Near-fatal airway obstruction after routine implant placement.

Implants have gained tremendous popularity over the past two decades, and their placement in the interior edentulous mandible has become routine. A case of near-fatal airway obstruction secondary to sublingual bleeding and hematoma is presented. The complication, anatomy of the area, and previous literature are reviewed, as are precautions to implant placement and other surgical procedures near the floor of the mouth. Although placing dental implants is generally a benign procedure, practitioners must be prepared for potential complications and have a rehearsed plan of action for the treatment of emergent situations. The floor of the mouth contains branches of the submental and sublingual and mylohyoid arteries that may lead to life-threatening complications. This caution obviously extends to any dentoalveolar surgical procedures that concerns the floor of the mouth such as tori removal, extractions, and iatrogenic dental injuries.

A simple device for incision retraction and protection in endoscopic-assisted brow and forehead lifting.

BACKGROUND: Endoscopic-assisted cosmetic surgery has revolutionized various procedures. Forehead and brow lifting performed with endoscopic technique has been shown to be predictable and has fewer complications than open techniques. Providing surgical access and protecting the hair follicles is paramount in endoscopically assisted brow and forehead lifting. OBJECTIVE: To describe a simple retraction device to assist in incision retraction and protect hair follicles. METHODS: A simple, inexpensive retraction device is described that has been used in 60 endoscopic brow incisions to effectively protect the hair follicles and retract incisions for operative techniques. In addition, other methods of follicular protection are discussed. RESULTS: Decreased incisional alopecia and improved surgical access are provided by the use of a simple retraction device and attention to follicular preservation. CONCLUSION: Endoscopic-assisted brow and forehead lifting is becoming the preferred method of upper facial rejuvenation. There is a steep learning curve and often the lack of attention to hair follicle protection results in localized incisional alopecia. In addition, improper surgical access complicates the procedure. A simple device is described to assist in retraction and follicular preservation.

Cosmetic oral and maxillofacial surgery options.

BACKGROUND: Dentistry and its related specialties have made exponential increases in the functional and cosmetic treatment of the maxillofacial region. Oral and maxillofacial surgeons historically have been involved in functional and cosmetic rejuvenation of the face, and newer technologies have enhanced the ability to make patients look and feel better. METHODS: Cosmetic oral and maxillofacial surgery is being taught in residency programs, is included in the oral and maxillofacial surgery board examinations and represents a part of contemporary oral and maxillofacial surgery. The author discusses common facial rejuvenation procedures with an emphasis on newer treatment technologies. RESULTS: Many oral and maxillofacial surgeons have the ability to improve the esthetics of the maxillofacial area and related structures. The large number of aging baby boomers and technological advances in cosmetic facial surgery have made these procedures easier to perform and more popular than ever. CONCLUSION: A global diagnosis and treatment plan to include facial esthetics can enhance cosmetic dentistry and serve to frame the work of the restorative dentist. The oral and maxillofacial surgeon can help the dentist and patient pursue both functional and cosmetic improvement with safe and effective procedures. CLINICAL IMPORTANCE: All dentists should be aware and abreast of advances in all areas of dentistry and have a basic understanding of available procedures that can benefit their patients. Cosmetic oral and maxillofacial surgery can enhance the work of the restorative dentist and improve facial esthetics, as well as enhance the well-being of the patient.

Cherubism: diagnosis, treatment, and comparison with central giant cell granulomas and giant cell tumors.

An extensive case of cherubism in a 17-year-old girl with no apparent familial history is presented. The rationale for treatment is presented and is compared with previous reports that have advocated nontreatment. The clinical and histologic similarities of cherubism to central giant cell granuloma and the giant cell tumor of bone are also discussed.