Gregoire C, Morrison A., OMFS Clinics of North America. 2013
Repair of fractures involving the nasofrontal region remains a mainstay of contemporary oral and maxillofacial surgery. This article discusses the epidemiology of these injuries, anatomy of the area, and management of these fractures with insight into potential complications. These include fractures of the frontal sinus, naso-orbital-ethmoidal region, root of the nose, and associated adjacent structures.
Morrison A, Brady J. Mandibular reconstruction using nonvascularized autogenous bone grafting. Curr Opin Otolaryngol Head Neck Surg. 2010 Aug;18(4):227-31.
Davis CM, Gregoire CE, Steeves TW, Demsey A. J Oral Maxillofac Surg. 2016 Jun;74(6):1199-206.
The purpose of this retrospective study was to determine the prevalence of surgical site infection (SSI) after orthognathic surgery at the Department of Oral and Maxillofacial Surgery of Capital Health and Dalhousie University (Halifax, NS, Canada).
A retrospective chart review of all patients undergoing orthognathic surgery from October 2005 through April 2013 was performed. The outcome variable was SSI. The primary predictor variable was the antibiotic used for prophylaxis. The secondary predictor variables were patient demographics, such as age, gender, medical comorbidities, and smoking status; duration of surgery; wisdom teeth extractions; single-jaw or bimaxillary surgery; and type of surgery. Data also were gathered on the diagnosis of SSIs and the treatment to resolve these infections.
In total, 2,521 patients underwent surgery, and 253 patients did not meet the inclusion criteria; therefore, the charts of 2,268 patients were reviewed (mean ± standard deviation, 26.9 ± 11.7 yr of age). Eight percent of patients developed an SSI. None of the patient demographics was associated with an increased risk for infection. Most initial infections (62%) and most recurrent infections (78%) occurred in the mandible. Twenty-six percent of patients who developed SSIs had recurrent infections after antibiotic treatment. SSIs necessitated hardware removal for 14% of patients. Adverse effects from the antibiotics were seen in 4.2% of patients. Infection was most frequently diagnosed 11 to 15 days postoperatively. The average length of surgery for patients who did not have an SSI was 136 minutes compared with an average of 157 minutes for patients who had an SSI (odds ratio = 1.0051; 95% confidence interval, 1.0026 to 1.0076; P < .001). Wisdom teeth were extracted in 49.6% of the 2,268 cases. The mean SSI prevalence for multiple jaw procedures (9.2%) was significantly higher than that for single surgical procedures (5.3%; P = .0013). Isolated Le Fort surgeries had a significantly lower prevalence of infection compared with the mean prevalence (3.9%; P = .02), whether they were single piece or segmented (3.5 and 4.3%, respectively; P = .98). The prevalence of infection was significantly lower in the cefazolin group (6.2%) compared with the penicillin (14.3%; P < .0001) and clindamycin (10.4%; P < .02) groups.
The prophylactic use of first-generation cephalosporins, such as cefazolin, appears to be more effective than penicillin and clindamycin for preventing SSIs in orthognathic surgery. In addition, bimaxillary surgery, mandibular procedures, and duration of surgery might demand antibiotic prophylaxis that is more effective. The presence of third molars and patient demographics are not risk factors for SSIs. A prospective randomized controlled study is underway to investigate the findings of this study.
Gregoire C, Davis C, Bullock M, Steeves T. Recurrent Osseous choristoma involving the mandibular buccal vestibule: a case report. Int J Oral and Dent Health. 2015 April.
Abstract
This case report is the third ever reported of a recurrent intraoral osseous choristoma. The lesion had manifested twice in the left mandibular buccal vestibule of a 63-year-old Caucasian female.
The patient was treated with wide local excision on both occasions. We believe that the lesions may have arisen as a result of previous trauma, although the exact etiology of the lesions is unknown. Interestingly, the recurrent lesion contained satellite nodules of bone, which suggests that the osseous choristoma may recur yet again.
Bell RB, Gregoire C., J Oral Maxillofac Surg. 2013 (in press).
Gregoire C., OMFS Knowledge Updates. 2013
Gregoire CE, Goodday R, Robertson C. The need for concomitant bone grafting during maxillomandibular advancement for the treatment of obstructive sleep apnea syndrome. J Oral Maxillofac Surg 2007; 65(9) Suppl: 42.e1 (abstract).
Pogrel MA, Schmidt BL, Robertson CG. Clinical Pathology: Odontogenic and Nonodontgenic Tumors of the Jaws. In: Ward-Booth P, Hausaman JE, Schendel S (eds.) Maxillofacial Surgery. 2nd ed. Churchill Livingstone, 2006.
Robertson CG. What are the roles of surgery, radiation therapy, and chemotherapy in the treatment of oral cancer? J Can Dent Assoc 2006; 72(6): 407-8.
Gregoire C, Robertson CG, Morrison AD, Goodday R. Intubation Difficulties Associated with Obstructive Sleep Apnea Syndrome. J Oral Maxillofac Surg 2005; 63(8) Suppl 1: 47 (abstract).