Effect of dexamethasone and dipyrone on lingual and inferior alveolar nerve hypersensitivity following third molar extractions: preliminary report.

AIMS: To study the effect of dexamethazone and dipyrone on sensory changes in the innervation territories of the inferior alveolar, infraorbital, and lingual nerves caused by third molar extractions. METHODS: Fourteen patients (8 men and 6 women) were divided randomly into 2 groups. The first group received dipyrone preoperatively, while the second group received dipyrone and dexamethazone preoperatively. All patients in the study received a prophylactic preoperative dose of amoxicillin (500 mg) as well as dipyrone postoperatively. In all patients, a single mandibular third molar was removed, while in 2 patients the contralateral third molar was removed at a subsequent time. Electrical detection thresholds were assessed in the inferior alveolar, lingual, and infraorbital nerve regions prior to surgery and 2 and 8 days following surgery. The level of perioperative pain, difficulty of extraction, and distance of molar root apices from the inferior alveolar nerve canal were also assessed. RESULTS: Patients who received only dipyrone had significantly reduced lingual and inferior alveolar nerve electrical detection thresholds 2 days after surgery, which returned to nearly baseline values by the eighth day postoperatively. In patients who received dexamethasone, no significant reduction in the electrical detection threshold was found. CONCLUSION: Preoperative treatment with dexamethasone and dipyrone but not dipyrone alone prevents sensory hypersensitivity following third molar extraction.

Fracture of glenoid fossa and traumatic dislocation of mandibular condyle into middle cranial fossa.

Traumatic mandibular condyle dislocations into the middle cranial fossa are rare. Thirty-three cases of middle cranial fossa injuries caused by condylar dislocations have been reported in the literature. A case report of a patient with a traumatic dislocated condyle into the middle cranial fossa, which was treated conservatively, is presented.

Dental erosion in gastroesophageal reflux disease.

Dentists are often the first health care professionals to diagnose dental erosion in patients with gastroesophageal reflux disease (GERD). Gastroesophageal reflux (GER) is the passage of gastric contents into the esophagus, and GERD is defined as symptoms or complications of GER. Twenty-four-hour monitoring of esophageal pH is helpful in diagnosing GERD. Treatment of dental erosion resulting from GERD involves a multidisciplinary approach among family physician, dentist, prosthodontist, orthodontist and gastroenterologist. When possible, dental erosion should be treated with minimal intervention, and such treatment should include control of microflora, remineralization, adhesive restorations and use of biomimetic materials.

Management of traumatic dislocation of the mandibular condyle into the middle cranial fossa.

Dislocation of the mandibular condyle into the middle cranial fossa is a rare complication of facial trauma that can have neurological and life-threatening implications. This article discusses the anatomic features that predispose patients to this type of injury, as well as the clinical features and mechanism of injury for this rare type of condylar deformity, to help practitioners recognize this easily overlooked injury and avoid disastrous complications. The article summarizes previously published case reports of this rare complication of condylar trauma and presents a case for which initial diagnosis and a management protocol are described.