The Importance of Maxillary Sinuses in Oral and Maxillofacial Surgical Procedures

Oral and maxillofacial surgical procedures, such as tooth extractions, surgical treatment of odontogenic maxillary sinus pathologies, dental implant surgery, orthognathic surgery, and sinus lift procedures, often correlate with the maxillary sinuses, due to anatomical proximity. For instance, in Le Fort I osteotomy, which is the predominant surgical technique preferred for the treatment of dentofacial deformities of the maxilla, the osteotomy line includes maxillary sinus and nasal walls. Maxillary sinus-lifting surgery is performed to regenerate bone in the posterior maxilla for dental implant placement. Additionally, maxillary sinus pathologies of odontogenic origin, such as sinusitis, cysts, and neoplasms, can impact the oral and maxillofacial region, and surgical intervention may be required to manage these conditions. Proper diagnosis, treatment planning, and surgical techniques are essential to optimize patient outcomes and minimize complications related to the maxillary sinuses in oral and maxillofacial surgical procedures

Treatment of trigeminal neuralgia with bupivacaine HCL using a temporary epidural catheter and pain pump: Preliminary study

Objectives: Trigeminal neuralgia (TN) is a rare form of neuropathic facial pain characterised by severe paroxysmal pain in the face. The treatment for trigeminal neuropathic pain disorder continues to be a major therapeutic challenge, as relief provided by medical therapy generally decreases over time. When medical therapy fails either due to poor or diminishing responses to drugs or to unacceptable side effects, peripheral intervention or surgical management of TN should be considered. Study design: Fourteen patients (eight men and six women) who were not responsive to further medical treatment and who were diagnosed with TN previously at other health centres were selected for treatment. For this purpose, the affected nerve was infused with 60 mL (1 mL h(-1)) of 0.5% bupivacaine HCl with a pain pump via an temporary epidural catheter. Patient's visual analogue scores (VAS) were recorded on the fifth preoperative day and on postoperative day 5, 2 weeks, 1, 3, 6 and 9 months. Results: There was a significant difference between mean preoperative and postoperative VAS value at day 5, 2 weeks, 1, 3, 6 and at the end of 9 months ((68.85 +/- 1.43) (13.57 +/- 6.68) (11.43 +/- 6.70) (14.29 +/- 6.52) (20.71 +/- 6.41) (20.71 +/- 6.41) and (21.43 +/- 6.10) respectively; *P < 0.05). Two of 14 patients did not show any pain relief. Conclusions: Continuous administration of 60 mL of 0.5% bupivacaine HCl at 1 mL h(-1) with a pain pump and epidural catheter can be used as a transition treatment for patients with side effects from high-dose antiepileptic drugs and for patients awaiting neurosurgery or individuals who refuse cranial surgery. It should not be considered as an alternative treatment of neurosurgical approaches, such as MVD, which has a definite long-lasting results. (C) 2011 European Association for Cranio-Maxillo-Facial Surgery

Tooth Fragment Lodged in the Upper Lip after Traumatic Dental Injury: an Unusual Case Report

Zubne traume uobičajene su komplikacije u slučaju ozljeda usne šupljine. Kod pacijenata s laceracijskom ranom gornje usne i dentalnom traumom prednjih zuba trebalo bi odmah pregledati preostale fragmente zuba. Desetogodišnji dječak bio je primljen na Odjel dječje stomatologije Stomatološkog fakulteta Sveučilišta Marmara u Istambulu. Imao je otečenu usnu, lokaliziranu oteklinu okolnog područja i traumatski oštećen gornji lijevi središnji sjekutić. Temeljitim intraoralnim pregledom otkrivana je nekomplicirana fraktura trajnoga lijevog gornjeg središnjeg sjekutića koja je uključivala caklinu i dentin bez eksponiranja zubne pulpe, a palpacija tkiva gornje usne upućivala je na strano tijelo. To je potvrđeno panoramskim radiogramom na kojem se vidjelo radiopakno tijelo slično koronarnom fragmentu središnjeg sjekutića koji je nedostajao. Taj je dio uklonjen kirurški, a slomljeni zub privremeno je restauriran. Nakon dva tjedna restauriran je adhezivnom tehnikom s pomoću sačuvanog fragmenta. Temeljiti klinički pregled i radiogrami mekih tkiva mogli bi omogućiti rano postavljanje dijagnoze i pravodobno kirurško uklanjanje.Dental fractures are common trauma complications in the oral cavity. When a patient has a laceration in the upper lip and dental trauma to the anterior dentition, an embedded tooth fragment should be suspected. A 10-year old boy was referred to the Department of Pediatric Dentistry, Dental School, Marmara University, Istanbul with a swollen lip, showing local edema and trauma to the maxillary left central incisor. A thorough intraoral examination revealed a fracture of the permanent left maxillary central incisor involving the enamel and dentin without pulp exposure while carefully palpating the tissues of the upper lip; the presence of a foreign body was felt. This was confirmed by a panoramic radiograph and it showed a radiopaque material, similar to the coronal fragment of the fractured incisor. The coronal fragment of the maxillary left central incisor was surgically removed. The fractured tooth was temporarily restored. After two weeks, the tooth was restored with the fragment using the adhesive technique. A thorough clinical examination with soft-tissue radiographs could provide an early diagnosis and indicate surgical removal

Analyses of anatomical relationship between mandibular third molar roots and variations in lingual undercut of mandible using cone-beam computed tomography

Background/purpose: Anatomical features of the lingual undercut region is a potential factor that might increase the risk of displacement of a tooth or fragment. The aim of this study was to report the normal anatomical relationship of impacted lower third molar roots to the lingual cortex and soft tissues of mandible and anatomical variations of lingual balcony in the impacted third molar region. Materials and methods: One hundred impacted third molars (54 males, 46 females) from 65 (31 men, 34 women) patients were evaluated for this study using cone-beam computed tomography. Three measurements [bone thickness, angle (Ang) 1 and Ang 2] were recorded on the coronal section slices of cone-beam computed tomography images; in these images, the impacted third molar root was closest to the lingual soft tissues. Results: The average distance between the tooth root and the lingual outer cortical bone layer (bone thickness) was 1.03 mm. The averages of Ang 1 and Ang 2 were 140.61 degrees and 153.44 degrees. Ang 1 and Ang 2 of female patients were larger than those of male patients. Conclusion: The narrow angulation of the lingual balcony region and the relationship between roots and lingual soft tissues should be noted to avoid undesirable complication of displacement of a tooth or fragment into sublingual, submandibular, and pterygomandibular spaces. There was no relation in the floor of the mouth between the position of the impacted third molar roots and different lingual undercut angulation variations. (C) 2017 Association for Dental Sciences of the Republic of China. Publishing services by Elsevier B.V