Reasonable necessity of preoperative laboratory tests in office-based oral and maxillofacial surgery

Objectives@#As medical history before surgery is often based on patient reporting, there is the possibility that patients intentionally hide underlying diseases or that dentists cannot recognize abnormal health states. Therefore, more professional and reliable treatment processes are needed under the Korean dental specialist system. The purpose of this study was to elucidate the necessity of a preoperative blood testing routine prior to office-based surgery under local anesthesia. @*Patients and Methods@#Preoperative blood lab data for 5,022 patients from January 2018 to December 2019 were assembled. Study participants were those who underwent extraction or implant surgery under local anesthesia at Seoul National University Dental Hospital. Preoperative blood tests included complete blood count (CBC), blood chemistry, serum electrolyte, serology, and blood coagulation data. Values outside of the normal range were considered an “abnormality,” and the percentage of abnormalities among the total number of patients was calculated. Patients were divided into two groups based on the presence of underlying disease. The rates of abnormalities in the blood tests were compared between groups. Chi-square tests were performed to compare data from the two groups, and P<0.05 was considered statistically significant. @*Results@#The percentages of males and females in the study were 48.0% and 52.0%, respectively. Of all patients, 17.0% (Group B) reported known systemic disease, while 83.0% (Group A) reported no specific medical history. There were significant differences between Groups A and B in CBC, coagulation panel, electrolytes, and chemistry panel (P<0.05). In Group A, the results of blood tests that required a change in procedure were identified even though the proportion was very small. @*Conclusion@#Preoperative blood tests for office-based surgery can detect underlying medical conditions that are difficult to identify from patient history alone and can prevent unexpected sequelae. In addition, such tests can result in a more professional treatment process and build patient confidence in the dentist.

Radiographic evaluation before surgical extraction of impacted third molar to reduce the maxillary sinus related complication

Objectives@#Surgical extraction of maxillary third molars is routine in departments devoted to oral and maxillofacial surgery. Because maxillary third molars are anatomically adjacent to the maxillary sinus, complications such as oroantral fistula and maxillary sinusitis can occur. Here we explore the factors that can cause radiographic postoperative swelling of the maxillary sinus mucosa after surgical extraction. @*Materials and Methods@#This retrospective study reviewed the clinical records and radiographs of patients who underwent maxillary third-molar extraction. Preoperative panoramas, Waters views, and cone-beam computed tomography were performed for all patients. The patients were divided into two groups; those with and those without swelling of the sinus mucosa swelling or air-fluid level in a postoperative Waters view. We analyzed the age and sex of patients, vertical position, angulation, number of roots, and relation to the maxillary sinus between groups. Statistical analysis used logistic regression and P<0.05 was considered statistically significant. @*Results@#A total of 91 patients with 153 maxillary third molars were enrolled in the study. Variables significantly related to swelling of the maxillary sinus mucosa after surgical extraction were the age and the distance between the palatal cementoenamel junction (CEJ) and the maxillary sinus floor (P<0.05). Results of the analysis show that the relationship between the CEJ and sinus floor was likely to affect postoperative swelling of the maxillary sinus mucosa. @*Conclusion@#Maxillary third molars are anatomically adjacent to the maxillary sinus and require careful handling when the maxillary sinus is pneumatized to the CEJ of teeth.

Oral Manifestation of Unknown Hematopoietic Malignancy

Burkitt lymphoma is a highly aggressive type of hematopoietic malignancy that is comparatively common in children and young people. It is important that Burkitt lymphoma be diagnosed as early as possible for prompt intervention due to its rapidly progressive, high-grade malignant nature. Dentists, especially maxillofacial surgeons, can play a life-saving role in patients with such unknown malignancy as the first clinical or radiological manifestation might occur in the oral region.

Next generation sequencing-based salivary biomarkers in oral squamous cell carcinoma

Selection of potential disease-specific biomarkers from saliva or epithelial tissues through next generation sequencing (NGS)-based protein studies has recently become possible. The early diagnosis of oral squamous cell carcinoma (OSCC) has been difficult, if not impossible, until now due to the lack of an effective OSCC biomarker and efficient molecular validation method. The aim of this study was to summarize the advances in the application of NGS in cancer research and to propose potential proteomic and genomic saliva biomarkers for NGS-based study in OSCC screening and diagnosis programs. We have reviewed four categories including definitions and use of NGS, salivary biomarkers and OSCC, current biomarkers using the NGSbased technique, and potential salivary biomarker candidates in OSCC using NGS

Adverse reaction to Coartem (artemether/ lumefantrine) resulting in oculogyric crisis / 대한악안면성형재건외과학회지

Background@#Artemether/lumefantrine (AL), sold under the brand name Coartem, is the most common artemisininbased combination therapy for the treatment of malaria. Drug-induced oculogyric crisis is a neurological disorder characterized by frequent upward deviations of the eye. In the literature, no cases of Coartem-induced oculogyric crisis have been reported in Ghana.Case presentation: A 19-year-old male patient, who presented fever measuring 37.9 °C, general body pains, and weakness was prescribed with antimalarial therapy artemether/lumefantrine, Coartem®, from a local pharmacy. Just after initiation of treatment, the patient complained of double vision, involuntary upward eye deviation, and inability to close both eyes. The patient was diagnosed with Coartem-induced oculogyric crisis and was treated with the cessation of the causing agent and intramuscular injection of promethazine hydrochloride. @*Conclusions@#When a patient exhibits a neurological disorder, such as oculogyric crisis, with normal conscious state and normal vital signs, special attention should be given to obtaining a history of recently administered medications. Clinicians should recognize adverse reactions to drugs based on a thorough patient history and examination. The goal of this report was to present Coartem-induced oculogyric crisis.

Acquired synechia of the tongue to the mouth floor

Sodium hydroxide or caustic soda is a corrosive agent that can cause extensive damage to the oral mucosa, lips, and tongue when ingested either accidentally or intentionally. These injuries include microstomia, shallow vestibule, ankyloglossia, speech impairment, loss of teeth and impairment in facial expression. In the present article, we report a unique case of tongue adhesion to the mouth floor and its surgical management in a 66-year-old female patient, who had a history of caustic soda ingestion.

Incidence and management of mandibular fractures in a low-resource health facility in Ghana

Objectives@#The mandible and other parts of the maxillofacial region suffer significant morbid injuries following road traffic accidents. Our studygives epidemiological description of mandibular fractures in Ghana and also evaluates the relevance of closed reduction and indirect fixation for managing mandibular fractures in low-resource health facilities in low-income countries like Ghana. @*Patients and Methods@#This is a retrospective study involving 268 patients who reported to the Department of Oral and Maxillofacial Surgery of the Sunyani Regional Hospital with mandibular fractures from January 2010 to December 2019. Patient medical records were assessed for information on age, sex, fracture etiology, anatomic location of fracture, time of day of road traffic accident, and other associated injuries. @*Results@#A total of 268 patients were included in this study (males, 216 [80.6%]; females, 52 [19.4%]). Motor vehicular accident (MVA) was the lead-ing cause of mandibular fractures (202 injuries, 75.4%). Other etiologies included assault (39, 14.6%), gunshot (13, 4.9%), falls (12, 4.5%), and indus-trial accidents (2, 0.7%). Of the 161 male cases caused by MVA, 121 (75.2%) occurred at night and in the evening while the remaining 40 (24.8%) oc-curred in the morning and afternoon. Among all managed 222 patients, 212 (79.1%) were treated with closed reduction and indirect fixation technique while 10 (3.7%) were treated with open reduction and direct fixation. @*Conclusion@#Closed reduction with indirect fixation could successfully be used to manage mandibular fractures in low resourced health facilities, es-pecially in low-income countries. The poor lightening system on roads in Ghana is a major contributory factor to motor vehicular accidents.

Solitary plasmacytoma in the maxillary sinus: 10-year follow-up

Solitary plasmacytoma (SP) is an uncommon form of plasma cell neoplasm occurring intraosseously or in soft tissue and presents as a single mass of monoclonal plasma cells. SP in the maxillary sinus is rare and can be misdiagnosed as other maxillary sinus tumors. The essential examinations in patients with the initial diagnosis of plasmacytoma are bone marrow biopsy, serum and urine electrophoresis, and kappa/lambda ratio (κ:λ ratio) to rule out multiple myeloma (MM). Herein, a rare case of SP in the maxillary sinus treated by surgery and localized radiation is reported. At the 10-year follow-up examination, local recurrence or disseminated development of MM were not evident.

An accurate diagnosis of odontogenic cutaneous sinus tract by different computed tomography unit setting

Due to their rarity and the lack of associated dental symptoms, odontogenic cutaneous sinus tracts (OCSTs) are often misdiagnosed and confused with cutaneous lesions or non-odontogenic infections. It has been estimated that 50% of individuals affected by OCSTs are subjected to inappropriate treatments before the correct diagnosis is established. We describe the diagnosis and treatment of two cases of OCSTs. By using a computed tomography (CT) with soft tissue window setting, the extent of cortical bone destruction and the path of the sinus tract in the soft tissue was easily identified. Thus, we recommend the use of imaging techniques such as CT, which can confirm the odontogenic origin and the exact location of the OCST.

Salivary biomarkers in oral squamous cell carcinoma

In disease diagnostics and health surveillance, the use of saliva has potential because its collection is convenient and noninvasive. Over the past two decades, the development of salivary utilization for the early detection of cancer, especially oral cavity and oropharynx cancer has gained the interest of the researcher and clinician. Until recently, the oral cavity and oropharynx cancers are still having a five-year survival rate of 62%, one of the lowest in all major human cancers. More than 90% of oral cancers are oral squamous cell carcinoma (OSCC). Despite the ease of accessing the oral cavity in clinical examination, most OSCC lesions are not diagnosed in the early stage, which is suggested to be the main cause of the low survival rate. Many studies have been performed and reported more than 100 potential saliva biomarkers for OSCC. However, there are still obstacles in figuring out the reliable OSCC salivary biomarkers and the clinical application of the early diagnosis protocol. The current review article discusses the emerging issues and is hoped to raise awareness of this topic in both researchers and clinicians. We also suggested the potential salivary biomarkers that are reliable, specific, and sensitive for the early detection of OSCC.