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BACKGROUND: In the past few decades, there has been an increasing interest in obtaining a more instantaneous return to normal function using diverse methods of direct fixation. AIMS AND OBJECTIVES: To compare the conventional 2-mm 2D (two-dimensional) miniplates and 2-mm 3D (three-dimensional) miniplates in terms of treatment outcome, stability, duration of surgery, and complications of treatment of symphysis and parasymphysis mandibular fractures. MATERIALS AND METHODS: 16 patients with clinical and radiological evidence of fractures of the mandible in symphysis and parasymphysis areas treated by open reduction and internal fixation with 2D miniplates and 3D miniplates. The patients were followed up for three months and assessed clinically and radiographically by taking orthopantomograms. The assessment was made on the immediate postoperative day, third day, fifth day, the seventh day, two weeks, three weeks, four weeks, two months, and three months. RESULTS: Mean intraoperative time taken for 2D miniplate was 54.8 min and for 3D miniplate was 40.6 min. Mild paraesthesia at the soft tissue region supplied by mental nerve was noticed in two patients (25%) of group I, whereas there was no such paraesthesia observed in group II patients. Wound dehiscence and infection were noticed in one patient in group I. CONCLUSION: 3D plates seem to be better than conventional 2-mm miniplates for symphysis and parasymphysis fractures.
RESUMO
AIMS AND OBJECTIVES: To assess the effectiveness of chitosan-based dressing after extraction in individuals on antithrombotics, without modification of their treatment schedule. MATERIALS AND METHODS: A randomized comparative study was carried out on 40 subjects who had two extraction sites, in dissimilar quadrants. The surgical site was chosen at random and post-extraction hemostasis was achieved by a custom-cut chitosan dressing (study site) and sterile cotton gauze dressing (suturing if required) at control site. Patients were reviewed on the first, third, fifth, and seventh postoperative days and every week till 4 weeks. The parameters assessed were timing of hemostasis, pain scores, and pus discharge. RESULTS: Out of 40 study subjects, 24 (60%) were males and 16 (40%) were females. The age was 40-65 years (mean age 54 years). The mean time for hemostasis was 0.63 ± 0.27 min in study group, whereas for controls, it was 9.10 ± 2.28 min. The difference in postoperative pain was significant (P = 0.001) on days one, five, and seven. In chitosan group extraction sites, dry socket was not seen, whereas four patients on day three and five patients on day five after extraction experienced dry socket in pressure gauze dressings group, with an insignificant difference (P = 0.058). In chitosan group extraction sites, no pus discharge was seen. Whereas four patients on days three and five after extraction had pus discharge in patients where pressure dressings were applied, with an insignificant difference (P = 0.058). CONCLUSION: Chitosan dressing is a competent hemostatic agent that significantly reduced the post-extraction bleeding, with better pain control. Chitosan group had no incidences of dry socket and pus discharge.
RESUMO
BACKGROUND: Recently, oral and maxillofacial surgeons are favoring three-dimensional (3D) miniplates to treat mandibular fractures. AIMS: The aim of the study is to evaluate the efficacy of 3D-miniplates over standard miniplates in the management of mandibular parasymphysis fracture. MATERIALS AND METHODS: Forty patients with mandibular parasymphysis fractures were divided into two groups of 20 patients each. Group I patients underwent osteosynthesis of mandibular fracture by noncompression, unicortical, and stainless steel 3D miniplates, and Group II patients underwent osteosynthesis by noncompression, unicortical, and stainless steel Champy's miniplates. All the patients were followed up 6 months' postoperatively, evaluating occlusion, mobility of fracture segment, pain, wound dehiscence, neurological deficit, and infection. STATISTICAL ANALYSIS USED: The data were analyzed by SPSS for windows (version 17) statistical package (SPSS Inc., Chicago, IL, USA). Chi-square test was carried out to determine the statistical difference between the groups. RESULTS: Mobility of the fractured site was evaluated postoperatively after 2 weeks, and it was found that mobility was absent in all the cases of Group I and 36 (80%) cases in Group II. There was significant difference in the mean visual analog scale scores among the Group I and II when compared from preoperative to 4-week follow-up. In Group II, two patients showed wound dehiscence. After 2 weeks, infection was seen in two patients of Group II. CONCLUSION: 3D plates in mandibular parasymphysis fractures give dimensional stability and carry low morbidity and infection rates.
RESUMO
AIMS AND OBJECTIVES: To evaluate the effect of bromelain on pain and swelling after surgical removal of third molars. MATERIALS AND METHODS: A prospective randomized clinical study was conducted among 40 patients requiring surgical removal of impacted mandibular third molars. All the impacted molars were surgically removed, and the patients were administered bromelain along with amoxicillin. Patients were recalled on day 1, day 3, and day 7 for postoperative pain assessment using visual analogue scale (VAS) and postoperative swelling assessment using facial reference points tragus and pogonion. VAS score was statistically analyzed using repeated analysis of variance with post-hoc Bonferroni test postoperatively on day 1, day 3, and day 7 using the Statistical Package for the Social Sciences software version 14. RESULTS: Out of the total 40 patients, bromelain was effective in 28 (70%) patients. In these patients, there was reduction in swelling and pain after taking bromelain. CONCLUSION: Bromelain can be used as a successful oral enzyme therapy for oral surgery patients, especially after removal of impacted third molars.
