Interforaminal hemorrhage during anterior mandibular implant placement: An overview

Implant surgery in mandibular anterior region may turn from an easy minor surgery into a complicated one for the surgeon, due to inadequate knowledge of the anatomy of the surgical area and/or ignorance toward the required surgical protocol. Hence, the purpose of this article is to present an overview on the: (a) Incidence of massive bleeding and its consequences after implant placement in mandibular anterior region. (b) Its etiology, the precautionary measures to be taken to avoid such an incidence in clinical practice and management of such a hemorrhage if at all happens. An inclusion criterion for selection of article was defined, and an electronic Medline search through different database using different keywords and manual search in journals and books was executed. Relevant articles were selected based upon inclusion criteria to form the valid protocols for implant surgery in the anterior mandible. Further, from the selected articles, 21 articles describing case reports were summarized separately in a table to alert the dental surgeons about the morbidity they could come across while operating in this region. If all the required adequate measures for diagnosis and treatment planning are taken and appropriate surgical protocol is followed, mandibular anterior region is no doubt a preferable area for implant placement.

Prosthetic rehabilitation of Oro-nasal defect

Maxillofacial defects may be due to congenital defect, trauma, tumor or infection. Among infections, fungal head and neck infections are common complication in patients with immunological or metabolic compromise. Cerebral extension of these infections often complicates the treatment plan. Treating these cases requires correction of the compromised state, local and systemic anti-fungal therapy and repeated radical debridement assisted by serial imaging. Following debridement, the resultant deformity can be corrected either surgically or prosthetically. Many factors are to be considered regarding the choice of the treatment. Here is a case report of a 55 year old male diabetic patient with oro-nasal mycosis, where debridement resulted in a gross morbid defect of the dorsum of the nose and the hard palate. Prosthetic rehabilitation was carried out with separate nasal prosthesis and a palatal feeding obturator.