M A Pogrel

University of California, San Francisco, San Francisco, California, United States

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Publications (175)216.8 Total impact

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    ABSTRACT: Odontogenic infections are rarely implicated in the causes of brain abscess formation. As such, there are very few reports of brain abscesses secondary to odontogenic infections in the literature. This is due partly to the relative rarity of brain abscesses but also to the difficulty in matching the causative organisms of a brain abscess to an odontogenic source. The authors report a case of a 50-year-old woman whose brain abscess may potentially have been secondary to an odontogenic infection. The patient's early diagnosis, supported by imaging and microbiologic assessment, along with early minicraniotomy and extraction of infected dentition followed by a course of cephalosporins and metronidazole, contributed to a successful outcome.
    10/2013; 117(2). DOI:10.1016/j.oooo.2013.08.011
  • M A Pogrel
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    ABSTRACT: In 2005, the World Health Organization renamed the lesion previously known as an odontogenic keratocyst as the keratocystic odontogenic tumor. The clinical features associated with the keratocystic odontogenic tumor show it to be a unilocular or multilocular radiolucency, occurring most frequently in the posterior mandible. These tumors are normally diagnosed histologically from a sample of the lining. With simple enucleation, it seems that the recurrence rate may be from 25% to 60%.
    Oral and maxillofacial surgery clinics of North America 12/2012; 25(1). DOI:10.1016/j.coms.2012.11.003 · 0.48 Impact Factor
  • M Anthony Pogrel
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    ABSTRACT: Permanent nerve involvement has been reported following inferior alveolar nerve blocks. This study provides an update on cases reported to one unit in the preceding six years. Lidocaine was associated with 25 percent of cases, articaine with 33 percent of cases, and prilocaine with 34 percent of cases. It does appear that inferior alveolar nerve blocks can cause permanent nerve damage with any local anesthetic, but the incidences may vary.
    Journal of the California Dental Association 10/2012; 40(10):795-7.
  • M Anthony Pogrel
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    ABSTRACT: The purpose of this article is to summarize the literature that addresses the following question: "Among patients undergoing third molar removal, do patients who are younger, eg, <25 years, when compared with older patients, have a decreased risk for postoperative complications and more rapid recovery?" For the purposes of this study, relevant articles were identified through a search of PubMed, Scopus, and the Cochrane Database, using the Medical Subject Headings search terms "third molars" or "wisdom teeth," "complications" and "age," linked to "recovery," "infections," "periodontal conditions," "temporomandibular joint problems," "nerve involvement," "sinus communication," and "mandibular fracture." Relevant studies have been identified and are reported for the following complications and their relationship to the patient's age: 1) time to recovery; 2) incidence of fractures; 3) rates of infection; 4) periodontal complications; 5) nerve involvement; 6) temporomandibular joint complications; 7) nerve injury; and 8) sinus-related complications. Studies indicate that as one becomes older, third molars (M3s) become more difficult to remove, may take longer to remove, and may result in an increased risk for complications associated with removal. The age of 25 years appears in many studies to be a critical time after which complications increase more rapidly. Conversely, there are no studies indicating a decrease in complications with increasing age. It also appears that recovery from complications is more prolonged and is less predictable and less complete with increasing age. As such, many clinicians recommend removal of M3s in patients as young adults. Advocates of M3 retention need to review carefully with their patients the risks of delaying M3 removal with the same degree of emphasis as the risks associated with operative treatment.
    Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 06/2012; 70(9 Suppl 1):S37-40. DOI:10.1016/j.joms.2012.04.028 · 1.28 Impact Factor
  • M Anthony Pogrel
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    ABSTRACT: The purpose of this article is to conduct a literature review, identify the studies with the highest level of evidence, and summarize the complications associated with operative treatment of impacted third molars (M3s). To address the research purpose, a search of PubMed, Scopus, and the Cochrane Database was performed, using the Medical Subject Headings search terms "third molars" or "wisdom teeth," "complications," "periodontal complications," "temporomandibular joint," "nerve involvement," "sinus communication," and "mandibular fracture." Individual case reports and anecdotal reports were excluded from review. Relevant studies for the following complications were identified and are reported: 1) periodontal, 2) temporomandibular joint, 3) nerve injury, 4) sinus, and 5) other. Quality-of-life studies have indicated that around 10% of patients undergoing M3 removal may have a complication. However, most complications are mild and self-limited and undergo complete resolution. Most patients are back at work or school after 2 to 3 days, and long-term complications are rare. Clinicians advocating M3 removal should review in detail the risks of operative intervention in conjunction with the benefits of removal and should be prepared to prevent, anticipate, and manage these complications.
    Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 06/2012; 70(9 Suppl 1):S33-6. DOI:10.1016/j.joms.2012.04.029 · 1.28 Impact Factor
  • Darpan Bhargava, Ashwini Deshpande, M Anthony Pogrel
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    ABSTRACT: The World Health Organization (WHO) has reclassified 'odontogenic keratocyst' (OKC) to 'keratocystic odontogenic tumour' (KCOT) in 2005. Currently, this tumour is classified as a benign neoplasm of odontogenic origin and not as a cyst. This article reviews and discusses history, classification scheme, aetiology and pathogenesis, molecular and genetic basis, incidence, epidemiology and site, clinical features, imaging, histopathology, immunohistochemistry, treatment options, prognosis, recurrence and malignant transformation of KCOT, with emphasis on understanding the basis of reclassification as 'keratocystic odontogenic tumour'. A systematic search and review of the literature was carried out in the online database of the United States National Library of Medicine to identify eligible titles for the study. Current evidence suggests that the scientific community still continues to use the term 'odontogenic keratocyst' more favourably than 'keratocystic odontogenic tumour'. The online database search indicates that the scientific community still continues to use the term 'odontogenic keratocyst' more favourably than 'keratocystic odontogenic tumour'. At this juncture, where the terminology has changed from a cyst to a tumour, a thorough review of literature on KCOT is presented.
    Oral and Maxillofacial Surgery 11/2011; 16(2):163-70. DOI:10.1007/s10006-011-0302-9
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    ABSTRACT: There is little information available on the long-term effects on patients of permanent involvement of the inferior alveolar or lingual nerve because of dental treatment. This study has attempted to document this information from patients who were reviewed between 3 and 9 years after injury. All patients with an ICD-9 diagnosis of 951.2 (injury to the trigeminal nerve) because of dental treatment, seen in the Oral and Maxillofacial Surgery Clinic at the University of California, San Francisco between January 1, 2001 and December 31, 2006, were contacted in an attempt to complete a telephone survey of long-term effects. Of the 727 patients who were eligible for the study, 145 patients (95 female and 50 male) completed the telephone surveys. Many patients had sought both conventional and alternative treatments after consultation at University of California, San Francisco. A small number of patients had undergone subsequent surgery elsewhere. Many patients reported significant life changes, including adverse effects on employment (13%), relationship changes (14%), depression (37%), problems speaking (38%), and problems eating (43%). In general, however, patients reported improvement over time, often using a number of different coping mechanisms. Males had a greater decrease in symptoms than females, and those older than 40 years reported more pain in the long term than those under 40. Lingual nerve symptoms improved more than inferior alveolar nerve symptoms. Although most patients continue to have long-term problems that affect the overall quality of life, for most patients there has been improvement in symptoms over time.
    Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 05/2011; 69(9):2284-8. DOI:10.1016/j.joms.2011.02.023 · 1.28 Impact Factor
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    ABSTRACT: The aim of this study was to determine whether there are differences in esthetic preferences and orthognathic treatment for Asian patients between US- and Asian-trained surgeons. Twenty-five Caucasian-American, 23 Asian-American, 24 Asian oral and maxillofacial surgeons (OMFS) completed an Institutional Review Board (IRB)-approved survey. They were asked to rate seven Asian male and female profiles from most attractive to least attractive and to choose maxillary advancement, mandibular setback, or no treatment for an Asian male and female patient with a maxillomandibular discrepancy. There was no statistical difference for the most and least attractive rankings among the OMFS. Variations in ranking for intermediate profiles showed a statistical difference between the Asian- and US-trained OMFS. These intermediate profile rankings appeared to explain the differences in surgical treatment. Treatment recommendations for the Asian male among the OMFS, regardless of ethnicity, preferred maxillary advancement. For the Asian female, all Asian-trained OMFS preferred mandibular setback, while nearly 40% of US-trained OMFS preferred maxillary advancement (p=0.003). Differences in surgical management of the Asian patient were dependent on whether the surgeon trained in the US or in Asia and the gender of the patient. There was concordance between the Asian-American and Caucasian-American surgeons.
    International Journal of Oral and Maxillofacial Surgery 05/2011; 40(5):458-63. DOI:10.1016/j.ijom.2010.11.025 · 1.36 Impact Factor
  • Jae H Jun, Zachary Peacock, M Anthony Pogrel
    Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 11/2010; 68(11):2906-8. DOI:10.1016/j.joms.2010.05.063 · 1.28 Impact Factor
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    M A Pogrel
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    ABSTRACT: This study reports the signs and symptoms that are the features of trigeminal nerve injuries caused by local anaesthesia (LA). Thirty-three patients with nerve injury following LA were assessed. All data were analysed using the SPSS statistical programme and Microsoft Excel. Lingual nerve injury (LNI; n = 16) and inferior alveolar nerve injury (IANI; n = 17) patients were studied. LNI were more likely to be permanent. Neuropathy was demonstrable in all patients with varying degrees of paraesthesia, dysaesthesia (in the form of burning pain) allodynia and hyperalgesia. All injuries were unilateral. A significantly greater proportion of LNI patients (75%) had received multiple injections, in comparison to IANI patients (41%) (p <0.05). Fifty percent of patients with LNI reported pain on injection. The presenting signs and symptoms of both LNI and IANI included pain. These symptoms of neuropathy were constant in 88% of the IANI group and in 44% of LNI patients. Functional difficulties were different between the LNI and IANI groups, a key difference being the presence of severely altered taste perception in nine patients with LA-induced LNI. Chronic pain is often a symptom after local anaesthetic-induced nerve injury. Patients in the study population with lingual nerve injury were significantly more likely to have received multiple injections compared to those with IANI.
    British dental journal official journal of the British Dental Association: BDJ online 11/2010; 209(9):452-3. DOI:10.1038/sj.bdj.2010.1009 · 1.08 Impact Factor
  • M Anthony Pogrel
    Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 03/2010; 68(3):654-7. DOI:10.1016/j.joms.2009.04.008 · 1.28 Impact Factor
  • M Anthony Pogrel
    British Journal of Oral and Maxillofacial Surgery 03/2010; 48(5):398-9. DOI:10.1016/j.bjoms.2010.02.011 · 1.13 Impact Factor
  • M Anthony Pogrel
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    ABSTRACT: Local anesthetic needle fractures occur rarely. Since reports are uncommon, the mechanism and optimal treatment remain controversial. The author reviewed 16 cases of needle fracture that were reported during a 25-year period in one academic institution. Of 16 needle fractures, 15 occurred in connection with an inferior alveolar nerve block, and one occurred in connection with a posterior superior alveolar block. Of the 16 fractures, 13 involved a 30-gauge needle. Five of the patients involved were younger than 10 years. The oldest patient was 28 years old. In all cases, a surgeon retrieved the needle, often with radiological guidance, while the patient was under general anesthesia in an operating room. Most needle fractures occur during the administration of inferior alveolar nerve blocks, often with 30-gauge needles and in children who are reported to have moved suddenly and violently as the dentist gave the injection. Dentists should avoid burying any needle up to the hub (so as to ensure the possibility of immediately retrieving the needle intraorally), avoid using 30-gauge needles to administer inferior alveolar nerve blocks and avoid bending the needle before inserting it.
    Journal of the American Dental Association (1939) 12/2009; 140(12):1517-22. DOI:10.14219/jada.archive.2009.0103 · 2.24 Impact Factor
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    M Anthony Pogrel, David Dorfman, Heshaam Fallah
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    ABSTRACT: The arrangement of the structures within the inferior alveolar neurovascular bundle has not been clearly defined. Because this could be of importance in surgery involving the inferior alveolar canal, a study was undertaken. The inferior alveolar neurovascular bundle was dissected from 8 cadaveric mandibles and examined for the arrangement of the inferior alveolar artery, vein, and nerve. Histologic sections were taken for examination, and simultaneously, the bundle was exposed as part of a clinical surgical procedure for a marginal resection of the mandible. All 3 studies confirm that the inferior alveolar vein lies superior to the nerve and that there are often multiple veins. The artery appears to be solitary and lies on the lingual side of the nerve, slightly above the horizontal position. This position appeared to be consistent in all cases. Knowledge of the arrangement of the inferior alveolar artery vein and nerve within the inferior alveolar canal can be of importance in surgical procedures that may involve these structures. Dentoalveolar surgery, implant-related surgery, and surgery for trauma or pathology could involve these structures.
    Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 11/2009; 67(11):2452-4. DOI:10.1016/j.joms.2009.06.013 · 1.28 Impact Factor
  • Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 11/2009; 68(3):658-63. DOI:10.1016/j.joms.2007.12.033 · 1.28 Impact Factor
  • Len Tolstunov, M Anthony Pogrel
    Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 09/2009; 67(8):1764-6. DOI:10.1016/j.joms.2009.03.057 · 1.28 Impact Factor
  • Michael Anthony Pogrel
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    ABSTRACT: Conventional wisdom advises that when a tooth needs to be extracted, the whole tooth should be removed, usually with as little surrounding bone as possible. However, the evidence to support this is not compelling, and every dentist has experienced cases where the apices of teeth are not removed for a variety of reasons and, in most cases, the patient seems to suffer no ill effects. If one extrapolates from this, it is evident that there might be instances where it is actually preferable to leave the apical part of the root rather than remove it, and this can be carried out deliberately. The usual time that one would consider this is when the inferior alveolar nerve is intimately related to the roots of the lower molar teeth, and this occurs most often in relation to the third molar. This concept of deliberately removing only the crown and part of the root of the tooth is known variously as coronectomy, partial root removal, deliberate vital root retention, or partial odontectomy.
    Alpha Omegan 07/2009; 102(2):61-7. DOI:10.1016/j.aodf.2009.04.011
  • M A Pogrel, D M Montes
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    ABSTRACT: This study aimed to determine the appropriate long-term management for ameloblastoma and the role of enucleation in the management of the subtypes of ameloblastoma (solid ameloblastomas, cystic ameloblastomas and peripheral ameloblastomas). They differ in their degrees of aggressive behavior and recurrence rates. This is an evidence-based study with review of relevant articles from PubMed, EMBASE and the Cochrane Library. Articles were categorized for quality according to the Oxford Center of Evidence-Based Medicine (CEBM). 58 articles met the inclusion criteria; their evidence level varied from IIA to V. No randomized control trials were identified. Solid and multicystic ameloblastomas have a high recurrence rate (60-80%) with simple enucleation and require more aggressive treatment. The treatment of choice is resection with 1-cm margins. This may require segmental resection in the mandible, and partial maxillectomy in the maxilla. For the unicystic ameloblastoma recurrence rates are high for simple enucleation. The intraluminal subtype of unicystic ameloblastoma may do well with enucleation, but the intramural subtype may not, and since these cannot be identified preoperatively more aggressive treatment is recommended, including peripheral ostectomy or enucleation with subsequent treatment of the surrounding bone with liquid nitrogen, Carnoy's solution, or similar physicochemical modality. The peripheral ameloblastoma has a different origin and responds to local excision.
    International Journal of Oral and Maxillofacial Surgery 04/2009; 38(8):807-12. DOI:10.1016/j.ijom.2009.02.018 · 1.36 Impact Factor
  • Tadakatsu Kasai, M Anthony Pogrel, Mehran Hossaini
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    ABSTRACT: The success rate of dental implants placed in female patients taking oral bisphosphonates, before the risks became known in 2003, were compared with a control group of females receiving implants and not taking bisphosphonates. The bisphosphonate group had an overall success rate of 86 percent versus a success rate of 95 percent in the control group. This suggests that the failure rate of implants placed in patients taking oral bisphosphonates may be higher unless suggested safeguards are taken.
    Journal of the California Dental Association 02/2009; 37(1):39-42.
  • Zachary S Peacock, M Anthony Pogrel, Brian L Schmidt
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    ABSTRACT: Oral cancer continues to be diagnosed and treated at a late stage, which has a negative effect on outcomes. This study identified and quantified delays in diagnosis and treatment. The authors conducted a study that included all new patients seen in the Department of Oral and Maxillofacial Surgery, University of California, San Francisco, between 2003 and 2007 who had a diagnosis of squamous cell carcinoma of the oral cavity. They identified the time intervals for six stages, beginning with the time at which patients first became aware of symptoms and ending with the time at which definitive treatment began. The total time from patients' first sign or symptoms to commencement of treatment was a mean of 205.9 days (range, 52-786 days). The longest delay was from the time symptoms first appeared to the initial visit to a health care professional (mean time, 104.7 days; range, 0-730 days). Health care professionals need to place greater emphasis on patient education to encourage early self-referrals. Patients should be encouraged to visit a health care professional when signs or symptoms of oral cancer first develop.
    Journal of the American Dental Association (1939) 11/2008; 139(10):1346-52. DOI:10.14219/jada.archive.2008.0046 · 2.24 Impact Factor

Publication Stats

4k Citations
216.80 Total Impact Points


  • 1984–2013
    • University of California, San Francisco
      • • Department of Oral and Maxillofacial Surgery
      • • School of Dentistry
      San Francisco, California, United States
  • 2008
    • Tripler Army Medical Center
      Honolulu, Hawaii, United States
  • 2003
    • Baylor College of Dentistry
      San Francisco, California, United States
  • 1988–1998
    • Center For Oral & Maxillofacial Surgery
      Georgia, United States
  • 1996
    • University of the Pacific (California - USA)
      Stockton, California, United States
  • 1987–1996
    • University of San Francisco
      San Francisco, California, United States
  • 1995
    • University of Illinois at Chicago
      Chicago, Illinois, United States
  • 1990
    • University of Glasgow
      Glasgow, Scotland, United Kingdom