International journal of oral and maxillofacial surgery
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Int J Oral Maxillofac Surg · Oct 2003
Randomized Controlled Trial Clinical TrialTranexamic acid mouthwash--a prospective randomized study of a 2-day regimen vs 5-day regimen to prevent postoperative bleeding in anticoagulated patients requiring dental extractions.
This prospective randomized study analyses the use of a prescribed 4.8% tranexamic acid post-operative mouthwash over 2 days vs 5 days to prevent bleeding in patients taking warfarin who require dental extractions. Eighty-five patients therapeutically anticoagulated with warfarin for various conditions, ranging in age from 21 to 86 years and requiring dental extractions, were randomly divided into two groups. Group A postoperatively received a 4.8% tranexamic acid mouthwash to be used over a 2-day period. ⋯ Eighty-two of the 85 patients encountered no postoperative problems. Two patients in group A and one in group B had minor postoperative bleeds that required minor ambulatory intervention to control. This study shows that a 2-day postoperative course of a 4.8% tranexamic acid mouthwash is as equally effective as a 5-day course in controlling haemostasis post-dental extractions in patient's anticoagulated with warfarin.
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Int J Oral Maxillofac Surg · Oct 2003
Comparative StudyFear of recurrence and possible cases of anxiety and depression in orofacial cancer patients.
Recurrence risk in orofacial cancer patients is relatively high in comparison to other cancers. Little information exists on whether patients are unduly concerned over the possibility of recurrence and the association of this concern with psychological morbidity. Aim of study was to assess fear of recurrence and psychological morbidity in orofacial cancer patients. ⋯ This effect was significant on both occasions that sample two patients were assessed (P's<0.002). Very few patients who expressed no concern about recurrence, at 3 months, were found to report anxiety or depression sufficient to be recognized as a possible case (3 and 0% respectively). The positive association between psychological morbidity and fears of recurrence was significant at the majority of data collection points, with the exception that depression was more independent of these concerns.
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Int J Oral Maxillofac Surg · Oct 2002
Randomized Controlled Trial Comparative Study Clinical TrialA comparative study of sevoflurane sedation with nitrous oxide sedation for dental surgery.
This study compares the use of inhalation sedation using sevoflurane (group S) with inhalation sedation using nitrous oxide (group N) in patients undergoing bilateral extraction of third molar teeth under local anaesthesia. The study was designed as a cross-over study. Seventeen ASA I, day surgery patients were studied. ⋯ Both methods gave good amnesia during the procedure. There was high acceptance of both methods and the patients rated the technique as equally satisfactory. We conclude that inhalation sedation with sevoflurane is a suitable alternative method to nitrous oxide sedation.
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Int J Oral Maxillofac Surg · Aug 2002
Mandibular nerve block at the oval foramen using reliable landmarks: refinement of a previously described procedure.
The aim of this study was to improve the injection technique when blocking the mandibular nerve at the oval foramen by using consistent landmarks. The lower lateral orbital angle (LLOA) and the junction of the external acoustic canal and the mastoid process (AM) proved to be reliable landmarks. Distances between landmarks for the localization of the puncture point (PP), cranial indices as well as the angle of the injection needle to the sagittal plane were calculated on 22 human dried skulls. ⋯ The angle of the injection needle to the sagittal plane was 71.86 degrees. No correlation was found between the cranial index and the angulation of the needle or the distances for the localization of the PP. From this study a modified puncture technique was developed.
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Int J Oral Maxillofac Surg · Aug 2002
Case ReportsIntraoperative ultrasound imaging to aid abscess drainage--a technical note.
Diagnostic ultrasound is used widely to identify the presence of fluid collections preoperatively. Although its role in other parts of the body is well established, this report describes the technique of using diagnostic ultrasound intraoperatively to aid drainage of a large fascial space abscess in the head and neck. ⋯ Furthermore, ultrasound demonstrated the adequacy of drainage and helped the surgeon to position the drain in the correct tissue space. We consider that intraoperative use of ultrasound has a role as a guidance tool to drain superficial fascial space abscesses in the head and neck region.