Postoperative pain and edema control following different protocols of preemptive analgesia in the surgical removal of impacted third molars: A triple-blind parallel randomized placebo-controlled clinical trial.

This randomized controlled clinical trial aimed to evaluate the preemptive effects of acetaminophen, ibuprofen, ketoprofen, nimesulide or dexamethasone on postoperative pain and edema in the surgical removal of impacted third molars. Participants underwent bilateral surgeries at 2 different times and were randomly given the test drug or placebo (split-mouth). Postoperative pain, edema and rescue medication were evaluated at different times. Study power was >80% for the observed effect size in the crossover repeated measures design. Differences between test drug and placebo were the response variable. Generalized Estimation Equation models were adjusted for each outcome. Sample comprised 5 groups (n = 20 each). Ibuprofen and nimesulide showed higher overall effects on pain scores over time, with no differences between them (p = 0.557). Acetaminophen showed significantly lower overall effects in edema control over time, when compared to other test drugs, that showed similar effects. Lower quantity of rescue medication were also observed for ibuprofen and nimesulide, with no differences between them (p = 0.999). Ibuprofen and nimesulide showed beneficial overall preemptive effects. Hence, in the decision-making process for preemptive analgesia in impacted third molar surgeries, ibuprofen and nimesulide should be considered on a case-by-case basis as the drugs of choice.

Diagnosis and Treatment of Paracoccidioidomycosis in the Maxillofacial Region: A Report of 5 Cases.

Paracoccidioidomycosis is a fungal infection initially described in Brazil in 1908 by Adolfo Lutz. Manifestation of this disease depends on numerous factors, such as microorganism virulence, hormonal profile, genetic predisposition, nutrition, and immune system. It is characterized classically by cutaneous lesions, lymphadenopathy, and pulmonary involvement. It presents male predilection, which can be explained by the protective effect of female hormones. Classic presentation within oral cavity is a superficial ulcer characterized by hemorrhagic dots of moriform aspect. Treatment should be established individually and closely monitored. This manuscript aims at reporting five cases of this pathology.

Tratamento cirúrgico de lipoma em região maxilofacial ­ relato de caso / Surgical treatment of lipoma in maxillofacial region ­ case report

O lipoma é a neoplasia mesenquimal de maior prevalência, sendo raro na região maxilofacial. Geralmente são lesões assintomáticas e se manifestam como massas nodulares, de superfície lisa e macia a palpação. Ao exame histopatológico, observa-se proliferação de células trapezoidais, de citoplasma claro, volumoso e exibindo núcleo deslocado para periferia. Este artigo tem por objetivo relatar um caso de um lipoma em mucosa jugal na região de corpo mandibular esquerdo, com paciente apresentando queixa estética. O tratamento cirúrgico instituído foi a biópsia excisional da lesão, com acompanhamento de 12 meses sem recidiva (AU).

Lipoma is the most prevalent mesenchymal neoplasm, being rare in the maxillofacial region. They are usually asymptomatic lesions and manifest as nodular masses, with smooth surface, and soft palpation. Histopathological examination shows proliferation of trapezoidal cells, clear cytoplasm, bulky and showing nucleus displaced to the periphery. This article aims to report a case of a lipoma in jugal mucosa in the region of the left mandibular body, with patient presenting aesthetic complaint. The surgical treatment instituted was the excisional biopsy of the lesion, with follow-up of 12 months without relapse (AU).