Orofacial infections in Iraq.

In Iraq, oral and maxillofacial (OMF) infections are common; these infections may be of odontogenic or nonodontogenic origin. The former, the commoner, gains importance from the catastrophic consequences that may take place in neglected or mismanaged patients and, as a paradox, from a fact that most of these infections are avoidable and preventable if a timely and accurate management took place for the primary dental problem. Nonodontogenic infections are not uncommon and are of life-threatening potential. Most of these infections are associated with an underlying medical condition that, whenever controlled, can help achieve acceptable results. Although missile injuries-associated infections are almost exclusively of bacterial origin, a separated section is assigned in this article for these infections, in addition to other varieties of bacterial, viral, and fungal infections. The article gives an account of common presentations, diagnostic procedures, treatment protocols, and outcomes of management of OMF infections in Baghdad's central OMF surgery department. These infections are considered as one of the elementary problems in OMF clinics; thus, highlighting significant points extirpated from an overall view of a more than 10-year experience can suggest where shortcomings in management are and can pave the way for future improvement.

Management outline of oral and maxillofacial missile injuries in Iraq: the value of the intermediate phase.

Oral and maxillofacial surgeons in Iraq are practicing in a paradoxical situation where a high number of extensive injuries are accompanied by limited resources. Steps of management should be followed cautiously in attempts to reduce residual deformities that characterize the end results of severe missile injuries. This study elucidate lessons extirpated from surgical experience in the management of diversity of causalities with special emphasis on the intermediate phase of management as well as different modalities of treatment, trying to get best benefit from available resources.

Surgical management of temporomandibular joint ankylosis.

Ankylosis of the temporomandibular joint (TMJ) is one of the causes of persistent and progressive limitation of mouth opening. It usually requires to be corrected surgically; an intervention not without complications. This study was conducted in a central surgical hospital in Iraq (Baghdad) in the era hallmarked by shortage of nearly all facilities needed to accomplish solutions for a surgical task. The surgical procedure is displayed along with modifications, complications, and follow-up protocol. Fifteen patients (21 joints) have been treated surgically for TMJ ankylosis of different severities. All patients were treated at the Department of Oral and Maxillofacial Surgery, Specialized Surgical Hospital-Baghdad Medical City, Iraq. The study was carried out in the period between 1998 and 2002 (inclusive). Patients' ages ranged between 4 and 52 years. In addition to the clinical diagnoses, further evaluation of the ankylosis area was assisted by the use of orthopantomography and spiral computerized scanning (axial, coronal sections, and three-dimensional views). Maximal incisal opening was registered before and after surgery for further follow-up evaluation. Al-Kayat and Bramely approach is advocated to expose the joint area. All 21 joints were operated through blind nasoendotracheal intubation general anesthesia. Computed tomography scans, wide exposures, aggressive resections, proper interposition materials, strict postoperative physiotherapy, and good family and patient compliance all may decrease the possibility of relapse and offer better results. Early management of TMJ ankylosis is important if more damage in orofacial structures and consolidation of bony union are to be avoided.