Making Things Possible

Residents’ Case Presentations

Slight Swelling of the Left Mid-Maxilla

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

57 y/o Female Who Presented With a Painful Lesion Which Had Ulceration and Erythema

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

Maxillary and Palatal Tumors and the Reconstruction Options

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

Complications With Orthognathic Surgery

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

An Orthognathic Case Which Resulted in a Pseudo-Aneurism

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

Presentation on Orbitomaxillary Reconstruction

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.
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A 28 y/o Female Presented With a Painless Swelling in the Anterior Maxilla

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.

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Presentation on Maxillofacial Trauma and Pan-Facial Trauma Management

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.
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