Fabrizio Carini

Hereditary Angioedema in Oral Surgery: Overview of the Clinical Picture and Report of a Case

p p t ngioedema is a pathologic condition first described y Quincke and Osler. It can be genetically deterined or acquired, and it is caused by a vascular eaction induced by deficiency or functional altertion of the C1 inhibitor (C1-INH), an enzyme inolved in the regulation of complement, contact, firinolytic, and coagulation systems. Two forms of angioedema have been described in he literature: hereditary angioedema (HAE) and acuired or idiopathic angioedema (AAE). HAE is characterized by dominant autosomal transission, early onset, and a positive family history. It s caused by a mutation of the gene for C1-INH, ocalized on chromosome 11. Type 1 HAE is the most requent form (85% of cases) and is associated with eficiency of functional C1-INH in plasma (10%-30% f normal values). Type 2 HAE is characterized by ormal or elevated plasma levels of dysfunctional C1NH. Type 3 HAE occurs mainly in women. Affected ersons display the typical clinical features of C1-INH

Osteoradionecrosis of the Posterior Maxilla: A New Approach Combining Erbium: Yttrium Aluminium Garnet Laser and Bichat Bulla Flap.

AbstractOsteoradionecrosis (ORN) of the jaw is a complication of radiation therapy for head and neck cancers. We report a case of ORN of the posterior maxilla treated with Er: YAG laser and a pedicled buccal fat pad (bichat bulla adipose) flap. A 69-year-old man presented complaining of pain on left maxilla. He had received high-dose radiotherapy (90u200aGy) for squamous cell carcinoma of the left soft palate 2 years earlier. Clinical and radiographic examinations revealed ORN of the left maxillary molar region and maxillary sinusitis. Daily home care consisted of 0.9% saline irrigation and 0.8% H2O2 gel application. Sequestrectomy and tooth extraction were followed by debridement with Er: YAG laser and repair with a pedicled buccal fat pad flap. Complete resolution of ORN and maxillary sinusitis was established one year postsurgically. The excellent clinical outcome suggests that Er: YAG laser debridement and pedicled buccal fat pad flap are a viable option to treat ORN of the posterior maxilla.