Oral and maxillofacial surgery
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Oral Maxillofac Surg · Sep 2013
Randomized Controlled Trial Comparative StudyAssessment of preemptive analgesia with ibuprofen coadministered or not with dexamethasone in third molar surgery: a randomized double-blind controlled clinical trial.
There is no conclusive evidence from clinical trial studies regarding preemptive analgesic interventions. Clinical trials are necessary to evaluate the efficacy of preemptive analgesic interventions already demonstrated in animal studies. Thus, it is necessary to evaluate the analgesic effect of preoperative administration of ibuprofen alone or coadministered with dexamethasone after third molar surgery. ⋯ The preemptive analgesia with ibuprofen was insufficient to inhibit central sensitization, whereas its association with dexamethasone was more effective in preventing pain in third molar surgery.
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Oral Maxillofac Surg · Sep 2013
Randomized Controlled Trial Comparative Study Historical ArticleAnalgesic efficacy and clinical acceptability of adjunct pre-emptive intravenous tramadol in midazolam sedation for third molar surgery.
This study aims to compare two routine procedures of sedation, with and without intravenous adjunct analgesia, in third molar surgery regarding postoperative pain and consumption of analgesics. ⋯ The lack of significant difference between the study and placebo groups indicates that tramadol at 1 mg/kg might be an insufficient dose, though the suitability for tramadol in oral and maxillofacial surgery has already been settled in other studies.
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Oral Maxillofac Surg · Jun 2013
Review Comparative StudyOpen versus closed reduction: comminuted mandibular fractures.
The purpose of the study was to review the literature regarding the evolution of current thoughts on management of comminuted mandibular fractures (CMFs). ⋯ Open reduction and internal fixation (ORIF) in cases of CMFs are indicated in (a) severe injuries with significant displacement to allow restoration of pretraumatic anatomic relationships, (b) in the edentulous and semi-dentate patient, who may benefit from ORIF of CMFs when stable occlusal relationships are absent, and (c) in cases with multiple fractures of the midface, in which the mandible has to serve as a guide to reposition the midfacial bones. However, there is still a place for closed reduction/conservative treatment (CTR). ORIF in CMFs is not indicated in cases of minimally displaced comminuted fractures that could easily and adequately be treated with CTR. If the surgical team is not well versed in the nuances of rigid internal fixation, or the necessary equipment is not available, it is far better to do simple CTR. However, it would be more reasonable to refer the patient to a hospital that can provide means of ORIF in cases of clear indication of its use in CMFs. In cases where ORIF is indicated, stabilization by compression or any other form of load-sharing osteosynthesis is obviously contraindicated because small fragments cannot be compressed and are not capable of sharing loads. Thus, the ORIF of CMFs is best performed using load-bearing osteosynthesis; most experience has been gained with 2.7-mm reconstruction plates. External pin fixation could be used in cases when there is so much comminution, soft tissue disruption (mostly gunshot wounds), and there are inadequate teeth on either side of the comminuted fracture to control the spatial relationship of the remaining mandibular fragments with maxillomandibular fixation (MMF).
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Oral Maxillofac Surg · Dec 2012
Randomized Controlled Trial Comparative StudyComparison of clonidine and midazolam as anxiolytic premedication before wisdom tooth surgery: a randomized, double-blind, crossover pilot study.
Anxiolytic and possible side effects of clonidine 150 μg compared to midazolam 7.5 mg for premedication in surgical wisdom tooth extraction were evaluated. ⋯ Oral administration of clonidine 150 μg and midazolam 7.5 mg were rated as medications with equal anxiolytic effects before wisdom tooth surgery under local anesthesia.
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Oral Maxillofac Surg · Dec 2012
Review Case ReportsTransient diplopia with ipsilateral abducent nerve palsy and ptosis following a maxillary local anesthetic injection: a case report and review of literature.
The posterior superior alveolar (PSA) nerve block is commonly used in dentistry for treatment of the maxillary molars. Although this procedure is associated with many complications, ocular complications have been rarely reported. ⋯ Although rare, the dentist should be aware of these complications to avoid being perplexed by this unexpected circumstance, thus adversely affecting the doctor-patient trust.