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Oral Surgery

How effective are antibiotics in the treatment of peri-implantitis?

This summary is based on the article published in the International Dental Journal: Clinical efficacy of antibiotics in the treatment of peri-implantitis (August 2013) Context  Various treatment regimes for Peri-implantitis (PI) have been proposed in the literature. As it is known that bacteria can transfer from periodontally involved teeth to an implant, and that the microbes associated with PI resemble those of periodontal disease, local or systemic delivery of antibiotics with traditional PI treatment regimes may eliminate periodontopathogenic bacteria to a greater extent compared with when these treatment regimes are performed alone. This in turn may facilitate healing of PI ...

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Are there adverse drug reactions to local anesthetics?

This summary is based on the article published in the Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology journal: Adverse drug reactions to local anesthetics: a systematic review (March 2013) Context  Local anesthetics (LAs) are widely used, especially in oral and ophthalmologic treatments. The types, doses, means of administration of LAs, and combined drugs are the main factors that could induce adverse drug reactions. Purpose of the Review Analyze adverse drug reactions (ADRs) associated with local anesthetics (LAs) and to characterize the safety profile of LAs in clinical application. Results A total of 922 articles were retrieved, and 101 of them, containing 1,645 events, ...

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How do I treat a mandible fracture during extraction?

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 oasisdiscussions@cda-adc.ca Your are invited to comment on this post and provide further insights by posting in the comment box which ...

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How do you manage the patient with a dry socket (Alveolar Osteitis)?

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 oasisdiscussions@cda-adc.ca ...

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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 ...

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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 ...

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How Do I Manage Oroantral Communication? Key Points

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 ...

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oasisImage of the Week: Persistent ‘mucocele’ in a 16 year old boy

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 ...

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