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 2015
Randomized Controlled Trial Comparative StudyA nasal high-flow system prevents hypoxia in dental patients under intravenous sedation.
Hypoxia is a major complication in dental patients under intravenous sedation (IVS). A nasal high-flow (NHF) system has been reported to achieve effective oxygenation in patients with sleep apnea syndrome. This study investigated the ability of the NHF system to prevent hypoxia in dental patients under IVS. ⋯ These results suggest that use of the NHF system can prevent hypoxia in dental patients under IVS. Further studies are necessary to determine the appropriate flow rate and indications for NHF in obese patients.
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J. Oral Maxillofac. Surg. · Jun 2015
How does the close surgical margin impact recurrence and survival when treating oral squamous cell carcinoma?
The surgical margin is the main prognostic factor over which the surgeon has control during resection of oral squamous cell carcinoma (OSCC). This study examined the association between surgical excision margins of patients with OSCC and outcomes of disease-free and overall survival. ⋯ The results suggest that the presence of a close surgical margin (1 to 5 mm) is an adverse risk feature comparable to an involved margin and therefore is associated with decreased disease-free and overall survival. Future studies are needed to replicate these findings before they can be used as a basis for clinical recommendations.
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J. Oral Maxillofac. Surg. · May 2015
Does salivary duct repositioning prevent complications after tumor resection or salivary gland surgery?
Tissue that is resected for the treatment of oral tumors often includes salivary gland ducts. At their institution, the authors conserve and transfer as much of the salivary duct as possible during these procedures to avoid obstructive complications. Differentiating these obstructive complications from a metastatic node can be challenging and can confound subsequent oncologic management. This study compared and examined the effectiveness of salivary duct repositioning in decreasing the incidence of obstructive complications. ⋯ Salivary duct repositioning is performed to prevent blockage of physiologic salivary discharge. Complications were more frequently associated with Wharton ducts than with Stensen ducts because of the unique physiologic and anatomic characteristics of the Wharton duct. Repositioning of the salivary duct is a suitable method for preventing complications associated with the Wharton duct.
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J. Oral Maxillofac. Surg. · May 2015
Temporomandibular joint arthrocentesis: outcomes under intravenous sedation versus general anesthesia.
Although arthrocentesis of the temporomandibular joint (TMJ) has been shown to be an effective, minimally invasive surgical procedure, there is a paucity of literature that has examined its effectiveness under intravenous (IV) sedation compared with general anesthesia (GA) with a secure airway. ⋯ Arthrocentesis is effective for treatment of TMJ pain and acute closed-lock conditions irrespective of Wilkes classification (grades I to III). Ninety-five percent of patients reported immediate resolution or decrease of pain within the first postoperative week. Although the procedure is effective when performed under IV sedation in an office setup, superior clinical outcomes were noticed when the procedure was performed with a secure airway under GA.