Changes in facial temperature measured by digital infrared thermal imaging in patients after transnasal sphenopalatine ganglion block: Retrospective observational study.

Sphenopalatine ganglion block (SPGB) is a technique developed in the 1990s for the management of head and neck pain patients. Recently, transnasal sphenopalatine ganglion block (TN-SPGB) has been widely used for these patients; however, no objective methods exist for validating the success of TN-SPGB. In this study, we measured the changes in facial temperature before and 30 minutes after TN-SPGB by using digital infrared thermal imaging (DITI) to validate its success.The medical records of patients, who underwent TN-SPGB and facial DITI between January 2016 and December 2017, were reviewed. TN-SPGB and facial DITI were performed 36 times in 32 patients. The changes in facial temperatures measured at the forehead (V1), maxillary area (V2), and mandibular area (V3) by using DITI before and 30 minutes after TN-SPGB were recorded and compared. The temperatures on the ipsilateral and contralateral sides of these areas were also compared. The comparison between pain relief group and pain maintenance group was analyzed.After TN-SPGB, the temperature decreased significantly on both sides of V1 (P = .0208, 0.0181). No significant differences were observed between the ipsilateral and contralateral sides (P > .05). There was no correlation between changes in temperature and changes in pain score in the pain regions after the procedure (P > .05).The temperature decreased significantly in V1 area at 30 minutes after TN-SPGB compared with the temperature before TN-SPGB. Based on these results, we propose using DITI to measure temperature changes as an objective method for verifying the success of TN-SPGB.

Clinical Study of a Flap Advancement Technique Without Vertical Incision for Guided Bone Regeneration.

PURPOSE: The aim of this study was to introduce a novel method of flap advancement without a vertical releasing incision for guided bone regeneration (GBR) and to discuss its clinical outcomes. MATERIALS AND METHODS: This retrospective study involved patients who had received GBR for dental implants between April 2012 and April 2013. In all patients, a typical midcrestal incision was made on the edentulous alveolar ridge, and a sulcular incision was extended to the adjacent two teeth; however, no vertical incision was performed. Instead, a wide periosteal releasing incision and an additional releasing incision that selectively cut part of the facial expression muscles (the orbicularis oris or the buccinator) were used. Postoperative complications, such as swelling, pain, paresthesia, signs of infection, and membrane exposure, were evaluated at 1, 2, 4, 12, and 24 weeks after surgery. RESULTS: Forty sites in 34 patients were evaluated. At all surgical sites, flap advancement of more than 7 mm was attained, and clinically passive primary closure was achieved. All patients experienced slight or mild postoperative swelling without functional limitation or discomfort during mouth opening, eye opening, and swallowing. No long-lasting pain (more than a week), paresthesia, or signs of infection occurred during the follow-up period of 6 months. However, delayed exposure of titanium mesh after 4 months was observed in two patients who had used a provisional removable prosthesis. Within 2 weeks, the exposures closed spontaneously after prosthesis use was halted and careful daily dressing was undertaken. CONCLUSION: The flap advancement technique presented in this study easily enables clinically passive primary closure, and there was no obvious failure of primary closure. This technique could be used successfully in GBR procedures.