Dento-Alveolar Complications, An Issue of Oral and Maxillofacial Surgery Clinics

James P. Mcandrews, Dennis-Duke R. Yamashita

Description

A comprehensive review of dento-alveolar complications for the oral and maxillofacial surgeon! Topics will include bleeding, dento-alveolar infections, infections extending into the neck, osteomyelitis and osteitis, endodontic complications, nerve injuries, local anesthesia, pathology, bone grafting, osteoradionecrosis, bisphosphonate associated jaw necrosis, and much more!

Sujets

• Oral Surgery
• Medical
• Médecine
• Dentistry

Informations

• Publié par: Saunders
• Date de parution: 28 août 2011
• Nombre de lectures: 0
• EAN13: 9781455712120
• Langue: English
• Poids de l'ouvrage: 2 Mo

Extrait

Oral and Maxillofacial Surgery Clinics of North America , Vol. 23, No. 3, August 2011
ISSN: 1042-3699
doi: 10.1016/S1042-3699(11)00115-4

Contributors
Oral and Maxillofacial Surgery Clinics of North America
Complications in Dentoalveolar Surgery
Dennis-Duke R. Yamashita, DDS
James P. McAndrews, DDS
Richard H. Haug, DDS
ISSN  1042-3699
Volume 23 • Number 3 • August 2011

Contents
Cover
Contributors
Forthcoming Issues
Complications in Dentoalveolar Surgery
Complications of Local Anesthesia Used in Oral and Maxillofacial Surgery
Oral Maxillofacial Surgery Displacement Complications
Complications in Oral and Maxillofacial Surgery: Management of Hemostasis and Bleeding Disorders in Surgical Procedures
Dentoalveolar Nerve Injury
Alveolar Osteitis and Osteomyelitis of the Jaws
Dentoalveolar Infections
Craniocervical Necrotizing Fasciitis Resulting from Dentoalveolar Infection
Complications in Bone Grafting
Bisphosphonates and Oral Health: Primer and an Update for the Practicing Surgeon
Osteoradionecrosis
Failure to Diagnose Pathology: An Avoidable Complication in Oral and Maxillofacial Surgery
The Law and Dentoalveolar Complications: Trends and Controversies
Index
Oral and Maxillofacial Surgery Clinics of North America , Vol. 23, No. 3, August 2011
ISSN: 1042-3699
doi: 10.1016/S1042-3699(11)00117-8

Forthcoming Issues
Oral and Maxillofacial Surgery Clinics of North America , Vol. 23, No. 3, August 2011
ISSN: 1042-3699
doi: 10.1016/j.coms.2011.05.002

Preface
Complications in Dentoalveolar Surgery

Dennis-Duke R. Yamashita, DDS
James P. McAndrews, DDS
Oral and Maxillofacial Surgery, Department of Dentistry, Los Angeles County/USC Medical Center, 1100 North State Street, A3C, Los Angeles, CA 90033, USA
E-mail address: [e-mail]
E-mail address: [e-mail]

Dennis-Duke R. Yamashita, DDS, Guest Editor
James P. McAndrews, DDS, Guest Editor
The responsibility of the oral and maxillofacial surgeon is to provide the best possible result for their patients. In today’s society, the barometer of success does not end at a successful surgery, but in the ultimate achievement of the clinician’s goals as well as those of the patient. The scope of our specialty is vast, ranging from dentoalveolar procedures and trauma management to cosmetic and reconstructive surgery. Yet, for most of us, the core of our practice remains dentoalveolar surgery. While we have developed the most advanced surgical methods and techniques, it is the management and treatment of complications that will continue to be the most challenging aspects of our practices.
This issue attempts to address some of the medical and surgical complications that may be encountered during the care and treatment of our patients. We asked our contributors to dedicate their efforts to producing a work that would inform and educate the reader about some of the common and less common perils related to dentoalveolar surgery. In our opinion, the authors have excelled in this pursuit. The articles in this issue review various problems and offer practical guidelines for successful management.
The complications related to surgical misadventures, nerve injury, hemostasis, local anesthesia, and grafting are reviewed, as well as the surgical and medical management of dentoalveolar infections, osteoradionecrosis, and bisphosphonate-related necrosis. The issue concludes with a discussion of the failure to diagnose issues as they relate to pathology and the medico-legal aspects associated with dentoalveolar complications.
We would like to thank our contributors, who have shared with us their vast knowledge and experience in this issue. It is through their collective wisdom that we may enhance our decision-making process and thus ensure the highest quality of care for our patients. The practice of oral and maxillofacial surgery will inevitably result in complications, but we hope this issue will serve as a valuable tool in their prevention or management. We wish to express our special thanks to Ms Julie Yamashita for her review of our manuscripts.
Oral and Maxillofacial Surgery Clinics of North America , Vol. 23, No. 3, August 2011
ISSN: 1042-3699
doi: 10.1016/j.coms.2011.04.009

Complications of Local Anesthesia Used in Oral and Maxillofacial Surgery

David R. Cummings, DDS a , b , Dennis-Duke R. Yamashita, DDS, FACD, FICD c , * , James P. McAndrews, DDS, FACD, FICD c
a Department of Oral and Maxillofacial Surgery, University of Southern California School of Dentistry, Los Angeles County/University of Southern California Medical Center, 925 West 34th Street, Los Angeles, CA 90089, USA
b Private Practice, 26302 La Paz Suite 102, Mission Viejo, CA 92691, USA
c Oral and Maxillofacial Surgery, Department of Dentistry, Los Angeles County/University of Southern California Medical Center, 1100 North State Street, A3C, Los Angeles, CA 90033
* Corresponding author. Oral and Maxillofacial Surgery, Department of Dentistry, Los Angeles County/University of Southern California Medical Center, 1100 North State Street, A3C, Los Angeles, CA 90033.
E-mail address: [e-mail]

Abstract
Local anesthetics are used routinely in oral and maxillofacial surgery. Local anesthetics are safe and effective drugs but do have risks that practitioners need to be aware of. This article reviews the complications of local anesthesia. A brief history is provided and the regional and systemic complications that can arise from using local anesthesia are discussed. These complications include paresthesia, ocular complications, allergies, toxicity, and methemoglobinemia. Understanding the risks involved with local anesthesia decreases the chances of adverse events occurring and ultimately leads to improved patient care.

Keywords
• Local anesthesia • Complications • Dental • Lidocaine • Paresthesia • Ocular • Toxicity • Articaine
Local anesthetics are used routinely in oral and maxillofacial surgery. Local anesthetics are safe and effective drugs but do have risks that practitioners need to be aware of. This article reviews the complications of local anesthesia. A brief history is provided and the regional and systemic complications that can arise from using local anesthesia are discussed. These complications include paresthesia, ocular complications, allergies, toxicity, and methemoglobinemia. Understanding the risks involved with local anesthesia decreases the chances of adverse events occurring and ultimately leads to improved patient care.

History of local anesthesia
In the 1860s, the first local anesthetic was isolated from coca leaves by Albert Niemann in Germany. Twenty years later, Sigmund Freud was researching the body’s ability to adapt to adverse circumstances. Freud had ordered some coca leaves and chewed them, only to find out that they made his tongue numb. Freud had a young colleague who was an ophthalmology resident, by the name of Karl Koller. Freud suggested that Koller try cocaine as a local anesthetic. In 1884, Koller published the first paper on the use of cocaine as a local anesthetic agent. He placed a 2% cocaine solution onto the corneas of rabbits and dogs, causing insensitivity to painful stimuli. 1 Following Koller’s work, Halsted administered cocaine near the mandibular nerve of a medical student, and within a few minutes, the student’s tongue, lower lip, and teeth were numb. Halsted went on to become a world-renowned professor of surgery at the Johns Hopkins University and is credited as the discoverer of conduction anesthesia. Soon after, the Harrison Narcotics Tax Act outlawed the sale and distribution of cocaine in the United States. In 1905, another important advance in local anesthesia occurred: the discovery of procaine (Novocain) by Alfred Einhorn. 2
Soon after, adrenaline was added to procaine to increase its efficacy. In 1949, a Swedish company introduced lidocaine, an amino amide–based local anesthetic that had fewer side effects and provided a deeper anesthetic compared with Novocain. In 2000, the US Food and Drug Administration approved articaine 4% with epinephrine 1:100,000, and articaine 4% with epinephrine 1:200,000. Lidocaine is currently the most widely used local dental anesthetic in most countries. 3

Regional complications

Paresthesia
The incidence of paresthesia after inferior alveolar nerve block has been reported by Pogrel to be as low at 1:850,000 and as high as 1:20,000. 4 Others have reported the incidence to be in the range of 0.15% to 0.54% for temporary paresthesia and a range of 0.0001% to 0.01% for permanent paresthesia. 5 - 8 According to Pogrel and Thamby, 9 there is no statistical difference between the right and left sides when administering a mandibular block, and they also reported a higher incidence of occurrences with the lingual nerve (79%) than with the inferior alveolar nerve (21%). 9 The investigators accounted for this because the mouth is open wide and the lingual nerve is more taut, making the nerve more immobile in the tissue and therefore unable to be deflected by the needle. 9 In 2003, Pogrel 10 studied the lingual nerve in 12 cadavers. Histologically, it was noted that there are from 1 to 8 fascicles making up the lingual nerve. Of the 12 nerves, 4 had only 1 fascicle. It is speculated that a unifascicular nerve may be injured more easily than a multifascicular one. This concept of the unifascicular nerve seems to be the most reasonable explanation for predilection of the lingual nerve compar