Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons
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The purpose of this study was to describe the imaging characteristics of posterior disc displacement of the temporomandibular joint (TMJ). ⋯ Posterior disc displacement of the TMJ is rare but has probably been overlooked in the past because of a lack of well-defined imaging characteristics.
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J. Oral Maxillofac. Surg. · Oct 1998
Randomized Controlled Trial Comparative Study Clinical TrialComparison of propofol and methohexital continuous infusion techniques for conscious sedation.
Methohexital and propofol have been shown to be effective agents for continuous intravenous infusion to produce conscious sedation during oral surgical procedures. The current study was conducted to compare these techniques for intraoperative cardiopulmonary stability, patient cooperation, amnesia, comfort, recovery time, and postoperative nausea and vomiting. ⋯ A continuous infusion technique using either methohexital or propofol (50 to 100 microg/kg/min) was found to be safe and effective, with no clinically significant differences in cooperation, cardiopulmonary stability, recovery time, amnesia, comfort, and the incidence of nausea or vomiting. However, the cost-effectiveness of methohexital is superior to that of propofol.
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J. Oral Maxillofac. Surg. · Oct 1998
The use of ultrasonography as a diagnostic tool for superficial fascial space infections.
This study examined the value of ultrasonography as a diagnostic tool in the treatment of superficial acute odontogenic fascial space infections. ⋯ Ultrasonography is an effective diagnostic tool to confirm abscess formation in the superficial fascial spaces and is highly predictable in detecting the stage of infection.
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J. Oral Maxillofac. Surg. · Sep 1998
Randomized Controlled Trial Comparative Study Clinical TrialIncremental bolus versus a continuous infusion of propofol for deep sedation/general anesthesia during dentoalveolar surgery.
This article compared the use of the traditional incremental bolus technique with the continuous infusion technique for the administration of propofol for deep sedation/general anesthesia. ⋯ This study, although finding advantages in the continuous infusion technique, showed satisfactory conditions associated with both techniques.
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J. Oral Maxillofac. Surg. · Sep 1998
The use of opioid drugs in management of chronic orofacial pain.
The use of opioid analgesics for the management of patients with chronic pain is controversial. However, randomized and double-blind clinical trials have shown that in select groups of patients with chronic pain, the daily administration of oral opioids decreases pain levels and improves quality of life. This article provides a review of the most recent basic and clinical research supporting the rationale for the use of opioids in a select group of patients with chronic orofacial pain. ⋯ It is essential that potential patients for this type of therapy have been carefully screened and have not had a history of drug addiction. The criteria to be evaluated when considering opioid therapy for chronic orofacial pain control include 1) inadequate pain diminution from prior nonopioid therapy, 2) negative history of substance abuse, 3) definitive determination that the pain being treated is of physiologic rather than psychologic origin, 4) a willingness to adhere to an "opioid contract" between the doctor and patient, 5) compliance with a scheduled, rather than "as needed" or "breakthrough," administration of an oral opioid, and 6) close clinical follow-up to evaluate pain relief, return to daily activities, and titration of drug levels. If these criteria are followed, administration of oral opioids may be a successful means of decreasing the patient's debilitating chronic pain to tolerable levels, enabling an improvement in the quality of life and return to function.