Motivation for and satisfaction with orthodontic-surgical treatment: a retrospective study of 28 patients.
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Motivation for starting treatment and satisfaction with treatment results were evaluated on the basis of replies to a 14-item questionnaire and clinical examination of 28 orthognathic patients from 6 months to 2 years after treatment. The most common reasons for seeking professional help were problems in biting and chewing (68 per cent). Another major reason was dissatisfaction with facial appearance (36 per cent). Many patients also complained of temporomandibular joint symptoms (32 per cent) and headache (32 per cent). Women (8/19) were more often dissatisfied with their facial appearance than men (2/9), but the difference was not statistically significant. In agreement with earlier studies, the results of orthognathic treatment fulfilled the expectations of almost every patient. Nearly 100 per cent of the patients (27/28) were satisfied with treatment results, although 40 per cent experienced some degree of numbness in the lips and/or jaw 1 year post-operatively. The most satisfied patients were those who stated temporomandibular disorders as the main reason for seeking treatment and whose PAR-index had improved greatly. The majority of the patients experienced the orthodontic treatment as painful and as the most unpleasant part of the whole treatment, but all the patients were satisfied with the pre-treatment information they were given on orthodontics. Orthodontic-surgical therapy should be of a high professional standard technically, but the psychological aspects are equally important in the treatment protocol. The professionals should make efforts to understand the patient's motivations for and expectations of treatment. Patients should be well prepared for surgery and supported for a long time after to help them to adjust to post-surgical changes. (+info)
Possibilities of preventing osteoradionecrosis during complex therapy of tumors of the oral cavity.
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In recent years, there has been a dramatic increase in the number of tumors of the head and neck. Their successful treatment is one of the greatest challenges for physicians dealing with oncotherapy. An organic part of the complex therapy is preoperative or postoperative irradiation. Application of this is accompanied by a lower risk of recurrences, and by a higher proportion of cured patients. Unfortunately, irradiation also has a disadvantage: the development of osteoradionecrosis, a special form of osteomyelitis, in some patients (mainly in those cases where irradiation occurs after bone resection or after partial removal of the periosteum). Once the clinical picture of this irradiation complication has developed, its treatment is very difficult. A significant result or complete freedom from complaints can be attained only rarely. Attention must therefore be focussed primarily on prevention, and the oral surgeon, the oncoradiologist and the patient too can all do much to help prevent the occurrence of osteoradionecrosis. Through coupling of an up-to-date, functional surgical attitude with knowledge relating to modern radiology and radiation physics, the way may be opened to forestall this complication that is so difficult to cure. (+info)
Progressive septal and palatal perforation secondary to intranasal cocaine abuse.
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Septal perforation from intranasal cocaine abuse is well recognised. We present a case of progressive septal as well as palatal perforation. Progression from septal perforation to palatal perforation occurred after cessation of intranasal cocaine abuse. This patient had a weakly positive cytoplasmic antineutrophilic cytoplasmic antibody (C-ANCA) but no histologic evidence of Wegener's Granulomatosis. The differential diagnosis for septal and palatal perforation is reviewed. This case represents the fifth reported case of palatal perforation secondary to cocaine abuse in the literature, and the second associated with positive C-ANCA. (+info)
Submental intubation in a patient with beta-thalassaemia major undergoing elective maxillary and mandibular osteotomies.
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A 33-yr-old woman with marked maxillo-facial deformities as a result of underlying beta-thalassaemia major was to undergo corrective maxillary and mandibular osteotomies. The placement of an endotracheal tube posed a problem in this patient because of anatomical deformities in her nasal passage, surgical constraints on using the oral route, and reluctance of the patient to have a tracheostomy. This case report describes the use of a submental tracheal intubation technique, and the associated anaesthetic difficulties encountered in patients with this pathology. (+info)
Lesions related to the formation of bone, cartilage or cementum arising in the oral area: a statistical study and review of the literature.
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This report contains a statistical review of 559 cases of lesions forming hard tissues that were diagnosed by the departments of Clinical Pathophysiology and of Pathology at Tokyo Dental College from 1966 to 2001. Sixteen kinds of lesions which were related to the formation of bone, cartilage or cementum were analysed: osteoma, osteo-chondroma, chondroma, osteoid osteoma, osteoblastoma, ossifying fibroma, cemento-ossifying fibroma, cementifying fibroma, so-called cementoma, cementoblastoma, gigantiform cementoma, periapical cemental dysplasia, osteosarcoma, chondrosarcoma, fibro-osseous lesion, and fibrous dysplasia of bone. The most common lesion was osteoma (203 cases). There is a marked tendency for this condition to occur in females (201 males cases and 358 female cases). The patients' ages ranged from 3 to 84 years, and the mean was 40.1 years old. Lesions with hard tissue formation were observed most frequently in the third decade and in the mandibular molar region. (+info)
Therapeutic use of hyperbaric oxygen for irradiated dental implant patients: a systematic review.
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The aim of this systematic review was to investigate the effectiveness of hyperbaric oxygen (HBO) therapy for irradiated patients who require dental implants using data from randomized controlled clinical trials (RCTs). The review was prepared according to Cochrane Collaboration guidelines. The Cochrane Oral Health Group Specialist Register and the Cochrane Controlled Trials Register were searched (Cochrane Library 2002, Issue 2), together with Medline from 1966 or Embase from 1974. Several journals were hand-searched, and fifty-five implant manufacturers were contacted in an attempt to identify ongoing or unpublished studies. The results were that no RCTs comparing HBO with no HBO for implant treatment in irradiated patients were identified. Our principal conclusions are that clinicians ought to be aware and make patients aware of the lack of reliable clinical evidence for or against the clinical effectiveness of HBO therapy in irradiated patients requiring dental implants. There is a need for RCTs to determine the effectiveness of HBO. (+info)
Orthognathic surgery in the University of Malaya.
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This is the first review on orthognathic surgery in Malaysia. The records of a total of 84 patients seen between 1977 and 1999 in the Department of Oral and Maxillofacial Surgery of the Faculty of Dentistry, University of Malaya were analysed. Skeletal III deformity formed 85% of the sample with a female dominance of 2 to 1. The patients' age ranged from 17 to 36 years, with a mean of 25.3 years. The common surgical techniques used were combined bilateral sagittal split and Le Fort I osteotomy. The predominant ethnic group was Chinese (n = 58, 69%); followed by Malay (n = 14, 17%) and Indian (n = 12, 14%). (+info)
Oral sequelae of head and neck radiotherapy.
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In addition to anti-tumor effects, ionizing radiation causes damage in normal tissues located in the radiation portals. Oral complications of radiotherapy in the head and neck region are the result of the deleterious effects of radiation on, e.g., salivary glands, oral mucosa, bone, dentition, masticatory musculature, and temporomandibular joints. The clinical consequences of radiotherapy include mucositis, hyposalivation, taste loss, osteoradionecrosis, radiation caries, and trismus. Mucositis and taste loss are reversible consequences that usually subside early post-irradiation, while hyposalivation is normally irreversible. Furthermore, the risk of developing radiation caries and osteoradionecrosis is a life-long threat. All these consequences form a heavy burden for the patients and have a tremendous impact on their quality of life during and after radiotherapy. In this review, the radiation-induced changes in healthy oral tissues and the resulting clinical consequences are discussed. (+info)