outcomes for T1-2N0-1 oral tongue cancer patients underwent surgery with and without postoperative radiotherapy

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Choi Eun

2010-05-01

Full Text Available Abstract Background The aim of this study was to assess the results of curative surgery with and without radiotherapy in patients with T1-2N0-1 oral tongue squamous cell carcinoma (OSCC and to evaluate survival and prognostic factors. Methods Retrospective analysis of 86 patients with T1-2N0-1 OSCC who received surgery between January 2000 and December 2006. Fourteen patients (16.3% received postoperative radiotherapy (PORT. Patient characteristics, tumor characteristics, treatment modality, failure patterns, and survival rates were analyzed. Results The median follow-up was 45 months. The five-year overall survival (OS and disease-free survival (DFS rates were 80.8% and 80.2%, respectively. Higher tumor grade and invasion depth ≥ 0.5 cm were the significant prognostic factors affecting five-year OS and DFS (OS rate; 65% vs. 91%, p = 0.001 for grade; 66% vs. 92%, p = 0.01 for invasion depth: DFS rate; 69% vs. 88%, p = 0.005 for grade; 66% vs. 92%, p = 0.013 for invasion depth. In the risk group, there was no local failure in patients with postoperative radiotherapy. Conclusions In T1-2N0-1 OSCC, factors that affected prognosis after primary surgery were higher tumor grade and deep invasion depth over 0.5 cm. Postoperative radiotherapy should be considered in early oral tongue cancer patients with these high-risk pathologic features.

Efficacy and feasibility of frontozygomatic angle approach for extra oral maxillary nerve block in oral surgery: a descriptive clinical trial.

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Radder, Kiran; Shah, Ashwin; Fatima, Shereen; Kothari, Chaitanya; Zakaullah, Syed; Siddiqua, Aaisha

2014-09-01

Pain control is an integral part of minor oral surgery and maxillary/mandibular nerve blocks have proved promising in achieving the same. Although intra oral techniques of maxillary nerve block are common and are widely used, there are certain inherent disadvantages and potential complications. Less commonly described in the literature, the extra oral techniques have a wide spectrum of indications as well as can be more advantageous than the intra oral approach. This prospective clinical trial is an attempt to evaluate the feasibility and the efficacy of the extra oral frontozygomatic approach to the foramen rotundum to block the maxillary nerve. Sample size was 100 patients and the inclusion criteria were patients of ASA I or II category who needed extraction of a minimum of 4 maxillary teeth in the same quadrant in a single sitting while exclusion criteria were patients with a history of allergy to local anesthesia, medically compromised patients in whom dental extraction was contraindicated. Mean age was 71.9 years and 56 patients were males while 44 were females. Only a single quadrant (first or second) was chosen as the operative site in each patient and local anaesthesia was secured using a 21 gauge 89 mm long spinal needle with frontozygomatic angle approach and the parameters used were pain experienced during the injection, onset of subjective symptoms, time required for the peak effect (objective symptoms), pain during extraction and the duration of anesthesia. All the parameters were expressed as mean values with standard deviations. A successful anesthesia was secured in first attempt in 98 patients while in 2 patients, the procedure had to be repeated owing to the difficulty in reaching the target site. A majority of the patients i.e., 71 % scored 0-2 (no pain) on visual analogue scale (VAS) while only 2 patients experienced a moderate degree of pain. Subjective symptoms were reported in 27.24 s (mean value) and 12.93 s (mean value) in the palate

Overview of surgery for oral cavity cancer in Ontario.

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Eskander, Antoine; Irish, Jonathan; Gullane, Patrick; Gilbert, Ralph; de Almeida, John R; Freeman, Jeremy; Giuliani, Meredith; Urbach, David R; Goldstein, David P

2016-07-01

The pupose of this study was to describe variations in incidence and resection rates of patients with oral cavity squamous cell carcinoma (SCC) in Ontario. All oral cavity SCCs in Ontario between 2003 and 2010 were identified from the Ontario Cancer Registry. Incidence and resection rates along with variations in care were compared by sociodemographic factors and Ontario health regions. The 8-year incidence rates for oral cavity SCC was 21.3 per 100,000 with variations by sex, age group, neighborhood income, and community size. Seventy-four percent of patients underwent an oral cavity cancer resection, of which 91% were at a regional head and neck cancer center. Variations in resection rates existed by region of residence and treatment. Oral cavity cancer incidence rates vary by sex, age, neighborhood income, community size, and health region. Resection rates vary by age and health region. Oral cavity cancer care is highly regionalized in Ontario. © 2015 Wiley Periodicals, Inc. Head Neck 38: 1113-1118, 2016. © 2015 Wiley Periodicals, Inc.

Treatment of oral soft tissues benign tumors using laser

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Crisan, Bogdan; Baciut, Mihaela; Crisan, Liana; Bran, Simion; Rotar, Horatiu; Dinu, Cristian; Moldovan, Iuliu; Baciut, Grigore

2014-01-01

The present study aimed to assess the efficacy and indications of surgical laser therapy in the treatment of oral soft tissues benign tumors compared to classic surgery. A controlled clinical study was conducted in a group of 93 patients presenting various forms of oral soft tissues benign tumors. These patients were examined pre-and postoperatively and the oral benign tumors were measured linearly and photographed. The surgery of laser-assisted biopsy excision of oral benign tumors was carried out using a diode laser device of 980 nm. In patients who received surgical laser treatment, therapeutic doses of laser to biostimulate the operated area were administered on the first day after the surgery. The interventions of conventional excision of oral soft tissues benign tumors consisted in removing them using scalpel. In patients who have received therapeutic doses of laser for biostimulation of the operated area, a faster healing of wound surfaces and tumor bed was observed during the first days after surgery. Two weeks after the surgical treatment, good healing without scarring or discomfort in the area of excision was documented. Surgical treatment of oral soft tissues benign tumors with laser assisted postoperative therapy confirms the benefits of this surgical procedure. A faster healing process of the excision area due to laser biostimulation of low intensity has been observed in patients with surgical laser assisted treatment in the postoperative period.

The application of 3-dimensional printing for preoperative planning in oral and maxillofacial surgery in dogs and cats

OpenAIRE

Winer, JN; Verstraete, FJM; Cissell, DD; Lucero, S; Athanasiou, KA; Arzi, B

2017-01-01

© 2017 The American College of Veterinary Surgeons Objective: To describe the application of 3-dimensional (3D) printing in advanced oral and maxillofacial surgery (OMFS) and to discuss the benefits of this modality in surgical planning, student and resident training, and client education. Study design: Retrospective case series. Animals: Client-owned dogs (n = 28) and cats (n = 4) with 3D printing models of the skulls. Methods: The medical records of 32 cases with 3D printing prior to major ...

Why Is Oral Health Important for Men?

Science.gov (United States)

... chronic pain, loss of function, irreparable facial and oral disfigurement following surgery and even death. More than 8,000 people die each year from oral and pharyngeal diseases. If you use tobacco, it ...

The effect of orthognathic surgery on the temporomandibular joint and oral function: a systematic review.

Science.gov (United States)

Te Veldhuis, E C; Te Veldhuis, A H; Bramer, W M; Wolvius, E B; Koudstaal, M J

2017-05-01

The objective of this systematic review was to examine the effect of orthognathic surgery (OS) on the temporomandibular joint and oral function. Electronic databases were systematically searched for studies published until October 2015. Articles were assessed against predefined inclusion criteria. The included papers were divided into four groups based on the type of OS performed. The following items were recorded: quality of evidence using the Oxford Centre for Evidence-Based medicine (CEBM) criteria, number of patients, presence/absence of controls, mean age at treatment, follow-up time, clinical examination findings, bite force, use of the Helkimo Index and Research Diagnostic Criteria for Temporomandibular Disorders, imaging findings, and patient questionnaire results. A total of 4669 articles were identified; 76 relevant articles were included in the review. These studies assessed a total 3399 patients and 380 controls, with a mean age of 25.4 years. The great variety of OS techniques, examination techniques, diagnostic criteria, and imaging techniques used in the articles studied, as well as the quality of the study designs, made it difficult to compare studies and to draw conclusions. However, looking at the different aspects studied in general, it can be stated that OS seems to have little or no harmful effect on the TMJ and oral function (level of evidence: levels II, III, and IV). Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Augmented reality system for oral surgery using 3D auto stereoscopic visualization.

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Tran, Huy Hoang; Suenaga, Hideyuki; Kuwana, Kenta; Masamune, Ken; Dohi, Takeyoshi; Nakajima, Susumu; Liao, Hongen

2011-01-01

We present an augmented reality system for oral and maxillofacial surgery in this paper. Instead of being displayed on a separated screen, three-dimensional (3D) virtual presentations of osseous structures and soft tissues are projected onto the patient's body, providing surgeons with exact knowledge of depth information of high risk tissues inside the bone. We employ a 3D integral imaging technique which produce motion parallax in both horizontal and vertical direction over a wide viewing area in this study. In addition, surgeons are able to check the progress of the operation in real-time through an intuitive 3D based interface which is content-rich, hardware accelerated. These features prevent surgeons from penetrating into high risk areas and thus help improve the quality of the operation. Operational tasks such as hole drilling, screw fixation were performed using our system and showed an overall positional error of less than 1 mm. Feasibility of our system was also verified with a human volunteer experiment.

[Use and Safety of Preoperative Oral Rehydration Therapy Using a Jelly Type Oral Rehydration Solution].

Science.gov (United States)

Yamada, Tomomi; Mukai, Nobuhiro; Tsuchida, Keiichirou; Hayashi, Kazuko

2015-04-01

Traditionally, perioperative nutritional management centered on fluid therapy, but in recent years, with the spread of enhanced recovery after surgery (ERAS) protocols, the utility of oral rehydration therapy (ORT) has been reported. There are few reports, however, on the safety of using jelly type oral rehydration solutions for ORT. We examined the effects of OS-1 jelly on gastric fluid and investigated its safety. A total of 147 patients (age range, 4-91 years), scheduled for elective surgery at our institution for whom ORT was indicated, were enrolled in this study. If the surgery was scheduled for the morning, patients were given two bottles of 200 g OS-1 jelly during the previous evening meal. If surgery was scheduled for the afternoon, two additional 200 g bottles were given to the patient with the morning meal on the day of surgery. Patients were allowed to drink water until two hours before the surgery. Gastric fluid was aspirated with a gastric tube after anesthesia induction, after which, volume and pH were measured. In all cases, gastric content was aspirated as a liquid, not a jelly. The volume and pH were 11.4 ± 14.6 ml and 2.8 ± 2.2, respectively. No major difference was seen in comparison with the data for OS-1 liquid. No postoperative aspiration pneumonia or reflux of gastric contents at the time of anesthesia induction was seen in any of the patients. From the present findings, if the time of water intake is strictly controlled, preoperative rehydration therapy using jelly-type oral rehydration solution is thought to be safe and comparable to liquid solution regarding its effects on gastric fluid.

Corrective Jaw Surgery

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Evaluation of Fibrin Sealants and Tissue Adhesives in Oral Surgery for Patients with Bleeding Disorders

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Gülsüm Ak

2012-03-01

Full Text Available OBJECTIVE: The aim of this study was to evaluate the efficiency of two local haemostatic agents administered together with preoperative dose of replacement therapy for oral surgical procedures in patients with bleeding disorders METHODS: Twenty-one patients were divided into three groups randomly. Patients in Group 1 (n=7 received preoperative replacement therapy with postoperative fibrin sealant application in the surgical site. Patients in Group 2 (n=7 received preoperative replacement therapy with postoperative tissue adhesive application in the surgical site. Patients in Group 3 (n=7 were given total dose of replacement therapy pre- and postoperatively. RESULTS: No postoperative bleeding was observed in 17 patients including five patients in Group 1 (71.42%, six patients in Group 2 (85.71% and six patients in Group 3 (85.71%. Haemorrhagic complication was observed in only four patients among all groups. CONCLUSION: We conclude that utilization of fibrin sealants and tissue adhesives in oral surgery is beneficial due to the lessened amount of factor concentrates used for replacement therapy and the rapid haemostasis at the operation side to perform serial surgical procedures in the same session.

Canine oral melanoma.

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Bergman, Philip J

2007-05-01

Melanoma is the most common oral malignancy in the dog. Oral and/or mucosal melanoma has been routinely considered an extremely malignant tumor with a high degree of local invasiveness and high metastatic propensity. Primary tumor size has been found to be extremely prognostic. The World Health Organization staging scheme for dogs with oral melanoma is based on size, with stage I = or = 4cm tumor and/or lymph node metastasis, and stage IV = distant metastasis. Median survival times for dogs with oral melanoma treated with surgery are approximately 17 to 18, 5 to 6, and 3 months with stage I, II, and III disease, respectively. Significant negative prognostic factors include stage, size, evidence of metastasis, and a variety of histologic criteria. Standardized treatments such as surgery, coarse-fractionation radiation therapy, and chemotherapy have afforded minimal to modest stage-dependent clinical benefits and death is usually due to systemic metastasis. Numerous immunotherapeutic strategies have been employed to date with limited clinical efficacy; however, the use of xenogeneic DNA vaccines may represent a leap forward in clinical efficacy. Oral melanoma is a spontaneous syngeneic cancer occurring in outbred, immunocompetent dogs and appears to be a more clinically faithful therapeutic model for human melanoma; further use of canine melanoma as a therapeutic model for human melanoma is strongly encouraged. In addition, the development of an expanded but clinically relevant staging system incorporating the aforementioned prognostic factors is also strongly encouraged.

Efficacy and Safety of Transdermal Buprenorphine versus Oral Tramadol/Acetaminophen in Patients with Persistent Postoperative Pain after Spinal Surgery.

Science.gov (United States)

Lee, Jae Hyup; Kim, Jin-Hyok; Kim, Jin-Hwan; Kim, Hak-Sun; Min, Woo-Kie; Park, Ye-Soo; Lee, Kyu-Yeol; Lee, Jung-Hee

2017-01-01

Control of persistent pain following spinal surgery is an unmet clinical need. This study compared the efficacy and safety of buprenorphine transdermal system (BTDS) to oral tramadol/acetaminophen (TA) in Korean patients with persistent, moderate pain following spinal surgery. Open-label, interventional, randomized multicenter study. Adults with persistent postoperative pain (Numeric Rating Scale [NRS] ≥ 4 at 14-90 days postsurgery) were enrolled. Patients received once-weekly BTDS ( n = 47; 5  μ g/h titrated to 20  μ g/h) or twice-daily TA ( n = 40; tramadol 37.5 mg/acetaminophen 325 mg, one tablet titrated to 4 tablets) for 6 weeks. The study compared pain reduction with BTDS versus TA at week 6. Quality of life (QoL), treatment satisfaction, medication compliance, and adverse events (AEs) were assessed. At week 6, both groups reported significant pain reduction (mean NRS change: BTDS -2.02; TA -2.76, both P pain following spinal surgery, BTDS is an alternative to TA for reducing pain and supports medication compliance. This trial is registered with Clinicaltrials.gov: NCT01983111.

3D printed optical phantoms and deep tissue imaging for in vivo applications including oral surgery

Science.gov (United States)

Bentz, Brian Z.; Costas, Alfonso; Gaind, Vaibhav; Garcia, Jose M.; Webb, Kevin J.

2017-03-01

Progress in developing optical imaging for biomedical applications requires customizable and often complex objects known as "phantoms" for testing, evaluation, and calibration. This work demonstrates that 3D printing is an ideal method for fabricating such objects, allowing intricate inhomogeneities to be placed at exact locations in complex or anatomically realistic geometries, a process that is difficult or impossible using molds. We show printed mouse phantoms we have fabricated for developing deep tissue fluorescence imaging methods, and measurements of both their optical and mechanical properties. Additionally, we present a printed phantom of the human mouth that we use to develop an artery localization method to assist in oral surgery.

Retrospective examination of the healthcare 'journey' of chronic orofacial pain patients referred to oral and maxillofacial surgery.

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Beecroft, E V; Durham, J; Thomson, P

2013-03-01

To gain a deeper understanding of the clinical journey taken by orofacial pain patients from initial presentation in primary care to treatment by oral and maxillofacial surgery. Retrospective audit. Data were collected from 101 consecutive patients suffering from chronic orofacial pain, attending oral and maxillofacial surgery clinics between 2009 and 2010. Once the patients were identified, information was drawn from their hospital records and referral letters, and a predesigned proforma was completed by a single examiner (EVB). Basic descriptive statistics and non-parametric inferential statistical techniques (Krushal-Wallis) were used to analyse the data. DATA AND DISCUSSION: Six definitive orofacial pain conditions were represented in the data set, 75% of which were temporomandibular disorders (TMD). Individuals within our study were treated in nine different hospital settings and were referred to 15 distinct specialties. The mean number of consultations received by the patients in our study across all care settings is seven (SD 5). The mean number of specialities that the subjects were assessed by was three (SD 1). The sample set had a total of 341 treatment attempts to manage their chronic orofacial pain conditions, of which only 83 (24%) of all the treatments attempted yielded a successful outcome. Improved education and remuneration for primary care practitioners as well as clear care pathways for patients with chronic orofacial pain should be established to reduce multiple re-referrals and improve efficiency of care. The creation of specialist regional centres for chronic orofacial pain may be considered to manage severe cases and drive evidence-based practice.

The 100 Most-Cited Human Cleft Lip and Palate-Related Articles Published in Dentistry, Oral Surgery, and Medicine Journals.

Science.gov (United States)

Christou, Panagiotis; Antonarakis, Gregory S

2015-07-01

To identify the 100 most-cited articles pertaining to human cleft lip and palate research published in dentistry, oral surgery, and medicine journals and to identify their principal bibliometric characteristics. Web-based bibliometric analysis. The Web of Science was searched to identify the 100 most-cited clinical articles related to cleft lip and/or palate. Information was extracted with regard to total number of citations, number of authors, affiliations, year, and journal of publication, Medical Subject Headings, type of study, specific area of study. Trends in citations were assessed. The 100 most-cited articles identified received between 437 and 58 citations. The oldest was published in 1954 and the most recent in 2008. The number of authors ranged from 1 to 12, with an average of three authors per article. Most of the first authors were affiliated with institutions in the United States, with the most prolific institution being the University of Iowa. More than 70% of the studies appeared in The Cleft Palate-Craniofacial Journal. There was a significant negative correlation between average citations per year and time since publication (P research published in dentistry, oral surgery, and medicine journals are listed and characterized. This can be used as a potential knowledge base for specialists in training or to produce relevant knowledge defining the direction of future research.

Managing hip fracture and lower limb surgery in the emergency setting: Potential role of non-vitamin K antagonist oral anticoagulants.

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Fisher, William

2017-06-01

Trauma, immobilization, and subsequent surgery of the hip and lower limb are associated with a high risk of developing venous thrombo-embolism (VTE). Individuals undergoing hip fracture surgery (HFS) have the highest rates of VTE among orthopedic surgery and trauma patients. The risk of VTE depends on the type and location of the lower limb injury. Current international guidelines recommend routine pharmacological thromboprophylaxis based on treatment with heparins, fondaparinux, dose-adjusted vitamin K antagonists and acetylsalicylic acid for patients undergoing emergency HFS; however, not all guidelines recommend pharmacological prophylaxis for patients with lower limb injuries. Non-vitamin K antagonist oral anticoagulants (NOACs) are indicated for VTE prevention after elective hip or knee replacement surgery, but at present are not widely recommended for other orthopedic indications despite their advantages over conventional anticoagulants and promising real-world evidence. In patients undergoing HFS or lower limb surgery, decisions on whether to anticoagulate and the most appropriate anti-coagulation strategy can be guided by weighing the risk of thromboprophylaxis against the benefit in relation to each patient's medical history and age. In addition, the nature and location of the fracture, operating times and times before fracture fixation should be considered. The current review discusses the need for anticoagulation in patients undergoing emergency HFS or lower limb surgery together with the current guidelines and available evidence on the use of NOACs in this setting. Appropriate thromboprophylactic strategies and practical advice on the peri-operative management of patients who present to the Emergency Department on a NOAC before emergency surgery are further outlined.

Corrective Jaw Surgery

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Full Text Available ... We Do Who We Are News Videos Contact Find a Surgeon What We Do Anesthesia Anesthesia Oral ... of sedation and general anesthesia. Click here to find out more. Cleft Lip/Palate and Craniofacial Surgery ...

Peri-operative oral caffeine does not prevent postoperative atrial fibrillation after heart valve surgery with cardiopulmonary bypass: A randomised controlled clinical trial.

Science.gov (United States)

Lagier, David; Nee, Laetitia; Guieu, Régis; Kerbaul, François; Fenouillet, Emmanuel; Roux, Nicolas; Giorgi, Roch; Theron, Alexis; Grisoli, Dominique; Gariboldi, Vlad; Collart, Frederic; Bruder, Nicolas; Velly, Lionel; Guidon, Catherine

2018-04-26

Raised plasma levels of endogenous adenosine after cardiac surgery using cardiopulmonary bypass (CPB) have been related to the incidence of postoperative atrial fibrillation (POAF). We wished to assess if caffeine, an adenosine receptor antagonist could have a beneficial effect on the incidence of POAF. A randomised controlled study. Single University Hospital. One hundred and ten patients scheduled for heart valve surgery with CPB. We randomly assigned patients to receive peri-operative oral caffeine (400 mg every 8 h for 2 days) or placebo. Adenosine plasma concentrations and caffeine pharmacokinetic profile were evaluated in a subgroup of 50 patients. The primary endpoint was the rate of atrial fibrillation during postoperative hospital stay. The current study was stopped for futility by the data monitoring board after an interim analysis. The incidence of atrial fibrillation was similar in the caffeine and in the placebo group during hospital stay (33 vs. 29%, P = 0.67) and the first 3 postoperative days (18 vs. 15%; P = 0.60). Basal and postoperative adenosine plasma levels were significantly associated with the primary outcome. Adenosine plasma levels were similar in the two treatment groups. Caffeine administration was associated with a higher incidence of postoperative nausea and vomiting (27 vs. 7%, P = 0.005). Oral caffeine does not prevent POAF after heart valve surgery with CPB but increased the incidence of postoperative nausea and vomiting. ClinicalTrials.gov, no.: NCT01999829.

The Assessment of Oral Microflora Exposed to 3% Ethanolic Extract of Brazilian Green Propolis Preparation Used for Hygiene Maintenance following Minor Oral Surgeries

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Tadeusz Morawiec

2015-01-01

Full Text Available The aim of this study was to investigate the influence of a topically administered hygienic preparation containing a 3% ethanolic extract of Brazilian green propolis (EEP-B on oral microflora spectrum changes in a group of patients who underwent common oral surgery procedures. Two gel samples were compared: the tested gel containing an active ingredient, that is, a 3% EEP-B (gel GA, and a placebo as the negative control (gel GC. The collection of microbiological material included 14 patients requiring surgical extraction of wisdom molars and short endosseous implant installation. Clinical examinations were carried out as follow-up, that is, baseline and after 5-6 weeks’ time. During the first and subsequent assessment, swabs were taken from the mucosal surface. The number of microorganism species was found to have increased following the application of GC gel over the period of 5-6 weeks. This mainly affected Gram-positive rods and bacilli as well as Gram-negative rods. Application of the GA gel enriched with 3% EEP-B caused a profound reduction in the amount of Neisseria spp. and Bifidobacterium spp. strains. Elimination of seven species of microorganisms was observed: Streptococcus acidominimus, Streptococcus oralis, Staphylococcus epidermidis, Veillonella parvula, Bifidobacterium breve, Bifidobacterium longum, and Lactobacillus acidophilus.

Corrective Jaw Surgery

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Full Text Available AAOMS - Oral and maxillofacial surgeons. The experts in face, mouth and jaw surgery.™ What We Do Who ... surgeons surgically treat the soft tissues of the face, mouth and gums to improve function, appearance and ...

Blue diode laser: a new approach in oral surgery?

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Fornaini, Carlo; Merigo, Elisabetta; Selleri, Stefano; Cucinotta, Annamaria

2016-02-01

The introduction of diode lasers in dentistry had several advantages, principally consisting on the reduced size, reduced cost and possibility to beam delivering by optical fibbers. Up today two diode wavelengths, 810 and 980 nm, were the most utilized in oral surgery but recently a new wavelength emitting in the blue had been proposed. The aim of this ex vivo study was to compare the efficacy of five laser wavelengths (450, 532, 808, 1064 and 1340 nm) for the ablation of soft tissues. Specimens were surgically collected from the dorsal surface of four bovine tongues and irradiated by the five different wavelengths. Thermal increase was measured by two thermocouples, the first at a depth of 0.5 mm, and the second at a depth of 2 mm while initial and final surface temperatures were recorded by IR thermometer. The quality of the incision was histologically evaluated by a pathologist by giving a score from 0 to 5. The time necessary to perform the excision varied between 215 seconds (1340 nm, 5W) and 292 seconds (808 nm, 3W). Surface temperature increase was highest for 1340 nm, 5W and lowest for 405 nm, 4 W. The most significant deep temperature increase was recorded by 1340 nm, 5 W and the lowest by 450 nm, 2 W. The quality of incision was better and the thermal elevation lower in the specimens obtained with shortest laser wavelength (450 nm).

Evaluating the effect of preoperative oral gabapentin on ...

African Journals Online (AJOL)

Evaluating the effect of preoperative oral gabapentin on postoperative pain in patients receiving spinal ... Southern African Journal of Anaesthesia and Analgesia ... Group III (n = 30) patients received an oral placebo one hour prior to surgery.

Oral surgery in a patient with cirrhosis and thrombocytopenia: a case report.

Science.gov (United States)

Patel, Seena; Perry, Maureen Munnelly; Spolarich, Ann Eshenaur

2016-01-01

While most oral surgical procedures can be safely performed in an outpatient setting, certain medical conditions may present a higher chance of postoperative complications. In particular, those predisposing the patient to bleeding abnormalities pose a potential risk when performing such treatments. The authors report a case involving full-mouth extractions in a patient with cirrhosis and thrombocytopenia after obtaining a platelet transfusion. A 62-year-old Caucasian female presented to a university special care dental clinic requiring extractions. Her pertinent medical history was remarkable for cirrhosis and thrombocytopenia, with a platelet count of 32,000/uL. Upon medical consultation, the patient was appointed for a prophylactic platelet transfusion. The surgery was rendered uneventfully, and the patient achieved adequate hemostasis without hospitalization. Patients with cirrhosis pose a potential bleeding risk with dental surgical procedures. Pre-operative medical consultation, review of pertinent laboratory values, and prophylactic platelet transfusion allow these patients to be managed safely in an outpatient setting. © 2015 Special Care Dentistry Association and Wiley Periodicals, Inc.

Per-oral endoscopic myotomy: Major advance in achalasia treatment and in endoscopic surgery

Science.gov (United States)

Friedel, David; Modayil, Rani; Stavropoulos, Stavros N

2014-01-01

Per-oral endoscopic myotomy (POEM) represents a natural orifice endoscopic surgery (NOTES) approach to laparoscopy Heller myotomy (LHM). POEM is arguably the most successful clinical application of NOTES. The growth of POEM from a single center in 2008 to approximately 60 centers worldwide in 2014 with several thousand procedures having been performed attests to the success of POEM. Initial efficacy, safety and acid reflux data suggest at least equivalence of POEM to LHM, the previous gold standard for achalasia therapy. Adjunctive techniques used in the West include impedance planimetry for real-time intraprocedural luminal assessment and endoscopic suturing for challenging mucosal defect closures during POEM. The impact of POEM extends beyond the realm of esophageal motility disorders as it is rapidly popularizing endoscopic submucosal dissection in the West and spawning offshoots that use the submucosal tunnel technique for a host of new indications ranging from resection of tumors to pyloromyotomy for gastroparesis. PMID:25548473

Laser ablation in temporomandibular joint disorders and a case report involving an ossifying fibroma: how optics could potentially advance treatments in oral and maxillofacial surgery

Science.gov (United States)

Tandon, Rahul; Stevens, Timothy W.; Stringer, Dale E.; Dean, Jeff S.; Herford, Alan S.

2013-03-01

Introduction: In the field of oral and maxillofacial surgery, there are many applications for lasers and optics. The first part of this manuscript is to discuss laser therapy and garner suggestions on how it can be improved. The second part is to present a case in which complications of a bone graft delayed healing and a return to normalcy for the patient. It is the goal of this paper to utilize the new advancements in optics so that patient care can be improved. Laser Therapy: Laser ablation and low-level laser therapy have been used in a variety of joint adhesion cases, including arthritis of the hand and foot. In the field of oral and maxillofacial surgery, this method has been used to treat pain and mobility dysfunction in patients with temporomandibular joint disease. While the outcomes have been promising, lack of familiarity with the device or doubt about its effects have reduced its use. This reduction in use has left the actual process of laser therapy relatively unchanged. Case Presentation: A 28 year-old female presented for a mandibular resection due to an ossifying fibroma. In the next several months her reconstructed area displayed significant signs of infection, as well as graft failure. X-rays, unfortunately, did not display the actual metabolic activity. Although the patient was reconstructed successfully thereafter, with more advanced technology available the patient could have endured a more comfortable treatment. Conclusion: While there are many more areas of oral and maxillofacial surgery that could potentially benefit from advances in optical technology, we have chosen to highlight these two areas due to their prevalence within our community.

HEAD AND NECK SURGERY

African Journals Online (AJOL)

+/-symptoms and signs), intravenous calcium gluconate and oral calcium lactate is .... facilitated by surgical stress, Vitamin D deficiency and hungry .... recurrence after thyroid surgery, excluding cancer. Chirurgie. ... Crea C, Alesina P, et al.

Preoperative radiochemotherapy and radical surgery in comparison with radical surgery alone

International Nuclear Information System (INIS)

Mohr, C.; Schettler, D.; Bohndorf, W.

1994-01-01

A multicentric, randomized study of squamous cell carcinoma (SCC) of the oral cavity and the oropharynx has been undertaken by DOeSAK. The results after radical surgery alone have been compared with the results of combined preoperative radiochemotherapy followed by radical surgery. Patients with primary (biopsy proven) SCC of the oral cavity or the oropharynx with tumor nodes metastasis (TNM) stages T2-4, N0-3, M0 were included in the study. A total of 141 patients were treated by radical surgery alone, whereas 127 patients were treated by radical surgery preceded by preoperative radiochemotherapy. The pre-operative treatment consisted of conventionally fractioned irradiation on the primary and the regional lymph nodes with a total dose of 36 Gy (5 x 2 Gy per week) and low-dose cisplatin chemotherapy with 5 x 12.5 mg cisplatin per m 2 of body surface during the first week of treatment. Radical surgery according to be DOeSAK definitions (DOeSAK, 1982) was performed after a delay of 10-14 days. During the follow-up period, 28.2% of all patients suffered from locoregional recurrence, and 27.2% of the patients died. The percentages were higher after radical surgery alone for locoregional recurrence (31% and 15.6%) and for death (28% and 18.6%). The life-table analysis showed improved survival rates of 4.5% after 1 year and 8.3% after 2 years in the group of patients treated with combined therapy. The demonstrated improvement appeared to be significant with the Gehan-Wilcoxon test as well as with the log rank test below a P value of 5%. (au) (29 refs.)

Surgical Treatment, Oral Rehabilitation, and Orthognathic Surgery After Failure of Pharmacologic Treatment of Central Giant Cell Lesion: A Case Report.

Science.gov (United States)

Maia Nogueira, Renato Luiz; Osterne, Rafael Lima Verde; Cavalcante, Roberta Barroso; Abreu, Ricardo Teixeira

2016-12-01

Although pharmacologic treatments for central giant cell lesions have gained much emphasis, these treatment modalities do not always have successful outcomes, and surgical treatment may be necessary. The purpose of the present study was to report a case of aggressive central giant cell lesion initially treated by nonsurgical methods without satisfactory results, necessitating segmental mandibular resection for definitive treatment and oral rehabilitation. A 20-year-old woman was diagnosed with an aggressive central giant cell lesion in the mandible. The patient was first treated with intralesional corticosteroid injections. Subsequently, the lesion increased in size. Therefore, a second pharmacologic treatment was proposed with salmon calcitonin nasal spray, but no signs of a treatment response were noted. Because of the lack of response, surgical excision was performed, and a mandibular reconstruction plate was installed. At 12 months after surgical resection, the patient underwent mandibular reconstruction with bone grafts. After 6 months, 7 dental implants were installed, and fixed prostheses were made. After installation of the prostheses, the patient experienced persistent mandibular laterognathism, and a mandibular orthognathic surgery was performed to correct the laterognathia. The follow-up examination 4 years after orthognathic surgery showed no signs of recurrence and good facial symmetry. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Increased ICU resource needs for an academic emergency general surgery service*.

Science.gov (United States)

Lissauer, Matthew E; Galvagno, Samuel M; Rock, Peter; Narayan, Mayur; Shah, Paulesh; Spencer, Heather; Hong, Caron; Diaz, Jose J

2014-04-01

ICU needs of nontrauma emergency general surgery patients are poorly described. This study was designed to compare ICU utilization of emergency general surgery patients admitted to an acute care emergency surgery service with other general surgery patients. Our hypothesis is that tertiary care emergency general surgery patients utilize more ICU resources than other general surgical patients. Retrospective database review. Academic, tertiary care, nontrauma surgical ICU. All patients admitted to the surgical ICU over age 18 between March 2004 and June 2012. None. Six thousand ninety-eight patients were evaluated: 1,053 acute care emergency surgery, 1,964 general surgery, 1,491 transplant surgery, 995 facial surgery/otolaryngology, and 595 neurosurgery. Acute care emergency surgery patients had statistically significantly longer ICU lengths of stay than other groups: acute care emergency surgery (13.5 ± 17.4 d) versus general surgery (8.7 ± 12.9), transplant (7.8 ± 11.6), oral-maxillofacial surgery (5.5 ± 4.2), and neurosurgery (4.47 ± 9.8) (all psurgery patients: acute care emergency surgery 73.4% versus general surgery 64.9%, transplant 63.3%, oral-maxillofacial surgery 58.4%, and neurosurgery 53.1% (all p surgery patients: acute care emergency surgery 10.8% versus general surgery 4.3%, transplant 6.6%, oral-maxillofacial surgery 0%, and neurosurgery 0.5% (all p surgery patients were more likely interhospital transfers for tertiary care services than general surgery or transplant (24.5% vs 15.5% and 8.3% respectively, p surgery (13.7% vs 6.7% and 3.5%, all p surgery and general surgery, whereas transplant had fewer. Emergency general surgery patients have increased ICU needs in terms of length of stay, ventilator usage, and continuous renal replacement therapy usage compared with other services, perhaps due to the higher percentage of transfers and emergent surgery required. These patients represent a distinct population. Understanding their resource needs

Safety and efficacy of transdermal buprenorphine versus oral tramadol for the treatment of post-operative pain following surgery for fracture neck of femur: A prospective, randomised clinical study.

Science.gov (United States)

Desai, Sameer N; Badiger, Santhoshi V; Tokur, Shreesha B; Naik, Prashanth A

2017-03-01

Transdermal buprenorphine, which is used in chronic pain management, has rarely been studied for use in acute pain management. The aim of this study was to compare the safety and efficacy of transdermal buprenorphine patch to oral tramadol for post-operative analgesia, following proximal femur surgeries. Fifty adult patients undergoing surgery for hip fracture under spinal anaesthesia were included in this study. One group (Group TDB) received transdermal buprenorphine 10 mcg/h patch applied a day before the surgery and other group received oral tramadol 50 mg three times a day for analgesia (Group OT). They were allowed to take diclofenac and paracetamol tablets for rescue analgesia. Pain scores at rest, on movement, rescue analgesic requirement and side effects were compared between the groups over 7 days. Chi-square and independent sample t -test were used for categorical and continuous variables, respectively. Resting pain scores and pain on movement were significantly lower in TDB Group on all 7 days starting from 24 h post-operatively. Rescue analgesic requirement was significantly lower in TDB Group compared to OT Group. All the patients needed rescue analgesic in OT Group whereas 68% of the patients needed the same in TDB Group. Incidence of vomiting was less and satisfaction scores were much higher in TDB Group as compared to OT Group (79% vs. 66%, P pain after 24 hours, with fewer side effects when compared to oral tramadol.

Oral chlorhexidine and microbial contamination during endoscopy

DEFF Research Database (Denmark)

Donatsky, Anders Meller; Holzknecht, Barbara Juliane; Arpi, Magnus

2013-01-01

BACKGROUND: One of the biggest concerns associated with transgastric surgery is contamination and risk of intra-abdominal infection with microbes introduced from the access route. The purpose of this study was to evaluate the effect of oral decontamination with chlorhexidine on microbial contamin......BACKGROUND: One of the biggest concerns associated with transgastric surgery is contamination and risk of intra-abdominal infection with microbes introduced from the access route. The purpose of this study was to evaluate the effect of oral decontamination with chlorhexidine on microbial...... contamination of the endoscope. METHODS: In a prospective, randomized, single-blinded, clinical trial the effect of chlorhexidine mouth rinse was evaluated. As a surrogate for the risk of intra-abdominal contamination during transgastric surgery, microbial contamination of the endoscope during upper endoscopy...... microbial contamination of the endoscope, but micro-organisms with abscess forming capabilities were still present. PPI treatment significantly increased CFU and should be discontinued before transgastric surgery....

21 CFR 520.530 - Cythioate oral liquid.

Science.gov (United States)

2010-04-01

... greyhounds or in animals that are pregnant, sick, under stress, or recovering from surgery. Federal law... Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS ORAL DOSAGE FORM NEW ANIMAL DRUGS § 520.530 Cythioate oral liquid. (a...

Functional benefits of implants placed during ablative surgery: A 5-year prospective study on the prosthodontic rehabilitation of 56 edentulous oral cancer patients.

Science.gov (United States)

Wetzels, Jan Willem; Koole, Ron; Meijer, Gert J; de Haan, Anton F J; Merkx, Matthias A W; Speksnijder, Caroline M

2016-04-01

The timing of placement as well as the functional benefit of interforaminal implants in edentulous patients treated for oral cancer is unclear. Fifty-six patients were recruited at 2 institutions. In 1 institution, interforaminal implants were placed during ablative surgery, the other institution used conventional prosthodontics with optional placement of implants postsurgery (postponed-placement). Masticatory performance, bite force, and subjective masticatory function were assessed before and 6 months, 1 year, and 5 years after surgery. Implant-retained overdentures (IODs) demonstrated the highest bite force and the least problems with solid food and food choice. Masticatory performance was equal for IODs and conventional dentures. After 5 years, IODs from patients in the during-ablative-surgery cohort tend to have higher bite force and masticatory performance than those from patients in the postponed-placement cohort. IODs produce the highest overall masticatory function. Implant placement during ablative surgery seems to be functionally beneficial. © 2016 Wiley Periodicals, Inc. Head Neck 38: E2103-E2111, 2016. © 2016 Wiley Periodicals, Inc.

Function after oral oncological intervention, reconstruction and rehabilitation

NARCIS (Netherlands)

Speksnijder, C.M.

2011-01-01

In the Netherlands, the incidence of oral cancer is increasing. Progress in (reconstructive) surgery, radiotherapy and chemotherapy, however, has improved survival and loco-regional control while trying to preserve or restore oral function and quality of life. Despite the progress in treatment,

Sevoflurane-emergence agitation: Effect of supplementary low-dose oral ketamine premedication in preschool children undergoing dental surgery

Directory of Open Access Journals (Sweden)

Khattab Ahmed

2009-01-01

: Adding a low dose of oral ketamine to midazolam-based oral premedication in preschool children undergoing dental surgery reduced sevoflurane-related emergence agitation without delaying discharge.

Harvesting oral mucosa for one-stage anterior urethroplasty

Directory of Open Access Journals (Sweden)

Sanjay Balwant Kulkarni

2014-01-01

Full Text Available Oral mucosa has been the most popular substitute material for urethral reconstructive surgery because it is easy to harvest, is easy to access, has a concealed donor site scar, and obviates most of the problems associated with other grafts. However, the success of using oral mucosa for urethral surgery is mainly attributed to the biological properties of this tissue. Herein, the surgical steps of harvesting oral mucosa from the inner cheek are presented with an emphasis on tips and tricks to render the process easier and more reproducible and to prevent intra and post-operative complications. The following steps are emphasized: Nasal intubation, ovoid shape graft, delicate harvesting leaving the muscle intact, donor site closure and removal of submucosal tissue.

Oral tumors in dogs and cats. II. Prognosis and treatment

International Nuclear Information System (INIS)

Dhaliwal, R.S.; Kitchell, B.E.; Marretta, S.M.

1998-01-01

Small size and rostral location generally are positive prognostic factors for all types of oral tumors.:Standard treatment modalities for oral tumors include surgery, radiation therapy, intralesional matrix cisplatin, photodynamic therapy, and chemotherapy, Investigational therapeutic regimens, such as immunotherapy and gene therapy are not:yet widely available to practicing veterinarians. Surgery and radiation therapy are the-treatments of-choice for oral tumors because these neoplasms are locally aggressive and rarely metastasize. The advent of radical,surgical techniques coupled: with the use of radiation therapy has dramatically: improved survival Fates for dogs with oral tumors. When considered for oral tumors, chemotherapy is always palliative therapy because a complete cure cannot be anticipated with chemotherapy alone. However, using concurrent chemotherapy (as a radiation Sensitizer) and radiation therapy is gaining a lot of interest in clinical research. Part I of this two-part presentation discussed clinical Signs,diagnosis, and histologic types of various oral tumors; Part II reviews prognosis and treatment

CONTINUOUS HOLTER MONITORING OF PATIENTS WITH CARDIOVASCULAR DISEASES IN ORAL SURGERY

Directory of Open Access Journals (Sweden)

Hristo Daskalov

2011-09-01

Full Text Available Introduction. Pain control and anxiety management are important aspects of modern dental treatment. Although many local anesthetics and anesthesia techniques have so far been studied, there is still no clarity as to what anesthetic should be used in cardiovascularly compromised patients. This anesthetic and its dosage should be very carefully chosen to achieve optimal effective pain control; the possible side effects occurring mainly in morbidly compromised patients should also be well studied.Methods. The aim of this study was to study the effect of vasoconstrictors on local anesthetics in 18 patients with heart diseases. The study contingent was recruited from the patients visiting often their general dental practitioners and diagnosed with the following heart diseases: Heart failure (after 6 months; ischemic heart disease, including mild angina pectoris. Articaine was used as local anesthetic. Results. The ST segment on the ECG was used to detect myocardial ischemia and to study the effect of the administered local anesthesia.Conclusion. The study results suggest that pain control in a cardiovascularly compromised patient subjected to oral surgery should be carried out only after thorough analysis is conducted of the specific condition and current status of the patient. Additional hematological tests shoud be done to enable the dentist to build a viable treatment plan.

Applications of navigation for orthognathic surgery.

Science.gov (United States)

Bobek, Samuel L

2014-11-01

Stereotactic surgical navigation has been used in oral and maxillofacial surgery for orbital reconstruction, reduction of facial fractures, localization of foreign bodies, placement of implants, skull base surgery, tumor removal, temporomandibular joint surgery, and orthognathic surgery. The primary goals in adopting intraoperative navigation into these different surgeries were to define and localize operative anatomy, to localize implant position, and to orient the surgical wound. Navigation can optimize the functional and esthetic outcomes in patients with dentofacial deformities by identifying pertinent anatomic structures, transferring the surgical plan to the patient, and verifying the surgical result. This article discusses the principles of navigation-guided orthognathic surgery. Copyright © 2014 Elsevier Inc. All rights reserved.

Current management of oral cancer. A multidisciplinary approach.

Science.gov (United States)

Ord, R A; Blanchaert, R H

2001-11-01

Recent basic science discoveries have contributed to our understanding of the etiology of oral cancer and allowed us to consider innovative approaches to therapy. The authors evaluated and summarized current approaches to the management of oral cancer, emphasizing the multidisciplinary team approach to coordinate surgery, radiation therapy and chemotherapy. Current concepts in management, including complications of therapy, are described. State-of-the-art surgical techniques can spare patients with oral cancer from much of the morbidity and complications common in the past. The refinement of treatment strategies reduces complications and improves efficacy. Many exciting new clinical trials in the areas of gene therapy and immunomodulation are showing promise. Management of oral cancer has undergone radical change in the past 10 years and continues to evolve rapidly. Discoveries in molecular biology, diagnosis, surgery, radiation therapy and medical oncology have altered many traditional concepts and practices. General dental practitioners need to understand current treatment modalities for oral and pharyngeal cancers to determine to whom they should refer patients for the most appropriate treatment, and to make recommendations regarding complications associated with these cancers.

MANAGEMENT OF ORAL LEUKOPLAKIA - ANALYSIS OF THE LITERATURE

Directory of Open Access Journals (Sweden)

Elitsa G. Deliverska

2017-03-01

Full Text Available Oral leukoplakia is the most common potentially malignant disorder affecting oral cavity. Various surgical and non-surgical treatments have been reported, but currently there is no universal consensus on the most appropriate one and on the duration or interval of follow-up of patients with this condition. The aim of this article is to present a review of the management of oral leukoplakia according to the literature until now. Management of oral leukoplakia should begin with elimination of risk factors (if any such as tobacco abuse, betel chewing, alcohol abuse, superimposed candida infection over the lesion etc. Conservative treatment includes use of chemopreventive agents such as vitamins (vitamins A, C, E, fenretinide (Vitamin A analogue, carotenoids (beta-carotene, lycopene, bleomycin, protease inhibitor, anti-inflammatory drugs, green tea, curcuma etc. Surgical treatment includes conventional surgery, electrocoagulation, cryosurgery, and laser surgery (excision or evaporation. The main purpose of oral leukoplakia management is to avoid malignant transformation of the lesion or if this happened to detect this in early stages.

Head, Neck, and Oral Cancer

Medline Plus

Full Text Available ... in face, mouth and jaw surgery.™ What We Do Who We Are News Videos Contact Find a Surgeon What We Do Anesthesia Anesthesia Oral and maxillofacial surgeons are extensively ...

Durvalumab Before Surgery in Treating Patients With Oral Cavity or Oropharynx Cancer

Science.gov (United States)

2017-12-20

Human Papillomavirus Infection; Stage I Oral Cavity Squamous Cell Carcinoma; Stage I Oropharyngeal Squamous Cell Carcinoma; Stage II Oral Cavity Squamous Cell Carcinoma; Stage II Oropharyngeal Squamous Cell Carcinoma; Stage III Oral Cavity Squamous Cell Carcinoma; Stage III Oropharyngeal Squamous Cell Carcinoma; Stage IVA Oral Cavity Squamous Cell Carcinoma; Stage IVA Oropharyngeal Squamous Cell Carcinoma; Stage IVB Oral Cavity Squamous Cell Carcinoma; Stage IVB Oropharyngeal Squamous Cell Carcinoma; Stage IVC Oropharyngeal Squamous Cell Carcinoma

Preparation of patients submitted to thyroidectomy with oral glucose solutions.

Science.gov (United States)

Libiszewski, Michał; Drozda, Rafał; Smigielski, Janusz; Kuzdak, Krzysztof; Kołomecki, Krzysztof

2012-05-01

The AIM OF THE STUDY was to determine postoperative insulin-resistance in patients subject to total thyroidectomy, the prevalence of subjective feelings of hunger immediately before surgery, and the incidence of nausea/vomiting after surgery in patients prepared for elective operations by means of oral glucose solutions. The study group comprised 115 patients, including 71 patients prepared for surgery by means of oral glucose solutions (12.5% glucose) administered 12 and 3 hours before the procedure, at a dose of 800 and 400 ml. The control group comprised 44 patients prepared for surgery by means of the traditional manner- the last meal was served before 2pm the day before the surgical procedure, while fluids before 10pm. Considering both groups, we evaluated glucose and insulin levels three times, as well as determined the insulin-resistance ratio (HOMA-IR) 24 before, and 12 hours and 7 days after surgery. The incidence of nausea and vomiting after surgery, and the subjective feeling of hunger before surgery were also evaluated. Statistically significant differences considering insulin level and HOMA-IR values were observed during the II and III measurements. The glucose and insulin values, and the HOMA-IR insulin-resistance ratio, showed no statistically significant differences during measurement I. No statistically significant glucose level differences were observed during measurements II and III. A significantly greater subjective feeling of hunger before surgery and nausea/vomiting afterwards were observed in the control group. The preparation of patients with oral glucose solutions decreases the incidence of postoperative (thyroidectomy) insulin-resistance, and occurrence of nausea/vomiting during the postoperative period.

Diode Laser Excision of Oral Benign Lesions.

Science.gov (United States)

Mathur, Ena; Sareen, Mohit; Dhaka, Payal; Baghla, Pallavi

2015-01-01

Lasers have made tremendous progress in the field of dentistry and have turned out to be crucial in oral surgery as collateral approach for soft tissue surgery. This rapid progress can be attributed to the fact that lasers allow efficient execution of soft tissue procedures with excellent hemostasis and field visibility. When matched to scalpel, electrocautery or high frequency devices, lasers offer maximum postoperative patient comfort. Four patients agreed to undergo surgical removal of benign lesions of the oral cavity. 810 nm diode lasers were used in continuous wave mode for excisional biopsy. The specimens were sent for histopathological examination and patients were assessed on intraoperative and postoperative complications. Diode laser surgery was rapid, bloodless and well accepted by patients and led to complete resolution of the lesions. The excised specimen proved adequate for histopathological examination. Hemostasis was achieved immediately after the procedure with minimal postoperative problems, discomfort and scarring. We conclude that diode lasers are rapidly becoming the standard of care in contemporary dental practice and can be employed in procedures requiring excisional biopsy of oral soft tissue lesions with minimal problems in histopathological diagnosis.

Water swallow screening test for patients after surgery for head and neck cancer: early identification of dysphagia, aspiration and limitations of oral intake.

Science.gov (United States)

Hey, Christiane; Lange, Benjamin P; Eberle, Silvia; Zaretsky, Yevgen; Sader, Robert; Stöver, Timo; Wagenblast, Jens

2013-09-01

Patients with head and neck cancer (HNC) are at high risk for oropharyngeal dysphagia (OD) following surgical therapy. Early identification of OD can improve outcomes and reduce economic burden. This study aimed to evaluate the validity of a water screening test using increasing volumes postsurgically for patients with HNC (N=80) regarding the early identification of OD in general, and whether there is a need for further instrumental diagnostics to investigate the presence of aspiration as well as to determine the limitations of oral intake as defined by fiberoptic endoscopic evaluation of swallowing. OD in general was identified in 65%, with aspiration in 49%, silent aspiration in 21% and limitations of oral intake in 56%. Despite a good sensitivity, for aspiration of 100% and for limitations of oral intake of 97.8%, the presented water screening test did not satisfactorily predict either of these reference criteria due to its low positive likelihood ratio (aspiration=2.6; limitations of oral intake=3.1). However, it is an accurate tool for the early identification of OD in general, with a sensitivity of 96.2% and a positive likelihood ratio of 5.4 in patients after surgery for HNC.

Interfaces between bariatric surgery and oral health: a longitudinal survey Interface entre cirurgia bariátrica e saúde bucal: estudo longitudinal

Directory of Open Access Journals (Sweden)

Juliane Avansini Marsicano

2011-01-01

Full Text Available PURPOSE: To evaluate oral changes, such as dental caries, periodontal disease, dental wear and salivary flow in bariatric patients. Fifty four obese patients who underwent bariatric surgery were studied before (n=54, up after 3 months (n=24 and 6 months (n=16. METHODS: Indices for evaluating oral conditions were: DMFT, CPI, DWI and salivary flow. OIDP questionnaire was used to assess the impact of oral health on quality of life. ANOVA and Spearman correlation were used (p0.05, presence of periodontal pockets in 50%, 58% and 50% of patients (p>0.05, tooth wear in dentin present in 81.5%, 87.5% and 87.5% before, 3 and 6 months after surgical treatment respectively. There were differences between the three periods for prevalence and severity of dental wear (p = 0.012. Salivary flow was 0.8±0.5 ml/min before surgery, 0.9±0.5 ml/min for 3 months and 1.1±0.5m/min for 6 months (p>0.05. The impact of oral health on quality of life decreased with time after bariatric surgery (p= 0.029. CONCLUSION: The lifestyle changes after bariatric surgery and these changes may increase the severity of pre-existing dental problems. However, these alterations in oral health did not influence the quality of life.OBJETIVO: Avaliar alterações bucais, como cárie dentária, doença periodontal, desgaste dentário e fluxo salivar, em pacientes bariátricos. MÉTODOS: Cinquenta e quatro pacientes obesos, submetidos à cirurgia bariátrica, tiveram suas condições bucais avaliadas antes (n=54, aos 3 meses (n=24 e aos 6 meses (n=16 após a cirurgia bariátrica. Os índices para avaliação das condições bucais foram: CPOD, IPC, IDD e o volume de fluxo salivar. O questionário OIDP foi utilizado para verificar o impacto da saúde bucal na qualidade de vida. ANOVA e correlação de Spearman foram utilizados para análise estatística (p0,05, bolsa periodontal foi encontrada em 50%, 58% e 50% dos pacientes (p>0,05 e o desgaste dentário em dentina em 81,5%, 87,5% e 87

Oral submucous fibrosis: an update

Directory of Open Access Journals (Sweden)

Wollina U

2015-04-01

Full Text Available Uwe Wollina,1 Shyam B Verma,2 Fareedi Mukram Ali,3 Kishor Patil4 1Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany; 2Nirvana Skin Clinic, Vadodara, Gujarat, India; 3Departments of Oral and Maxillofacial Surgery, SMBT Dental College, Sangamner, Maharashtra, India; 4Departments of Oral Pathology and Microbiology, SMBT Dental College, Sangamner, Maharashtra, India Abstract: Oral submucous fibrosis (OSF is a premalignant condition caused by betel chewing. It is very common in Southeast Asia but has started to spread to Europe and North America. OSF can lead to squamous cell carcinoma, a risk that is further increased by concomitant tobacco consumption. OSF is a diagnosis based on clinical symptoms and confirmation by histopathology. Hypovascularity leading to blanching of the oral mucosa, staining of teeth and gingiva, and trismus are major symptoms. Major constituents of betel quid are arecoline from betel nuts and copper, which are responsible for fibroblast dysfunction and fibrosis. A variety of extracellular and intracellular signaling pathways might be involved. Treatment of OSF is difficult, as not many large, randomized controlled trials have been conducted. The principal actions of drug therapy include antifibrotic, anti-inflammatory, and antioxygen radical mechanisms. Potential new drugs are on the horizon. Surgery may be necessary in advanced cases of trismus. Prevention is most important, as no healing can be achieved with available treatments. Keywords: betel nut, betel quid, oral disease, squamous cell carcinoma, tobacco, fibrosis

Validity of Self Completed Health Questionnaire among Oral ...

African Journals Online (AJOL)

Objective of this study is to determine the degree of validity of self completed health questionnaire among oral surgery patient at the Capitol Dental when compared with a structured oral interview. A prospective random selection method was applied using a standardized questionnaire. The cohorts are patients attending ...

Oral symptoms and functional outcome related to oral and oropharyngeal cancer.

Science.gov (United States)

Kamstra, Jolanda I; Jager-Wittenaar, Harriet; Dijkstra, Pieter U; Huisman, Paulien M; van Oort, Rob P; van der Laan, Bernard F A M; Roodenburg, Jan L N

2011-09-01

This study aimed to assess: (1) oral symptoms of patients treated for oral or oropharyngeal cancer; (2) how patients rank the burden of oral symptoms; (3) the impact of the tumor, the treatment, and oral symptoms on functional outcome. Eighty-nine patients treated for oral or oropharyngeal cancer were asked about their oral symptoms related to mouth opening, dental status, oral sensory function, tongue mobility, salivary function, and pain. They were asked to rank these oral symptoms according to the degree of burden experienced. The Mandibular Function Impairment Questionnaire (MFIQ) was used to assess functional outcome. In a multivariate linear regression analyses, variables related to MFIQ scores (p≤0.10) were entered as predictors with MFIQ score as the outcome. Lack of saliva (52%), restricted mouth opening (48%), and restricted tongue mobility (46%) were the most frequently reported oral symptoms. Lack of saliva was most frequently (32%) ranked as the most burdensome oral symptom. For radiated patients, an inability to wear a dental prosthesis, a T3 or T4 stage, and a higher age were predictive of MFIQ scores. For non-radiated patients, a restricted mouth opening, an inability to wear a dental prosthesis, restricted tongue mobility, and surgery of the mandible were predictive of MFIQ scores. Lack of saliva was not only the most frequently reported oral symptom after treatment for oral or oropharyngeal cancer, but also the most burdensome. Functional outcome is strongly influenced by an inability to wear a dental prosthesis in both radiated and non-radiated patients.

Immediate free jejunum transfer for salvage surgery of gastric tube necrosis.

Science.gov (United States)

Umezawa, Hiroki; Matsutani, Takeshi; Ogawa, Rei; Hyakusoku, Hiko

2014-01-01

Gastric tube necrosis after esophagus cancer surgery is a rare but critical situation. Salvage reconstruction of the esophagus remains a challenging procedure for head and neck surgeons. Historically, surgeons have employed a two-stage salvage surgery consisting of debridement followed by reconstruction. While this procedure generates good results, the time to restart oral alimentation is long. The present report describes the case of a 62-year-old male who developed gastric tube necrosis 3 days after undergoing surgery for thoracic-cervical esophageal cancer and immediate reconstruction with the retrosternal gastric pullup technique. He was treated with debridement and simultaneous free jejunum transfer 4 days after the primary surgery. He was able to restart oral alimentation 10 days after the salvage surgery. This rapid return to oral alimentation is a major advantage of the one-stage immediate esophagus salvage reconstruction. Another advantage is the ease of the reconstructive procedure: the absence of scarring and prolonged inflammation, which are disadvantages of the two-stage procedure, meant that recipient vessel selection and anastomosis were uncomplicated. The one-step procedure may be particularly useful in cases where the inflammation is discovered early.

Head, Neck, and Oral Cancer

Medline Plus

Full Text Available ... We Do Who We Are News Videos Contact Find a Surgeon What We Do Anesthesia Anesthesia Oral ... of sedation and general anesthesia. Click here to find out more. Cleft Lip/Palate and Craniofacial Surgery ...

Head, Neck, and Oral Cancer

Medline Plus

Full Text Available ... one of your body's most important early warning systems. Don't ignore any suspicious lumps or sores. ... and maxillofacial surgeon. Oral and maxillofacial surgeons: The experts in face, mouth and jaw surgery Contact Us ...

Freeze-Dried Black Raspberries in Preventing Oral Cancer Recurrence in High-Risk Appalachian Patients Previously Treated With Surgery For Oral Cancer

Science.gov (United States)

2018-03-04

Stage I Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage I Squamous Cell Carcinoma of the Oropharynx; Stage I Verrucous Carcinoma of the Oral Cavity; Stage II Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage II Squamous Cell Carcinoma of the Oropharynx; Stage II Verrucous Carcinoma of the Oral Cavity; Stage III Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage III Squamous Cell Carcinoma of the Oropharynx; Stage III Verrucous Carcinoma of the Oral Cavity; Stage IVA Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVA Squamous Cell Carcinoma of the Oropharynx; Stage IVA Verrucous Carcinoma of the Oral Cavity; Stage IVB Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVB Squamous Cell Carcinoma of the Oropharynx; Stage IVB Verrucous Carcinoma of the Oral Cavity; Stage IVC Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVC Squamous Cell Carcinoma of the Oropharynx; Stage IVC Verrucous Carcinoma of the Oral Cavity; Tongue Cancer

Imaging in oral cancers

International Nuclear Information System (INIS)

Arya, Supreeta; Chaukar, Devendra; Pai, Prathamesh

2012-01-01

Oral cavity squamous cell cancers form a significant percentage of the cancers seen in India. While clinical examination allows direct visualization, it cannot evaluate deep extension of disease. Cross-sectional imaging has become the cornerstone in the pretreatment evaluation of these cancers and provides accurate information about the extent and depth of disease that can help decide the appropriate management strategy and indicate prognosis. Early cancers are treated with a single modality, either surgery or radiotherapy while advanced cancers are offered a combination of surgery, radiotherapy and chemotherapy. Imaging can decide resectability, help plan the precise extent of resection, and indicate whether organ conservation therapy should be offered. Quality of life issues necessitate preservation of form and function and pretreatment imaging helps plan appropriate reconstruction and counsel patients regarding lifestyle changes. Oral cavity has several subsites and the focus of the review is squamous cancers of the gingivobuccal region, oral tongue and retromolar trigone as these are most frequently encountered in the subcontinent. References for this review were identified by searching Medline and PubMed databases. Only articles published in English language literature were selected. This review aims to familiarize the radiologist with the relevant anatomy of the oral cavity, discuss the specific issues that influence prognosis and management at the above subsites, the optimal imaging methods, the role of imaging in accurately staging these cancers and in influencing management. A checklist for reporting will emphasize the information to be conveyed by the radiologist

Oral cavity and lip cancer: United Kingdom National Multidisciplinary Guidelines.

Science.gov (United States)

Kerawala, C; Roques, T; Jeannon, J-P; Bisase, B

2016-05-01

This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. It provides recommendations on the assessment and management of patients with cancer of the oral cavity and the lip. Recommendations • Surgery remains the mainstay of management for oral cavity tumours. (R) • Tumour resection should be performed with a clinical clearance of 1 cm vital structures permitting. (R) • Elective neck treatment should be offered for all oral cavity tumours. (R) • Adjuvant radiochemotherapy in the presence of advanced neck disease or positive margins improves control rates. (R) • Early stage lip cancer can be treated equally well by surgery or radiation therapy. (R).

Perturbation of cobalt 60 radiation doses by metal objects implanted during oral and maxillofacial surgery

International Nuclear Information System (INIS)

Tatcher, M.; Kuten, A.; Helman, J.; Laufer, D.

1984-01-01

The influence on cobalt 60 dose distributions of typical metal parts used in oral and maxillofacial surgery was studied. Relative doses were determined by exposing x-ray films in a polystyrene phantom set-up containing samples of vitallium, titanium, and stainless steel. Optical densities were converted to doses with the aid of sensitometric curves. The results show that for normal incidence there is a 25% to 40% increase in dose at the entrance side of the metal and a 20% to 25% decrease in dose at the exit side. The enhancement effect falls off rapidly and becomes negligible at about 1 mm from the interface. The reduction effect decreases more gradually and is still evident at distances of a few centimeters. These dose perturbations should be taken into account in the planning of radiation therapy for patients in whom metal objects have been implanted

Pattern of online communication in teaching a blended oral surgery course.

Science.gov (United States)

Marei, H F; Al-Khalifa, K S

2016-11-01

To explore the factors that might affect the patterns of interaction amongst dental students that can be found in asynchronous online discussion fora. It is a qualitative study that involved the participation of 71 dental students (42 male and 29 female) who belong to one academic year. Students were participated in asynchronous online discussion fora as a part of a blended oral surgery course that involved both face-to-face lecture and an online learning environment using the Blackboard learning management system. Qualitative analysis of students' pattern of discussion was performed using Transcript Analysis Tool. The total number of postings was 410. Sixty-seven of 71 students participated in the discussion by writing posts, whereas all of the students had accessed all of the postings. A positive correlation between imposing vertical questions and the number of non-referential and referential statements was observed. Regarding horizontal questions, a positive correlation was observed with the number of referential statements, whilst there was a negative correlation with the number of non-referential statements. Asynchronous online discussion fora that are integrated as a part of a whole pedagogical practice may provide an opportunity for promoting learning, especially when consideration is given to the structure of problems, timely feedback by tutors and supportive strategies within the discussion threads. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A multiple-dose, double-blind comparison of intramuscularly and orally administered ketorolac tromethamine and Ketogan in patients with pain following orthopaedic surgery

DEFF Research Database (Denmark)

Gebuhr, Peter Henrik; Soelberg, M; Strauss, W

1994-01-01

combination product containing the narcotic analgesic, ketobemidone, plus a spasmolytic agent) by intramuscular injection every 1-6 h as needed for pain. When patients were able to tolerate an oral diet and were expected to respond to oral analgesic medication, based on overall pain sensitivity, they were...... and at the end of each day. Both treatments were effective immediately after the first dose and during the subsequent multiple-dose phase. There were no statistically significant differences between ketorolac and Ketogan. The results show that 10-mg doses of ketorolac in intramuscular injections followed by 10......In this multiple-dose, double-blind study 100 patients with moderate, severe or very severe pain following orthopaedic surgery were randomly assigned to receive ketorolac, a non-steroidal anti-inflammatory drug with potent analgesic properties (10 mg), or the standard regimen of Ketogan (a...

An audit of the quality of referral letters received by the Department of Oral and Maxillofacial Surgery, Dublin Dental School and Hospital.

LENUS (Irish Health Repository)

Moloney, Justin

2010-10-01

One hundred consecutive referral letters, sent by dental practitioners to the Department of Oral and Maxillofacial Surgery, Dublin Dental School and Hospital, were audited in terms of quality. The audit was based on the Scottish Intercollegiate Guidelines Network (SIGN) recommendations of 1998. The audit demonstrated that in general referral letters required modification and did not give the clinician the required information. This paper sets out the results of the audit and suggests a template that should be used for future referrals.

An audit of the quality of referral letters received by the Department of Oral and Maxillofacial Surgery, Dublin Dental School and Hospital.

LENUS (Irish Health Repository)

Moloney, Justin

2010-11-01

One hundred consecutive referral letters, sent by dental practitioners to the Department of Oral and Maxillofacial Surgery, Dublin Dental School and Hospital, were audited in terms of quality. The audit was based on the Scottish Intercollegiate Guidelines Network (SIGN) recommendations of 1998. The audit demonstrated that in general referral letters required modification and did not give the clinician the required information. This paper sets out the results of the audit and suggests a template that should be used for future referrals.

Malignant tumors of the oral cavity

International Nuclear Information System (INIS)

Henk, J.M.; Langdon, J.D.

1985-01-01

This book discusses carcinomas of the oral cavity including the lymph nodes and salivary glands. Topics include; Epidemiology and etiology; Immunolgical and virological aspects; Basic principles of management; Surgery; Radiotherapy; Chemotherapy; and Cryosurgery

Immediate Oral Rehabilitation of Atrophic Mandible

OpenAIRE

Batista Mendes GC; Padovan LEM; da Silva WS; Ribeiro-Junior PD

2016-01-01

The oral rehabilitation using osseointegrated implants in atrophic mandibles (AM) with severe bone resorption remains a surgical and prosthetic challenge, due to the risk of mandible fracture during implant surgery or under functional loading, paresthesia and pain. A patient with severe atrophic mandible was treated using a 2.0 locking system reconstruction plate combined with dental implants, in immediate loading system. Surgery was performed through intraoral approach and preserving mental ...

Clinical analysis of oral carcinoma treated in the department of otolaryngology, Niigata University Hospital

International Nuclear Information System (INIS)

Sato, Katsuro; Takahashi, Sugata; Tomita, Masahiko; Watanabe, Jun; Matsuyama, Hiroshi

2007-01-01

One hundred and thirty-five sites of oral carcinoma (118 patients) treated in our department during 15 years (1991 to 2005) were clinically analyzed. Multiple carcinomas within the oral cavity arose in 17 sites. In our department, tongue and oral floor were common subsites, followed by buccal mucosa, gingiva, lip, and hard palate. The number of patients increased according to the elevation of clinical stage. Since the subsites and stage characteristics of our department might be due to patients' distribution among medical and dental clinics, correlation of information among medical and dental schools was considered important The significance of multiple malignancies in patients with oral carcinoma was confirmed since multiple malignancies within and outside of the oral cavity occurred at a high rate. The five-year survival rate was 73.8% in tongue carcinoma patients and 58.9% in oral floor carcinoma patients, and the prognosis of patients was fair with positive application of surgery. Since the prognosis of patients without surgery was poor, it is important to consider the treatment strategy for patients who reject surgery and to recommend that they visit a clinic before the tumor advances to an unresectable stage. (author)

Prevalence of oral and parafunctional habits in Nigerian patients ...

African Journals Online (AJOL)

This study was conducted to determine the prevalence of oral and parafunctional habits in Nigerian patients suffering temporomandibular joint pain and dysfunction. It consisted of patients that were referred for treatment at the oral and maxillofacial surgery clinic of the University of Benin Teaching Hospital, Benin City, ...

Nitrousoxide as a conscious sedative in minor oral surgical procedure.

Science.gov (United States)

Mohan, Rakesh; Asir, Vigil Dev; Shanmugapriyan; Ebenezr, Vijay; Dakir, Abu; Balakrishnan; Jacob, Jeffin

2015-04-01

Nitrous oxide (N2O) is the most commonly used inhalation anesthetic in dentistry and is commonly used in emergency centers and ambulatory surgery centers as well. When used alone, it is incapable of producing general anesthesia reliably. However, as a single agent, it has an impressive safety and is excellent for providing minimal and moderate sedation for apprehensive minor oral surgical procedure. In this article, action of N2O in overcoming the anxiety and pain of the patient during the minor oral surgery and its advantages and disadvantages, have been reviewed.

Complications associated with orthognathic surgery

Science.gov (United States)

2017-01-01

While most patients undergo orthognathic surgery for aesthetic purposes, aesthetic improvements are most often followed by postoperative functional complications. Therefore, patients must carefully decide whether their purpose of undergoing orthognathic surgery lies on the aesthetic side or the functional side. There is a wide variety of complications associated with orthognathic surgery. There should be a clear distinction between malpractice and complications. Complications can be resolved without any serious problems if the cause is detected early and adequate treatment provided. Oral and maxillofacial surgeons must have a full understanding of the types, causes, and treatment of complications, and should deliver this information to patients who develop these complications. PMID:28280704

Full-mouth rehabilitation with immediate loading of implants inserted with computer-guided flap-less surgery: a 3-year multicenter clinical evaluation with oral health impact profile.

Science.gov (United States)

Marra, Roberto; Acocella, Alessandro; Rispoli, Alessandra; Sacco, Roberto; Ganz, Scott D; Blasi, Andrea

2013-10-01

The purpose of this report is to present the clinical outcomes and patients' satisfaction of full-mouth rehabilitation using computer-aided flapless implant placement and immediate loading of a prefabricated prosthesis. The study included 30 consecutive fully edentulous patients who received 312 implants. Mandible and maxilla were treated in the same surgical session with computer-guided flapless approach using the NobelGuide protocol. Prefabricated screw-retained fixed prostheses were inserted at the end of surgery. Clinical and radiographic evaluations were assessed at 6, 12, and 36 months. At baseline and 6 months after surgery, patients answered Oral Health Impact Profile in Edentulous Adults questionnaire to assess satisfaction. The implant survival rate was 97.9%, whereas the average marginal bone loss was 1.9 ± 1.3 mm after 3 years. At 6 months, patients showed significantly greater satisfaction with their fixed rehabilitation when compared with conventional dentures. The results of this study confirm that rehabilitation with a prefabricated fixed prosthesis supported by implants placed with NobelGuide protocol is a viable and predictable treatment and increases patients' satisfaction and improves oral health-related quality of life.

Recovery after Orthognathic Surgery: Short-term Health-Related Quality of Life Outcomes

Science.gov (United States)

Blakey, George; Jaskolka, Michael

2008-01-01

Purpose Assess the patient-reported time to recovery for quality of life outcomes: post-surgery sequelae, discomfort/pain, oral function, and daily activities following orthognathic surgery Methods 170 patients (age 14 to 53) were enrolled in a prospective study prior to orthognathic surgery. Each patient was given a 20 item Health-Related Quality of Life instrument (OSPostop) to be completed each post-surgery day (PSD) for 90 days. The instrument was designed to assess patients’ perception of recovery for 4 domains: post-surgery sequelae; discomfort/pain; oral function; and daily activities. Discomfort/pain was recorded with a 7-point Likert-type scale; all other items were measured on a 5-point Likert-type scale. Results Post-surgery sequelae, except swelling, resolved within the first week after surgery for over 75% of the subjects. Discomfort/pain and medication usage persisted for two to three weeks after surgery for most subjects. Return to usual activities, except for recreational activities, which took substantially longer, mirrored the resolution of discomfort/pain. Problems with oral function took the longest to resolve, approximately 6 to 8 weeks for the majority of subjects. Conclusions Comprehensive daily postoperative patient quality of life data provides the orthognathic surgeon with estimated recovery times in distinct domains. This information is vital in the provision of informed consent as well as pre-operative education of patients regarding peri-operative and post-operative expectations. Ultimately this data can be combined with individual risk factors to provide personalized consent and expectations as well as tailor peri-operative and post-operative management regimens. PMID:18848110

Efficacy and safety of oral robenacoxib (tablet) for the treatment of pain associated with soft tissue surgery in client-owned dogs.

Science.gov (United States)

Friton, Gabriele; Thompson, Caryn Marie; Karadzovska, Daniela; King, Stephen; King, Jonathan N

2017-06-26

Non-steroidal anti-inflammatory drugs (NSAIDs) have been proven to be effective in controlling peri-operative pain in dogs. Robenacoxib is an NSAID with high selectivity for the cyclooxygenase (COX)-2 isoform. The objective of this study was to assess the efficacy and safety of an oral tablet formulation of robenacoxib in client-owned dogs undergoing soft tissue surgery. The study was a prospective, multi-center, randomized, masked, placebo-controlled, parallel-group clinical trial. A total of 239 dogs were included and randomly allocated in a 1:1 ratio to receive either robenacoxib or placebo. Each dog received an oral tablet administration of either robenacoxib, at a target dose of 2 mg/kg, or placebo once prior to surgery and for two additional days post-operatively. All dogs also received a pre-anesthetic dose of 0.2 mg/kg butorphanol (intravenous or intramuscular). Pain assessments were performed using the short form of the Glasgow Composite Measure Pain Scale. Robenacoxib was compared to the placebo group on a success/failure basis. Treatment failure was defined as the need for rescue therapy to control post-operative pain. Significantly (P = 0.019) more dogs administered robenacoxib were considered treatment successes (89 of 116, 76.72%) compared to dogs given placebo (74 of 115, 64.35%). The percentage of treatment failure was therefore 23.28% in the robenacoxib and 35.65% in the placebo group. The least squares mean total pain scores were significantly different between groups and in favor of robenacoxib at 3 and 5 hours (P dogs receiving robenacoxib versus placebo (P dogs.

Intravenous or oral administration of vinorelbine in adjuvant chemotherapy with cisplatin and vinorelbine for resected NSCLC

DEFF Research Database (Denmark)

Sorensen, Steffen Filskov; Carus, Andreas; Meldgaard, Peter

2015-01-01

OBJECTIVES: Cisplatin and vinorelbine given intravenously is a well-established adjuvant chemotherapy regimen after surgery for early-stage NSCLC. Vinorelbine can also be administered orally. However, the efficacy of orally administrated vinorelbine in adjuvant treatment of NSCLC is unknown. We...... University Hospital (Denmark) from 2005 to 2012 for adjuvant chemotherapy after surgery for NSCLC. RESULTS AND CONCLUSION: Of the 265 patients included in this study, 126 patients received i.v. and 139 received p.o. vinorelbine/cisplatin. The two groups were comparable with respect to important baseline....... In conclusion we observed that intravenous or oral administration of vinorelbine in combination with cisplatin after surgery for NSCLC appear equally effective in terms of overall and disease-free survival....

Laser treatment of an oral squamous papilloma in a pediatric patient: A case report

Directory of Open Access Journals (Sweden)

Ahmet Ferhat Misir

2013-01-01

Full Text Available Oral squamous papilloma is a benign proliferation of the stratified squamous epithelium, which results in a papillary or verrucous exophytic mass induced by human papilloma virus (HPV. These oral mucosa lesions are most often asymptomatic and have small progression. Laser assisted surgery is common nowadays with several advantages including successful hemostasis, devoid of sutures, wound sterilization and minimal post-operative pain and edema. The aim of this report is to present the oral squamous papilloma in a pediatric patient and its treatment with soft tissue laser. The lesion was excised with diode laser and the healing was uneventful in follow-up visit after one year. Oral squamous papillomas can be found in child′s oral cavity and laser dentistry can be used by dental clinicians to treat these kinds of oral lesions and should be considered as an alternative to conventional surgery.

[Oral maxillofacial-head and neck tumor and holistic integrative medicine].

Science.gov (United States)

Zhang, C P

2017-08-09

The advance of clinical diagnosis and treatment in oral and maxillofacial-head and neck tumors has been through the process of specialization and multidisciplinary cooperation. In most cases, a single discipline cannot meet the requirements of diagnosis and treatment, which needs the cooperation of oral and maxillofacial surgery, otolaryngology and oncology approach and therapeutic method such as surgery, radiotherapy and chemotherapy. Holistic integrative medicine aims at integrating the most effective clinical practice experience and patients' individual situation and prognosis, establishing new medical mode conforming to the modern concept and fulfilling the medical system adapting to the specific characteristics of the diseases.

Nitrousoxide as a conscious sedative in minor oral surgical procedure

Directory of Open Access Journals (Sweden)

Rakesh Mohan

2015-01-01

Full Text Available Nitrous oxide (N 2 O is the most commonly used inhalation anesthetic in dentistry and is commonly used in emergency centers and ambulatory surgery centers as well. When used alone, it is incapable of producing general anesthesia reliably. However, as a single agent, it has an impressive safety and is excellent for providing minimal and moderate sedation for apprehensive minor oral surgical procedure. In this article, action of N 2 O in overcoming the anxiety and pain of the patient during the minor oral surgery and its advantages and disadvantages, have been reviewed.

An innovative virtual reality training tool for orthognathic surgery.

Science.gov (United States)

Pulijala, Y; Ma, M; Pears, M; Peebles, D; Ayoub, A

2018-02-01

Virtual reality (VR) surgery using Oculus Rift and Leap Motion devices is a multi-sensory, holistic surgical training experience. A multimedia combination including 360° videos, three-dimensional interaction, and stereoscopic videos in VR has been developed to enable trainees to experience a realistic surgery environment. The innovation allows trainees to interact with the individual components of the maxillofacial anatomy and apply surgical instruments while watching close-up stereoscopic three-dimensional videos of the surgery. In this study, a novel training tool for Le Fort I osteotomy based on immersive virtual reality (iVR) was developed and validated. Seven consultant oral and maxillofacial surgeons evaluated the application for face and content validity. Using a structured assessment process, the surgeons commented on the content of the developed training tool, its realism and usability, and the applicability of VR surgery for orthognathic surgical training. The results confirmed the clinical applicability of VR for delivering training in orthognathic surgery. Modifications were suggested to improve the user experience and interactions with the surgical instruments. This training tool is ready for testing with surgical trainees. Copyright © 2018 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Relationship between obesity and oral diseases

African Journals Online (AJOL)

2014-04-14

Apr 14, 2014 ... obesity among patients attending a Nigerian oral surgery clinic,[15] but a link ... Data collected include participants' age, sex, and smoking status, highest ..... that the percentage of caries free teeth in older persons was on the ...

Oral pregnancy tumor

Directory of Open Access Journals (Sweden)

Shailesh M Gondivkar

2010-01-01

Full Text Available Pyogenic granuloma is one of the inflammatory hyperplasias seen in the oral cavity. This term is a misnomer because the lesion is unrelated to infection and in reality arises in response to various stimuli such as low-grade local irritation, traumatic injury, or hormonal factors. It predominantly occurs in the second decade of life in young females, possibly because of the vascular effects of female hormones. Clinically, oral pyogenic granuloma is a smooth or lobulated exophytic lesion manifesting as small, red erythematous growth on a pedunculated or sometimes sessile base, which is usually hemorrhagic. Although excisional surgery is the treatment of choice , some other treatment protocols such as the use of Nd:YAG laser, flash lamp pulsed dye laser, cryosurgery, intralesional injection of ethanol or corticosteroids, and sodium tetradecyl sulfate sclerotherapy have been proposed. We present the case of a 25-year-old pregnant woman with large oral pyogenic granuloma.

Bioengineering in the oral cavity: our experience

Directory of Open Access Journals (Sweden)

Catalfamo L

2013-10-01

Full Text Available L Catalfamo,1 E Belli,2 C Nava,1 E Mici,1 A Calvo,1 B D'Alessandro,1 FS De Ponte1 1Unit of Maxillofacial Surgery, University of Messina, Azienda Ospedaliera Universitaria, Policlinico G Martino, Messina, Italy; 2Unit of Maxillofacial Surgery, University Rome Sapienza, Azienda Ospedaliera Sant Andrea, Rome, Italy Background: To date, there are no studies reported in the literature on the possible use of bovine collagen, oxidized regenerated cellulose, or synthetic hyaluronic acid medications in the oral cavity. The aim of this paper is to report the use of bovine collagen, oxidized regenerated cellulose, and synthetic hyaluronic acid medications to improve wound healing in the oral cavity by stimulating granulomatous tissue. Methods: From 2007 to 2011, 80 patients (median age 67 years suffering from oral mucosal lesions participated in this double-blind study. The patients were divided into two groups, each consisting of 40 patients. One group received conventional medications, while the other group of patients were treated with the advanced medications. Results: Advanced medications allowed re-epithelialization of the wound margin in 2–20 days, whereas patients receiving conventional medication showed a median healing duration of 45 days. Conclusion: The results of this study demonstrate that treating oral mucosal wounds with advanced medication has an advantage with regard to wound healing time, allowing patients to have a rapid, functional, and esthetic recovery. Keywords: bioengineering, oral cavity, mucosal recovery

Biologic and clinical aspects of integration of different bone substitutes in oral surgery: a literature review.

Science.gov (United States)

Zizzari, Vincenzo Luca; Zara, Susi; Tetè, Giulia; Vinci, Raffaele; Gherlone, Enrico; Cataldi, Amelia

2016-10-01

Many bone substitutes have been proposed for bone regeneration, and researchers have focused on the interactions occurring between grafts and host tissue, as the biologic response of host tissue is related to the origin of the biomaterial. Bone substitutes used in oral and maxillofacial surgery could be categorized according to their biologic origin and source as autologous bone graft when obtained from the same individual receiving the graft; homologous bone graft, or allograft, when harvested from an individual other than the one receiving the graft; animal-derived heterologous bone graft, or xenograft, when derived from a species other than human; and alloplastic graft, made of bone substitute of synthetic origin. The aim of this review is to describe the most commonly used bone substitutes, according to their origin, and to focus on the biologic events that ultimately lead to the integration of a biomaterial with the host tissue. Copyright © 2016 Elsevier Inc. All rights reserved.

Oral White Lesions: Presentation and Comparison of Oral Submucous Fibrosis with Other Lesions

International Nuclear Information System (INIS)

Maqsood, A.; Aman, N.

2013-01-01

Objective: To compare oral submucous fibrosis with other white oral lesions for presentation and associated factors. Study Design: Cross-sectional study. Place and Duration of Study: The Departments of Oral Medicine and Oral and Maxillofacial Surgery, Dr. Ishrat-ul-Ibad Institute of Oral Health Sciences (DIKIOHS), Karachi, from May 2008 to May 2009. Methodology: Patients presenting with oral white lesions were selected by consecutive non-purposive sampling and clinico-demographic data was collected. For patients with oral submucous fibrosis (OSF), additional information like duration of habits, maximal incisal opening (MIO), presence of any other associated lesion were noted. OSF was compared with other white lesions for any association between characteristic of subjects. Chi-square and independent t-tests for determining the statistical significance at p < 0.05. Results: OSF was present in 59.6% (n = 106) of the 178 patients; other white lesions were 40.4% (n = 72). The mean age of patients with OSF was 34 +- 12.7 years and 45.81 +- 16.2 years in patients with other white lesions, (p < 0.0001). Items containing areca nut were consumed more by patients with OSF, with a significant (p < 0.0001) compared to patients with other white lesions. Conclusion: OSF was the predominant white lesion in patients examined at DIKIOHS. Areca nut was found to be chewed more by patients with OSF and still longer by patients with SCC. (author)

Retromolar trigone--oropharynx junction maligns tumor surgery: transmandibular versus oral approach.

Science.gov (United States)

Cobzeanu, B M; Popescu, Eugenia; Costan, V V; Ungureanu, Didona; Cobzeanu, M D

2015-01-01

This study proposes a new approach to a borderline pathology between Otorhinolaryngology (E.N.T.) and Oral and Maxillofacial Surgery (O.M.F.), the malignant tumors of the oropharyngeal and retromolar trigone junction. 52 cases of retromolar trigone and oropharynx malign tumors were solved in the ENT department of "St. Spiridon" Universitary Hospital Iasi between 2012 and 2014. All patients were males, 35-64 years old, in different TNM stages. The novelty stands in the multidisciplinary approach, with an operating team consisting of both E.N.T. and O.M.F. surgeons, which joined their knowledge and expertise in order to offer a better treatment for the patient. Human Papilloma Virus (HPV) infection has been known as a trigger factor in head and neck cancers. The connection between HPV infection and malignant tumors of the oropharyngeal--retromolar trigone junction, together with the other traditional risk factors (smoking, alcohol, stress and sexual behavior) are involved in the therapeutic protocols, improving the life quality, the survival rate and reducing the treatment costs. Excision of the malignant tumors at the level of the junction between the oropharynx and retromolar trigone often requires repairing the tissular defects that remain using different flaps. Postsurgical mecanotherapy (physiotherapy) under the surveillance of an experienced physiotherapist is also needed for a complete recovery. This therapeutical protocol aims to assure a better life quality for the patients, with a faster postsurgical recovery and social reinsertion by reducing the healing time of the areas affected by inflammation and necrosis generated by the neoplastic process.

Nutrition management in enhanced recovery after abdominal pancreatic surgery.

Science.gov (United States)

Márquez Mesa, Elena; Baz Figueroa, Caleb; Suárez Llanos, José Pablo; Sanz Pereda, Pablo; Barrera Gómez, Manuel Ángel

Multimodal rehabilitation programs are perioperative standardized strategies with the objective of improving patient recovery, and decreasing morbidity, hospital stay and health cost. The nutritional aspect is an essential component of multimodal rehabilitation programs and therefore nutritional screening is recommended prior to hospital admission, avoiding pre-surgical fasting, with oral carbohydrate overload and early initiation of oral intake after surgery. However, there are no standardized protocols of diet progression after pancreatic surgery. A systematic review was been performed of papers published between 2006 and 2016, describing different nutritional strategies after pancreatic surgery and its possible implications in postoperative outcome. The studies evaluated are very heterogeneous, so conclusive results could not be drawn on the diet protocol to be implemented, its influence on clinical variables, or the need for concomitant artificial nutrition. Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Oral mask ventilation is more effective than face mask ventilation after nasal surgery.

Science.gov (United States)

Yazicioğlu, Dilek; Baran, Ilkay; Uzumcugil, Filiz; Ozturk, Ibrahim; Utebey, Gulten; Sayın, M Murat

2016-06-01

To evaluate and compare the face mask (FM) and oral mask (OM) ventilation techniques during anesthesia emergence regarding tidal volume, leak volume, and difficult mask ventilation (DMV) incidence. Prospective, randomized, crossover study. Operating room, training and research hospital. American Society of Anesthesiologists physical status I and II adult patients scheduled for nasal surgery. Patients in group FM-OM received FM ventilation first, followed by OM ventilation, and patients in group OM-FM received OM ventilation first, followed by FM ventilation, with spontaneous ventilation after deep extubation. The FM ventilation was applied with the 1-handed EC-clamp technique. The OM was placed only over the mouth, and the 1-handed EC-clamp technique was used again. A child's size FM was used for the OM ventilation technique, the mask was rotated, and the inferior part of the mask was placed toward the nose. The leak volume (MVleak), mean airway pressure (Pmean), and expired tidal volume (TVe) were assessed with each mask technique for 3 consecutive breaths. A mask ventilation grade ≥3 was considered DMV. DMV occurred more frequently during FM ventilation (75% with FM vs 8% with OM). In the FM-first sequence, the mean TVe was 249±61mL with the FM and 455±35mL with the OM (P=.0001), whereas in the OM-first sequence, it was 276±81mL with the FM and 409±37mL with the OM (P=.0001). Regardless of the order used, the OM technique significantly decreased the MVleak and increased the TVe when compared to the FM technique. During anesthesia emergence after nasal surgery the OM may offer an effective ventilation method as it decreases the incidence of DMV and the gas leak around the mask and provides higher tidal volume delivery compared with FM ventilation. Copyright © 2016 Elsevier Inc. All rights reserved.

Treatment for cancer in the cervical esophagus. Surgery versus definitive chemoradiotherapy

International Nuclear Information System (INIS)

Umeno, Hirohito; Fujita, Hiromasa; Inoue, Youjirou

2012-01-01

Eighty-two patients with cervical esophageal cancer were treated by definitive chemoradiotherapy (10 patients) or surgery (72 patients) between 1989 and 2009 at the Kurume University Hospital. The 3-year overall survival rate after surgery was 51% and that after definitive chemoradiotherapy was 44%, showing no significant difference between the two groups. The 3-year local control rate after surgery was significantly better than that after definitive chemoradiotherapy. The overall 5-year survival rate of patients requiring a mediastinal tracheostomy was 11%, while that of those without a mediastinal tracheostomy was 39%. There was no significant difference between the two groups. The commencement of oral intake took a long time after treatment in patients with a T4 tumor who underwent chemoradiotherapy and who had vocal fold paralysis. Almost all patients who underwent esophageal reconstruction using the alimentary tract after pharyngolaryngoesophagectomy could take food within two weeks after surgery. On the other hand, in patients with vocal cord paralysis after cervical esophagectomy without laryngectomy, several months were needed after surgery to take food orally. (author)

Surgery and transplantation – Guidelines on Parenteral Nutrition, Chapter 18

Directory of Open Access Journals (Sweden)

Holland-Cunz, S.

2009-11-01

Full Text Available In surgery, indications for artificial nutrition comprise prevention and treatment of catabolism and malnutrition. Thus in general, food intake should not be interrupted postoperatively and the re-establishing of oral (e.g. after anastomosis of the colon and rectum, kidney transplantation or enteral food intake (e.g. after an anastomosis in the upper gastrointestinal tract, liver transplantation is recommended within 24 h post surgery. To avoid increased mortality an indication for an immediate postoperatively artificial nutrition (enteral or parenteral nutrition (PN also exists in patients with no signs of malnutrition, but who will not receive oral food intake for more than 7 days perioperatively or whose oral food intake does not meet their needs (e.g. less than 60–80% for more than 14 days. In cases of absolute contraindication for enteral nutrition, there is an indication for total PN (TPN such as in chronic intestinal obstruction with a relevant passage obstruction e.g. a peritoneal carcinoma. If energy and nutrient requirements cannot be met by oral and enteral intake alone, a combination of enteral and parenteral nutrition is indicated. Delaying surgery for a systematic nutrition therapy (enteral and parenteral is only indicated if severe malnutrition is present. Preoperative nutrition therapy should preferably be conducted prior to hospital admission to lower the risk of nosocomial infections. The recommendations of early postoperative re-establishing oral feeding, generally apply also to paediatric patients. Standardised operative procedures should be established in order to guarantee an effective nutrition therapy.

Efficacy and Safety of Transdermal Buprenorphine versus Oral Tramadol/Acetaminophen in Patients with Persistent Postoperative Pain after Spinal Surgery

Directory of Open Access Journals (Sweden)

Jae Hyup Lee

2017-01-01

Full Text Available Purpose. Control of persistent pain following spinal surgery is an unmet clinical need. This study compared the efficacy and safety of buprenorphine transdermal system (BTDS to oral tramadol/acetaminophen (TA in Korean patients with persistent, moderate pain following spinal surgery. Methods. Open-label, interventional, randomized multicenter study. Adults with persistent postoperative pain (Numeric Rating Scale [NRS] ≥ 4 at 14–90 days postsurgery were enrolled. Patients received once-weekly BTDS (n=47; 5 μg/h titrated to 20 μg/h or twice-daily TA (n=40; tramadol 37.5 mg/acetaminophen 325 mg, one tablet titrated to 4 tablets for 6 weeks. The study compared pain reduction with BTDS versus TA at week 6. Quality of life (QoL, treatment satisfaction, medication compliance, and adverse events (AEs were assessed. Findings. At week 6, both groups reported significant pain reduction (mean NRS change: BTDS −2.02; TA −2.76, both P<0.0001 and improved QoL (mean EQ-5D index change: BTDS 0.10; TA 0.19, both P<0.05. The BTDS group achieved better medication compliance (97.8% versus 91.0%. Incidence of AEs (26.1% versus 20.0% and adverse drug reactions (20.3% versus 16.9% were comparable between groups. Implications. For patients with persistent pain following spinal surgery, BTDS is an alternative to TA for reducing pain and supports medication compliance. This trial is registered with Clinicaltrials.gov: NCT01983111.

Preoperative concurrent irradiation and cisplatin for cancer of the oral cavity

International Nuclear Information System (INIS)

Herbolsheimer, M.; Richter, E.; Weber, W.; Aydin, H.; Wuerzburg Univ.

1988-01-01

Tumors of the oral cavity are commonly treated by surgery, RT or a combination of both. The results are poor especially in patients with advanced regional disease. Many attempts were made to improve the results by combining chemotherapy with irradiation and surgery. The combination of irradiation and cisplatin gave encouraging results in the treatment of advanced and often inoperable cancers of the head and neck. We evaluated patients with operable cancer of the oral cavity. Most of these patients have been entered on a prospective intergroup study of DOESAK (Deutsch-oesterreichisch-schweizerischer Arbeitskreis fuer Tumoren im Mund-, Kiefer- und Gesichtsbereich). (orig.)

Radiotherapy for Oral Cavity Cancer

International Nuclear Information System (INIS)

Shim, Jae Won

1993-01-01

Eighty five patients of oral cavity cancer, treated with radiation at the Department of Therapeutic Radiology, Korea Cancer Center Hospital, during the period from March 1985 to September 1990 were analyzed retrospectively. Among 85 patients, 37 patients were treated with radiation only and 48 patients were treated with radiation following surgery And 70 patients received external irradiation only by 60 Co with or without electron, the others were 7 patients for external irradiation plus interstitial implantation and 8 patients for external irradiation plus oral cone electron therapy. Primary sites were mobile tongue for 40 patients, mouth floor for 17 patients, palate for 12 patients, gingiva including retromolar trigone for 10 patients, buccal mucosa for 5 patients, and lip for 1 patient. According to pathologic classification, squamous cell carcinoma was the most common (77 patients). According to AJC TNM stage, stage I + II were 28 patients and stage III + IV were 57 patients. Acturial overall survival rate at 3 years was 43.9%, 3 year survival rates were 60.9% for stage I + II, and 23.1% for stage III + IV, respectively. As a prognostic factor, primary T stage was a significant factor (p<0.01). The others, age, location, lymph node metastasis, surgery, radiation dose, and cell differentiation were not statistically significant. Among those factors, radiation plus surgery was more effective than radiation only in T3 + T4 or in any N stage although it was not statistically sufficient(p<0.1). From those results, it was conclusive that definitive radiotherapy was more effective than surgery especially in the view of pertaining of anatomical integrity and function in early stage, and radiation plus surgery was considered to be better therapeutic tool in advanced stage

Treatments of the oral leukoplakia by laser

Science.gov (United States)

Capocci, M.; Mohsen, M.; Lo Giudice, R.; Del Vecchio, A.; Gaimari, G.; Tribolati, L.; Palaia, G.; Romeo, U.

2016-03-01

Oral leukoplakia is catalogued under the group of "potentially malignant disorders". In daily practice, the World Health Organization definition "white patch or plaque that cannot be characterized clinically or histologically as any other disease" is completed by including the observation that it cannot be removed by simple scraping, thereby distinguishing it from pseudo-membranous candidiasis. The aim of this study is to find a definitive treatment of oral leukoplakia, because of its recurrence and its potentiality to the malignant transformation. There are currently different approaches to oral leukoplakia: scalpel surgery, systemic therapy (carotenoids, vitamins, etc.), electro-cauterization, cryotherapy and the use of the laser. In every lesion, biopsy and histological analysis has been performed to identify the stage and classification of the oral leukoplakia. Laser can be used for the complete excision of the lesion (which is more effective, but also more invasive), for the photodynamic therapy (non-invasive procedure, which requires several applications) or for the vaporization of the lesion (very precise treatment and relatively easy to perform). Laser treatments have shown better healing, less soft tissues retraction and less post-operative pain, comparing with traditional surgery. The use of systemic therapies and smoking habit interruption (where present) has been also useful to reduce the lesions before the clinical treatments. The treatment has always to be supported by histological analysis to identify the risk and consequently planning the clinical approach.

Are postoperative intravenous antibiotics necessary after bimaxillary orthognathic surgery? A prospective, randomized, double-blind, placebo-controlled clinical trial.

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Tan, S K; Lo, J; Zwahlen, R A

2011-12-01

Postoperative antibiotic prophylaxis is often administered intravenously, despite an increased morbidity rate compared with oral application. This study investigates whether a postoperative oral antibiotic regimen is as effective as incorporation of intravenous antibiotics after bimaxillary orthognathic surgery. 42 patients who underwent bimaxillary orthognathic surgery between December 2008 and May 2010 were randomly allocated to 2 placebo-controlled postoperative antibiotic prophylaxis groups. Group 1 received oral amoxicillin 500mg three times daily; group 2 received intravenous ampicillin 1g four times daily, during the first two postoperative days. Both groups subsequently took oral amoxicillin for three more days. Clinically, the infection rate was assessed in both study groups for a period of 6 weeks after the surgery. 9 patients (21.4%) developed infection. No adverse drug event was detected. No significant difference (p=0.45) was detected in the infection rate between group 1 (3/21) and group 2 (6/21). Age, type of surgical procedures, duration of the operative procedure, surgical procedure-related events, blood loss, and blood transfusion were all found not related to infection (p>0.05). Administration of more cost-effective oral antibiotic prophylaxis, which causes less comorbidity, can be considered to be safe in bimaxillary orthognathic surgery with segmentalizations. Copyright © 2011 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Orthognathic surgery with or without induced hypotension.

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Carlos, E; Monnazzi, M S; Castiglia, Y M M; Gabrielli, M F R; Passeri, L A; Guimarães, N C

2014-05-01

This study involved a retrospective evaluation of patients subjected to surgery for dentofacial deformities treated without induced controlled hypotension (group I, n=50) and a prospective evaluation of patients who were subjected to surgery under hypotensive general anaesthesia (group II, n=50). No statistical differences were found between the study groups with regard to the duration of surgery. However, there were statistically significant differences in the need for blood transfusion and the occurrence of bradycardia during the maxillary down-fracture. Hypotensive anaesthesia decreased the need for a blood transfusion and the occurrence of bradycardia, and is therefore considered highly beneficial for patients undergoing orthognathic surgery. Copyright © 2013 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

A Retrospective Radiographic Survey of Pathology Associated with Impacted Third Molars among Patients Seen in Oral & Maxillofacial Surgery Clinic of College of Dentistry, Riyadh.

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Khawaja, Naveed Ahmad; Khalil, Hesham; Parveen, Kauser; Al-Mutiri, Abdulmajeed; Al-Mutiri, Saif; Al-Saawi, Abdullah

2015-04-01

The purpose of this study is to determine the type and frequency of pathological conditions around third molar teeth among randomly selected patient's records in Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, Riyadh. Totally, 281 patient panoramic radiographs were selected with detectable pathology among 570 files of patients seen in oral and maxillofacial surgery clinics 2 years retrospectively. Almost 17-55 years age (mean age 25.43) was selected. The following radiographs were analyzed for all pathology associated impacted teeth; dental caries, bone resorption, periodontitis, and apical pathology. The study found caries, external bone resorption and periodontitis are highly frequent to mesioangular and horizontal in mandibular impacted third molar compared to maxillary impacted third molar. Overall result evaluated that tooth #28 related periodontitis is significant (P = 0.021), and tooth #38 related bone resorption, tooth #48 related root caries, bone resorption and apical pathology are highly significant (P = 0.000) comparing to others. This study also concluded the high frequency of root caries, bone resorption and apical pathology reported in relation to mandibular impacted third teeth. Significant results were also achieved with periodontitis in relation to mesiangular and vertical angulation of left impacted maxillary third molars. Prophylactic removal of impacted third molars is recommended in many studies to avoid future risk of associated pathology. Retained asymptomatic impacted third molars imply pathology that could be difficult in later ages as less morbidity in younger ages.

A Chemopreventive Nanodiamond Platform for Oral Cancer Treatment.

Science.gov (United States)

Yen, Albert; Zhang, Kangyi; Daneshgaran, Giulia; Kim, Ho-Joong; Ho, Dean

2016-02-01

Standard oral cancer therapy generally includes a combination of surgery with chemotherapy and/or radiotherapy. This treatment paradigm has not changed in some time. In this paper, we propose a chemopreventive nanodiamond platform for the delivery of celecoxib (Celebrex) to oral cancer lesions. This innovative platform allows for sustained drug release under physiological conditions, potentially enhancing chemopreventive efficacy of celecoxib without the physical and toxicological damage associated with conventional means of drug delivery.

Guided Surgery in de implantologie: een overzicht

NARCIS (Netherlands)

Tahmaseb, A.; Wismeijer, D.; Derksen, W.D.C.

2015-01-01

Het gebruik van Guided Surgery (computergeleide chirurgie) staat binnen de orale implantologie al jaren in de belangstelling van tandartsen en onderzoekers. Met betrekking tot de nauwkeurigheid van deze systemen lopen de klinische en wetenschappelijke resultaten uiteen. Ook zijn in de literatuur

No effect of melatonin to modify surgical-stress response after major vascular surgery

DEFF Research Database (Denmark)

Kücükakin, B.; Wilhelmsen, M.; Lykkesfeldt, Jens

2010-01-01

A possible mechanism underlying cardiovascular morbidity after major vascular surgery may be the perioperative ischaemia-reperfusion with excessive oxygen-derived free-radical production and increased levels of circulating inflammatory mediators. We examined the effect of melatonin infusion during...... surgery and oral melatonin treatment for 3 days after surgery on biochemical markers of oxidative and inflammatory stress....

Reoperation after laparoscopic colorectal surgery. Does the laparoscopic approach have any advantages?

Science.gov (United States)

Ibáñez, Noelia; Abrisqueta, Jesús; Luján, Juan; Sánchez, Pedro; Soriano, María Teresa; Arevalo-Pérez, Julio; Parrilla, Pascual

2018-02-01

The laparoscopic approach in colorectal complications is controversial because of its difficulty. However, it has been proven that it can provide advantages over open surgery. The aim of this study is to compare laparoscopic approach in reoperations for complications after colorectal surgery with the open approach taking into account the severity of the patient prior to reoperation. Patients who underwent laparoscopic colorectal surgery from January 2006 to December 2015 were retrospectively reviewed. Patients requiring urgent surgical procedures for complications in the postoperative period were divided in two groups: laparoscopic surgery (LS) and open surgery (OS). To control clinical severity prior to reoperation, The Mannheim Peritonitis Index (MPI) was calculated. A total of 763 patients were studied, 40 required urgent surgery (24 OS/16 LS). More ileostomies were performed in the LS group (68.7% vs. 29.2%) and more colostomies in the OS group (37.5% vs. 6.2%), pstart of oral tolerance and less surgical wound infection (pstart of oral tolerance and a lower abdominal wall complication rate in patients with low severity index. Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Oral foregut cyst in a neonate.

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Rosa, Ana Cláudia Garcia; Hiramatsu, Daniel Martins; de Moraes, Fábio Roberto Ruiz; Passador-Santos, Fabrício; de Araújo, Vera Cavalcanti; Soares, Andresa Borges

2013-11-01

Oral foregut cysts are congenital choristomas that arise in the oral cavity during embryonic development from remnants of foregut-derived epithelium. This is an unusual report of a neonate with a large congenital sublingual cystic lesion, extending superficially from the left ventral tongue to the anterior floor of the mouth, impeding breast-feeding. The differential diagnosis included dermoid cyst, epidermoid cyst, mucous retention cyst, and oral lymphangioma. The treatment of choice was enucleation under general anesthesia. Histology showed a cystic lesion with a ciliated pseudostratified columnar epithelium with numerous goblet cells. Immunohistochemistry was positive for cytokeratin 7 and thyroid transcription factor 1 and negative for cytokeratin 20, resulting in a final diagnosis of an oral foregut cyst. Three weeks after surgery, the tongue had healed with good mobility, and breast-feeding could be established. No recurrence was present at 6 months of follow-up.

Telemedicine Consultations in Oral and Maxillofacial Surgery: A Follow-Up Study.

Science.gov (United States)

Wood, Eric W; Strauss, Robert A; Janus, Charles; Carrico, Caroline K

2016-02-01

The purpose of this study was to follow up on the previous study in evaluating the efficiency and reliability of telemedicine consultations for preoperative assessment of patients. A retrospective study of 335 patients over a 6-year period was performed to evaluate success rates of telemedicine consultations in adequately assessing patients for surgical treatment under anesthesia. Success or failure of the telemedicine consultation was measured by the ability to triage patients appropriately for the hospital operating room versus the clinic, to provide an accurate diagnosis and treatment plan, and to provide a sufficient medical and physical assessment for planned anesthesia. Data gathered from the average distance traveled and data from a previous telemedicine study performed by the National Institute of Justice were used to estimate the cost savings of using telemedicine consultations over the 6-year period. Practitioners performing the consultation were successful 92.2% of the time in using the data collected to make a diagnosis and treatment plan. Patients were triaged correctly 99.6% of the time for the clinic or hospital operating room. Most patients (98.0%) were given sufficient medical and physical assessment and were able to undergo surgery with anesthesia as planned at the clinic appointment immediately after telemedicine consultation. Most patients (95.9%) were given an accurate diagnosis and treatment plan. The estimated amount saved by providing consultation by telemedicine and eliminating in-office consultation was substantial at $134,640. This study confirms the findings from previous studies that telemedicine consultations are as reliable as those performed by traditional methods. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

"Nil per oral after midnight": Is it necessary for clear fluids?

Directory of Open Access Journals (Sweden)

Kajal S Dalal

2010-01-01

Full Text Available Fasting before general anaesthesia aims to reduce the volume and acidity of stomach contents, thus reducing the risk of regurgitation and aspiration. Recent guidelines have recommended a shift in fasting policies from the standard ′nil per oral from midnight′ to a more relaxed policy of clear fluid intake a few hours before surgery. The effect of preoperative oral administration of 150 ml of water 2 h prior to surgery was studied prospectively in 100 ASA I and II patients, for elective surgery. Patients were randomly assigned to two groups. Group I (n = 50 was fasting overnight while Group II (n = 50 was given 150 ml of water 2 h prior to surgery. A nasogastric tube was inserted after intubation and gastric aspirate was collected for volume and pH. The gastric fluid volume was found to be lesser in Group II (5.5 ± 3.70 ml than Group I (17.1 ± 8.2 ml which was statistically significant. The mean pH values for both groups were similar. Hence, we conclude that patients not at risk for aspiration can be allowed to ingest 150 ml water 2 h prior to surgery.

Squamous cell carcinoma of the oral cavity

International Nuclear Information System (INIS)

Lindeloev, B.; Kirkegaard, J.; Hansen, H.S.; Copenhagen Univ. Hospital

1990-01-01

Three hundred and four patients with squamous cell carcinomas of the oral cavity were treated at the Finsen Institute in cooperation with the ENT-surgical departments between 1978 and 1982. The primary treatment consisted of radiotherapy alone in 74%, surgery alone in 4%, and a combination of radiotherapy and surgery in 15% of the patients. 2% received other treatment (cryotherapy), 5% did not complete the planned radiotherapy, and 1% were not treated at all. Of 203 patients with tumour remnant or first recurrence, 45% were operated, 2% received radiotherapy, and 2% combined treatment. This treatment strategy made 38% of the patients free of disease in the follow-up period (3 1/2 to 8 years) or until the patients died from other causes. Fifty-nine percent of the patients died from their oral carcinomas. Tumour size (T), lymph node status (N), and tumour stage were as expected important prognostic factors. (orig.)

Natural ways to prevent and treat oral cancer

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Shweta Danaraddi

2014-01-01

Full Text Available Oral cancer is one of the usual causes of mortality all over the world, with a five-year survival rate of only 50%. Oral cancers are treated primarily by surgery with / without adjuvant radiotherapy and / or chemotherapy. However, there is significant post-treatment morbidity and mortality secondary to recurrences. Dietary supplements like fruits and vegetables are rich in phytochemicals and provide a variety of antioxidants like vitamin A, C, E. Spirulina, Selenium, Green tea (EGCG, Neem, Tomatoes (lycopene, Turmeric (curcumin, and some medicinal mushrooms are also used as chemopreventive and chemotherapeutic agents. This overview emphasizes on natural therapies to fight against oral cancer. Thus, there are several natural compounds that can enhance the prevention of oral cancer.

Role of oral gabapentin as preemptive adjuvant with spinal anesthesia for postoperative pain in patients undergoing surgeries under spinal anesthesia

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Roshan Lal Gogna

2017-01-01

Full Text Available Background and Aims: The study was undertaken to evaluate postoperative benefit in patients administered tablet gabapentin as premedication with the primary outcome determining the effect on duration of analgesia with total analgesic requirement and measurement of postoperative sedation scores as our secondary outcomes. Methods: The study was a prospective randomized observational study in sixty patients undergoing surgeries in spinal anesthesia (SA. Patients were randomly assigned into two groups. Group A (n = 30 patients received tablet gabapentin (600 mg while Group B (n = 30 received a placebo (Vitamin B complex orally 2 h before surgery. Postoperative pain was managed with intravenous tramadol 2 mg/kg. Postoperative monitoring and assessment included pain assessment every 2 h with Numeric Rating Scale (0–10 for 12 h and then at 24 h. Results: On comparison of intergroup data, the duration of analgesia was prolonged in Group A (288.79 ± 38.81 min as compared to Group B (218.67 ± 37.62 min with P (0.0001. Total opioid requirement was higher in placebo group as compared to the Group A (P = 0.025. Statistical difference in mean (standard deviation pain score at 24 h was statistically significant (P = 0.0002. Sedation scores were significantly higher in Group A at 2 and 4 h post-SA. Conclusion: Single dose of gabapentin administered 2 h before surgery provides better pain control as compared to placebo. It prolongs the duration of analgesia, reduces the total analgesic requirement during the postoperative period.

Short communications published online in the British Journal of Oral and Maxillofacial Surgery during 2010-2011.

Science.gov (United States)

Colbert, S; Southorn, B; Rosenbaum, G; Aldridge, T; Brennan, P A

2012-09-01

The British Journal of Oral and Maxillofacial Surgery (BJOMS) publishes many types of papers including original articles, review articles, and short communications. Many of the latter are isolated case reports of rare or interesting diseases or of difficult or unexpected complications. While case reports are sometimes considered to be of little educational or clinical value, and as such do little to advance medical knowledge, they do have an important role, and many trainees begin their publishing careers writing such papers. There is increasing pressure for space in paper medical journals and, for this reason, some journals either limit or do not publish short publications in print copy but instead put them online. Using established criteria, we previously evaluated all 142 short communications published in the BJOMS during 2008-2009 and found that 48% of them had little or no educational value. As a result, the editorial board of BJOMS took the decision to publish most short communications online only. We have now analysed 48 short communications that were published online only during 2010-2011. Most (80%) were single case reports that covered virtually the whole remit of the specialty, and over half (56%) were published by authors based in the UK. While many of these papers did not add important new information to existing knowledge, these types of article are clearly of value both for trainees and for experienced surgeons. We think that these should continue to be supported as, in addition to their educational value, they are an excellent way for trainees to start to write. Copyright © 2012 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Quality of life as predictor of survival: A prospective study on patients treated with combined surgery and radiotherapy for advanced oral and oropharyngeal cancer

International Nuclear Information System (INIS)

Oskam, Inge M.; Verdonck-de Leeuw, Irma M.; Aaronson, Neil K.; Kuik, Dirk J.; Bree, Remco de; Doornaert, Patricia; Langendijk, Johannes A.; Leemans, Rene C.

2010-01-01

Background and purpose: The relation between health-related quality of life (HRQOL) and survival was investigated at baseline and 6 months in 80 patients with advanced oral or oropharyngeal cancer after microvascular reconstructive surgery and (almost all) adjuvant radiotherapy. Materials and methods: Multivariate Cox regression analyses of overall and disease-specific survival were performed including sociodemographic (age, gender, marital status, comorbidity), and clinical (tumor stage and site, radical surgical, metastasis, radiotherapy) parameters, and HRQOL (EORTC QLQ-C30 global quality of life scale). Results: Before treatment, younger age and having a partner were predictors of disease-specific survival; younger age predicted overall survival. At 6 months post-treatment, disease-specific and overall survival was predicted by (deterioration of) global quality of life solely. Global health-related quality of life after treatment was mainly influenced by emotional functioning. Conclusion: Deterioration of global quality of life after treatment is an independent predictor of survival in patients with advanced oral or oropharyngeal cancer.

TREATMENT OF DOGS WITH ORAL MELANOMA RECURRENCE BY DIODE LASER EXCISION

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Cornel Igna

2016-11-01

Full Text Available Introduction: Treatment of oral melanomas utilizes the surgical excision-resection (Culp et al., 2013 and/or radiation therapy (Proulx et al., 2003, chemotherapy with carboplatin (Brockley et al., 2013, immunotherapy (Ottnod et al., 2013. Treatment based on surgical excision is usually palliative (Freeman et al., 2003. Aims: In the literature even though there are data concerning the prognosis of oral melanomas in dogs after surgery, are missing data after laser excision. Taking into account these findings we wished to present our experience regarding three cases of oral melanoma recurrence and immediate and long term laser surgery results. Materials and Methods: The casuistry consisted of three dogs with recurrent oral malignant melanomas, subjected to surgical reintervention. The initial diagnosis was melanotic melanoma in stage I or II. The animals were brought back at different time intervals from originally excision with electric scalpel. Before reintervention, dogs were subjected to clinical, paraclinical exam and biopsy. Excision of the tumor mass was made with an optical fiber hawing a diameter of 400µm, at a power of 10W and a wavelength of 940 nm with a diode laser. At 1, 2, 3, 6 and 12 months after laser reintervention the dogs were reexamined. Results: Average time in which appeared canine oral melanoma relapse was 58.6 days. After reexamination all cases where reinstatement in stage I. Operators times were held in conditions of comfort with wide access, minimum bleeding, effective hemostasis. After surgery at 24 hours on the intervention place a slight local redness, without swelling and bleeding was observed. Palpation revealed initially also a slight local sensitivity which completely disappeared in 48 hours. There were no grasping and chewing disturbances. Macroscopic healing occurred in 7-9 days. At last recheck performed at 12 months there were no evidences of tumour recurrence or metastasis. Conclusion: Diode laser excision

Botulinum toxin in preparation of oral cavity for microsurgical reconstruction.

Science.gov (United States)

Corradino, Bartolo; Di Lorenzo, Sara; Mossuto, Carmela; Costa, Renato Patrizio; Moschella, Francesco

2010-01-01

Infiltration of botulinum toxin in the major salivary glands allows a temporary reduction of salivation that begins 8 days afterwards and returns to normal within 2 months. The inhibition of salivary secretion, carried out before the oral cavity reconstructive surgery, could allow a reduction of the incidence of oro-cutaneous fistulas and local complications. Saliva stagnation is a risk factor for patients who have to undergo reconstructive microsurgery of the oral cavity, because of fistula formation and local complications in the oral cavity. The authors suggest infiltration of botulinum toxin in the major salivary glands to reduce salivation temporarily during the healing stage. During the preoperative stage, 20 patients with oral cavity carcinoma who were candidates for microsurgical reconstruction underwent sialoscintigraphy and a quantitative measurement of the salivary secretion. Injection of botulinum toxin was carried out in the salivary glands 4 days before surgery. The saliva quantitative measurement was repeated 3 and 8 days after infiltration, sialoscintigraphy after 15 days. In all cases, the saliva quantitative measurement revealed a reduction of 50% and 70% of the salivary secretion after 72 h and 8 days, respectively. A lower rate of local complications was observed.

Oral Complications and Management Strategies for Patients Undergoing Cancer Therapy

Science.gov (United States)

2014-01-01

With cancer survival rate climbing up over the past three decades, quality of life for cancer patients has become an issue of major concern. Oral health plays an important part in one's overall quality of life. However, oral health status can be severely hampered by side effects of cancer therapies including surgery, chemotherapy, radiotherapy, and hematopoietic stem cell transplantation. Moreover, prevention and treatment of these complications are often overlooked in clinical practice. The present paper aims at drawing health care professionals' attention to oral complications associated with cancer therapy by giving a comprehensive review. Brief comments on contemporary cancer therapies will be given first, followed by detailed description of oral complications associated with cancer therapy. Finally, a summary of preventive strategies and treatment options for common oral complications including oral mucositis, oral infections, xerostomia, and dysgeusia will be given. PMID:24511293

The use of contraception for patients after bariatric surgery.

Science.gov (United States)

Ostrowska, Lucyna; Lech, Medard; Stefańska, Ewa; Jastrzębska-Mierzyńska, Marta; Smarkusz, Joanna

2016-01-01

Obesity in women of reproductive age is a serious concern regarding reproductive health. In many cases of infertility in obese women, reduction of body weight may lead to spontaneous pregnancy, without the need for more specific methods of treatment. Bariatric surgery is safe and is the most effective method for body weight reduction in obese and very obese patients. In practice there are two bariatric techniques; gastric banding, which leads to weight loss through intake restriction, and gastric bypass, leads to weight loss through food malabsorption. Gastric bypass surgery (the more frequently performed procedure), in most cases, leads to changes in eating habits and may result in vomiting, diarrhea and rapid body mass reduction. There are reliable data describing the continuous increase in the number of women who are trying to conceive, or are already pregnant, following bariatric surgery. Most medical specialists advise women to avoid pregnancy within 12-18 months after bariatric surgery. This allows for time to recover sufficiency from the decreased absorption of nutrients caused by the bariatric surgery. During this period there is a need for the use of reliable contraception. As there is a risk for malabsorption of hormones taken orally, the combined and progestogen-only pills are contraindicated, and displaced by non-oral hormonal contraception or non-hormonal methods, including intrauterine devices and condoms.

Total hip arthroplasty and perioperative oral carbohydrate treatment: a randomised, double-blind, controlled trial.

Science.gov (United States)

Harsten, Andreas; Hjartarson, Hjörtur; Toksvig-Larsen, Sören

2012-06-01

Perioperative oral carbohydrate intake is beneficial to general surgery patients. Total hip arthroplasty is a common surgical procedure, and even a moderate improvement in patient outcome could have a significant effect on the resources needed for these patients. However, few studies have focused on the effects of carbohydrate intake on orthopaedic patients. The purpose of this study was to investigate if perioperative oral carbohydrate intake alters the postoperative course for patients undergoing total hip arthroplasty. The primary hypothesis was that pain scores would be lower in patients treated with carbohydrate. A randomised, double-blind, controlled trial. This study was carried out between September 2009 and April 2011 at a district Swedish hospital that specialises in orthopaedic surgery. Sixty ASA physical status I-III patients scheduled for elective total hip arthroplasty were included. Exclusion criteria were obesity, diabetes, prior hip surgery to the same hip, ongoing infection, immunological deficiency or age less than 50 or more than 80 years. Patients were given 400 ml of either an oral 12.5% carbohydrate solution or a placebo beverage (flavoured water) 1.5 h before and 2 h after surgery. Visual analogue scales were used to score six discomfort parameters. Immediately prior to surgery, the carbohydrate-treated patients were less hungry (median score 9.5 vs. 22 mm) and experienced less nausea (0 vs. 1.5 mm) (Phip arthroplasty.

A comparison of effect of preemptive use of oral gabapentin and pregabalin for acute post-operative pain after surgery under spinal anesthesia

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Bafna, Usha; Rajarajeshwaran, Krishnamoorthy; Khandelwal, Mamta; Verma, Anand Prakash

2014-01-01

Background and Aims: Preemptive analgesia is an antinociceptive treatment that prevents establishment of altered processing of afferent input. Pregabalin has been claimed to be more effective in preventing neuropathic component of acute nociceptive pain of surgery. We conducted a study to compare the effect of oral gabapentin and pregabalin with control group for post-operative analgesia Materials and Methods: A total of 90 ASA grade I and II patients posted for elective gynecological surgeries were randomized into 3 groups (group A, B and C of 30 patients each). One hour before entering into the operation theatre the blinded drug selected for the study was given with a sip of water. Group A- received identical placebo capsule, Group B- received 600mg of gabapentin capsule and Group C — received 150 mg of pregabalin capsule. Spinal anesthesia was performed at L3-L4 interspace and a volume of 3.5 ml of 0.5% bupivacaine heavy injected over 30sec through a 25 G spinal needle. VAS score at first rescue analgesia, mean time of onset of analgesia, level of sensory block at 5min and 10 min interval, onset of motor block, total duration of analgesia and total requirement of rescue analgesia were observed as primary outcome. Hemodynamics and side effects were recorded as secondary outcome in all patients. Results: A significantly longer mean duration of effective analgesia in group C was observed compared with other groups (P < 0.001). The mean duration of effective analgesia in group C was 535.16 ± 32.86 min versus 151.83 ± 16.21 minutes in group A and 302.00 ± 24.26 minutes in group B. The mean numbers of doses of rescue analgesia in the first 24 hours in group A, B and C was 4.7 ± 0.65, 4.1 ±0.66 and 3.9±0.614. (P value <0.001). Conclusion: We conclude that preemptive use of gabapentin 600mg and pregabalin 150 mg orally significantly reduces the postoperative rescue analgesic requirement and increases the duration of postoperative analgesia in patients undergoing

Overview of Facial Plastic Surgery and Current Developments

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Chuang, Jessica; Barnes, Christian; Wong, Brian J. F.

2016-01-01

Facial plastic surgery is a multidisciplinary specialty largely driven by otolaryngology but includes oral maxillary surgery, dermatology, ophthalmology, and plastic surgery. It encompasses both reconstructive and cosmetic components. The scope of practice for facial plastic surgeons in the United States may include rhinoplasty, browlifts, blepharoplasty, facelifts, microvascular reconstruction of the head and neck, craniomaxillofacial trauma reconstruction, and correction of defects in the face after skin cancer resection. Facial plastic surgery also encompasses the use of injectable fillers, neural modulators (e.g., BOTOX Cosmetic, Allergan Pharmaceuticals, Westport, Ireland), lasers, and other devices aimed at rejuvenating skin. Facial plastic surgery is a constantly evolving field with continuing innovative advances in surgical techniques and cosmetic adjunctive technologies. This article aims to give an overview of the various procedures that encompass the field of facial plastic surgery and to highlight the recent advances and trends in procedures and surgical techniques. PMID:28824978

Adherence to a new oral anticoagulant treatment prescription: dabigatran etexilate

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L Bellamy

2009-07-01

Full Text Available L Bellamy1, N Rosencher1, BI Eriksson21Anaesthesiology Department, Hôpital Cochin (AP-HP, René Descartes University, Paris 75014 France; 2Orthopaedic Department, University Hospital Sahlgrenska/Ostra, Gothenburg, SwedenAbstract: The recent development of new oral anticoagulants, of which dabigatran etexilate is currently at the most advanced stage of development, is the greatest advance in the provision of convenient anticoagulation therapy for many years. A new oral anticoagulation treatment, dabigatran etexilate, is already on the market in Europe. The main interest probably will be to improve the prescription and the adherence to an effective thromboprophylaxis in medical conditions such as atrial fibrillation without bleeding side effects, without the need for monitoring coagulation, and without drug and food interactions such as vitamin K anticoagulant (VKA treatment. Dabigatran is particularly interesting for extended thromboprophylaxis after major orthopedic surgery in order to avoid daily injection for a month. However, oral long-term treatments such as VKA are not systematically associated with a higher compliance level than injected treatments such as low-molecular-weight heparins. Indeed, adherence to an oral treatment, instead of the usual daily injection in major orthopedic surgery, is complex, and based not only on the frequency of dosing but also on patient motivation, understanding, and socio-economic status. New oral anticoagulants may be useful in this way but education and detection of risk factors of nonadherence to treatment are still essential.Keywords: oral anticoagulant, adherence, compliance, education, dabigatran

Preoperative fluid and electrolyte management with oral rehydration therapy.

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Taniguchi, Hideki; Sasaki, Toshio; Fujita, Hisae; Takamori, Mina; Kawasaki, Rieko; Momiyama, Yukinori; Takano, Osami; Shibata, Toshinari; Goto, Takahisa

2009-01-01

We hypothesized that oral rehydration therapy using an oral rehydration solution may be effective for preoperative fluid and electrolyte management in surgical patients before the induction of general anesthesia, and we investigated the safety and effectiveness of oral rehydration therapy as compared with intravenous therapy. Fifty female patients who underwent breast surgery were randomly allocated to two groups. Before entry to the operation room and the induction of general anesthesia, 25 patients drank 1000 ml of an oral rehydration solution ("oral group") and 25 patients were infused with 1000 ml of an intravenous electrolyte solution ("intravenous group"). Parameters such as electrolyte concentrations in serum and urine, urine volume, vital signs, vomiting and aspiration, volumes of esophageal-pharyngeal fluid and gastric fluid (EPGF), and patient satisfaction with the therapy (as surveyed by a questionnaire) were assessed. After treatment, the serum sodium concentration and the hematocrit value, which both declined within the normal limits, were significantly higher in the oral group than in the intravenous group (sodium, 140.8 +/- 2.9 mEq x l(-1) in the oral group and 138.7 +/- 1.9 mEq x l(-1) in the intravenous group; P = 0.005; hematocrit, 39.03 +/- 4.16% in the oral group and 36.15 +/- 3.41% in the intravenous group; P = 0.01). No significant difference was observed in serum glucose values. Urine volume was significantly larger in the oral group (864.9 +/- 211.5 ml) than in the intravenous group (561.5 +/- 216.0 ml; P rehydration therapy, as judged by factors such as "feeling of hunger", "occurrence of dry mouth", and "less restriction in physical activity". The volume of EPGF collected following the induction of anesthesia was significantly smaller in the oral group than in the intravenous group (6.03 +/- 9.14 ml in the oral group and 21.76 +/- 30.56 ml in the intravenous group; P rehydration therapy with an oral rehydration solution before surgery is

Preventing bleeding and thromboembolic complications in atrial fibrillation patients undergoing surgery

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Charles André

2015-08-01

Full Text Available Neurologists feel uneasy when asked about temporary anticoagulant interruption for surgery in patients with atrial fibrillation (AF. Rational decisions can be made based on current scientific evidence. Method Critical review of international guidelines and selected references pertaining to bleeding and thromboembolism during periods of oral anticoagulant interruption. Results Withholding oral anticoagulants leads to an increased risk of perioperative thromboembolism, depending on factors such as age, renal and liver function, previous ischemic events, heart failure etc. Surgeries are associated with a variable risk of bleeding - from minimal to very high. Individualized decisions about preoperative drug suspension, bridging therapy with heparin and time to restart oral anticoagulants after hemostasis can significantly reduce these opposing risks. Conclusion Rational decisions can be made after discussion with all Health care team professionals involved and consideration of patient fears and expectations. Formal written protocols should help managing antithrombotic treatment during this delicate period.

A randomized controlled trial comparing a standard postoperative diet with low-volume high-calorie oral supplements following colorectal surgery.

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Sharma, M; Wahed, S; O'Dair, G; Gemmell, L; Hainsworth, P; Horgan, A F

2013-07-01

Postoperative oral nutritional supplementation is becoming a part of most patient care pathways. This study examined the effects of low-volume high-calorie prescribed supplemental nutrition on patient outcome following elective colorectal surgery. Patients undergoing elective colorectal resections were randomized to a prescribed nutritional supplementation group (SG) [standard diet + 6 × 60 ml/day of Pro-Cal (60 ml = 200 kcal + 4 g protein)] or conventional postoperative diet group (CG) (standard diet alone). Preoperative and daily postoperative hand-grip strengths were measured using a grip dynamometer after randomization. Daily food intake, return of bowel activity, nausea score for the first 3 days and postoperative length of hospital stay (LOS) were prospectively recorded. Micro-diet standardized software was used to analyse food diaries. Nonparametric tests were used to analyse the data. Fifty-five patients were analysed (SG 28, CG 27). There was no difference in median preoperative and postoperative handgrip strengths at discharge within each group (SG 31.7 vs 31.7 kPa, P = 0.932; CG 28 vs 28.1 kPa, P = 0.374). The total median daily calorie intake was higher in SG than CG (SG 818.5 kcal vs CG 528 kcal; P = 0.002). There was no difference in median number of days to first bowel movement (SG 3 days vs CG 4 days, P = 0.096). The median LOS was significantly shorter in SG than CG (6.5 vs 9 days; P = 0.037). Prescribed postoperative high-calorie, low-volume oral supplements in addition to the normal dietary intake are associated with significantly better total daily oral calorie intake and may contribute to a reduced postoperative hospital stay. Colorectal Disease © 2013 The Association of Coloproctology of Great Britain and Ireland.

Differences in Expression of EGFR, Ki67 and p-EPK in Oral Cavity ...

African Journals Online (AJOL)

Purpose: To evaluate the expression of EGFR, Ki67, and p-EPK in oral cavity and oropharyngeal cancers, and to investigate their clinical significance as prognostic markers. Methods: One hundred patients who underwent curative surgery for oral cavity or oropharyngeal squamous cell carcinoma in a Chinese People's ...

Pre- and postoperative irradiation in advanced oral carcinoma

International Nuclear Information System (INIS)

Zini, G.; Barbieri, E.; Neri, S.; Silvano, N.; Babini, L.; Campobassi, A.; Dallera, P.; Marchetti, C.; Romagnoli, D.; Emiliani, E.

1989-01-01

The combination of radiotherapy and surgery in the treatment of advanced oral carcinoma (T3 and T4 lesions) yields good possibilities of recovery; whether radiotherapy should be given before or after surgery is still debated. Fifty patients with advanced oral carcinomas were analyzed: 24 of them were irradiated before and 26 after surgery; doses ranged from 40 to 56 Gy for the first group of patients, and from 50 to 68 Gy for the second one. The disease-free survival 48 months after the diagnosis was 36% in patients who received preoperative irradiation, and 53.6% in patients who received postoperative radiotherapy. the latter allowed local control of the disease to be significantly improved (χ 2 3.99, 0.01< p<0.05). The quality of survival was worse in the group receiving preoperative irradiation, because of radiation-induced surgical complications, which were especially observed in patients with diffuse disease. The findings suggest that postoperative radiotherapy may be advisable if the tumor is resectable, since tolerance and local control rate were acceptable. On the contrary, nearly inoperable masses and massive neck diseases often require preoperative irradiation

A clinical study of oral carcinoma

International Nuclear Information System (INIS)

Sato, Shigenori; Ito, Zenya; Takahashi, Kazuhiko; Ohkubo, Hideki; Wada, Tetsuro; Senarita, Masamitsu; Hara, Akira; Kusakari, Jun; Ohara, Kiyosi

1999-01-01

Seventy patients of oral carcinoma, including lip and tongue cancer, were treated at University of Tsukuba Hospital from March 1988 to March 1998. Treatment for each patient was determined according to TNM classification (UICC, 1987). Eight cases of non-squamous cell carcinoma, which were insensitive to radiation or chemotherapy, were surgically treated. Out of 70 cases, sixty-two were pathologically categorized as squamous cell carcinoma (SCC). For SCC cases of stage I or II, full-dose irradiation, including brachytherapy as well as conventional irradiation, was fundamentally the treatment of choice, but in six cases surgical treatment was performed after irradiation of 50 Gy in order to assure curability. In cases of stage III or IV, the treatment of choice was a combination of the surgery and radiotherapy. Fifteen cases, however, were treated only by conventional radiotherapy, brachytherapy (RALS) and/or chemotherapy, because of the patient's refusal to surgery, local or systemic condition, his or her age, and so on. Our treatment plans have consequently resulted in the overall 5-year survival rate of 75.2% for oral SCC. (author)

Podoplanin emerges as a functionally relevant oral cancer biomarker and therapeutic target.

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Retzbach, Edward P; Sheehan, Stephanie A; Nevel, Evan M; Batra, Amber; Phi, Tran; Nguyen, Angels T P; Kato, Yukinari; Baredes, Soly; Fatahzadeh, Mahnaz; Shienbaum, Alan J; Goldberg, Gary S

2018-03-01

Oral cancer has become one of the most aggressive types of cancer, killing 140,000 people worldwide every year. Current treatments for oral cancer include surgery and radiation therapies. These procedures can be very effective; however, they can also drastically decrease the quality of life for survivors. New chemotherapeutic treatments are needed to more effectively combat oral cancer. The transmembrane receptor podoplanin (PDPN) has emerged as a functionally relevant oral cancer biomarker and chemotherapeutic target. PDPN expression promotes tumor cell migration leading to oral cancer invasion and metastasis. Here, we describe the role of PDPN in oral squamous cell carcinoma progression, and how it may be exploited to prevent and treat oral cancer. Copyright © 2018 Elsevier Ltd. All rights reserved.

980 nm diode lasers in oral and facial practice: current state of the science and art.

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Desiate, Apollonia; Cantore, Stefania; Tullo, Domenica; Profeta, Giovanni; Grassi, Felice Roberto; Ballini, Andrea

2009-11-24

To evaluate the safety and efficacy of a 980 nm diode laser for the treatment of benign facial pigmented and vascular lesions, and in oral surgery. 20 patients were treated with a 980 nm diode laser. Oral surgery: 5 patients (5 upper and lower frenulectomy). Fluence levels were 5-15 J/cm(2); pulse lengths were 20-60 ms; spot size was 1 mm. Vascular lesions: 10 patients (5 small angiomas, 5 telangiectases). Fluences were 6-10 J/cm(2); pulse lengths were 10-50 ms; spot size was 2 mm. In all cases the areas surrounding the lesions were cooled. Pigmented lesions: 5 patients (5 keratoses). All the lesions were evaluated by dermatoscopy before the treatment. Fluence levels were 7-15 J/cm(2); pulse lengths were 20-50 ms; spot size was 1 mm. All the patients were followed at 1, 4 and 8 weeks after the procedure. Healing in oral surgery was within 10 days. The melanoses healed completely within four weeks. All the vascular lesions healed after 15 days without any residual scarring. The end results for the use of the 980 nm diode laser in oral and facial surgery appears to be justified on the grounds of efficacy and safety of the device, and good degree of acceptance by the patients, without compromising their health and function.

The oral microflora in obesity and type-2 diabetes

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Edward Shillitoe

2012-10-01

Full Text Available Background: Type 2 diabetes mellitus (T2DM is prevalent in people with obesity. It has been proposed that these conditions are related to specific features of the microflora of the mouth and lower gastrointestinal (GI tract. Hyperglycemia often resolves quickly after Roux-en-Y gastric bypass (RYGB but the role of the GI microflora cannot be examined easily because of reduced intestinal mobility. We propose that the study of microorganisms present in the mouth of patients undergoing RYGB will contribute to our understanding of the role of bacteria in the pathogenesis of T2DM. Objective: To conduct a feasibility study to examine differences in oral microbes in obese patients with and without T2DM and to determine whether it is feasible to measure changes after gastric bypass surgery. Methods: Individuals with morbid obesity (n=29, of whom 13 had T2DM, were studied. Oral rinses, stool samples, and blood samples were obtained before RYGB, and oral rinses and blood samples were obtained at 2 and 12 weeks postsurgery. Results: Prior to surgery, participants with T2DM had slightly higher total levels of oral bacteria than those without diabetes. Those with HbA1c > 6.5% had rather lower levels of Bifidobacteria in the mouth and stool. At 2 weeks post-RYGB, patients with T2DM were able to reduce or discontinue their hypoglycemic medications. Stool samples could not be obtained but oral rinses were readily available. The levels of oral Bifidobacteria had increased tenfold and levels of circulating endotoxin and tumor necrosis factor-alpha had decreased. Conclusions: The study of oral bacteria before and after RYGB is feasible and should be tested in larger patient populations to increase our understanding of the role of microorganisms in the pathogenesis of obesity and T2DM.

Are we ready for the ERAS protocol in colorectal surgery?

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Kisielewski, Michał; Rubinkiewicz, Mateusz; Pędziwiatr, Michał; Pisarska, Magdalena; Migaczewski, Marcin; Dembiński, Marcin; Major, Piotr; Rembiasz, Kazimierz; Budzyński, Andrzej

2017-01-01

Modern perioperative care principles in elective colorectal surgery have already been established by international surgical authorities. Nevertheless, barriers to the introduction of routine evidence-based clinical care and changing dogmas still exist. One of the factors is the surgeon. To assess perioperative care trends in elective colorectal surgery among general surgery consultants in surgical departments in Malopolska Voivodeship, Poland. An anonymous standardized 20-question questionnaire was developed based on ERAS principles and sent out to Malopolska Voivodeship general surgery departments. Answers of general surgery consultants showed the level of acceptance of elements of perioperative care. The overall response rate was 66%. Several elements (antibiotic and antithrombotic prophylaxis, postoperative oxygen therapy, no nasogastric tubes) had quite a high acceptance rate. On the other hand, most crucial surgical perioperative elements (lack of mechanical bowel preparation, preoperative oral carbohydrate loading, use of laparoscopy and lack of drains, early fluid and oral diet intake, early mobilization) were not followed according to evidence-based ERAS protocol recommendations. Surgeons were not willing to change their practice, but were supportive of changes in anesthesiologist-dependent elements of perioperative care, such as restrictive fluid therapy, use of transversus abdominis plane blocks, etc. Many elements of perioperative care in elective colorectal surgery in Malopolska Voivodeship are still dictated by dogma and are not evidence-based. The level of acceptance of many important ERAS protocol elements is low. Surgeons are ready to accept only changes that do not interfere with their practice.

Oral pyogenic granuloma in Ghanaians: a review of cases

African Journals Online (AJOL)

McRoy

1Department of Oral and Maxillofacial Surgery, University of Ghana Dental School, Korle Bu. Teaching ... Other sites included the lips (18.52%), buccal mucosa ... were treated by complete excision and no recurrences were noted in the few.

Submucosal surgery: novel interventions in the third space.

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Teitelbaum, Ezra N; Swanstrom, Lee L

2018-02-01

Traditional surgeries involve accessing body cavities, such as the abdomen and thorax, via incisions that divide skin and muscle. These operations result in postoperative pain and convalescence, and a risk of complications such as wound infection and hernia. The development of flexible endoscopy allowed diseases as varied as gastrointestinal bleeding and colon adenomas to be treated without incisions, but this technique is restricted by its endoluminal nature. A novel category of surgical endoscopic procedures has recently been developed that uses flexible endoscopic techniques to enter and access the submucosa of the gastrointestinal tract. Through this approach, the advantages of incisionless endoscopy can be applied to areas of the body that previously could only be reached with surgery. This Review introduces this new class of interventions by describing two examples of such submucosal surgeries for the treatment of benign gastrointestinal disease: per-oral endoscopic myotomy and per-oral pyloromyotomy. The approach to pre-procedure patient evaluation, operative technique, and the published outcomes are discussed, as well as potential future applications of similar techniques and procedures in this so-called third space. Copyright © 2018 Elsevier Ltd. All rights reserved.

Photodynamic Therapy Using Temoporfin Before Surgery in Treating Patients With Recurrent Oral Cavity or Oropharyngeal Cancer

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2014-09-02

Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Stage I Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage I Squamous Cell Carcinoma of the Oropharynx; Stage I Verrucous Carcinoma of the Oral Cavity; Stage II Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage II Squamous Cell Carcinoma of the Oropharynx; Stage II Verrucous Carcinoma of the Oral Cavity; Tongue Cancer

The Effectiveness of Public Simulated Oral Examinations in Preparation for the American Board of Surgery Certifying Examination: A Systematic Review.

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Pennell, Christopher; McCulloch, Peter

2015-01-01

The purpose of this study was to determine whether American Board of Surgery Certifying Examination (CE) performance is improved among residents who prepare using simulated oral examinations (SOEs). EMBASE and MEDLINE were searched using predefined search terms. No language restrictions were imposed and the latest search date was in November 2014. Included studies must have reported on residents training in a general surgery residency in the United States who used SOEs to prepare for the CE and have measured their performance against those without exposure to SOEs. Studies meeting inclusion criteria were qualitatively and quantitatively analyzed and a fixed effects meta-analysis was performed to determine the net effect of SOEs on CE performance. Overall, 4 of 25 abstracts reviewed met inclusion criteria and are included in this review. The most common simulation format included public examinations in front of resident peers during scheduled education sessions. All 4 included studies trended toward improved performance with SOEs and in 2 of these studies the improvement was statistically significant. Overall, 3 studies were of adequate quality to perform a meta-analysis and demonstrated a relative risk for first-attempt CE success of 1.22 (95% CI: 1.07-1.39, p = 0.003) for residents preparing with SOEs compared to those without SOEs. The published literature evaluating SOEs is limited and generally of fair quality. A modest improvement in CE performance was identified when public SOEs were used as an educational tool aimed to improve professionalism and communication skills, encourage reading at home, and provide a regular review of clinically relevant topics. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

A novel rotational matrix and translation vector algorithm: geometric accuracy for augmented reality in oral and maxillofacial surgeries.

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Murugesan, Yahini Prabha; Alsadoon, Abeer; Manoranjan, Paul; Prasad, P W C

2018-06-01

Augmented reality-based surgeries have not been successfully implemented in oral and maxillofacial areas due to limitations in geometric accuracy and image registration. This paper aims to improve the accuracy and depth perception of the augmented video. The proposed system consists of a rotational matrix and translation vector algorithm to reduce the geometric error and improve the depth perception by including 2 stereo cameras and a translucent mirror in the operating room. The results on the mandible/maxilla area show that the new algorithm improves the video accuracy by 0.30-0.40 mm (in terms of overlay error) and the processing rate to 10-13 frames/s compared to 7-10 frames/s in existing systems. The depth perception increased by 90-100 mm. The proposed system concentrates on reducing the geometric error. Thus, this study provides an acceptable range of accuracy with a shorter operating time, which provides surgeons with a smooth surgical flow. Copyright © 2018 John Wiley & Sons, Ltd.

Oral Sedation in the Dental Office.

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Sebastiani, Francesco R; Dym, Harry; Wolf, Joshua

2016-04-01

This article highlights the commonly used medications used in dentistry and oral surgery. General dentists and specialists must be knowledgeable about the pharmacology of the drugs currently available along with their risks and benefits. Enteral sedation is a useful adjunct for the treatment of anxious adult and pediatric patients. When enteral sedation is used within the standards of care, the interests of the public and the dental profession are served through a cost-effective, effective service that can be widely available. Oral sedation enables dentists to provide dental care to millions of individuals who otherwise would have unmet dental needs. Copyright © 2016 Elsevier Inc. All rights reserved.

Neoadjuvant Chemotherapy for Locally Advanced Squamous Carcinoma of Oral Cavity: a Pilot Study.

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Sanambar Sadighi

2015-06-01

Full Text Available To evaluate the effect of adding neoadjuvant chemotherapy to surgery and radiation therapy for locally advanced resectable oral cavity squamous cell carcinoma, 24 patients with T3 or T4a oral cavity squamous cell carcinoma were randomly assigned to surgery alone or Docetaxel, Cisplatin, and 5-FU (TPF induction chemotherapy followed by surgery. All patients were planned to receive chemoradiotherapy after surgery. The primary end-points were organ preservation and progression-free-survival. SPSS version 17 was used for data analysis. Median follow-up was 16 months. The median age of the patients was 62 years old (23-75 years. Man/woman ratio was 1.13. The primary site of the tumor was the tongue in most patients (48%. No significant difference was observed between pathologic characteristics of the two groups. Chemotherapy group showed 16% complete pathologic response to TPF. No significant difference in organ preservation surgery or overall survival was detected. However, the patients in the chemotherapy group had longer progression-free-survival (P=0.014. Surgery followed by chemoradiotherapy with or without TPF induction results in similar survival time. However, progression-free-survival improves with the TPF induction chemotherapy. Studies with more patents and new strategies are recommended to evaluate organ preservation improvement and long-term outcomes.

Premedication with oral Dextromethorphan reduces intra-operative Morphine requirement

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R Talakoub

2005-09-01

Full Text Available Background: Intra-operative pain has adverse effects on hemodynamic parameters. Due to complications of opioids for pain relief, using non-opioids medication is preferred. The purpose of this study was to investigate the effect of oral dextrometorphan premedication on intra-operative Morphine requirement. Methods: After approval of the Ethics committee and informed consent, 40 adult patients who stand in American Society of Anesthesiologists Physical Status I and II, under general anesthesia for elective laparatomy were selected and classified in two equal groups randomly. In group A, oral dextromethorphan (60mg was administered at 10 PM and 6 AM preoperatively. In group B, placebo (dextrose was administered. After induction of general anesthesia and before skin incision, intravenous morphine (0.01 mg/kg was administered. During surgery, when systolic blood pressure or heart rate was increased more than 20% of the preoperative baseline, 0.01 mg/kg morphine was administered. At the end of surgery, the totally prescribed morphine (mg/kg and maximal increase in systolic, diastolic, mean arterial blood pressure and heart rate relative to the baseline values were calculated and statistically compared with student’s t-test. Results: The mean dose of administered morphine during surgery was significantly less in group A than group B (P<0.0001. Also, Maximal increase in systolic, diastolic and mean arterial blood pressure was significantly less in group A (p<0.003, p<0.004, p<0.0001, respectively. There was no significant difference in maximal heart rate increase between two groups (p<0.114. Conclusion: Oral dextromethorphan premedication may decrease intra-operative morphine requirement and reduce maximal increase in systolic and mean arterial blood pressure during surgery. Key words: Dextromethorphan, Morphine, Intra-operative, Premedication Hemodynamic

Cancer of the oral cavity

International Nuclear Information System (INIS)

Wang, C.C.

1987-01-01

Squamous cell carcinomas of the oral cavity are curable. When early tumor (T1 and T2) is diagnosed and treated, cure rates by surgery or irradiation are high. The choice of therapeutic modalities for these lesions is complex and depends on the site of origin and size of the tumor, the presence or absence of nodal metastases, and the age, physical, medical, and socioeconomic status of the patient. Other factors include the willingness of the patient to return for a protracted course of radiation therapy, the skill of the physician, and the relative morbidity and cosmesis of the two forms of treatment. In general, surgery may be considered for early (T1) lesions if the deformity resulting from surgery is minimal. If resection involves major morbidity, such as a deformity that alters cosmesis or the function of the speech and swallowing mechanisms, then radiation therapy is preferred. For medium-sized (T2) tumors, superficial radiation therapy is the treatment of choice, for it controls the disease and preserves normal function and anatomy. Surgery is reserved for radiation failures. Extensive disease (T3 and T4) often associated with bone and muscle involvement and cervical lymph node metastases is rarely curable by radiation therapy or surgery alone; a combined approach using radiation therapy and surgery is therefore the procedure of choice

Managing direct oral anticoagulants in patients undergoing dentoalveolar surgery.

Science.gov (United States)

Patel, J P; Woolcombe, S A; Patel, R K; Obisesan, O; Roberts, L N; Bryant, C; Arya, R

2017-02-24

Our objective was to describe our experience of managing a cohort of adult patients prescribed direct oral anticoagulants (DOACs) undergoing dentoalveolar procedures between November 2012 and May 2016. Prior to conducting a procedure a formal assessment was made of each patient's anticoagulation treatment. A specific plan was then formulated, balancing the risk of bleeding with the risk of thrombosis. Patients received a telephone consultation one week following treatment to assess any post-operative bleeding. Eighty-two patients underwent 111 oral surgical procedures, the majority of which were dental extractions. In the case of 35 (32%) procedures, advice was given to omit the DOAC, either before or after treatment. There was no bleeding following the majority of procedures. Persistent bleeding followed 15 (13.5%) procedures, of which 7 (6.3%) procedures required specific intervention. The majority of patients prescribed DOACs can undergo dentoalveolar procedures safely. Important considerations when planning treatment are: (i) when the patient usually takes their dose of DOAC, (ii) the time the procedure is performed and, (iii) when the DOAC is taken post-procedure. In our experience, if these factors are considered carefully, omission of DOAC doses is unlikely to be required for most patients.

Targeted intra-arterial carboplatin chemoradiotherapy and tegafur/uracil for oral and oropharyngeal cancer

International Nuclear Information System (INIS)

Oya, Ryoichi; Takagi, Shinji; Inenaga, Ryuichiro; Nakamura, Shoichi; Ikemura, Kunio; Onari, Nobuhiro; Imada, Hajime; Korogi, Yukunori

2006-01-01

The aim of this study was to evaluate the usefulness of targeted intra-arterial carboplatin chemoradiotherapy in allowing less invasive surgery for patients with oral and oropharyngeal squamous cell carcinoma. Twenty patients with previously untreated squamous cell carcinoma of the oral cavity and oropharynx (T4; 8, T2; 12 patients) were treated with targeted transfemoral intra-arterial carboplatin infusion with concurrent hyperfractionated radiotherapy and the administration of tegafur/uracil (UFT). Of 20 patients, 15 underwent surgery after completion of one course of targeted chemoradiotherapy, and five were given another course or radiotherapy only. Eighteen (90%) of 20 patients had a clinically complete response at the primary site and two (10%) had a partial response. Of the 15 patients who underwent tumor resection, 11 (73%) showed histopathological disappearance of cancer cells at the primary site. Sixteen (80%) of 20 tumors were controlled at the primary site within a mean follow-up of 30 months. Adverse effects were relatively mild. Targeted intra-arterial chemoradiotherapy caused a down-staging of tumors and facilitated the use of less invasive surgery in patients with squamous cell carcinoma of the oral cavity and oropharynx as a result of its favorable anti-tumor effect. (author)

Oral hygiene in patients with oral cancer undergoing chemotherapy and/or radiotherapy after prosthesis rehabilitation: protocol proposal.

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Rapone, B; Nardi, G M; DI Venere, D; Pettini, F; Grassi, F R; Corsalini, M

2016-01-01

This study was aimed at assessing the effectiveness and the importance of an oral hygiene (OH) protocol in patients undergoing radiation therapy and chemotherapy after prosthesis rehabilitation, in order to reduce or minimize oral complications. This study was carried out at the Department of Dental Science, at the University of Bari-Italy from December 2012 to December 2015 on 34 selected patients with primary oral cancer undergoing chemotherapy and radiotherapy after prosthesis rehabilitation. They were divided into 2 groups according to their age, sex and cancer therapy. Seventeen patients were assigned to the control group and seventeen in the experimental one. In the experimental group (Table 1), patients underwent an oral hygiene protocol whereas in the control group (Table 2) patients received the usual care provided within the clinical setting. All the patients gave written informed consent. It has been asked and obtained the authorisation from the Ethics Committee of the Dental Science and Surgery Department. Results show that in patients undergoing the oral hygiene protocol, the complications and the risks of infection and permanent dental problems have been minimized. Indeed, of the seventeen patients undergoing the OH protocol, 70% obtained positive results and were satisfied with the program outcome. The role of the health care providers is essential to educate patients to adhere to the prescribed treatments and reinforce their motivation in oral hygiene. The oral hygiene procedures prevent and ameliorate oral complications due to the radiation therapy and chemotherapy.

Risk Factors and Dose-Effect Relationship for Mandibular Osteoradionecrosis in Oral and Oropharyngeal Cancer Patients

International Nuclear Information System (INIS)

Lee, Ik Jae; Koom, Woong Sub; Lee, Chang Geol; Kim, Yong Bae; Yoo, Sei Whan; Keum, Ki Chang; Kim, Gwi Eon; Choi, Eun Chang; Cha, In Ho

2009-01-01

Purpose: To analyze risk factors and the dose-effect relationship for osteoradionecrosis (ORN) of the mandible after radiotherapy of oral and oropharyngeal cancers. Materials and Methods: One-hundred ninety-eight patients with oral (45%) and oropharyngeal cancer (55%) who had received external radiotherapy between 1990 and 2000 were retrospectively reviewed. All patients had a dental evaluation before radiotherapy. The median radiation dose was 60 Gy (range, 16-75 Gy), and the median biologically effective dose for late effects (BED late ) in bone was 114 Gy 2 (range, 30-167 Gy 2 ). Results: The frequency of ORN was 13 patients (6.6%). Among patients with mandibular surgery, eight had ORN at the surgical site. Among patients without mandibular surgery, five patients had ORN on the molar area of the mandible. The median time to ORN was 22 months (range, 1-69 months). Univariate analysis revealed that mandibular surgery and Co-60 were significant risk factors for ORN (p = 0.01 and 0.04, respectively). In multivariate analysis, mandibular surgery was the most important factor (p = 0.001). High radiation doses over BED 102.6 Gy 2 (conventional dose of 54 Gy at 1.8 Gy/fraction) were also a significant factor for ORN (p = 0.008) and showed a positive dose-effect relationship in logistic regression (p = 0.04) for patients who had undergone mandibular surgery. Conclusions: Mandibular surgery was the most significant risk factor for ORN of mandible in oral and oropharyngeal cancers patients. A BED of 102.6 Gy 2 or higher to the mandible also significantly increases the risk of ORN.

African Journal of Paediatric Surgery - Vol 10, No 2 (2013)

African Journals Online (AJOL)

Histopathological review of breast tumours in children and adolescents in Delta ... of early and late oral feeding in intestinal anastomosis surgeries in children ... Paediatric urologic pathologies at the national teaching hospital in Cotonou: A ...

Oral rehabilitation of the cancer patient: A formidable challenge.

Science.gov (United States)

Petrovic, Ivana; Rosen, Evan B; Matros, Evan; Huryn, Joseph M; Shah, Jatin P

2018-05-03

Rehabilitation of oral functions following surgery on the jaws is a goal that is often difficult to achieve. Removable dentures supported by remaining teeth or gum are often unstable and seldom satisfactory. On the other hand, endosseous (dental) implants offer a mechanism to provide stability to the dentures. This review, discusses factors related to the tumor, patient, treatment, and physicians which impact upon the feasibility and success of dental implants in patients with oral cancer. © 2018 Wiley Periodicals, Inc.

Postoperative radiation therapy following laser surgery in locally advanced head and neck cancer

International Nuclear Information System (INIS)

Pradier, O.; Schmidberger, H.; Christiansen, H.; Florez, R.; Hess, C.F.; Jackel, M.C.; Steiner, W.

2002-01-01

The results achieved with trans oral micro-surgery in advanced head and neck carcinoma with adjuvant radiotherapy are comparable to those with radical surgery. The haemoglobin level has an important role in the loco regional control and on survival. Split course radiation therapy regimen has not a place in the adjuvant situation. (author)

Orthognathic surgery in the office setting.

Science.gov (United States)

Farrell, Brian B; Tucker, Myron R

2014-11-01

The delivery of care by oral and maxillofacial surgeons is becoming more challenging because of escalating health care costs and limited reimbursement from insurance providers. The changing health care landscape forces surgical practices to be flexible and adaptive to change in order to remain viable. The delivery of surgical services continues to evolve as care traditionally performed in a hospital environment is now routinely achieved in an outpatient setting. Outpatient facilities can aid in controlling the perioperative costs associated with orthognathic surgery. Safe and efficient orthognathic surgery completed in the office can aid in controlling the escalation of health care costs. Copyright © 2014 Elsevier Inc. All rights reserved.

Comparison of pregabalin versus ketamine in postoperative pain management in breast cancer surgery

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Essam Mahran

2015-01-01

Full Text Available Background: Breast surgery compromises one of the most common cancer surgeries in females and commonly followed by acute postoperative pain. Pregabalin and ketamine have been used in many previous studies and was found to have a good analgesic profile. We assumed that pregabalin and ketamine can be used in control of postoperative pain in female patients undergoing breast cancer surgery. Material and Methods: Ninety female patients scheduled for cancer breast surgery were allocated in three groups (30 patients each, control group (group c received preoperative placebo, pregabalin group (group p received oral 150 mg pregabalin 1 h before surgery, ketamine group (group k received intravenous (IV 0.5 mg/kg ketamine with induction of anesthesia followed by 0.25 mg/kg/h IV throughout the surgery. All patients received general anesthesia and after recovery, the three groups were assessed in the first postoperative 24 h for postoperative visual analog scale (VAS , total 24 h morphine consumption, incidence of postoperative nausea and vomiting (PONV, sedation score >2 and any complications from the drugs used in the study. Results: The use of pregabalin or ketamine was found to reduce total postoperative morphine consumption with P 2. Conclusion: The use of preoperative oral 150 mg pregabalin 1 h before surgery or IV 0.5 mg ketamine with induction of anesthesia can reduce postoperative opioid consumption in breast cancer surgery without change in sedation or PONV and with a good safety profile.

Cochlear implant revision surgeries in children.

Science.gov (United States)

Amaral, Maria Stella Arantes do; Reis, Ana Cláudia Mirândola B; Massuda, Eduardo T; Hyppolito, Miguel Angelo

2018-02-16

The surgery during which the cochlear implant internal device is implanted is not entirely free of risks and may produce problems that will require revision surgeries. To verify the indications for cochlear implantation revision surgery for the cochlear implant internal device, its effectiveness and its correlation with certain variables related to language and hearing. A retrospective study of patients under 18 years submitted to cochlear implant Surgery from 2004 to 2015 in a public hospital in Brazil. Data collected were: age at the time of implantation, gender, etiology of the hearing loss, audiological and oral language characteristics of each patient before and after Cochlear Implant surgery and any need for surgical revision and the reason for it. Two hundred and sixty-five surgeries were performed in 236 patients. Eight patients received a bilateral cochlear implant and 10 patients required revision surgery. Thirty-two surgeries were necessary for these 10 children (1 bilateral cochlear implant), of which 21 were revision surgeries. In 2 children, cochlear implant removal was necessary, without reimplantation, one with cochlear malformation due to incomplete partition type I and another due to trauma. With respect to the cause for revision surgery, of the 8 children who were successfully reimplanted, four had cochlear calcification following meningitis, one followed trauma, one exhibited a facial nerve malformation, one experienced a failure of the cochlear implant internal device and one revision surgery was necessary because the electrode was twisted. The incidence of the cochlear implant revision surgery was 4.23%. The period following the revision surgeries revealed an improvement in the subject's hearing and language performance, indicating that these surgeries are valid in most cases. Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Minimally invasive endoscope-assisted trans-oral excision of huge parapharyngeal space tumors.

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Li, Shang-Yi; Hsu, Ching-Hui; Chen, Mu-Kuan

2015-04-01

Parapharyngeal space tumors are rare head and neck neoplasms, and most are benign lesions. Complete excision of these tumors is difficult because of the complexity of the surrounding anatomic structures. The algorithm for excision of these tumors is typically based on the tumor's characteristics; excision is performed via approaches such as the trans-oral route, the trans-cervical route, and even a combination of the trans-parotid route and mandibulotomy. However, each of these approaches is associated with some complications. Endoscope-assisted minimally invasive surgery is being increasingly employed for surgeries in the head and neck regions. It has the advantage of leaving no facial scars, and ensures better patient comfort after the operation. Here, we report the use of endoscope-assisted trans-oral surgery for excision of parapharyngeal space tumors. The technique yields an excellent outcome and should be a feasible, safe, and economic method for these patients. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Retrospective analysis of oral and maxillofacial surgery cases in a ...

African Journals Online (AJOL)

Method: This was a retrospective study conducted at the Oral Dental Health Centre, Akure, Ondo state, Nigeria covering the period September, 2000 and April, 2004. ... Conclusion: A wide variety of cases were seen but socioeconomic, human resource and infrastructural problems limited the scope of practice. Keywords: ...

[Percutaneous maxillary nerve block anesthesia in maxillofacial surgery].

Science.gov (United States)

Robiony, M; Demitri, V; Costa, F; Politi, M

1999-01-01

Personal experience in percutaneous maxillary nerve block anesthesia in association with transmucosal anesthesia of the sphenopalatine ganglion in oral and maxillofacial surgery, is presented. Six Caldwell-Luc, 9 anthrotomies and biopsies of maxillary sinus, 8 removals of extensive odontogenic cysts and 12 surgical maxillary expansions were performed from 1994 to 1996 at our Department. Maxillary transcutaneous nerve block in association with transmucosal anesthesia of the sphenopalatine ganglion were performed. Carbocaine without adrenaline in association with NaCO3 1/10 for maxillary nerve block anesthesia and lidocaineoprilocaine cream (EMLA) for transmucosal anesthesia were employed. Intra- and post-operative pain were evaluated by visual analogue scale in all the patients. Anesthesiological procedures revealed to be effective in all surgical interventions and postoperative analgesia allowed easier pain control. The simplicity of execution, the effective pre- and postoperative anesthesia and the absence of side effects make this procedure particularly indicated in oral and maxillofacial surgery.

Efficacy of midazolam as oral premedication in children in comparison to triclofos sodium

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Kolathu Parambil Radhika

2016-01-01

Full Text Available Background and Aims: The perioperative behavioural studies demonstrate that children are at greater risk of experiencing turbulent anaesthetic induction and adverse behavioural sequelae. We aimed to compare the efficacy of midazolam 0.5 mg/kg with triclofos sodium 100 mg/kg as oral premedication in children undergoing elective surgery. Methods: In this prospective, randomised and double-blind study, sixty children posted for elective lower abdominal surgery were enrolled. The patients were randomly divided into midazolam group (Group M and triclofos sodium group (Group T of thirty each. Group M received oral midazolam 0.5 mg/kg 30 min before induction, and Group T received oral triclofos sodium 100 mg/kg 60 min before induction. All children were evaluated for level of sedation after premedication, behaviour at the time of separation from parents and at the time of mask placement for induction of anaesthesia. Mann–Whitney U-test was used for comparing the grade of sedation, ease of separation and acceptance of face mask. Results: Oral midazolam produced adequate sedation in children after premedication in comparison to oral triclofos (P = 0.002. Both drugs produced successful separation from parents, and the children were very cooperative during induction. No adverse effects attributable to the premedicants were seen. Conclusions: Oral midazolam is superior to triclofos sodium as a sedative anxiolytic in paediatric population.

Is stopping of anticoagulant therapy really required in a minor dental surgery? - How about in an endodontic microsurgery?

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Yong-Wook Cho

2013-08-01

Full Text Available Nowadays, oral anticoagulants are commonly prescribed to numerous patients for preventing cardiovascular accident such as thromboembolism. An important side effect of anticoagulant is anti-hemostasis. In a major surgery, the oral anticoagulant therapy (OAT regimen must be changed before the surgery for proper post-operative bleeding control. However, in a minor dental surgery and endodontic surgery, the necessity for changing or discontinuing the OAT is open to debate. In this study, risks of the consequences were weighed and analyzed. In patients who stop the OAT, the occurrence of thromboembolic complication is rare but the result is fatal. In patients who continuing the OAT, post-operative bleeding can be controlled well with the local hemostatic measures. In the endodontic surgery, there are almost no studies about this issue. The intra-operative bleeding control is particularly important in the endodontic surgery because of its delicate and sensitive procedures such as inspection of resected root surface using dental microscope and retrograde filling. Further studies are necessary about this issue in the viewpoint of endodontic surgery.

Changes in Hematology and Calcium Metabolism After Gastric Bypass Surgery

DEFF Research Database (Denmark)

Worm, Dorte; Madsbad, Sten; Kristiansen, Viggo B

2015-01-01

.001), excessive weight loss in men, and younger age in women (p vitamin B12 increased from before surgery to 24 months after surgery (p Vitamin D increased from baseline to month 24 in both...... months after surgery. Daily supplement of 800 mg calcium, 800 U vitamin D, a multivitamin, and a vitamin B12 injection (1 mg) every third month was recommended. In subjects with low ferritin and decreasing hemoglobin levels, oral, or intravenous iron was administered. RESULTS: Hemoglobin concentration...... sexes (p vitamin D was sufficient. Iron substitution did not prevent anemia, which especially affected premenopausal women. More attention should...

Superselective intra-arterial chemoradiotherapy for advanced oral cancer

International Nuclear Information System (INIS)

Kobayashi, Wataru; Sakaki, Hirotaka; Kakehata, Shinya; Kawaguchi, Hideo; Takai, Yoshihiro; Kimura, Hiroto; Teh, Beng Gwan

2012-01-01

Functional preservation is important in the treatment of advanced oral cancer in terms of patient's quality of life (QOL), therefore surgery is not ideal for advanced oral cancer. In order to ensure both curability and functional preservation, superselective intra-arterial chemoradiotherapy (SSIACRT), which is considered to be superior to conventional surgical treatment, has been conducted. Thirty-four patients with advanced oral cancer have been treated with SSIACRT with a combination of nedaplatin (CDGP) and docetaxel (DOC) since 2003. Complete response was achieved in 30 (89%) out of the 34 patients. Amongst the 25 patients with positive neck diseases, 23 (92%) were assessed as disease-free. The 5-year overall survival rate was 71.4%. Wide resection of both primary and neck lesions was avoidable and oral cavity function (swallowing, speech, mastication) after SSIACRT was satisfactory. A problem for SSIACRT is the development of late adverse events of xerostomia and osteoradionecrosis. (author)

Seeking beauty: understanding the psychology behind orthognathic surgery.

Science.gov (United States)

Oluwajana, F

2015-12-01

Orthognathic surgery to correct serious skeletal discrepancies of the jaw improves both function and appearance, but patients should spend a lot of time thinking about, discussing, and planning operations that have such a considerable impact. The drive to improve appearance by such radical means is based on social and personal reasons, and this must be understood before treatment is considered. In this paper, we will review studies on the psychology of orthognathic surgery. Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Pre-emptive 8 mg dexamethasone and 120 mg etoricoxib for pain prevention after periodontal surgery: A randomised controlled clinical trial

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Kranti Konuganti

2015-01-01

Full Text Available Several anti-inflammatory drugs have been used to reduce pain and discomfort after periodontal surgeries. This study evaluates the efficacy of using etoricoxib and dexamethasone for pain prevention after open-flap debridement surgery. In this study, 60 patients who were undergoing open flap debridment surgery were randomly assigned to receive a single dose preoperative medication 1 hour prior to surgery. The patients were divided into three groups. In Group 1, 20 patients were given placebo drug orally. In Group 2, 20 patients were given 8 mg Dexamethasone orally and in Group 3, 20 patients were given 120 mg Etoricoxib orally. Patients were instructed to complete a pain diary hourly for the first 8 hours after each surgery and three times a day on the following 3 days. The four point verbal rating scale (VRS 4 and Numerical rate scale were used to assess discomfort. Post-operative Assessment of Pain and Discomfort showed that persistent discomfort and pain were found to be more in the placebo group compared to dexamethasone and etoricoxib group. The adoption of a preemptive medication protocol using either etoricoxib or dexamethasone may be considered effective for pain and discomfort prevention after open-flap debridement surgeries.

Enhanced Recovery After Surgery: It's Time to Change Practice

NARCIS (Netherlands)

Steenhagen, E

Perioperative surgical care is undergoing a paradigm shift. Traditional practices such as prolonged preoperative fasting (nil by mouth from midnight), bowel cleaning, and reintroduction of oral nutrition 3-5 days after surgery are being shunned. These and other similar changes have been formulated

Laser surgery in ear, nose and throat

International Nuclear Information System (INIS)

Winter, F.Oe.; Teig, E.; Haye, R.

1991-01-01

This survey is based on own experiences and a study of the literature. The CO 2 laser has certain advantages in the surgical treatment of otosclerosis, both in the primary operation and in reoperation. In rhinal surgery the argon laser has been used with good results in Osler's disease. Laser surgery is not recommended for vasomotoric rhinitis and polyposis. The CO-2 laser has improved the quality of treatment of laryngeal papilloma. With high precision and minimal bleeding the postoperative voice is better than with conventional surgery. The CO 2 laser can also be used to exstirpate small malignant tumours of the tongue and leukoplasia of the oral mucosa. Healing is rapid and involves relatively little pain. The postoperative functional results is usually good, due to moderate formation of scars. 11 refs., 2 tabs

Randomised controlled trial comparing oral and intravenous paracetamol (acetaminophen) plasma levels when given as preoperative analgesia.

Science.gov (United States)

van der Westhuizen, J; Kuo, P Y; Reed, P W; Holder, K

2011-03-01

Gastric absorption of oral paracetamol (acetaminophen) may be unreliable perioperatively in the starved and stressed patient. We compared plasma concentrations of parenteral paracetamol given preoperatively and oral paracetamol when given as premedication. Patients scheduled for elective ear; nose and throat surgery or orthopaedic surgery were randomised to receive either oral or intravenous paracetamol as preoperative medication. The oral dose was given 30 minutes before induction of anaesthesia and the intravenous dose given pre-induction. All patients were given a standardised anaesthetic by the same specialist anaesthetist who took blood for paracetamol concentrations 30 minutes after the first dose and then at 30 minute intervals for 240 minutes. Therapeutic concentrations of paracetamol were reached in 96% of patients who had received the drug parenterally, and 67% of patients who had received it orally. Maximum median plasma concentrations were 19 mg.l(-1) (interquartile range 15 to 23 mg.l(-1)) and 13 mg.l(-1) (interquartile range 0 to 18 mg.l(-1)) for the intravenous and oral group respectively. The difference between intravenous and oral groups was less marked after 150 minutes but the intravenous preparation gave higher plasma concentrations throughout the study period. It can be concluded that paracetamol gives more reliable therapeutic plasma concentrations when given intravenously.

Intraocular levels of methotrexate after oral low-dose treatment in chronic uveitis.

Science.gov (United States)

Puchta, Joachim; Hattenbach, Lars-Olof; Baatz, Holger

2005-01-01

To determine the intraocular levels of methotrexate in low-dose treatment of noninfectious uveitis. One day after oral administration, the methotrexate level was measured in the aqueous humor and serum of a patient with noninfectious uveitis, who underwent cataract surgery. A fluorescence polarization immunoassay was used for determination. After oral administration, methotrexate was only measurable in aqueous humor but not in serum. In uveitis, orally administered low-dose methotrexate reaches detectable levels in aqueous humor, even in the absence of detectable levels in serum. Copyright (c) 2005 S. Karger AG, Basel.

Perspectives of stem cell use in reconstructive maxillofacial surgery

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Mikhail G. Semyonov

2016-12-01

Full Text Available The discovery of stem cells is one of the greatest achievements of molecular and cell biology, and associated research has confirmed the possibility of self-renewal and differentiation into specialized tissue stem cells. The use of cellular technologies is an important trend in modern medicine. The aim of this article is to briefly review current findings on the use of stem cells in cardiology, endocrinology, neurology, traumatology, and maxillofacial surgery. All data were retrieved from experimental and clinical studies using various cell technologies. The material is part of ongoing maxillofacial surgery research to investigate the possible use of stem cells in reconstructive maxillofacial surgery for jaw bone pathologies in children. Present tissue engineering methods provide some opportunities for solving difficult clinical problems in oral and maxillofacial surgery. Despite some international achievements of effective application of IC in various diseases, clinical use in reconstructive surgery requires further investigation.

Oral Health Equals Total Health: A Brief Review

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Adrian Yap

2017-08-01

Full Text Available Oral health is essential to total health and satisfactory quality of life. According to the World Health Organization (2012, oral health has been defined as a state of being free of mouth and facial pain, oral infections and sores, and oral and other diseases that limit an individual’s capacity in biting, chewing, smiling, speaking, and psychosocial well-being. Oral conditions like dental caries and periodontal (gum disease continue to plague humanity. Nearly all adults have existing tooth decay, and severe gum disease occurs in 15 to 20% of middle-aged adults. The adverse effects of inadequate care for teeth, gums, bite, and jaws can move beyond the mouth to affect overall physical and psychological health. Research has indicated that poor oral health may be associated with medical conditions such as heart disease, stroke, diabetes, pneumonia, and other respiratory diseases. It has also been linked to pre-term births and low-birth-weight babies. Jaw problems are also a common cause of headaches and ear and facial pain. Dental clearance prior to medical treatment, including cancer/bisphosphonate therapy and cardiac surgery, minimizes both oral and systemic complications. Many medical conditions have oral manifestations, and some medications have side effects that lead to compromised oral health as well as jaw function disabilities. This paper summarizes and highlights the importance of oral-systemic connections. In addition, the features of common dental problems are discussed. 

Enhanced recovery after surgery in gastric resections.

Science.gov (United States)

Bruna Esteban, Marcos; Vorwald, Peter; Ortega Lucea, Sonia; Ramírez Rodríguez, Jose Manuel

2017-02-01

Enhanced recovery after surgery is a modality of perioperative management with the purpose of improving results and providing a faster recovery of patients. This kind of protocol has been applied frequently in colorectal surgery, presenting less available experience and evidence in gastric surgery. According to the RICA guidelines published in 2015, a review of the bibliography and the consensus established in a multidisciplinary meeting in Zaragoza on the 9th of October 2015, we present a protocol that contains the basic procedures of fast-track for resective gastric surgery. The measures to be applied are divided in a preoperative, perioperative and postoperative stage. This document provides recommendations concerning the appropriate information, limited fasting and administration of carbohydrate drinks 2hours before surgery, specialized anesthetic strategies, minimal invasive surgery, no routine use of drainages and tubes, mobilization and early oral tolerance during the immediate postoperative period, as well as criteria for discharge. The application of a protocol of enhanced recovery after surgery in resective gastric surgery can improve and accelerate the functional recovery of our patients, requiring an appropriate multidisciplinary coordination, the evaluation of obtained results with the application of these measures and the investigation of controversial topics about which we currently have limited evidence. Copyright © 2016 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Constipation Risk in Patients Undergoing Abdominal Surgery

Science.gov (United States)

Celik, Sevim; Atar, Nurdan Yalcin; Ozturk, Nilgun; Mendes, Guler; Kuytak, Figen; Bakar, Esra; Dalgiran, Duygu; Ergin, Sumeyra

2015-01-01

Background: Problems regarding bowel elimination are quite common in patients undergoing abdominal surgery. Objectives: To determine constipation risk before the surgery, bowel elimination during postoperative period, and the factors affecting bowel elimination. Patients and Methods: This is a cross-sectional study. It was conducted in a general surgery ward of a university hospital in Zonguldak, Turkey between January 2013 and May 2013. A total of 107 patients were included in the study, who were selected by convenience sampling. Constipation Risk Assessment Scale (CRAS), patient information form, medical and nursing records were used in the study. Results: The mean age of the patients was found to be 55.97 ± 15.74 (year). Most of the patients have undergone colon (37.4%) and stomach surgeries (21.5%). Open surgical intervention (83.2%) was performed on almost all patients (96.3%) under general anesthesia. Patients were at moderate risk for constipation with average scores of 11.71 before the surgery. A total of 77 patients (72%) did not have bowel elimination problem during postoperative period. The type of the surgery (P < 0.05), starting time for oral feeding after the surgery (P < 0.05), and mobilization (P < 0.05) were effective on postoperative bowel elimination. Conclusions: There is a risk for constipation after abdominal surgery. Postoperative practices are effective on the risk of constipation. PMID:26380107

Frequency of periodontal pathogens and Helicobacter pylori in the mouths and stomachs of obese individuals submitted to bariatric surgery: a cross-sectional study

Science.gov (United States)

PATARO, André Luiz; CORTELLI, Sheila Cavalca; ABREU, Mauro Henrique Nogueira Guimarães; CORTELLI, José Roberto; FRANCO, Gilson Cesar Nobre; AQUINO, Davi Romeiro; COTA, Luis Otavio Miranda; COSTA, Fernando Oliveira

2016-01-01

ABSTRACT Objectives This cross-sectional study compared the frequency of oral periodontopathogens and H. pylori in the mouths and stomachs of obese individuals with or without periodontitis submitted to bariatric surgery. Material and Methods One hundred and fifty-four men and women aged 18-65 were conveniently distributed into four groups. Two groups were composed of individuals who underwent bariatric surgery with (BP) (n=40) and without (BNP) (n=39) periodontitis and two obese control groups with (CP) (n=35) and without (CNP) (n=40) periodontitis. The oral pathogens Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Parvimonas micra, Treponema denticola, Tannerella forsythia, Campylobacter rectus, and Helicobacter pylori were detected by a polymerase chain reaction technique using saliva, tongue and stomach biopsy samples. Results Statistical analysis demonstrated that periodontopathogens were highly frequent in the mouth (up to 91.4%). In the bariatric surgically treated group, orally, P. gingivalis, T. denticola and T. forsythia were more frequent in periodontitis, while C. rectus was more frequent in non-periodontitis subjects. Stomach biopsies also revealed the high frequency of five oral species in both candidates for bariatric surgery (91.6%) and the bariatric (83.3%) groups. H. pylori was frequently detected in the mouth (50.0%) and stomach (83.3%). In the stomach, oral species and H. pylori appeared in lower frequency in the bariatric group. Conclusions Obese individuals showed high frequencies of periodontopathogens and H. pylori in their mouths and stomachs. Bariatric surgery showed an inverse microbial effect on oral and stomach environments by revealing higher oral and lower stomach bacterial frequencies. PMID:27383704

Short-term Recovery after Orthognathic Surgery: A Medical Daily Diary Approach

Science.gov (United States)

Blakey, George

2008-01-01

This study assessed the utility of a quality-of-life diary for the assessment of postoperative recovery following orthognathic surgery. A 20-item daily recovery diary was designed to assess the patients’ perception of recovery in 4 domains (postoperative sequelae; pain/discomfort; oral function; daily activities) during each of the first 90 days after surgery. Fifteen of 185 patients who had agreed to participate did not return any portion of the diary. Of the remaining patients, 87% returned the full 90 days requested. Younger patients were more likely to complete the entire protocol (P = 0.01). At 30 days, a lower percentage, in general, of patients who completed all 90 days reported recovery in oral function and general activity compared with those who did not complete all diary days. This study confirms that patients will cooperate with the completion of structured medical / health-related quality-of-life diaries during the first few months after orthognathic surgery. Information from such diaries would be valuable to patients deciding on treatment options and to the clinicians counseling them. PMID:18768296

Clinical Usefulness of Oral Supplementation with Alpha-Lipoic Acid, Curcumin Phytosome, and B-Group Vitamins in Patients with Carpal Tunnel Syndrome Undergoing Surgical Treatment

Directory of Open Access Journals (Sweden)

Giorgio Pajardi

2014-01-01

Full Text Available We investigated the clinical usefulness of oral supplementation with a combination product containing alpha-lipoic acid, curcumin phytosome, and B-group vitamins in 180 patients with carpal tunnel syndrome (CTS, scheduled to undergo surgical decompression of the median nerve. Patients in Group A (n=60 served as controls and did not receive any treatment either before or after surgery. Patients in Group B (n=60 received oral supplementation twice a day for 3 months both before and after surgery (totaling 6 months of supplementation. Patients in Group C (n=60 received oral supplementation twice a day for 3 months before surgery only. Patients in Group B showed significantly lower nocturnal symptoms scores compared with Group A subjects at both 40 days and 3 months after surgery (both P values <0.05. Moreover, patients in Group B had a significantly lower number of positive Phalen’s tests at 3 months compared with the other study groups (P<0.05. We conclude that oral supplementation with alpha-lipoic acid, curcumin phytosome, and B-group vitamins twice a day both before and after surgery is safe and effective in CTS patients scheduled to undergo surgical decompression of the median nerve.

Results of a survey of the treatment policy for early stage tongue and oral floor cancer

International Nuclear Information System (INIS)

Asakura, Kohji; Kataura, Akikatsu; Hareyama, Masato

1998-01-01

To realize the treatment policy for early stage oral cancer, a survey of 102 institutes in Japan was performed by questionnaire. A majority of the otolaryngologists preferred surgery for the treatment of T1N0 and T2N0 cases of oral cancer. The preferred method of treatment for the T1N0 cases was simple tumor resection and that for the T2N0 cases was extended tumor resection with plastic surgery, elective neck dissection and combined radio-and/or chemotherapy. A majority of the radiologists preferred brachytherapy for T1N0 and non-invasive T2N0 cases. For invasive cases of T2N0 oral cancer, radiologists preferred either surgical treatment or the combination of brachytherapy and external irradiation. (author)

Oral and Oropharyngeal Reconstruction with a Free Flap.

Science.gov (United States)

Jeong, Woo Shik; Oh, Tae Suk

2016-06-01

Extensive surgical resection of the aerodigestive track can result in a large and complex defect of the oropharynx, which represents a significant reconstructive challenge for the plastic surgery. Development of microsurgical techniques has allowed for free flap reconstruction of oropharyngeal defects, with superior outcomes as well as decreases in postoperative complications. The reconstructive goals for oral and oropharyngeal defects are to restore the anatomy, to maintain continuity of the intraoral surface and oropharynx, to protect vital structures such as carotid arteries, to cover exposed portions of internal organs in preparation for adjuvant radiation, and to preserve complex functions of the oral cavity and oropharynx. Oral and oropharyngeal cancers should be treated with consideration of functional recovery. Multidisciplinary treatment strategies are necessary for maximizing disease control and preserving the natural form and function of the oropharynx.

Primary radical ablative surgery and fibula free-flap reconstruction for T4 oral cavity squamous cell carcinoma with mandibular invasion: oncologic and functional results and their predictive factors.

Science.gov (United States)

Camuzard, Olivier; Dassonville, Olivier; Ettaiche, Marc; Chamorey, Emmanuel; Poissonnet, Gilles; Berguiga, Riadh; Leysalle, Axel; Benezery, Karen; Peyrade, Frédéric; Saada, Esma; Hechema, Raphael; Sudaka, Anne; Haudebourg, Juliette; Demard, François; Santini, José; Bozec, Alexandre

2017-01-01

The aims of this study were to evaluate clinical outcomes and to determine their predictive factors in patients with oral cavity squamous cell carcinoma (OCSCC) invading the mandibular bone (T4) who underwent primary radical surgery and fibula free-flap reconstruction. Between 2001 and 2013, all patients who underwent primary surgery and mandibular fibula free-flap reconstruction for OCSCC were enrolled in this retrospective study. Predictive factors of oncologic and functional outcomes were assessed in univariate and multivariate analysis. 77 patients (55 men and 22 women, mean age 62 ± 10.6 years) were enrolled in this study. Free-flap failure and local and general complication rates were 9, 31, and 22 %, respectively. In multivariate analysis, ASA score (p = 0.002), pathologic N-stage (p = 0.01), and close surgical margins (p = 0.03) were independent predictors of overall survival. Six months after therapy, oral diet, speech intelligibility, and mouth opening functions were normal or slightly impaired in, respectively, 79, 88, and 83 % of patients. 6.5 % of patients remaining dependent on enteral nutrition 6 months after therapy. With acceptable postoperative outcomes and satisfactory oncologic and functional results, segmental mandibulectomy with fibula free-flap reconstruction should be considered the gold standard primary treatment for patients with OCSCC invading mandible bone. Oncologic outcomes are dependent on three main factors: ASA score, pathologic N-stage, and surgical margin status.

[Problems in the admission to in-hospital oral surgical care from the patient's viewpoint--results of patient interviews in the hospital for dental and maxillo-facial surgery of the Karl Marx University, Leipzig].

Science.gov (United States)

Erpenbeck, F; Birnbaum, K; Langanke, B; Niemand, B; Thomzyk, I

1979-06-01

The author deals with the results from the interviewing of oral surgery patients on their problems concerning the sending and the admission to the hospital, with special attention to the problems of waiting for admission, the familiarization with the clinical environment and the improvement suggestions of the patients. The conclusions concern tasks arising from the medical and dental care for inpatients as well as for outpatients.

Hypofractionated Radiation Therapy Followed by Surgery in Treating Patients With Advanced Squamous Cell Carcinoma of the Oral Cavity

Science.gov (United States)

2017-11-15

Stage III Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage III Verrucous Carcinoma of the Oral Cavity; Stage IVA Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVA Verrucous Carcinoma of the Oral Cavity; Stage IVB Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVB Verrucous Carcinoma of the Oral Cavity; Tongue Cancer

Problems associated with basic oral surgical techniques

International Nuclear Information System (INIS)

Kapatkin, A.S.; Marretta, S.M.; Schloss, A.J.

1990-01-01

The veterinarian must be able to diagnose several types of dental problems. History, physical examination, clinical pathology, and radiography are important in making an accurate diagnosis. Basic oral surgery includes various extraction techniques and management of their associated complications. Knowledge of dental anatomy and proper surgical technique can make an extraction curative rather than a frustrating procedure with multiple complications

Comparing disciplines: outcomes of non melanoma cutaneous malignant lesions in oral and maxillofacial surgery and dermatology.

Science.gov (United States)

Thavarajah, M; Szamocki, S; Komath, D; Cascarini, L; Heliotis, M

2015-01-01

300 cases of non-melanoma cutaneous lesion procedures carried out by the Oral and Maxillofacial Surgery and Dermatology departments in a North West London hospital over a 6 month period between September 2011 and February 2012 were included in a retrospective case control study. The results from each speciality were compared. The mean age of the OMFS group was 75.8 years compared to 69.9 years in the dermatology group. There was no statistically significant difference in gender between the 2 groups. The OMFS group treated a higher proportion of atypical (17%) and malignant (64.9%) cases compared to the dermatology group (11.3% and 50.5% respectively). This could also account for the fact that the OMFS group carried out a higher number of full excisions compared to dermatology. Both groups had a similar number of false positives (a benign lesion initially diagnosed as malignant) and a similar proportion of false negatives (a malignant lesion initially diagnosed as benign). Overall, the results show that both specialities had similar outcomes when managing non-melanoma cutaneous lesions. Both groups adhere to the guidelines set out by the British Association of Dermatologists and the National Institute of Clinical Excellence when managing such lesions. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

Surgical and cryosurgical salvage of oral and oropharyngeal cancer recurring after radical radiotherapy

International Nuclear Information System (INIS)

Meyza, J.W.; Towpik, E.

1991-01-01

The results of salvage surgery or cryosurgery performed in 62 cases or oral or oropharyngeal cancer, recurring or persisting after radical radiotherapy, were analysed retrospectively. Salvage surgery was performed in 33 cases. The relatively high frequency of postoperative complications observed in years 1973-1984 has declined since 1985, concomitant with the introduction of myocutaneous flaps for reconstruction. Twenty-nine patients who were disqualified from major surgery, were treated by cryosurgery. Using both methods, 3-year overall survival was obtained in 24.1% of cases. (author)

Non-surgical complications following bariatric surgery

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Polovina Snežana

2017-01-01

Full Text Available Bariatric surgery is the most efficient treatment for obesity and comorbidities. This treatment modality is the most potent for weight reduction with long-term weight maintenance and positive metabolic effects. The effect on weight loss and possible side effect depends of type of surgery. Micro and macronutrient deficiencies can occur after malapsorptive procedures. Iron deficiency occurs in almost half of patients following RYGB (Roux-en-Y gastric bypass. The main causes of iron deficiency are insufficient meat ingestion and lack of hydrochloric acid after removal of pylorus. B12 deficiency occured 6 months after RYGB in patients with oral supplementation of B12. Bone turnover increased three months after RYGB, and the levels of bone turnover markers increased 200% in next 12-18 months. Impaired vitamin D absorption leads to decreased calcium absorption and secondary hyperparathyroidism with lower bone mineral density. After the bariatric surgery, testosterone level becomes higher and all sexual quality indicators improving. Malapsorptive procedures with nutritive deficiency can cause oligo-astenozooteratospermia and male infertility. Due to the same reason pregnancy is not recommended in the first year bariatric surgery. Possible side effect of pregnancy within 12 months after surgery is fetal growth retardation. There is twice higher incidence for developing alcohol or other addition after bariatric surgery then in non-operated obese patients. The frequency of depressive episodes and suicide attempt is higher after bariatric surgery.

Bilateral Acute Angle-closure after Intraocular Surgery.

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Hoskens, Kirsten; Pinto, Luis Abegão; Vandewalle, Evelien; Verdonk, Nancy; Stalmans, Ingeborg

2014-01-01

We report the case of a 75-year-old woman who developed an acute bilateral angle-closure associated with choroidal effusion a day after an uneventful cataract surgery. The same patient had undergone a similarly uneventful cataract surgery two weeks before, under the same protocol, with no postoperative complication in the other eye. Medical treatment, including the use of oral sulfamide-related drugs (acetazolamide), topical beta-blockers and steroids led to a gradual decrease in intraocular pressure (IOP) and choroidal effusion. Despite initial reports suggesting a link between sulfamide-exposure and these rare forms of angle-closure, our report would suggest a more complex pathophysiology behind this intriguing phenomenon. How to cite this article: Hoskens K, Pinto LA, Vandewalle E, Verdonk N, Stalmans I. Bilateral Acute Angle-closure after Intraocular Surgery. J Curr Glaucoma Pract 2014;8(3):113-114.

Application of interstitial radiotherapy for cancers of the tongue and oral caving mucosa

International Nuclear Information System (INIS)

Zamyatin, O.A.; Vakhramova, M.P.; Razorenova, E.V.

1997-01-01

The report deals with new procedures of interstitial, complex and combined treatment of cancer of the tongue and mucosa of fundus of the oral cavity with time space-differentiated doses of radiation. If indicated, cervical lymph nodes undergo surgery at the final stage of therapy. Interstitial radiotherapy has proved a highly-effective radical component of said treatment for cancers of the tongue and oral cavity

No effect of melatonin to modify surgical-stress response after major vascular surgery: a randomised placebo-controlled trial

DEFF Research Database (Denmark)

Kücükakin, B; Wilhelmsen, M; Lykkesfeldt, Jens

2010-01-01

A possible mechanism underlying cardiovascular morbidity after major vascular surgery may be the perioperative ischaemia-reperfusion with excessive oxygen-derived free-radical production and increased levels of circulating inflammatory mediators. We examined the effect of melatonin infusion during...... surgery and oral melatonin treatment for 3 days after surgery on biochemical markers of oxidative and inflammatory stress....

The effect of video-assisted oral feedback versus oral feedback on surgical communicative competences in undergraduate training.

Science.gov (United States)

Ruesseler, M; Sterz, J; Bender, B; Hoefer, S; Walcher, F

2017-08-01

Feedback can significantly improve future performance. Reviewing one's performance by video is discussed as useful adjunct to debriefing, particularly for non-technical skills. Communicative competencies are an essential part of daily clinical practice; thus should be taught and assessed during undergraduate training. The aim of this study was to compare the educational value of video-assisted feedback versus oral feedback in communicative competencies in the surgical context. Fourth-year medical students completed a 210-min training unit of 'taking patient's history and obtaining informed consents prior to surgery' using role plays. Oral feedback was received directly thereafter using agenda-led, outcome-based guidelines (ALOBA). In the study group, the role plays were video-taped and reviewed thereafter. Afterwards, students completed two OSCE stations, where they were assessed regarding their communicative competencies and the content of the clinical scenario. One-hundred students (49 receiving video-assisted feedback, 51 oral) participated in the study. Those receiving video-assisted feedback performed significantly better in overall score in both OSCE stations (p feedback offered a significant educational benefit over oral feedback alone during a simulated patient encounter in a surgical context.

Changes in quality of life and impact on patients′ perception of esthetics after orthognathic surgery

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Kavin, Thangavelu; Jagadesan, Anbuselvan Gobichetty Palayam; Venkataraman, Siva Subramaniam

2012-01-01

Objectives: The aim of our study is to determine the changes in quality of life and patient′s perception of esthetic improvement after anterior maxillary osteotomy. Materials and Methods: Our prospective study consisted of 14 patients who had been diagnosed of skeletal orthodontic deformity and underwent anterior maxillary osteotomy, along with orthodontic correction. The quality of life was evaluated using questionnaires based on Oral Health Impact Profile-14 questionnaire (OHIP-14) and a 22-item orthognathic quality of life questionnaire. They were evaluated at baseline pre-surgical, 8 weeks postoperatively, and 24 weeks postoperatively. Results: Our results showed mild improvement in generic health related quality of life immediately following surgery, while condition-specific quality of life and patient′s perception of esthetic improvement were noted only at 24 weeks following anterior maxillary osteotomy. Conclusion: We conclude that anterior maxillary osteotomy had a positive impact on the quality of life. The improvement in patient's perception of esthetics is seen only 2 months after surgery, while improvements in oral health and function were seen within 2 months following surgery. The acceptance and satisfaction of patient toward surgery was more positive 2 months after surgery. PMID:23066273

The use of optical coherence tomography in maxillofacial surgery

Science.gov (United States)

Al-Obaidi, Mohammed; Tandon, Rahul; Tiwana, Paul

2015-02-01

The ever-evolving medical field continues to trend toward less invasive approaches to the diagnosis and treatment of pathological conditions. Basic sciences research has allowed for improved technologies that are translated to the clinical sciences. Similarly, advancements in imaging modalities continue to improve and their applications become more varied. As such, surgeons and pathologists are able to depend on smaller samples for tissue diagnosis of pathological disease, where once large sections of tissue were needed. Optical coherence tomography (OCT), a high-resolution imaging technique, has been used extensively in different medical fields to improve diagnostic yield. Its use in dental fields, particularly in oral and maxillofacial surgery, remains limited. Our goal is to assess the use of OCT for improving soft tissue analysis and diagnosis, particularly for its applications in the field of oral and maxillofacial surgery. Optical coherence tomography is a modality that uses an optical signal using safe near-infrared light which is reflected off the sub-surface structures. This allows for high-resolution cross-sectional images of the tissue morphology to be obtained. Ophthalmologists have been using OCT to obtain images of the retina to assess for age-related macular degeneration. More recently, OCT has been used by Interventional Cardiology to image coronary arteries, and assess plaque thickness and morphology. This technology is now being investigated in several medical fields as a form of optical biopsy, providing in situ images with high-resolution morphology of tissues. We are particularly interested in its use on epithelial tissues, and therefore performed a literature review on the use of OCT for assessing epithelium. Evaluation of histologically-diagnosed actinic keratosis, for example, was found to correlate well with the imaging discrepancies found on OCT; and the in vivo assessment of atypical keratinocytes was firmly established. Additionally

Analysis of oral cancer treated by preoperative radiotherapy

International Nuclear Information System (INIS)

Hosokawa, Yoichiro; Kaneko, Masayuki; Yasuda, Motoaki

1997-01-01

Fifty-eight patients with squamous cell carcinoma of the oral region, treated by preoperative radiotherapy between January 1988 and December 1993, were reviewed to evaluate the relation between prognosis and pathological findings after preoperative radiotherapy. All patients underwent external radiotherapy of up to 40 Gy in 16 fractions (2.5 Gy a day, 4 fractions a week) before surgery, and the average term from the end of preoperative radiotherapy to surgery were 27.3 days. According to pathological findings during surgery, the patients were divided into a radiation effective group and a radiation noneffective group. There was a significant difference in the survival rates of the two groups, but there was no difference in local control rates. After surgery, regional lymph node metastasis and distant metastasis were more common in the radiation noneffective group than in the radiation effective group. It was considered that regional lymph node metastasis after treatment in the noneffective group is the determining factor in the progress. (author)

The results of CO2 laser surgery in patients with oral leukoplakia : a 25 year follow

NARCIS (Netherlands)

van der Hem, PS; Nauta, JM; van der Wal, JE; Roodenburg, JLN

Oral leukoplakia, is an important premalignant Lesion of the oral mucosa. We treat this Lesion prophylactically with CO2 laser evaporation. In the period from 1976 to 2001, a group of 200 patients with 282 oral leukoplakias were treated by CO2 laser evaporation. In a follow up period of 1-219 months

Using a clinical protocol for orthognathic surgery and assessing a 3-dimensional virtual approach: current therapy.

Science.gov (United States)

Quevedo, Luis A; Ruiz, Jessica V; Quevedo, Cristobal A

2011-03-01

Oral and maxillofacial surgeons who perform orthognathic surgery face major changes in their practices, and these challenges will increase in the near future, because the extraordinary advances in technology applied to our profession are not only amazing but are becoming the standard of care as they promote improved outcomes for our patients. Orthognathic surgery is one of the favorite areas of practicing within the scope of practice of an oral and maxillofacial surgeon. Our own practice in orthognathic surgery has completed over 1,000 surgeries of this type. Success is directly related to the consistency and capability of the surgical-orthodontic team to achieve predictable, stable results, and our hypothesis is that a successful result is directly related to the way we take our records and perform diagnosis and treatment planning following basic general principles. Now that we have the opportunity to plan and treat 3-dimensional (3D) problems with 3D technology, we should enter into this new era with appropriate standards to ensure better results, instead of simply enjoying these new tools, which will clearly show not only us but everyone what we do when we perform orthognathic surgery. Appropriate principles need to be taken into account when implementing this new technology. In other words, new technology is welcome, but we do not have to reinvent the wheel. The purpose of this article is to review the current protocol that we use for orthognathic surgery and compare it with published protocols that incorporate new 3D and virtual technology. This report also describes our approach to this new technology. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Penetration of topical, oral, and combined administered ofloxacin into the subretinal fluid

OpenAIRE

Cekic, O.; Batman, C.; Yasar, U.; Totan, Y.; Basci, N.; Bozkurt, A.; Zilelioglu, O.; Kayaalp, S

1999-01-01

AIMS—To assess the subretinal fluid (SRF) levels of ofloxacin following topical, oral or combined administration.
METHODS—31 patients undergoing conventional retinal reattachment surgery were randomly assigned to three groups. Nine patients received topical ofloxacin, 11 patients received oral ofloxacin, and the other 11 patients received combined administration. Collected SRF samples were analysed for drug level by using high performance liquid chromatography.
RESULTS—SRF drug levels after o...

Cultivated Oral Mucosa Epithelium in Ocular Surface Reconstruction in Aniridia Patients

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Dariusz Dobrowolski

2015-01-01

Full Text Available Purpose. Efficacy of cultivated oral mucosa epithelial transplantation (COMET procedure in corneal epithelium restoration of aniridia patients. Methods. Study subjects were aniridia patients (13 patients; 17 eyes with irregular, vascular conjunctival pannus involving visual axis who underwent autologous transplantation of cultivated epithelium. For the procedure oral mucosa epithelial cells were obtained from buccal mucosa with further enzymatic treatment. Suspension of single cells was seeded on previously prepared denuded amniotic membrane. Cultures were carried on culture dishes inserts in the presence of the inactivated with Mitomycin C monolayer of 3T3 fibroblasts. Cultures were carried for seven days. Stratified oral mucosa epithelium with its amniotic membrane carrier was transplanted on the surgically denuded corneal surface of aniridia patients with total or subtotal limbal stem cell deficiency. Outcome Measures. Corneal surface, epithelial regularity, and visual acuity improvement were evaluated. Results. At the end of the observation period, 76.4% of the eyes had regular transparent epithelium and 23.5% had developed epithelial defects or central corneal haze; in 88.2% of cases visual acuity had increased. VA range was from HM 0.05 before the surgery to HM up to 0.1 after surgery. Conclusion. Application of cultivated oral mucosa epithelium restores regular epithelium on the corneal surface with moderate improvement in quality of vision.

In vitro studies of nanosilver-doped titanium implants for oral and maxillofacial surgery

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Pokrowiecki R

2017-06-01

Full Text Available Rafał Pokrowiecki,1,2 Tomasz Zaręba,3 Barbara Szaraniec,4 Krzysztof Pałka,5 Agnieszka Mielczarek,6 Elżbieta Menaszek,7 Stefan Tyski3,8 1Center for Cranio-Maxillo-Facial Surgery, Voivodeship Children’s Hospital, Olsztyn, 2Department of Oral Surgery, Jagiellonian Medical University, Kraków, 3Department of Antibiotics and Microbiology, National Medicines Institute, Warsaw, 4Faculty of Material Science and Ceramics, AGH University of Science and Technology, Kraków, 5Department of Materials Engineering, Lublin University of Technology, Lublin, 6Department of Conservative Dentistry, Medical University of Warsaw, Warsaw, 7Department of Cytobiology, Collegium Medicum, Jagiellonian University, Kraków, 8Department of Pharmaceutical Microbiology, Medical University of Warsaw, Warsaw, Poland Abstract: The addition of an antibacterial agent to dental implants may provide the opportunity to decrease the percentage of implant failures due to peri-implantitis. For this purpose, in this study, the potential efficacy of nanosilver-doped titanium biomaterials was determined. Titanium disks were incorporated with silver nanoparticles over different time periods by Tollens reaction, which is considered to be an eco-friendly, cheap, and easy-to-perform method. The surface roughness, wettability, and silver release profile of each disc were measured. In addition, the antibacterial activity was also evaluated by using disk diffusion tests for bacteria frequently isolated from the peri-implant biofilm: Streptococcus mutans, Streptococcus mitis, Streptococcus oralis, Streptococcus sanguis, Porphyromonas gingivalis, Staphylococcus aureus, and Escherichia coli. Cytotoxicity was evaluated in vitro in a natural human osteoblasts cell culture. The addition of nanosilver significantly increased the surface roughness and decreased the wettability in a dose-dependent manner. These surfaces were significantly toxic to all the tested bacteria following a 48-hour exposure

[Orthognathic surgery in adults: state of the art].

Science.gov (United States)

Charrier, Jean-Baptiste

2014-03-01

The objective of orthognathic surgery is the repositioning of the osseous bases of the jaws. Its consequences are both aesthetic and functional. As adults are increasingly concerned with appearance, orthognathic surgery is today, more than ever, a close collaboration between the orthodontist, surgeon and general dentist. The whole team must be capable of coordinating its approach with an aesthetic objective. For the surgeon, a perfect knowledge of complementary techniques (rhinoplasty, bone grafts, plastic surgery of the face, lipostructure or fillers) makes orthognathic surgery a completely separate surgical speciality. The aim of this article is to establish the philosophy underlying this type of treatment and define relevant fundamental aspects. We propose an esthetic "extra-oral" clinical approach not focused on occlusal anomalies but on classification of tooth positional abnormalities in the smile and the therapeutic options that we have for placing teeth in correct positions in the smile. © EDP Sciences, SFODF, 2014.

Pharmacokinetics of Repeated Melatonin Drug Administrations Prior to and After Surgery

DEFF Research Database (Denmark)

Harpsøe, Nathja Groth; Andersen, Lars Peter Kloster; Mielke, Louise Vennegaard

2016-01-01

BACKGROUND: Recent clinical studies have documented the analgesic, anti-inflammatory, antioxidative and anxiolytic effects of exogenous melatonin. The pharmacokinetic properties of melatonin have primarily been investigated in experimental studies. OBJECTIVE: The aim of this study was to estimate...... the pharmacokinetics of melatonin in patients undergoing surgery and general anesthesia. METHODS: The study was designed as a prospective, two-phase cohort study. Patients were candidates for subpectoral breast augmentation surgery, and surgical procedures were performed by a single surgeon. The perioperative...... treatment protocol was standardized between patients. During the study, each patient received two separate oral administrations of melatonin 10 mg. Melatonin was administered 60 min before surgery, and at 9:00 p.m. the evening after surgery. The pharmacokinetic variables absorption half-life (t ½ absorption...

Proteomic and transcriptomic profiling of in vitro established radiation resistant oral cancer cells for identification of radioresistance related biomarkers

International Nuclear Information System (INIS)

Mohd Yasser; Pawar, Sagar; Teni, Tanuja

2016-01-01

Radiotherapy is an integral part of oral cancer treatment, either alone or in combination with surgery. But, during radiotherapy, oral tumours of a subset of patients develop radioresistance that creates major obstruction towards its efficacy. The aim of our study was to establish radioresistant cell lines from different oral subsites using clinically admissible low dose radiation and profile them by proteomic and transcriptomic approaches to identify proteins associated with radioresistance in oral cancer

[Three Cases of Unresectable, Advanced, and Recurrent Colorectal Cancer Associated with Gastrointestinal Obstruction That Were Treated with Small Intestine-Transverse Colon Bypass Surgery].

Science.gov (United States)

Ida, Arika; Miyaki, Akira; Miyauchi, Tatsuomi; Yamaguchi, Kentaro; Naritaka, Yoshihiko

2016-11-01

Herein, we report 3cases of unresectable, advanced, and recurrent colorectal cancer associated with gastrointestinal obstruction. The patients were treated with small intestine-transverse colon bypass surgery, which improved the quality of life (QOL)in all cases. Case 1 was an 80-year-old woman who presented with subileus due to ascending colon cancer. After surgery, her oral intake was reestablished, and she was discharged home. Case 2 was an 89-year-old woman whose ileus was caused by cecal cancer with multiple hepatic metastases. After surgery, the patient was discharged to a care facility. Case 3 was an 83-year-old man whose ileus was caused by a local recurrence and small intestine infiltration after surgery for rectosigmoid cancer. He underwent surgery after a colonic stent was inserted. His oral intake was re-established and he was discharged home. Small bowel-transverse colon bypass surgery can be used to manage various conditions rostral to the transverse colon. It is still possible to perform investigations in patients whose general condition is poorer than that of patients who undergo resection of the primary lesion. This avoids creating an artificial anus and allows continuation of oral intake, which are useful for improving QOL in terminal cases.

Oral rehabilitation of segmental mandibulectomy patient with osseointegrated dental implant

Directory of Open Access Journals (Sweden)

Archana Singh

2014-01-01

Full Text Available Surgical management of oral cancer lesions results in explicit aesthetic and functional disfigurement, including facial deformity, loss of hard and soft tissue, impaired speech, swallowing and mastication, which modify the patient′s self-image and quality-of-life. Recent advances in head and neck reconstruction techniques and dental implant based prosthetic rehabilitation may significantly improve the quality-of-life and self-esteem for such post-surgery patients. This clinical report describes rehabilitation of oral cancer patient having segmental mandibulectomy with implant-supported fixed partial denture.

Clinical outcome and health-related quality-of-life following microsurgical reconstruction in patients with oral and oropharyngeal cancer

DEFF Research Database (Denmark)

Al-Hayder, Shems; Elberg, Jens Jørgen; Charabi, Birgitte

2017-01-01

L in patients with oral or oropharyngeal cancer following free flap reconstruction. Methods: A retrospective review of medical records and self-administered HRQoL questionnaires, EORTC QLQ-C30, and -H&N35. All patients who underwent surgery for oral or oropharyngeal cancer followed by primary reconstruction...

Phase II trial of induction chemotherapy followed by surgery for squamous cell carcinoma of the oral tongue in young adults.

Science.gov (United States)

Kies, Merrill S; Boatright, Dowin H; Li, Guojun; Blumenschein, George; El-Naggar, Adel K; Brandon Gunn, G; Lewin, Jan S; Steinhaus, Ganene D; Sturgis, Erich M

2012-09-01

We conducted a phase II clinical trial of induction chemotherapy followed by surgery ± radiotherapy for squamous cell carcinoma of the oral tongue (SCCOT) in young adults. From September 2001 to October 2004, 23 patients aged 18 to 49 years with clinical T2-3 N0-2 M0 SCCOT and no prior radiotherapy, chemotherapy, or neck dissection underwent induction chemotherapy (paclitaxel, ifosfamide, and carboplatin) followed by glossectomy and neck dissection ± radiotherapy and chemotherapy. On final surgical pathology, 9 patients (39%) had a complete/major (2 complete) histologic response at the primary tumor site; 8 patients (35%) had no response or progression. Similarly, 9 patients (39%) had a complete response in the neck or remained node negative; 6 patients (26%) had an increase in nodal category. No treatment-associated deaths occurred, and toxicity was modest. At a median follow-up from the end of treatment of 52 months (minimum, 23 months), 10 patients (43%) developed recurrence, and all 10 died of cancer. Crude recurrence/cancer death rates were associated with ≤ a partial response at the tongue (p = .029), poor histologic differentiation (p = .012), and multiple adverse features on final surgical pathology (p = .040). Response rates and overall survival with this induction chemotherapy regimen were limited, but complete/major response at the tongue was associated with excellent prognosis. Additionally, improved patient selection and predictive tumor biomarkers will be needed for induction chemotherapy to be routinely incorporated into the treatment of oral tongue cancer in young adults. Copyright © 2011 Wiley Periodicals, Inc.

A randomized trial of preoperative oral carbohydrates in abdominal surgery

OpenAIRE

Sada, Fatos; Krasniqi, Avdyl; Hamza, Astrit; Gecaj-Gashi, Agreta; Bicaj, Besnik; Kavaja, Floren

2014-01-01

Background Carbohydrate-rich liquid drinks (CRLDs) have been recommended to attenuate insulin resistance by shortening the preoperative fasting interval. The aim of our study the effect of preoperative oral administration of CRLDs on the well-being and clinical status of patients. Methods A randomized, double blind, prospective study of patients undergoing open colorectal operations (CR) and open cholecyctectomy (CH) was conducted. Patients were divided into three groups: study, placebo, and ...

COMPARISON OF THE EFFECTS OF ORAL VS. PERITONSILLAR INFILTRATION OF KETAMINE IN PAIN REDUCTION AFTER TONSILLECTOMY: A RANDOMIZED CLINICAL TRIAL.

Science.gov (United States)

Norouzi, Afsaneh; Jafari, Abolfazl; Vishteh, Hamid Reza Khoddami; Fateh, Shahin

2015-02-01

Although oral ketamine has been used in some cases to reduce pain in children, the use of this drug to reduce pain after tonsillectomy has not been studied yet. This double-blind clinical trial was conducted in 2009 in 92 children who were aged three to nine years old, met ASA I or II criteria, and were candidate for tonsillectomy. Patients were divided randomly into two groups. Half an hour before general anesthesia, 5 mg/kg ketamine mixed in 2 cc/kg apple juice was given to the children in oral ketamine group and 2 cc/kg of apple juice alone was given to the children in the peritonsillar group. After general anesthesia and three minutes before surgery 1 cc of 0.9% normal saline in the oral group and 1cc of ketamine (0.5 mg/kg) in the peritonsillar group was injected to the tonsil bed of patients. There was no difference between the two groups in terms of sex, age, and weight. Duration of surgery was significantly shorter in the peritonsillar group (P pain in children six hours after surgery according to CHEOPS criteria was significantly lower in the peritonsillar group (0.9 ± 0.8) than in the oral group (2.6 ± 1) (P ketamine, the use of oral ketamine before general anesthesia was less effective in reducing postoperative pain of tonsillectomy in children.

Preoperative oral dextromethorphan does not reduce pain or morphine consumption after open cholecystectomy

Directory of Open Access Journals (Sweden)

Mahmoodzadeh Hossein

2009-01-01

Full Text Available Background: Dextromethorphan, the D-isomer of the codeine analog levorphanol, is a weak, noncompetitive N-Methyl-D-Aspartate (NMDA receptor antagonist. It has been suggested that NMDA receptor antagonists induce preemptive analgesia when administered before tissue injury occurs, thus decreasing the subsequent sensation of pain. Materials and Methods: The study was conducted in the Dr. Ali Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran, between February 2005 and December 2006. In this study, 72 patients scheduled for elective cholesyctectomy were randomized into three groups to receive either oral dextromethorphan 45 mg (Group D45 = 24, dextromethorphan 90 mg (Group D90 = 24, or placebo (Group C, n = 24, as premedication, 120 minutes before surgery. A visual analog scale (VAS for pain of each patient was measured at arrival in the ward and six and 24 hours after surgery. Results: The demographic characteristics of patients, ASA physical status class, duration of surgery, and the basal VAS pain score were similar in the two groups. There was no significant difference in the mean of the VAS pain scores measured over time or morphine consumption among the three groups. Conclusion: Dextromethorphan 45 mg and 90 mg, administrated orally, two hours before surgery, had no effect on postoperative morphine requirement and pain intensity.

Combined-modality treatment in advanced oral squamous cell carcinoma. Primary surgery followed by adjuvant concomitant radiochemotherapy

International Nuclear Information System (INIS)

Kreppel, Matthias; Dreiseidler, Timo; Zoeller, Joachim E.; Scheer, Martin; Drebber, Uta; Eich, Hans-Theodor; Mueller, Rolf-Peter

2011-01-01

The efficacy of adjuvant radiochemotherapy (RCT) in patients with advanced stage head and neck carcinoma has been proven in prospective randomized trials. However, these trials focused on different head and neck sites. Specific analyses for treatment effects in squamous cell carcinoma of the oral cavity (OSCC) are missing. We evaluated our experiences with adjuvant concomitant RCT in advanced OSCC to compare the results with other treatment schemes using adjuvant RCT. A total of 183 patients with OSCC of UICC stages II-IVb were reviewed retrospectively. All patients were treated with radical surgery followed by adjuvant, conventional fractionated concomitant RCT using carboplatin. Overall survival was plotted by Kaplan-Meier analysis. Prognostic factors were identified through univariate and multivariate analysis. Univariate analysis showed a significant impact of T, N, and UICC stage, histopathologic grading, surgical margins, extracapsular spread (ECS), and lymphangiosis carcinomatosa on overall survival (Table 3). Patients with stage IVa had a higher 5-year overall survival rate (42.8%) than patients with stage IVb (25.0%) (Figure 1). The differences were significant in multivariate analysis (p = 0.033) (Table 4). Adjuvant concomitant RCT is an effective treatment in patients with advanced stage OSCC. However, it remains unclear, which patients should be treated with adjuvant RCT. For patients with stage IVb, adjuvant RCT yields poor results. Prospective randomized trials are needed to confirm which patients should be treated with adjuvant RCT. (orig.)

Assessment of bleeding during minor oral surgical procedures and extraction in patients on anticoagulant therapy

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S Jimson

2015-01-01

Full Text Available Introduction: The risk of postoperative hemorrhage from oral surgical procedures has been a concern in the treatment of patients who are receiving long-term anticoagulation therapy. A study undertaken in our institution to address questions about the amount and severity of bleeding associated with minor outpatient oral surgery procedures by assessing bleeding in patients who did not alter their anticoagulant regimen. Subjects and Methods: Eighty-three patients receiving long-term anticoagulant therapy visited Department of Oral and Maxillofacial Surgery from May 2010 to October 2011 for extractions and minor oral surgical procedures. Each patient was required to undergo preoperative assessment of prothrombin time (PT and measurement of the international normalized ratio. Fifty-six patients with preoperative PT values within the therapeutic range 3-4 were included in the study. The patients′ age ranged between 30 and 75 years. Application of surgispon was done following the procedure. Extraction of teeth performed with minimal trauma to the surrounding tissues, the socket margins sutured, and sutures removed after 5 days. Results: There was no significant incidence of prolonged or excessive hemorrhage and wound infection and the healing process was normal.

Why Do Women Choose to Enter Academic Oral and Maxillofacial Surgery?

Science.gov (United States)

Kolokythas, Antonia; Miloro, Michael

2016-05-01

To determine why women choose to enter an academic career in oral and maxillofacial surgery (OMS). An online questionnaire was developed and e-mailed to female OMS surgeons to assess the reasons women choose to pursue an academic career, the perceived positive and negative features of academia for women, and proposed measures to increase the percentage of women choosing to specialize in OMS and pursue an academic career. Thirty-one female OMS surgeons completed the questionnaire; 1 additional participant accessed the survey but did not respond to any of the questions. There were 25 full-time academics and 6 part-time academics (≥50% time commitment). Of the responders, 72% were married, and of these, 72% were married before entering academics. Forty-seven percent of the women had children, all during their academic tenure. Among the full-time academicians with children, only 2 (7.7%) reported moderate difficulty finding the time for childbirth and maternity leave, whereas 3 of the 5 part-time academics with children reported moderate or significant difficulty with childbirth and maternity leave. Factors associated with choosing and enjoying an academic career are involvement in resident-student teaching (78%), followed by colleague camaraderie and collaboration (65.6%), research potential (50%), time flexibility, and not having to deal with excessive "business" practice issues (33%). The main reason for considering leaving an academic OMS career and/or among the least enjoyable aspects of being in academics was the potential for a higher income in private practice (56%). Less significant reasons for considering leaving an academic OMS career were a more flexible work schedule in the private sector and less institutional red tape (37.5%), as well as independence/being in control and more family time (22%). Engaging residents and students by female OMS surgeons, better mentorship from academic OMS surgeons, and increasing the number of women serving in leadership

Use of oral mucoperiosteal and Pterygo-masseteric muscle flaps as ...

African Journals Online (AJOL)

Background: The most common complication of surgery for the release of temporomandibular joint (TMJ) ankylosis is relapse of the ankylosis. To prevent re‑ankylosis, a variety of interpositional materials have been used. Aim: The aim was to compare the surgical outcome of oral mucoperiosteal flap, not hitherto used as ...

A intervenção fonoaudiológica no pós-operatório da hipertrofia benigna do músculo masseter The miofunctional oral intervention in the surgery treatment for the masseter muscle hipertrophy

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Laura Davison Mangilli

2006-04-01

Full Text Available OBJETIVO: descrever a abordagem fonoaudiológica no pós-operatório de pacientes que realizaram correção cirúrgica da hipertrofia do músculo masseter. METODOLOGIA: foram coletados dados referentes à avaliação e ao tratamento fonoaudiológico de 4 prontuários de sujeitos de ambos os gêneros, com faixa etária entre 16 e 24 anos, com hipertrofia benigna do músculo masseter, tratados cirurgicamente. RESULTADOS: as principais queixas pós-cirúrgicas estiveram relacionadas à limitação da abertura da boca, à dor na região da cirurgia, à rigidez muscular e a estalo em região da ATM. A terapia fonoaudiológica baseou-se em orientação quanto à retirada de hábitos deletérios; termoterapia na região do músculo masseter; manipulação da musculatura envolvida extra e intrabucais; alongamento da musculatura facial e cervical; alavanca de abertura forçada de boca e exercícios de órgãos fonoarticulatórios. CONCLUSÕES: a terapia fonoaudiológica apresenta-se como uma possibilidade de complementação ao tratamento cirúrgico, na adequação da amplitude dos movimentos mandibulares, assim como na eliminação dos sintomas presentes no pós-cirúrgico e na conscientização dos hábitos deletérios, que são apontados pela literatura como possíveis fatores desencadeantes.AIM: the aim of this study was to describe miofunctional oral intervention in patients with Masseter muscle hipertrophy treated by surgery. METHODS: the sample consisted of 4 patients, male and female, with ages between 16 and 24 years, with Masseter muscle hipertrophy treated by surgery. RESULTS: the main complains on the postoperative were related to trismus, muscle rigidity, and clicking in the temporomandibular joint. The myofunctional oral therapy was based on orientation in the abnormal habits (bruxism, clenching elimination, hyperthermia induced in the masseter muscle, oral muscles massage, facial and cervical muscles stretching, miofunctional exercises and

Maximum mouth opening and trismus in 143 patients treated for oral cancer: a 1-year prospective study.

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Wetzels, Jan-Willem G H; Merkx, Matthias A W; de Haan, Anton F J; Koole, Ron; Speksnijder, Caroline M

2014-12-01

Patients with oral cancer can develop restricted mouth opening (trismus) because of the oncologic treatment. Maximum mouth opening (MMO) was measured in 143 patients shortly before treatment and 0, 6, and 12 months posttreatment, and the results were analyzed using a linear mixed-effects model. In every patient, MMO decreased after treatment. The patients who underwent surgery, recovered partially by 6 and 12 months after treatment, whereas the patients who received both surgery and radiotherapy or primary radiotherapy did not recover. Tumor location, tumor size, and alcohol consumption had independent effects on MMO. Having trismus (MMO oral cancer treatment. © 2014 Wiley Periodicals, Inc.

Secondary Bleedings in Oral Surgery Emergency Service: A Cross-Sectional Study

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Sebastian Igelbrink

2018-01-01

Full Text Available Introduction. Bleeding after dental surgery is still a common cause for emergency presentation in patients using anticoagulants. Our aim was to analyze pertinent characteristic features on the one hand and to bare existing problems in handling on the other. Materials and Methods. The study included 76 patients. We documented basic data, anticoagulant medication, type of surgery, and tooth socket sutures in respective patients. Results. The vast majority of patients took a coumarin derivative (41 and acetylsalicylic acid (27. Nine (12% of the patients had to be hospitalized due to ongoing bleeding despite local haemostyptic steps and/or circulatory dysregulation. Most patients could be successfully treated in outpatient settings. No statistically significant correlation between bleeding, level of INR value, number of extracted teeth, and sewed alveoli could be shown. Sixty-five percent of cases with tooth extractions did not have suture of tooth sockets. Eighty-seven percent of the patients denied being informed about possible self-treatment options by their surgeon/dentist, and none of the patients got presurgical-fabricated bandage plate(s. Conclusions. Patients taking coumarin derivative currently, furthermore, represent the biggest anticoagulant after-bleeding group in dentoalveolar surgery. The major part of after-bleedings (90% can be handled in an outpatient setting with simplest surgical interventions. Unfortunately, the biggest part of the patient collective got no suture, no prefabricated dental bandage plate(s, and no explanation by their dentist how to handle in case of after-bleeding. Therefore, dental practitioners should furthermore get enlightenment on how to prevent after-bleeding situations.

Cryosurgery as an effective alternative for treatment of oral lesions in children.

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Rezende, Karla Mayra; Moraes, Paulo de Camargo; Oliveira, Luciana Butini; Thomaz, Luiz Alexandre; Junqueira, José Luiz Cintra; Bönecker, Marcelo

2014-01-01

Children can exhibit a wide variety of oral pathologies, such as oral lesions, bone lesions, tumors, cysts and cutaneous lesions. Different techniques have been described for the treatment of these lesions, but all of them are invasive. This paper presents a series of cases that demonstrate the clinical efficacy of cryosurgery as an alternative to invasive surgical treatments of the most common oral lesions in children. This technique has been well tolerated by patients due to the absence of anesthesia, rapid healing and minimal bleeding. Cryotherapy has many applications in oral medicine and is an extremely useful alternative in patients to whom surgery is contraindicated due to age or medical history. It is a simple procedure to perform, minimally invasive, low-cost and very effective in pediatric dentistry clinic.

Long-Term Endocrine Outcomes Following Endoscopic Endonasal Transsphenoidal Surgery for Acromegaly and Associated Prognostic Factors.

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Babu, Harish; Ortega, Alicia; Nuno, Miriam; Dehghan, Aaron; Schweitzer, Aaron; Bonert, H Vivien; Carmichael, John D; Cooper, Odelia; Melmed, Shlomo; Mamelak, Adam N

2017-08-01

Long-term remission rates from endoscopic transsphenoidal surgery for acromegaly and their relationship to prognostic indicators of disease aggressiveness are not well documented. To investigate long-term remission rates in patients with acromegaly after endoscopic transsphenoidal surgery, and correlate this with molecular and radiographic markers of disease aggressiveness. We identified all patients undergoing endoscopic transsphenoidal surgery for acromegaly from 2005 to 2013 at Cedars-Sinai Pituitary Center. Hormonal remission was established by normal insulin-like growth factor (IGF)-1, basal serum growth hormone <2.5 ng/mL, and growth hormone suppression to <1 ng/mL following oral glucose tolerance test. Oral glucose tolerance test was performed at 3 months after surgery, and then as indicated. IGF-1 was measured at 3 months and then at least annually. We evaluated tumor granularity, nuclear expression of p21, Ki67 index, and extent of cavernous sinus invasion, and correlated these with remission status. Fifty-eight patients that underwent surgery had follow-up from 38 to 98 months (mean 64 ± 32.2 months). There were 21 microadenomas and 37 macroadenomas. Three months after surgery 40 of 58 patients (69%) were in biochemical remission. Four additional patients were in remission at 6 months after surgery, and 1 patient had recurrence within the first year after surgery. At last follow-up, 43 of 44 (74.1%) of patients remained in remission. Cavernous sinus invasion by tumor predicted failure to achieve remission. Prognostic markers of disease aggressiveness other than cavernous sinus invasion did not correlate with surgical outcome. Long-term remission after surgery alone was achieved in 74% of patients, indicating long-term efficacy of endoscopic surgery. Copyright © 2017 by the Congress of Neurological Surgeons

Accuracy of clinical coding for procedures in oral and maxillofacial surgery.

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Khurram, S A; Warner, C; Henry, A M; Kumar, A; Mohammed-Ali, R I

2016-10-01

Clinical coding has important financial implications, and discrepancies in the assigned codes can directly affect the funding of a department and hospital. Over the last few years, numerous oversights have been noticed in the coding of oral and maxillofacial (OMF) procedures. To establish the accuracy and completeness of coding, we retrospectively analysed the records of patients during two time periods: March to May 2009 (324 patients), and January to March 2014 (200 patients). Two investigators independently collected and analysed the data to ensure accuracy and remove bias. A large proportion of operations were not assigned all the relevant codes, and only 32% - 33% were correct in both cycles. To our knowledge, this is the first reported audit of clinical coding in OMFS, and it highlights serious shortcomings that have substantial financial implications. Better input by the surgical team and improved communication between the surgical and coding departments will improve accuracy. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Orthognathic Surgery in a Patient with Multiple Sclerosis.

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Al-Bazie, Saleh A

2015-06-01

The aim of this paper was to report a case of orthognathic surgery successfully done in a patient with multiple sclerosis. Multiple sclerosis (MS) is a chronic, progressive inflammatory disorder of the central nervous system affecting young adults, characterized by lymphocytic infiltration of the brain and spinal cord leading to demyelination and focal axonal damage. Clinically, MS patients present with reversible neurological dysfunction in the early stages, which progresses to irreversible neurological disability and deficit. Oral manifestations of MS include facial numbness or pain, neuralgias, facial paralysis, dysarthria and dysphagia. While dental treatment is not contraindicated in MS patients, it is, however, limited to preventive and supportive dental care. A 23-year-old Saudi male patient with a diagnosis of MS since 2008 reported to the oral and maxillo-facial surgery (OMFS) department for correction of dentofacial deformity. The patient was under follow-up with the neurology department and was being treated with interferon beta-1a. Following consent from the neurologist and the patient, a Lefort 1 segmental osteotomy was done under general anesthesia. The patient was stable throughout the surgical procedure and during the postoperative period. The patient was discharged upon complete surgical recovery and no acute exacerbations of MS were reported during the perioperative period. Based on our observations, orthognathic and maxillofacial surgical procedures can be safely carried out in patients with MS, provided a strict perioperative prophylactic regimen for stress reduction and prevention of acute attacks of MS is adhered to. Due to the stressful nature of dental treatment and oral and maxillofacial surgical procedures, acute exacerbations of MS are very much likely. Hence, it is imperative that dental and oral surgical practitioners are aware of the manifestations of MS and are able to manage such patients with suitable treatment modifications.

Flap Hitching Technique to the Teeth after Oral Cancer Resection

African Journals Online (AJOL)

Flap surgery for reconstruction is an integral part in the surgical management of head and neck tumors. After resection of the tumors of oral cavity adjacent to the mandible, but not requiring a marginal mandibulectomy (tumors of the tongue, on the labial side, and tumors of the buccal mucosa on the buccal aspect),.

Care of oral cavity in irradiated patients

International Nuclear Information System (INIS)

Konecny, M.

1981-01-01

Procedures are reviewed of therapeutic and preventive care in patients with malignant tumours in the area of the head and neck during radiotherapy and during the subsequent follow-up of patients. As compared with previous views, the care is now more conservative, indications for tooth extractions are now limited, careful oral hygiene is emphasized and, in particular, the long-term use of fluorine gel is recommended. Surgery is only recommended where conservative treatment fails. (author)

Care of oral cavity in irradiated patients

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Konecny, M [Onkologicky Ustav, Brno (Czechoslovakia). Betatronove Pracoviste

1981-12-01

Procedures are reviewed of therapeutic and preventive care in patients with malignant tumours in the area of the head and neck during radiotherapy and during the subsequent follow-up of patients. As compared with previous views, the care is now more conservative, indications for tooth extractions are now limited, careful oral hygiene is emphasized and, in particular, the long-term use of fluorine gel is recommended. Surgery is only recommended where conservative treatment fails.

Emprego de altas doses de amiodarona via oral na reversão da fibrilação atrial no pós-operatório de cirurgia cardíaca High dose amiodarone for the reversion of atrial fibrillation during the postoperative period of cardiac surgery

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João Carlos Vieira da Costa Guaragna

1997-12-01

Full Text Available OBJETIVO: Relatar a experiência no emprego de altas doses de amiodarona via oral (1800mg/d na reversão da fibrilação atrial (FA em pacientes submetidos à cirurgia cardíaca. MÉTODOS: Analisados, retrospectivamente, 80 pacientes que apresentaram FA no pós operatório de cirurgia cardíaca, constituindo 2 grupos: grupo A com 28 pacientes em uso de amiodarona e grupo B recebendo digital, sendo que este grupo foi subdividido no grupo C com 21 pacientes onde foi associada amiodarona, quando não houvesse reversão da arritmia em 48h. As diferenças foram consideradas significativas para um valor de PPURPOSE: To report our experience using high dose oral amiodarone (1,800mg/day for the reversion of atrial fibrillation to sinus rhythm in patients submitted to cardiac surgery. METHODS: We retrospectively analyzed the records of 80 patients who had atrial fibrillation during the postoperative period after cardiac surgery, initially divided in two groups: group A, 28 patients that used amiodarone, and group B composed of patients receiving digoxin. The latter group was divided further in a third group (C, with 21 patients in which amiodarone was associated with digoxin if there was no reversion of the arrhythmia after 48 hours of treatment. The observed differences were considered significant at P<0.05. RESULTS: Atrial fibrillation occurred in 19.4% of the patients submitted to surgery, predominating in males, 60 to 69 years-old. In group A there was reversion to sinus rhythm in 78.6% of the cases. In group B digoxin succeeded in 60%, and in group C 90% of the patients reverted to sinus rhythm. CONCLUSION: High dose oral amiodarone, alone or combined to digoxin, can be safe and effective for the treatment of atrial fibrillation after cardiac surgery.

COMPARATIVE ASSESSMENT OF ANESTHESIA METHODS FOR GYNECOLOGIC SURGERY

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I. I. Khusainova

2016-01-01

Full Text Available The purpose of the study: to improve the quality of anesthesia for gynecologic cancer surgery. materials and methods. The study included 421 patients who underwent a routine hysterectomy. The patients were divided into 3 groups with respect to analgesic method. The method of multimodal balanced analgesia was used in all cases. Group I patients additionally received epidural analgesia. Group II patients did not receive epidural analgesia (the control group. Group III patients received 600 mg of gabapentin as an adjuvant to opioid analgesia. Results. A significant difference in pain intensity within the first 72 hours after surgery between 3 groups of patients was found. Oral gabapentin as an adjunct to patient-controlled epidural analgesia provided efficient pain relief, reduction in the need for opioid analgesics in the perioperative period, as well as reduction in the incidence of postoperative nausea and vomiting after surgery.

On a definition of the appropriate timing for surgical intervention in orthognathic surgery.

Science.gov (United States)

Hernández-Alfaro, F; Guijarro-Martínez, R

2014-07-01

Together with the introduction of new orthodontic techniques and minimally invasive surgery protocols, the emergence of modern patient prototypes has given way to novel timing schemes for the handling of dento-maxillofacial deformities. The aim of this study was to define, justify, and systematize the appropriate timing for orthognathic surgery. A retrospective analysis of orthognathic surgery procedures carried out over a 3-year period was performed. Six timing schemes were defined: 'surgery first', 'surgery early', 'surgery late', 'surgery last', 'surgery only', and 'surgery never'. Gender, age at surgery, main motivation for treatment, orthodontic treatment length, and number of orthodontic appointments were evaluated. A total of 362 orthognathic procedures were evaluated. The most common approach was 'surgery late'. While aesthetic improvement was the leading treatment motivation in 'surgery first', 'surgery early', and 'surgery last' cases, occlusal optimization was the chief aim of 'surgery late'. Sleep-disordered breathing was the main indication for treatment in 'surgery only'. Compared to 'surgery late', orthodontic treatment was substantially shorter in 'surgery early' and 'surgery first' cases, but the number of orthodontic appointments was similar. In conclusion, the skilful management of dento-maxillofacial deformities requires a comprehensive analysis of patient-, orthodontist-, and surgeon-specific variables. Each timing approach has well-defined indications, treatment planning considerations, and orthodontic and surgical peculiarities. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Early and late surgical site infections in ear surgery.

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Bastier, P L; Leroyer, C; Lashéras, A; Rogues, A-M; Darrouzet, V; Franco-Vidal, V

2016-04-01

A retroauricular approach is routinely used for treating chronic otitis media. The incidence of surgical site infections after ear surgery is around 10% in contaminated or dirty procedures. This observational prospective study describes surgical site infections after chronic otitis media surgery with the retroauricular approach and investigated their potential predictive factors. This observational prospective study included patients suffering from chronic otitis media and eligible for therapeutic surgery with a retroauricular approach. During follow-up, surgical site infections were defined as "early" if occurring within 30 days after surgery or as "late" if occurring thereafter. The data of 102 patients were analysed. Concerning early surgical site infections, four cases were diagnosed (3.9%) and a significant association was found with preoperative antibiotic therapy, wet ear at pre-operative examination, class III (contaminated) in the surgical wound classification, NNIS (National Nosocomial Infection Surveillance) index > 1, and oral post-operative antibiotic use. Seven late surgical site infections were diagnosed (7.1%) between 90 and 160 days after surgery and were significantly correlated to otorrhoea during the 6 months before surgery, surgery duration ≤60 minutes, canal wall down technique and use of fibrin glue. Surgical site infections after chronic otitis media surgery seem to be associated with factors related to the inflammatory state of the middle ear at the time of surgery in early infections and with chronic inflammation in late infections. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.

An Assessment of the Quality of Life of Patients With Class III Deformities Treated With Orthognathic Surgery.

Science.gov (United States)

Kilinc, Adnan; Ertas, Umit

2015-07-01

To evaluate quality of life (QoL) from a broad perspective by a comparison of Turkish patients undergoing orthognathic surgery to correct Angle Class III skeletal deformity with a control group composed of participants without dentofacial deformity using general health, generic oral health, and condition-specific QoL approaches. Thirty patients who underwent orthognathic surgery to correct Class III relations (monomaxillary and bimaxillary groups) and 30 participants with Class I skeletal structure and good dentofacial harmony (control group) were evaluated. Condition-specific QoL through a 22-item Orthognathic Quality of Life Questionnaire (OQLQ), generic oral health-related QoL through a 14-item Short-Form Oral Health Impact Profile (OHIP-14), and generic health-related QoL through a 36-item Short-Form Health Survey (SF-36) were assessed. When the groups were compared, OQLQ scores showed a significant difference in the oral function domain only in the bimaxillary group (P orthognathic surgical patients appeared to be similar to that of participants without dentofacial deformities. Oral health-related QoL of orthognathic surgical patients seemed moderately similar to that of participants without dentofacial deformities. The combined use of these methods is helpful for evaluating QoL from a larger perspective. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Oral lesions following radiation therapy and their preventive considerations

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Ghavam M

2001-09-01

Full Text Available Oral cancers account for a relatively high percent of neoplasms in the elderly population. Treatment protocols often include anti-neoplastic pharmaco-therapeutics, irradiation of the head and neck region, and surgery. These treatments, specially radiation, have detrimental effects on oral hard and soft tissues. Salivary glands undergo a distinct and longterm dysfunction, which leads to decrease in salivary How. Xerostomia is a common clinical problem in these patients which contributes to dry mouth, mucosites, change in oral ecosystem and dental caries, followed by difficulties in speech, swallowing and use of dentures which cause malnutrition. This phenomenon has an irreversible weakening effect on the patient's health. To prevent this negative impact on oral health in this group of patients, definitive dental treatments prior to the initiation of medical therapies is imperative, and will decrease the morbidity rates. Today's dentistry benefits from improved methods and materials, which enable us to give these patients a better preventive dental treatment. Consultation between dentist and medical team would be the best way to help our sufferer patients.

Orthognathic model surgery with LEGO key-spacer.

Science.gov (United States)

Tsang, Alfred Chee-Ching; Lee, Alfred Siu Hong; Li, Wai Keung

2013-12-01

A new technique of model surgery using LEGO plates as key-spacers is described. This technique requires less time to set up compared with the conventional plaster model method. It also retains the preoperative setup with the same set of models. Movement of the segments can be measured and examined in detail with LEGO key-spacers. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Design of a Randomized Placebo-Controlled Trial to Assess Dabigatran and Omeprazole in Patients with Myocardial Injury after Noncardiac Surgery (MANAGE)

DEFF Research Database (Denmark)

Duceppe, Emmanuelle; Yusuf, Salim; Tandon, Vikas

2018-01-01

BACKGROUND: Worldwide approximately 200 million adults undergo major surgery annually, of whom 8 million are estimated to suffer a myocardial injury after noncardiac surgery (MINS). There is currently no trial data informing the management of MINS. Antithrombotic agents such as direct oral antico...

A simple working classification proposed for the latrogenic lesions of teeth and associated structures in the oral cavity.

Science.gov (United States)

Shamim, Thorakkal

2013-09-01

Iatrogenic lesions can affect both hard and soft tissues in the oral cavity, induced by the dentist's activity, manner or therapy. There is no approved simple working classification for the iatrogenic lesions of teeth and associated structures in the oral cavity in the literature. A simple working classification is proposed here for iatrogenic lesions of teeth and associated structures in the oral cavity based on its relation with dental specialities. The dental specialities considered in this classification are conservative dentistry and endodontics, orthodontics, oral and maxillofacial surgery and prosthodontics. This classification will be useful for the dental clinician who is dealing with diseases of oral cavity.

HORMONE SUBSTITUTION AFTER GASTRIC BYPASS SURGERY IN PATIENTS WITH HYPOPITUITARISM SECONDARY TO CRANIOPHARYNGIOMA.

Science.gov (United States)

Wolf, Peter; Winhofer, Yvonne; Smajis, Sabina; Kruschitz, Renate; Schindler, Karin; Gessl, Alois; Riedl, Michaela; Vila, Greisa; Raber, Wolfgang; Langer, Felix; Prager, Gerhard; Ludvik, Bernhard; Luger, Anton; Krebs, Michael

2016-05-01

Craniopharyngiomas (CPs) are benign brain tumors presenting frequently in childhood and are treated by surgery with or without radiotherapy. About 50% of cured patients suffer from eating disorders and obesity due to hypothalamic damage, as well as hypopituitarism, necessitating subsequent hormone substitution therapy. Gastric bypass surgery has been reported to be an efficient treatment strategy for morbid hypothalamic obesity. However, so far it is unknown whether oral hormone substitution is affected by impaired intestinal drug absorption, potentially leading to severe hypopituitarism or pituitary crisis. Four morbidly obese CP patients with panhypopituitarism treated by gastric bypass surgery were included in this retrospective analysis. Dosages of hormone substitution therapy, blood concentrations of hormones, potential complications of impaired drug absorption, and anthropometric characteristics were investigated pre- and postoperatively after 6 to 14 months and 13 to 65 months. In all CP patients (3 female/1 male; baseline body mass index, 49 ± 7 kg/m(2)), gastric bypass resulted in distinct weight loss (-35 ± 27 kg). In follow-up examinations, mean daily dosage of thyroid hormone (levothyroxinebaseline 156 ± 44 μg/day versus levothyroxinefollow-up 150 ± 30 μg/day), hydrocortisone (hydrocortisonebaseline 29 ± 12 mg/day versus hydrocortisonefollow-up 26 ± 2 mg/day), growth-hormone (somatotropinbaseline 0.9 ± 0.5 mg/day versus somatotropinfollow-up 1.0 ± 0.4 mg/day), and desmopressin (desmopressinbaseline 222 ± 96 μg/day versus desmopressinfollow-up 222 ± 96 μg/day) substitution was unchanged. No patient developed adrenal insufficiency. Oral thyroid/hydrocortisone absorption testing performed in 1 patient indicated sufficient gastrointestinal drug absorption after bariatric surgery. Our preliminary results suggest that oral hormone substitution therapy is not impaired following gastric bypass operation in CP patients with morbid obesity

Oral Clefts and Academic Performance in Adolescence

DEFF Research Database (Denmark)

Clausen, Nicola G; Pedersen, Dorthe A; Pedersen, Jacob K

2017-01-01

OBJECTIVE:   Early life exposure to anesthesia and surgery is suspected to associate with cognitive impairment later in life. We compared academic achievement among adolescents with cleft lip only (CL), cleft palate only (CP), and cleft lip and cleft palate (CLP) with a noncleft control group to ......:   Oral cleft type rather than number and timing of anesthesia and operations associate to poorer academic performance. Although a potential neurotoxic effect due to anesthetic agents is not reflected in the data, it cannot be completely excluded.......OBJECTIVE:   Early life exposure to anesthesia and surgery is suspected to associate with cognitive impairment later in life. We compared academic achievement among adolescents with cleft lip only (CL), cleft palate only (CP), and cleft lip and cleft palate (CLP) with a noncleft control group...

Remifentanil Reduces Blood Loss During Orthognathic Surgery.

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Matsuura, Nobuyuki; Okamura, Taiki; Ide, Satoko; Ichinohe, Tatsuya

2017-01-01

Remifentanil is reported to reduce oral tissue blood flow. We performed a retrospective investigation using logistic regression analysis of anesthesia records to investigate whether the use of remifentanil infusion in a balanced anesthesia technique was useful as a primary technique to reduce blood loss during orthognathic surgery. Subjects were 80 patients who underwent Le Fort I osteotomy and sagittal split ramus osteotomy of the mandible. The variables included gender, age, weight, type of maintenance anesthetic, type and dose or infusion rate of opioid, mean systolic blood pressure (SBP-mean), coefficient of variation of systolic blood pressure (CVSBP) during surgery, mean heart rate (HR-mean), duration of surgery, total blood loss, volume of infusion used, amount of local anesthetic used, body temperature, and urine output. Gender, type of maintenance anesthetic, type of opioid, SBP-mean, CVSBP, HR-mean, and duration of surgery were used as candidates for independent variables. Logistic regression analysis was performed for the selected independent variables with the total blood loss as the dependent variable. The factors associated with the reduction of blood loss were the use of remifentanil (odds ratio, 3.112; 95% CI, 1.166-8.307; P = .023) and smaller CVSBP (odds ratio, 2.747; 95% CI, 1.07-7.053; P = .036). Use of remifentanil and smaller CVSBP were associated with a reduction of blood loss during orthognathic surgery.

Colgajo lateral de brazo en reconstrucción de la cavidad oral Lateral arm flap in oral cavity reconstruction

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A. Dean Ferrer

2008-08-01

flap may be preferable in some situations. Objectives. The aim of the present paper is to show the advantages and disadvantages and our indications and results for the lateral arm flap in intraoral reconstruction. Material and methods. This is a prospective work on the use of the lateral arm free flap for the reconstruction of oral cavity defects after ablative surgery. The parameters that have been evaluated are: flap viability, morbidity in the donor site, length of the pedicle, selection of recipient vessels, complications and functional results in the reconstructed area. Results. The lateral arm flap has been used in primary reconstruction after ablative surgery for squamous cell carcinoma of the oral cavity in ten patients. One flap was lost because of venous thrombosis. The donor site was repaired by direct closure in 8 cases and a split thickness skin graft had to be used in 2 cases. Mean pedicle length was 8.75 cm. In 9 cases a favorable functional result was achieved. Conclusions. Fasciocutaneous lateral arm flap allows the reconstruction of oral cavity defects achieving good functional results. Morbidity in the donor site is minimal and, in most cases, direct closure permits the repair of the donor site.

Restorative dentistry and oral rehabilitation: United Kingdom National Multidisciplinary Guidelines.

Science.gov (United States)

Butterworth, C; McCaul, L; Barclay, C

2016-05-01

This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK and provides recommendations on the pre-treatment oral and dental assessment, during and after treatment and oral rehabilitation. Restorative dentists are core members of the multidisciplinary team treating head and neck cancer patients, involved from the treatment planning phase through to long-term rehabilitation. Recommendations • Preventative oral care must be delivered to patients whose cancer treatment will affect the oral cavity, jaws, salivary glands and oral accessibility. (G) • Close working and communication between the surgeons, oncologists and restorative dental specialists is important in ensuring optimal oral health outcomes. (G) • Intensity-modulated radiotherapy has been shown to reduce long-term xerostomia and should be offered to all appropriate patients. (R) • If patients are deemed at risk of trismus they should be warned and its progressive and potentially irreversible nature explained. (G) • Where it is known that adjuvant radiotherapy will be given, extractions should take place at primary surgery to maximise the time for healing and minimise the number of surgical events for patients. (G) • Osseointegrated implants should be considered for all patients having resection for head and neck cancer. (G).

Locally advanced oral cavity squamous cell carcinoma: Barriers related to effective treatment

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K C Lakshmaiah

2015-01-01

Full Text Available Background: Oral cavity cancer is a significant health problem in India. Majority of patients present with locally advanced disease requiring multimodality treatment. Compliance to recommended treatment is an important factor affecting outcome. Aims: The aim was to evaluate the outcome of locally advanced oral cavity cancer patients with regards to treatment adherence and to assess reasons of noncompliance. Materials and Methods: This was a prospective observational study. We included patients referred to Department of Medical Oncology for induction chemotherapy in view of locally advanced oral cavity cancer. Results: Only 15 (26% patients completed planned treatment schedule. Their 1 year overall survival was 93%. The remaining 43 patients who received inadequate treatment had a dismal 21% 1 year overall survival. Illiteracy, poverty, long waiting list for surgery, prolonged delay for health scheme treatment plan approval and dissatisfaction with attitude of hospital staffs are major barriers related to effective treatment of these patients. Conclusions: A detailed discussion with patient and their relatives regarding recommended treatment, proper implementation of health schemes, increasing trained manpower to avoid long waiting list for surgery, provision of additional financial support for family member accompanying the patient and a sympathetic approach toward patients are needed to help these patients overcome the battle.

Oral health in Brazil - Part II: Dental Specialty Centers (CEOs

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Vinícius Pedrazzi

2008-08-01

Full Text Available The concepts of health promotion, self-care and community participation emerged during the 1970s and, since then, their application has grown rapidly in the developed world, showing evidence of effectiveness. In spite of this, a major part of the population in the developing countries still has no access to specialized dental care such as endodontic treatment, dental care for patients with special needs, minor oral surgery, periodontal treatment and oral diagnosis. This review focuses on a program of the Brazilian Federal Government named CEOs (Dental Specialty Centers, which is an attempt to solve the dental care deficit of a population that is suffering from oral diseases and whose oral health care needs have not been addressed by the regular programs offered by the SUS (Unified National Health System. Literature published from 2000 to the present day, using electronic searches by Medline, Scielo, Google and hand-searching was considered. The descriptors used were Brazil, Oral health, Health policy, Health programs, and Dental Specialty Centers. There are currently 640 CEOs in Brazil, distributed in 545 municipal districts, carrying out dental procedures with major complexity. Based on this data, it was possible to conclude that public actions on oral health must involve both preventive and curative procedures aiming to minimize the oral health distortions still prevailing in developing countries like Brazil.

Efficacy of custom made oral appliance for treatment of obstructive sleep apnea

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V R Cilil

2015-01-01

Full Text Available Introduction: oral appliance for the treatment of OSA is considered as an effective, low-risk alternative to CPAP. Demand for oral appliance increases as an alternative for those who cannot tolerate CPAP and refuse surgery. Oral appliances uses the traditional methods to advance the mandible thus modify the posture and their by enlarge the airway or otherwise reduce the collapsibility. Aims and Objectives: The main objective of this study was to evaluate the efficacy of custom made oral appliance on sleep characteristics of OSA patients. Materials and Methods: Polysomnography was done on 15 patients of 24-60 years of age before (T1, and after the delivery of the custom made oral appliance (T2. Statistical Analysis: Paired t tests were performed to determine the significance of change in the polysomnographic and cephalometric variables. P < 0.05 was considered as significant. Results: All patients with oral appliance showed an improvement in sleep parameters with an increase in sleep efficiency, and desaturation index with the use of oral appliance. ESS and cephalometric findings showed improvement in the sleep apnea in concordance with the sleep parameters. Conclusions: Custom made oral appliance is a useful treatment option for improving quality of sleep and can be considered as an alternative treatment modality.