Treatment of large sized cystic lesion of the jaws with specific appliance for decompression: cases report

Cystic lesions on the jaws with expansion can invade the adjacent anatomical structure, infiltrate and expand the jaws, cause facial deformity, etc. There is great potential for pathologic fractures after cyst enucleation, and damage to the major structures like the nerve, artery. For these reasons, marsupialization and decompression are commonly used to reduce the cystic size. In 1947, Thomas first mentioned decompression that reduces the osmotic pressure in a cyst by making a hole in the cyst and insert a drain. In our cases, a large sized cystic lesion was treated with a specific device made from an orthodontic band and spinal needle. This device is easy and effective for applications and self irrigation.

The prospective preliminary clinical study of open reduction and internal fixation of mandibular angle fractures using 2 miniplates

INTRODUCTION: The placement of a single miniplate is not sufficient to achieve rigid fixation in mandibular angle fractures. It often causes difficulties in reducing the intermaxillary fixation (IMF) period. Consequently, the placement of 2 miniplates is preferable. The intraoral approach in an open reduction and internal fixation (ORIF) of a mandibular angle fracture with 2 miniplates is often challenging. Accordingly, an alternative of transbuccal approach is performed. However, this method leaves a scar on the face and can result in facial nerve injury. This clinical study suggests a protocol that can maintain rigid fixation without a transbuccal approach in mandibular angle fractures. MATERIALS AND METHODS: The subjects were 7 patients who sustained fractures of the mandibular angle and treated at Department of Oral and maxillofacial surgery, Sacred Heart Hospital, Hallym University. ORIF under general anesthesia was done using the intraoral approach. One miniplate was inserted on external oblique ridge of the mandible, and the other was placed on lateral surface of the mandibular body with contra-angle drill and driver. A radiographic assessment and occlusal contact point examination was carried out before surgery, and 2, 4 and 6 weeks after surgery. RESULTS: The mean operation time was 80 minutes. Regarding the occlusion state, the number of contact points increased after surgery. Paresthesia and infection were reported to be complications before surgery. CONCLUSION: The placement of 2 miniplates using contra-angle drill for ORIF of mandibular angle fractures allows early movement of the mandible without IMF. We propose this approach to reduce the patients' discomfort and simplify the surgical procedure.

Hemorrhage of Sublingual Region and Airway Obstruction That Occurred after Dental Implant Placement on Mandible Anterior Edentulous Area: Case Report

Because sublingual region is well-vascularized and sublingual artery is passed throughout this region, it should be careful not to perforate lingual cortex when placing dental implant on mandible. A 83-years-old male complained severe sublingual hematoma, hemorrhage and dyspnea came our outpatient department. He had received dental implant placement in the same day. He needed hemostasis and airway control. If soft tissue of sublingual region and the artery are injured, it may result in life-threatening excessive hemorrhage. In dental implant surgery, especially mandible, we should recognize the accurate shape of mandible and anatomy of sublingual region. It is important to stop anticoagulant agent before surgery. When a patient has airway obstruction, the operator should manage airway quickly.