Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons
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J. Oral Maxillofac. Surg. · Oct 2008
Recovery after orthognathic surgery: short-term health-related quality of life outcomes.
The purpose of this study was to assess the patient-reported time to recovery for quality of life outcomes: postsurgery sequelae, discomfort/pain, oral function, and daily activities after orthognathic surgery. ⋯ 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 preoperative education of patients regarding perioperative and postoperative expectations. Ultimately this data can be combined with individual risk factors to provide personalized consent and expectations as well as tailor perioperative and postoperative management regimens.
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J. Oral Maxillofac. Surg. · Oct 2008
Randomized Controlled TrialNitroglycerin- and nicardipine-induced hypotension does not affect cerebral oxygen saturation and postoperative cognitive function in patients undergoing orthognathic surgery.
The aim of this study was to investigate the influence of nitroglycerin- and nicardipine-induced hypotension on regional cerebral oxygen saturation (rSO(2)) and postoperative cognitive function in patients undergoing orthognathic surgery. ⋯ Cerebral oxygen saturation and postoperative cognitive function were not impaired during nitroglycerin- and nicardipine-induced hypotension in patients undergoing orthognathic surgery.
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J. Oral Maxillofac. Surg. · Oct 2008
Comparative Study Controlled Clinical TrialComparison of methohexital and propofol use in ambulatory procedures in oral and maxillofacial surgery.
Short-acting anesthetic agents, such as propofol and methohexital, are commonly used for ambulatory procedures in the practices of oral and maxillofacial surgeons (OMS). This study compares the safety and anesthetic outcomes of propofol and methohexital. In addition, the study compares the safety and outcomes of these agents when administered either by an OMS who simultaneously provides anesthesia and performs the procedure (anesthetist/surgeon), or by a non-OMS provider of anesthesia (anesthesiologist or certified registered nurse anesthetist; CRNA) whose sole obligation is to provide anesthesia. ⋯ There is a statistically significant increase in adverse events related to methohexital compared with propofol or benzodiazepine/narcotics for anesthesia. Propofol appears to have the lowest risk for adverse events. There is no statistically significant difference in the number of adverse outcomes between the administration of propofol for ambulatory surgery by OMS as an anesthetist/surgeon and anesthesiologist/nurse anesthetist. It remains critical that our specialty maintains the highest standards, to provide safe anesthesia and to reduce adverse anesthetic events.
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J. Oral Maxillofac. Surg. · Oct 2008
A biomechanical evaluation of plating techniques used for reconstructing mandibular symphysis/parasymphysis fractures.
The purpose of this investigation was to evaluate and compare the biomechanical behavior of 5 different methods used to repair mandibular symphysis/parasymphysis fractures. ⋯ Although statistically significant differences were noted between each of the fixation systems in their abilities to resist loads under the conditions tested, when placed in the context of functional parameters, all systems met the requirements for incisal edge loading. When molar loading was considered, the lag screw technique performed more favorably than the other systems.
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J. Oral Maxillofac. Surg. · Oct 2008
Algorithm for head computed tomography imaging in patients with mandible fractures.
Trauma to the mandible can potentially increase our predictive accuracy for intracranial injuries (ICIs) because of the mandible's strength, anatomic proximity, and direct connection to the skull base. Our goals were to: 1) investigate the association of mandible fractures with traumatic brain injury (TBI) and intracranial lesions (ICLs); and 2) determine predictors of ICIs in a level 1 Canadian trauma center with distinct patient demographics and fracture etiologies. ⋯ Some authors have advocated treating mandible fractures on an outpatient basis, with a focused workup. Our results of significant concomitant ICI in mandible-fracture patients, conversely, suggest that such management may inadvertently result in the oversight of potentially life-threatening injuries. Thus, we recommend mandatory intracranial CT imaging if the patient's neurologic status at time of injury is unknown or meets the criteria of TBI, or if positive predictors for ICL are present.