Oral Surg Oral Med O
-
Oral Surg Oral Med O · Dec 2004
Randomized Controlled Trial Clinical TrialA prospective randomized crossover study of the preemptive analgesic effect of nitrous oxide in oral surgery.
Preliminary animal data has shown that nitrous oxide has a preemptive analgesic effect on postoperative pain. Whether a similar effect occurs in humans is not established. In this prospective randomized crossover study, we investigated the effect of preincisional versus postincisional nitrous oxide on postoperative oral surgical pain.Study design The trial was a crossover study where 36 patients had each of their symmetrical impacted mandibular third molars randomly scheduled for removal in 2 sessions. Each of the 36 patients acted as his or her own control; one side of the jaw was allocated randomly to receive nitrous oxide preoperatively (pretreated side) and the other side postoperatively (posttreated side). The pretreated side received 50% nitrous oxide preoperatively for 20 minutes and 100% oxygen postoperatively for 20 minutes as placebo. The posttreated side received 100% oxygen preoperatively for 20 minutes and 50% nitrous oxide postoperatively for 20 minutes. The difference in postoperative pain between the pretreated and posttreated sides was assessed by 4 primary end-points: pain intensity as measured by a 100-mm visual analog scale (VAS) hourly for 8 hours, time to first analgesic, total analgesic consumption during the first 48 hours, and a 5-point categorical patient global assessment scale (0=poor, 1=fair, 2=good, 3=very good, and 4=excellent). ⋯ Our results do not support the preliminary animal data that nitrous oxide has a preemptive analgesic effect for postoperative pain. 50% nitrous oxide administered preoperatively for 20 minutes has no preemptive analgesic effect on postextraction pain.
-
Oral Surg Oral Med O · Sep 2004
Case ReportsEffectiveness of an educational program in reducing the incidence of wrong-site tooth extraction.
The aim of the study was to investigate the effectiveness of an educational program on the reduction of the incidence of wrong-site tooth extraction at the outpatient department of a university hospital in Taiwan. ⋯ Our results suggest the effectiveness of an educational program comprising case-based materials, information feedback, and clinical guidelines in reducing the incidence of wrong-site tooth extraction.
-
Oral Surg Oral Med O · Jul 2004
Randomized Controlled Trial Clinical TrialInjection pain and postinjection pain of the anterior middle superior alveolar injection administered with the Wand or conventional syringe.
The purpose of this prospective, randomized, blinded study was to compare the pain of injection and post-injection pain of the AMSA injection using the computer-assisted Wand Plus injection system versus a conventional syringe. ⋯ The AMSA injection, using the Wand Plus, resulted in similar pain ratings for needle insertion as the conventional syringe but statistically lower pain ratings upon anesthetic solution deposition. However, the AMSA, using either the Wand Plus or a conventional syringe, has the potential to be a painful injection. We found the incidence of postinjection pain and sequelae was low with both techniques.
-
Oral Surg Oral Med O · Jul 2004
Review Case ReportsPseudo bilateral tonsilloliths: a case report and review of the literature.
Tonsilloliths are very rare concretions found in the tonsillar crypt. They are usually single and unilateral, but occasionally may be multiple or bilateral. Small concretions in the tonsils are common, but well formed giant unilateral or bilateral tonsilloliths are extremely uncommon. ⋯ A case of unilateral tonsillolith, mimicking bilateral tonsilloliths taken with the orthopantogram (OPT) in a 57-year-old Malaysian Indian female with squamous cell carcinoma of the oral cavity is described. Although the OPT is a reliable and standard panoramic X-ray unit used in dentistry, superimposition of a lesion involving one side of the jaw creates a pseudo or ghost image on the contralateral side leading to a misdiagnosis of bilateral lesions. This report highlights that tonsilloliths, though rare, should be considered in the differential diagnosis of radiopaque masses involving the mandibular ramus, and that investigations such as CT scan or MRI may be required to differentiate pseudo or ghost images from true bilateral pathologies.
-
Pregnancy results in physiologic changes in almost all organ systems in the body mediated mainly by female sex hormones. Physiologic changes of pregnancy influence the dental management of women during pregnancy. Understanding these normal changes is essential for providing quality care for pregnant women. ⋯ Information about the compatibility, complications, and excretion of the common drugs during pregnancy is provided. Drugs and their usage during breast-feeding are also discussed. Guidelines for the management of a pregnant patient in the dental office are summarized.