Inferior alveolar nerve damage secondary to orthodontic treatment: A systematic scoping review

2021 ◽  
pp. 1-17
Author(s):  
Ahmad M. AlAli ◽  
Talal H. AlAnzi
Keyword(s):  
Orthodontic Treatment ◽  
Case Reports ◽  
Treatment Plan ◽  
Inferior Alveolar Nerve ◽  
Common Complication ◽  
Pharmacological Management ◽  
Electronic Search ◽  
Close Proximity ◽  
Bite Plate ◽  
Risk Patients

BACKGROUND: Neurosensory impairment is a common complication following inferior alveolar nerve (IAN) damage. OBJECTIVE: To document and report the various causes, diagnosis, and management of IAN damage secondary to orthodontic treatment. METHODS: An electronic search for studies that reported IAN damage in patients undergoing orthodontic treatment was performed up to July 15, 2020 using MEDLINE, EMBASE, and PubMed databases. Descriptive analyses and linear regression model were performed. RESULTS: A total of 15 case reports were identified including 16 patients with an overall mean age of 23.3. All the included studies reported temporary sensory alterations which manifested as anesthesia (19%, n = 3), paresthesia (75%, n = 12), or combined (6%, n = 1). The majority of cases managed by stopping the orthodontic force (75%, n = 12), followed by appliance adjustments (19%, n = 3), providing a bite plate (13%, n = 2), and/or providing pharmacological management (38%, n = 6). Full recovery median duration reported in all cases following the aforementioned managements was 17.5 days. CONCLUSIONS: IAN damage secondary to orthodontic treatment is emerging in the literature in recent years. Identifying high risk patients with close proximity to the IAN canal is a must to formulate a proper treatment plan to avoid such complications.

scholarly journals Cephalad misplacement of a pulmonary artery catheter in a patient with a preexisting Hickman catheter

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hoon Choi ◽  
Joon Pyo Jeon ◽  
Jaewon Huh ◽  
Youme Kim ◽  
Wonjung Hwang
Keyword(s):  
Mitral Valve ◽  
Pulmonary Artery ◽  
Pulmonary Artery Catheter ◽  
Case Reports ◽  
Mitral Valve Regurgitation ◽  
Catheter Insertion ◽  
Routine Practice ◽  
Hickman Catheter ◽  
Risk Patients ◽  
The Right

Abstract Background Pulmonary artery catheter insertion is a routine practice in high-risk patients undergoing cardiac surgery. However, pulmonary artery catheter insertion is associated with numerous complications that can be devastating to the patient. Incorrect placement is an overlooked complication with few case reports to date. Case presentation An 18-year-old male patient underwent elective mitral valve replacement due to severe mitral valve regurgitation. The patient had a history of synovial sarcoma, and Hickman catheter had been inserted in the right internal jugular vein for systemic chemotherapy. We made multiple attempts to position the pulmonary artery catheter in the correct position but failed. A chest radiography revealed that the pulmonary artery catheter was bent and pointed in the cephalad direction. Removal of the pulmonary artery catheter was successful, and the patient was discharged 10 days after the surgery without complications. Conclusions To prevent misplacement of the PAC, clinicians should be aware of multiple risk factors in difficult PAC placement, and be prepared to utilize adjunctive methods, such as TEE and fluoroscopy.

scholarly journals The effects of a preoperative multidisciplinary conference on outcomes for high-risk patients with challenging surgical treatment options: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masayoshi Koike ◽  
Mie Yoshimura ◽  
Yasushi Mio ◽  
Shoichi Uezono
Keyword(s):  
Patient Safety ◽  
Retrospective Study ◽  
High Risk ◽  
Treatment Plan ◽  
Treatment Options ◽  
High Risk Patients ◽  
Appropriate Treatment ◽  
Risk Patients ◽  
Treatment Plans ◽  
Multidisciplinary Conference

Abstract Background Surgical options for patients vary with age and comorbidities, advances in medical technology and patients’ wishes. This complexity can make it difficult for surgeons to determine appropriate treatment plans independently. At our institution, final decisions regarding treatment for patients are made at multidisciplinary meetings, termed High-Risk Conferences, led by the Patient Safety Committee. Methods In this retrospective study, we assessed the reasons for convening High-Risk Conferences, the final decisions made and treatment outcomes using conference records and patient medical records for conferences conducted at our institution from April 2010 to March 2018. Results A total of 410 High-Risk Conferences were conducted for 406 patients during the study period. The department with the most conferences was cardiovascular surgery (24%), and the reasons for convening conferences included the presence of severe comorbidities (51%), highly difficult surgeries (41%) and nonmedical/personal issues (8%). Treatment changes were made for 49 patients (12%), including surgical modifications for 20 patients and surgery cancellation for 29. The most common surgical modification was procedure reduction (16 patients); 4 deaths were reported. Follow-up was available for 21 patients for whom surgery was cancelled, with 11 deaths reported. Conclusions Given that some change to the treatment plan was made for 12% of the patients discussed at the High-Risk Conferences, we conclude that participants of these conferences did not always agree with the original surgical plan and that the multidisciplinary decision-making process of the conferences served to allow for modifications. Many of the modifications involved reductions in procedures to reflect a more conservative approach, which might have decreased perioperative mortality and the incidence of complications as well as unnecessary surgeries. High-risk patients have complex issues, and it is difficult to verify statistically whether outcomes are associated with changes in course of treatment. Nevertheless, these conferences might be useful from a patient safety perspective and minimize the potential for legal disputes.

Orthodontic Conundrums Part 3: Indications for the loss of a lower incisor

2021 ◽  
Vol 14 (2) ◽  
pp. 72-79
Author(s):  
Naeem I Adam ◽  
Minnie Lyons-Coleman ◽  
Adam Jowett ◽  
Trevor Hodge
Keyword(s):  
Clinical Relevance ◽  
Orthodontic Treatment ◽  
Treatment Plan ◽  
Clinical Scenario ◽  
Lower Incisor ◽  
Highly Effective ◽  
Extraction Pattern ◽  
Final Article ◽  
Dental Professionals

The final article in our series on orthodontic conundrums considers the extraction of a single lower incisor as part of a wider orthodontic treatment plan. This is a relatively uncommon approach; however, when used in the appropriate clinical scenario, it can be highly effective. Extraction of a lower incisor may be required to provide space for alignment of the teeth and serve as a pragmatic way to facilitate treatment while preserving posterior units. This article explores some of the possible orthodontic indications and contraindications for extraction of a lower incisor. CPD/Clinical Relevance: In certain clinical situations, extraction of a lower incisor has significant advantages. Dental professionals should be aware of this extraction pattern and its limitations.

In Support of Initial Parenteral Medical Management of Intrathecal Baclofen Withdrawal in Spasticity Patients

2021 ◽  
pp. 875512252110392
Author(s):  
Brian L. LaRowe ◽  
Vicki M. Nussbaum
Keyword(s):  
Case Reports ◽  
Treatment Plan ◽  
Correct Diagnosis ◽  
Treatment Protocol ◽  
Patient Characteristics ◽  
Clinical Problem ◽  
Clinical Situation ◽  
Intrathecal Baclofen ◽  
Wide Range ◽  
Baclofen Withdrawal

Background: Spasticity may present as a wide range of symptoms and conditions. With this protean presentation, a consensus regarding the best course of treatment does not exist. Those patients most severely affected may receive significant benefit from intrathecal baclofen delivery. However, this therapy may itself lead to patient injury in the event of withdrawal. Objective: Withdrawal from intrathecal baclofen may devolve rapidly into a situation in which the patient may incur significant morbidity and even death. A focused, prompt treatment plan would afford the patient the best possible outcome. Methods: The medical literature was reviewed for reports of plans of treatment of baclofen withdrawal and the results obtained. The nature of this problem does not lend itself to a typical study design, depending on case reports and basic pharmacological science application. The paucity of such reports severely limits categorical comparison of patient characteristics and clinical circumstances. Clinical situations, patient characteristics, and therapies were considered and compared. Outcomes of the varied treatments were evaluated for efficacy. Results: Inaccurate diagnoses, delayed correct diagnoses, and the absence of a consistent, treatment plan contributed to widely disparate outcomes. Prompt, correct diagnosis and intensive care unit–based continuous benzodiazepine infusion with titration led to a controlled clinical situation and maximized patient outcomes. Conclusions: Patients going through withdrawal from intrathecal baclofen achieved best outcomes when treated with a continuous infusion and titration of an intravenous benzodiazepine. A well-defined treatment protocol employing this management, reporting serial outcomes, would enable further refinement of the treatment of this clinical problem.

scholarly journals Pharmacological management of seizures in patients with COVID-19: a systematic review

2021 ◽  
Vol 4 ◽  
pp. 29
Author(s):  
Priscilla Kolibea Mante ◽  
Nana Ofori Adomako ◽  
John-Paul Omuojine ◽  
Paulina Antwi
Keyword(s):  
Systematic Review ◽  
Sodium Valproate ◽  
Case Reports ◽  
Meta Analysis ◽  
Descriptive Data ◽  
Pharmacological Management ◽  
Drug Choice ◽  
Number Of Patients ◽  
Clonic Seizures ◽  
Antiepileptic Drug Therapy

Background: Some patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been reported to exhibit neurological symptoms such as seizures and impaired consciousness. Our study reviews reported cases to assess the pharmacological approach to managing seizures in SARS-CoV-2 patients and associated outcomes. Methods: A systematic review of case reports on the incidence of seizures following coronavirus disease 2019 (COVID-19) among patients that reported use of antiepileptic drugs (AEDs) in management was performed by using the PRISMA (preferred reporting items for systematic reviews and meta-analysis) guidelines. Databases used included EMBASE, PubMed, SCOPUS, and Google Scholar. Data was presented as qualitative and descriptive data. Results: In total, 67 articles were selected for full-text assessment, of which 19 were included in the final review. Patients had a median age of 54 years, most of whom were male. Remdisivir, dexamethasone, Laminavir, hydroxychloroquine, azithromycin, and Lopinavir-ritonavir were common agents used in the management of COVID-19. Most patients presented with either generalized tonic-clonic seizures or status epilepticus. Most patients received levetiracetam as drug choice or as part of their regimen. Other AEDs commonly prescribed included midazolam and sodium valproate. Some patients received no antiepileptic drug therapy. Most of the patients who died had more than one comorbidity. Also, most of the patients who died received COVID-19 treatment drugs. None of the patients who received midazolam as drug choice or as part of their regimen developed recurrent seizures in contrast to patients who received levetiracetam and sodium valproate as drug choice or as part of their regimen. Interestingly, none of the patients who received no AEDs suffered recurrent seizures or died. Conclusions: Standard guidelines for managing seizures in COVID-19 patients may be required. A limitation of this review is that it involved the use of case reports with no controls and a small number of patients.

CU-SIL DENTURE AS A TRANSITIONAL PROSTHESIS TO PRESERVE THE REMAINING NATURAL TEETH USING PERMANENT SILICONE LINER

2021 ◽  
Vol 17 (2) ◽  
pp. 69-73
Author(s):  
Manu Rathee ◽  
◽  
Divakar S ◽  
Sujata Chahal ◽  
Sandeep Singh
Keyword(s):  
Alternative Treatment ◽  
Case Reports ◽  
Treatment Plan ◽  
Alveolar Ridge ◽  
Psychological Benefits ◽  
Missing Teeth ◽  
Denture Base ◽  
Natural Teeth ◽  
Set Up ◽  
The Stability

The goal of modern dentistry is to be conservative, preserving teeth but also maintaining the stability of the remaining alveolar ridge and the periodontium's proprioceptive capabilities. Cu-sil denture is the simplest approach in the preservation of teeth and maintaining proprioception. It is a type of transitional denture that provides an alternative treatment plan for the patients willing to replace their missing teeth while retaining their remaining natural teeth. It gives potential psychological benefits to the patients by avoiding extractions. It's a tissue-bearing acrylic appliance with a soft viscoelastic wrap that clasps the neck of each dentition, sealing out food and water simultaneously protecting and splinting each remaining tooth from the rigid acrylic denture base. This case reports series describes chairside techniques to fabricate Cu-sil dentures in the usual dental set-up

Coronectomy: A Surgical Option for Impacted Third Molars in Close Proximity to the Inferior Alveolar Nerve—A 5-Year Follow-Up Study

2019 ◽  
Vol 77 (6) ◽  
pp. 1116-1124 ◽  
Author(s):  
Giuseppe Monaco ◽  
Mattia D'Ambrosio ◽  
Giselle De Santis ◽  
Elisabetta Vignudelli ◽  
Maria Rosaria Antonella Gatto ◽  
...  
Keyword(s):  
Inferior Alveolar Nerve ◽  
Third Molars ◽  
Follow Up Study ◽  
Close Proximity ◽  
Surgical Option

scholarly journals Case Reports of Orthodontic Treatment of Maxillary Central Incisors with Short Roots

2012 ◽  
Vol 53 (4) ◽  
pp. 163-171 ◽  
Author(s):  
Hidenori Katada ◽  
Keiichi Terakado ◽  
Kenji Sueishi
Keyword(s):  
Orthodontic Treatment ◽  
Case Reports

scholarly journals Functionally orientated/systemic approach to orthodontic treatment of severe class II division 1 malocclusions: an adapted device, the FABP

2018 ◽  
Vol 21 (3) ◽  
pp. 304
Author(s):  
J.-L. Raymond
Keyword(s):  
Orthodontic Treatment ◽  
Treatment Protocol ◽  
Class Ii ◽  
Surgical Correction ◽  
Systemic Approach ◽  
Deep Bite ◽  
Division 1 ◽  
Bite Plate ◽  
Class Ii Division 1

The orthodontic treatment of severe class II division 1 malocclusions is often difficult, which leads some specialists to offer a surgical correction of the overjet. Treatment is made complex by the value of the horizontal overlap as much as the « depth » of deep bite that is very often present alongside the malocclusion. This is why we are offering a treatment protocol including a FABP (Fixed Anterior Bite Plate) which will allow, if the patient cooperates, to correct the anatomic anomaly while concurrently establishing new masticatory cycles in order to stabilize and preserve the results obtained. It is this systemic approach of treatment that is the focus of this article.

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