Clinical comparative study of the effectiveness of two dosages of Dexamethasone to control postoperative swelling, trismus and pain after the surgical extraction of mandibular impacted third molars.

PURPOSE: The aim of this study was to evaluate the effect of two different concentrations (4 and 8 mg) of dexamethasone to decrease the swelling and trismus after the surgical extraction of mandibular impacted third molars. METHODS: This randomized clinical trial comprised thirty (30) adult patients of both genders with no local or systemic problems, with bilateral impacted lower third molars in similar position, where surgical extraction had been indicated. They were given 4 mg and 8 mg of dexamethasone 1 hour before the surgical procedure at the first or second surgery. The choice of which side to operate first and the amount of concentration of medication to use was made randomly and double-blindly. Postoperative pain was evaluated using a visual analog scale (VAS) and the degree of swelling was evaluated through facial reference points' variation. The presence of trismus was analyzed through measurement of the interincisal distance (IID). These assessments were obtained before the operation and 24h and 48 h after the surgery. RESULTS: Based on statistic analysis (pared t-student and Wilcoxon tests), the results showed a significant difference in the measurements of the degree of swelling and trismus of the treated sample. 8 mg of dexamethasone promoted a greater reduction of symptoms than 4 mg of dexamethasone CONCLUSIONS: The administration of 8 mg of the dexamethasone was more effective than 4 mg of the dexamethasone to reduce the degree of swelling and trismus. However, it had no effect on pain control.

Oral manifestation of systemic lupus erythematosus: lupus nephritis--report of a case.

Systemic lupus erythematosus (SLE) is a disease of unknown origin that can affect organs and cause severe damage. Lupus is diagnosed through biopsies and laboratory examinations; however, certain clinical characteristics and the presence of lesions can help with early diagnosis and improve the disease prognosis. SLE patients generally receive immunosuppressants that may cause systemic implications---such as suture dehiscence, increased risk of infection, and delayed healing--that deserve specific attention during dental treatment. This article presents a case of a SLE patient with oral manifestations: ulcerative lesions in the mouth and development of lupus nephritis. This article seeks to emphasize the importance of recognizing the lesions related to SLE, which may help the dentist to establish an early diagnosis.

Patient's perception of the events during and after osteogenic alveolar distraction.

OBJECTIVE: The aim of the study was to evaluate the patient s perception of the events during and after an osteogenic alveolar distraction (OAD) procedure MATERIALS AND METHODS: A total of fifty-five (55) osteogenic alveolar distraction (OAD) procedures were performed in fifty (50) patients, who then were asked to answer ten (10) questions related to the treatment. Six (6) questions made reference to predefined values in a Visual Analogical Scale (VAS), three (3) questions could be answered by a predetermined answer, and only one (1) question had a free answer. RESULTS: In 76% of cases, the patient s description of the sensation felt during the surgery was good and bearable; 84% of the patients didn t feel pain after surgery. 4% of the patients felt pain during the activation period and 58% of the patients described the sensation during the activation period as pressure, felt most commonly, at the end of the period, and for about 20 minutes (66.6 %). In these cases the most frequently used analgesic was Paracetamol. Also, 46% expressed having had some difficulty to activate the device, with 10% of them in need of extra help. The presence of the activation rod caused discomfort in 52%. Finally, 78% of the patients treated with OAD would undergo this procedure again if it was necessary. A bone graft was performed in 27 out of the 50 treated patients, with 70% of them describing the bone graft surgery as more painful than the OAD. CONCLUSION: The OAD technique had a high degree of acceptance among the treated patients, however, some details as the interference of the activation rod continue to disturb them. The acceptance of the OAD technique is much better when compared with bone graft surgery technique as a second treatment.

Manifestaciones clínicas del herpes zoster en la región maxilofacial / Clinical manifestations of herpes zoster in the maxillofacial region

El Herpes zoster, es una enfermedad viral causada por el virus varicela-zoster, el mismo causante de la varicela. Ocurre a partir de la reactivación del virus latente presente en los ganglios, lo que provoca afecciones en la piel, de mayor o menor gravedad, afectando generalmente individuos inmunocomprometidos. La lesión está caracterizada por presentar vesículas con regiones rojizas que acompañan alguna ramificación nerviosa, que en la mayoria de los casos se presenta de forma unilateral unilateral. El diagnóstico en la mayoría de los casos es extremadamente clínico, pudiendo ser realizados algunos exámenes complementarios. El presente trabajo tiene como objetivo mostrar las manifestaciones clínicas del herpes zoster en la región maxilofacial, así como realizar una revisión de la literatura

O Herpes zoster, é uma doença viral causada pelo vírus varicela-zoster, o mesmo causador da varicela. Ocorre a partir da reativação do vírus latente presente nos gânglios, o que provoca afecções na pele, de maior ou menor gravidade, acometendo geralmente indivíduos imunocomprometidos. A lesão é caracterizada por apresentar vesículas com regiões avermelhadas que acompanham um ramo nervoso, sendo unilateral. O diagnóstico na maioria das vezes é extremamente clínico, podendo ser realizados alguns exames complementares. O presente trabalho tem como objetivo demonstrar as manifestações clinicas do herpes zoster na região maxilofacial, além de realizar uma breve revista da literatura

The Herpes zoster, is a viral disease caused by the varicella-zoster virus, that the same causer of varicella. It occurs from the reactivation of latent virus present in the lymph nodes, what provoke affection in the skin, of greater or lesser severity, generally affecting immunocompromised individuals. The lesion is characterized to present vesicles with red regions that accompany a branch nervous, being unilateral. The diagnosis the most of the time is extremely clinical, and can be made some complementary tests. This work objective to report two cases of herpes zoster in maxillofacial region, and accomplish a brief review of literature

Uso de la intubación submentoniana en cirugía buco-maxilofacial / Use of submental intubation in oral and maxillofacial surgery

Diferentes métodos de intubación endotraqueal están disponibles para manutención de las vías aéreas durante el tratamiento quirúrgico de pacientes portadores de fracturas maxilofaciales severas. Cuando los métodos de intubación nasotraqueal y orotraqueal estén contraindicados, la intubación endotraqueal por vía submentoniana es una alternativa útil para esos pacientes severamente traumatizados en los cuales el bloqueo maxilo-mandibular intra-operatorio es necesario. Esta técnica permite el establecimiento de una vía aérea segura y posibilita la realización de fijación intermaxilar durante la cirugía, que es esencial para conseguir un óptimo resultado en la reducción y fijación de las fracturas en los huesos faciales, evitando de esa forma la realización de una traqueotomía y las complicaciones inherentes a ese procedimiento. El presente trabajo tiene como objetivo describir la técnica de intubación submentoniana, sus indicaciones así como relatar un caso clínico

Diferentes métodos de intubação endotraqueal estão disponíveis para manutenção das vias aéreas durante o tratamento cirúrgico de pacientes portadores de fraturas maxilofaciais severas. Quando os métodos de intubação nasotraqueal e orotraqueal estiverem contra-indicados, a intubação endotraqueal pela via submentoniana é uma alternativa útil para esses pacientes severamente traumatizados de face nos quais o bloqueio maxilomandibular intraoperatório é necessário. Essa técnica permite o estabelecimento de uma via aérea segura e possibilita a realização da fixação intermaxilar durante a cirurgia, que é essencial para se conseguir um ótimo resultado na redução e fixação das fraturas nos ossos da face, evitando dessa maneira a realização de uma traqueostomia e as complicações inerentes a esse procedimento. O presente trabalho tem o objetivo descrever a técnica de intubação submentoniana, suas indicações, assim como relatar um caso clinico

Different endotracheal intubation methods are available for airway maintenance during surgical treatment of patients who have severe maxillofacial fracture. When the nasotracheal as well as the orotracheal intubation methods are not indicated, the endotracheal intubation through the submental route is a useful alternative for such patients who have had a severe trauma in their face in which the maxilomandibular intraoperatory is required. Such technique allows the accomplishment of the intermaxilary fixation during the surgery, which is essential in order to get an excellent  result concerning the reduction and fixation of face bone fractures, avoiding this way, the tracheotomy and its complications. The aim of the present research is to report the case of a patient who was victim of a car accident and who presented nasal pyramid fracture, which contraindicated the nasotracheal intubation, besides other fractures in the midface.  The orotracheal intubation would not be viable due to the necessity of reestablishing occlusion of the patient using intermaxilary fixation during the transoperatory. This way the submental intubation technique was indicated for the surgical treatment of this case. In this article we are going to describe and discuss the clinical use of such procedure