Mediastinitis is a rare, progressive, and destructive infectious process due to cervical or odontogenic infections, which, if not diagnosed early, may lead to several complications, including airway involvement and even an imminent risk of death. Herein, we report an unusual case of a 37-year-old male with a bilateral submandibular hard swelling after the left third molar extraction. After surgical intervention with submandibular drainage and antibiotic therapy, the infection persisted without explanation, since the patient was not hypertensive, did not have diabetes mellitus or sexually transmitted infections such as HIV or syphilis, and did not smoke or drink alcoholic beverages. A thoracic surgeon then intervened, treating the mediastinitis surgically by drainage, thus obtaining a significant improvement of the patient's health. Mediastinitis is a serious condition. Clinicians and maxillofacial surgeons should be alert to make an immediate diagnosis and select the appropriate treatment in order to prevent worsening of the patient's clinical condition.
Displacement of orthodontic appliances to the fascial spaces and segments of the airways during orthognathic surgery is rare; however, it may cause potential complications to the patients. Additionally, the removal of foreign bodies in the maxillofacial region can be a great challenge. Herein, we describe a case of a 43-year-old female patient with an orthodontic band displaced to the coronoid process during orthognathic surgery. In addition, the indications, treatments and outcomes of the image intensifier used in maxillofacial surgery were discussed. The object was successfully removed using an image intensifier, which allowed real-time visualization of the displaced appliance while using a haemostat to remove it through a conservative surgical wound. This article reports on a viable and safe method of a navigation system for the removal of foreign bodies in the region of the coronoid process. Maxillofacial surgeons should introduce this technique in selected cases in order to ensure safe and minimally invasive surgery.
This article aims to describe orocraniofacial alterations in children with Congenital Zika Syndrome. A descriptive case series study was carried out with 20 children with the syndrome, attended at a rehabilitation center in the city of Recife, Pernambuco, Brazil. The presence of oral, craniofacial and neurological alterations, oral health condition and gestational period were evaluated. Data were obtained from medical records and interviews with the children's mothers, followed by a physical examination. Among the main alterations found are microcephaly, craniofacial disproportion, epicanthal folds, bruxism, anterior open bite, ankyloglossia, tongue interposition and delay in teeth eruption. The child may have difficulty reporting any discomfort due to neurological impairment, therefore, these findings reinforce the importance of preventive dental consultations and the performance of the dental surgeon in the elaboration of protocols and guidelines aimed at providing a better quality of life for these patients.
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