Surgical treatment of mandibular fracture resulting from first molar extraction: case report

Extraction is one of the most common procedures performed by dental surgeons in their daily clinical practice. Among the trans and postoperative complications associated with this procedure can be mentioned the occurrence of trismus, infections, edema, alveolitis, paresthesia or fractures. The purpose of this study was to report a clinical case of a mandibular fracture associated with first molar extraction, approaching its main risk factors and treatment. Patient JSS, 24 years old, female, was referred to the service of Maxillofacial Surgery due to complications resulted from the extraction of element 36. On physical examination, was observed the presence of fragment mobility, communication of bone tissue with the oral environment and pain complaint was reported by the patient. Computed tomography showed the presence of a fracture in the region of the mandibular body on the left side. The planned surgical proposal was the intraoral debridement of bone fragments, extraoral access in the base of the mandible, fixation of the fracture with plate 2.4 and intraoral and extraoral access suture. During the surgical procedure, it is of great importance that the dental surgeon be aware to the signals emitted by the patient, such as clicks associated with severe pain, profuse bleeding or crackling as these symptoms may be the result of mandibular fracture. When any of these signs are found during the operation, the professional must investigate the occurrence of a possible fracture. It is concluded that in addition to performing a good preoperative evaluation, the dental surgeon must carry out a correct planning of the surgical act based on the basic principles of the surgical technique.

Definition and assessment of chronic pain in advanced disease

This chapter discusses the various definitions applied to pain including chronic, nociceptive, neuropathic, and breakthrough. It gives a broad overview of the epidemiology of pain including its prevalence of greater than 50% in those patients with advanced disease and its under-treatment. The second part of the chapter explains how best to characterize the pain complaint. It acknowledges the importance of a thorough history, including pain characteristics such as severity and associated features. Several pain measurement scales, which can be used both in clinical practice and research, are presented. Clinical examination and imaging are also discussed as aids to diagnosis and management of pain. It concludes with how to assess pain in the context of a palliative plan of care, stressing the need to consider the many challenges that patients face with advancing disease and how the management of pain is affected by other symptoms patients may have.

Pediatric cancer pain

Cancer pain management in children is reviewed in this chapter. It remains a central component of modern, compassionate cancer care. Cancer pain in children is predominantly from treatment and procedures. Even though many patients may present with an initial pain complaint, treatment will rapidly bring these presenting pain complaints under control. Pain then becomes postoperative, chemotherapy, radiation therapy, or complication related, rather than disease related. Intensive treatment modalities and repetitive painful procedures will dominate as etiologies of pain. Many options for pain management are available and reviewed in this chapter.

Temporomandibular Disorders: Current Concepts and Controversies in Diagnosis and Management

Temporomandibular disorders (TMD) are a group of orofacial pain conditions which are the most common non-dental pain complaint in the maxillofacial region. Due to the complexity of the etiology, the diagnosis and management of TMD remain a challenge where consensus is still lacking in many aspects. While clinical examination is considered the most important process in the diagnosis of TMD, imaging may serve as a valuable adjunct in selected cases. Depending on the type of TMD, many treatment modalities have been proposed, ranging from conservative options to open surgical procedures. In this review, the authors discuss the present thinking in the etiology and classification of TMD, followed by the diagnostic approach and the current trend and controversies in management.

Temporomandibular Joint Disorders: Current Concepts and Controversies in Diagnosis and Management

Temporomandibular disorders (TMD) is a group of orofacial pain conditions which is the most common non-dental pain complaint in the maxillofacial region. Due to the complexity of the etiology and often cyclical nature of the disease, the diagnosis and management of TMD remain a challenge where consensus is still lacking in many aspects. While clinical examination is considered the most important process in the diagnosis of TMD, imaging may serve as a valuable adjunct in selected cases. Depending on the type of TMD, many treatment modalities have been proposed, ranging from conservative options to open surgical procedures. In this review, the authors discuss the present thinking in the etiology and classification of TMD, followed by the diagnostic approach and the current trend and controversies in management.

Alveolar echinococcosis of the liver with a rare infiltration of the adrenal gland

SummaryHuman alveolar echinococcosis (AE) is a silently-progressing disorder that has become a threat in many countries. Since 2000, when the first case was recorded, the number of human AE patients in Slovakia is on continuous raise. The article presents a rare case of alveolar echinococcosis with infiltration in the adrenal gland and discusses the problems associated with differential diagnosis of the disease. In 2016, abdominal ultrasound performed due abdominal pain complaint showed the presence of cystic lesions in the right liver lobe of 54-year old female patient. During surgery, another lesion in the right adrenal gland was found, and neoplastic processes or echinococcosis were considered in the differential diagnosis. Due to unclear correlation between radiology, serology and histopathology results and endemic situation in Slovakia, molecular examination was recommended. Subsequently E. multilocularis was confirmed as etiological agent of infection. Alveolar echinococcosis is considered as a rare disease, with very few patients referred to clinicians or hospitals that sometimes have almost none existing experience with the diagnosis and treatment of the disease. Therefore, the establishment of networks or reference centres specialized on management of the disease would be suitable way to provide the patients with the best care and improve the disease diagnosis, treatment and prognosis.

WORK POSTURE RELATIONS WITH LOW BACK PAIN COMPLAINT ON PARTNERS PART OF PT 'X' MANUFACTURE OF TOBACCO PRODUCTS

Backgroud: Non-ergonomic work posture at work will risk the occurrence of occupational diseases and occupational accidents. One complaint due to work is low back pain (LBP) which is a pain that is felt on the lower back. Purpose: to determine the relationship of work posture with subjective complaints low back pain at PT X. Method: Research method is analytic with cross sectional research design. Sampling was done with total sampling of 53 samples. Assessment of work posture with rapid entire body assessment (REBA) method and subjective subjective complaints assessment of low back pain using modified questionnaire oswestry low back pain disability. Statistical test used spearman correlation test. The frequency distribution of job posture assessment with reba method is 35 respondents have medium value and 10 has high value, while for low back pain complaint there are 36 respondents who have severe crippled disability category. Results: The results showed there was a significant relationship between posture work with low back pain complaints with p value = 0.047 and r = 0.282. Conclusion: From the work posture assessment that for workers who have medium and high risk Reba for immediate action such as repair of work stations and providing understanding of ergonomic work positions.

Analisis lesi endo-perio di periapikal melalui radiografi

Objectives: Endodontic lesions and periodontal lesions that appear together in the same tooth are called endo-perio lesions. This study is aimed to explain further on radiography characteristics of endo-perio lesions. Case Report: Case 1, A 21-year-old male patient came to RSGM with a lower left lower back pain complaint. The tooth was once cursed 1 year ago. In the radiographic picture there is a large radiolucent lesion on the alveolar bone around the distal root. Case 2, A 25-year-old female patient came to the Installation of Dental Conservation Specialist RSGM FKG Padjadjaran University complained that the lower left molar was sore and swollen gums had been 3 days. The tooth has been treated by a dentist in another city, but the treatment is not completed. Patients have taken the drug of mefenamic acid and amoxicillin each one grain. Conclusion: Periapical radiography is one of diagnostic imaging tools to help establish a more accurate diagnosis of endo-perio lesions.

Giant Aggressive Aneurismal Bone Cyst of the Proximal Humerus Unresponsive to Denosumab

Aneurysmal Bone Cyst (ABC) is a destructive lesion. The main treatment is curettage, local adjuvant and grafting. However, it is difficult to apply the optimal surgical procedure in aggressive lesions. In these cases, the use of denosumab prior to surgery has been shown to reduce bone destruction and facilitate surgical treatment. A 22-year-old woman was referred for limited shoulder movement and pain complaints. Physical examination and radiological findings were interpreted in favor of ABC. The biopsy was also found to be consistent with the ABC. Since the lesion was aggressive, denosumab was applied prior to surgery. The mass quickly became calcified and patient’s pain complaint decreased. After stopping denosumab treatment, lesion progressed rapidly and destructive character became dominant at every part of lesion. The patient underwent proximal humeral resection and prosthesis. A painless limb with limited shoulder movement was achieved. Although denosumab application prior to surgery was initially good in this case, after termination of treatment, lesion progressed rapidly and the gains associated with denosumab use was lost.