Journal of oral surgery (American Dental Association : 1965)
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Protracted anterior dislocation of the mandible was successfully treated by a conservative method without recurrence after a year.
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Comparative Study
Hypothalamic-pituitary-adrenal suppression after short-term dexamethasone therapy for oral surgical procedures.
Ten patients were given dexamethasone therapy for prevention of postoperative complications after oral surgical procedures. The hypothalamic-pituitary-adrenal response of the patients was measured by their response to a single-dose metyrapone test. A significant difference was found between preoperative values of 11-deoxycortisol and values three days postoperatively. ⋯ There appears to be an initial suppression of the normal feedback mechanism of the hypothalamic-pituitary-adrenal axis followed by a complete return of normal functioning by the seventh postoperative day. The amount of surgical stress involved in these routine oral surgical procedures is of an insufficient magnitude to overcome this hypothalamic-pituitary-adrenal suppression of the negative feedback mechanism caused by dexamethasone therapy. The presence of adequate amounts of synthetic steroids at a cellular level appears to prevent manifestations of adrenal insufficiency despite suppression of endogenous production of steroids.
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Malignant hyperthermia is a dominantly inherited, usually subclinical, disease that occurs in individuals who have an underlying muscular disorder and connotes the gravest possible consequences. When it occurs, it is usually during the use of muscle relaxants in anesthesia and potent anesthetic agents such as halothane. ⋯ A careful monitoring regimen must be established for the procedure and some means of cooling the patient must be ready in case pyrexia occurs. Dantrolene sodium is currently the preferred drug for prevention of the syndrome and may be valuable for its treatment.
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Comparative Study
Microscarring in skeletal muscle after repeated exposures to lidocaine with epinephrine.
To assess the effect of repeated exposures to clinically used local anesthetic, rat thighs were given up to five supramuscular injections of 2% lidocaine with epinephrine, 1:50,000. Substantial damage to muscles followed by rapid regeneration occurred; however, in some areas evidence of retarded regeneration of muscles and microscarring was observed.
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Occupational exposure to inhalation anesthetics can be substantially reduced by control measures that have been recently developed. The incentive for their use should be the suspected relationship between chronic exposure to trace concentrations of agents, such as nitrous oxide, and health hazards. Control measures include the use of a newly developed scavenging nasal mask, relatively gastight anesthetic equipment, and vented suction machine, supported by an air monitoring program. With these measures, the concentration of nitrous oxide inhaled by the oral surgeons studied was reduced 97%.