The British journal of oral & maxillofacial surgery
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Br J Oral Maxillofac Surg · Apr 2000
Randomized Controlled Trial Clinical TrialBehavioural measurement of postoperative pain after oral surgery.
The amount and type of postoperative analgesia prescribed depends on the clinician's judgement of the patient's need. Among other factors, this judgement is likely to be based on the patient's behaviour. ⋯ The results also show differences between the sexes in their reaction to pain. Significantly more women than men showed signs of pain, despite little difference in self-rating pain scores.
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Br J Oral Maxillofac Surg · Apr 2000
Case ReportsActinomycotic ulcer of the oral mucosa: an unusual presentation of oral actinomycosis.
Although the oral mucosa is often the site of entry of actinomyces into the deeper tissues, actinomycosis in the oral mucosa is extremely rare. Actinomycotic lesions are usually described as either single or multiple abscesses or indurated masses with hard fibrous walls and soft central loculations. Actinomyces israelii is the principal cause of human actinomycosis. We present a rare case of actinomycosis caused by Actinomyces odontolyticus; it presented primarily as a long-standing ulcer of the oral mucosa mimicking a squamous cell carcinoma.
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Br J Oral Maxillofac Surg · Apr 2000
Management of anticoagulation in patients with prosthetic heart valves undergoing oral and maxillofacial operations.
There is wide variation in the management of patients with mechanical prosthetic valves who are taking anticoagulants and who require non-cardiac surgery. In this paper, we outline a pragmatic, practical approach to the adjustment of anticoagulation in relation to both the degrees of surgical trauma during oral and maxillofacial surgery and the risk of thromboembolism associated with the prosthetic valve. ⋯ For major surgery, warfarin is stopped preoperatively and low-molecular-weight heparin is used. For emergency surgery, partial reversal of anticoagulation with low-dose parenteral vitamin K is obtained.