Oral Maxillofac Surg Clin North Am
· 2023 May · PMID 37019507
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Although acute immune-mediated lesions of the oral cavity (AIML) can have an onset over several months, they often demonstrate rapid onset and can be self-limited. Despite the self-limiting nature of some disorders, pati...Although acute immune-mediated lesions of the oral cavity (AIML) can have an onset over several months, they often demonstrate rapid onset and can be self-limited. Despite the self-limiting nature of some disorders, patients with AIML can have significant pain and multisystem involvement. It is vital for the oral health care provider to arrive at the proper diagnosis with distinction from overlapping conditions, as the oral manifestations may be harbingers of more serious systemic complications.
Oral Maxillofac Surg Clin North Am
· 2023 May · PMID 37019506
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White lesions in the oral cavity may be diverse in etiology and may present with significant clinical and sometimes histologic overlap between categories, making accurate diagnosis difficult at times. Although white lesi...White lesions in the oral cavity may be diverse in etiology and may present with significant clinical and sometimes histologic overlap between categories, making accurate diagnosis difficult at times. Although white lesions of immune and infectious etiology are covered in another article, this article discusses the differential diagnosis between developmental, reactive, idiopathic, premalignant, and malignant white lesions focusing on clinical features of each category.
Oral Maxillofac Surg Clin North Am
· 2023 May · PMID 37019505
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Several dermatological conditions may manifest in the oral cavity, particularly those that are immune-mediated, and they must be distinguished from the various other types of oral ulcerations. This chapter discusses the...Several dermatological conditions may manifest in the oral cavity, particularly those that are immune-mediated, and they must be distinguished from the various other types of oral ulcerations. This chapter discusses the clinical features, pathogenesis, differential diagnosis, and diagnostic features, including histology and immunofluorescence findings, as well as management of vesiculobullous diseases. These diseases include pemphigus Vulgaris, benign mucous membrane pemphigoid, bullous pemphigoid, and epidermolysis bullosa acquisita. These diseases have a significant impact on the quality of life, as they can lead to serious complications, depending on the extent of the disease. Therefore, early recognition is crucial, helping to reduce disease-related morbidity, mortality and prevent life-threatening complications.
Oral Maxillofac Surg Clin North Am
· 2023 May · PMID 37019504
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The human herpesvirus (HHV) family is a group of enveloped DNA viruses containing 8 members known to produce oral mucosal lesions. Following initial exposure, which may result in symptomatic primary infection, the viruse...The human herpesvirus (HHV) family is a group of enveloped DNA viruses containing 8 members known to produce oral mucosal lesions. Following initial exposure, which may result in symptomatic primary infection, the viruses establish latency within specific cells/tissues. After reactivation, herpesviruses can cause localized symptomatic or asymptomatic recurrent (secondary) infections or diseases. HHV may have a significant role in the cause of oral mucosal infectious diseases in immunocompromised patients. This article discusses the role of those herpesviruses that can induce oral mucosal lesions, with focus on the clinical features and treatment/management.
Oral Maxillofac Surg Clin North Am
· 2023 May · PMID 37019503
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Nonodontogenic bacterial infections of the oral cavity are not a common finding in the United States. Nevertheless, there has been an increase in prevalence of certain bacterial sexually transmitted diseases, such as syp...Nonodontogenic bacterial infections of the oral cavity are not a common finding in the United States. Nevertheless, there has been an increase in prevalence of certain bacterial sexually transmitted diseases, such as syphilis and gonorrhea, and conditions such as tuberculosis still pose a serious threat to certain segments of the population. Finally, given the uncommon nature and pathophysiology of these diseases, diagnosis is often delayed, resulting in more clinically significant disease and potential contamination of individuals. Thus, it is prudent that clinicians be familiar with these uncommon but potentially serious infectious diseases, so treatment can be instituted promptly.
Oral Maxillofac Surg Clin North Am
· 2023 May · PMID 37019502
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Pigmented lesions are a common finding in the oral cavity. Oral pigmented lesions may range from solitary to multiple, pinpoint to diffuse, and have a variety of clinical implications. Nearly all solitary pigmented lesio...Pigmented lesions are a common finding in the oral cavity. Oral pigmented lesions may range from solitary to multiple, pinpoint to diffuse, and have a variety of clinical implications. Nearly all solitary pigmented lesions require a biopsy to rule out mucosal melanoma. Oral mucosal melanoma has a grim prognosis and early discovery is of utmost importance. Multiple pigmented lesions in the oral cavity may indicate a systemic condition about which the patient may not be aware. The presentation and management of these various lesions is the focus of this article.
Oral Maxillofac Surg Clin North Am
· 2023 Aug · PMID 37005171
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Proton therapy (PT) is a form of highly conformal external-beam radiotherapy used to mitigate acute and late effects following radiotherapy. Indications for treatment include both benign and malignant skull-base and cent...Proton therapy (PT) is a form of highly conformal external-beam radiotherapy used to mitigate acute and late effects following radiotherapy. Indications for treatment include both benign and malignant skull-base and central nervous system pathologies. Studies have demonstrated that PT shows promising results in minimizing neurocognitive decline and reducing second malignancies with low rates of central nervous system necrosis. Future directions and advances in biologic optimization may provide additional benefits beyond the physical properties of particle dosimetry.
Hsieh KJ, Addae-Mensah K, Alrohaibani Y
… +2 more, Goad A, Learned K
Oral Maxillofac Surg Clin North Am
· 2023 Aug · PMID 37005170
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Perineural tumor spread (PNS) is a well-recognized entity in head and neck cancers and represents a mode of metastasis along nerves. The trigeminal and facial nerves are most affected by PNS, and their connections are re...Perineural tumor spread (PNS) is a well-recognized entity in head and neck cancers and represents a mode of metastasis along nerves. The trigeminal and facial nerves are most affected by PNS, and their connections are reviewed. MRI is the most sensitive modality for detecting PNS, and their anatomy and interconnections are reviewed. MRI is the most sensitive modality for detecting PNS, and imaging features of PNS and important imaging checkpoints are reviewed. Optimal imaging protocol and techniques are summarized as well as other entities that can mimic PNS.
Oral Maxillofac Surg Clin North Am
· 2023 May · PMID 36805904
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Oral fungal infections are opportunistic and due to impaired host resistance. The increasing number of immunosuppressed individuals contributes to rising numbers of mycoses worldwide, and the ease of global migration has...Oral fungal infections are opportunistic and due to impaired host resistance. The increasing number of immunosuppressed individuals contributes to rising numbers of mycoses worldwide, and the ease of global migration has allowed the geographic range of endemic mycoses to expand. Deep fungal infections can clinically mimic other pathologic conditions including malignancy. This review highlights the pathogenesis, clinical features, diagnosis, and treatment recommendations of eight fungal infections that can be encountered in the dental setting.
Oral Maxillofac Surg Clin North Am
· 2023 May · PMID 36805903
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Ulcerated and inflammatory lesions of the oral mucosa are not rare. A detailed patient medical and social history including habits and abuses, as well as the duration, location, focality and presence, or lack of local an...Ulcerated and inflammatory lesions of the oral mucosa are not rare. A detailed patient medical and social history including habits and abuses, as well as the duration, location, focality and presence, or lack of local and/or systemic symptoms is critical in establishing a proper diagnosis. This article discusses the clinical presentation, management, and histopathologic characteristics of a variety of ulcerative and inflammatory lesions seen in the oral cavity.
Oral Maxillofac Surg Clin North Am
· 2023 May · PMID 36805902
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Plasma cell gingivitis (PCG) is an inflammatory condition that affects the gingival mucosa of the oral cavity. It is characterized by polyclonal dense plasma cell infiltrate in the connective tissue. Lesions do not respo...Plasma cell gingivitis (PCG) is an inflammatory condition that affects the gingival mucosa of the oral cavity. It is characterized by polyclonal dense plasma cell infiltrate in the connective tissue. Lesions do not respond to prophylactic treatment. Etiology is most likely hypersensitivity to certain antigens (eg, toothpastes, oral rinses, chewing gums, spices). Differential diagnosis of PCG includes reactive, granulomatous, and neoplastic lesions. The diagnostic workup is based on patient's history and the clinicopathologic correlation to rule out mimics of PCG. Dermatologic patch test may be indicated in chronic conditions to identify the allergen.
Oral Maxillofac Surg Clin North Am
· 2023 May · PMID 36805901
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Oral manifestations may be the first sign of a systemic disease, or represent lesions associated with an established or recurrent disease. Oral health care providers are often the first to recognize these signs. Some les...Oral manifestations may be the first sign of a systemic disease, or represent lesions associated with an established or recurrent disease. Oral health care providers are often the first to recognize these signs. Some lesions have characteristic features that allow for early detection and intervention. On the contrary, clinical manifestations may be diverse and require a comprehensive evaluation to establish a definitive diagnosis. This article reviews the oral manifestations of select systemic diseases to help clinicians develop a differential diagnosis that leads to early diagnosis and timely intervention.
Oral Maxillofac Surg Clin North Am
· 2023 May · PMID 36805899
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Lichenoid lesions involving the oral cavity present with an array of complex clinical manifestations and etiologies. The etiology ranges from local factors, systemic entities, and even autoimmune conditions. Several diff...Lichenoid lesions involving the oral cavity present with an array of complex clinical manifestations and etiologies. The etiology ranges from local factors, systemic entities, and even autoimmune conditions. Several different types of lichenoid lesions may affect the oral cavity, and it is imperative that these are correctly diagnosed to ensure effective patient care. Lichenoid lesions such as chronic ulcerative stomatitis prove to be challenging as these are recalcitrant, present with overlapping features, require unique treatment and patients suffer a long time if not promptly diagnosed.
Oral Maxillofac Surg Clin North Am
· 2023 Feb · PMID 36336603
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Changing the facial appearance with facial contouring surgery is popular, especially in East Asian countries where a square face is a common chief complaint. Mandibular angle reduction, malar reduction, genioplasty, and...Changing the facial appearance with facial contouring surgery is popular, especially in East Asian countries where a square face is a common chief complaint. Mandibular angle reduction, malar reduction, genioplasty, and chin and body contouring surgery can be performed as independent or ancillary procedures during orthognathic surgery. Many techniques have been developed and different osteotomy designs have been proposed to enhance outcomes and minimize complication risks. Here, we review the surgical techniques and considerations for mandibular angle and malar reduction, the two most commonly performed contouring surgeries in East Asia to correct the square face.
Oral Maxillofac Surg Clin North Am
· 2023 Feb · PMID 36336602
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An important aesthetic goal in orthognathic planning is to improve facial balance, harmony, volume, and symmetry. It is therefore logical that adjunctive aesthetic procedures become a part of the overall orthognathic tre...An important aesthetic goal in orthognathic planning is to improve facial balance, harmony, volume, and symmetry. It is therefore logical that adjunctive aesthetic procedures become a part of the overall orthognathic treatment plan and that their possibilities are discussed with orthognathic candidates. Such procedures help to improve the final outcome of the orthognathic treatment and enhance patient satisfaction. Training and experience are of utmost importance when offering and performing aesthetic facial surgery. This article discusses various facial aesthetic procedures that can be combined with orthognathic surgery, to the patient's benefit, to help them become the most beautiful version of themselves.
Oral Maxillofac Surg Clin North Am
· 2023 Feb · PMID 36336601
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Currently, the wish to optimize facial esthetics-in the context of a dysfunctional occlusion or not-has become the main motivation for orthognathic surgery in many cases. In this context, considering that protrusive face...Currently, the wish to optimize facial esthetics-in the context of a dysfunctional occlusion or not-has become the main motivation for orthognathic surgery in many cases. In this context, considering that protrusive faces are advised more attractive and that the lack of skeletal support accelerates the aging process, orthognathic surgery will mostly involve a forward movement of the maxillamandibular complex..
Oral Maxillofac Surg Clin North Am
· 2023 Feb · PMID 36336600
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Bimaxillary protrusion is a unique dentofacial deformity trait that can exist in an individual as an isolated problem or in combination with other skeletal and dental-related issues. Orthodontist and oral and maxillofaci...Bimaxillary protrusion is a unique dentofacial deformity trait that can exist in an individual as an isolated problem or in combination with other skeletal and dental-related issues. Orthodontist and oral and maxillofacial surgeons are often the main primary team involved in the management of bimaxillary protrusion. Clinical dilemma often exists as cases can either be treated orthodontically or may require a combination of orthodontic and skeletal segmental orthognathic surgery. This article aims to help clinicians improve their approach to management of bimaxillary protrusion by creating a classification based on the severity that can guide treatment selection.
Ramanathan M, Panneerselvam E, Parameswaran A
… +1 more, Kanno T
Oral Maxillofac Surg Clin North Am
· 2023 Feb · PMID 36336599
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In contemporary orthognathic surgery planning, the genium/chin constitutes an important part that contributes to the maxillofacial profile. The aesthetics of the lower face is affected by the position of the genium which...In contemporary orthognathic surgery planning, the genium/chin constitutes an important part that contributes to the maxillofacial profile. The aesthetics of the lower face is affected by the position of the genium which makes reestablishment of genial morphology an essential component. It is hence necessary to evaluate the genium objectively on its individual merit, and any discrepancy is addressed accordingly. This review presents an overview of contemporary genioplasty techniques, their applications, and considerations on stability, osteosynthesis, complications, and the future developments.
Oral Maxillofac Surg Clin North Am
· 2023 Feb · PMID 36336598
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Orthognathic surgery is a well-recognized method to correct dentofacial deformities. The main goal of orthognathic surgery is to improve soft tissue change. Soft tissue changes to the nose have been well documented. Simu...Orthognathic surgery is a well-recognized method to correct dentofacial deformities. The main goal of orthognathic surgery is to improve soft tissue change. Soft tissue changes to the nose have been well documented. Simultaneous rhinoplasty during orthognathic surgery can be performed to correct existing inherent nasal deformities and also the unfavorable changes that arose from the maxillary surgery. Challenges for concurrent nasal surgery with jaw surgery include preoperative, perioperative, and postoperative which can be overcome with meticulous planning and experience. In complex cases, rhinoplasty can be staged in the last 6 months after the orthognathic surgery.