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Ho-Young Chung Replied at Sun, Feb 18, 2018 9:28 AM
Good decision Chad. Dr Jin answered everything. I have seen and treated cases with larger intraosseous arteries (seen on cbct) but yours shows up on PA. mind you I take cbct and Pano usually.
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Bernard Jin Replied at Fri, Feb 16, 2018 9:10 AM
Your observation is typical of the PSA. It usually sits attached to the schneidarian membrane if you are able to dissect it from the bone. Sometimes it can be embedded within the cortical plate itself. Yes - often we encounter it when performing the osseous removal.
Bleeding management? Pretty much all of the above. However, the best practice is not to severe it to begin with. Incidence of the bleeding varies on clinician's experience and approach; for me, the bleeding is an issue maybe <10% of the time. If you perform very delicate window preparation, often you will notice the vessel move with the membrane as you lift it.
Steroids - well - that's controversial. My IV sedation mentors were never proponents of it. Oral surgeon mentors were. I take it as a case-by-case basis - if the medical history permits it. Steroids WILL minimize the inflammation for only a few days - but the inflammatory process still occurs... maybe distant enough for patient to blame you/the surgery. LoL.
Hope that answers your questions :)