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AIM: Temporomandibular joint ankylosis (TMJA) management involves many surgical treatment modalities depending on the experience of the operator. A lot of literature has been published on various treatment modalities. Many systematic reviews (SRs) were published without any published prior protocol. So, the study aimed to evaluate the quality of SRs with meta-analysis of TMJA management. MATERIALS AND METHODS: Systematic reviews with meta-analysis were included for the quality assessment using AMSTAR (assessment of multiple SRs) and Glenny et al. checklist by two independent teams. The search was limited to the Medline database archival (from January 1980 to December 2018). RESULTS: The primary search identified 1,507 related articles. After activation of different filters, abstracts screening, and cross-referencing, finally, a total of six studies were assessed to make the overview up-to-date. CONCLUSION: The articles scored 8 to 11 with AMSTAR and 7 to 13 with the Glenny et al. checklist. None of the published reviews received maximum scores. The methodology and heterogeneity are essential factors to assess the quality of the published literature. CLINICAL SIGNIFICANCE: None of the included meta-analysis was registered or published protocol with Prospero or Cochrane before publication for better validity of the studies. The authors are advised to follow reporting criteria so that in the future it is possible to provide the standards of care for TMJA with the highest quality of evidence.
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Anquilose , Lista de Checagem , Humanos , Articulação Temporomandibular , Resultado do TratamentoRESUMO
INTRODUCTION: A prospective randomized double-blind controlled trial was conducted to evaluate the latency and duration of pterygomandibular nerve block with a mixture of 1.8 ml 2% lignocaine with 1:80,000 epinephrine and 1 ml of 4 mg dexamethasone and its impact on postoperative sequelae after surgical extraction of impacted mandibular third molars. MATERIALS AND METHODS: This study was conducted in 40 subjects referred to the department of oral and maxillofacial surgery; they were divided into 20 subjects each in group A and B with the age range of 18-72 years planned for elective surgical removal of unilateral impacted mandibular third molar. Each patient was randomly selected to receive anesthesia using 1.8 ml 2% lignocaine with 1:80,000 epinephrine in group A or 2.8 ml twin mix (1.8 ml 2% lignocaine with 1:80,000 epinephrine + 1 ml 4 mg dexamethasone) in group B. After injection of the anesthetic solution, the time to anesthetic effect, duration of anesthesia from initial patient perception of the anesthetic effect to the time when the effect subsides, need to reanesthetize the surgical site were recorded, and 10-point visual analog scale (VAS) was used to subjectively assess the overall pain intensity while injecting the study drug, during surgery, and in the postoperative period. RESULTS: Mean VAS value for pain on local anesthetic injection was less in twin-mix group. The time of onset of the local anesthetic was significantly less for the study group T, 51.35 ± 7.15 s when compared with patients in study group C (P less than 0.0001). The duration of soft tissue anesthesia was longer for all the patients in the study group T. On comparative evaluation between study group C and study group T, patients in the control group had more severe swelling and reduction in mouth opening in the postoperative period. CONCLUSION: The addition of dexamethasone to lignocaine and its administration as an intraspace injection significantly shortens the latency and prolongs the duration of the soft tissue anesthesia, with improved quality of life in the postoperative period after surgical extraction of mandibular third molars.
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Effects of enucleation followed by pinealectomy and administration of exogenous melatonin on air-breathing activity rhythm in a fresh water catfish, C. batrachus maintained at LD 12:12 and laboratary temperature during its prepratory phase, were examined. Results of cosinor analysis clearly reveal that most of the intact individuals exhibited circadian rhythm in their air-breathing activity and such rhythm persists even after enucleation followed by pinealectomy and then melatonin administration. However, the period (tau) of the activity obtained by power spectrum analysis was prominent 24 hr in most of the intact individuals, but it was increased (tau > 24 hr) after enucleation in most of the individuals. In most of the enucleated + pinealectomized individuals tau was less than 24 hr, and after receiving melatonin treatment tau was shifted to prominent 24 hr in most of the individuals. In addition, visual analysis of the actograms depicted that in intact individuals air-breathing activity is entrained with the timings of lights on/off with elevation of activity during dark period and decreased activity during light hours. However, enucleated and enucleated + pinealectomized individuals showed free run in their activity rhythm. The treatment of melatonin reestablished the entrainment of activity at least with the timing of lights off, in most of the studied individuals. Further, daily mean of the air-breathing activity was decreased in enucleated + pinealectomized individuals as compared with other studied groups (intact, enucleated, enucleated + pinealectomized + melatonin receiving). It could be speculated that there may be existence of extraretinal and extrapineal photoreceptors in C. batrachus. However, eyes play an important role in regulating air-breathing activity rhythm in such species. In addition, exogenous melatonin may also have some modulatory effect on such rhythm.