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Oral and Maxillofacial Surgery Clinics of North America

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https://www.readbyqxmd.com/read/29885876/discectomy-versus-disc-preservation-for-internal-derangement-of-the-temporomandibular-joint
#1
REVIEW
Shravan Kumar Renapurkar
Anterior disc displacement with or without reduction is a common finding in symptomatic and asymptomatic individuals. When symptomatic and associated with dysfunction it requires an intervention. Once nonsurgical management fails and the patient does not respond to minimally invasive procedures, open surgical treatment is indicated. However, controversy exists about whether disc-preservation procedures, such as repositioning/repairing or disc removal, is the preferred treatment. This article evaluates the current evidence supporting both treatment options and highlights the indications, contraindications, and consequences of each...
June 6, 2018: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/29866455/combined-or-staged-temporomandibular-joint-and-orthognathic-surgery-for-patients-with-internal-derangement-and-dentofacial-deformities
#2
REVIEW
Somi Kim, David A Keith
Patients with internal derangement of the temporomandibular joint and dentofacial deformities need appropriate evaluation for both conditions. Correct diagnosis of internal derangement is vital in determining the correct orthognathic surgery plan, and it is particularly important to differentiate between myofascial dysfunction and intra-articular joint problems. Depending on the stage of internal derangement, patients may need treatment for temporomandibular dysfunction symptomatically, staged, or concurrently with orthognathic surgery...
June 1, 2018: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/29866454/the-role-of-stress-in-the-etiology-of-oral-parafunction-and-myofascial-pain
#3
REVIEW
Richard Ohrbach, Ambra Michelotti
Oral parafunction during waking comprises possible behaviors that can be measured with a comprehensive checklist or behavioral monitoring. Multiple studies lead to largely consistent findings: stressful states can trigger parafunctional episodes that contribute to myofascial pain. However, this simple causal pathway coexists with at least 3 other pathways: anxiety and stress are potent direct contributors to pain, pain results in maladaptive behaviors such as parafunction, and parafunction may be a coping response to potential threat coupled with hypervigilance and somatosensory amplification...
June 1, 2018: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/29866453/malocclusion-as-a-cause-for-temporomandibular-disorders-and-orthodontics-as-a-treatment
#4
REVIEW
Bhavna Shroff
This article explores the long-standing controversy between orthodontics and temporomandibular disorders (TMDs). It reviews the history of this controversy and presents a discussion of the current literature concerning the potential role of malocclusion in the onset of TMDs. It also explores the potential role of orthodontic treatment as a possible cure for TMDs and concludes, based on the most current evidence-based literature, that there is no relationship.
June 1, 2018: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/29866452/arthroscopy-versus-arthrocentesis-for-treating-internal-derangements-of-the-temporomandibular-joint
#5
REVIEW
Daniel M Laskin
The introduction of arthroscopy of the temporomandibular joint represented a major change in the management of internal derangements and to the realization that re-establishing joint mobility by arthroscopic lysis and lavage was as effective as surgically restoring disc position. It was subsequently shown that such treatment could be done without joint visualization. This raised the question of whether the inability to visualize the joint and perform other surgical manipulations limited its usefulness. A comparison of the literature shows that although their effectiveness is essentially the same, arthrocentesis is simpler, has less morbidity, and has fewer complications than arthroscopic surgery...
June 1, 2018: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/29866451/orthognathic-surgery-as-a-treatment-for-temporomandibular-disorders
#6
REVIEW
M Franklin Dolwick, Charles G Widmer
Well-controlled clinical trials supporting orthognathic surgery as the primary management for temporomandibular disorders (TMDs) are lacking. Most published studies lack an adequate experimental design to minimize biases. Studies that did minimize some biases do support an overall reduction in the frequency of TMD signs and symptoms in some Class III and Class II patients who had orthognathic surgery. However, Class II correction with counter-clockwise rotation of the mandible increased TMD. Individual variability precludes the ability to predict TMD outcome after surgery...
June 1, 2018: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/29866450/the-role-of-imaging-in-the-diagnosis-of-temporomandibular-joint-pathology
#7
REVIEW
Tore A Larheim, Caroline Hol, Margareth Kristensen Ottersen, Bjørn B Mork-Knutsen, Linda Z Arvidsson
Diagnostic imaging is sometimes necessary to supplement the clinical findings in patients with suspected temporomandibular disorders (TMDs). However, the interpretation of pathology in the imaging findings is often complicated by the presence of similar findings in asymptomatic volunteers, as well as by the use of inadequate imaging techniques and poor image quality. This article focuses on these issues and gives guidance on the appropriate use of diagnostic imaging in patients with suspected TMD.
June 1, 2018: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/29866449/the-use-of-oral-appliances-in-the-management-of-temporomandibular-disorders
#8
REVIEW
Charles S Greene, Harold F Menchel
Oral appliances (OAs) are widely used for treating various types of temporomandibular disorders (TMDs); however, many controversies persist about how they should be designed, how they should be used, and even what their ultimate purpose might be. This article discusses 6 of the current controversies, with a focus on the evidence available to support reasonable practice guidelines for the clinical use of OAs in treating certain TMDs.
June 1, 2018: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/29866448/injectable-agents-versus-surgery-for-recurrent-temporomandibular-joint-dislocation
#9
REVIEW
Shravan Kumar Renapurkar, Daniel M Laskin
Recurrent temporomandibular joint dislocation (TMJD) is a distressing entity to the patient and a therapeutic challenge to the treating provider. Absence of high-level evidence in literature among currently available treatment options creates a lack of consistency in management. This article reviews the current literature on common injectable agents used and the open surgical techniques. Based on the findings, an injectable agent is the initial treatment of choice for recurrent TMJD, with capsulorraphy and eminectomy being used in nonresponding patients...
June 1, 2018: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/29861340/the-use-of-synovial-fluid-analysis-for-diagnosis-of-temporomandibular-joint-disorders
#10
REVIEW
Gary F Bouloux
There has been considerable progress in the identification of the various synovial fluid cytokines and growth factors associated with various disorders of the temporomandibular joint. However, the presence of the same inflammatory mediators and proteins in these conditions, despite differing causes, makes it very difficult to identify the specific disease using synovial fluid analysis alone.
June 1, 2018: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/29858130/occlusal-equilibration-for-the-management-of-temporomandibular-disorders
#11
REVIEW
Daniele Manfredini
The concept of equilibrating the occlusion to treat and/or to prevent temporomandibular disorders found its background in the old precepts of gnathology, but an assessment of the available literature as well as an appraisal of its biological rationale suggests that it is not recommended for routine use.
May 29, 2018: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/29622317/-unknown-title
#12
EDITORIAL
David W Todd, Robert C Bosack
No abstract text is available yet for this article.
May 2018: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/29622315/anesthetic-pump-techniques-versus-the-intermittent-bolus-what-the-oral-surgeon-needs-to-know
#13
REVIEW
Richard C Robert, Chirag M Patel
The most popular agents in use for office-based anesthesia are propofol, ketamine, and remifentanil, which have the desirable properties of rapid onset and short duration of action. A useful parameter in assessing these agents is the context-sensitive half-time. These anesthetic agents demonstrate relatively low, flat plots compared with older agents. For delivery of intravenous anesthetics, oral and maxillofacial surgeons have relied small incremental boluses with great success. However, relatively simple syringe infusion pumps can provide an even "smoother" anesthetic...
May 2018: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/29622314/airway-management-for-the-oral-surgery-patient
#14
REVIEW
Allan Schwartz
This article discusses anesthesia assessment concepts related to airway evaluation and airway maintenance for safe and reliable selection of either open system (entrainment of room air) or closed system (no entrainment of room air) airway devices, which can be used during office-based oral surgical procedures, depending on the needs of a patient. Dental facial and oral structures are integral to an anesthetist's preoperative patient evaluation prior to surgery. The preoperative medical history and physical examination as well as the nature of the oral surgical procedure affect the selection of a proper and safe airway device...
May 2018: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/29622313/the-american-association-of-oral-and-maxillofacial-surgeons-simulation-program
#15
REVIEW
David W Todd, John J Schaefer
Patient safety in dental anesthesia has been called into question in recent years. Simulation training has been proposed and developed as one possibility for increasing preparedness and training in cases of adverse events in dental anesthesia. This article presents an overview of the challenges of patient safety in dental anesthesia and how to address them with simulation training. The American Association of Oral and Maxillofacial Surgeons simulation program is unique in its potential to become a standardized, validated competency course with objective grading criteria, mastery-based cooperative learning model, and low facilitator-to-participant ratio, leading to a practical delivery cost structure...
May 2018: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/29622312/oral-surgery-patient-safety-concepts-in-anesthesia
#16
REVIEW
Richard C Robert, Chirag M Patel
An effective office emergency preparedness plan for the oral and maxillofacial surgery office can be developed through the use of well-designed checklists, cognitive aids, and regularly scheduled in situ simulations with debriefings. In order to achieve this goal, the hierarchal culture of medicine and dentistry must be overcome, and an inclusive team concept embraced by all members of the staff. Technologic advancements in office automation now make it possible to create interactive cognitive aids. These enhance office emergency training and provide a means for more rapid retrieval of essential information and guidance during both simulations and a real crisis...
May 2018: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/29622311/anesthesia-for-the-pediatric-oral-and-maxillofacial-surgery-patient
#17
REVIEW
Deepak G Krishnan
Pediatric patients present to the oral and maxillofacial surgeon for surgical services that can be performed safely and efficiently. Children and parents tend to be anxious; achieving cooperation is paramount for successful procedures. Several techniques can be used to alleviate anxiety and provide analgesia and anesthesia. This article outlines the anatomy and physiology of children and the preoperative anesthetic preparation and techniques unique to pediatric anesthesia. It discusses standards in training in pediatric anesthesia and current recommendations for monitoring...
May 2018: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/29622310/the-failed-sedation-solutions-for-the-oral-and-maxillofacial-surgeon
#18
REVIEW
Robert C Bosack
Due to wide variation in patient responses, both intended and adverse, it is impossible to successfully sedate all patients. Choosing the right drug and dose regimen can be challenging, especially in patients who are naïve to anesthesia. Underdosing can lead to pain perception, patient movement and combativeness, awareness with recall, and the sympathetic neuroendocrine stress response. Overdosing can lead to unintended loss of upper airway tone, hypoventilation/apnea, adverse cardiovascular changes, and prolonged sedation (with its attendant problems)...
May 2018: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/29622309/anesthetic-agents-commonly-used-by-oral-and-maxillofacial-surgeons
#19
REVIEW
Kyle J Kramer, Jason W Brady
Oral and maxillofacial surgeons have a variety of anesthetic agents that can be used to provide anesthesia safely and efficiently in the office-based environment. However, it is critical to have a thorough understanding of the particulars for each agent. Commonly used anesthetic agents, administered either individually or in combination, include diazepam, midazolam, propofol, ketamine, opioid agonists such as fentanyl or remifentanil, dexmedetomidine, and inhalational agents, including nitrous oxide and sevoflurane...
May 2018: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/29622308/oral-and-maxillofacial-surgery-team-anesthesia-model-and-anesthesia-assistant-training
#20
REVIEW
Stephanie J Drew
The model for oral and maxillofacial surgery (OMFS) delivery of office-based, open airway anesthesia has morphed from the operator-anesthetist to the delivery of team anesthesia, supporting a widespread focus on organizational aspects of the delivery of care. The training, continuing education, and coordination of a diverse anesthesia team provides a system to improve the safety and efficacy of anesthesia delivery. The hallmarks of this system include communication, checks and balances, monitoring, team dynamics, protocols, emergency scenario preparation and rehearsal, and crisis resource management during an emergent situation...
May 2018: Oral and Maxillofacial Surgery Clinics of North America
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