Histological evaluation of inferior alveolar nerve injury after osteotomy of mandibular buccal cortex using piezoelectric versus conventional rotary devices: a split-mouth randomised study in rabbits.

Up until now, only a limited number of evidence-based studies with different results has evaluated traumatic nerve injury after maxillofacial surgery using piezoelectric devices versus rotary instruments. The present experiment was performed to evaluate damage to the inferior alveolar nerve (IAN), histologically, after osteotomy of the buccal cortex of the mandible using piezoelectric devices versus surgical handpieces. Forty rabbits underwent bilateral osteotomy of the mandibular buccal cortex. For the osteotomy of one side, piezoelectric devices were used, and for the other, conventional rotary handpieces. After cleavage of the osteotomised cortical bone segments, the exposed part of the IAN was excised and examined histologically for nerve injury. IAN damage was scored histologically from Grade 0 (no nerve damage) to Grade 4 (complete nerve transection). It was found that 25% and 17.5% of nerves had Grade 0; 17.5% and 10% had Grade 1; 25% and 20% had Grade 2; 17.5% and 27.5% had Grade 3; and 15% and 25% had Grade 4 injury in piezosurgery and rotary groups, respectively. Statistical analyses revealed no significant difference between groups in damage to the IAN. The present study showed that piezosurgery devices, similar to conventional rotary instruments, have the potential to cause severe nerve damage during surgery and should therefore be used with care.

Intravenous magnesium sulfate for post-operative pain in patients undergoing lower limb orthopedic surgery.

INTRODUCTION: This study looks at the effect of supplementary intravenous magnesium sulfate on acute pain when administered in patients undergoing lower limb orthopedic surgery using spinal anesthesia with bupivacaine. METHOD AND MATERIALS: In this double-blind, randomized, placebo-controlled clinical trial, 60 patients were selected and randomly divided into two groups. Efforts were made to place both groups under the same method of anesthesia. One group received 8 mg/kg intravenous magnesium sulfate, started before the incision and continued up to the end of the surgical procedure, using a 50 ml syringe, via a peripheral large bore catheter; the second group received the same volume of placebos using the same method. To present the results, mean (+/- SD) was used; a P value of <0.05 was considered significant. RESULTS: There was no difference between the two groups in terms of the basic variables. Pain reported by the first group that received magnesium sulfate was significantly less at the first, third, sixth and 12th hours after the operation in comparison with the group that received placebo. Also, the intravenous morphine requirements in the first 24 h after the surgery were less in the magnesium group (4.2 +/- 1.6 mg) than in the control group (9.8 +/- 2.1 mg). CONCLUSION: Intravenous magnesium sulfate can serve as a supplementary analgesic therapy to suppress the acute post-operative pain, leading to less morphine requirements in the first 24 h.

Oral infestation with leech Limnatis nilotica in two mixed-breed dogs.

Leeches are bloodsucking hermaphroditic parasites that attach to tissues using two muscular suckers, ingest large amounts of blood and may cause severe anaemia in the host. Two four-month-old mixed-breed dogs (one bitch and one male) were referred with anorexia, retching, hypersalivation and bleeding from the oral cavity. On physical examination, two live leeches were detected on the ventral aspect of the tongue of the bitch and one in a similar position in the male. The leeches were gently detached and removed using Adson tissue forceps after applying vinegar over the area. Microcytic hypochromic anaemia was detected in the bitch and mild leukocytosis in the dog. One month after treatment both animals were re-examined and a complete blood count was normal. Given that infestation with leeches as described here is associated with contaminated water, the use of clean and safe drinking water is recommended to avoid such diseases.