OMFS notes

Random Oral and Maxillofacial surgery Information

[OMFS notes @DrMS_OMFS]

Fordyce spots are small, yellowish or white, harmless bumps that are actually enlarged, ectopic sebaceous cysts (oil) glands. They commonly appear on the lips, buccal mucosa , and in the genital area .

[OMFS notes @DrMS_OMFS]

Nerve Repair
First 3 months :high potential for self-healing, observation is essential.
3–6M :If no recovery is observed, repair is most effective during this period.
After 6 M : Fibrosis and permanent nerve changes may develop, selected cases may still benefit from microsurgery.

[OMFS notes @DrMS_OMFS]

Joint replacements can proceed even just 1 day after a non- or minimally invasive dental procedure.
But procedures that involve more tissue penetration, from gingival probing to extractions and other oral surgeries, should wait at least 3 months after arthroplasty.

[OMFS notes @DrMS_OMFS]

mylohyoid nerve block location in the inner surface of the mandibular bone, just behind the distal root of the last molar tooth in the quadrant .

[OMFS notes @DrMS_OMFS]

A mylohyoid nerve block can be a valuable adjunct during wisdom tooth extraction to supplement the inferior alveolar nerve block (IANB), especially if the patient experiences pain on the lingual side of the lower molar despite an IANB .

[OMFS notes @DrMS_OMFS]

According to BAOMS ,after coronectomy ,roots may become infected in the future and need removing
If this happens ,usually rise upwards, away from nerve, reducing risk of numbness
migration of root or delayed healing happens in 15% of cases, resulting in a need for further surgery

[OMFS notes @DrMS_OMFS]

cardiac patients, diclofenac potassium is preferred over diclofenac sodium because it is absorbed more quickly and have a lower risk of cardiovascular complications. Diclofenac sodium tends to cause more salt and water retention in the body, which can exacerbate heart conditions.

[OMFS notes @DrMS_OMFS]

Duloxetine , serotonin - norepinephrine reuptake inhibitor ( SNRI ),can affect blood clotting and increase risk of bleeding.
Diclofenac , nonsteroidal anti-inflammatory drug ( NSAID ),have a risk of bleeding, especially in stomach and intestines. Combining them amplify this risk

[OMFS notes @DrMS_OMFS]

diapneusie (or " diapneusie buccale ") refers to a soft, sessile nodule that can form on the oral mucous membrane due to chronic irritation, often caused by habits like cheek biting.

[OMFS notes @DrMS_OMFS]

Enamel is the hardest substance in the human body, even harder than bone and cementum .

[OMFS notes @DrMS_OMFS]

Vitamin B complex, particularly vitamins B1 (thiamine), B6 (pyridoxine), and B12 (cobalamin), are often recommended for nerve injuries due to their role in nerve health and regeneration .

[OMFS notes @DrMS_OMFS]

lidocaine is considered in Category B, the safest of the local anesthetics in pregnancy .
Articaine , Mepivacaine and bupivacaine are Category C and may be used with caution .

[OMFS notes @DrMS_OMFS]

The lingual nerve is positioned above the lingual alveolar crest at the retromolar area in 14% of cases .

[OMFS notes @DrMS_OMFS]

The " Yonsei point " is a specific location on the face for Botox injections to correct a gummy smile cuased by hyperactive lip muscle (1 - 3 units per side)
muscles targted are :
1- levator labii superioris
2- levator labii superioris alaeque nasi
3- zygomaticus minor muscles.

[OMFS notes @DrMS_OMFS]

Applying ice before Botox injections can help minimize pain and reduce the risk of bruising and swelling, making the procedure more comfortable for the patient.
it is recommended to put ice for 10 minutes prior to injection and another 5 minutes after injection. .

[OMFS notes @DrMS_OMFS]

Chinulite, also known as chin dimpling ,chin cellulite , refers to the dimpled or uneven skin on the chin caused by the overactivity of mentalis muscle.
treatment option is Mentalis Botox 4-10 units ,points are usually located along the chin midline and slightly lateral to it .

[OMFS notes @DrMS_OMFS]

Kounis syndrome & anaphylactic shock are both severe allergic reactions.
Anaphylactic is a systemic life-threatening reaction affecting multiple organ systems.
Kounis specifically involves acute coronary syndromes (... myocardial infarction ) during or after an allergic reaction.

[OMFS notes @DrMS_OMFS]

As a general rule of thumb, dosing for Dysport is 2.5–3 times the number of units required for Botox .
so if you need :
30 unites of botox ( onabotulinumtoxinA ) per side in masseter hypertrophy .
you will need :
75 - 90 unites of dysport ( abobotulinumtoxinA ) per side .

[OMFS notes @DrMS_OMFS]

Botox should be reconstituted gently ( shaking and trauma to the toxin can diminish its potency ) .

[OMFS notes @DrMS_OMFS]

1- Botox 100 units should be diluted by 2mm normal saline
Which makes every 0.1 = 5 units
2- Dysport 500 units should be diluted by 2.5 mm which make every 0.1 = 20 unites
3- If you want to give 30 units for masseter muscle, you give
0.6 mm Botox
Or
0.15 mm dysport