This Urgent Care Scenario (USC) is presented by the JCDA Oasis Team in collaboration with Dr. Henry Lapointe. It is also available on the Oasis Help system Dr. Henry Lapointe is Chair of the Oral & Maxillofacial Surgery Program at the Schulich School of Medicine and Dentistry, University of Western Ontario A mandible fracture is a sudden, intra-operative fracture of mandibular bone. Do you need further information related to this subject? Do you have any comments or suggestions? Email us at email@example.com Your are invited to comment on this post and provide further insights by posting in the comment box which ...Read More »
This Urgent Care Scenario (USC) is presented by the JCDA Oasis Team in collaboration with Dr. Daisy Chemaly. The USC is also available through Oasis Help Complication of wound healing following the extraction of a tooth. The patient experiences severe throbbing pain caused by bone exposure at the site of extraction. Following the extraction, a blood clot forms at the socket to protect the bone. When the clot dislodges or dissolves prematurely, the nerves and bone become exposed, leading to pain. Do you need further information related to this subject? Do you have any comments or suggestions? Email us at firstname.lastname@example.org ...Read More »
Is inadequate osseointegration a concern in radiation-treated patients, if implants are treatment planned?
This question was submitted by a general dentist: Is inadequate osseointegration a concern in patients who have received radiation therapy for a head and neck malignancy if implants are treatment planned? Dr. Jeff Chadwick, at Princess Margaret Hospital, Dental Oncology, Ocular, and Maxillofacial Prosthetics Group, provided a preliminary response to this question Yes, however … As with most questions related to this patient population, the answer is: “it depends.” Careful examination is a vital step in determining which restorative/prosthodontic approach best suits the individual. Examination also mandates a thorough review of their cancer diagnosis as well as the constituents and sequence ...Read More »
What are the risk factors for osteoradionecrosis (ORN), in a xerostomic radiation-treated patient, if extractions are required?
This question was submitted to us by a general dentist: If extractions are required, what are the risk factors for osteoradionecrosis (ORN) in a xerostomic patient with rampant decay two years after the successful treatment of their head and neck cancer (radiation, chemotherapy and surgery)? Dr. Jeff Chadwick, at Princess Margaret Hospital, Dental Oncology, Ocular, and Maxillofacial Prosthetics Group, provided a preliminary response to this question: With the numerous comorbidities associated with head and neck radiation (oral mucositis, radiodermatitis, dysgeusia, dysphagia/odynophagia, trismus, and xerostomia), arises a critical issue with tooth extraction is the altered biology of the maxilla and mandible due ...Read More »
This Urgent Care Scenario (USC) is presented by the JCDA Oasis Team in collaboration with Dr. Archie Morrison and is also available through the JCDA Oasis Mobile Oroantral Communication (Oroantral Fistula) Oroantral Communication (OAC) is an abnormal communication between the maxillary sinus and the oral cavity. It may be the result of different pathological processes and often occurs following an extraction. Other causes for OAC include: infection, inflammatory conditions, neoplasm, Paget’s disease, iatrogenic injury, and trauma. Presentation Population Individuals who recently underwent maxillary posterior tooth extractions. Individuals presenting for extraction of a long-standing lone posterior maxillary molar. Individuals presenting with ...Read More »
A 16 year old boy had a swelling in his right lower lip removed at age 4 while living overseas. At that time the surgeon told the father that it was multiple small mucoceles and that he could not get all of it. The specimen was sent to a general pathologist who confirmed it as a mucocele. Between the ages of 13 and 15, the lesion returned, larger and more sore. It was excised again at age 15 and at that time it was diagnosed as a verruca vulgaris with submucosal capillary ectasia and edema with stromal inflammation. They now ...Read More »
Clinical Case: How do I quantify the risk of nerve injury with wisdom teeth extraction? (VIDEO SOLUTION)
This case is presented by Drs Stephen Cho & Ian Furst at Coronation Dental Specialty Group & Cambridge Memorial Hospital A 56 year old male has a partially impacted wisdom tooth #3.8, communication to the mouth, pericoronitis and a complaint of persistent pain associated with the tooth. You take a panorex and note the overlap of the inferior alveolar nerve. Based on current scientific data, what is the risk, during an extraction, of an intimate association between the tooth and nerve? Is there a scientifically valid way of determining which developing wisdom teeth are likely to become partially impacted? The ...Read More »
A 35-year old man develops a serious infection from an impacted 2.8. The tooth is extracted and the infection is drained but he develops a serious bleed 3 days after surgery (from the internal maxillary artery) which requires neuroradiology embolization. One month later, he has recurrent swelling around the left temple and TMJ but also complains he feels numbness in the entire trigeminal nerve, including V-1. Attached is a slice of the MRI and an intraoperative shot. Why can’t he feel his forehead?Read More »