Patient?s perception of improvement after surgical assisted maxillary expansion (SAME) : pilot study

Objective: Clinicians often assume that changes following orthognathic surgery are both physically and psychologically beneficial to the patient. The present study investigates patient perception regarding improvement after surgically assisted rapid maxillary expansion. Study design: A survey with twenty-three patients was carried out to identify satisfaction with the surgical outcome and assess whether the surgery met patient expectations. General information was also collected on schooling, age, gender, chief complaint and reasons for seeking treatment. Results: Most patients (n = 19; 82%) were advised to undergo surgery by a dentist. Twenty-two (95%) patients reported being satisfied with the operation procedure. Twenty-one (91%) patients reported that the procedure met their expectations. Nineteen respondents would undergo the same operation again and would recommend treatment to others with similar problems. Conclusion: The need for surgery associated with orthodontic appliances to correct a transverse maxillary deficiency requires a proper explanation to patients regarding the procedure and postoperative period in order to ensure realistic expectations concerning the surgical goals

Cervical Necrotizing Fasciitis Caused by Dental Extraction

Cervical necrotizing fasciitis is an unusual infection characterized by necrosis of the subcutaneous tissue and fascial layers. Risk factors for the development of necrotizing fasciitis include diabetes mellitus, chronic renal disease, peripheral vascular disease, malnutrition, advanced age, obesity, alcohol abuse, intravenous drug use, surgery, and ischemic ulcers. This report presents a case of necrotizing fasciitis in the cervical area caused by dental extraction in a 73-year-old woman. Cervical necrotizing fasciitis in geriatric patient is rare, and even when establishing the diagnosis and having it timely treated, the patient can suffer irreversible damage or even death. Clinical manifestations in the head and neck usually have an acute onset characterized by severe pain, swelling, redness, erythema, presence of necrotic tissue, and in severe cases obstruction of the upper airways. Therefore, the presentation of this clinical case can serve as guidance to dentists as a precaution to maintain an aseptic chain and be aware of the clinical condition of older patients and the systemic conditions that may increase the risk of infections