Esthetic facial surgery for women.

Women of all ages are increasingly seeking facial cosmetic surgery for personal and professional reasons. A wide array of surgical procedures is available to address each woman's specific request. Esthetic facial surgery and cosmetic dentistry may complement each other to provide dramatic results.

Topical antibiotic prophylaxis for bacteremia after dental extractions.

OBJECTIVE: Current prophylaxis for endocarditis in patients undergoing dental procedures consists of oral administration of amoxicillin. There is concern that the risk of anaphylaxis from systemically administered antibiotics might approach the incidence of endocarditis. Emergence of resistance among bacteria is also favored by systemically administered antibiotics. The present study was designed to assess the efficacy of topical amoxicillin given prophylactically as a mouthwash in reducing the incidence of bacteremia after dental extraction. STUDY DESIGN: Thirty-six outpatients in a dental clinic were randomized in a 3:2:2 ratio to experimental prophylaxis of topical amoxicillin (3 g per mouthwash rinse; 15 patients), standard prophylaxis of oral amoxicillin (3 g in a single dose; 11 patients), or no prophylaxis (10 patients), respectively. Patients were stratified by severity of periodontal disease and number of teeth extracted. Data were analyzed for differences in the incidence of bacteremia by means of the 2-tailed Fisher exact test. RESULTS: Breakthrough bacteremia after dental extraction was observed in 60% (6 of 10 patients) who received topical amoxicillin and in 89% (8 of 9 patients) who received no prophylaxis (P =.30). By comparison, breakthrough bacteremia after dental extraction was observed in 10% (1 of 10 patients) who received standard prophylaxis with oral amoxicillin (60% vs 10%; P =.05). CONCLUSIONS: Topical amoxicillin decreased the incidence of bacteremia in comparison with no prophylaxis, but statistical significance was not achieved (P =.30). Topical amoxicillin was significantly less effective than standard prophylaxis with oral amoxicillin in decreasing the incidence of bacteremia after dental extractions.

Surgical management of sports-related traumatic injuries.

The increasing popularity of all sporting events results in increased potential for injury. Despite helmet, facemask, and mouthguard use, the face often remains an exposed area at risk in many sports. Dentists rehabilitating patients after facial injuries should understand their patients' previous injuries and treatment.

Hepatitis: implications for dental care.

Patients with hepatitis and liver dysfunction present an array of pathophysiologic alterations for the practitioner to evaluate. An understanding of how treatment may be affected by liver disease is essential before dental treatment is begun.

Diagnosis and treatment of postoperative complications after skin resurfacing.

Chemical peel, dermabrasion, and laser skin resurfacing are alternative methods to achieve skin resurfacing for reconstructive or cosmetic applications. The potential postoperative complications are similar with all of these techniques. These postoperative complications and their therapy are reviewed.

Pharmacology of agents used in the management of patients having skin resurfacing.

Many medications are used in the preparation, operative, and postoperative phases of skin resurfacing. This article reviews those medications that impact on laser, chemical peel, and dermabrasion surgery. Facial cosmetic surgeons must fully appreciate the "chemistry" of skin resurfacing.

Pediatric facial injuries associated with all-terrain vehicles.

All-terrain vehicles (ATVs) are becoming increasingly popular recreational devices. Multiple injuries have been associated with ATV accidents. This report reviews pediatric injuries treated at a regional pediatric trauma center, with special attention to facial trauma, as well as the ATV injury data for the United States.

Management of the oral and maxillofacial surgery patient with end-stage renal disease.

Chronic renal failure (CRF) is the consequence of a multitude of diseases that cause permanent destruction of the nephron. Concurrent with renal failure are a host of changes affecting the homeostatic functioning of the individual. This report outlines the pathophysiology of CRF and highlights its effects on surgical manipulation of the oral and maxillofacial region in this patient population. In addition, some of the common physical findings and alterations in blood chemistries frequently observed in these patients are discussed.

Facial-skeletal manifestations of Engelmann's disease.

Engelmann's disease is a hereditary bone disorder that affects the axial and the appendicular skeleton. The facial examination is altered secondary to the progressive osseous changes. This report presents a case of Engelmann's disease in a patient with maxillofacial trauma and reviews the associated facial and skeletal manifestations.

Incidence of nasolacrimal injury and turbinectomy--associated atrophic rhinitis with Le Fort I osteotomies.

Injury to the lacrimal system can occur with trauma, craniofacial surgery, rhinoplasty and nasal antrostomy. Nasolacrimal duct injury may potentially occur with Le Fort I superior repositioning. Atrophic rhinitis is also a potential complication secondary to turbinectomy required during Le Fort I superior repositioning. A review of thirty-four cases over three years of Le Fort I osteotomies with superior repositioning found no postoperative lacrimal injury and no subsequent atrophic rhinitis associated with turbinectomy. An anatomical study relating the position of the nasolacrimal duct opening within the inferior meatus and the distance available for maxillary impaction is reviewed.

Transmaxillary temporalis transfer for reconstruction of a large palatal defect: report of a case.

The infratemporal transmaxillary transfer of a temporalis myofascial flap for reconstruction of an extensive palatal defect in an adult cleft palate patient is described. A modified temporal approach is discussed.

Closure of alveolar clefts with corticocancellous block grafts and marrow: a retrospective study.

A surgical technique is presented for maxillary alveolar cleft repair that includes a contoured iliac crest corticocancellous block graft and marrow packing, along with closure by a Y-vestibular mucosal advancement flap. A retrospective study of graft survival in 48 cleft sites showed a 94% success rate with no complications; the remaining 6% of the cases showed minor complications.

The use of tracheotomy in oral and maxillofacial surgery.

Tracheotomy is discussed as a method of airway management required in various clinical situations. The anatomy and operative technique involved have been well-established. This paper reviews additional aspects of the procedure: indications, complications, the physiologic effects on tracheolaryngeal function, and postoperative care.