Kinesio Taping as an Adjunct Therapy in Postoperative Care after Extraction of Impacted Third Lower Molars-A Randomized Pilot Study.

Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly administered according to protocol for the management of complications such as pain, swelling, and trismus following the removal of the third impacted lower molar; however, treatment with NSAIDs may result in multiple adverse effects. The aim of this study was to compare the effectiveness of kinesio taping (KT) and the use of NSAIDs in the treatment of postoperative complications after extraction of an impacted third lower molar. MATERIAL AND METHODS: The study comprised a group of 30 patients, randomly divided into the test group (with KT, n = 15) or the control group (without KT, n = 15). The surgery was performed according to standard procedures. In the test group, KT was applied immediately after surgery. Pain, swelling, and trismus were assessed. The VAS scale was used to assess pain. Swelling was measured based on six reference points on the face using a tailor's meter, and a caliper was used to measure the distance between the upper and lower medial incisors of the upper and lower teeth to determine the extent of trismus. Measurements were performed three times: on the day of the surgery, on the second day following the surgery, and on the 7th day after the surgery. RESULTS: Pain intensity (day of procedures), maximum mouth opening (on the seventh day after the surgery), and the use of NSAIDs (day of surgery) were significantly lower (p < 0.05) in the test group than in the control group. CONCLUSIONS: Kinesio taping in addition to NSAIDs was found to be more effective than NSAIDs alone in increasing the degree of jaw opening, decreasing pain intensity, and reducing the non-steroid anti-inflammatory dosage in patients after impacted mandibular wisdom teeth surgery.

Status of Microbiota in Odontogenic Inflammatory Lesions and Dental Surgery Procedures Performed on an Outpatient Basis.

Inflammations of the facial part of the skull are most commonly caused by a bacterial infection. They are a frequently occurring pathological process, which results from a rich bacterial flora of the oral cavity, as well as diseased teeth and periodontal tissues. These inflammations have a primarily mixed character with the prevalence of anaerobic bacteria. Gangrene of the dental pulp is the most common odontogenic cause. In the case of inflammations of oral tissues an early and corrective treatment results in quick recovery. The purpose of this work was to assess the efficiency of empirical antibiotic therapy applied in patients with inflammations of oral tissues on the basis of a drug susceptibility profile of bacteria isolated from material extracted from inflammatory lesions. The research material consisted of smears collected from patients with existing acute inflammations in the oral cavity. The smear was collected from the bottom of the lesion after its prior surgical treatment and pus evacuation, and again, 7 days after surgery. In patients with acute odontogenic inflammations the recommended first-line therapy are extended-spectrum penicillins, characterized by a low risk of side effects and strong antimicrobial activity. In the study group, both clindamycin and amoxicillin exhibited high efficiency in treating acute odontogenic inflammatory lesions in the oral cavity.

Odontogenic keratocyst of the mandible: A case report and literature review.

Based on a literature review, we analyzed the World Health Organization (WHO) classification and the treatment algorithm for the odontogenic keratocyst (OKC), formerly referred to as keratocystic odontogenic tumor (KCOT). The KCOT reclassification from benign odontogenic tumors to odontogenic developmental cysts resulted from the emergence of new evidence regarding their morphogenesis and biological behavior. The authors of the most recent 2017 classification do not provide specific guidelines for OKC. Nevertheless, it has been observed that conservative surgical management is not necessarily associated with recurrences characteristic of neoplastic disease. The aim of this paper was to present the effective management strategy for a local recurrence that developed following conservative OKC enucleation in a 53-year-old patient. The treatment for recurrence consisted of enucleation, marginal osteotomy and augmentation with a cancellous bone graft harvested from a tibial tuberosity. A 6-year observation period (clinical and radiological monitoring) revealed normal bone regeneration and no evidence of recurrence. The algorithm applied in our center for the treatment of OKC/KCOT was compared with the management strategies proposed by other authors.

The application of L-PRP in AIDS patients with crural chronic ulcers: A pilot study.

PURPOSE: Nonhealing wounds or skin ulcerations are the result of insufficient repair and destruction of a local healing potential. Opportunistic infections which cause a lot of ulcer complications influence the worsening general condition of patients with AIDS, ultimately leading to death. The chronicity of the condition and poor results of conventional therapy have prompted the search for new methods of treatment. MATERIALS AND METHODS: We have examined venous or arteriovenous insufficiency-related extensive crural ulcers in AIDS patients. Crural ulcer healing processes were evaluated with clinical observations and histopathological, immunohistochemical and molecular examinations of tissue samples harvested from the wound edges before and on day 10 after L-PRP cover dressing. RESULTS: Clinical observations showed positive effects of L-PRP in all patients. However, complete wound closure was noted in 60% of cases. Statistical analysis of histological examination showed increased epidermal processes between samples, but the difference was nonsignificant. However, immunohistochemical investigations showed an increased healing process with strong statistical significance. The mean VEGF level before L-PRP usage was 114.3 vessels/mm2 and on day 10 118.9 (p=0.001523). The mean FLK level was 103.2 and 109.9 respectively (p=0.008241). The biggest differences were observed for CD34, with values of 68.2 on day 0 and 100.8 on day 10 (p=0.006982). Molecular analysis generally showed decreased gene expression and confirmed vascular formation and reepithelialization processes. CONCLUSIONS: In our opinion, L-PRP may be used to eradicate microorganisms from wounds, to induce neovascularization, and in unhealed cases prepare the base and edge of the ulcer for skin grafting and tissue expansion procedures.

Mandibular reconstruction--biomechanical strength analysis (FEM) based on a retrospective clinical analysis of selected patients.

Restoration of mandible discontinuity defects continues as a challenge for maxillofacial surgeons. Despite the development of algorithms for reconstruction plates fixation and autogenous grafting techniques, complications are still encountered including screw loosening, bone resorption or delayed/incomplete union. The aim of the study was to analyze the possibility of obtaining bone union in the aspect of biomechanical conditions of two mandible reconstructions using an autogenous iliac crest bone graft stabilized with a reconstruction plate, and to attempt to predict patient outcomes based on strength parameters obtained by the finite element analysis. The authors of the present paper were trying to determine to what extent the reconstruction model and changes occurring in hard tissues of the bone and autogenous graft (simulated by changes in material properties) might help predict individual patient courses. The effort of reconstruction plates was defined using the values of the von Mises stress (σHMH) while the effort of bones was determined based on the values of strain intensity εint. The results of the above mentioned simulations are presented in the form of bar graphs and strain/stress distribution maps. Our strength analyses indicate that uncomplicated healing of grafts fixed with reconstruction plates requires that the initial loading of the stomatognatic system should not result in strain intensity exceeding 20-40 [×10⁻4]. This range of strain intensity evokes an increase in the mineral phase. The state of nonunion between the mandibular bone and the graft might result from prolonged periods of insufficient loading of the mandible during treatment.

Numerical analysis of displacements of mandible bone parts using various elements for fixation of subcondylar fractures.

The paper presents an analysis of the distribution of dislocations in the case of fixation of a mandible low subcondylar fracture. Three types of elements have been used for fixation: NiTi shape-memory staples, miniaturized titanium plates and the Synthes compression plate, also called the Synthes zygomatic plate. The analysis was conducted using the finite element method. The degree of the mobility of the fractures was analysed as well as the tendency towards their separation on the basis of value analysis and the distribution of dislocation areas. The results obtained allowed a preliminary assessment of predicted healing effects and the possibility of being able to predict developing complications after osteosynthesis with the use of the elements analysed.

Effectiveness of hyperbaric oxygen therapy in mandibular osteoradionecrosis shown by thermography monitoring.

BACKGROUND: Osteoradionecrosis (ORN) of the mandible is the most serious and severe side effect of combined treatment of head and neck tumors. Due to frequent failure of its conventional management, new methods are being sought and tested, including hyperbaric oxygen therapy (HBO); however, effective methods of monitoring HBO results are not yet available. The purpose of our study was to assess thermographic records of ORN patients in different stages of hyperbaric oxygen therapy. MATERIAL/METHODS: In the years 2003-2008, hyperbaric oxygen was used as an adjunct in the conventional management of 4 patients with progressive osteoradionecrosis of the mandible. The effects of the treatment were evaluated based on the clinical, radiological, and thermographic examinations. In each patient thermograms were obtained before and after HBO. RESULTS: Clinical examination showed ORN remission following 30 exposures in a hyperbaric chamber at 2.5 atmospheres for 90 minutes. Follow-up thermograms obtained after 35-60 exposures revealed a marked warming of the osteoradionecrotic area of the mandible resulting from an increase in blood supply and tissue metabolism increase. In 1 case of therapy cessation, just 5 sessions of HBO therapy was associated with a decrease in acute inflammation, as manifested by local cooling seen in a follow-up thermogram. CONCLUSIONS: Thermography is an effective method of monitoring HBO results in patients with osteoradionecrosis. However, thermograms should be interpreted in combination with the corresponding clinical picture and radiological findings.

Long-term outcome in the treatment of mandibular condylar fractures.

Background. Fractures of the condylar process of the mandible, whether isolated or coexisting with other injuries, are often difficult to manage. Treatment outcome in patients with mechanical injuries of the temporomandibular joints and fractures of mandibular condylar process, which is an element of this joint, depends mostly when and how treatment is initiated. The goal of our study was to assess functional abnormalities in patients following fractures of the condylar process of the mandible in relation to the treatment method used. Material and methods. We analyzed patient documentation and the results of follow-up examinations of 147 patients hospitalized for fractures of the condylar process. This material included both isolated fractures of the condylar process and those accompanied by fractures of the body of the mandible. All mandibular body fractures were managed by means of multiplate osteosynthesis. Fractures of the condylar process were treated in a conservative-orthopedic manner or surgically, depending on the degree of shortening of the mandibular ramus. Anamnesis regarding pain and a functional examination of mandibular kinetics and audible effects gave a basis for assessing the function of temporomandibular joints following treatment. The Helkimo Dysfunction Index was used to assess changes in masticatory function and disorders in the temporomandibular joint. Results. Functional disturbances of the temporomandibular were observed in 38.1% of the examined patients. The most frequently observed symptoms of dysfunction were periodic pain and crackles on mandibular abduction, subluxation, deviation of the mandible, and slight limitation of jaw opening. The intensity depended mainly on when rehabilitation was commenced, and to a less degree on the type of treatment used. No joint dysfunctions were observed in patients of developmental age who sustained isolated condylar process fractures.