Pain Levels Did Not Differ Following Uncomplicated Third Molar Extractions Utilizing Liposomal Bupivacaine Versus Standard Bupivacaine.

PURPOSE: Operations in the oral cavity are often characterized by an acute period of postoperative pain historically mitigated via opioids and other analgesics. The purpose of the study was to determine if liposomal bupivacaine infiltration (LBI) following uncomplicated extraction of bilateral, mandibular third molars will significantly reduce postoperative pain when compared to standard bupivacaine. MATERIALS AND METHODS: The study was designed as a parallel-arm randomized clinical trial. The sample size was calculated for the primary outcome variable: postoperative pain levels measured at 48-hours. Using a power analysis, a sample size of n = 13 for each group was required. Patients meeting the inclusion/exclusion criteria requiring exodontia from November 4, 2018, to June 16, 2022, were recruited out of the oral and maxillofacial surgery clinic. The patients were randomized and divided into 2 groups. Group A was administered 0.50% bupivacaine (with 1:200,000 epinephrine) via infiltration while group B underwent LBI. The primary outcome of interest was postoperative pain levels followed by the secondary outcomes of postoperative narcotic analgesic use, return to oral function, and satisfaction. Patient demographics and characteristics were analyzed as potential covariates utilizing the Fisher exact test and t test for continuous outcomes, respectively. RESULTS: Thirty patients were recruited for the study. The average age of patients receiving the third molar operation was 24.1 ± 5.8 years. Of the 30, 62.5% were female, and 37.5% were male. Seventy-five percent of the patients were Caucasian, 20.8% were African American, and 4.2% were Asian. Forty-eight-hour postoperative interviews revealed mean pain levels of 2.5 ± 2.8 in the control group and 2.9 ± 2.3 in the LBI group (P = .730) as measured on a visual analog scale. The 48-hour postoperative interview identified a mean of 1.9 ± 2.1 narcotic pills used in the control group and 2.5 ± 5.0 pills used in the LBI group (P = .693). CONCLUSIONS: Mandibular LBIs following bilateral mandibular third molar extractions showed no statistically significant advantage over the standard bupivacaine at either time point analyzed. Furthermore, no statistically significant difference was found regarding narcotic use between the 2 groups.

Time to Open Repair of Mandibular Fractures and Associated Complications.

PURPOSE: The aim of this study was to determine whether a correlation exists between the time from injury to repair of mandibular fractures and the development of postoperative complications. We also sought to assess whether a delay in treatment manifests in an increased surgical time. PATIENTS AND METHODS: We performed a retrospective cohort study and enrolled a sample (N = 64) derived from patients treated with open repair of mandibular fractures at Augusta University Medical Center by the oral and maxillofacial surgery service from July 2015 to June 2018. Time from injury to surgical repair was analyzed as a continuous variable, and the primary outcome was the presence of any of the following postoperative complications: infection, mechanical complication, cranial nerve V3 deficit, or cranial nerve VII deficit. Secondary outcome variables included the presence of substance abuse, surgical approach, and surgery time. Logistical regression was performed. RESULTS: Among 64 patients, there were 27 patients with a total of 32 complications, including infection (n = 9), mechanical complications (n = 3), cranial nerve V3 deficits (n = 13), and cranial nerve VII deficits (n = 7). The mean time to fixation was 13.26 days in patients without complications versus 17.52 days in patients with complications. The association between time to surgical repair and complication rate was not statistically significant (P = .203). No association was found between time to surgical repair and surgery time (P = .699). CONCLUSIONS: Our study did not find a significant association between the timing of repair of mandibular fractures and complications. Our study also failed to show a correlation between a delay in surgical intervention and increased technical challenges manifested by an increased surgical time.

The Controlled Palatal Harvest (CPH) Technique for Harvesting a Palatal Subepithelial Connective Tissue Graft.

The use of methamphetamines is a significant public health concern not only in America but worldwide. The consequences of this drug's use are widespread, having major physiologic and psychological effects that are damaging to users' bodies and well-being. Meth use wreaks havoc on one's oral health, with the effects including demineralization of tooth surfaces, carious lesions, inflammation of the periodontium, and more. In addition to examining the neurotoxic effects that methamphetamines have on the brain, this article will discuss how dental professionals can approach treatment of individuals who are affected by this debilitating drug, utilizing a strategy that combines caries arrest with oral hygiene improvement and disease prevention. It will also review the use of various products to help establish a neutral oral pH and enhance enamel remineralization.