Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons
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J. Oral Maxillofac. Surg. · May 2007
Clinical TrialRelationships between surgical difficulty and postoperative pain in lower third molar extractions.
To investigate the influence of surgical difficulty on postoperative pain after extraction of mandibular third molars. ⋯ Pain after extraction of a mandibular third molar increases with increased surgical difficulty and duration of the intervention.
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J. Oral Maxillofac. Surg. · May 2007
The submental flap in facial reconstruction: advantages and limitations.
Complex defects resulting from surgical excision of facial cancer sometimes require reconstruction using microvascular free tissue transfer. Tissue transfer from areas distant from the face can resolve many problems, but often provides a poor cosmetic match with facial skin. The submental flap helps surmount this problem. Cervical skin has similarities with face skin, and because this is a regional flap, it helps eliminate microsurgical risks. In this article we present a series of 9 cases, review the anatomy and the surgical technique, and explain the advantages and limitations of the submental flap. ⋯ The submental artery island flap is a useful reconstructive procedure that offers options to the reconstructive surgeon and has definite advantages over distant flaps in terms of ease of dissection and donor site appearance.
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J. Oral Maxillofac. Surg. · Apr 2007
Management of penetrating neck injuries: a new paradigm for civilian trauma.
Improvements in imaging technology, particularly computed tomographic angiography (CTA), have altered the management of patients with penetrating neck injuries. Although some centers still advocate routine exploration for all zone 2 neck injuries penetrating the platysma, many civilian centers in the United States have adopted a policy of selective exploration based on clinical and radiographic examination. The purpose of this retrospective study is to evaluate our 5-year experience with the management of penetrating neck injuries, to further elucidate the role of CTA in clinical decision-making, and to assess treatment outcome. ⋯ The management of stable patients with neck injuries that penetrate the platysma has evolved at our institution into selective surgical intervention based on clinical examination and CTA and has resulted in minimal morbidity and mortality.
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J. Oral Maxillofac. Surg. · Apr 2007
Comparative StudyEvaluation of sedation failure in the outpatient oral and maxillofacial surgery clinic.
Our goal was to report on the incidence of sedation failures in our outpatient oral surgery clinic. Sedation failure is the inability to complete a procedure under intravenous sedation. There is very little in the oral surgery literature on this subject. ⋯ The mandible fracture population and multiple teeth extraction patients had higher rates of failure than other groups. This may be the result of procedure length, type of procedure, or a preoperative anxiety and attitude toward treatment expressed by the patient making sedation unpredictable. Level of training and experience of the practitioner may contribute to sedation failure. These results allow us to develop a prospective study protocol of outpatient sedation and to quantify more detailed information about preoperative anxiety, medical status, and social history than we had available during our chart review. More specific conclusions may help us determine if certain patient populations are at a higher risk for failed sedations.