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Point-of-care-ultrasound (PoCUS) is performed by the clinician at the patient's bedside and is an essential diagnostic tool in many medical subspecialties, in hospital-based care, emergencies, trauma, and in general practice. A simple, novel approach for implementation of PoCUS of the oral cavity and maxillofacial complex is introduced. Relevant indications include differentiating abscess from cellulitis, detecting jaw and facial fractures, assessment of surgical complications, removing foreign bodies, and evaluating soft tissue masses. Intraoral and transcutaneous approaches may be used alone or in combination. This pilot series shows the capability of PoCUS to improve diagnostic accuracy, speed diagnosis, guide procedures, and improve management. Prospective studies are underway to determine the strengths and weaknesses of the method and its impact on patient outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Maxillofacial metastases from distant primary sites account for less than 1% of cancer in the head-and-neck region and are often misdiagnosed as benign or inflammatory conditions. The purpose of this study was to describe the clinical characteristics of patients with maxillofacial metastases, treatment and outcomes. Materials and Methods: Subjects with head-and-neck cancer were identified from the institutional database. Descriptive statistics were employed. Results: Of 532 patients with head-and-neck cancer between 2008 and 2020, 15 (2.8%) had histologically verified metastatic lesions, of which 53.33% males with a mean age of 69 years. The median time from symptom onset to diagnosis was 17 days (range: 7–60). The mandible was the most common location (40%), followed by the parotid gland (33.33%) and maxilla (13.33%). Adenocarcinoma was the most frequent histology (60%), and half of the patients had extraoral manifestations. Tumour origin was gastrointestinal, lung (33.33% each), prostate (20%) and breast (13.3%). No predilection for tumour type or histology and location were seen. Radiographic features were non-specific, with computed tomography (CT) demonstrating periosteal reaction, bone expansion and lytic lesions and high variability in Positron Emission Tomography (PET) standardised uptake value (minimum: 2.0, maximum: 10.93 and mean: 4.14). Diagnosis led to altered treatment in 60%, more in extraoral than intraoral manifestations (71% vs. 37.5%); 40% received radiotherapy, 20% systemic treatment and none underwent surgery. Over half of the patients passed away within 6 months, median survival was 5 months, shorter in patients with intraoral than extraoral disease (3 vs. 13.2 months, P < 0.05). Discussion: Maxillofacial metastases have elusive manifestations and often warrant specific treatment. Prospective data should evaluate associations between timely diagnosis and symptomatic improvement and survival. [ABSTRACT FROM AUTHOR]

Implant dentistry is considered to be a safe and routine surgical procedure. However, cases of life-threatening hematoma of the floor of the mouth resulting in airway obstruction were previously reported as a complication of implant placement in the anterior mandible. Massive bleeding in this anatomical site may be caused by perforating the lingual cortex and/or damaging the lingual perimandibular vessels. In the long term, dental implants can fail, mainly due to peri-implantitis, and must be removed. Explantation procedure may occasionally become a complex challenge, with a risk for various complications. Case report: This report presents the first case of life-threatening hematoma of the floor of the mouth, as a complication secondary to a failed attempt of dental implant removal at the anterior mandible. The proximity of the implant to the lingual vascular canal might have served as a cause for vascular damage during explantation. Conclusions: Implant removal complications are scarcely described in the literature. Nonetheless, damaging blood vessels during explantation should not be underestimated. Computed tomography (CT) may be of value not only in preoperative implant planning but also before implant removal in jeopardized anatomical zones such as the anterior mandible. Lingual vascular canals should be looked for on computed tomography scans. [ABSTRACT FROM AUTHOR]

Necrotizing sialometaplasia is a benign, self-limiting, inflammatory disease of salivary glands, mainly involving the minor salivary glands in the palate. This lesion can mimic a malignant neoplasm, both clinically and histopathologically, manifesting as a submucosal swelling or as an ulcer of the palate. This report presents a case of an otherwise healthy bodybuilder with anabolic androgenic steroids abuse with bilateral necrotizing sialometaplasia in the palate, and discusses computed tomography findings in the pre-ulceration phase. Literature review revealed another two cases of necrotizing sialometaplasia with preoperative imaging, both performed in the ulceration phase. The importance of radiographic findings as an aid in differential diagnosis is further discussed, as well as the role of possible predisposing factors including anabolic androgenic steroids abuse in the pathogenesis of necrotizing sialometaplasia. [ABSTRACT FROM AUTHOR]