[Oral metal foreign bodies]. / Corps étranger métallique de la cavité buccale.

Oral foreign bodies are most encountered in children. They rarely pose diagnostic problems. But the therapeutic management can use the therapeutic escalation from simple extraction chair to extraction per endoscopic under general anesthesia. We report an unusual case of metal foreign body (umbrella's support) penetrating the oral cavity and measuring 18 cm long in a 5 years-old boy. A radiograph of skull centered on the mouth as great interest in the diagnostic and particulary in the management of the metallic foreign body. The extraction of foreign body was done by oral approaches under general anesthesia.

Variation in arterial supply to the floor of the mouth and assessment of relative hemorrhage risk in implant surgery.

OBJECTIVES: Bleeding in the floor of the mouth during implant surgery is attributed to arterial injuries in the sublingual space: clinicians may injure the submental and sublingual arteries, which originate from the facial and lingual arteries, respectively. This study aimed to clarify the three-dimensional courses of submental and sublingual arteries and their topographic relation to the mandible. MATERIALS AND METHODS: During the gross anatomy course at the Faculty of Dentistry and Graduate School, Niigata University (2009-2011), we investigated the relationship between the courses of submental and sublingual arteries and their dividing patterns of the mylohyoid muscle, sublingual gland, and mandible using 27 human cadavers. RESULTS: The courses of submental and sublingual arteries were divided into four patterns: (1) the sublingual space was supplied by the sublingual artery (type I: 63%), (2) it was supplied by both the sublingual and submental arteries (type II: 5.6%), (3) it was supplied by the submental artery without the sublingual artery (type III: 29.6%), and (4) type III without the deep lingual artery originated from the lingual artery (type IV: 1.8%). In type II, III, and IV, the submental artery perforates the mylohyoid muscle or takes a roundabout route to travel near the surface of the mandible. The percentage occurrence of arteries traveling between the sublingual gland and mandible in type II, III, and IV (55%) is higher than that in type I (8.8%). CONCLUSION: Susceptibility of the submental artery in type II, III, and IV to injury during implant surgery is suggested.

A toothbrush impalement injury of the floor of mouth in autism child.

Penetrating injuries in the oral cavity are common in children. However, penetrating injuries with retained foreign bodies are rare. We report a case of a toothbrush impalement injury of the floor of the mouth in a child with autism. A 5-year-old boy with autism presented with an accidentally impaled toothbrush in the oral cavity. He was taken to the operation room and examined under general anesthesia. The handle of the toothbrush was cut off using rib scissors for mask ventilation, and intra-oral intubation was performed. The toothbrush was located approximately 2.5 cm into the floor of the mouth. The toothbrush was removed uneventfully. Intravenous antibiotic therapy was instituted during hospitalization, and discharge from the hospital occurred 4 days after the operation.

Aesthetic and anatomic subunit reconstruction of composite mandibular gunshot wound.

BACKGROUND: Gunshot facial traumas involving the mandible and surrounding soft tissues are represented by the potential for loss of relationships between the functional and the aesthetic subunits of the head. METHODS: A patient presented with an 8-cm composite mandibular defect, resulting from a self-inflicted gunshot injury. Taking into account the anatomic/aesthetic subunits involved, a fibular osseoseptocutaneous flap was transferred to reconstruct the left lateral mandibular segment and the floor of the mouth, whereas a preexpanded temporal scalp flap was transferred to restore the hair-bearing skin of the left buccomandibular subunit. A review of the literature is also presented. RESULTS: A satisfactory functional and aesthetic outcome was achieved. Although current literature supports the value of aesthetic subunit face reconstruction and the use of double flaps for the reconstruction of through-and-through oromandibular defects, there is no previous report of the combined use of temporal scalp flap and fibular osseocutaneous flap. CONCLUSIONS: The combined use of hair-bearing skin and osseocutaneous flap may achieve optimal results in through-and-through oromandibular defects.

Blood collection from the sublingual vein in mice and hamsters: a suitable alternative to retrobulbar technique that provides large volumes and minimizes tissue damage.

Blood examination is a key element in studies of laboratory animals. In rodents, retrobulbar venous plexus puncture is a commonly used method for obtaining a blood sample. Although this technique yields large volumes of blood, the disadvantage is that it can lead to severe tissue damage. The aim of the present study was to develop the puncture of V. sublingualis as a suitable alternative technique for drawing blood in mice and other rodents. In rats, this method has been established for collecting large blood volumes. During the first part of the study, the sublingual bleeding technique was developed for use in mice and hamsters. Guinea pigs, however, do not have a sublingual vein; therefore, in this species the method is not possible. In the second part of the study, retrobulbar and sublingual methods were compared using male CD-1 mice. When compared with the retrobulbar method, sublingual venepuncture showed less tissue destruction in mice, with a decreased mean severity in the histological examination. In conclusion, sublingual venepuncture can be recommended as a suitable, alternative blood collection technique, because of the reduced risk of tissue damage in mice and hamsters.

Management outline of oral and maxillofacial missile injuries in Iraq: the value of the intermediate phase.

Oral and maxillofacial surgeons in Iraq are practicing in a paradoxical situation where a high number of extensive injuries are accompanied by limited resources. Steps of management should be followed cautiously in attempts to reduce residual deformities that characterize the end results of severe missile injuries. This study elucidate lessons extirpated from surgical experience in the management of diversity of causalities with special emphasis on the intermediate phase of management as well as different modalities of treatment, trying to get best benefit from available resources.

Floor of mouth haemorrhage and life-threatening airway obstruction during immediate implant placement in the anterior mandible.

A majority of the procedures performed in the dental office setting are considered safe and minimally invasive. Despite this fact, as healthcare providers it is our responsibility to be able to anticipate, recognize and manage life-threatening emergencies that may occur. In the following report, the authors will describe a life-threatening complication that resulted from the placement of mandibular implants.

Two patterns of impalement injury to the oral cavity: Report of four cases and review of literature.

Impalement injuries to the oral cavity are common, and typically resolve with minimal intervention. We encountered two distinct patterns of injury that required active intervention in four consecutive patients. The first two patients, aged 2 and 7 years, sustained injuries to the floor of mouth and subsequently developed infectious complications necessitating surgical drainage. The other two, aged 4 and 5 years, sustained injuries to the junction of the hard and soft palate, avulsing deep flaps that required repair. Neurovascular complications, despite their rarity have earned maximal discussion in the literature. We feel that traumatic lacerations and infectious complications have far more clinical relevance due to their frequency of occurrence, and should thus occupy a more prominent position in the management flow chart.

Water spout injection into the neck.

Work-related high-pressure injection injuries to the extremities are well publicized, and treatment plans are well established. However, water spout injection injuries to the oral cavity are rare. To our knowledge, there have been no reports of water injection injuries in the oral cavity. We describe one case in which a child suffered an intraoral low-pressure injury to the floor of the mouth, which resulted in water dissection to the neck and subcutaneous tissues. Management and eventual outcome are detailed.

Hemorrhage of the floor of the mouth resulting from lingual perforation during implant placement: a clinical report.

The edentulous mandible provides a frequent indication for oral implants. In many cases implants are placed in the interforaminal region to support fixed prostheses or give retention to removable overdentures. One of the hazards of this seemingly safe surgical area is hemorrhage of the floor of the mouth. In this article, two cases of this life-threatening complication are reported.

Infrahyoid myocutaneous flap in reconstructive maxillofacial cancer and trauma surgery.

We report the use of an island infrahyoid myocutaneous flap, pedicled on the superior thyroid vessels, in a group of 21 patients. This flap allows reconstruction of intraoral defects or defects of the lower portion of the face, as large as 10 x 4 cm. We used it in 15 cases to repair parts of the oral cavity, after tumour resection, in 2 patients with mandibular osteoradionecrosis and in 4 patients with gunshot injuries. Among the 21 flaps, no muscular necrosis was observed; however, 4 total necrosis and 4 partial necrosis (< or = 25% of the skin area) of the skin paddle were recorded. Loss of the skin paddle was primarily attributable to the anatomical variations of the veins draining this flap.

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.

Treatment injuries in dentistry--cases from one year in the Swedish Patient Insurance Scheme.

Eight hundred and fifty-one claims submitted to the Swedish Patient Insurance Scheme were studied and analysed. The most frequent claim referred to root fractures of roots with posts, and to root perforations also related to root posts. Other relatively frequent claims referred to pulpal complications in connection with fixed prosthodontics, root perforations related to endodontic treatment, and dysaesthesia. The mean latency time (the time from the actual treatment to the diagnosis of the injury) was for root fractures 10.6 months, and the mean latency time for root perforations that were not directly observed during preparation was 15.9 months. Pulpal complications of teeth treated with crowns or fixed partial dentures had a mean latency time of 7.6 months. Injuries with a low frequency were, for example, fracture of vital abutments for crowns or fixed partial dentures, damage to tissue by electrosurgery or to the floor of the mouth by drilling, or perforations to the antrum. Two cases of particles dropped into the patient's eye were also reported.

Management of the iatrogenically displaced anterior sublingual floor.

Trauma and neoplasms may be responsible for ablative procedures performed in the anterior mandibular region. This surgery, as well as alveoloplasty, ridge augmentation, and placement of subperiosteal implants, may be responsible for the anterior malpositioning of the floor of the mouth along with its adnexa, which brings Wharton's carunculae directly over the crest of the ridge. A technique has been devised to correct this problem.

Diagnosis, management, and follow-up of extensive dermoid cyst of the submental region

Dermoid cyst (DC) is a cystic lesion of developmental origin and uncertain etiology that rarely affects the floor of the mouth. We report a case of a large lesion found in the submental and submandibular region in a 25-year-old male patient. Computed tomography revealed extensive hypodense lesion in the submental and submandibular space without peripheral enhancement. The microscopical analysis showed a cystic cavity lined by orthokeratinized stratified squamous epithelium. The cystic capsule was composed of dense fibrous connective tissue containing cutaneous attachments, such as sebaceous and sweat glands. The diagnosis of DC was made. The differential diagnosis of expansive sublingual lesions can be clinically challenging due to the similarity with several lesions frequently observed in this region. Herein, we describe a case of extensive DC arising in the floor of the mouth, presenting clinical, imaging, and microscopical features.

Cinco años de seguimiento de tratamiento no invasivo para lesiones auto-infligidas en un niño con parálisis cerebral / Five year follow-up of non-invasive treatment for self-inflicted oral trauma in a child with cerebral palsy

ABSTRACT Introduction: Cerebral palsy involves loss or impairment of motor function attributed to non-progressive disturbances occurring in the developing fetal or infant brain. Self-inflicted oral trauma is a recurrent parafunctional habit in individuals with cerebral palsy. Objective: Describe two treatment modes for self-inflicted oral trauma in a 6-year-old male patient with cerebral palsy over a 5-year follow-up period. Case presentation: The child had been having pain due to injuries to the mouth floor and lingual frenum regions. Initially, low-level laser therapy was applied to accelerate the healing process of the wounds. Five years later, the child started to present worse oral injuries and placement of a fixed oral appliance was proposed. Intraoral examination showed that the wounds had healed completely in response to the oral appliance. Conclusions: Different therapies may be useful to control the recurrence of self-inflicted oral injuries(AU)

RESUMEN Introducción: La parálisis cerebral provoca una pérdida o deterioro de la función motora atribuida a trastornos no progresivos del desarrollo cerebral fetal o infantil. La lesión autoinfligida es un hábito parafuncional recurrente en personas con parálisis cerebral. Objetivo: Describir dos modalidades de tratamiento para las lesiones autoinfligidas en un niño de 6 años de edad con parálisis cerebral durante un periodo de seguimiento de 5 años. Presentación del caso: El niño presentaba dolor debido a lesiones en la región del suelo de la boca y el frenillo lingual. Inicialmente se aplicó terapia con láser de baja intensidad para acelerar el proceso de cicatrización de las heridas. Cinco años más tarde el niño empezó a presentar lesiones bucales más severas, por lo que se propuso la colocación de un dispositivo oral fijo. El examen intraoral mostró que las lesiones habían cicatrizado completamente en respuesta al dispositivo oral instalado. Conclusiones: Diferentes terapias pueden ser útiles para controlar la recurrencia de las lesiones orales autoinfligidas(AU)

Epidemiology of maxillofacial injury in children under 15 years of age in southern China.

OBJECTIVE: This retrospective study was conducted to report the epidemiology of maxillofacial injuries of children <15 years old in China. STUDY DESIGN: Data collected in this study included age, sex, etiology, date of injury, anatomic site of injury, and treatment modality. Regarding treatment, conservative technique and surgery were both used. The analyses involved were descriptive statistics and χ(2) test. RESULTS: There were 335 men and 135 women, with a gender ratio of 2.48:1. Bicycle accident was the leading cause of injury. The common sites of soft tissue injury included gingiva, chin, lip, cheek, palate/pharynx, and tongue/mouth floor. In addition, the mandible was most involved in facial skeleton injury. Conservative treatment was generally preferred for such pediatric patients. CONCLUSIONS: Boys were prone to be victims of maxillofacial trauma. Preventive measures should be applied both indoors and outdoors. Patients in the growing phase should be monitored periodically to detect and prevent early facial asymmetry or malocclusion.

Don't hang your coat here.

Report 2 cases of coat hanger floor of mouth injuries in children. We describe 2 cases of children who presented with coat hanger impalement injuries of the floor of mouth and their management. Removal under anesthesia is safe with a period of observation postoperatively. Impalement injury with coat hangers in the head and neck is a rarely encountered or described mechanism of trauma. We report the first case series of coat hanger impalement injuries in the floor of mouth in two children. Plain film radiographs may be useful to determine the depth of injury and trajectory of the foreign body. Careful removal under anesthesia is safe. Little if any floor of mouth edema was encountered postoperatively, but close observation for potential critical floor of mouth hematoma or edema should be considered.