The British journal of oral & maxillofacial surgery
-
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.
-
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.
-
Br J Oral Maxillofac Surg · Oct 1999
Randomized Controlled Trial Comparative Study Clinical TrialUse of intra-articular morphine for postoperative analgesia following TMJ arthroscopy.
Recent studies have suggested that giving opioids locally into inflamed tissue may cause analgesia. This antinociceptive effect has been attributed to the interaction of the drug with opioid receptors upregulated by inflammation in the peripheral tissues. ⋯ Twenty-one patients took part in a randomized controlled double-blind trial and received one of these three solutions at the end of operation. The pain scores, time to the first request for analgesia, and the analgesic consumption of the patients in the three groups did not differ significantly at any time during the study period.