One of the most common infectious processes known to ancient and modern medicine alike, the majority of these illnesses are odontogenic in identity. The majority of these infections can be treated surgically, including drainage, endodontic treatment, and exodontia in order to be controlled without resorting to antimicrobials. Due to the intricate anatomy involved and the potential for catastrophic medical problems even with expert therapy, severe space infections pose a difficult dilemma for maxillofacial surgeons. Because of the proximity of the submandibular and submental areas, infections can also affect several spaces. Streptococcus pyogenes, a Gram-positive aerobic pathogen, was found to be the most frequent organism linked to orofacial infection. Possibly deadly consequences that may appear after MSI include septicemia, airway compromise, cavernous sinus thrombosis, necrotizing fasciitis, and mediastinitis. Deep space maxillofacial and cervicofacial infections should be managed according to certain principles, including immediate and prompt evaluation of the infection's extent based on anatomical location, rate of development, and possibility for airway impairment. Penicillin is still the preferred empiric medication, at least for outpatients, according to recent data on the antibiotic sensitivity of the most frequently identified bacteria of odontogenic infections. With respect to surgical intervention, many surgeons have been shown to favor tracheotomy to endotracheal intubation for maintaining the airway in patients with airway blockage. In contrast to those who receive endotracheal intubation, patients with severe cervicofacial infections who receive tracheotomy for airway support have been shown to have a shorter stay in critical care, experience fewer problems, and pay less overall. After assessing the host immunity, early definite operative therapy is essential for halting the infection's spread.
The zygomatic bone, which includes the lateral and inferior orbital rims as well as the malar eminence, comprises the lateral part of the midface, giving it width and projection. Zygomatic arch fractures account for 10% to 15% of all facial fractures and are commonly caused by a direct blow to the face. Zygomatic fractures are most caused by blunt trauma. Paediatric zygomatic fractures are a rare complication in the continuum of craniofacial injuries that cosmetic and reconstructive surgeons deal with. The combination between etiology, force of damage, and stage of craniofacial development determines the location and distribution of facial fractures in children. The purpose of this research is to review the available information about the epidemiology, classification and management of zygomatic fractures in children. Although facial fractures especially zygomatic fractures in children are quite uncommon and rare, appropriate screening and diagnosis, as well as prompt treatment, are necessary to avoid consequences. Surgeons face tremendous hurdles when dealing with facial trauma associated with serious injuries, as there is a functional and aesthetic impact on the growing children, as well as a financial and emotional burden on the patient and family. The early management of zygomatic fractures in children, like any trauma, detects situations that require rapid treatment to avoid life-threatening consequences. Paediatric zygomatic fractures are quite uncommon due to the specific anatomic, physiologic, social, and environmental aspects that accompany craniofacial growth however the literature data is lacking and quite scarce, more epidemiological studies targeting age group of children are needed.
Temporomandibular joints (TMJ) disorders are a group of morphological and functionally abnormal degenerative musculoskeletal problems. Limited or divergent movement, painful joint sounds, articular, muscular, or neural pain involving the joint are the hallmarks of the joint’s pathology. Temporomandibular disorders (TMD) have a broad spectrum. Various biological, environmental, social, and psychosomatic stimuli comprise the complex etiology of TMD. Mechanically induced remodeling, while progressive and regressive, is a physiological development initially. Osteoarthritis arises when the joint's rebuilding capability has been exceeded. The TMJ exhibits typical osteoarthritic changes, such as flattening of fossae, reduced pronunciation of articular eminence, reduced condyle proportions, and thicker disk. Decreased adaptability in the articular tissues or severe or recurrent physical stress on the joint’s tissues can also cause degenerative remodeling, that is noted in pathologic TMJs. It has been determined that non-invasive treatment options should be investigated first for patients looking to manage their temporomandibular disorders symptoms. However, there is a demand for more intrusive treatments because to the temporomandibular joint's complexity and the incapacitating nature of advanced-stage disease. Enhanced scope of movement, diminished synovitis, and the prevention of additional degeneration of joint surfaces are the foremost goals of the approaches used in managing TMD.
Surgical site infection is a common post-operative complication that is encountered by surgeons and is associated with notable morbidity and mortality. Oral cavity due to the presence of bacteria is more prone to infection and diseases. Even performance under complete sterilization cannot prevent the infection in oral surgeries and the prevalence of infection rate accounts to approximately 10%-15%. Post-operatively oral and maxillofacial surgeries have increased chances of infection due to bacterial load and access to incision site during healing time. The purpose of this research is to review the available information about the types, causes and complication rates of surgical site infection post maxillofacial surgery. Various procedure and patient related factors in oral and maxillofacial surgery contribute to surgical site infections. Procedure's duration and invasiveness as well as bone equipment, biomaterial use, surgical technique, and sterilization practices are some of determinants of surgical site infection. Cellulitis, abscess, maxillary sinusitis, and osteomyelitis are all common postoperative infections. Surgical site infections often result in requirement of additional treatment procedures, prolongs the hospital stay and also negatively affects health of the patient. Efficient interventions by the oral and maxillofacial surgery teams can play a vital role in prevention of such infections. Although surgical site infection is an area of concern for oral and maxillofacial surgeons’ literature on this aspect is quite scarce and very limited studies are available. In future, more clinical and comprehensive research can be beneficial.
Maxillofacial pediatric fractures are highly uncommon due to their unique characteristics of high elasticity, cartilaginous tissue, lack of pneumatization, evolutionary stages of dentition and other protective features. However, despite their rarity, pediatric facial fractures often seen by pediatric surgeons, plastic surgeons and in the emergency department. The mandible is the most commonly fractured pediatric facial bone. In this review, we will discuss the various patterns of mandibular fractures, their rates and prevalence in the pediatric population. An extensive search was conducted from various electronic databases such as PubMed, Medline Embase, Google Scholar and Cochrane Library to retrieve original researches and narrative reviews. The most common site to be fractured in the mandible is the condylar process, followed by the symphysis and the angle. Condylar process fractures are more common in younger children between the ages of 1 to 13 and angular fractures supersede during the teenage years. Mandibular fractures are also categorized based on the localization and number of fractures such as a single fracture, or multiple fracture both unilateral and bilateral. Further studies with larger sample sizes and specific age groups should be conducted to achieve more significant results.
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