Ewing sarcoma of the mandible mimicking an odontogenic abscess – a case report

Ewing sarcoma (ES) of the mandible is rare and can be mistaken for inflammation of dental origin. We present a 24-year old male patient which underwent radical tumour surgery and primary reconstruction with a microvascular osteoseptocutaneous free fibular flap as well as postoperative adjuvant chemotherapy. Incomplete osseous tumour resection required a second intervention. This case report recapitulates the clinical and histopathological findings in oral ES, demonstrates its sometimes difficult diagnosis and discusses the (dis-)advantages of primary osseous reconstruction in ablative tumour surgery

Dental management considerations for the patient with an acquired coagulopathy. Part 1: Coagulopathies from systemic disease

Current teaching suggests that many patients are at risk for prolonged bleeding during and following invasive dental procedures, due to an acquired coagulopathy from systemic disease and/or from medications. However, treatment standards for these patients often are the result of long-standing dogma with little or no scientific basis. The medical history is critical for the identification of patients potentially at risk for prolonged bleeding from dental treatment. Some time-honoured laboratory tests have little or no use in community dental practice. Loss of functioning hepatic, renal, or bone marrow tissue predisposes to acquired coagulopathies through different mechanisms, but the relationship to oral haemostasis is poorly understood. Given the lack of established, science-based standards, proper dental management requires an understanding of certain principles of pathophysiology for these medical conditions and a few standard laboratory tests. Making changes in anticoagulant drug regimens are often unwarranted and/or expensive, and can put patients at far greater risk for morbidity and mortality than the unlikely outcome of postoperative bleeding. It should be recognised that prolonged bleeding is a rare event following invasive dental procedures, and therefore the vast majority of patients with suspected acquired coagulopathies are best managed in the community practice setting

Surgical Complications of Orthognathic Surgery

Objectives: Orthognathic surgery is popular and provides patients with improved aesthetics and functionality. The procedure is considered safe and predictable. Possible complications do exist and can be life-threatening. The aim of this study is to assess the prevalence of intra- and post-operative complications, and to define possible correlations between diagnoses. Study Design: Medical records of 103 patients who underwent orthognathic surgery in a 4.5-year period (2013–2017), at the Baruch Padeh “Tzafon” Medical Center in Poriya (PMC), Israel, were retrospectively collected. The data were analyzed for descriptive statistics and non-parametrical tests. Results: In total, there were 56 complications in 45 patients (43.7% probability of complication per patient). Major complication occurred in only one case (1%), moderate complications appeared in 8.7% of the cases, while the most prevalent minor complications were temporary nerve injury and hardware issues (17.5% and 15.5%, respectively). Statistical analysis revealed that bi-max surgery has significantly higher (OR 1.34, CI 99% 1.05–1.69, p = 0.019) prevalence of complications than one-jaw surgery, as did skeletal class II patients (OR 2.75, CI 99% 2.25–3.35, p = 0.022), as compared to skeletal class III patients. Conclusions: Serious complications seem to be rare in orthognathic surgery at PMC

Surgical Complications of Orthognathic Surgery

Objectives: Orthognathic surgery is popular and provides patients with improved aesthetics and functionality. The procedure is considered safe and predictable. Possible complications do exist and can be life-threatening. The aim of this study is to assess the prevalence of intra- and post-operative complications, and to define possible correlations between diagnoses. Study Design: Medical records of 103 patients who underwent orthognathic surgery in a 4.5-year period (2013–2017), at the Baruch Padeh “Tzafon” Medical Center in Poriya (PMC), Israel, were retrospectively collected. The data were analyzed for descriptive statistics and non-parametrical tests. Results: In total, there were 56 complications in 45 patients (43.7% probability of complication per patient). Major complication occurred in only one case (1%), moderate complications appeared in 8.7% of the cases, while the most prevalent minor complications were temporary nerve injury and hardware issues (17.5% and 15.5%, respectively). Statistical analysis revealed that bi-max surgery has significantly higher (OR 1.34, CI 99% 1.05–1.69, p = 0.019) prevalence of complications than one-jaw surgery, as did skeletal class II patients (OR 2.75, CI 99% 2.25–3.35, p = 0.022), as compared to skeletal class III patients. Conclusions: Serious complications seem to be rare in orthognathic surgery at PMC