Minor oral surgery procedures in patients taking warfarin: a 5-year retrospective study at Sultan Qaboos University Hospital, Sultanate of Oman

Minor oral surgery [MOS] procedures in warfarinised patients carry the risk of post-operative bleeding. The aim of this study was to conduct a retrospective analysis and to describe the profile of warfarinised patients who underwent MOS procedures at Sultan Qaboos University Hospital. A retrospective study of 124 warfarinised patients [41 men and 83 women], who had a pre-operative international normalised ratio [INR] of

Factors contributing to the spread of odontogenic Infections: a prospective pilot study

Spreading odontogenic infections [SOI] are the commonest type of serious infections encountered in the orofacial region. A prospective multi-centre study was conducted in the West of Scotland to investigate the contributing role of social, systemic and microbial factors in the pathogenesis of SOI. Twenty-five patients with severe odontogenic infections were recruited over a period of six months. At admission, clinical assessment included temperature rise, haematological and biochemical investigations. Demographic data, social and past medical histories were obtained. Microbiology samples were collected to identify causative microorganisms and the clinical management of each infection was recorded. Results: Most infections were associated with teeth or roots. Eighty percent of the patients were tobacco smokers and 72% came from deprived areas. Five patients were intravenous drug users, four admitted chronic alcohol abuse, six had underlying systemic disorders and two were at high risk of malnutrition. A raised C-reactive protein at admission was a useful indicator of the severity of infection. Inappropriate prior antibiotic treatment in the absence of surgical drainage was common. Microbiology results showed a predominance of strict anaerobes, notably anaerobic streptococci, Prevotella and Fusobacterium species. SOIs remain surprisingly common and our present pilot study showed a particular association with social deprivation and tobacco smoking. Further elucidation of the role of malnutrition in SOI would be of interest. Molecular characterisation of the microflora associated with SOI may help to highlight whether bacterial factors play a role in converting a localised dentoalveolar abscess into a serious, spreading odontogenic infection

Maxillary hyperplasia and hyperostosis cranialis. A rare manifestation of renal osteodystrophy in a patient with hyperparathyroidism secondary to chronic renal failure

This case report describes a 21-year-old female patient with a complex medical condition of end-stage chronic renal failure and secondary hyperparathyroidism presenting with a history of gradual enlargement of the facial bones over a period of one year. The facial enlargement primarily involves the maxilla causing a bizarre facial and dental deformity. Based on the clinical, radiographic, and laboratory investigations the facial deformity was confirmed as a rare manifestation of renal osteodystrophy presenting as maxillary hyperplasia and hyperostosis cranialis