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. · Sep 1998
The use of nonopioid drugs in management of chronic orofacial pain.
Although controversial, opioid analgesics have been prescribed for patients with chronic facial pain. Based primarily on survey data and a few well-controlled clinical trials, long-term opioid treatment provides adequate pain reduction in 41% to 100% of patients with chronic nonmalignant pain. However, only 25% of chronic facial pain patients reported adequate pain relief with chronic opioid treatment. ⋯ This article shows that the use of long-term opioids for chronic facial pain is not justified based on the available data. Despite these perceived problems, there is anecdotal evidence that chronic facial pain patients will respond positively to opioid analgesics. In our experience, the pain assessment scale and a modification of the World Health Organization's three-step analgesic ladder, which prescribes nonopioid analgesics, can be the starting point for the successful management of chronic facial pain.
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The purpose of this retrospective study was to evaluate the functional and cosmetic results of the treatment of gunshot wounds associated with attempted suicide that resulted in facial injury. ⋯ Only 3 of 12 patients returned for follow-up and reconstruction. It was therefore concluded that relatives of these patients believe that the repair of such deformities, even if it is a functional deformity, is not necessary. Thus, in such cases, one should do as much reconstruction as possible at the primary surgical intervention.
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J. Oral Maxillofac. Surg. · Jul 1998
Surgical treatment of squamous cell carcinoma of the lower lip: evaluation of long-term results and prognostic factors--a retrospective analysis of 184 patients.
A retrospective study was undertaken to evaluate the results of surgical treatment of primary squamous cell carcinoma of the vermilion border of the lower lip and to identify parameters of the primary tumor that may predict local recurrence and regional metastasis. ⋯ Surgical treatment for small squamous cell carcinomas of the lower lip has a favorable prognosis. Particular parameters of the primary tumor seem to predict the chance of development of local recurrence and regional lymph node metastasis.
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J. Oral Maxillofac. Surg. · Jul 1998
Case ReportsManagement of animal bite injuries of the face: experience with 94 patients.
Because of the large number of bacteria in the oral cavity, animal bite wounds are generally contaminated, and their treatment is difficult because of the risk of infection, especially in extensive injuries. This report describes the management of a large series of patients and recommends treatment guidelines on the basis of the results. ⋯ Extensive animal bite wounds on the face, even with soft tissue defects, should be treated according to the criteria of a esthetic reconstructive facial surgery. In view of the low infection rate, routine antibiotic prophylaxis is not justified.
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J. Oral Maxillofac. Surg. · Apr 1998
Randomized Controlled Trial Comparative Study Clinical TrialPropofol and fentanyl compared with midazolam and fentanyl during third molar surgery.
The purpose of this study was to measure the safety and efficacy of propofol combined with fentanyl as sedative agents during third molar outpatient surgery. ⋯ Propofol appears to be a safe and efficacious drug for use during outpatient oral surgical procedures.