1/17. Nonsurgical and nonextraction treatment of skeletal Class III open bite: its long-term stability.Two female patients, aged 14 years 5 months and 17 years 3 months with skeletal Class III open bite and temporomandibular dysfunction are presented. They had previously been classified as orthognathic surgical cases, involving first premolar removal. The primary treatment objective was to eliminate those skeletal and neuromuscular factors that were dominant in establishing their malocclusions. These included abnormal behavior of the tongue with short labial and lingual frenula, bilateral imbalance of chewing muscles, a partially blocked nasopharyngeal airway causing extrusion of the molars, with rotation of the mandible and narrowing of the maxillary arch. Resultant occlusal interference caused the mandible to shift to one side, which in turn produced the abnormal occlusal plane and curve of Spee. As a result, the form and function of the joints were adversely affected by the structural and functional asymmetry. These cases were treated by expanding the maxillary arch, which brought the maxilla downward and forward. The mandible moved downward and backward, with a slight increase in anterior facial height. Intruding and uprighting the posterior teeth, combined with a maxillary protraction, reconstructed the occlusal plane. A favorable perioral environment was created with widened tongue space in order to produce an adequate airway. myofunctional therapy after lingual and labial frenectomy was assisted by vigorous gum chewing during and after treatment, together with a tooth positioner. Normal nasal breathing was achieved.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
2/17. Near-fatal airway obstruction after routine implant placement.Implants have gained tremendous popularity over the past two decades, and their placement in the interior edentulous mandible has become routine. A case of near-fatal airway obstruction secondary to sublingual bleeding and hematoma is presented. The complication, anatomy of the area, and previous literature are reviewed, as are precautions to implant placement and other surgical procedures near the floor of the mouth. Although placing dental implants is generally a benign procedure, practitioners must be prepared for potential complications and have a rehearsed plan of action for the treatment of emergent situations. The floor of the mouth contains branches of the submental and sublingual and mylohyoid arteries that may lead to life-threatening complications. This caution obviously extends to any dentoalveolar surgical procedures that concerns the floor of the mouth such as tori removal, extractions, and iatrogenic dental injuries.- - - - - - - - - - ranking = 0.25keywords = extraction (Clic here for more details about this article) |
3/17. life-threatening hemorrhage after extraction of third molars:case report and management protocol.Few dental procedures have fatal complications, but severe postoperative hemorrhage can result in preventable death. This report describes a case of postextraction hemorrhage that led to airway compromise necessitating emergency airway management. This complication is rare, and a review of the literature revealed little in the way of case reports and treatment protocols. This article reviews the causes of and risk factors related to severe postoperative bleeding and presents an algorithm for management both in the dental office and in the hospital.- - - - - - - - - - ranking = 1.25keywords = extraction (Clic here for more details about this article) |
4/17. Plastic bronchitis mimicking foreign body aspiration that needs a specific diagnostic procedure.OBJECTIVE: To report two children admitted to our emergency department with respiratory failure, one for status asthmaticus with pneumomediastinum and requiring mechanical ventilation and the other for high suspicion of foreign body aspiration. INTERVENTIONS: bronchoscopy revealed obstructive plugs and permitted their extraction and their identification as bronchial casts after the immersion in normal saline. Allergy was suspected in the first one, and Hemophilus influenzae infection was present in the second. The outcome was favorable. CONCLUSIONS: Plastic bronchitis is an infrequent cause of acute life-threatening respiratory failure that can mimic foreign body aspiration or status asthmaticus. Bronchoscopic extraction must be performed urgently in the case of severe obstruction. This entity is probably underestimated as the casts with their specific ramifications are difficult to recognize. We recommend the immersion in normal saline of all plugs discovered in children with predisposing diseases mainly represented by infections, allergy, acute chest syndrome, and congenital cardiopathies.- - - - - - - - - - ranking = 0.5keywords = extraction (Clic here for more details about this article) |
5/17. laryngeal edema and death from asphyxiation after tooth extraction in four patients with hereditary angioedema.BACKGROUND: Recurrent angioedema is the hallmark of various inherited or acquired angioedema diseases. Hereditary angioedema, or HAE, due to C1 inhibitor, or C1NH, deficiency has considerable implications for dental health care providers because dental surgery may trigger distressing and even life-threatening episodes. CASE DESCRIPTION: The authors reviewed the literature, focusing on the pathogenesis, clinical signs and treatment of HAE. They also provided case reports of four patients who died from laryngeal edema induced by tooth extraction. In patients with HAE, dental surgery--including tooth extraction--may be followed by self-limiting edema episodes, including lip swelling, facial swelling, tongue edema and laryngeal edema with upper airway obstruction. Preoperative prophylaxis has been performed with attenuated androgens, fresh frozen plasma, C1NH concentrate and antifibrinolytics. The four patients described underwent tooth extraction, which, after a symptom-free latency of four to 30 hours, provoked laryngeal edema. Three of the patients died of asphyxiation the night after surgery, and the fourth died on the second night. In three of the patients, laryngeal edema had not occurred previously. CLINICAL IMPLICATIONS: Before undergoing dental surgery, patients with a history of recurrent angioedema should be evaluated for C1NH deficiency. If it is present, they are at risk of developing life-threatening laryngeal edema.- - - - - - - - - - ranking = 1.75keywords = extraction (Clic here for more details about this article) |
6/17. Aspiration of a dislodged endotracheal tube: a rare cause of acute total airway obstruction.We report an unusual cause of acute total airway obstruction after aspiration of a dislodged tube that was separated from its metallic connector. A 5-year-old boy had an emergence agitation and bucking to the endotracheal tube with a vigorous bite before extubation of the trachea. The whole uncuffed endotracheal tube was aspirated deep into the lower trachea causing laryngotracheal obstruction. The patient showed sudden oxygen desaturation and was then in an immediate life-threatening airway obstruction. We could not rescue oxygenation and were unable to establish a patent airway. Mask ventilation failed to relieve the progressive of hypoxemia. Immediate extraction of the tube using a pair of Magill's forceps before irreversible exacerbation was performed. We discuss our experience and the importance of prompt decision making and management for the extraction of the dislodged tube.- - - - - - - - - - ranking = 0.5keywords = extraction (Clic here for more details about this article) |
7/17. Intraoral vascular malformation and airway management: a case report and review of the literature.A patient with a large airway venous malformation underwent anesthesia for a tooth extraction. The procedure was uneventful until extubation, immediately after which complete airway obstruction resulted. After unsuccessful attempts to relieve the problem, the patient's trachea was reintubated. laryngoscopy showed that the venous malformation in the airway had enlarged and was responsible for the airway obstruction. Another attempt at extubation after corrective maneuvers was again unsuccessful. A tracheostomy was required, which was eventually removed after a complete recovery. Anesthesiologists must be concerned with any airway vascular abnormality. Most abnormalities involving the airway are either hemangiomas or venous malformations. The anesthesiologist must diagnose the problem correctly because even minor manipulation of a venous malformation may result in exsanguination, or the malformation may become engorged and compromise the airway.- - - - - - - - - - ranking = 0.25keywords = extraction (Clic here for more details about this article) |
8/17. Sublingual hematoma formation during immediate placement of mandibular endosseous implants.BACKGROUND: Sublingual hematoma during placement of mandibular endosseous dental implants is a rare, but potentially life-threatening, complication. The development of a sublingual hematoma during a dental procedure may result in the need for acute airway management, including intubation or even emergent tracheostomy. dental implants are becoming a well-accepted treatment, and thousands of implants are placed every year by general practitioners and specialists, with few adverse sequelae. Clinicians rarely discuss this complication with patients before surgery, and no reports of death secondary to sublingual hematoma formation have been published. The incidence of this event is difficult to ascertain, and only, a few cases have been reported. CASE DESCRIPTION: A 56-year-old man with severe caries underwent multiple mandibular tooth extractions and alveoloplasty and received endosseous implants. During the surgical procedure, the patient developed a large sublingual hematoma that required hospitalization. CLINICAL IMPLICATIONS: Practitioners who perform implant surgery in the anterior mandible should notify patients of the potential risk of sublingual hematoma formation, and be able to manage acute airway issues that may result from this complication.- - - - - - - - - - ranking = 0.25keywords = extraction (Clic here for more details about this article) |
9/17. A Christmas tree in the larynx.A 2 year-old boy presented with acute upper airway obstruction following a 15-month history of noisy breathing and hoarseness. An urgent laryngotracheal bronchoscopy was performed following inhalational induction of anesthesia. Using a fiberoptic bronchoscope, visualization of the larynx through a laryngeal mask airway revealed a flat plastic Christmas tree embedded within granulomatous cords causing almost complete obstruction and requiring tracheostomy prior to extraction. Twelve days later, the tracheostomy was successfully decannulated with the child's voice beginning to normalize. The family remembered the decoration from Christmas celebrations 2 years prior and recalled a coughing episode that predated the onset of hoarseness.- - - - - - - - - - ranking = 0.25keywords = extraction (Clic here for more details about this article) |
10/17. Non-resolving pneumonia in a young boy--beware of foreign body aspiration.A 4 1/2-year-old boy presented with recurrent cough and cold of 2 years duration. Chest x-ray revealed collapse consolidation of right lower lobe. Rigid bronchoscopy was done and the nozzle of a pen was extracted from right main bronchus. The radiological improvement took three months after extraction of the foreign body. Undetected foreign body aspiration is one of the causes of nonresolving pneumonia in children.- - - - - - - - - - ranking = 0.25keywords = extraction (Clic here for more details about this article) |
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