Dental management of patients with bone marrow and solid organ transplantation
Goldman, Kim E
With advances in transplant science, an increasing number of people are undergoing and surviving hematopoietic stem cell and solid organ transplantation. Those transplant recipients are also living longer. This means that many dentists nowadays will occasionally treat patients who are anticipating or who have received a transplant. Dentists thus should be knowledgeable about issues related to this population. The dentist's role is important because transplant patients are especially vulnerable to infection, which can stem from poor oral and dental hygiene. This article provides dentists with an overview of transplant science and guidance for dentists treating transplant patients.
Complications of alpha-interferon therapy for aggressive central giant cell lesion of the maxilla [Case Report]
Goldman, Kim E; Marshall, Melanie K; Alessandrini, Edward; Bernstein, Mark L
Treatment of giant cell lesions of the jaws is currently a subject of acute interest in the maxillofacial community. Based on their presumptive histological and biological similarities to both the "brown tumors" of hyperparathyroidism as well as proliferative vascular lesions, both calcitonin and interferon alpha administration have been attempted in patients suffering from these lesions. We present a case report of one young female in which both of these treatment modalities were instituted. We also discuss a rarely reported complication consisting of drug-induced lupus erythematosis and pancreatitis secondary to interferon alpha use.
Lingual flap retraction for third molar removal
Pogrel, M Anthony; Goldman, Kim E
PURPOSE/OBJECTIVE:Lingual nerve damage following lower third molar surgery remains a clinical problem. The traditional approach in the United States has been a buccal approach avoiding exposure or surgery on the lingual side of the crest of the ridge. An alternative technique is to deliberately expose the lingual tissues and retract the lingual nerve lingually before tooth removal. This study reports a trial of this technique. MATERIALS AND METHODS/METHODS:Patients had removal of their lower third molars carried out using a technique that raises a lingual flap in addition to a buccal flap and places a specially designed lingual retractor to ensure that the lingual nerve is held out of the surgical field. This technique was used in cases where the crown of the tooth had to be sectioned or when distal bone needed to be removed. RESULTS:Two hundred fifty patients were treated by this method. There were 4 cases of transient lingual paresthesia, presumably caused by traction pressure from the retractor. Three of these cases were mild and resolved within 3 weeks. The fourth case had more profound paresthesia, but still resolved within 2 months. There were no cases of permanent nerve damage, and in many cases removal of the third molar was simplified by the superior access. CONCLUSION/CONCLUSIONS:Lingual retraction for third molar removal improves access to the surgical site and can simplify third molar removal. In this prospective study there were no cases of permanent lingual nerve injury.