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Biomedical subjects

S Taicher

Publications and source records attributed to S Taicher.

At least 37 records · Page 2Linked to original sources
PubMed2000

Emergency tracheostomy following life-threatening hemorrhage in the floor of the mouth during immediate implant placement in the mandibular canine region.

BACKGROUND: The edentulous interforaminal mandibular area is frequently the preferred area for implant placement. METHODS: A case of emergency tracheostomy following life-threatening hemorrhage in the floor of the mouth during immediate implant placement in the mandibular canine region is described. The probable cause was bleeding from the sublingual artery or a branch of that artery following implant perforation of the lingual cortex. RESULTS: Healing was uneventful and the patient was released from the hospital after 11 days. Three years later, CT showed a well-osseointegrated implant with a severe buccolingual inclination. CONCLUSIONS: It is stressed that short implants (14 mm or less) should be used in the mandibular canine region and that effective treatment of this complication is essential.

Arteries↗
PubMed1999

[Sport-related maxillofacial fractures].

The records of 537 patients with 750 maxillofacial fractures were reviewed and analyzed. 55 (10.2%) had sport-related injuries and the rest were due to other causes. The sport-related group was predominantly male (ratio 9:1) with a mean age of 24.5 years. The mandible was most commonly injured (52.5%), followed by the zygomatic complex (32.8%). The incidence of complicated mid-facial fractures was only 2.8%, and of comminuted fractures 9%. This distribution of injuries is most likely due to the relatively low-energy of trauma associated with many sport activities. The relatively low mean age of the patients, most of whom had full dentition, allowed for conservative treatment of most of the mandibular fractures, using closed reduction. Injuries were caused by 11 different sports. The highest incidence was soccer (45%), followed by skating (15%), basketball (9%) and horse-riding (9%). Contact sports were the cause of injuries in 72.2%, with the highest incidence of trauma due to impact with another player (60%). Better protection of the oral and maxillofacial region is needed, especially during high-contact sport.

Adolescent↗
PubMed1999

Lingual cyst with respiratory epithelium: an entity of debatable histogenesis.

PURPOSE: The purpose of this report was to describe a new case of lingual cyst with respiratory epithelium, to review and analyze the literature regarding lingual cyst of foregut origin and lingual alimentary cyst, and to discuss the suitable terminology for these uncommon cysts. MATERIAL AND METHODS: Data from articles published in the English language between the years 1942 and 1947 were used. RESULTS: The review of the literature showed 53 lingual cysts of which 29 could be grouped into lingual alimentary tract cysts and 24 into lingual cysts of foregut origin. There was an overlap in histologic and clinical features and embryogenesis of both cysts. CONCLUSIONS: Differentiation between both cysts cannot be supported, and until further information is accumulated it is suggested that histologic descriptive terms be used such as lingual cyst with respiratory epithelium, lingual cyst with gastric epithelium, or lingual cyst with respiratory and gastric epithelium.

Child↗
PubMed1999

Risk factors contributing to symptomatic plate removal in orthognathic surgery patients.

PURPOSE: This study analyzed the fate of miniplates in orthognathic surgery and defined risk factors that eventually result in plate removal. PATIENTS AND METHODS: The outpatient clinic files of 70 patients who had undergone orthognathic surgery were reviewed. All osteotomies were rigidly fixed with stainless steel or titanium miniplates. Study variables included age, gender, plate material, site of plates, and reasons for plate removal. RESULTS: Of 260 plates used for fixation, 31 were removed (12%). When all factors were considered together, only age was statistically significant. Patients older than 30 years of age were more likely to have plate removal (22% vs. 9%). Only when each factor was considered separately were gender and plate material statistically significant. Females (15.4% vs. 6.7%) and stainless steel plates (15.5% vs. 6.7%) were more prone to plate removal. Although more plates were removed from the buttress (15.5%) and chin (14.5%) compared with the piriform area (6.4%), this was not statistically significant. CONCLUSIONS: Age can be defined as a primary risk factor for plate removal, whereas gender and plate material are secondary. Although age and gender are not controllable, the use of titanium plates and infection control may lower the number of symptomatic plates and the need for their removal.

Adolescent↗
PubMed1999

Dental extractions in patients maintained on continued oral anticoagulant: comparison of local hemostatic modalities.

OBJECTIVE: The purpose of this study was to evaluate postoperative bleeding in patients treated with oral anticoagulant drugs who underwent dental extractions without interruption of the treatment and to compare the effect of 3 different hemostatic modalities. STUDY DESIGN: A total of 150 patients who underwent dental extractions were divided into 3 groups. Local hemostasis was carried out as follows: group 1 (119 extractions), with gelatin sponge and sutures; group 2 (117 extractions), with gelatin sponge, sutures, and mouthwash with tranexamic acid; group 3 (123 extractions), with fibrin glue, gelatin sponge, and sutures. RESULTS: Of 150 patients, 13 (8.6%) presented with postoperative bleeding: 3 patients from group 1, 6 patients from group 2, and 4 patients from group 3. CONCLUSIONS: Dental extractions can be performed without interruption in patients treated with oral anticoagulant. Local hemostasis with gelatin sponge and sutures is sufficient.

Administration, Oral↗
PubMed1999

Unusual peripheral odontogenic tumors in the differential diagnosis of gingival swellings.

Differential diagnosis of gingival mass lesions includes several conditions and causes. Peripheral odontogenic tumors may mimic gingival swellings and, although rare, must be included in the differential diagnosis. The purpose of this article is to describe 3 different cases of peripheral odontogenic tumors and to discuss the differential diagnosis of gingival swelling. Histologic examination is mandatory when localized gingival swellings are surgically removed.

Adult↗
PubMed1999

Use of lyodura for bone augmentation of osseous defects around dental implants.

BACKGROUND: Lyodura has been used in periodontology and maxillofacial surgery to overcome different clinical conditions. The use of lyodura to induce new bone formation in humans has not been widely reported. The purpose of this article is to describe the use of lyodura as a resorbable barrier to promote bone formation in osseous defects around dental implants. METHODS: The study group consisted of 22 healthy patients (12 women and 10 men), with a mean age of 32 (range 20 to 45). A total of 44 implants (9 titanium screw-type and 35 hydroxyapatite-coated cylinder implants) were placed. Of these, 27 implants were placed in the maxilla and 17 in the mandible. At 27 extraction sites bony vertical defects were measured on the buccal, lingual, mesial and distal sides of the implant. In the remaining 17 cases, where either immediate or staged implantation was performed, and a dehiscence was present, its vertical length was measured from the alveolar crest. All bony defects were grafted with autogenous bone harvested from the tuberosity. Each site was covered with lyodura. RESULTS: Healing was uneventful; no inflammation, infection, or soft tissue dehiscence was observed. At all extraction sites and in 76% of the dehiscence defects, hard tissue appearing clinically similar to bone completely filled the defect. Of those defects not completely filled, a mean vertical bone increase of 2.5 mm was recorded. A mean vertical bone increase of 2.6 mm was achieved at extraction sites and a mean increase of 2.79 mm was achieved at dehiscence sites. CONCLUSIONS: Lyodura can safely and effectively be used for guided bone regeneration at both extraction sites and for dehiscence defects.

Absorbable Implants↗
PubMed1998

Electrocardiographic changes in cardiac patients having dental extractions under a local anesthetic containing a vasopressor.

PURPOSE: This study attempted to identify which group of cardiac patients is most at risk when dental extractions are performed under a local anesthetic with a vasopressor. PATIENTS AND METHODS: Forty cardiac patients who had dental extractions under local anesthesia were connected to a Holter monitor for 24 hours, starting an hour before the procedure. The electrocardiogram was analyzed for the number of premature beats, ST depression, and cardiac rhythm. A mean rate was calculated for the first 2 hours after injection of the local anesthetic and for the subsequent 22 hours. The preoperative electrocardiogram was compared with the electrocardiogram performed 1 week before treatment. RESULTS: Electrocardiographic changes were observed in 15 patients (37.5%), and all occurred during the first 2 hours after injection of the local anesthetic. Of the 15 patients, eight were being treated with digoxin. CONCLUSIONS: Cardiac patients being treated with digoxin had more electrocardiographic changes after administration of a local anesthetic than other cardiac patients. When the local anesthetic contained a vasopressor, there was a greater incidence of tachycardia but less arrhythmia or ST depression.

Adult↗
PubMed1998

The influence of the osteotomy slope on bony changes after advancement genioplasty.

PURPOSE: The purpose of this study was to develop a prediction method for advancement genioplasty that would result in accurate preoperative cephalometric planning of the osteotomy slope and that could be transferred to the patient during the surgical procedure. PATIENTS AND METHODS: Serial cephalometric tracings of 20 patients who underwent advancement genioplasty were retrospectively analyzed. The osteotomy slope angle was defined as the angle between the osteotomy and a line perpendicular to the occlusal plane. The measured angle was compared with the calculated angle deduced from the horizontal and vertical genial postoperative changes. RESULTS: The measured osteotomy slope angle closely resembled the calculated angle. CONCLUSIONS: The close similarity between the calculated and measured osteotomy slope angles in this study shows that simple mathematical calculations can be applied clinically to aid surgeons in achieving a more predictable result. The osteotomy slope can be determined early in the prediction stage as a calculated figure based on the desired horizontal and vertical movements of the chin and can be transferred to the patient's chin during the surgical stage.

Adolescent↗
PubMed1998

The use of ultrasonography as a diagnostic tool for superficial fascial space infections.

PURPOSE: This study examined the value of ultrasonography as a diagnostic tool in the treatment of superficial acute odontogenic fascial space infections. PATIENTS AND METHODS: The study group consisted of 50 patients in whom both radiographic and sonographic examinations, as well as a needle aspiration, were performed. RESULTS: Purulent fluid was aspirated in 22 of the 50 patients. Six patients diagnosed as suffering from cellulitis had a repeated ultrasonography scan. In four, abscess formation was diagnosed on the third day. CONCLUSIONS: Ultrasonography is an effective diagnostic tool to confirm abscess formation in the superficial fascial spaces and is highly predictable in detecting the stage of infection.

Abscess↗
PubMed1998

Radiological features of osteogenic sarcoma of the jaws. A comparative study of different radiographic modalities.

OBJECTIVE: To evaluate the clinical and radiological features of osteogenic sarcoma of the jaws with particular reference to the effectiveness of the radiographic modalities used. MATERIAL AND METHODS: A total of 66 cases (57 from the English-language literature and nine new cases) were critically evaluated for the features depicted with intra-oral and panoramic radiography and CT. RESULTS: The mean age of the patients was 36 years (median 31.5 years). There were no differences in gender distribution. A ratio of 1:1.6 between the maxilla and the mandible was found. Lesions had diffuse borders in 78% of cases and defined but not corticated borders in 22%. Twenty-nine per cent were radiolucent, 29% radiopaque and 41% mixed density. Widening of the periodontal ligament space (PDL) was seen in 14 of the 47 (28%) lesions associated with teeth and structural changes in the mandibular canal in 34% of the mandibular lesions. There was a periosteal reaction in 48% and soft tissue involvement in 33% of the lesions. CONCLUSIONS: Widening of the PDL space was best demonstrated on periapical radiographs. Structural changes in the mandibular canal were shown mainly with panoramic radiographs. Periosteal reaction was best demonstrated by occlusal radiographs and soft tissue involvement by CT. Thorough radiological examination using periapical, occlusal and panoramic radiography, and recognition of the radiological features of osteogenic sarcoma should lead to earlier diagnosis.

Adolescent↗
PubMed1997

Oral manifestations of sarcoidosis.

OBJECTIVE: To report two new cases of sarcoidosis of the buccal mucosa and to analyze the literature on oral manifestations of sarcoidosis. STUDY DESIGN: Oral lesions with histologic features of sarcoidosis were analyzed according to their location and appearance. RESULTS: Analysis of 45 cases of oral sarcoidosis (43 from the literature and the 2 new presented cases) revealed 12 lesions in the jaws, 10 in the buccal mucosa, 6 in the gingiva, 5 in the lips, 5 in the floor of the mouth, 4 in the tongue, and 3 in the palate. Sarcoidosis in the jaw was located in the alveolar bone and presented as an ill-defined radiolucency. Submucosal nodules were observed in sarcoidosis affecting the buccal mucosa, palate, and lip. Swelling was the main manifestation in the gingiva. In the floor of the mouth, sarcoidosis presented as ranula and that of the tongue as induration. In most of the cases, the lesions in the buccal mucosa, gingiva, and tongue were the first clinical manifestation of the disease. CONCLUSION: Oral sarcoidosis lesions should be considered in the differential diagnosis of oral soft tissue swellings and jaw lesions.

Adult↗
PubMed1997

Vigabatrin-induced gingival overgrowth.

Vigabatrin is a relatively new medication used in the treatment of epilepsia. The present report concerns the use of vigabatrin by a 19-year-old woman. The patient manifested marked gingival overgrowth compatible clinically and histologically with the overgrowth induced by phenytoin, cyclosporine and calcium channel blockers. This is the 1st report of vigabatrin-induced gingival overgrowth. Clinicians should be aware of similar lesions in patients using new anticonvulsants.

Adult↗
PubMed1996

[Oral surgical procedures during anticoagulant therapy].

Minor oral surgery, in patients being treated with anticoagulant therapy, constitutes a problem for the oral and maxillofacial surgeon. 77 patients getting coumarin underwent 168 oral surgical procedures (tooth extraction, apicoectomy, crown-lengthening, excision of lesions) without lowering the dose of anticoagulant. Local hemostasis was achieved in all cases by silk suture. For tooth extraction gelfoam was used as well. In 12 patients who presented with postoperative bleeding, it was controlled in all by gauze pressure with tranexamic acid and/or biologic glue and/or surgical splinting. Postoperative bleeding was not correlated with the international normalized ratio (INR), but with degree of local inflammation. The study shows that interruption of anticoagulant therapy in such cases is not justified, and the use of tranexamic acid or biological glue can control bleeding.

Adult↗
PubMed1996

Burkitt's lymphoma mimicking an acute dentoalveolar abscess.

Burkitt's lymphoma is a monoclonal proliferation of B lymphocytes classified histologically as a poorly differentiated lymphocytic lymphoma. The jaw and retroperitoneal structures are the most commonly involved sites. Prognosis is highly dependent on the stage of the disease. In some cases, the first manifestation of Burkitt's lymphoma is in the jaws, and symptoms may be misdiagnosed as infection. Dental radiographs can play an important role in the diagnosis. A case of a peculiar Burkitt's lymphoma involving the mandible that was misdiagnosed as an acute dentoalveolar abscess is presented.

Adolescent↗
PubMed1996

Electrocardiographic changes in cardiac patients undergoing dental extractions under local anesthesia.

PURPOSE: The purpose of this study was to identify which group of cardiac patients is most at risk when dental extractions are performed under local anesthesia. PATIENTS AND METHODS: Forty cardiac patients who had dental extraction under local anesthesia (Mepivacain HCl three percent) were connected to a Holter monitor for 24 hours starting 1 hour before the procedure. Of the 40 patients, 24 had coronary artery disease, 12 had valvular disease, 3 were being treated with antiarrhythmic drugs, and 1 had malignant arterial hypertension. Sixteen patients were being treated with digoxin. The electrocardiogram was analyzed for the number of premature beats, ST depression, and cardiac rhythm. A mean rate was calculated for the first 2 hours after injecting the local anesthetic and surgical procedure, and for the subsequent 22 hours. RESULTS: All electrocardiographic changes occurred during the first 2 hours after injecting the local anesthetic. When the mean rate of that period was compared with the remaining 22 hours, new pathologic signs of arrhythmia, tachycardia, or ST depression were seen in 14 patients (35%). Of these, 12 were being treated with digoxin. CONCLUSION: Patients being treated with digoxin for atrial fibrillation or congestive heart failure are more prone to complications during dental extractions under local anesthesia than other cardiac patients.

Aged↗