Comparative study of analgesia of ketorolac, tramadol, and flupirtine in the management of third molar surgery.

Introduction: The most commonly performed surgical procedure in most oral and maxillofacial surgery practices is the removal of third molars. Postoperative pain is considered a form of acute pain due to surgical trauma with an inflammatory reaction. Materials and Methods: One hundred and fifty patients were included in the study which were divided into GROUP-A, B, and C-50 patients each; those who underwent third molar removal under local anesthesia. Local anesthesia was obtained by inferior alveolar, lingual, long buccal, posterior superior alveolar, and greater palatal nerve block injections after first complain of pain, all patients were prescribed analgesics (Ketorolac-10 mg), (Tramadol-50 mg), (Flupirtine-100 mg), and antibiotics co-amoxiclav-625 mg) T. D. S in all the three groups A, B, C, respectively, for 5 days and the timing noted in the patients assessment sheet. The statistical analysis was done using SPSS Version 15.0 statistical analysis software. Results: The flupirtine group has early onset and also had minimum side effects. All the groups showed similar trend in change in pain score from 3 h. P. O to different time intervals. It was observed the pain score increased significantly till 6 h. Post operative a decreased trend was found at 24 h, 48 h, 78 h, after 6 h. and this change was found to be statistically significant for all three groups. Conclusion: Flupirtine had faster onset and comparable pain management profile as compared to tramadol, it also had minimum side effects, hence the use of flupirtine might be recommended for postoperative pain management in cases undergoing third molar surgery.

Odontogenic myxoma.

Odontogenic myxoma is a rare, benign, locally aggressive and non metastasizing neoplasm which is believed to arise from the odontogenic ectomesenchyme and bears a close microscopic resemblance to mesenchymal portion of a tooth germ. This is a case report of odontogenic myxoma in a 32 year old female patient and the treatment rendered to her.

An epidemiological study on pattern and incidence of mandibular fractures.

Mandible is the second most common facial fracture. There has been a significant increase in the number of cases in recent years with the advent of fast moving automobiles. Mandibular fractures constitute a substantial proportion of maxillofacial trauma cases in Lucknow. This study was undertaken to study mandibular fractures clinicoradiologically with an aim to calculate incidence and study pattern and the commonest site of fractures in population in and around Lucknow. Patient presenting with history of trauma at various centers of maxillofacial surgery in and around Lucknow were included in this study. Detailed case history was recorded followed by thorough clinical examination, and radiological interpretation was done for establishing the diagnosis and the data obtained was analyzed statistically. Out of 66 patients with mandibular fractures, highest percentage was found in 21-30 years of age with male predominance. Road traffic accidents were the most common cause of fracture with parasymphysis being commonest site. Commonest combination was parasymphysis with subcondyle. There was no gender bias in etiology with number of fracture sites. The incidence and causes of mandibular fracture reflect trauma patterns within the community and can provide a guide to the design of programs geared toward prevention and treatment.

Autogenous tooth transplantation as a treatment option.

Autogenous tooth transplantation is the surgical movement of a tooth from one location in the mouth to another in the same individual. Though done for years but it has achieved variable success rates. Although the indications for autotransplantation are narrow, careful patient selection coupled with an appropriate technique can lead to exceptional esthetic and functional results. This article discusses the reviews of previous works done and highlights the criteria and factors influencing the success of autotransplant along with reports of two cases of transplantation of impacted and malposed canine. How to cite this article: Chugh A, Aggarwal R, Chugh VK, Wadhwa P, Kohli M. Autogenous Tooth Transplantation as a Treatment Option. Int J Clin Pediatr Dent 2012;5(1):87-92.

Platelet rich fibrin: a novel approach for osseous regeneration.

UNLABELLED:  : To evaluate the efficacy of autologous platelet rich fibrin in soft tissue healing and bone regeneration in mandibular third molar extraction sockets. METHOD: The study was conducted in 20 patients visiting in outpatient department of Oral and Maxillofacial Surgery, requiring extraction of bilateral mandibular third molar, following extraction platelet rich fibrin (PRF) was placed in one extraction sockets, the other socket was studied as the control sites with no PRF. The patient were assessed for post operative pain, soft tissue healing and trabecular pattern in healing bone. Radiological assessment of the extraction site was done for period of 3 months to evaluate the change in bone density. RESULTS: Pain was less in study side compare to control site soft tissue was healing was better in study site. Evaluation of trabecular bone formation started earlier in PRF site compare to control site. The evaluation of bone density by radiological assessment showed the grey level value calculated after 3 months at the PRF site well comparatively higher than the average baseline value of the bone density at the extraction site in control site. CONCLUSION: The study showed that autologous PRF is biocompatible and has significantly improved soft tissue healing. Bone regeneration and increase in bone density in extraction sockets. However, a more elaborate study with a large number of clinical cases is essential to be more conclusive regarding its efficacy.

Gorlin-Goltz syndrome.

Gorlin-Goltz syndrome is an inherited autosomal dominant disorder with complete penetrance and extreme variable expressivity. The authors present a case of an 11-year-old girl with typical features of Gorlin-Goltz syndrome with special respect to medical and dental problems which include multiple bony cage deformities like spina bifida with scoliosis having convexity to the left side, presence of an infantile uterus and multiple odonogenic keratocysts in the maxillofacial region.

Cystic hygroma.

Surgical management of cystic hygroma is very challenging since it has a thin wall consisting of endothelium which can easily be torn during its enucleation leading to recurrence. The other treatment options are intralesional injection of OK-432, triamcinolone followed by surgical excision, if necessary, injection of sclerosing agents, repeated aspiration, radiotherapy and finally spontaneous regression without any form of treatment. This is a case report of cystic hygroma of parotid region where regression occurred without any form of treatment.

In vitro evaluation of microbiological flora of orofacial infections.

OBJECTIVE: To assess the most common micro-organisms causing odontogenic infections and their antimicrobial susceptibility. METHODS: The study was conducted in 80 patients with orofacial infection. The pus sample was collected, cultured (aerobically and anaerobically) and stained for morphological study of the isolates. Antibiotic sensitivity test for the isolates were performed. RESULTS: A total of 109 micro-organisms were isolated, no pathogenic organism were isolated in 3 cases. Out of 109 micro-organism isolated, 107 bacteria and 2 fungi were identified. Pure aerobes were identified in 28(35%) of cases, pure anaerobes in 18(22.5%), mixed aerobes and anaerobes in 10(12.5%), mixed aerobes in 15(18.75%) and mixed anaerobes were isolated in 6(7.5%) cases. Among the entire pure gram positive isolates, ofloxacin was the most sensitive drug 83.33% followed by ciprofloxacin 76.2% and sparfloxacin 76.2%. The most resistant drugs were amoxicillin (92.85%) and ampicillin (92.85%). Cefotaxime was found sensitive in 75% of pure gram negative isolates. CONCLUSION: Ofloxacin was the most sensitive drug followed by ciprofloxacin and sparfloxacin for pure gram positive isolates. The most resistant drugs were amoxicillin and ampicillin. The gram negative colonies were sensitive to Cefotaxime.