Outcome of Surgical Excision for Managing the Oral Pyogenic Granuloma

Objective: To determine the outcome of surgical removal of oral pyogenic granuloma in terms of post-operative pain (POP), post-operative healing and post-operative infection. Materials and methods: This observational study was conducted at Oral and Maxillofacial Surgery department, Liaquat University of Medical and Health Sciences Jamshoro/Hyderabad, from October 2018 to March 2019. Patients of oral pyogenic granuloma, 18-45 years old and either of gender were included. Surgical process of oral pyogenic granuloma were done under local anesthetic by giving infiltration surrounding deep oral pyogenic granuloma by 2% Xylocaine along with adrenaline. Patients were followed for three weeks on weekly basis to access post-operative complications including post-operative healing. Data was collected via study proforma. Results: Total 37 patients took part in the study; their mean age was 47.86+7.61 years. On 1st week assessment all patients were noted with history of mild pain, moderate pain and severe pain (19, 10 and 8 cases respectively), while healing was achieved in 19 patients. On second week assessment 25 patients exhibited mild pain and 6 exhibited moderate pain and healing was achieved by 16 patients. On 3rd week assessment, only 09 patients exhibited mild pain and mostly were healed few cases showed minor infection. Conclusion: It was concluded that surgical removal is valuable procedure for the management of pyogenic granuloma of oral cavity with lower rates of post-operative infection and pain, and highest rates of post-operative healing.

Download Full-text

Granulomatosis with polyangiitis: potentially lethal gingival lesions presenting to the dentist

BMJ Case Reports ◽

10.1136/bcr-2019-229607 ◽

2019 ◽

Vol 12 (4) ◽

pp. e229607 ◽

Cited By ~ 1

Author(s):

Amy Patrick ◽

Keith Altman

Keyword(s):

Rare Disease ◽

Granulomatosis With Polyangiitis ◽

Maxillofacial Surgery ◽

Oral And Maxillofacial Surgery ◽

Oral Lesions ◽

Blood Tests ◽

Eosinophilic Infiltrate ◽

Gingival Bleeding ◽

History Of ◽

Surgery Department

Gingival pathology is a daily presentation, however a small number of systemic conditions can manifest similar to a common gingival condition and have fatal results. Dentist referred 56-year-old woman to Oral and Maxillofacial Surgery department with a 2-week medical history of gingival bleeding not responding to local measures. Biopsy showed eosinophilic infiltrate and vasculitis, and blood tests showed positive markers including cytoplasmic antineutrophil cytoplasmatic antibodies. Granulomatosis with polyangiitis is a rare disease affecting the respiratory tract, blood vessels and kidneys. Oral lesions are rarely the primary presenting feature. When left untreated, most cases are fatal within a year of diagnosis. The diagnosis can only be made when certain criteria are found, including granular oral lesions exhibiting an eosinophilic inflammatory infiltrate on biopsy. With 5% of cases showing intraoral lesions as the primary feature, it is essential that dentists have the knowledge of this rare disease to refer and not to treat as a common gingival condition.

Download Full-text

442 COVID-19 And the Oral Surgery/Orthodontic Interface: Has A Delay in Treatment Complicated the Position of Unerupted And Ectopic Teeth Planned for Surgical Removal or Exposure?

British Journal of Surgery ◽

10.1093/bjs/znab259.613 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

R Devine ◽

A Holden ◽

A Felstead

Keyword(s):

Oral Surgery ◽

Maxillofacial Surgery ◽

Oral And Maxillofacial Surgery ◽

Surgical Removal ◽

Surgical Time ◽

Delayed Treatment ◽

Clinically Significant ◽

Surgery Department ◽

Repeat Imaging ◽

Delay In Treatment

Abstract Aim To evaluate whether there has been a change in clinical or radiographic position and the resultant occurrence of complications of unerupted and ectopic teeth due to delayed treatment during the COVID-19 pandemic Method Data was collected over a three-month period at the Royal United Hospital, Bath, Oral and Maxillofacial Surgery Department. This was via a questionnaire distributed to clinicians and prospectively completed for each surgical procedure planned for the removal or exposure of ectopic canines, premolars, and supernumerary teeth. Results A total of 20 surgical extractions or exposures were performed during the three-month period, with 33% (n = 6) having a marked difference between their expected and final position. Complications occurred in 66.6% (n = 4) of cases that demonstrated a discrepancy in location. These were an increased surgical time, increased removal of bone or a cancellation of intended treatment. This cancellation occurred as the tooth had erupted enough for non-surgical management. In cases where there was no discrepancy (n = 14), no complications were reported. Conclusions These findings suggest the delay in treatment caused by the COVID-19 pandemic has resulted in a clinically significant change in the position of ectopic teeth planned for surgical removal or exposure. Given these findings, it is crucial that clinicians be aware that radiographic investigations are diagnostic and recent. The threshold for repeat imaging in all cases which have been delayed should be low to avoid unexpected surgical complications arising from inaccuracy in tooth localisation.

Download Full-text

Phosphaturic Mesenchymal Tumor: A Case Report

Journal of Dentistry and Oral Sciences ◽

10.37191/mapsci-2582-3736-2(4)-061 ◽

2020 ◽

Author(s):

Tahir Ullah Khan

Keyword(s):

Early Stage ◽

Maxillofacial Surgery ◽

Mesenchymal Tumor ◽

Oral And Maxillofacial Surgery ◽

Phosphaturic Mesenchymal Tumor ◽

Mesenchymal Neoplasms ◽

History Of ◽

Surgery Department ◽

And Inversion

Phosphaturic Mesenchymal Tumor (PMT) is a polymorphic group of extremely rare and usually benign, slow-growing tumors. PMT is frequently associated with tumor-induced osteomalacia (TIO), a paraneoplastic syndrome that manifests as renal phosphate wasting. The diagnosis is often delayed due to the non-specific nature of the symptoms and is also misdiagnosed due to histological overlap with other mesenchymal neoplasms. Serious disabilities may occur if they are not treated. Complete resection of the tumor is curative and leads to the normalization of biochemical abnormalities and inversion of symptoms. The majority of these tumors occur in the extremities (95%) with rare cases reported in the jaws. This patient presented to the Oral and Maxillofacial Surgery Department, Lady Reading Hospital Peshawar Pakistan with a recurrent PMT involving a mandible with a history of three months, which had already been misdiagnosed previously. Biochemical reports were normal as our case was diagnosed at a very early stage due to a prominent location and rapidly increasing size. Resection of the tumor was performed with a 1.5 cm safe margin. The mandibular reconstruction was then done with an L-type reconstruction plate fixed with bi-cortical screws on the remaining mandible on each side. Patient recovery was uneventful and he is now on follow up. At present, the patient remains well without any evidence of local recurrence.

Download Full-text

Pyogenic Granuloma: A Case Report

Journal of Gandhara Medical and Dental Science ◽

10.37762/jgmds.8-4.261 ◽

2021 ◽

Vol 8 (4) ◽

pp. 61-64

Author(s):

Maria Jabbar ◽

Hira Butt ◽

Nauman Rauf Khan

Keyword(s):

Case Report ◽

Oral Cavity ◽

Maxillofacial Surgery ◽

Surgical Excision ◽

Pyogenic Granuloma ◽

Oral And Maxillofacial Surgery ◽

Granulomatous Disease ◽

Second Trimester ◽

Solitary Nodule ◽

Abnormal Growth

Pyogenic granuloma is a type of inflammatory hyperplasia of the oral mucosa and skin that occurs commonly. Histopathologically, it mimics an angiomatous lesion instead of granulomatous disease. These lesions generally appear as a sessile papule or solitary nodule and may have a smooth or lobulated surface clinically. These granulomas present in a variety of sizes, ranging from a few millimeters to several centimeters. About 75% of the pyogenic granulomas of the oral cavity are associated with the gingiva. In this case report a 31 years old female presented in the department of oral and maxillofacial surgery with the complaint of abnormal growth of gingiva in maxillary anterior region. The patient was diagnosed with the pyogenic granuloma (pregnancy tumor), which had developed in the second trimester of her pregnancy. Surgical excision was done to remove the lesion.

Download Full-text

138 Sexual History, Is it Important?

British Journal of Surgery ◽

10.1093/bjs/znab134.118 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

S Duggal ◽

C Wanis

Keyword(s):

Opportunistic Infections ◽

Oral Candidiasis ◽

Maxillofacial Surgery ◽

Sexual History ◽

Oral And Maxillofacial Surgery ◽

Immunodeficiency Virus ◽

Common Opportunistic Infection ◽

History Of ◽

Surgery Department ◽

Complete History

Abstract Oral candidiasis (OC) is the most common opportunistic infection seen in patients infected with Human Immunodeficiency Virus (HIV) and remains the second AIDS-defining illness in Europe, as it has previously been reported in 11-51% of cases. We present a case of a 70-year-old male who attended the Oral and maxillofacial surgery department with refractory OC and was later diagnosed with HIV after multiple visits to various departments in hospital. Sadly, the patient declined medically and died of multi-organ failure one month following this diagnosis. On reflection, it was found that the patient suffered from the medical conditions and opportunistic infections which can be associated with HIV, but as no sexual history was ascertained this diagnosis was missed. It is prudent that we, as clinicians, take a step back and look at each patient as a whole, in order to ensure complete and holistic care. We argue that sexual history is sometimes vital in achieving a complete history of a patients’ condition, especially in cases of refractory OC where it can be a key piece in the diagnostic puzzle.

Download Full-text

Study on Efficacy of Dexamethasone and Methylprednisolone in Postoperative Swelling and Trismus Following Mandibular 3rd Molar Surgery

Journal of Shaheed Suhrawardy Medical College ◽

10.3329/jssmc.v9i2.37264 ◽

2018 ◽

Vol 9 (2) ◽

pp. 60-64

Author(s):

Md Helal Uzzaman ◽

AFM Shahidur Rahman ◽

Md Masudur Rahman ◽

Md Shafiqul Alam ◽

Mohammad Shameemur Rahman ◽

...

Keyword(s):

Soft Tissues ◽

Maxillofacial Surgery ◽

Oral And Maxillofacial Surgery ◽

Surgical Removal ◽

Facial Soft Tissue ◽

Inflammatory Reactions ◽

Group I ◽

Surgery Department ◽

Facial Soft Tissues ◽

Postoperative Swelling

Introduction: Surgical removal of 3rd molars causes significant swelling and trismus which are unpleasant and uncomfortable for the patient even when teeth are removed by gentle surgical technique. Our surgical procedures can lead to serious inflammatory reactions in the facial soft tissues and should be minimized as much as possible. The aim of this study was to compare the effect of a single intramuscular (I/M) dose of two different corticosteroids on postoperative facial soft tissue swelling and trismus.Methodology: This interventional study was conducted in oral and maxillofacial surgery department of BSMMU. 60 patients (33 male and 27 female)were included in this study and were randomly divided into two groups. In Group-I, 30 patients were included and 4mg of Dexamethasone was injected into the Deltoid region 30 minutes prior to extraction of mandibular 3rd molars. In Group-II,another 30 patients were included and 40mg of Methylprednisolone was injected into theDeltoid region 30 minutes prior to extraction of mandibular 3rd molars.Facial swelling was evaluated preoperatively, on 2nd POD and 7th POD by using measuring tape. Trismus was determined by measuring the maximum inter-incisal distance pre-operatively, on 2nd POD and 7th POD by vernier caliper.Result:Result showed that swelling and trismus was significantly reduced in both groups, p>0.05(not significant).Conclusion:The result concluded that the preoperative single dose of I/M administration of Dexamethasone or Methylprednisolone significantly reduces postoperative swelling and trismus after surgical removal of mandibular 3rd molars.J Shaheed Suhrawardy Med Coll, December 2017, Vol.9(2); 60-64

Download Full-text

1359 Everyone Deserves to Smile: An Audit on The Success Rate of Dental Implants in Complex Maxillofacial Patients

British Journal of Surgery ◽

10.1093/bjs/znab259.147 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

P Lugaric ◽

C Frezzini ◽

A Patterson

Keyword(s):

Dental Implants ◽

Maxillofacial Surgery ◽

Survival Rates ◽

Oral And Maxillofacial Surgery ◽

Head And Neck Reconstruction ◽

Success Rates ◽

Native Bone ◽

Local Standard ◽

Edentulous Patients ◽

Surgery Department

Abstract Aim To determine the success rates of dental implants in complex patients treated in the Oral and Maxillofacial Surgery Department at Rotherham General Hospital (RGH). Method All patients who received dental implants in the period January 2010 – March 2017 at RGH were included in the audit. Standards 90% local standard Results 68 dental implants were placed in 22 patients: 15 patients head and neck reconstruction, 5 atrophic edentulous patients, 2 trauma. Conclusions Survival rates for dental implants in the literature is variable ranging from 91 -96% in native bone and mucosa and 46 - 98% in irradiated tissue.

Download Full-text

Evaluation of demographic and radiological risk factors for assessment of difficulty in surgical removal of impacted mandibular third molar – A prospective study.

International Journal of Medical and Surgical Sciences ◽

10.32457/ijmss.2019.005 ◽

2019 ◽

Vol 6 (1) ◽

pp. 10-13

Author(s):

Manu R. Goel ◽

Milind D. Shringarpure ◽

Vasant V. Shewale ◽

Tejasvini Dehankar ◽

Ajit Joshi

Keyword(s):

Risk Factors ◽

Scientific Evidence ◽

Maxillofacial Surgery ◽

Third Molar ◽

Oral And Maxillofacial Surgery ◽

Surgical Removal ◽

Third Molars ◽

Surgical Time ◽

Impacted Tooth ◽

Surgical Difficulty

The extraction of impacted third molars is among the most common surgical procedures carried out in the field of Oral and Maxillofacial Surgery. Both the patient and dentist must therefore have scientific evidence-based information concerning the estimated level of surgical difficulty of every case to consider in referring cases of impacted third molars for specialists’ handling. We have undertaken a study in which demographic and radiological variables were considered together to evaluate the risk factors for surgical difficulty in a cohort of 100 impacted mandibular third molars. There were 13 variables evaluated for surgical difficulty. Total surgical time intervention was noted at the end of each surgery. Each variable was analysed with total surgical time intervention with univariate and multiple linear regression. Out of 13 variables, 9 were found statistically significant. The most significant predictors for surgical difficulty were Body Mass Index, Depth of impacted tooth and Retromolar space. No postoperative complications were reported.

Download Full-text