A triple-blind randomized clinical trial of different associations between dexamethasone and non-steroids anti-inflammatories for preemptive action in third molar extractions.

The aim of this study is to evaluate the preemptive analgesic effects of dexamethasone (DEX) alone or combined with non-steroidal anti-inflammatory drugs (NSAIDs) in third molar surgeries. The subjects were divided into five groups (n = 20 teeth/group); subjects received only 8 mg of dexamethasone 1 h before the surgical procedure (DEX group), or in combination with etodolac (DEX + ETO), ketorolac (DEX + KET), ibuprofen (DEX + IBU), loxoprofen (DEX + LOX). Paracetamol 750 mg was provided as the number of rescue analgesics (NRA). Salivary PGE2 expression was measured preoperatively and at 48 h. Edema and Maximum mouth opening (MMO) were measured postoperatively at 48 h and 7 days. A visual analog scale (VAS) was performed postoperatively at 6, 12, 24, 48, 72 h, and 7 days. Salivary expression of PGE2 showed a decrease only for the DEX group. Edema and MMO and NRA consumption showed no significant differences among the groups (P > 0.05). The VAS showed a significantly lower pain perception at 6 h after the surgery for the DEX + ETO and DEX + KET groups (P < 0.05). The combination of DEX and NSAIDS should be considered for preemptive acute postsurgical pain management in third molar surgery. In some drug associations such as dexamethasone 8 mg + NSAIDS (ETO and KET) in the pre-operative time, only a few rescue analgesics are necessary.

Alveolar bone dynamics in osteoporotic rats treated with raloxifene or alendronate: confocal microscopy analysis.

In this study, the characteristics of the alveolar bone of rats with induced osteoporosis were examined. Thirty-two rats were divided into four groups according to the induction of osteoporosis and drugs administered: OG, osteoporotic rats without treatment (negative control); SG, rats which underwent sham surgery ovariectomy (SHAM); alendronate (AG), osteoporotic rats treated with alendronate; and RG, osteoporotic rats treated with raloxifene (RG). On the 8th day after ovariectomy and SHAM surgeries, drug therapy was started with AG or RG. On the 52nd day, 20 mg/kg calcein was administered to all of the rats, and on the 80th day, 20 mg/kg alizarin red was administered. Euthanasia was performed on the 98th day. The bone area marked by fluorochromes was calculated and data were subjected to two-way ANOVA test and Tukey's post-hoc test (p < 0.05). The comparison of the induced osteoporosis groups showed no statistically significant differences in bone turnover only between RG and SG (p = 0.074) and AG and OG (p = 0.138). All other comparisons showed significant differences (p < 0.001). The largest bone turnover was observed in RG and SG groups. RG was the medication that improved the dynamics of the alveolar bone of rats with induced osteoporosis, resembling that of healthy rats.

Tratamento de fraturas indesejáveis durante cirurgia ortognática: relato de dois casos clínicos / Treatment of undesirable fractures during ortognatic surgery: report of two clinical cases

O presente trabalho tem como objetivo relatar dois casos clínicos de fraturas indesejáveis durante a osteotomia sagital do ramo mandibular. Em ambos os casos após detecção das fraturas indesejáveis, prosseguiu-se com a separação total dos cotos proximais e distais, bloqueio intermaxilar e fixação interna rígida com placas e parafusos do sistema 2.0. No pós-operatório de 18 meses os pacientes não apresentaram défices sensoriais e mantiveram relação oclusal estável. No acompanhamento radiográfico não se notou mudanças de posicionamento das placas e parafusos, bem como havia bom posicionamento dos côndilos nas suas respectivas cavidades articulares. Houve muitas modificações da Osteotomia sagital do ramo mandibular desde a técnica proposta por Trauner e Obwegeser (1957), e também diferentes modalidades de tratamento foram apresentadas 57 na literatura para o tratamento das fraturas indesejáveis. No presente artigo os autores demonstraram duas modalidades de tratamento com bons resultados pós-operatórios.

We report two cases of unfavorable segment fracture during a sagittal split osteotomy procedure. In both cases, the undesirable fractures were conducted until its stabilization and fixation with bone plates and screws. The radiographic follow up period are demonstrated without alterations to the screws and plates planned position, with good occlusal relationship and no sensorial deficit. There have been many modifications of the Sagittal Split Osteotomy technique since Tauner and Obwegeser proposed it in 1957, with different treatment modalities been shown in specific literature to solve the bad split situation. In this paper the authors demonstrated two of these techniques with good post-operative results.

Enucleação de fibroma cemento-ossioficante extenso em maxila: relato de caso clínico / Enucleation of fibroma cemento-ossioficante full in the jaw: a case report

Os tumores ósseos benignos dos maxilares possuem características semelhantes entre si, tais como o crescimento lento, assintomático ecapazes de causar a expansão do osso cortical adjacente. Entre ver o comportamento clínico e a conduta terapêutica para este tipo de tumor.

Benign osseous tumors of the maxillaries have similar characteristics among them selves, such as the slow, asymptomatic growth and being able to cause expansion of the adjacent cortical bone. Amongst these, the cemento-ossifying fibroma has a rare incidence, with predilection for females and more frequent localization in the mandible. This case-report aims to describe the clinical behavior and the therapeutic conduct for this type of tumor.