A comparative analysis of postoperative morbidity and alveolar bone regeneration following surgical extraction of impacted lower third molar teeth using piezosurgery and conventional instruments: a split-mouth clinical investigation.

BACKGROUND-OBJECTIVE(S): This randomized, split-mouth study aimed to compare postoperative complications following the surgical extraction of impacted lower third molars using piezosurgery versus conventional rotary instruments. MATERIALS AND METHODS: Twenty-one patients, aged 18-35 years, with bilaterally and symmetrically impacted lower third molars, were randomly assigned to undergo extraction using piezosurgery on one side and conventional rotary instruments on the other. RESULTS: The piezosurgery method required a longer operation time. However, it resulted in quicker resolution of postoperative swelling by the 7th day compared to the conventional method, where swelling persisted longer. Mandibular angle-tragus measurements were significantly higher with the conventional method on the 1st, 3rd, and 7th postoperative days. Although mouth opening decreased significantly after piezosurgery, it returned to preoperative levels by the 7th day, outperforming the conventional method. Postoperative pain was notably higher with the conventional method during the first four days but showed no significant difference from the 5th day onward. Alveolar bone healing was significantly better with piezosurgery at the 3rd and 6th months. Temporary paresthesia occurred in one patient from the conventional group, resolving within four weeks. Neither method resulted in alveolar osteitis. CONCLUSION(S): Within the study's limitations, piezosurgery demonstrated a reduction in postoperative discomfort, suggesting its advantage in enhancing patient recovery following lower third molar extractions. CLINICAL SIGNIFICANCE: Piezosurgery, when used appropriately, can reduce postoperative complications compared to conventional methods. Clinicians should be aware of its indications, benefits, and potential challenges. Trial registration This study was registered as a clinical trial to the ClinicalTrials.gov, and the registration ID is NCT06262841 ( https://clinicaltrials.gov/study/NCT06262841 ).

Oncologists awareness about bisphosphonate related osteonecrosis of the jaws.

OBJECTIVE: To evaluate the oncologists thoughts about the positive and adverse effects of bisphosphonates, drug holiday and the awareness about BRONJ. METHODS: A written questionnaire was sent to 7 hospitals, which have oncology facilities in Ankara, Turkey. Results were evaluated as percentages. Chi Square and Kruskal Wallis H test was used to analyze the data. RESULTS: A total of 53 oncologists replied to the questionnaire. BRONJ is the most seen complication (66%) due to bisphosphonates usage. Temporary suspension of the drug (52.8%) is the best treatment choice for this complication. Oncologists usually prefered dentist consultatation (39.6%). CONCLUSIONS: A good cooperation of oncologists and dentists is very important to prevent BRONJ.

Comparison of Different Fixation Types Used in Unilateral Mandibular Condylar Fractures: An In Vivo Study With New Biomechanical Model.

INTRODUCTION: The aim of this in vivo study is to compare the single-titanium, double-titanium mini plate, and single resorbable plate systems used in internal rigid fixation of the unilateral mandibular condylar fractures on new design biomechanical model. METHODS: Thirty synthetic polyurethane models were used for biomechanical testing. Fracture lines were created for each model. Fragments were fixed with single-titanium plates in Group A (n = 10), double-titanium plates in Group B (n = 10), and single biodegradable plate (PPLA) in Group C (n = 10). Masticatory forces were applied to the models and the biomechanical properties of the titanium plate and screws, resorbable plate, and screws were evaluated. RESULTS: The average failure force for Group A, Group B, and Group C is 199, 324, 177N and the average bone displacement for Group A, Group B, Group C is 1.9, 0.3, 2.1 mm, respectively. DISCUSSION: Double titanium plates showed the most acceptable results in the fixation of unilateral subcondylar fractures where the single titanium and biodegradable plate systems failed to provide enough stability in unilateral subcondylar fracture fixation. Biodegradable plate systems are still not an alternative in fixation of unilateral condylar fractures.

Prospective short term comparison of outcomes after single or double puncture arthrocentesis of the temporomandibular joint.

Our aim was to compare the single puncture technique for arthrocentesis of the temporomandibular joint (TMJ) with the double puncture technique and to evaluate the short-term effects of a single puncture. Forty patients were randomly divided into two groups: the first was treated by single puncture, and the second with double puncture, arthrocentesis. During the one-month follow-up period the visual analogue and verbal scales for pain, maximal mouth opening, and satisfaction were evaluated within each group and between the two groups. Both groups recorded significant improvements compared with the baseline values in almost all outcome variables. There were no significant differences between the groups. Arthrocentesis of the TMJ was successful with both techniques.

Postoperative analgesia in orthognathic surgery patients: diclofenac sodium or paracetamol?

Our aim was to compare the analgesic affects of paracetamol and the non-steroidal anti-inflammatory drug (NSAID) diclofenac sodium for the relief of postoperative pain in patients having bimaxillary osteotomy. Thirty patients were randomly allocated into two groups (n = 15 in each) using sealed envelopes. The first group was given paracetamol 1g intravenously and the second diclofenac sodium 75 mg intramuscularly. The analgesics were given during the last 15 min of the operation while the mucosa was being sutured. The number of requests for further analgesia, and the amount of analgesia given postoperatively (as diclofenac sodium) were recorded. The intensity of postoperative pain was recorded on a visual analogue scale (VAS), and postoperative requests for analgesia, haemodynamic variables (systolic blood pressure and heart rate), and complications were compared. The groups were comparable. A single dose of diclofenac or paracetamol effectively decreases the intensity of postoperative pain after bimaxillary osteotomy.

Effects of low-dose midazolam with propofol in patient-controlled sedation (PCS) for apicectomy.

We studied the effects of low-dose midazolam with propofol for patient control sedation (PCS) in 30 healthy (ASA grade I) patients who were randomly allocated into two equal groups (n = 15 in each). They were given a propofol infusion of 2mg/kg/h after a bolus dose of 0.7 mg/kg. The second group was given the 2mg/kg/h propofol infusion after a dose of midazolam 0.03 mg/kg and a bolus dose of propofol 0.7 mg/kg. The standard dose for PCS was propofol 0.2mg/kg in both groups. Clinical data were taken and haemodynamic variables, and oxygen saturation were recorded before and on the 5th, 10th, 20th, and 30th minutes during the operations. The level of sedation, amnesia and conditions of each patient were evaluated during the study. Patients' satisfaction was recorded using a modified visual analogue scale (VAS). All results were evaluated statistically. We conclude that low-dose midazolam with propofol during PCS neither reduced oxygen saturation nor prolonged the time of discharge. Low-dose midazolam with propofol also improved the acceptability and comfort for patients and made the operation easier, which makes it preferable to propofol alone.