Residents’ Case Presentations
Lewis Christensen DDS from NUMC presented a case of a 7 y/o boy who presented with a slight swelling of the left mid- maxilla two weeks after he was shot with a BB. Xray showed no fragments and he was sent home. He came back in two weeks with increased edema of the left face with deviation of the nose and loss of vestibule. Panorex showed normal mixed dentition but the left maxillary permanent cuspid showed a radiolucency around its crown. Continue reading
Dr. Appelblatt presented a case of a 57 y/o female who presented with a painful lesion which had ulceration and erythema. It proved to be squamous cell carcinoma and the lesion was resected, leaving a palatal defect. The patient refused further surgery and was treated with an obturator. The second case was that of a 32 y/o male who had had a pleomorphic adenoma in the palate and had had it resected and presented with an obturator. Continue reading
Rachel Appelblatt MD, DDS from Bellevue gave a review of maxillary and palatal tumors and the reconstruction options. The size of the residual defect makes a big difference in the reconstruction. The margins of the surgery are affected by whether the lesion is benign or malignant. Objectives of reconstruction include level of function, speech problems, the possibility of regurgitation and the esthetics. Continue reading
Dr. Amin Bellil from Montefiore Hospital gave a talk on complications with orthognathic surgery; it was a general overview of problems that they have seen in their hospital covering well over 600 cases. He started with problems with bleeding, loss of teeth in osteotomy cuts and errors in fixation. He said that they have had no internal maxillary artery hemorrhages. Continue reading
Dr. James Kim from Cornell gave a presentation of an orthognathic case which resulted in a pseudo-aneurism. The case was that of a 15 y/o make with Asperger’s syndrome and slight asthma who presented with a retrognathic mandible with an open bite. The surgery planned was for a segmental LeFort I maxillary osteotomy and then bilateral vertical buccal osteotomies of the mandible. During surgery, there was some hemorrhage but it was controlled with pressure and local measures. The post op course was normal with discharge. Continue reading
Calvin Jung, DDS, MD from Bellevue/NYU gave a presentation on orbitomaxillary reconstruction.
The mid face gives structure to the face in both the vertical and horizontal planes and is a major focus in imaging. It has major functional and psychological implications. It supports the globes and determines alar position; it supports the upper dentition and is critical in nasolacrimal drainage.
Jesse Doscher, DDS, MSc, from St. Raphael’s in New Haven gave the second case. A 28 y/o female presented with a painless swelling in the anterior maxilla adjacent to the left central and lateral incisor. She gave a history of a slow growth near her upper teeth. She had had an unknown procedure in the area several months prior. Exam revealed a nodular swelling of the alveolus adjacent to t#9 and 10 with some raising of the upper lip and some extension to the frenum area and to the palate. Dental xray showed an increase in the PDL of #10. Biopsy demonstrated chondrosarcoma of low to intermediate grade.
David Cundrick, DDS, from Nassua University Medical Center gave a presentation on maxillofacial trauma and pan-facial trauma management. His case was that of a 31 y/0 Hispanic male who was struck by a side mirror of a semitrailer truck. After he was stabilized in the ER, an OMS consult was called. The patient had extreme crepitus in the anterior mandible with a comminuted parasymphasis Fx; a Fx of the left condylar head with shortening of the left mandible height; a floating maxilla and multiple dental injuries.