Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons
-
J. Oral Maxillofac. Surg. · May 2007
Clinical TrialRelationships between surgical difficulty and postoperative pain in lower third molar extractions.
To investigate the influence of surgical difficulty on postoperative pain after extraction of mandibular third molars. ⋯ Pain after extraction of a mandibular third molar increases with increased surgical difficulty and duration of the intervention.
-
J. Oral Maxillofac. Surg. · May 2007
A protocol for the management of frontal sinus fractures emphasizing sinus preservation.
The purpose of this retrospective study is to review the incidence and etiology of frontal sinus fractures at an urban trauma center and validate a treatment protocol by assessing the outcome of a consecutive series of patients treated over a 10-year period. ⋯ Application of the management protocol described in this report results in functional sinus preservation for the majority of patients, with relatively few significant perioperative complications.
-
J. Oral Maxillofac. Surg. · Apr 2007
Management of penetrating neck injuries: a new paradigm for civilian trauma.
Improvements in imaging technology, particularly computed tomographic angiography (CTA), have altered the management of patients with penetrating neck injuries. Although some centers still advocate routine exploration for all zone 2 neck injuries penetrating the platysma, many civilian centers in the United States have adopted a policy of selective exploration based on clinical and radiographic examination. The purpose of this retrospective study is to evaluate our 5-year experience with the management of penetrating neck injuries, to further elucidate the role of CTA in clinical decision-making, and to assess treatment outcome. ⋯ The management of stable patients with neck injuries that penetrate the platysma has evolved at our institution into selective surgical intervention based on clinical examination and CTA and has resulted in minimal morbidity and mortality.
-
J. Oral Maxillofac. Surg. · Apr 2007
Comparative StudyEvaluation of sedation failure in the outpatient oral and maxillofacial surgery clinic.
Our goal was to report on the incidence of sedation failures in our outpatient oral surgery clinic. Sedation failure is the inability to complete a procedure under intravenous sedation. There is very little in the oral surgery literature on this subject. ⋯ The mandible fracture population and multiple teeth extraction patients had higher rates of failure than other groups. This may be the result of procedure length, type of procedure, or a preoperative anxiety and attitude toward treatment expressed by the patient making sedation unpredictable. Level of training and experience of the practitioner may contribute to sedation failure. These results allow us to develop a prospective study protocol of outpatient sedation and to quantify more detailed information about preoperative anxiety, medical status, and social history than we had available during our chart review. More specific conclusions may help us determine if certain patient populations are at a higher risk for failed sedations.