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1.
J Oral Maxillofac Surg ; 77(7): 1381-1388, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-30902603

RESUMEN

PURPOSE: Because no study has evaluated the postoperative pain caused by the shape of dental implants, this study compared the level of postoperative pain between tapered and cylindrical implants inserted in the posterior region of the maxilla. MATERIALS AND METHODS: The study was designed as a double-blinded randomized clinical trial and conducted in 50 healthy patients 20 to 60 years old who were edentulous in the posterior maxilla and were candidates for single implantation. All patients had the same surgical difficulty with appropriate bone width and height. BioHorizons (Birmingham, AL) implants (tapered vs cylindrical) with 4.5-mm platform diameter were randomly selected for each group. The visual analog scale was used to evaluate the level of pain. Pain severity in each group was measured at 30-minute, 3-hour, 6-hour, 12-hour, 24-hour, 2-day, 3-day, and 1-week intervals. The predictor variable was implant shape and the outcome was postoperative pain severity. Data were statistically analyzed with SPPS 16 (SPSS, Inc, Chicago, IL) at the significance level of a P value less than .05. RESULTS: Fifty patients (n = 25 per group) with the mean age of 43.7 ± 10.9 years were included in this study. The pain level in the 2 groups reached its maximum at the 6-hour postoperative interval. Pain severity decreased significantly over time in the 2 implant groups (P < .001). Severities of postoperative pain in the tapered group at 3-, 6-, 12-, and 24-hour intervals were statistically lower than those in the cylindrical group (P < .05). CONCLUSIONS: Implant shape had an impact on postoperative pain. It can be concluded that tapered implants lead to less postoperative pain compared with cylindrical ones.


Asunto(s)
Implantación Dental Endoósea , Implantes Dentales , Dolor Postoperatorio , Adulto , Chicago , Implantes Dentales/efectos adversos , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Humanos , Persona de Mediana Edad , Dolor , Resultado del Tratamiento , Adulto Joven
2.
J Oral Maxillofac Surg ; 77(3): 556-564, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30511642

RESUMEN

PURPOSE: The purpose of this study was to investigate and determine the relations between mandibular third molar (M3) impaction types and mandibular angle and condylar fractures. MATERIALS AND METHODS: A retrospective study was conducted in patients with mandibular angle and condylar fractures referred to the Oral and Maxillofacial Surgery Department of the Shahid Kamyab Hospital (Mashhad, Iran) from 2013 to 2018. Data sources were patients' hospital documents and panoramic radiographs. Predictor variables were the presence and position of impacted M3s. The Pell-Gregory classification was used to identify the horizontal and vertical positions of impaction. The impaction angulation was determined using the Schiller classification. Outcome variables were the presence of angle and condylar fractures. Data were analyzed using SPSS 16 (IBM Corp, Armonk, NY) and χ2 and Fisher exact tests. RESULTS: The study sample consisted of 117 patients (63.2% with condylar fractures, 30.8% with angle fractures, and 6% with concomitant fractures of the condyle and angle). Most patients (88.9%) with angle fracture had impacted M3s; however, impacted M3s were absent in 59.5% of condylar fracture cases. Mesioangular and vertical positions were the most prevalent impaction angulation types in patients with mandibular angle fracture. Classes II and B were the most frequent horizontal and vertical impaction types, respectively, according to the Pell-Gregory classification. There was a statistically significant difference between fracture site and the presence or absence of impacted M3s (P < .001). Moreover, a significant relation was observed between horizontal impaction type and fracture site in patients with impacted M3s (P = .001). CONCLUSIONS: The presence of impacted M3s increased the risk of angle fractures and simultaneously decreased the risk of condylar fractures. Fractures of the angle region were more commonly seen in patients with superficially impacted (vs deeply impacted) M3s.


Asunto(s)
Fracturas Mandibulares , Tercer Molar , Diente Impactado , Humanos , Irán , Cóndilo Mandibular , Estudios Retrospectivos , Factores de Riesgo
3.
J Oral Maxillofac Surg ; 74(1): 129.e1-6, 2016 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-26454033

RESUMEN

Guillain-Barré syndrome (GBS) is a multifactorial and lethal inflammatory demyelinating neuronal disorder with concurrent polyradiculopathy and polyneuropathy presentations. This rare syndrome affects the peripheral nerve myelin sheath and is characterized by ascending muscle weakness and paralysis. There have been rare reports of GBS after head or brachial plexus trauma, general anesthesia, neurosurgery, orthopedic surgery, cesarean section, laparoscopy, and general surgery, and the occurrence of GBS after oral and maxillofacial surgery is not common. A review of the related literature and a new case of GBS after maxillofacial surgery are presented.


Asunto(s)
Síndrome de Guillain-Barré/etiología , Fracturas Mandibulares/cirugía , Complicaciones Posoperatorias , Adulto , Electroencefalografía/métodos , Electromiografía/métodos , Femenino , Estudios de Seguimiento , Fijación Interna de Fracturas/métodos , Humanos , Técnicas de Fijación de Maxilares/instrumentación , Cóndilo Mandibular/lesiones , Fracturas Mandibulares/terapia , Conducción Nerviosa/fisiología , Recuperación de la Función/fisiología
4.
Med Oral Patol Oral Cir Bucal ; 20(6): e729-36, 2015 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-26116845

RESUMEN

BACKGROUND: The epidemiology of facial injuries varies in different countries and geographic zones. Population concentration, lifestyle, cultural background, and socioeconomic status can affect the prevalence of maxillofacial injuries. Therefore, in this study, we evaluated the maxillofacial fractures epidemiology and treatment plans in hospitalized patients (2012-2014) which would be useful for better policy making strategies. MATERIAL AND METHODS: In this retrospective study, the medical records of 386 hospitalized patients were evaluated from the department of maxillofacial surgery at Bahonar Hospital of Kerman, Iran. The type and cause of fractures and treatment plans were recorded in a checklist. For data analysis, ANOVA, t-test, Chi-square, and Fisher's exact test were performed, using SPSS version 21. RESULTS: The majority of patients were male (76.5%). Most subjects were within the age range of 20-30 years. Fractures were mostly caused by accidents, particularly motorcycle accidents (MCAs), and the most common site of involvement was the mandible (parasymphysis). There was a significant association between the type of treatment and age. In fact, the age group of 16-59 years under went open reduction internal fixation (ORIF) more than other age groups (P=0.02). Also, a significant association was observed between gender and the occurrence of fractures (P=0.01). CONCLUSIONS: Considering the geographic and cultural indices of the evaluated population, it can be concluded that patients age and gender and trauma causes significantly affect the prevalence of maxillofacial traumas and fracture kinds and treatment plans.


Asunto(s)
Fracturas Maxilares/epidemiología , Fracturas Maxilares/terapia , Adolescente , Adulto , Anciano , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Lactante , Irán/epidemiología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Adulto Joven
5.
World J Plast Surg ; 11(1): 132-137, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-35592230

RESUMEN

Surgical ciliated cysts of the maxilla arise from respiratory epithelium that lodges in the maxilla after radical maxillary or sinus surgery. This case report was conducted in 2020 in Mashhad Dental School, Mashhad University of Medical Science, Mashhad, Iran. We present here an unusual case of surgical ciliated cyst of a 73-year-old adult male patient with a history of nasal polyp surgery 40 years ago. Early diagnosis due to CBCT and Clinical examination was a residual cyst or OKC (odontogenic keratocyst). The histopathology result of this lesion surprised us after the excisional biopsy and enucleation. The clinical examinations and radiographs of the jaw lesions may lead the maxillofacial surgeons to misdiagnosis and mistreatment. Therefore, it is obligatory to notice all aspects of these lesions carefully.

6.
World J Plast Surg ; 11(1): 51-58, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-35592233

RESUMEN

BACKGROUND: We aimed to evaluate the possibility of temporomandibular joint (TMJ) dysfunction following mandibular advancement surgery in skeletal class 2 patients. Methods: All healthy non-syndromic patients with Class 2 deformity, who were eligible for mandibular advancement surgery, were included in this before-after quasi-experimental study. The main intervention was mandibular advancement through bilateral sagittal split osteotomy (BSSO). Maxillary impaction or setback surgery using LeFort 1 osteotomy was simultaneously performed in some cases. Variables such as TMJ pain, clicking, crepitus, or any other type of sounds or complaint as well as the amount of maximum mouth opening (MMO) were evaluated before surgery and two months postoperatively. Results: Thirty patients including 15 men and 15 women with a mean age of 23.3 ±2.7 yr were studied. The mean amount of mandibular advancement displacement was 3.30 ± 0.87 mm. The rate of TMJ dysfunctions and complaints was relatively low two months postoperatively when compared to the preoperative state. Postoperative evaluation demonstrated that there was no significant correlation between the presence of TMJ symptoms and dysfunctions and the type of surgery. After treatment was completed, the mean MMO reduced significantly from 39.03±5.86 to 38.12±6.05 (P<0.001). Conclusion: Mandibular advancement with BSSO surgery in skeletal class 2 patients did not clinically lead to TMJ dysfunctions. Among all the investigated factors, only preoperative pain, noises, or complaints were proven to have predictive value for postoperative TMJ dysfunction.

7.
World J Plast Surg ; 11(1): 141-147, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-35592238

RESUMEN

Odontomas are the most common odontogenic benign tumors categorized as hamartomas. Odontoma is primarily made up of enamel and dentin, although it may also contain cementum and pulp tissue in various forms. It is known for having slow-growth and non-aggressive nature. It is made up of either dental tissues categorized as a complex or a compound odontoma based on radiological and histological characteristics. Complex odontomas are less prevalent among them, and they usually show as a tiny, silent radiopaque mass enclosed by a radiolucent border, seen on routine radiographic examinations. To avoid tooth eruption disturbances and additional clinical problems, odontomas should be managed and surgically removed once they have been detected. The present study describe a rare case of giant complex odontoma in the posterior mandible with an unusual dimension in a 16-year-old Iranian female patient referred to the Department of Oral and Maxillofacial, Mashhad Dental School, Mashhad, Iran, in May 2021. The case was effectively treated with surgical curettage and tumor enucleation, emphasizing the significance of early detection to minimize complications. Additionally, the clinical, radiological, and histopathological aspects and probable surgical treatments were discussed.

8.
World J Plast Surg ; 10(3): 25-33, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34912664

RESUMEN

BACKGROUND: We aimed to assess the incidence of bad split fractures during Bilateral Sagittal Split Osteotomy (BSSO) mandibular setback surgery using Dal Pont and Hunsuck techniques. METHODS: All healthy adults with skeletal class III discrepancy, who were candidates for mandibular setback surgery were enrolled in this randomized clinical trial in the Maxillofacial Surgery Department of Qaem Hospital, Mashhad, Iran; from 2018-2020. These patients were randomly divided into two equal groups; one group underwent BSSO using Dal Pont osteotomy while the Hunsuck osteotomy was employed for the other group. A bad split fracture which identified through intra-operative clinical and postoperative radiographic examination was the outcome variable. The significance level was set at 0.05 using SPSS 16. RESULTS: Overall, 104 consecutive patients, comprising of 52 (50%) males with an average age of 23.09±3.08 were recruited. The average duration of osteotomy and splitting was reported to be 22.74±3.06 min. 10 bad split fractures (9.62%) were observed; 7 of which occurred in the Dal Pont group and 3 in the Hunsuck group. However, this difference was not significant. In 80% of the cases, bad split osteotomy occurred in the proximal segment, while this finding was identified in the distal segment in 20% of cases. The average duration of osteotomy and splitting was significantly longer in the Dal Pont group (P<0.001). CONCLUSION: The duration of osteotomy and splitting is much shorter when the Hunsuck technique is employed, and the incidence of unfavorable fractures is also less compared to the Dal Pont osteotomy technique.

9.
World J Plast Surg ; 10(3): 126-133, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34912679

RESUMEN

Fibrous dysplasia is a rare bony disorder with recurrent character distinguished by abnormal fibro-osseous tissue. One or more bones may be involved in this lesion; however, the maxilla is the most commonly affected bone in the maxillofacial region. Here, we present an interesting case of a surgically treated 12-year-old adult female patient with a diagnosis of craniofacial fibrous dysplasia (CFD) in the maxillary bone with an invasive expansion to the orbital bone who was referred to the Department of Oral and Maxillofacial, Mashhad Dental School, Mashhad, Iran, in Apr 2021. The patient was treated under general anesthesia by the surgical recontouring and bone shaving of the tumor. Several factors should be considered in choosing the best treatment such as pathological features of the lesion, patient's age, and risk of recurrence. However, surgical treatment, in this case, was beneficial to help the patient resuming a normal life. There is no published report describing bone recontouring and shaving management in an invasive case of craniomaxillofacial FD before the age of skeletal maturity due to the psychological effect of the deformity.

10.
World J Plast Surg ; 10(2): 46-54, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-34307097

RESUMEN

BACKGROUND: This study aimed to investigate the positional changes of the hyoid bone following orthognathic surgery in skeletal class III patients. METHODS: This double-blinded quasi-experimental study was carried out in Mashhad University of Medical Sciences, Iran, from Apr 2019 to Jun 2020. All skeletal Class III patients who were candidates for orthogenetic surgery were included. They underwent mandibular setback surgery using bilateral sagittal split osteotomy. Cephalometric assessments in relation to hyoid bone position and posterior airway space (PAS) were conducted one day preoperatively (T0), as well as one week (T1), six months (T2) and one year (T3) postoperatively, determining the parameters like the Long axis of the hyoid bone (LAH), Retrognation (RGn), Hyoidale (H), Palatal plane (PP), Mandibular plane (MP) and C3 Vertebrae (C3). All cephalograms were examined using AudaxCeph, Planmeca software. The data analysis was performed via SPSS-19 (P<0.05). RESULTS: 25 class III patients, including 18 females (72%) and 7 males (28%) with a mean age of 24.32±5.87, were studied. The cephalometric analysis demonstrated significant decreases in variable angles during the follow-up periods, except for LAH-MP angle (P<0.001). The hyoid bone moved downward and backward relative to its original position following the mandibular setback surgery. However, the bone gradually returned to the preoperative location between 6 to 12 months postoperatively. CONCLUSION: The findings revealed the downward and backward movement of the hyoid bone following the mandibular setback surgery, returned near to its preoperative position after 1 year, postoperatively.

11.
World J Plast Surg ; 9(1): 92-98, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32190599

RESUMEN

The mental nerve is a sensory nerve which traverses through mental foramen to innervate the lower lip, chin skin and the mandibular labial gingiva. Interestingly, it's variant such as the accessory mental foramen (AMF) was described as an unusual finding in the recent literature. Hereby, we reported a patient who was operated to treat the mandibular bisphosphonate-related osteonecrosis of the jaw (BRONJ) lesion. Intraoperatively, an accessory mental foramen was detected posterior to the main foramen and nerve, on the right side of the mandible. This case report highlighted the necessity for proper radiological and clinical evaluation of mental foramina in order to avoid nerve injury and postoperative paresthesia. The review of the literature and the clinical findings were also discussed in this article.

12.
Front Dent ; 17(7): 1-6, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33615305

RESUMEN

OBJECTIVES: The purpose of this study was to determine the mini-plate and screw removal rate and reasons in maxillofacial surgery patients under previous semi-rigid fixation treatment in the past five years at the main trauma center of Mashhad. MATERIALS AND METHODS: This was a census-based retrospective study. All the candidates who admitted to our department for maxillofacial plate removal due to symptomatic or infected mini-plates were included in this study. The patients' age and gender, plate removal etiologies, and the time between plate insertion and removal were analyzed. RESULTS: Mini-plates were inserted for 1026 patients. However, only 94 patients with a mean age of 29.4±11.1 years were candidates for plate removal. The plate removal rate was 9.16%. Infection and exposure were the most common causes of plate removal. The most prevalent removal site was the mandible (angle and body). The interval between mini-plate insertion and removal was an average of 12.9±5.6 months. It is noteworthy that the shortest lasting duration was when plate removal was secondary to pain (6.67 months) and infection (11.45 months). CONCLUSION: This research showed that the routine removal of plates does not appear to be generally indicated in healthy subjects unless there is an obvious and definitive clinical indication.

13.
World J Plast Surg ; 9(2): 146-152, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32934925

RESUMEN

BACKGROUND: Obstructive sleep apnea is a disorder of repetitive complete or partial airway obstruction during sleep. The aim of this study was to assess the impact of alveolar cleft reconstruction on the obstructive sleep apnea (OSA) condition and apnea/hypopnea index (AHI). METHODS: In a double-blinded prospective quasi-experimental study, all healthy systemic children (n=30 female cleft patients) with unilateral alveolar cleft defects within the age range of 8-14 years and BMI less than 30 kg/m2 who admitted for alveolar cleft repair were enrolled. OSA monitoring was performed one week before surgery, and 3 months postoperatively by Apnea Link device. Sleep apnea indices such as AHI, respiratory disturbance index (RDI), oxygen desaturation index (ODI) and oxyhemoglobin saturation (SpO2) as well as pulse rate (PR) and respiratory rate (RR) were the variables. RESULTS: The patients' mean age was 11.0±1.4 years, and BMI average was 21.48±4.4 kg/m2. Mean AHI was 21.6±5.0 events/hour, preoperatively; which decreased significantly and reached 4.4±2.5 events/hour after alveolar cleft reconstruction surgery (p=0.005). Moreover, the other OSA variables (SpO2, RDI, and ODI), as well as vital signs (PR, and RR) improved postoperatively (p=0.005). In other words, the preoperative moderate OSA status relieved after alveolar cleft repair and reconstruction. CONCLUSION: Our study showed that the OSA and AHI ameliorated after bone graft surgery in alveolar cleft repair. More clinical trials including larger sample sizes may be required for relevancy.

14.
J Maxillofac Oral Surg ; 19(1): 85-92, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31988569

RESUMEN

INTRODUCTION AND AIM: The aim of this study was to evaluate the effect of two concentrations of caffeine (1.5% and 3%) powder added to Bio-Oss xenograft on bone healing rate of iatrogenic mandibular defects in dogs. MATERIALS AND METHOD: The researchers implemented a pilot study on ten male adult mongrel dogs. Two 4-mm circular critical-sized defects were trephined on each side of the mandibular body (a total of 4 defects for each dog). One of the defects remained empty as a control group. The other three defects in each case were randomly filled with 1.5% or 3% caffeinated Bio-Oss or pure Bio-Oss. The mandible specimens were sent for histological and histomorphometric assessments, 4 months postoperatively. Our predictor variable was the type of bone substitute. The study outcomes were new bone formation, angiogenesis, and fibrosis. The p value was set at 0.05 using SPSS 16. RESULTS: The histological assessment showed that the administration of 1.5% caffeinated Bio-Oss to mandibular defects caused more angiogenesis and more new bone formation as well as less fibrosis compared to the other groups (p < 0.05). CONCLUSION: This study suggested that the application of 1.5% caffeinated Bio-Oss in bone defects of dogs resulted in the higher new bone formation. However, further clinical trials are needed to support its relevancy.

15.
J Maxillofac Oral Surg ; 19(3): 374-379, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32801531

RESUMEN

OBJECTIVE: Narrow dentoalveolar ridges remain a serious challenge for the successful placement of dental implants. The aim of this study was to compare the clinical outcomes of piezosurgery versus surgical disc on ridge splitting in the atrophic edentulous maxilla. MATERIALS AND METHODS: This was a double-blinded randomized clinical trial. The healthy subjects who were candidates for maxillary ridge expansion were included in this experiment. Patients were randomly divided into two groups: piezosurgery group and surgical disc group. The width of the bone in the surgical site was measured by surgical calliper before the osteotomy. The bone width was remeasured after ridge-split completion (before suturing) and during the implant placement (4 months later). Then data were analysed by SPSS software, and the P value was set at 0.05. RESULTS: The study sample size included 20 cases. Our outcomes showed that both techniques (surgical disc and piezotome) were effective in ridge splitting (P < 0.001). However, the average bone width which was obtained after ridge splitting was significantly higher in the piezosurgery group (P < 0.05). CONCLUSION: It can be concluded that both methods of piezosurgery and surgical disc can significantly lead to increase in the ridge width. However, the piezosurgery technique was more effective in ridge splitting.

16.
J Clin Exp Dent ; 10(4): e346-e351, 2018 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-29750095

RESUMEN

BACKGROUND: Hyoid bone plays a significant role in physiological functions of craniofacial region and it's position adapts to changes of the head. The purpose of this study was to determine the position of the hyoid bone among subjects with class I, class II and class III skeletal patterns and evaluate the gender differences. MATERIAL AND METHODS: One hundred and ten lateral cephalograms (59 females and 51 males) from different skeletal patterns (class I, II and III) were selected. The skeletal patterns were determined according to ANB angle. Using MicroDicom software, different linear and angular measurements (6 variables) was carried out to determine the position of hyoid bone. Intraclass correlation coefficient was used to verify reliability. Descriptive statistics of the variables were calculated and analyzed using two-way ANOVA and Bonferroni statistical methods. RESULTS: The mean distance from the hyoid bone (H) to mandibular plane (MP), to palatal plane (PP), as well as to a third cervical vertebra (C3) was more in males than females (p=0.023, p<0.001, p<0.001 respectively). The mean H to PP distance was significantly more in skeletal class I compared to class III (P=0.01). The mean H to C3 distance was significantly more in skeletal class I compared to class II (P=0.008). The mean angle between H-MP and H-PP did not show any statistical difference among three skeletal classes (p=0.102, P=0.213) and among male and female groups (P=0.172, P=0.904). CONCLUSIONS: The hyoid bone is positioned more superior and posterior in females than males and its location differs among different skeletal classes. It is placed more posterior in skeletal class II patterns and more inferior and anterior in skeletal class I patterns. Key words:Hyoid bone, Lateral cephalometry, Class III, Class II, skeletal pattern, Orthodontics.

17.
Arch Iran Med ; 20(8): 481-486, 2017 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-28846011

RESUMEN

INTRODUCTION: Armored removable connector tubes are not always available in operating rooms for routine Altemir submental intubation (SMI) technique. The present study addresses a fiber-optic glidoscopy assisted 2-tubes modification of Green & Moore sequence for submandibular intubation. METHODS: The sample was composed of 11 patients (8 males and 3 females) with panfacial fractures where neither the oral and nasal intubation techniques nor tracheostomy were feasible. The inter-operative procedure duration was recorded and a comparison was made between the present results with those obtained in similar studies. Moreover, postoperative complications were assessed over a duration of 6 months. RESULTS: The average duration of this modified procedure was 8-13 min. (Mean, 10.54 ± 1.75 min). No perioperative or postoperative complications were observed. Based on the findings in this study, it is suggested that this new technique is safe, quick and reliable for submandibular intubation. CONCLUSION: This modification establishes a secure airway for treatment of maxillofacial panfacial fractures, where traditional methods are impossible due to non-detachable connector tubes. No perioperative or postoperative complications were observed. This study suggests that this new technique is safe, quick and reliable for submandibular intubation.


Asunto(s)
Obstrucción de las Vías Aéreas/prevención & control , Intubación Intratraqueal/métodos , Traumatismos Maxilofaciales/cirugía , Músculos del Cuello/cirugía , Fracturas Craneales/cirugía , Adulto , Femenino , Humanos , Masculino , Suelo de la Boca/cirugía , Traqueotomía , Adulto Joven
18.
J Craniomaxillofac Surg ; 45(10): 1614-1621, 2017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-28864284

RESUMEN

INTRODUCTION: There are controversies in recent studies over the application of NSAIDs for controlling pain and swelling after implant surgeries for osseointegration. The aim of this study was to compare caffeine-containing versus codeine-containing analgesics in relation to their anti-inflammatory and analgesic effects after dental implant surgeries. MATERIALS AND METHODS: 80 patients (40 in each group) were selected as the final sample size. Forty drug packs, which were formulated and made by the consultant pharmacist, each containing 10 capsules of acetaminophen caffeine (consisting of 300 mg of acetaminophen and 20 mg of caffeine), and another 40 packs, each containing 10 capsules of acetaminophen codeine (consisting of 300 mg acetaminophen and 20 mg codeine) were prepared. These drugs were administered randomly to patients 1 h before surgery and every 6 h afterward until 48 h, according to the protocol. The patients' pain severities were determined at 30-min, 3-h, 6-h, 12-h, 1-day, 2-day, and 1-week intervals. In addition, the swelling was evaluated after 1-day, 2-days, 3-days, and 1-week. Data were analyzed with Mann-Whitney, student's t, and chi-squared tests, using SPSS 11. RESULTS: A total of 76 patients, including 38 males and 38 females, with a mean age of 41.06 ± 5 and an age range of 35-53 years, were studied. The pain severities in patients in the codeine group were significantly less than those in the caffeine group at 3-, 6-, and 12-h postoperative intervals (p = 0.001). However, the pain severities at the above intervals, even in caffeine group, were within the moderate pain severity range (VAS = 3-7). It is also interesting to note that the pain was at its maximum severity at the 6-h postoperative interval, and at its minimum at the 1-week interval. The severity of swelling was also evaluated in both groups, indicating that it was significantly less in the caffeine group at 1-, 2-, and 3-day postoperative intervals (p = 0.018). CONCLUSION: According to this study, the codeine-containing analgesics are significantly more effective than caffeine-containing ones in reducing postoperative pain. It was also concluded that caffeine-containing analgesics are significantly more effective than codeine-containing ones in reducing postoperative swelling, which was reported to be significantly less within the first 3-days in the caffeine group. As a result, caffeine-containing analgesics are effective and acceptable in reducing both postoperative pain and swelling.


Asunto(s)
Analgésicos Opioides/uso terapéutico , Cafeína/uso terapéutico , Codeína/uso terapéutico , Implantación Dental , Edema/tratamiento farmacológico , Dolor Postoperatorio/tratamiento farmacológico , Complicaciones Posoperatorias/tratamiento farmacológico , Adulto , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad
19.
Artículo en Inglés | MEDLINE | ID: mdl-23277863

RESUMEN

Osteopetrosis represents a heterogeneous group of rare, hereditary bone dysplasias that share the hallmark of increased bone density caused by osteoclast dysfunction. It can manifest through a spectrum of symptoms and severity, from neonatal onset with life-threatening complications ("malignant" autosomal recessive osteopetrosis) to two more benign conditions with the incidental radiographic findings, principally affecting adults (autosomal dominant osteopetrosis type I and type II). We report 2 new cases of autosomal dominant osteopetrosis type II. Both subjects were short in stature. Multiple healed fractures of long bones, diminished marrow spaces and hypoplastic maxillary sinuses were remarkable findings. To our knowledge they are the first reported cases of autosomal dominant type II of this disease in Iran.

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