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. · Jun 2010
Surgical management of orbital trapdoor fracture in a pediatric population.
Orbital trapdoor fractures are pure orbital floor fractures with herniation and entrapment of the orbital contents, leading to restricted eye movement and diplopia. Trapdoor fractures in children have been discussed widely in published reports; however, the treatment policy and outcome remain controversial, although early treatment has been advocated. Our retrospective study analyzed the long-term results of pediatric patients undergoing surgery for trapdoor fractures to determine the outcome in relation to the type of fracture and the timing and technique of intervention. ⋯ We found a correlation between the outcome and the timing of surgery for trapdoor fractures in the pediatric population. The success rate was significantly better when the fractures were treated within 24 hours of the injury. The results of the present study have strengthened the assertion that trapdoor orbital fractures pose a true surgical emergency.
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J. Oral Maxillofac. Surg. · Jun 2010
Review Case ReportsClassification of potential risk factors for trigeminocardiac reflex in craniomaxillofacial surgery.
Trigeminocardiac reflex (TCR) in craniomaxillofacial surgery can lead to severely life-threatening situations. At least mild forms are probably much more common than the existing surgical literature suggests. Therefore, the aim of this presentation of cases and literature review was to evaluate the predisposing factors leading to a classification of risk factors for potential TCR and to give information concerning preventive measures and management procedures. ⋯ All craniomaxillofacial surgeons involved in orbital surgery in general and in the treatment of midface fractures, eyelid surgery, and orthognathic procedures in particular should be aware of the possibility of the TCR and should be familiar with its prevention and therapy.
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J. Oral Maxillofac. Surg. · Jun 2010
Randomized Controlled TrialRandomized, double-blind study of effectiveness of intra-alveolar application of chlorhexidine gel in reducing incidence of alveolar osteitis and bleeding complications in mandibular third molar surgery in patients with bleeding disorders.
Chlorhexidine (CHX) is an antimicrobial agent used in the prevention of tooth decay, periodontal disease, and postextraction alveolar osteitis (AO). Recently, a bioadhesive gel to deliver the active substance, CHX, was introduced. The intra-alveolar placement of the bioadhesive gel allows a more direct and prolonged therapeutic effect of CHX, which is useful in the prevention of AO after extraction of impacted third molars. The intra-alveolar application of the bioadhesive CHX gel in patients with bleeding disorders may increase the risk of postoperative bleeding complications. Inversely, bleeding disorders might influence the efficacy of CHX for AO prevention. The purpose of the present study was to evaluate the effectiveness of the bioadhesive 0.2% CHX gel in reducing the incidence of impacted third molar postextraction AO in patients with bleeding disorders. ⋯ As described in previous studies, the single intra-alveolar application of the bioadhesive 0.2% CHX gel in an intraoperative fashion seems to reduce the incidence of AO after removal of impacted third molars in patients with bleeding disorders. On the basis of the reported percentage of bleeding complications, the routine use of postoperative local hemostatic measures is recommended.
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J. Oral Maxillofac. Surg. · Jun 2010
Comparative StudyEfficacy of temporomandibular joint ankylosis surgical treatment.
The purpose of the present study was to answer the following clinical question: of the patients with temporomandibular joint ankylosis, do those treated with ankylosis resection and ramus-condyle unit reconstruction with a prosthetic total joint (total joint replacement [TJR]) have improved jaw function and decreased pain compared with those treated with ankylosis resection and interpositional arthroplasty (IA)? ⋯ Ankylosis resection and ramus-condyle unit reconstruction with a prosthetic total joint and IA produced comparable outcomes in terms of mandibular range of motion and pain.