Faculty Bibliography

Despite the many types of oral pathologic lesions found in infants and children, the most commonly encountered are benign soft tissue lesions. The clinical features, diagnostic criteria, and treatment algorithms of pathologies in the age group from birth to 18 years of age are summarized based on their prevalence in each given age distribution. Treatment modalities include both medical and surgical management.

Statement of Problem: According to the Centers for Disease Control (CDC), approximately 26.5 million Americans carry a diagnosis of heart disease, over 2.6 million have atrial fibrillation, and as many as half of a million people are diagnosed with deep vein thromboses (DVT) or pulmonary embolisms (PE) each year.1 As the American population ages and rates of obesity increase, each of those statistics are expected to rise over the foreseeable future. Many of the patients afflictedwith these diagnoses take anticoagulant medications as part of their daily regimen. Oral and maxillofacial surgeons work in one of the most vascular parts of the body, the head and neck. As the statistics indicate, surgeons can expect to frequently encounter patients taking one or more medications that can prolong bleeding or inhibit proper clot formation. As new drugs enter the market, it is important for oral and maxillofacial surgeons to be aware of the pharmacology of these medications and the proper approaches to treating patients taking them. Methods: We undertook a comprehensive review of common outpatient anticoagulant medications, both new and old. Recommendations and guidelines from organizations such as the American Heart Association and the American Society of Hematology were analyzed and compiled with emphasis placed on perioperative management in both elective and emergent situations. Results: The traditional anticoagulants and antiplatelet agents reviewed were low molecular weight heparin, warfarin, fondaparinux, acetylsalicylic acid, and clopidogrel. New medications reviewed include dabigatran, prasugrel, ticagrelor, apixaban and rivaroxaban.2-5 Conclusion: Oral and maxillofacial surgeons can expect to frequently encounter patients taking anticoagulant and anti-platelet medications. It is extremely important to be aware of the risks of surgical treatment while patients are taking these drugs and equally important to be aware of emergency protocols for medication reversal, if possible. We seek to propose !

The incidence of salivary gland infections in the pediatric population is low but not infrequently seen in pediatric oral and maxillofacial surgery practices and hospital environs. With an ever increasing armamentarium of diagnostic tools and medical and surgical therapies, these patients can be managed successfully with minimum morbidity and decreased incidence of recurrences.

Dapsone is a leprostatic agent commonly prescribed for the management of leprosy, malaria, and the immunosuppression-induced infections of Pneumocystis carinii and Toxoplasma gondii. In susceptible patients, methemoglobinemia, a potentially life-threatening event, can occur. We report a case of dapsone-induced methemoglobinemia which was observed during general anesthesia for the management of a fractured mandible. The pathophysiology, diagnosis, and management of dapsone-induced methemoglobinemia will be discussed.

Eating disorders are common in girls and women. Two common eating disorders--anorexia nervosa and bulimia nervosa--have significant medical complications. Oral and maxillofacial surgeons must be cognizant of the signs, symptoms, and medical consequences of these disorders. The increased incidence of these diseases has implications in the surgical management the oral and maxillofacial surgery patient. A review of the literature and guidelines in the perioperative management of these surgical patients are presented in this article.

Placement of endosseous implants and inferior alveolar nerve transposition is a treatment option for patients with an edentulous posterior mandible with inadequate bone height superior to the inferior alveolar canal. Complications associated with these procedures include infection, prolonged neurosensory disturbances, and/or pathologic fracture. This report presents the surgical management of a patient with a mandible fracture after inferior alveolar nerve transposition with concurrent placement of two endosseous implants.