Prosthetic treatment for chemical burns of the oral cavity

Management of pain and sublingual hematoma caused by suture irritation after implant surgery: a clinical report

Hematoma in the sublingual region is an adverse consequence of implant surgery in the mandibular posterior region. Improved knowledge and understanding of the anatomy as well as the use of advanced radiographic imaging have all contributed to minimizing adverse surgical complications in this region. Delayed sublingual hematoma caused by suture irritation after implant surgery has not previously been reported. This article describes the management of a patient with a delayed sublingual hematoma after implant surgery in the posterior mandible had been performed. No evidence of encroachment of the vascular structures was noted at the time of implant surgery. However, at a 48-hour follow-up, the patient presented with severe pain and irritation of the sublingual mucosa, along with extravasation and a collection of blood in the sublingual region. Based on the patient's symptoms and clinical signs, the source of the problem was determined to be the stiff tags of polypropylene suture, which had been used to attain primary closure of the surgical flaps. The situation was conservatively and successfully managed by the use of a custom soft tissue guard to protect the patient's sublingual mucosa and the tongue from the stiff suture tags. Various suture materials and measures for preventing and managing similar situations are discussed in this article.

Adaptations of Mouthguards for Patients with Special Needs

The adaptations and applications of mouthguard appliances are many and varied, with uses ranging from protective to therapeutic. These modifications serve the individual needs of patients. This requires problem-solving based on combining form and function with the skills of the dentist.

Oral Burn Contractures in Children

Oral burn contractures in children present major reconstructive problem. Only few reports in literature discussed oral burns in children. Electrical, chemical, and thermal agents are the main causative agents for oral burns. Oral contractures can be classified into anterior, posterior, and total. Anterior contractures are usually caused by electrical burns and involve the oral commissure, lips, anterior buccal sulcus and surrounding mucosa, and anterior tongue. Posterior oral contractures are caused by caustic ingestion and involve the posterior buccal mucosa, posterior tongue, retro-molar area and oro-pharynx. Total oral contractures involve the lips, tongue, oral cavity, and oro-pharyngeal mucosa and are caused by lye caustic ingestion. This report reviews three children; one with posterior, two with total oral cavity contracture. All cases were managed by linear release of scar contracture and skin grafting followed by a prolonged intra-oral splinting with a fixed mouth-block and commissural splint. A successful outcome was observed in all cases.

Treatment of caustic ingestion

This article reviews the management of patients following caustic ingestion. The initial care is conservative, consisting mainly of IV antibiotics and steroids. Patency of the airway is of immediate concern and achieved via either intubation or tracheostomy. Early intervention with oral splint therapy is recommended to minimize scar contracture. It is important that the oral and maxillofacial surgeon be acquainted with the primary care of such patients, as well as with the subsequent management of the secondary complications of decreased stomal opening, loss of the mucobuccal fold, and limitation of tongue movement.