The British journal of oral & maxillofacial surgery
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Obtaining consent to undertake orthognathic surgery is a legal requirement that starts at the initial visit when treatment is being considered and continues until the operation itself. The process includes discussion of the benefits, risks, and potential complications of the proposed procedure, and any alternative (including doing nothing), but there is no consensus about how much information should be disclosed. ⋯ The purpose of this study was to look at the current practice of obtaining consent for orthognathic surgery by oral and maxillofacial surgeons in the UK to act as a benchmark and potentially to stimulate further debate. We also review common and serious complications that might be included in the process.
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Br J Oral Maxillofac Surg · Mar 2012
Randomized Controlled TrialSubmucous tramadol increases the anesthetic efficacy of mepivacaine with epinephrine in inferior alveolar nerve block.
The purpose of this study was to evaluate the effect of submucous tramadol as adjuvant of mepivacaine with epinephrine in inferior alveolar nerve block. A double-blind, randomized, placebo-controlled, crossover clinical trial was conducted. Twenty healthy young volunteers were randomized into two treatment sequences using a series of random numbers. ⋯ We evaluated the duration of anesthesia of lower lip, anesthetic efficacy, and local and systemic adverse events. Anesthetic efficacy was better in group receiving submucous tramadol during the first 2h compared with group receiving submucous placebo (P<0.05). Submucous tramadol increased the anesthetic efficacy of mepivacaine with epinephrine of soft tissue in inferior alveolar nerve block.
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Br J Oral Maxillofac Surg · Mar 2012
ReviewReview of evidence for the use of steroids in orthognathic surgery.
Primarily, steroids are used routinely in orthognathic surgery to reduce swelling, but there is no nationally accepted regimen for the use of glucocorticoids in the UK. This article examines the evidence base for the use of steroids to reduce swelling, nausea, vomiting, and pain, and looks at evidence of the ratio of risks:benefits in orthognathic surgery and related publications. ⋯ The current regimens are associated with little morbidity and low cost. A well designed multi-centre study whose design would allow objective measures of swelling is required to resolve the areas of debate.