Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons
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J. Oral Maxillofac. Surg. · Dec 2011
Randomized Controlled TrialBleeding evaluation during single tooth extraction in patients with coronary artery disease and acetylsalicylic acid therapy suspension: a prospective, double-blinded, and randomized study.
Acetylsalicylic acid (ASA) has been used for the primary and secondary prevention of cardiovascular events. To reduce bleeding, the administration of ASA has traditionally been suspended before dental procedures; however, this suspension potentially increases the risk of thromboembolic events. The effect of ASA on the amount of bleeding that occurs during tooth extraction procedures is controversial, and perioperative guidelines recommend that ASA administration should not be altered for such procedures. The aim of this study was to evaluate the amount of bleeding that occurs during the intraoperative period of tooth extraction procedures in patients with coronary artery disease who are either undergoing acetylsalicylic acid (ASA) therapy or who have been instructed to suspend their ASA use. ⋯ There was no difference in the amount of bleeding that occurred during tooth extraction between patients who continued ASA therapy versus patients who suspended their ASA therapy. The platelet reactivity test demonstrated a reduction in platelet aggregation in the ASA therapy group (group NS), but this reduction was without clinical consequence.
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J. Oral Maxillofac. Surg. · Dec 2011
Randomized Controlled TrialThe efficacy of dextrose prolotherapy for temporomandibular joint hypermobility: a preliminary prospective, randomized, double-blind, placebo-controlled clinical trial.
The aim of this study was to assess the efficacy of dextrose prolotherapy for the treatment of temporomandibular joint (TMJ) hypermobility. ⋯ Prolotherapy with 10% dextrose appears promising for the treatment of symptomatic TMJ hypermobility, as evidenced by the therapeutic benefits, simplicity, safety, patients' acceptance of the injection technique, and lack of significant side effects. However, continued research into prolotherapy's effectiveness in patient populations with large sample sizes and long-term follow-up is needed.
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J. Oral Maxillofac. Surg. · Dec 2011
Two-stage treatment protocol for management of temporomandibular joint ankylosis with secondary deformities in adults: our institution's experience.
Treatment of adult patients with temporomandibular joint (TMJ) ankylosis and secondary deformities is a challenging problem. Although various techniques, including arthroplasties, orthognathic surgery, autogenous bone graft, and distraction osteogenesis, have been described for the management of patients with this condition, an appropriate treatment protocol has not been established. The purpose of this report is to describe a 2-stage treatment protocol, comprising TMJ reconstruction as the initial surgery, followed by orthodontic treatment, and correction of secondary deformities as the second surgery, for the management of TMJ ankylosis with secondary deformities in adults. ⋯ The 2-stage treatment protocol described not only restores oral function but also improves the patient's esthetic appearance. We believe that it is a good approach for management of TMJ ankylosis with secondary deformities in adult patients.