Idiopathic bone cavities of the mandible: an update on recurrence rates and case report.

Idiopathic bone cavities (IBCs) are usually an incidental finding, often found in long bones but also in the craniofacial skeleton. Typically solitary, IBCs can present at multiple sites. Surgical exploration alone has proved effective, although recurrence does occur, particularly in cases with multiple lesions. The average time necessary to observe either recurrence or complete healing has been reported to be more than 3 years. Previously reported low recurrence rates for IBCs in the craniofacial skeleton may have been artificially low because of insufficient long-term follow-up. Providers should be prepared for long-term follow-up and care of these patients. The case of the patient presented here supports the need for long-term follow-up.

Are nitrogen-containing intravenous bisphosphonates implicated in osteonecrosis of appendicular bones and bones other than the jaws? A survey and literature review.

PURPOSE: The purpose of this study was to determine the incidence of osteonecrosis of appendicular bones due to nitrogen-containing intravenous bisphosphonates and the incidence of adverse effects in bones other than the jaws. MATERIALS AND METHODS: A detailed search of the professional medical and dental literature was conducted. In addition, a questionnaire was mailed to all known orthopedic surgery training programs in the United States. Programs were queried as to clinical findings and other various scenarios. RESULTS: There was a great paucity of literature that addressed the issue. Of the 154 questionnaires mailed, 29 (19%) were returned. Identification was optional; therefore, it was impossible to determine the geographic origin of the returned questionnaires. No orthopedic surgery training program indicated positive findings of osteonecrosis in the long bones due to nitrogen-containing intravenous bisphosphonates. There were rare reports in the literature of osteonecrosis in other areas of the bony skeleton. CONCLUSION: On the basis of literature searches and national orthopedic questionnaires, there is only a rare incidence of osteonecrosis of the appendicular bones and bones other than the jaws due to nitrogen-containing intravenous bisphosphonates. There were no reports of adverse long bone effects, based on the questionnaires. There were rare reports in the literature.

Parameters for treatment of cocaine-positive patients.

PURPOSE: The purpose of this study was to identify the parameters by which oral and maxillofacial surgeons and anesthesiologists make decisions as to the safety for proceeding with surgery and anesthesia in cocaine-positive patients and to determine a national consensus of opinion, if possible. METHODS: Questionnaires were mailed to all known oral and maxillofacial surgery training programs and anesthesiology training programs in the United States (n = 241). Programs were queried as to screening, testing, parameters, and outcomes. RESULTS: Of the 241 questionnaires mailed, 114 (47%) were returned. Identification on the returns was optional; therefore, it was impossible to determine the total from each discipline. Only 16% of the programs had a formalized policy for cocaine screening prior to surgery and anesthesia. There was significant variability in the length of delay/time lapse before proceeding with anesthesia and surgery in the face of cocaine positivity. CONCLUSION: Based on the returned questionnaires and literature searches, the authors propose that patients who test positive for cocaine in their urine may undergo necessary surgical and anesthetic care, after an 8-hour period of discontinuing of cocaine, if the individual is hemodynamically stable.