International journal of oral and maxillofacial surgery
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Int J Oral Maxillofac Surg · Dec 2018
Determinants of level Ib involvement in oral squamous cell carcinoma and implications for submandibular gland-sparing neck dissection.
Traditional neck dissection for oral squamous cell carcinoma (OSCC) involves removal of the submandibular salivary gland. Several studies have cited the low incidence of direct gland invasion by tumours and have recommended gland-sparing neck dissection. In this study, a detailed audit of level Ib involvement in OSCC was performed in order to assess the feasibility of submandibular gland-sparing in neck dissection; the rate of direct involvement by the primary tumours, the involvement of periglandular level Ib nodes, and their determinants were investigated. ⋯ Determinants of periglandular lymphadenopathy were depth of invasion >10mm (P<0.001), perineural invasion (P=0.02), lymphovascular invasion (P=0.014), and moderate/poor differentiation (P<0.0001). Gland-sparing neck dissection is safe in early tumours (pT1pN0-1), with a good chance of minimizing xerostomia without radiotherapy. Larger tumours without clear evidence of submandibular gland invasion or suspicious level Ib lymphadenopathy may be considered for gland preservation, however the oncological safety is unclear.
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Int J Oral Maxillofac Surg · Dec 2018
Coronectomy of mandibular third molars: a clinical and radiological study of 231 cases with a mean follow-up period of 5.7years.
Coronectomy is a widely accepted treatment for mandibular third molars that are in close relationship to the mandibular canal. However, long-term studies on morbidity following this procedure have not been presented. The aim of this study was to examine the long-term morbidity after coronectomy, with sensory disturbances of the inferior alveolar nerve (IAN) and root migration as the primary outcome variables. ⋯ Infections occurred in 11.7% of the cases and all were treated with antibiotics. Overall, 97% of the retained roots showed signs of migration and 65% showed signs of rotation. Therefore, coronectomy of the mandibular third molars with an intimate relationship to the mandibular canal seems to be a safe treatment modality with a good long-term prognosis.
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Int J Oral Maxillofac Surg · Dec 2018
Case ReportsExtensive subcutaneous emphysema, pneumomediastinum, and pneumorrhachis following third molar surgery.
Third molar extraction is a common procedure in dental surgery. Common complications that may occur post procedure include pain, trismus, bleeding, dry socket, and nerve injuries. ⋯ A rare case of extensive cervicofacial subcutaneous emphysema, pneumomediastinum, and pneumorrhachis following third molar extraction is reported here. Issues relating to the diagnosis, aetiology, and management of these complications are discussed.