Surveillance of the use of adrenaline auto-injectors in Japanese children

Publication date: Available online 4 August 2017
Source:Allergology International
Author(s): Komei Ito, Manabu Ono, Naoyuki Kando, Teruaki Matsui, Tomoko Nakagawa, Shiro Sugiura, Motohiro Ebisawa
BackgroundThe appropriate usage of an adrenaline auto-injector (AAI, Epipen^®) is a key aspect of patient and social education in the management of anaphylaxis. However, although AAIs are being prescribed increasingly frequently, there are few reports on their actual use.MethodsThe Anaphylaxis Working Group of the Japanese Society of Pediatric Allergy and Clinical Immunology requested that society members register cases in which AAIs were used. Two hundred and sixty-six cases were collected from March 2014 to March 2016.ResultsThe cases included 240 events of immediate-type food allergies caused by cow's milk (n = 100), hen's egg (n = 42), wheat (n = 40), and peanuts (n = 11). Exercise-related events were reported in 19 cases; however, the diagnosis of food-dependent exercise-induced anaphylaxis with a specific causative food was only made in 4 cases (wheat, n = 2; fish, n = 1; squid, n = 1). The frequent reasons for the causative intake included programmed intake (n = 48), failure to check the food labeling (n = 43), and consuming an inappropriate food (n = 26). AAIs were used at schools or nurseries in 67 cases, with school or nursery staff members administering the AAI in 39 cases (58%). On arriving at the hospital, the symptom grade was improved in 71% of the cases, while grade 4 symptoms remained in 20% of the cases. No lethal cases or sequelae were reported.ConclusionsAAIs were used effectively, even by school teachers. The need to visit a hospital after the use of an AAI should be emphasized because additional treatment might be required.



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A new indication for barbed threads: static reanimation of the paralyzed face

Publication date: Available online 5 August 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Victor Vlad Costan, Eugenia Popescu, Daniela Sulea, Ioan Sorin Stratulat
PurposeThe objective of this study is to present our experience in the area of static facial reanimation using a straightforward incisionless procedure adapted from techniques commonly used for performing minimally invasive face-lifts.MethodsA total of 17 patients were treated by static suspension using barbed sutures and all the resulting changes were reviewed. The technique used for suture placement is described in detail, as are the author's tips for achieving the best aesthetic and functional results. All patients had preoperative indication for physiotherapy and rehabilitation procedures (local massage and mirror therapy). Facial nerve function was evaluated using the Arianna Disease Scale (ADS).ResultsThe cosmetic outcome improved in all cases, with significant amelioration of the preoperative facial asymmetry. Oral competence was enhanced by elevating the oral commissure and reinforcing the cheek, while a reduction of the symptoms related to lagophthalmos was achieved through increased support and decreased pull on the inferior eyelid. The addition of physiotherapy procedures with specific rehabilitation exercises before the surgical intervention increased the success rate.ConclusionThis technique proved to be a good alternative to other static reanimation procedures due to its straightforward technique, availability, good outcomes, low complication rate and ability to perform minor adjustments and corrections at any time.



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How Accurate are Implant Surgical Guides Produced with Desktop Stereolithographic 3D-printers?

Publication date: Available online 5 August 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): George R. Deeb, Riley K. Allen, V. Patrick Hall, Daniel Whitley, Daniel M. Laskin, Sompop Bencharit
IntroductionThe use of tooth-supported static stereolithographic guides has greatly improved the ability to ideally place implants. This study was designed to determine the accuracy of in office-printed implant surgical guides.Materials and MethodsUsing 3shape Implant Studio, a treatment plan for #8 implant placement was made using digital intraoral scan from a Trios scanner and cone-beam computed tomography (CBCT). Ten stereolithographic guides were printed using a Form2 3D printer. Pre- and post-implant insertion digital scans were used to determine distance and angulation differences in mesiodistal and faciolingual position of the implants compared to the planned position.ResultsThe mean difference in mesiodistal direction at the alveolar crest between planned implants and placed implants was 0.28 mm (range 0.05-0.62mm) and the difference in the faciolingual direction was 0 .49 mm (range 0.08-0.72mm). The mean mesiodistal angulation deviation was 0.84 degrees (range 0.08-4.48) and the mean faciolingual angulation deviation was 3.37 degrees (range 1.12-6.43).ConclusionsIn-office fabricated stereolithographic implant surgical guides demonstrate similar accuracy to laboratory or manufacturer prepared guides. This technique provides a convenient and cost-effective means of assuring proper implant placement.



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Is SSND safer than SOHND for oral carcinoma patients with N0 neck in terms of shoulder morbidity and recurrence rate?

Publication date: Available online 5 August 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Sanjay Rastogi, Ashish Sharma, Rupshikha Choudhury, Siddhi Tripathi, Hessa Al Wayli, Anand Amrithraj A, Mahendra P. Reddy
AimTo estimate the clinical and functional results of patients who experienced distinctive varieties of neck dissection, with particular consideration to the shoulder function, rate of recurrence, and quality of life in N0 neck patients.Material and MethodA randomized clinical trial was conducted from August 2014 to March 2017 in which 20 adult patients with T1 to T3 lesions of the oral cavity with N0 neck were included. The subjects were randomly allocated to either Group I (10, selective neck dissection) or Group II (10, super-selective neck dissection). All patients were evaluated objectively for degree of abduction of the arm and subjectively for quality of life in the form of questionnaire both pre and post operatively for 6 months. Also, loco-regional recurrence was investigated for 2.5 years. The data was scrutinized by applying mean standard deviation, unpaired T- test and Mann Whitney U test and Kaplan-Meier test.ResultThe mean values of arm abduction test and quality of life were statistically significant (p<.05) in super selective neck dissection i.e. group II as compared to selective neck dissection i.e. group I at all-time intervals. The data analyzed for loco-regional recurrence revealed that that there was a statistical notable differentiation found amid both the groups (p<0.05) i.e. group II has better outcome.ConclusionThe results depict less shoulder morbidity and improved quality of life for Super selective neck dissection (group II) compared to Selective neck dissection (group I). Furthermore, the group II is better in terms of loco-regional recurrence which determines the oncologic safety of the procedure.



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Does guided bone regeneration prevents unfavurable bone shape in distraction gap ?

Publication date: Available online 5 August 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Umut Demetoglu, Alper Alkan., Erdem Kiliç, Mustafa Ozturk, Suheyb Bilge
PurposeComplications related to distraction osteogenesis may cause the degradation of newly regenerated bone. Additionally, an unfavorable shape of regenerated bone at the distraction gap can reduce the quantity of regenerated bone. The aim of this study was to prevent unfavorable shapes of regenerated bone with guided bone regeneration during distraction.Materials and methodsBilateral alveolar distraction was performed in 10 beagle dog mandibles. One side of the mandibles formed the experimental group and the other side served as the control group. In the experimental group, guided bone regeneration was performed simultaneously with distraction osteogenesis. In the control group, only alveolar distraction was applied. At the end of a 1-week latent period, all mandibles were distracted 10 mm (1 mm/d), and 3 months were then allowed for consolidation. After consolidation, all animals were sacrificed and the shape of regenerated bone was determined to be favorable or unfavorable. Densitometric evaluation and area measurements were performed with computed tomography. Statistical evaluation was performed using the independent t-test, with a significance level of p < 0.05.ResultsIn the experimental group, there was no unfavorable bone shape in the distraction gap and the new bone had similar surface and volume as the segments, whereas in the control group, four subjects had unfavorable bone shape in the distraction gap, and the other four subjects showed favorable bone healing with no defect. The surface area of the regenerating bone in the experimental group was significantly higher than that in the control group. Surface area differed significantly between the experimental and control groups (p < 0.05). Densitometric values did not differ between groups (p < 0.05).ConclusionsConcomitant use of guided bone regeneration with distraction osteogenesis may be considered an optimal way to generate a favorable bone shape within the distraction gap.



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Subcutaneous lipoatrophy and skin depigmentation, secondary to a TMJ intra-articular injection of corticosteroids

Publication date: Available online 5 August 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Nicolás Patricio Skármeta P, Fernando Ariel Hormazábal N, Juan Alvarado, Ana Maria Rodriguez
BackgroundChronic orofacial pain is a complex multidimensional experience that produces disability and impairment of normal mandibular functions. Overall estimations of chronic orofacial pain prevalence are between 7-11% of the general population. Temporomandibular disorders (TMD) are one of the most prevalent chronic orofacial pain conditions, as temporomandibular joint (TMJ) arthralgia accounted for 30.1% of TMD patients. Interventional procedures are often used in pain and palliative medicine to achieve reasonable and cost-effective pain relief. The use of intra-articular corticosteroids in relieving arthralgia and improving joint function is well documented.Case DescriptionThe authors will present a clinical case of an 84-year-old female patient who was derived to Hospital del Salvador Orofacial Pain service with preauricular pain, limited range of movement, provoked pain at palpation, and function in the preauricular region. The patient was diagnosed, following DC/TMD criteria, with left TMJ arthralgia and degenerative joint disease, which was later corroborated with a CBCT scan. An intra-articular injection of 10mg of methylprednisolone was programmed, and the patient underwent the procedure, according to Hospital del Salvador's intraarticular injection protocol. The intervention underwent without any inconvenience. At the three-week control, the authors noticed that the patient presented a depigmented depression zone adjacent to the site of injection. After doing an echotomography, the authors concluded that the patient presented a skin depigmentation and subcutaneous lipoatrophy that were consecutive to the intra-articular injection of methylprednisolone. To our knowledge, this is the first time that this complication is ever-reported secondary to an interventional procedure in the TMJ.ConclusionsClinicians should be aware and patients must be advised of this rare complication before performing an intra-articular intervention.



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Plasma cell granuloma of the jaw and the infratemporal fossa: a clinical case

Publication date: Available online 5 August 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): A. Vahedi, A. Moya–Plana, S. Guyot, G. Touré
IntroductionPlasma cell granuloma or inflammatory pseudotumour (IPT) is diagnosed by a process of elimination. The precise etiology is unknown, although it can occur following a bout of periodontal infection. Our observation presents the various stages of progression for this ailment.ObservationA 49-year-old female patient without any significant prior medical history presented with a recurrent periodontal abscess accompanied by progressive and severe destruction of the right maxilla. There was invasion of the infratemporal fossa and very tight trismus. Histological examination concluded it was a reactive plasma cell granuloma.DiscussionIPT is an entity recognized by the World Health Organization (WHO). A triggering infectious or inflammatory factor is often present. In the maxilla, progression is very aggressive. Treatment relies on corticotherapy, with or without radiotherapy, and administration of cyclosporine.



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