👉 Do you have questions about applying to Oral & Maxillofacial Surgery residency 💀 or dental school 🦷? Keep an eye out for my next Q&A session, held on Instagram at the end of every month, for my live & personalized mentoring. This is for YOU 🤜🤛

🙋🏼‍♂️ These are clips from Instagram LIVE Q&A sessions, Tik Toks & Reels, and zoom events that I’ve hosted both individually and with our company Top Professionals 🙌 If you’re a club or organization and you’d like me to host your zoom event or conference, DM me on insta that is the best way to contact me directly 👌

*** 👉 PreDent Mentor Map is now live btw, at predentmentormap.org ! ***

⛈ If you have questions, thoughts or ideas that you’d like to discuss involving my other ventures, including entrepreneurship (Top Professionals LLC 🏔, Vé Club 🍷), our products/services (PreDent Mentor Map, Dentist Map, Winery Map), NFTs 🖼(@feelings.nft 🎨, or my NFTs story highlight) workouts 💪, music producing/performing 🎶 (SoundCloud, violin 🎻 ), DM me and let’s talk 🤙

❤️ MOST importantly: THANK YOU for watching and being on my team- I do this for YOU. Mentoring is what got me here, and it is how I’ll help you achieve your dream goals as best I can. You are a MASSIVE part of this journey to me, more than you know 🙌🙏🙌

🤠 @doctorgallagher

https://www.instagram.com/doctorgallagher/

🦷 Oral & Maxillofacial Surgery Resident

🏔 Top Professionals Cofounder

🎙 Podcast

🍷@topwineries

👨‍⚕️@doseofdentalpodcast

🦁@movesandmindset

🥭 coming soon!

Instagram: https://www.instagram.com/doctorgallagher/

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YouTube Shorts: https://youtube.com/channel/UCNqbFjVctSWlACMB-8wxymg

Twitter: @drgallagher_

10.6.23 👉 Do you have questions about applying to Oral & Maxillofacial Surgery residency 💀 or dental school 🦷? Keep an eye out for my next Q&A session, held on Instagram at the end of every month, for my live & personalized mentoring. This is for YOU 🤜🤛

🙋🏼‍♂️ These are clips from Instagram LIVE Q&A sessions, Tik Toks & Reels, and zoom events that I’ve hosted both individually and with our company Top Professionals 🙌 If you’re a club or organization and you’d like me to host your zoom event or conference, DM me on insta that is the best way to contact me directly 👌

*** 👉 PreDent Mentor Map is now live btw, at predentmentormap.org ! ***

⛈ If you have questions, thoughts or ideas that you’d like to discuss involving my other ventures, including entrepreneurship (Top Professionals LLC 🏔, Vé Club 🍷), our products/services (PreDent Mentor Map, Dentist Map, Winery Map), NFTs 🖼(@feelings.nft 🎨, or my NFTs story highlight) workouts 💪, music producing/performing 🎶 (SoundCloud, violin 🎻 ), DM me and let’s talk 🤙

❤️ MOST importantly: THANK YOU for watching and being on my team- I do this for YOU. Mentoring is what got me here, and it is how I’ll help you achieve your dream goals as best I can. You are a MASSIVE part of this journey to me, more than you know 🙌🙏🙌

🤠 @doctorgallagher

https://www.instagram.com/doctorgallagher/

🦷 Oral & Maxillofacial Surgery Resident

🏔 Top Professionals Cofounder

🎙 Podcast

🍷@topwineries

👨‍⚕️@doseofdentalpodcast

🦁@movesandmindset

🥭 coming soon!

Instagram: https://www.instagram.com/doctorgallagher/

LinkedIn: https://www.linkedin.com/in/brendan-gallagher-dds-bb8848a1

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Podcast: https://open.spotify.com/show/6OaweNluu3Y36uTcqlTBkK?si=_EMcxf12R9ex1Hxwg9N99A

YouTube Shorts: https://youtube.com/channel/UCNqbFjVctSWlACMB-8wxymg

Twitter: @drgallagher_

10.3.23

Quick Read #66 - #pathology #oralpathology #doctorgallagher #oralsurgery #oralsurgeon #dentist #dentistry #dental

The inferior alveolar nerve (IAN) is an essential structure in dentistry and oral surgery, as it provides sensory innervation to the mandibular teeth and the lower lip. A bifid inferior alveolar nerve refers to a variation where there is a branching or duplication of the nerve within the mandible.

1.Incidence: The incidence of a bifid inferior alveolar nerve is variable and depends on the study and imaging method used. While traditional panoramic radiographs might not always detect this anatomical variation, CBCT (cone-beam computed tomography) offers more precise visualization. Studies using CBCT have reported incidences ranging from 1% to upwards of 23%, but the average is often cited between 1% and 5%.

2.Complications:

•Dental Implant Surgery: A bifid IAN can pose a risk during the placement of dental implants in the posterior mandible, leading to nerve injury if not identified preoperatively.

•Endodontic Procedures: During root canal treatments, especially in cases with over-instrumentation or overfilling, a bifid IAN might be inadvertently affected.

•Third Molar Extractions: The removal of impacted third molars can pose a risk of nerve injury if the bifid branch is in close proximity.

•Local Anesthesia: Achieving profound anesthesia might require additional injections if the bifid IAN isn’t identified, leading to inadequate pain control during dental procedures.

•Orthognathic Surgery: Procedures that involve the surgical manipulation or movement of the mandible need to take into account the presence of a bifid IAN to prevent post-operative sensory complications.

Considering these potential complications, it’s essential for dental professionals to be aware of the possibility of a bifid IAN and, when in doubt, use advanced imaging techniques like CBCT to get a clear view of the anatomy before embarking on surgical or complex dental procedures.

References:

1. Parnia, F., Moslehifard, E., Hafezeqoran, A., Mahboub, F., & Mojaver-Kahnamoui, H. (2012). Characteristics of anatomical landmarks in the mandibular interforaminal region: A cone-beam computed tomography study. Medicine Oral, Patologia Oral y Cirugia Bucal, 17(3), e420.

2. Juodzbalys, G., Wang, H. L., & Sabalys, G. (2013). Anatomy of mandibular vital structures. Part II: Mandibular incisive canal, mental foramen and associated neurovascular bundles in relation with dental implantology. Journal of Oral & Maxillofacial Research, 4(1).

3. Bataineh, A. B., Al-Qudah, M. A., & Rawashdeh, M. A. (2005). The effect of surgical removal of third molars on the risk of injury to the inferior alveolar nerve. Journal of Oral and Maxillofacial Surgery, 63(5), 660-664.

4. ChatGPT. 2023.

10.2.23

Quick Read #65 - #trauma #mandible #fracture #surgery #facialtrauma #doctorgallagher #oralsurgery #oralsurgeon #dentist #dentistry #dental #jawfracture #jaw

1. Preoperative Planning & Assessment:

• Evaluate the nature and extent of the fracture with radiographic examinations (ie. panoramic radiographs, CT scans).

• Assess patient’s general health, allergies, and medications.

2. Anesthesia:

• General anesthesia is typically utilized for these cases.

3. Surgical Access:

• A common approach for parasymphysis fractures is the intraoral, or “transoral”, approach.

• An incision is made in the mucobuccal fold overlying the fracture site to access the fractured bone.

• Skeletonization of the mental nerve may be involved if in proximity to the fracture or surgical site.

4. Fracture Exposure and Debridement:

• Gently retract the soft tissues to expose the fracture site.

• Remove any debris or hematoma present in the fracture line.

• The fracture is exposed, and arch bars are applied.

5. Reduction:

• Manually reposition the fractured segments to achieve anatomical alignment.

• Manipulate the mandibular fragments until anatomic reduction is achieved. Apply the reduction forceps and then place the patient into occlusion with MMF.

6. Internal Fixation:

• Once the bone segments are aligned, and proper occlusion is verified in MMF, they are stabilized using titanium plates and screws. The number, size, and positioning of these will depend on the specifics of the fracture.

• Simple (linear) fractures can easily be treated with miniplates. However, these are often associated with additional injuries in the mandibular arch, and the surgeon may elect to use more rigid fixation.

• Locking plates with different profiles offer increased stability and can still be placed using the same surgical approach.

• Confirm adequate reduction.

• MMF is released, and the occlusion is checked.

• Depending on the fracture and repair, such as if 2 plates were used and occlusion and alignment was deemed appropriate, the arch bars may potentially be removed at this point in time.

7. Closure:

• The incision is closed using absorbable sutures. Ensure that there is no tension on the wound to prevent dehiscence.

8. Postoperative Care:

• Prescribe antibiotics and analgesics as required.

• Diet modification (soft diet) for a certain period.

• Instruct the patient on oral hygiene practices to keep the surgical site clean.

• Schedule follow-up appointments to monitor healing.

References:

1. Ellis, E., & Price, C. (2001). Treatment protocol for fractures of the atrophic mandible. Journal of Oral and Maxillofacial Surgery, 59(4), 419-425.

2. Miloro, M., Ghali, G. E., Larsen, P. E., & Waite, P. (Eds.). Peterson’s Principles of Oral and Maxillofacial Surgery (4th ed.). Springer.

3. AO Foundation. (2023). AO surgery reference. (www.aofoundation.org).

4. ChatGPT. 2023.

👉 Do you have questions about applying to Oral & Maxillofacial Surgery residency 💀 or dental school 🦷? Keep an eye out for my next Q&A session, held on Instagram at the end of every month, for my live & personalized mentoring. This is for YOU 🤜🤛

🙋🏼‍♂️ These are clips from Instagram LIVE Q&A sessions, Tik Toks & Reels, and zoom events that I’ve hosted both individually and with our company Top Professionals 🙌 If you’re a club or organization and you’d like me to host your zoom event or conference, DM me on insta that is the best way to contact me directly 👌

*** 👉 PreDent Mentor Map is now live btw, at predentmentormap.org ! ***

⛈ If you have questions, thoughts or ideas that you’d like to discuss involving my other ventures, including entrepreneurship (Top Professionals LLC 🏔, Vé Club 🍷), our products/services (PreDent Mentor Map, Dentist Map, Winery Map), NFTs 🖼(@feelings.nft 🎨, or my NFTs story highlight) workouts 💪, music producing/performing 🎶 (SoundCloud, violin 🎻 ), DM me and let’s talk 🤙

❤️ MOST importantly: THANK YOU for watching and being on my team- I do this for YOU. Mentoring is what got me here, and it is how I’ll help you achieve your dream goals as best I can. You are a MASSIVE part of this journey to me, more than you know 🙌🙏🙌

🤠 @doctorgallagher

https://www.instagram.com/doctorgallagher/

🦷 Oral & Maxillofacial Surgery Resident

🏔 Top Professionals Cofounder

🎙 Podcast

🍷@topwineries

👨‍⚕️@doseofdentalpodcast

🦁@movesandmindset

🥭 coming soon!

Instagram: https://www.instagram.com/doctorgallagher/

LinkedIn: https://www.linkedin.com/in/brendan-gallagher-dds-bb8848a1

TikTok: https://www.tiktok.com/@doctorgallagher_?_t=8WfqIHAlDEE&_r=1

Podcast: https://open.spotify.com/show/6OaweNluu3Y36uTcqlTBkK?si=_EMcxf12R9ex1Hxwg9N99A

YouTube Shorts: https://youtube.com/channel/UCNqbFjVctSWlACMB-8wxymg

Twitter: @drgallagher_

👉 Do you have questions about applying to Oral & Maxillofacial Surgery residency 💀 or dental school 🦷? Keep an eye out for my next Q&A session, held on Instagram at the end of every month, for my live & personalized mentoring. This is for YOU 🤜🤛

🙋🏼‍♂️ These are clips from Instagram LIVE Q&A sessions, Tik Toks & Reels, and zoom events that I’ve hosted both individually and with our company Top Professionals 🙌 If you’re a club or organization and you’d like me to host your zoom event or conference, DM me on insta that is the best way to contact me directly 👌

*** 👉 PreDent Mentor Map is now live btw, at predentmentormap.org ! ***

⛈ If you have questions, thoughts or ideas that you’d like to discuss involving my other ventures, including entrepreneurship (Top Professionals LLC 🏔, Vé Club 🍷), our products/services (PreDent Mentor Map, Dentist Map, Winery Map), NFTs 🖼(@feelings.nft 🎨, or my NFTs story highlight) workouts 💪, music producing/performing 🎶 (SoundCloud, violin 🎻 ), DM me and let’s talk 🤙

❤️ MOST importantly: THANK YOU for watching and being on my team- I do this for YOU. Mentoring is what got me here, and it is how I’ll help you achieve your dream goals as best I can. You are a MASSIVE part of this journey to me, more than you know 🙌🙏🙌

🤠 @doctorgallagher

https://www.instagram.com/doctorgallagher/

🦷 Oral & Maxillofacial Surgery Resident

🏔 Top Professionals Cofounder

🎙 Podcast

🍷@topwineries

👨‍⚕️@doseofdentalpodcast

🦁@movesandmindset

🥭 coming soon!

Instagram: https://www.instagram.com/doctorgallagher/

LinkedIn: https://www.linkedin.com/in/brendan-gallagher-dds-bb8848a1

TikTok: https://www.tiktok.com/@doctorgallagher_?_t=8WfqIHAlDEE&_r=1

Podcast: https://open.spotify.com/show/6OaweNluu3Y36uTcqlTBkK?si=_EMcxf12R9ex1Hxwg9N99A

YouTube Shorts: https://youtube.com/channel/UCNqbFjVctSWlACMB-8wxymg

Twitter: @drgallagher_

Quick Read #64 - #infection #teeth #pathology #oralpathology #doctorgallagher #oralsurgery #oralsurgeon #dentist #dentistry #dental

Leukocytosis refers to an elevated white blood cell (WBC) count in the bloodstream. White blood cells are a crucial part of the immune system, and their numbers can increase in response to various factors, including infections and inflammation.

In certain odontogenic infections, such as dental abscesses or severe gum infections, leukocytosis can occur as a response to the infection. This happens because the body recognizes the presence of bacteria or other pathogens in the oral cavity and mobilizes white blood cells to fight the infection.

The elevation of WBC count in infections is a part of the body's natural defense mechanism. When pathogens invade the body, the immune system releases signaling molecules called cytokines, which stimulate the bone marrow to produce more white blood cells. This increased production leads to a higher WBC count in the bloodstream.

Key signs and symptoms that clinicians should look for to assess the severity of an infection, in addition to the WBC, may include:

1. Vital signs including blood pressure, heart rate, and fever, which indicates an inflammatory response.

2. Pain, edema, and erythema at the site of the infection.

3. Trismus; difficulty when opening the jaw.

4. Pus or discharge from the affected area.

5. Extent of swelling into other spaces of the face, head and neck.

6. Enlarged lymph nodes in the neck or jaw area.

7. Systemic symptoms such as fatigue and malaise.

8. Recent administration of corticosteroids (ie. dexamethasone, for example, can cause an increase in WBC; sometimes given to decrease inflammation in the setting of surgery)

Clinicians may also use imaging studies, such as X-rays or CT scans, to assess the extent of the infection and its potential complications, such as abscess formation or involvement of nearby structures.

It's important to note that not all infections lead to leukocytosis, and the degree of elevation in WBC count can vary depending on the type and severity of the infection, as well as individual patient factors. Monitoring the WBC count, along with clinical symptoms and imaging, can help guide treatment decisions in cases of odontogenic infections or any other infectious condition.

References:

1. Janeway, C. A., Travers, P., Walport, M., & Shlomchik, M. J. (2001). Immunobiology: The Immune System in Health and Disease. Garland Science.

2. Newman, M. G., Takei, H. H., Klokkevold, P. R., & Carranza, F. A. (2014). Carranza’s Clinical Periodontology. Saunders.

3. Kumar, V., Abbas, A. K., Aster, J. C., & Robbins, S. L. (2020). Robbins Basic Pathology. Elsevier.

4. ChatGPT. 2023.