scholarly journals An evidence based surgical algorithm for management of Odontogenic keratocyst

2021 ◽  
Author(s):  
Fadekemi Olufunmilayo Oginni ◽  
Nasser Alasseri ◽  
Oladunni Mojirayo Ogundana ◽  
Bamidele Adetokunbo Famurewa ◽  
Anthony Pogrel ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Treatment Options ◽  
Maxillofacial Surgery ◽  
Odontogenic Keratocyst ◽  
Wide Resection ◽  
Oral And Maxillofacial Surgery ◽  
Evidence Based ◽  
Recurrence Rates ◽  
Appropriate Treatment ◽  
Lesion Type

Abstract The effective management of odontogenic keratocyst (OKC) remains a subject of interest and confusion in the Oral and Maxillofacial surgery literature. Currently, there is a lack of consensus regarding the most appropriate treatment for patients with odontogenic keratocyst. Of the various treatment options available, no modality to date has been shown to demonstrate a zero-or near zero recurrence rates except wide resection with clear margins. With the prevailing dearth of evidence based surgical protocols for the management of patients with odontogenic keratocyst in the literature, this study aims to present a surgical algorithm, based on meta-analysis results, that hopefully will be beneficial in enhancing treatment of patients with this condition. Using parameters of; size, lesion type (primary or secondary), syndromic or solitary nature of the lesion, presence of cortical perforations, and locularity; we present a decision tree, to aid treatment planning and help attain the least chance of recurrence in the management of the odontogenic keratocyst.

scholarly journals Junctional Rhythm Preoperatively and During General Anesthesia for Oral and Maxillofacial Surgery

2017 ◽  
Vol 64 (3) ◽  
pp. 165-167 ◽  
Author(s):  
Naotaka Kishimoto ◽  
Ikue Kinoshita ◽  
Yoshihiro Momota
Keyword(s):  
General Anesthesia ◽  
Local Anesthesia ◽  
Anesthetic Management ◽  
Maxillofacial Surgery ◽  
Oral And Maxillofacial Surgery ◽  
Anesthesia Induction ◽  
Sagittal Split Ramus Osteotomy ◽  
Junctional Rhythm ◽  
Appropriate Treatment ◽  
Slow Heart Rate

We report a case of junctional rhythm that occurred both preoperatively and later during a portion of general anesthesia. A 19-year-old woman was scheduled to undergo bilateral sagittal split ramus osteotomy after being diagnosed with a jaw deformity. Preoperative electrocardiography (ECG) revealed a junctional rhythm with a slow heart rate (HR). At 90 minutes after anesthesia induction, local anesthesia with 10 mL of 1% lidocaine and 1:100,000 adrenaline was administered. A junctional rhythm appeared 15 minutes after the local anesthesia. We believe that the atrioventricular nodal pacemaker cells accelerated because of the increased sympathetic activity due to the adrenaline. On the preoperative ECG, the junctional rhythm with slow HR appeared as an escaped beat caused by slowing of the primary pacemaker. Therefore, we think that the preoperative junctional rhythm and the junctional rhythm that appeared during general anesthesia were due to different causes. Understanding the cause of a junctional rhythm could lead to more appropriate treatment. We therefore believe that identifying the cause of the junctional rhythm is important in anesthetic management.

scholarly journals Cone Beam Computed Tomography in Oral and Maxillofacial Surgery: An Evidence-Based Review

2019 ◽  
Vol 7 (2) ◽  
pp. 52 ◽  
Author(s):  
Robert Weiss ◽  
Andrew Read-Fuller
Keyword(s):  
Computed Tomography ◽  
Head And Neck ◽  
Cone Beam Computed Tomography ◽  
Financial Burden ◽  
Maxillofacial Surgery ◽  
Cone Beam ◽  
Future Research ◽  
Oral And Maxillofacial Surgery ◽  
Evidence Based ◽  
3 Dimensional

Cone Beam Computed Tomography (CBCT) is a valuable imaging technique in oral and maxillofacial surgery (OMS) that can help direct a surgeon’s approach to a variety of conditions. A 3-dimensional analysis of head and neck anatomy allows practitioners to plan appropriately, operate with confidence, and assess results post-operatively. CBCT imaging has clear indications and limitations. CBCT offers the clinician 3-dimensional and multi-planar views for a more accurate diagnosis and treatment without the financial burden and radiation exposure of conventional computed tomography (CT) scans. Furthermore, CBCT overcomes certain limitations of 2-dimensional imaging, such as distortion, magnification, and superimposition. However, CBCT lacks the detailed depiction of soft tissue conditions for evaluation of pathologic conditions, head and neck infections, and temporomandibular joint (TMJ) disc evaluation. This review evaluates the evidence-based research supporting the application of CBCT in the various fields of oral and maxillofacial surgery, including dentoalveolar surgery, dental implants, TMJ, orthognathic surgery, trauma, and pathology, and will assess the value of CBCT in pre-operative assessment, surgical planning, and post-operative analysis when applicable. Additionally, the significant limitations of CBCT and potential areas for future research will be discussed.

Evidence-based diagnosis

2008 ◽  
Vol 13 (3_suppl) ◽  
pp. 57-63 ◽  
Author(s):  
Penny Whiting ◽  
Roger Harbord ◽  
Isabel de Salis ◽  
Matthias Egger ◽  
Jonathan Sterne
Keyword(s):  
Quality Assessment ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Diagnostic Process ◽  
Test Accuracy ◽  
Evidence Based ◽  
Literature Searching ◽  
Summary Receiver Operating Characteristic ◽  
Statistical Knowledge ◽  
Appropriate Treatment

Making an accurate diagnosis is essential to ensure that a patient receives appropriate treatment and correct information regarding their prognosis. Characteristics of diagnostic tests are quantified in test accuracy studies, but many such studies have methodological flaws. The HSRC evidence-based diagnosis programme has focused on methods for systematic reviews of test accuracy studies, and the wider context in which tests are ordered and interpreted. We carried out a range of projects relating to literature searching, quality assessment, meta-analysis, presentation of results, and interactions between doctors and patients during the diagnostic process. We have shown that systematic reviews of test accuracy studies should search a range of databases and that current diagnostic filters do not have sufficient accuracy to be used in test accuracy reviews. Summary quality scores should not be used in test accuracy reviews; the Quality Assessment of Studies of Diagnostic Accuracy included in Systematic Reviews (QUADAS) tool for assessing test accuracy studies is acceptable for quality assessment. We have shown that the hierarchical summary receiver operating characteristic (HSROC) and bivariate models for meta-analysis of test accuracy are statistically equivalent in many circumstances, and have developed an add-on module for the statistical software package Stata that enables these statistically rigorous models to be fitted by those without expert statistical knowledge. Three areas that would benefit from further research are literature searching, synthesis of results from individual patient data and presentation of results.

scholarly journals AN IMPACTED, INVERTED AND ROTATED MAXILLARY CENTRAL INCISORS AND ITS SURGICAL MANAGEMENT: A CASE REPORT.

2021 ◽  
pp. 8-9
Author(s):  
Prashant Dewang ◽  
Abhijeet Humne
Keyword(s):  
Maxillofacial Surgery ◽  
Anterior Region ◽  
Deciduous Teeth ◽  
Oral And Maxillofacial Surgery ◽  
Inverted Position ◽  
Maxillary Central Incisor ◽  
Appropriate Treatment ◽  
Nasal Floor ◽  
Surgical Extraction ◽  
Missing Tooth

A female patient aged 13 years was referred to the Department of Oral and Maxillofacial Surgery, CSMSS Dental College, Aurangabad, Maharashtra, India with a complaint of a missing tooth in the upper anterior region of the jaw. The patient was apparently healthy with no relevant family, medical and dental history. This case is peculiar due to the fact that the impacted maxillary central incisors are not frequently reported in our routine dental practice. Here, a case of impacted maxillary left permanent central incisors, with only a few reported cases in the literature, is presented. On radio diagnosis, it was observed that the tooth was sprawling in an inverted position in the anterior region of the maxilla with mild dilaceration. Moreover, the tooth was located beneath the remnants of the root stumps of the deciduous maxillary central incisors and lateral incisors. The treatment for this case was planned with mutual efforts of the orthodontists, the oral surgeon, and the patient with his parents. The most appropriate treatment of choice for this case was the Surgical extraction of the impacted maxillary central incisor along with the root stumps of deciduous teeth that were performed under local anaesthesia without any hindrance to the nasal floor

scholarly journals Multiple Keratocyst Glimpses Falx Cerebri and Bifid Rib- A Case of Gorlin-Goltz Syndrome

2020 ◽  
Author(s):  
Vrushali Baburao Zamare ◽  
Rahul Bhowate ◽  
Vidya Lohe ◽  
Mrunal Meshram
Keyword(s):  
Histopathological Examination ◽  
Maxillofacial Surgery ◽  
Panoramic Radiograph ◽  
Odontogenic Keratocyst ◽  
Oral And Maxillofacial Surgery ◽  
Histopathological Diagnosis ◽  
Imaging Evaluation ◽  
Falx Cerebri ◽  
Cutaneous Manifestations ◽  
Goltz Syndrome

Multiple Odontogenic keratocysts with multi-organ abnormalities are a feature of Gorlin-Goltz Syndrome (GGS) which is an autosomal dominant inherited disorder. The most common oral manifestation of GGS is odontogenic keratocyst. Early diagnosis of GGS without cutaneous manifestations is important as this syndrome has basal cell carcinoma as one of its major criteria. This paper includes a case report of a 24-year-old female who reported with swelling and pus discharge in lower right posterior region. The swelling was clinico-radiologically diagnosed as odontogenic keratocyst on a panoramic radiograph which revealed the presence of multiple cystic lesions in symphysis, parasymphysis, and bilateral maxillary region. Postero-Anterior (PA) chest showed bifid ribs and PA skull showed calcification of falxcerebri. Histopathological diagnosis confirmed the Odontogenic keratocyst. Ultrasonography (USG) abdomen revealed a simple ovarian cyst on the right side. Clinical examination findings and radiological imaging evaluation with histopathological examination of cystic lesion confirms Gorlin-Goltz. Surgical enucleation of the keratocyst, peripheral ostectomy followed by bone graft substitute, and primary closure under General Anaesthesia (GA) were done in the Department of Oral and Maxillofacial Surgery. Follow-up healing was uneventful after one month.

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