Evaluation of the effects of pregabalin and dexamethasone coadministration on preemptive multimodal analgesia and anxiety in third molar surgeries: a triple-blind randomized clinical trial.

OBJECTIVE: To evaluate the efficacy of pregabalin and dexamethasone coadministration in preemptive analgesia and anxiety control in lower third molar surgery. MATERIALS AND METHODS: A triple-blind, split-mouth clinical trial conducted with patients divided into two groups: control group, receiving placebo and dexamethasone, and test group, receiving pregabalin and dexamethasone preoperatively. The evaluated variables were pain, measured by the Visual Analog Scale (VAS), anxiety assessed through the State-Trait Anxiety Inventory (STAI) questionnaires, hemodynamic parameters [Blood Pressure (BP), Heart Rate (HR), Oxygen Saturation (SpO2)], and sedation assessed by the Ramsay scale. RESULTS: A total of 31 patients were included. The test group exhibited a significant reduction in pain at 2,4,6,8,12,16,24, and 48 h after surgery and in the consumption of rescue analgesics. Anxiety, evaluated by STAI and VAS, showed a significant decrease in the test group (p < 0.001). Additionally, there was a significant decrease in BP at most of the assessed time points (p < 0.05) and a significant reduction in HR at two different time intervals (p = 0.003 and p = 0.009), indicating a positive effect in the test group. There was no significant difference in SpO2 between the groups. Sedation assessment revealed a significant difference at all time points favoring the test group (p < 0.05). There were no significant postoperative adverse effects. CONCLUSIONS: Pregabalin coadministered with dexamethasone demonstrated significant efficacy in controlling postoperative pain and anxiety, as well as a sedative effect. CLINICAL RELEVANCE: The coadministration of pregabalin with dexamethasone may presents potential advantages in both pain modulation and psychological well-being of individuals undergoing third molar surgeries. TRIAL REGISTRATION: Brazilian Clinical Trials Registry (REBEC), No. RBR-378h6t6.

Effect of simvastatin topical use on alveolar bone after tooth extraction: a scoping review.

OBJECTIVES: Conducting a scoping review (SR) to assess scientific evidence for topical simvastatin's impact on alveolar bone regeneration and determine its level of support for clinical applications. MATERIALS AND METHODS: This SR followed the PRISMA-ScR and OSF registries protocol; systematic searching was conducted on MEDLINE/PubMed, Cochrane, Embase, Scopus, Web of Science, and LILACS, to identify relevant articles until June 2023. Inclusion criteria covered clinical trials, case series, prospective and retrospective studies, along with in vivo investigations, involving participants of any sex and age. RESULTS: Out of 1312 identified studies, 20 (9 in vivo, 11 RCTs) met inclusion criteria. RCTs focused on third molar extraction, in vivo on mandibular incisor surgery. The majority of RCTs employed a collagen sponge and a simvastatin concentration of 10mg; conversely, most in vivo studies favored polylactide-co-glycolide and a 2 mg simvastatin concentration. RCTs had 3-month follow-ups; in vivo, studies extended to 8 weeks. Seven RCTs assessed pain outcomes, simvastatin did not significantly affect pain in six studies. Among four RCTs on postoperative swelling, only two observed a significant increase in the simvastatin group. In general, positive bone formation and the absence of adverse effects directly linked to topical simvastatin were observed across the study models. CONCLUSIONS: Intra-alveolar simvastatin post-tooth extraction has been to be shown to be effective and safe for preserving alveolar bone, with varied concentrations and carriers, with no significant adverse effects. CLINICAL RELEVANCE: This review provides critical insights into the effects of simvastatin on alveolar bone regeneration, informing potential benefits and possible challenges associated with its post-extraction application. OSF REGISTRY PROTOCOL: osf.io/q3bnf.

Tomographic evaluation of the effect of simvastatin topical use on alveolar bone microarchitecture, pain and swelling after mandibular third molar extraction: a randomized controlled trial.

OBJECTIVES: To evaluate the effect of a collagen sponge containing simvastatin on socket healing in terms of bone microarchitecture through tomographic analysis, pain, and swelling after impacted third molar extraction. MATERIALS AND METHODS: In this single-blind, split-mouth, randomized clinical trial, 29 patients undergoing impacted third molar extraction were allocated into two groups: (i) test group, a collagen sponge containing simvastatin was inserted within the sockets; and (ii) control group, in which sockets retained the clot. Bone volume (BV), bone volume fraction (BV/TV), trabecular thickness (Tb.Th), trabecular spacing (Tb.Sp), and gray scale were evaluated using cone beam computed tomography (CBCT) acquired immediately postoperative and 3 months after surgery. Pain, swelling, and wound healing were evaluated using the 10-point visual analogue scale, three extra-oral reference measurements, and the Landry index. RESULTS: In total, 22 participants remained in the study; no loss-to-follow-up was related to the intervention. BV and BV/TV were significantly higher at 3 months postoperatively in the test group compared with the control group and were correlated with greater bone trabeculation. Pain, edema, and the Landry index revealed a greater inflammatory response in the test group during early repair. Simvastatin contributed to bone healing, with no adverse effects or postoperative complications. CONCLUSIONS: The absorbable collagen sponge containing simvastatin improved BV, BV/TV, and trabecular bone, indicating the potential of this drug to induce the formation of autogenous bone. CLINICAL RELEVANCE: Intraosseous statins represent a promising, low-cost, and easy-to-use alternative for alveolar ridge preservation and bone regeneration. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials (REBEC), No. RBR-523N7R.

Intraoral Approach for Surgical Treatment of Psammomatoid Juvenile Ossifying Fibroma.

Psammomatoid juvenile ossifying fibroma (PJOF) is a rare benign tumor that usually affects the paranasal sinuses, orbit, and skull. In most cases, extensive incisions are necessary for full access to the tumor site. The aim of this paper is to report a case of extensive PJOF in which an intraoral surgical approach was performed with complete excision of the tumor. A female patient, 18-year old had a deforming volume increase in the region of the left facial middle third with an approximate evolution time of 2 years. She complained of headache, epiphora in the left eye, and total obstruction of the left nostril. Extraoral examination showed facial asymmetry with dystopia, ocular proptosis, and considerable sclera exposition of the left eye. Tomography examination showed a mixed aspect lesion on the left side of the face, well delimited. The intraoral surgical approach was chosen for the excision of the lesion. Under general anesthesia and nasotracheal intubation, total resection was performed, followed by exodontia of the directly involved teeth. In the definitive histopathological examination, the diagnosis was confirmed. The patient is currently with 2 years and 6 months of postoperative follow-up and has good healing of intraoral surgical wounds and stable occlusion. Extraoral examination showed harmonic projection of the facial middle third, but still with excessive exposure of the sclera of the left eye due to the defect in the orbital floor. The surgical treatment of PJOF was possible by intraoral approach, even taking into account the limitations of the access and the complexity of the anatomy of the facial bones involved.

Virtual Surgical Planning and One-Stage Treatment of Active Hemimandibular Hyperplasia.

Hemimandibular hyperplasia was first described in 1836 by Adams as a disorder that causes condylar hyperplasia, deforming facial asymmetry and has an unknown etiology. The objective of this study was to report a patient with surgical correction through orthognathic surgery and high condilectomy for the treatment of hemimandibular hyperplasia. The patient complained of pain and cracking in the right temporomandibular joint region and was dissatisfied with the aesthetic appearance of the face. Virtual planning was done for bimaxillary orthognathic surgery and preparation of prototyped surgical guides. Stereolithographic models were used for the preparation of the acrylic guides of the osteotomies for the high condilectomy and the contour of the mandibular base. Orthognathic surgery resulted in the maxillary repositioning with correction of the inclination of the occlusal plane, reduction of the height of the ramus and right mandibular body and class I dental attachment. Mandibular contour osteotomy was performed with acrylic guide in the basilar. The condilectomy was performed by endaural access. In 2-year follow-up, there are no signs of recurrence.

Líquen plano oral: um relato de caso / Oral lichen planus: a case report

O líquen plano oral é uma doença crônica sistêmica comum, que se caracteriza por ser mucocutânea, autoimune, porém de etiologia incerta. O objetivo do presente trabalho é o de relatar um caso clínico com diagnóstico precoce e tratamento imediato, bem como acompanhamento de sua evolução. Foi descrito o caso de uma paciente do serviço de Traumatologia Buco-Maxilo-Facial do Hospital Universitário Oswaldo Cruz ­ HUOC. O teste para hepatite C se mostrou negativo para a paciente-alvo de nosso estudo e não há traços de transformação maligna nas lesões, considerando o acompanhamento clínico de 6 meses. O líquen plano oral necessita de diagnóstico preciso, para que a implementação de uma correta conduta terapêutica possa ser realizada... (AU)

Oral lichen planus is a common chronic systemic disease characterized as a mucocutaneous, autoimmune but of uncertain etiology. The aim of this study was to report a case with early diagnosis, prompt treatment and a six-month follow-up. It described the case of a patient of Buco-Maxillofacial Service of the University Hospital Oswaldo Cruz - HUOC. The test for hepatitis C was negative for the patient and no traces of malignant transformation lesions was found, taking into account the clinical six-month follow-up. Oral lichen planus requires an accurate diagnosis for the implementation of a correct approach therapy... (AU)

Abscesso labial por manipulação de acne: relato de caso / Lip abscess by acne manipulation: case report

Os abscessos labiais são entidades pouco relatadas na literatura científica. São infecções potencialmente graves, de origem poli microbiana, podendo causar necrose tecidual e deformidades na região. A microbiota dessas infeções costuma ser conhecida, dispensando, muitas vezes, a cultura e o antibiograma. Antibióticoterapia empírica e drenagem apresentam boa resolutividade. O presente trabalho tem como objetivo relatar um caso de abscesso labial, causado por manipulação de acne. Paciente do sexo masculino, 19 anos de idade, com relato de manipulação de lesão pustulosa na linha de transição muco-cutânea do lábio inferior há 05 dias, evoluindo abscesso labial. O tratamento foi realizado com antibióticoterapia empírica, penicilina de amplo espectro associado com sal potássico de ácido clavulânico e drenagem. Após sete dias, o paciente já apresentou aspecto de normalidade na região. Diagnóstico e abordagem precoce foram determinantes para a resolutividade do caso... (AU)

The lip abscesses cases are little reported in the scientific literature. They are potentially serious infections, polymicrobial and may cause tissue necrosis and deformities in the region. The microbiota of these infections usually known, often dispensing culture and sensitivity. Antibiotic empiric therapy and drainage have good resoluteness. This study aims to report a case of lip abscess caused by acne handling. A 19-year-old male patient, presenting a pustular lesion on the mucocutaneous transition line in lower lip with 5 days of evolution. The treatment was performed with empirical antibiotic therapy, broad spectrum penicillin associated with clavulanic acid potassium salt and drainage. After seven days, the patient presented aspect of normality in the region. Early diagnosis and approach were instrumental in solving the case... (AU)

EFEITO DE REPOSITORES HIDROELETROLÍTICOS SOBRE A MICRODUREZA DE RESINAS COMPOSTAS / Effect on hydroeletrolitc reposition microhardness of composite resins

Objetivo: Verificar o efeito de repositores hidroeletrolíticos sobre a microdureza de resinas compostas. Materiais e Método: Por meio de um estudo in vitro, foram confeccionados dezesseis espécimes de resina composta, das marcas Rok®, Herculite Classic®, Filtek TM P-60® e EstelitΣ®, na cor B2, com dimensões de 5 mm de diâmetro e 2 mm de altura. Os espécimes foram obtidos através de incrementos de 2mm e fotopolimerização final por 20s. Os espécimes foram expostos à ação de três respositores hidroeletrolíticos comerciais, Marathon Sport®, Taeq Esporte® e Gatorade® (sabor uva), e a saliva artificial num período de três semanas. Previamnete foram mensurados o pH endógeno de cada bebida, através do pH - metro digital. Realizou-se a análise de microdureza Vickers das resinas a cada semana de exposição. Os dados foram analisados por meio de estatística descritiva e inferêncial teste de Kruskal-Wallis. Resultados: As maracas comerciais de resinas compostas apresentaram diferença estatisticamente significativas nos valores de microdureza após 1, 2 ou 3 semanas. Conclusão: Os repositores hidroeletrolíticos exerceram influência sobre a microdureza das resinas compostas.

Aim: To investigate the effect of electrolyte replacers on the microhardness of composite resins. Materials and Methods: Using an in vitro study, sixteen specimens were fabricated composite resin brands Rok ®, Herculite ® Classic, Filtek TM P-60 ® and ® EstelitΣ, color B2, with dimensions of 5 mm in diameter and 2 mm in height. The specimens were obtained in increments of 2 mm and final curing for 20s. The specimens were exposed to the action of three different hydroelectrolyte respositores, Marathon ® Sport, Sport Taeq ® and Gatorade ® (grape flavor), artificial saliva and within three weeks. Previamnete we measured the endogenous pH of each beverage by pH - meter type. Analysis was performed Vickers microhardness of resins each week exposure. Data were analyzed using descriptive and inferential statistics using the Kruskal-Wallis test. Results: The commercial maracas composites showed statistically significant difference in hardness values after 1, 2 or 3 weeks. Conclusion: The electrolyte replacers had an influence on the microhardness of resins.