ABSTRACT
A 21-year-old woman who was 9 weeks pregnant presented with osteomyelitis of the mandible that resolved spontaneously after delivery. To our knowledge a link between osteomyelitis of the jaws and pregnancy has not been reported previously.
Subject(s)
Mandibular Diseases/diagnosis , Osteomyelitis/diagnosis , Pregnancy Complications/diagnosis , Adult , Bone Resorption/diagnosis , Female , Humans , Osteonecrosis/diagnosis , Parturition , Pregnancy , Remission, SpontaneousABSTRACT
Recent reports have suggested that the practice of prophylactic lower third molar surgery is widespread, possibly account for up to 50% of all patients treated. An objective effort to refute the findings of the previously published data was undertaken by the Maxillofacial Unit of a large district general hospital trust. A prospective study of 454 consecutive patients referred for third molar surgery demonstrated that in 96% of the patients, at least one nationally defined criteria for surgery was present. A concurrent retrospective audit of patients already on the waiting list for surgery identified that 97% had at least one valid criterion for surgery. Of those patients who presented with unilateral symptoms, over half had only the troublesome side removed. Only 11 out of 454 patients were accepted for treatment without a defined criterion, all of whom had partially erupted teeth. The evidence presented in the current study is compared with previously reported data and possible reasons for the variance are discussed.
Subject(s)
Molar, Third/surgery , Adolescent , Adult , Aged , Decision Making , Dental Audit , Female , Humans , Male , Middle Aged , Prospective StudiesABSTRACT
A national survey was conducted to establish the current practice of postoperative review of third molar surgery by the 255 fellows of the British Association of Oral and Maxillofacial Surgeons. Of the 216 complete responses, 134 say that they routinely reviewed all patients, while 67 did not. A further 15 fellows (7%) are currently considering their practice. Five (2%) stated that routine review should be compulsory and failure to do so was medically negligent. We conclude that a policy of selective rather than routine review is safe for most patients, but if a patient is under age, mentally retarded, taking psychoactive drugs, or has any other associated condition, then routine follow-up should be undertaken.
Subject(s)
Molar, Third/surgery , Practice Patterns, Dentists' , Tooth Extraction , Age Factors , Dental Care/legislation & jurisprudence , Dental Care for Disabled/legislation & jurisprudence , Follow-Up Studies , Humans , Intellectual Disability , Malpractice/legislation & jurisprudence , Policy Making , Postoperative Care , Practice Guidelines as Topic , Practice Patterns, Dentists'/legislation & jurisprudence , Psychotropic Drugs/therapeutic use , Safety , Surgery, Oral , Surveys and Questionnaires , United KingdomABSTRACT
A retrospective assessment of labial sensory function following sagittal split osteotomy was undertaken by a combination of record analysis, postal questionnaire and objective sensory testing. Case records for 90 sides operated upon by a single consultant surgeon between 1979 and 1992 identified a prevalence of persisting sensory changed at 2 years of 6.7%. A higher incidence of sensory change was seen in patients treated with intermaxillary fixation/upper border wires than those managed with buccal monocortical miniplates. Postal questionnaire returns for 67 consultant operated sides identified a higher incidence of sensory change than recorded in the notes. 5.9% had long term persisting anaesthesia. Another 28% had more variable subtle sensory impairment. A similar relation to method of fixation was seen. An association between duration of temporary sensory change and magnitude of forward mandibular advance was noted. Objective sensory testing validated the subjectively reported sensory status but also identified many patients self-assessed as normal had some undetected sensory impairment. Possible mechanisms for the above findings and implications for clinical practice are presented.
Subject(s)
Hypesthesia/etiology , Lip/physiopathology , Mandible/surgery , Osteotomy/adverse effects , Bone Plates/adverse effects , External Fixators/adverse effects , Humans , Immobilization , Neurologic Examination , Retrospective Studies , Sensory Thresholds , Surveys and Questionnaires , ThermosensingABSTRACT
Le Fort I osteotomy is proposed as an alternative approach in the management of choanal atresia in the adult. It offers excellent access with full exposure of the atresia and the funnelling of the nasal cavity to the bony septum.
Subject(s)
Choanal Atresia/surgery , Nasal Cavity/surgery , Nasal Septum/surgery , Osteotomy/methods , HumansABSTRACT
A device is described to aid localisation of the mobilised premaxillary segment during intermediate bone grafting of bilateral alveolar clefts.
Subject(s)
Cleft Palate/surgery , Dental Equipment , Maxilla/surgery , Bone Transplantation , Dental Occlusion , Equipment Design , HumansABSTRACT
The demand for postoperative analgesia was compared between 29 patients treated with cryoanalgesia to the relevant intercostal nerves during thoracotomy and a control group who did not have cryoanalgesia. The cryoanalgesia group required significantly less (p < 0.005) postoperative analgesia than did the control group.
Subject(s)
Analgesia/methods , Cryosurgery/methods , Pain, Postoperative/prevention & control , Thoracic Surgery , Adult , Aged , Analgesics, Opioid/therapeutic use , Clinical Trials as Topic , Female , Humans , Intercostal Nerves , Male , Middle AgedABSTRACT
The biological sequelae to the experimental freezing of peripheral nerves have been shown to differ in several respects from those following other types of nerve injury. A clinical application of these effects utilising the extreme low temperature produced by modern cryosurgical equipment is proposed and a preliminary evaluation is made.
Subject(s)
Cryosurgery , Face , Pain, Intractable/surgery , Facial Neuralgia/surgery , Female , Herpesviridae Infections/complications , Humans , Male , Nerve Block , Neuralgia/etiology , Neuralgia/surgery , Peripheral Nerves/surgery , Sensation , Trigeminal Neuralgia/surgeryABSTRACT
The shopping behavior of three elementary school-age boys was analyzed and parent-child interactions assessed for one boy and his mother. Estimates of parent of consumer satisfaction with child shopping behavior were also obtained. The effects of a parent-mediated treatment package on child behavior were assessed using a multiple-baseline design. Treatment produced significant increases in appropriate shopping behavior in all three children and parents became increasingly satisfied with improved child behavior. Analysis of data for one mother also revealed that her manner of interacting with her child became more positive.
Subject(s)
Child Behavior Disorders/therapy , Parents/education , Social Behavior , Behavior Therapy , Child , Child, Preschool , Consumer Behavior , Humans , Male , Mother-Child Relations , Verbal BehaviorABSTRACT
Cryotherapy has been clinically applied to relieve pain using a new cryosurgical probe to block peripheral nerve function to achieve analgesia. Sixty-four patients with intractable pain were treated with cryoanalgesia. Fifty-two obtained relief of pain for a median duration of 11 days and a range of up to 224 days.
