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  1. Article ; Online: Spontaneous oral ulceration with bone sequestration: its relevance in current clinical practice.

    Lidhar, T / Ethunandan, A / Ethunandan, M

    The British journal of oral & maxillofacial surgery

    2020  Volume 58, Issue 9, Page(s) e75–e79

    Abstract: Oral ulceration associated with bony exposure and sequestration is uncommon and often related to well-recognised conditions. In a small group of patients no obvious aetiological factors can be elucidated, and various terminologies have been utilised to ... ...

    Abstract Oral ulceration associated with bony exposure and sequestration is uncommon and often related to well-recognised conditions. In a small group of patients no obvious aetiological factors can be elucidated, and various terminologies have been utilised to describe these lesions. We report six cases of spontaneous oral ulceration with bone sequestration as a specific entity and review the pertinent literature. We retrospectively reviewed patients presenting in the period 2013-2018. Data collected included demographic details, relevant medical, drug, and radiotherapy history; presentation, investigations, management, and outcome. Six patients with an age range of 49-65 years were identified with spontaneous oral ulceration with bone sequestration in the study period. All were males, and none had any relevant history. Five lesions occurred over the mylohyoid ridge and one was related to a lingual mandibular torus. The most common presentation was a painful ulcer with exposed bone, which had been present for 6 - 12 weeks. Occlusal radiographs demonstrated focal rarefaction in two patients. All were managed conservatively and by removal of the loose sequestrum. Healing occurred successfully in all cases, and this was earlier when the loose sequestrum was removed. Spontaneous oral ulceration with bone sequestration is a distinct lesion that most often presents over the prominence of the mylohyoid ridge. It is currently an uncommon entity (0.02%), but this could well be due to a lack of recognition and under-reporting. It should be considered as a diagnosis only when other causes have been excluded. Lesions heal successfully with conservative management and surgical intervention, and this occurs earlier following removal of the loose sequestrum.
    MeSH term(s) Aged ; Humans ; Jaw Diseases ; Male ; Mandible ; Middle Aged ; Oral Ulcer/etiology ; Osteonecrosis ; Retrospective Studies
    Language English
    Publishing date 2020-07-07
    Publishing country Scotland
    Document type Journal Article
    ZDB-ID 605685-4
    ISSN 1532-1940 ; 0266-4356
    ISSN (online) 1532-1940
    ISSN 0266-4356
    DOI 10.1016/j.bjoms.2020.06.030
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Split zygomaticus major muscle sling reconstruction for significant lower lip defects.

    Lidhar, T / Sharma, S / Ethunandan, M

    The British journal of oral & maxillofacial surgery

    2020  Volume 59, Issue 1, Page(s) 106–108

    Abstract: Defects to the lower lip remain surgically challenging to reconstruct. Restoration of aesthetics and function are crucial, of which the aims include restoring the tissues of the lower lip, maintaining oral competence, speech articulation, and restoring ... ...

    Abstract Defects to the lower lip remain surgically challenging to reconstruct. Restoration of aesthetics and function are crucial, of which the aims include restoring the tissues of the lower lip, maintaining oral competence, speech articulation, and restoring lip height and the vermillion. Further surgical techniques continue to be explored, with local flap surgery being the generally preferred method. However, many reconstructions leave the patient with pronounced deformity and morbidity. In this case report, we describe a new technique for the reconstruction of an 80% lower lip defect with an ipsilateral split zygomaticus major muscle sling, nasolabial flap, and facial artery musculomucosal flap. The reconstruction provided good oral competence, speech articulation and aesthetics, in addition to maintaining the oral commissure and lower lip height/length. Iatrogenic microstomia was avoided and zygomaticus functioning was normal. We are confident this technique will be useful to reconstructive surgeons in select cases of significant lip defects.
    MeSH term(s) Esthetics, Dental ; Humans ; Lip/surgery ; Lip Neoplasms/surgery ; Reconstructive Surgical Procedures ; Surgical Flaps
    Language English
    Publishing date 2020-08-30
    Publishing country Scotland
    Document type Case Reports ; Journal Article
    ZDB-ID 605685-4
    ISSN 1532-1940 ; 0266-4356
    ISSN (online) 1532-1940
    ISSN 0266-4356
    DOI 10.1016/j.bjoms.2020.06.031
    Database MEDical Literature Analysis and Retrieval System OnLINE

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