Morbidity from anterior iliac crest bone harvesting for secondary alveolar bone grafting: an outcome assessment study.

PURPOSE: To determine the postoperative morbidity of harvesting cancellous bone from the anterior iliac crest for treating secondary cleft alveolus patients. PATIENTS AND METHODS: Twenty-four patients treated for alveolar clefts in the Oral and Maxillofacial Surgery unit at the Jordan University Hospital were included. Medical notes were reviewed for intraoperative and postoperative complications; patients were interviewed to fill a questionnaire on postoperative recovery. The donor site was evaluated for the following factors: chronic pain, neurapraxia of the lateral femoral cutaneous nerve, abnormal gait, altered sensation over the scar, skin tenderness, bone tenderness, deformity of the bony contour, and scar length and width were measured. RESULTS: Age at the time of surgery was 14.0+/-4.1 years (mean +/- SD), and follow-up was 23.2+/-19.3 months. Patients spent a median of 3 days in hospital (range=2-4 days), patients walked normally after 10.4+/-13.2 days and resumed normal activities, including sports, after a mean of 16.0+/-19.6 days. Two patients had neurapraxia of the lateral femoral cutaneous nerve (8%), 2 reported mild residual scar tenderness (8%) and 1 of the latter complained of tenderness on palpating the iliac crest (4%). CONCLUSIONS: Harvesting cancellous bone from the anterior iliac crest in young patients is well-tolerated, allows early resumption of normal activities, has no effect on growth, has minimal morbidity, and a reasonable esthetic outcome.

Frequency estimates and risk factors for postoperative morbidity after third molar removal: a prospective cohort study.

PURPOSE: The aim of this study was to estimate the frequency of postoperative complications after mandibular third molar (M3) surgery and identify the risk indicators. PATIENTS AND METHODS: This was a prospective cohort study of a sample of subjects having at least 1 mandibular M3 surgically extracted at a teaching hospital in Jordan. The predictor variables were categorized as patient, anatomic, and operative specific. The outcome variables were postoperative complications recorded as present or absent. Bivariate analyses were computed, then a multivariate logistic regression model was used to identify independent predictors for the common postoperative complications. RESULTS: The study sample was comprised of 149 patients who had 245 extractions. The mean age was 21.6 +/- 3.32 years; 64.9% were females. In the multivariate logistic regression model, age (P = .033, odds ratio [OR] = 1.178), M3 side in relation to the handedness of the operator (P = .048, OR = 4.078), and lingual retraction (P = .001, OR = 11.293) were the variables found as independent predictors for alveolar osteitis. The level of impaction had a significant association with trismus, and operation time acted as an independent predictor for pain (P < .001, OR = 1.085). CONCLUSION: Postoperative morbidity increases with older age, deeper impaction, M3 side differing from the handedness of the operator, and longer procedures.

Cholesterol granuloma of the maxillary sinus encountered during floor augmentation procedure: A case report.

BACKGROUND: Cholesterol granuloma (CG) is a foreign-body reaction to the deposition of cholesterol crystals. Its occurrence in the paranasal sinuses is very rare. PURPOSE: This report describes a new case of maxillary sinus CG discovered incidentally during sinus-floor augmentation for dental implant placement in a 60-year-old female patient. MATERIALS AND METHODS: The preoperative clinical and radiological examinations revealed a normal maxillary antrum with no evidence of sinus pathology. After lateral osteotomy, a dark-green, viscous soft tissue mass appeared through the thin mucous membrane inside the sinus. Enucleation and curettage of the sinus contents including the sinus membrane were performed for histopathologic analysis. The augmentation and implant placement procedures were postponed. RESULTS: Histopathologic analysis showed several fragments of granulation tissue containing diffuse cholesterol clefts surrounded by mixed chronic inflammatory cell infiltrate including plasma cells and lymphocytes. These features were compatible with the diagnosis of CG. The patient was followed up for 3 months after the first procedure, and a second attempt of sinus augmentation and dental implant insertion was then carried out. The inserted dental implants were followed up for 6 months without any complications. CONCLUSIONS: CG of maxillary sinus can be an incidental finding. For this reason, the final diagnosis can only be achieved after examination of the material under the microscope.