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. · Sep 2005
Randomized Controlled Trial Comparative Study Clinical TrialConservative therapy in patients with anterior disc displacement without reduction using 2 common splints: a randomized clinical trial.
We performed a comparative evaluation of different types of splint therapy for anterior disc displacement without reduction (ADDWR) of the temporomandibular joint. ⋯ Centric splints seem to be more effective than distraction splints. Therefore, before the surgical treatment of ADDWR, centric splints should be used instead of distraction splints.
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J. Oral Maxillofac. Surg. · Sep 2005
ReviewAnesthetic considerations for the obese and morbidly obese oral and maxillofacial surgery patient.
The purpose of this article is to review the problems of anesthetic management of the obese patient and review current literature on this topic. Obesity is associated with a wide spectrum of medical problems. Anesthetic management requires being familiar with the pathophysiologic changes associated with obesity as well as the specific management issues that can arise. We will review recommendations from the literature on anesthesia management as they apply to the oral and maxillofacial surgeon.
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J. Oral Maxillofac. Surg. · Aug 2005
Comparative StudyComparison of the severity of bilateral Le Fort injuries in isolated midface trauma.
The Le Fort classification pattern established in 1901 by the French surgeon Rene Le Fort is commonly used in describing midface fractures. This frequently used classification system is based on predictable patterns of midface fractures initially described for blunt trauma. The purpose of this study was to compare the profile and outcome of patients with isolated bilateral Le Fort I, II, and III fractures. ⋯ Patients with higher Le Fort injuries are characterized by an overall greater severity of injuries as measured by the ISS and the more frequent need for a surgical airway. Patients with Le Fort III injuries have a higher chance of requiring neurosurgical intervention or of experiencing vision-threatening ocular trauma. Immediate operative intervention and/or ICU care is more frequently indicated in these patients.
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J. Oral Maxillofac. Surg. · Aug 2005
Randomized Controlled Trial Comparative Study Clinical TrialThe analgesic efficacy of intravenous versus oral tramadol for preventing postoperative pain after third molar surgery.
The aim of this study was to compare the analgesic efficacy of single-dose preoperative intravenous versus oral tramadol for preventing pain after third molar surgery. ⋯ We conclude that preoperative intravenous tramadol is superior to oral tramadol for preventing postoperative pain following third molar surgery. However, it should be noted that there is a difference in the bioavailability between the 2 formulations of up to 30%, which may explain the findings.
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J. Oral Maxillofac. Surg. · Aug 2005
Multicenter Study Comparative Study Clinical TrialPain medication as an indicator of interference with lifestyle and oral function during recovery after third molar surgery.
Purpose This study was designed to assess the impact of taking pain medications, as a more comprehensive indicator of perceived pain, on the extent of interference with lifestyle and oral function during recovery after third molar surgery. Patients and Methods Recovery data after the removal of 4 third molars were available for patients enrolled in an institutional review board-approved, prospective, multicenter clinical trial. A self-administered health-related quality of life instrument, designed to assess a patients perception of recovery for pain, lifestyle, and oral function, was completed each postsurgery day (PSD) for 14 days. ⋯ Conclusions Patients with pain sufficient to prompt taking pain medications were likely to report interference with recovery for lifestyle and oral function. A patients choice to take pain medication appears to be a better indicator of a patients perceived pain and the impact of that pain on recovery than numerical pain scales. This method provides more sensitive behavioral information during the period of recovery after third molar removal.