Assessment of routine diet (garlic consumption) as a pre- and postoperative protocol in oral and maxillofacial surgical interventions: An evidence-based literature review.

BACKGROUND: It was hypothesized that pathological bleeding (PB) during and/or after oral surgical procedures is higher in systemically healthy patients who have a history of garlic intake compared to controls (patients without a history of garlic consumption). AIM: The aim of the present review article was to identify studies in which garlic consumption was included as a patient management protocol before and after oral and maxillofacial surgery (OMFS). METHODS: A review of pertinent indexed literature was performed. The focused question that was addressed was "Has diet (garlic consumption) been considered as a patient management protocol before and after OMFS?" The inclusion criteria were: (a) studies published in indexed databases, (b) original studies, (c) studies on OMFS, and (d) studies that considered diet (garlic consumption) as a patient management protocol before and after OMFS. Literature review, commentaries, letters to the editor, and studies published in non-indexed resources were excluded. The pattern of the present review was customized to summarize the pertinent information. RESULTS: The initial search using the terms "oral," maxillofacial," "protocol," and "surgery" yielded 1478 studies. The addition of the term "diet" to this search strategy reduced the number of studies to five. Further filtration of these studies using the terms "garlic" and/or "Allium sativum" showed no studies. CONCLUSIONS: Garlic intake predisposes patients to PB. However, there are no studies in the indexed literature that have considered the inclusion of garlic consumption in patient management protocols before and after OMFS.

Effect of Supplementary Administration of Anaheal on Reducing Pain, Swelling and Trismus after Mandibular Third Molar Surgery: A Splitmouth Controlled Randomized Clinical Trial

Objective: To evaluate the effect of supplementary administration of Anaheal capsule in reducing pain, swelling and trismus after surgical removal of impacted mandibular third molars. Material and Methods: This single-blind controlled randomized clinical trial was conducted on 36 patients referring to Tabriz University of Medical Sciences. Each of the 36 patients had bilateral surgical removal of mandibular third molars in two sessions, with at least a 4-week interval between sessions. In the same individual, one of the sites randomly received a test medication whereas the other site was used as a control. In the test subgroup (test medication side), the first dose of Anaheal capsule was given as a 200-mg dose of bromelain immediately after surgery according to manufacturer's instructions and the subsequent doses were given at 6-hour intervals after the first dose. The medication was administrated for 3 days. In the control subgroup (control side), Anaheal was not administered. The severities of pain, swelling and maximum mouth opening (MMO) were recorded one and three days postoperatively. Paired t-test and t-test for independent samples were used. Statistical significance was defined at p<0.05. Results: A total of 72 surgical extractions were performed; 36 procedures served as control and 36 cases received Anaheal. Pain, swelling and trismus of the patients were at the highest levels one day after surgery, which decreased on day 3. However, independent t-test showed no significant differences in pain, swelling and trismus after surgery between the study subgroups (p>0.05). Conclusion: Supplementary administration of Anaheal (800 mg bromelain daily) had no significant effect on decreasing pain, swelling and trismus at 1- and 3-day intervals after surgical removal of mandibular third molars.

High-intensity laser application in Orthodontics

ABSTRACT Introduction: In dental practice, low-level laser therapy (LLLT) and high-intensity laser therapy (HILT) are mainly used for dental surgery and biostimulation therapy. Within the Orthodontic specialty, while LLLT has been widely used to treat pain associated with orthodontic movement, accelerate bone regeneration after rapid maxillary expansion, and enhance orthodontic tooth movement, HILT, in turn, has been seen as an alternative for addressing soft tissue complications associated to orthodontic treatment. Objective: The aim of this study is to discuss HILT applications in orthodontic treatment. Methods: This study describes the use of HILT in surgical treatments such as gingivectomy, ulotomy, ulectomy, fiberotomy, labial and lingual frenectomies, as well as hard tissue and other dental restorative materials applications. Conclusion: Despite the many applications for lasers in Orthodontics, they are still underused by Brazilian practitioners. However, it is quite likely that this demand will increase over the next years - following the trend in the USA, where laser therapies are more widely used.

Indications of Potassium Titanyl Phosphate Laser Therapy for Slow-Flow Vascular Malformations in Oral Region.

BACKGROUND: Indications for laser therapy for slow-flow vascular malformations in the oral and maxillofacial regions have not been clearly documented. The authors aimed to estimate the frequency of resolution of slow-flow vascular malformations and to identify risk and prognostic factors associated with resolution in potassium titanyl phosphate (KTP) laser treatment. METHODS: This study was designed as a prospective cohort study. Patients who had diagnosed slow-flow vascular malformations were continuously assigned to receive KTP laser therapy. All patients had intralesional laser photocoagulation performed under local anesthesia. Administered power of the KTP laser was fixed at 2 watts throughout the procedure in all patients. The primary endpoint was to understand the frequency of resolution of slow-flow vascular malformations in KTP laser treatment. Secondary endpoints were: treatment outcomes based on lesion size; treatment outcomes based on location; treatment outcomes based on total energy in joules; types of complications. Treatment outcomes were judged by a clinical assessment as well as reduction in lesion size on magnetic resonance imaging. RESULTS: Data were obtained from 26 patients (9 men, 17 women) with 38 lesions. The average lesion size was 13.5 ±â€Š7.7 mm. Treatment outcomes based on lesion size showed that cure and regression were obtained in lesions less than 30 mm in size. However, lesions larger than 30 mm showed no response. Lesions in the tongue and lips showed higher cure rates than in other areas. Treatment outcomes based on administered total energy in joules showed that 68% of lesions were treated and responded well at less than 400 joules. Complication rate was relatively high in the buccal mucosal lesions. Immediate postoperative complications such as necrosis were more common in high-energy administration than in low-energy administration. CONCLUSION: Our results indicated that KTP laser therapy was effective for slow-flow vascular malformations less than 30 mm in size without significant side effects.

High-intensity laser application in Orthodontics.

INTRODUCTION: In dental practice, low-level laser therapy (LLLT) and high-intensity laser therapy (HILT) are mainly used for dental surgery and biostimulation therapy. Within the Orthodontic specialty, while LLLT has been widely used to treat pain associated with orthodontic movement, accelerate bone regeneration after rapid maxillary expansion, and enhance orthodontic tooth movement, HILT, in turn, has been seen as an alternative for addressing soft tissue complications associated to orthodontic treatment. OBJECTIVE: The aim of this study is to discuss HILT applications in orthodontic treatment. METHODS: This study describes the use of HILT in surgical treatments such as gingivectomy, ulotomy, ulectomy, fiberotomy, labial and lingual frenectomies, as well as hard tissue and other dental restorative materials applications. CONCLUSION: Despite the many applications for lasers in Orthodontics, they are still underused by Brazilian practitioners. However, it is quite likely that this demand will increase over the next years - following the trend in the USA, where laser therapies are more widely used.

Freio lingual: abordagem clínica interdisciplinar da Fonoaudiologia e Odontopediatria / Lingual frenulum: interdisciplinary clinical approach of Speech Terapy and Pediatric Dentistry

Introdução: O freio lingual é uma estrutura anatômica cujo papel é muito importante para a sucção, fala e alimentação. Um freio curto e aderido pode impedir o movimento da língua e com isso causar impactos anatômicos e funcionais para o paciente. Objetivos: O objetivo deste relato de caso é demonstrar, com olhar clínico interdisciplinar, as ações conjuntas entre a Odontopediatria e a Fonoaudiologia frente à alteração de freio lingual em uma criança com alteração na fala. Foi realizado diagnóstico em conjunto e traçado o plano de tratamento que constou de frenectomia e acompanhamento fonoaudiológico no intuito de monitorar as evoluções e proporcionar tratamento global. Conclusão: O procedimento cirúrgico, realizado pela Odontopediatria trouxe ganhos anatômicos e de mobilidade de língua, entretanto os aspectos alterados da fala permaneceram imediatamente após a intervenção, enfatizando a necessidade do tratamento e do acompanhamento fonoaudiológico.

Introduction: The lingual frenulum is an important anatomic structure involved in the act of suction, speech and feeding. A short and adhered frenulum limits the tongue movement and therefore, can cause anatomic and functional impacts in the patient. Aim: The aim of this case report is to show, with an interdisciplinary approach, strategies implemented by the Speech Therapy and Pediatric Dentistry for alterations in a lingual frenulun of a child with speech problems. This alteration was diagnosed and the treatment plan defined by both professionals and the frenectomy was conducted. Speech therapist followed up the patient in order to provide global treatment. Conclusion: Surgical procedure, conducted by the pediatric dentist improved tongue mobility, however speech alterations still were present after the intervention, emphasizing the need of a speech monitoring and therapy.

Controle da dor após a aplicação ou não da laserterapia em exodontias de terceiros molares inferiores inclusos - relato de sete casos / Pain management after the application or non-application of laser therapy in the extraction of mandibular third molar – report of seven cases

As maiores preocupações dos cirurgiões dentistas no caso de extrações dentária são com o pós-operatório em relação ao controle da dor, inflamações e edema. Esse trabalho tem como objetivo fazer um comparativo do nível de dor após as exodontias de terceiros molares inclusos, utilizando ou não a laserterapia. Foi realizado um estudo comparativo, boca dividida, duplo-cego em que sete pacientes foram submetidos … extração do terceiro molar inferior em um dos lados e, neste lado, foi aplicado o laser de baixa intensidade, sendo que o laser utilizado foi o de arseneto de gálio infravermelho. Pelo menos 15 dias após o procedimento foi extraído o outro terceiro molar inferior, mas sem a aplicação da laserterapia. Utilizou-se as escalas de dor nos tempos de 2, 4, 6, 8, 12, 24, 36 e 48 horas após a cirurgia para avaliar se houve dor ou algum tipo de desconforto. Com relação … dor, o lado em que foi utilizado o laser terapêutico teve melhores resultados, já o lado em que o laser não foi utilizado teve mais desconforto. Pode-se concluir que a laserterapia se mostrou útil e eficaz na diminuição da dor após extrações de terceiros molares

Dentists’ majors concerns in cases of tooth extraction are due to postoperative issues such as: pain management, possible inflammation and edema. This paper aimed at making a comparison of the pain level after the extraction of third molars, using laser therapy or not. We conducted a comparative, double-blinded, split mouth in which 7 patients underwent extraction of third molar on one side and, on this side, the low-intensity laser was applied. The laser used was gallium arsenide infrared. At least 15 days after the procedure, another third molar was extracted, but without the application of laser therapy. With regard to pain, the side submitted to the laser therapy achieved better results; on the other hand, the side that didn’t receive the treatment with laser suffered more discomfort, reported by the patient. We can conclude that laser therapy proved itself useful and effective in reducing pain after third molar extractions

Hipnosis como complemento en la cirugía oral del adulto mayor / Hypnosis as a complement to oral surgery in elderly persons

Introducción: el envejecimiento poblacional es un fenómeno mundial y la cirugía oral es compleja en los adultos mayores, por lo que la preparación preoperatoria es de vital importancia para una evolución satisfactoria. Este trabajo tiene como objetivo demostrar la eficacia de la hipnosis en pacientes con temor en la cirugía oral del adulto mayor. Métodos: se realizó un estudio descriptivo, transversal, con muestra de 20 pacientes de 60 años o más, atendidos en la consulta de Cirugía Maxilofacial del Hospital Universitario Comandante Manuel Fajardo, en el año 2011, donde se analizaron las variables edad, sexo, número de sesiones de hipnosis, antecedentes patológicos, diagnósticos más frecuentes y temor. Resultados: el mayor número de pacientes se encontró entre 60-69 años de edad, (70 por ciento) y el menor en 70-79, (30 por ciento). El sexo femenino prevaleció con 70 por ciento. El número de sesiones fue en el grupo de 60-69 con 58, con un promedio total de 4 por pacientes. En los antecedentes patológicos más frecuentes fue la hipertensión arterial en 14 (70 por ciento) y le siguió la diabetes tipo II en 2 (10 por ciento). En los diagnósticos más frecuentes fue la caries de cuarto grado con 10 (50 por ciento) seguido por los dientes parodontósicos con 4 (20 por ciento). El temor se midió en una escala confeccionada, en la que los pacientes con cifras de l0, 8 y 7 se redujeron a 4 y 5. Conclusiones: Se demuestra la efectividad de la terapia de hipnosis para disminuir el temor y realizar la cirugía oral en el adulto mayor(AU)

Introduction: population aging is a worldwide phenomenon, and oral surgery is complex in elderly patients. Therefore, preoperative preparation is vital to their satisfactory evolution. The purpose of the present paper is to show the efficacy of hypnosis in elderly patients who fear oral surgery. Methods: a descriptive cross-sectional study was conducted with a sample of 20 patients aged 60 or over, cared for at the maxillofacial surgery service of Comandante Manuel Fajardo University Hospital in the year 2011. The variables analyzed were age, sex, number of hypnotic sessions, disease history, most frequent diagnoses and fear. Results: most patients fell into the 60-69 age group (70 percent). The remaining 30 percent were in the 70-79 age group. Female sex predominated with 70 percent. The highest number of sessions was 58 in the 60-69 age group, with an average of 4 per patient. The most frequent pathological antecedents were hypertension in 14 (70 percent), followed by type II diabetes in 2 (10 percent). The most common diagnoses were fourth degree caries in 10 (50 percent), followed by parodontic teeth in 4 (20 percent). Fear was measured with a dedicated scale on which patient scores of 10, 8 and 7 were reduced to 4 and 5. Conclusions: hypnotic therapy was shown to be effective to relieve fear of oral surgery in elderly persons(AU)

Chronic oroantral fistula: combined endoscopic and intraoral approach under local anesthesia.

OBJECTIVE: To evaluate the outcome of combined surgical treatment of oroantral communications associated with chronic maxillary sinusitis. PATIENTS AND METHODS: 8 consecutive patients affected by complicated oroantral fistula were included in the study. The protocol consisted of: clinical, endoscopic and radiological preoperative evaluation (panoramic tomogram and computed tomography); systemic antibiotic and steroid therapy 2 weeks before surgery; one-stage surgical procedure under local anaesthesia consisting in uncinectomy with enlargement of the osteomeatal complex through endoscopic nasal approach associated with the closure of the oroantral communication by means of a mucoperiosteal flap; postoperative antibiotic and cortisone-based therapy. Follow-up consisted of weekly clinical evaluation during the first month, and nasal endoscopy at 3, 8 and 24 weeks after surgery. RESULTS: After surgical treatment, all patients were symptom-free and had no endoscopic and radiological evidences of maxillary sinusitis at the 6-month follow-up. No recurrent oroantral fistulas were found. CONCLUSIONS: The current prospective study showed that a one-stage, combined endoscopic and intraoral approach under local anaesthesia represents a feasible and minimally invasive procedure for the long-term effective treatment of chronic complicated oroantral communications. Moreover, it represents an easily applicable approach also in outpatient clinics with minor patient discomfort.

Sarcomas mandibulares: experiencia quirúrgica en los últimos 10 años / Mandibular sarcomas: surgical experience over the past 10 years

Introducción: Los sarcomas mandibulares representan una entidad de difícil estudio por su escasa incidencia e histopatología. Pacientes y métodos: Presentamos la experiencia del servicio de Cirugía Oral y Maxilofacial del Hospital Vall d’Hebron de Barcelona en los últimos 10 años (2001-2010) en el manejo de los sarcomas mandibulares, realizando una revisión retrospectiva de 12 casos de pacientes afectos por este tipo de tumor. Resultados: La técnica más utilizada para la reconstrucción fue el colgajo microvascularizado (hueso peroné: 8/12), recibiendo tratamiento adyuvante (quimioterapia y/o radioterapia) el 82% de los pacientes. Cinco pacientes fallecieron (42%), 2 se encuentran con progresión de la enfermedad (16%) y 5 sobreviven libres de enfermedad (42%) hasta la finalización del seguimiento. Conclusiones: Los casos descritos representan una serie singular debido a la localización mandibular, no antes publicadas en la literatura. Aún así, los resultados obtenidos en términos de supervivencia y factores pronóstico son similares a los descritos para los sarcomas de cabeza y cuello. La consecución de márgenes libres con la cirugía es la clave del tratamiento, siendo necesario el tratamiento complementario para mejorar el pronóstico(AU)

Introduction: Sarcomas located in the mandible are difficult to study due to their relatively rare appearance and histology. Patients and Methods: We present the experience of the Oral and Maxillofacial Surgery Department of the Vall d’Hebron Hospital in Barcelona over the last 10 years (2001-2010) in the management of jaw sarcomas, performing a retrospective review of 12 cases of patients affected by this type of tumour. Results: The technique mostly used for the reconstruction was the microvascularised bone graft (fibula: 8/12), with 82% of the patients receiving adjuvant therapy (chemotherapy and radiotherapy). Five of the patients died (42%), twowere found with disease progression (16%), and 5 survived free of disease (42%) until the end of follow-up. Conclusions: The cases described are a unique series due to the mandibular location. Prognostic factors and survival rates are similar to those described for head and neck sarcomas. Free margin during surgery must be the goal of treatment, additional chemotherapy or radiotherapy or both being required to improve the survival rates(AU)

Plasma rico en plaquetas: fundamentos biológicos y aplicaciones en cirugía maxilofacial y estética facial / Platelet-rich plasma: biology and applications in maxillofacial surgery and facial aesthetics

Esta revisión presenta el uso del preparado de plasma rico en plaquetas (PRP) como una herramienta potenciadora de ciertas características histológicas de los tejidos conformados por células con receptores para los factores de crecimiento plaquetarios. Se ha realizado una revisión sobre el plasma rico en plaquetas de la literatura publicada en PubMed. Se describen los fundamentos biológicos del PRP a nivel celular, la técnica de obtención, y sus usos clínicos en la actualidad(AU)

This review shows platelet-rich-plasma (PRP) as an enhancer of the histological characteristics of the tissues with platelet-derived growth factor receptors. A review has been made of the literature on the platelet-rich plasma published in PubMed. The article describes the cellular biology of PRP, the technique for obtaining it, and its clinical applications(AU)

Autologous platelet concentrates for bone graft enhancement in sinus lift procedure.

BACKGROUND: Autologous platelet (PLT)-rich plasma has been reported in some studies to promote osteogenesis. The goal of this study was to demonstrate that osteogenesis gained by mixing autologous PLT concentrates (APCs) with a small quantity of autologous bone graft could give a sufficient quality to lead to dental implant placement. The second goal was to compare this osteogenesis with that obtained by a traditional method (iliac bone graft), through clinical, radiologic, and histologic methods. STUDY DESIGN AND METHODS: Eighteen patients needing bilateral sinus floor augmentation were enrolled. One sinus was grafted with iliac crest bone alone, and the other sinus with a small quantity of bone and APC. Panoramic view, computed tomography scan, and biopsies were performed 6 months after the initial surgery to compare ossification. RESULTS: The adjunction of APCs permitted a 60 percent reduction of bone graft required for sinus floor elevation. The bone obtained with APCs had the same histologic and mechanical characteristics as the bone obtained by traditional graft. CONCLUSION: Topical use of APCs might be helpful in bone reconstruction. No clinical, radiologic, or histologic osteogenesis inhibition of high PLT concentration was observed. The resulting osteogenesis was adapted to dental implant placements.

Efficacy and safety of the use of autologous plasma rich in platelets for tissue regeneration: a systematic review.

BACKGROUND: Autologous plasma rich in platelets (PRP) is a derived blood product whose application in clinical practice is growing. A systematic review was conducted to evaluate its efficacy and safety. STUDY DESIGN AND METHODS: A search was performed in electronic databases. Randomized controlled clinical trials (RCTs) in adult patients were included and assessed for methodologic quality. The main outcomes were "tissue regeneration" and "safety." Relative risks (RRs) and standardized mean differences (SMDs) were calculated to show pooled estimates for these outcomes. When the results heterogeneity was more than 50 percent, a sensitivity analysis was performed. RESULTS: Twenty RCTs were included (11 of oral and maxillofacial surgery, 7 of chronic skin ulcers, and 2 of surgery wounds). Four RCTs evaluated the depth reduction in gingival recession in chronic periodontitis; the SMD was 0.54 (95% confidence interval [CI], 0.16 to 0.92) mm, favorable to PRP. Three RCTs evaluated the clinical attachment level in chronic periodontitis; the SMD was 0.33 (95% CI, -0.71 to 1.37) mm. Six RCTs assessed the complete skin epithelialization in wound ulcers; the RR was 1.40 (95% CI, 0.85 to 2.31). Only 6 RCTs reported adverse effects without differences between groups. CONCLUSIONS: PRP improves the gingival recession but not the clinical attachment level in chronic periodontitis. In the complete healing process of chronic skin ulcers, the results are inconclusive. There are little data about PRP safety. There are several methodologic limitations and, consequently, future research should focus on strong and well-designed RCTs that assess the efficacy and safety of PRP.

Manejo del sangrado en cirugía ortognática / Handling bleeding in orthognathic surgery

La magnitud y el control del sangrado, junto al requerimiento de transfusión, han sido temas muy controvertidos en la cirugía ortognática. En la literatura se menciona el uso de técnicas y criterios disímiles y contradictorios. Hemos querido actualizar los criterios sobre el manejo del sangrado en la cirugía maxilofacial en base a nuestra experiencia con el uso de técnicas quirúrgicas y anestésicas actuales. Se presenta aquí una revisión crítica de las publicaciones sustentada por la experiencia clínica del equipo quirúrgico. Se discuten temas relacionados con el sangrado intraoperatorio tales como la predonación sanguínea, la reducción del sangrado mediante técnicas de hipotensión controlada, y el uso de vasoconstrictores o antifibrinolíticos junto a los fármacos anestésicos. Se realizan recomendaciones en base a nuestra experiencia clínica. La presente revisión concluye que con las técnicas actuales, como la anestesia hipotensiva y la anestesia basada en la analgesia simpaticolítica, se logra una mínima pérdida de sangre durante la cirugía ortognática. Estas técnicas prácticamente eliminan la necesidad de transfusiones sanguíneas, predonación y el uso rutinario de antifibrinolíticos, y las posibles complicaciones que estos conllevan.

The magnitude and management of blood loss, as well as the necessity of transfusion have been controversial themes in orthognathic surgery. Different and contradictory techniques and criteria have been used and exposed in the current literature. The aim of this study is to bring up to date the criteria concerning management of blood loss in maxillofacial surgery, based on our clinical experience with recent surgical and anesthetic techniques. A critical revision of the literature is exposed, according to the experience of the surgical team of the Maxillofacial department in. Themes related to intraoperative blood loss, preoperative autologous blood donation, drugs used in the anesthetic technique, reduction of blood loss with hypotensive anesthesia, the use of epinephrine and antifibrinolytic agents are discussed. Finally we present some recommendations based on our experience. This study shows that blood loss during orthognathic surgery is minimal with techniques such as hypotensive anesthesia and the analgesic sympathicolytic based anesthesia. These techniques practically eliminate the necessity of transfusion, preoperative autologous donation, the use of habitual antifibrinolytic agents and its complications.

A intensidade e o controle do sangramento, e a necessidade de transfusao, sao assuntos muito controvertidos na cirurgia ortognática. Na literatura se menciona o uso de técnicas e critérios diferentes e contraditórios. Atualizamos os princípios do manejo do sangramento na cirurgia maxilofacial em base a nossa experiencia no uso das técnicas cirúrgicas e anestésicas atuais. Fazemos uma revisao crítica das publicaçoes sustentada pela experiencia clínica da equipe de cirurgia. Sao discutidos temas relacionados com o sangramento intra-operatório, tais como a pre-doaçao de sangue, a reduçao do sangramento mediante técnicas de hipotensao controlada, e o uso de vasoconstritores ou antifibrinolíticos junto aos fármacos anestésicos. Fazemos recomendaçoes em base a nossa experiencia clínica. Conclui-se que com as técnicas atuais, como a anestesia hipotensiva e a anestesia baseada na analgesia simpaticolítica, é possível reduzir ao mínimo a perda de sangre durante a círurgia ortognática. Estas técnicas praticamente eliminam a necessidade de transfusoes sanguíneas, a pré-doaçao e o uso rotineiro de antifibrinolíticos, e as possíveis conseqüentes complicaçoes.

Laser applications in oral surgery and implant dentistry.

Lasers have been used for many years in oral surgery and implant dentistry. In some indications, laser treatment has become state of the art as compared to conventional techniques. This article is a comprehensive review of new laser applications in oral surgery and implant dentistry. One of the most interesting developments over the last years was the introduction of the 9.6-microm CO(2) laser. It has been shown in the recent literature that the use of this new device can preserve tissue with almost no adverse effects at the light microscopic level. In contrast, modifications of approved CO(2) laser therapies of premalignant lesions resulted in higher recurrence rates than the conventional defocused laser technique. However, several studies indicate that other wavelengths such as Nd-YAG (lambda = 1,064 nm) or diode lasers (lambda = 810 nm) may be also of value in this field. In many other indications, the use of lasers is still experimental. Intraoperatively used photodynamic therapy or peri-implant care of ailing implants with the CO(2) laser seems to be more of value than conventional methods. However, further studies are required to assess standard protocols. Over the past years, research identified some new indications for laser treatment in oral surgery and implant dentistry. Moreover, well-known laser applications were defined as state of the art. Nevertheless, further studies are required for laser treatment in oral surgery and implant dentistry.

[Comparison of analgetic effect of magnetic and laser stimulation before oral surgery procedures]. / Porównanie efektu przeciwbólowego lasero- i magnetostymulacji przed chirurgicznymi zabiegami stomatologicznymi.

Oral surgery procedures are often the cause of painful sensations because of their tissue invasiveness. To avoid these sensations a wide use of nonsteroid antiinflammatory drugs is usually accepted. Because of plenty side effects of these drugs alternative antipain agents are desired. The goal of this study was to assess antipain effect of laser stimulation and alternating magnetic field in oral surgery procedures. Pain sensations in patients during: local anesthetics application, surgical procedure and after it were assessed according to VAS scale. Level of stomatological fear was assessed with the use of Corah's scale. Achieved results were analyzed statistically. Conclusion of this analysis is that laser stimulation and alternating magnetic field applied directly before oral surgery procedure are effective antipain agents that decrease intra and postoperative sensations. It was observed that patients with high level of stomatological fear had more pain sensations but even in this group laser and magnetic stimulation significantly lowered these complaints.

Evaluación del postoperatorio en exodoncias con electroacupuntura vs tratamiento convencional / Evaluation of postoperatory in exodonties with electroacupuncture vs conventional

Se realizó un ensayo clínico fase II, aleatorio, controlado y abierto en la clínica estomatológica del Policlínico Previsora de Camagüey en el período comprendido de febrero a julio de 1999 con el objetivo de determinar la presencia de dolor en el transoperatorio y la eficacia postoperatoria en exodoncia realizadas con acupuntura o tratamiento convencional según la ubicación y el estado del diente a extraer La muestra quedó constituida por 90 pacientes de ambos sexos, mayores de 15 años, a los cuales fue indicada la extracción dentaria. Se dividió en dos grupos: estudio y control integrado cada uno por 45 pacientes. El método de asignación fue sistemático, con arranque al azar, en dependencia de la aceptación de las personas a realizarse la exodoncia con acupuntura o la anestesia química, hasta completar la muestra para evaluar la eficiencia de la analgesia acupuntural comparada con el tratamiento convencional en el postoperatorio de extracciones dentarias y presencia de dolor transoperatorio en ambos grupos según ubicación y estado del diente a extraer. Se utilizaron esquemas acupunturales de acuerdo a la localización del diente a extraer, se emplearon los puntos corporales: Ig 4, Ig 20, E3, E4, E5, E6, E7, Id 18, Vg 26, Vc 24, Ex Jiaghengjiang. El tratamiento fue ambulatorio. Luego de colocadas las agujas utilizamos para su estimulación el equipo multipropósito KWD – 808 II que cumple los requisitos para su uso. Se obtuvo en el postoperatorio una eficacia buena en la totalidad de los pacientes tratados con acupuntura, mientras que con la utilización del anestésico local fue solo del 68.88 por ciento (P= 0.05) por lo que concluimos que la terapia acupuntural es altamente eficaz comparada con el tratamiento convencional en el postoperatorio de extracciones dentarias

Evaluación del postoperatorio en exodoncias con electroacupuntura vs tratamiento convencional / Evaluation of postoperatory in exodonties with electroacupuncture vs conventional

Se realizó un ensayo clínico fase II, aleatorio, controlado y abierto en la clínica estomatológica del Policlínico Previsora de Camagüey en el período comprendido de febrero a julio de 1999 con el objetivo de determinar la presencia de dolor en el transoperatorio y la eficacia postoperatoria en exodoncia realizadas con acupuntura o tratamiento convencional según la ubicación y el estado del diente a extraer La muestra quedó constituida por 90 pacientes de ambos sexos, mayores de 15 años, a los cuales fue indicada la extracción dentaria. Se dividió en dos grupos: estudio y control integrado cada uno por 45 pacientes. El método de asignación fue sistemático, con arranque al azar, en dependencia de la aceptación de las personas a realizarse la exodoncia con acupuntura o la anestesia química, hasta completar la muestra para evaluar la eficiencia de la analgesia acupuntural comparada con el tratamiento convencional en el postoperatorio de extracciones dentarias y presencia de dolor transoperatorio en ambos grupos según ubicación y estado del diente a extraer. Se utilizaron esquemas acupunturales de acuerdo a la localización del diente a extraer, se emplearon los puntos corporales: Ig 4, Ig 20, E3, E4, E5, E6, E7, Id 18, Vg 26, Vc 24, Ex Jiaghengjiang. El tratamiento fue ambulatorio. Luego de colocadas las agujas utilizamos para su estimulación el equipo multipropósito KWD 808 II que cumple los requisitos para su uso. Se obtuvo en el postoperatorio una eficacia buena en la totalidad de los pacientes tratados con acupuntura, mientras que con la utilización del anestésico local fue solo del 68.88 por ciento (P= 0.05) por lo que concluimos que la terapia acupuntural es altamente eficaz comparada con el tratamiento convencional en el postoperatorio de extracciones dentarias(AU)

Antibioterapia sistémica preventiva de la alveolitis seca en la exodoncia del tercer molar inferior: revisión sistemática / Systemic antibiotherapy in the prevention of dry socket in lower third molar exodontia: systematic review

Introducción: El objetivo de esta revisión sistemática es responder a la pregunta: ¿son eficaces los antibióticos sistémicos en la cirugía del tercer molar inferior para reducir la frecuencia de alveolitis seca?. Método: Búsqueda bibliográfica, sin limitaciones, en repertorios y bases de datos informáticas. Criterios inclusión: exposición (antibioterapia sistémica), efecto (alveolitis seca) y diseño (ensayos clínicos aleatorizados- evidencia I). Se evaluaron la validez de los estudios primarios según la síntesis de la mejor evidencia disponible (escala Jadad) y los componentes individuales. De los ensayos seleccionados se verificó la validez externa de sus conclusiones. Resultados: Once ensayos clínicos cumplían los criterios de inclusión y obtuvieron puntuación >= 1 en la escala de Jadad. En ninguno de los estudios se realizó análisis por intención de tratar. Sólo en uno se analizó la potencia y cálculo previo del tamaño muestral, y en dos el intervalo de confianza. Conclusión: No existe evidencia a favor o en contra de la eficacia de la antibioterapia sistémica preventiva en la exodoncia de los cordales inferiores. (AU)