Redução de dor, edema e trismo: benefícios do uso da dexametasona via intramuscular como medicação preemptiva na cirurgia oral / Reduction of pain, swelling and trismus: benefits of using intramuscular dexamethasone as preemptive medication in oral surgery / Reducción del dolor, edema y trismo: beneficios del uso de dexametasona intramuscular como medicación preventiva en cirugía oral

Complicações pós-operatórias como edema, dor e trismo são comuns em cirurgias orais. Terapias, como o uso de analgésicos e anti-inflamatórios, são indicadas para estas complicações. No entanto, intervenções pré-operatórias podem ser alternativas. Desta forma, o presente estudo avaliou o efeito da dexametasona no edema, intensidade de dor e abertura de boca (trismo) no pós-operatório de retirada de terceiros molares inferiores. Pacientes (n=14, 9 mulheres) foram incluídos em um estudo clínico, cruzado, cego, randomizado, placebo-controlado e boca dividida. Pacientes receberam aleatoriamente medicação preemptiva (dexametasona 8mg, intramuscular, músculo masseter) ou placebo (soro fisiológico) uma hora antes da primeira cirurgia. O procedimento contralateral foi realizado 21 dias após. Avaliou se o edema e a abertura bucal nos momentos pré-operatórios e no 3º e 7º dias pós-operatórios, além de dor espontânea (imediatamente, 2 e 24 horas, 3 dias e 7 dias). Os dados foram analisados usando anova de medidas repetidas seguida do teste post hoc LSD de Fisher. Comparado ao placebo, a medicação reduziu edema (3 dias), dor (2 e 24 horas) e trismo (3 dias). Os resultados sugerem que o uso preemptivo da dexametasona intramuscular é capaz de aumentar o bem-estar dos pacientes submetidos a cirurgias orais, tendo o potencial de reduzir os custos pós-operatórios... (AU)

Postoperative complications such as edema, pain, and trismus are common in oral surgery. Therapies, such as the use of painkillers and anti inflammatory drugs, are indicated for the reversal of these complications. However, preoperative (preemptive) interventions can be alternatives. Thus, the present study aimed to evaluate the effect of dexamethasone on edema, pain intensity, and mouth opening (trismus) in the postoperative period of removal of impacted lower third molars. Patients (n = 14, 9 women) were included in a clinical, crossover, blinded, randomized, placebo-controlled, and divided mouth study. Preemptive mediation (dexamethasone 8mg, intramuscular, masseter muscle) or placebo (saline) was randomly given before the first surgery. The contralateral procedure was performed 21 days later. In the postoperative period, edema, mouth opening (preoperative, 3 and 7 days), and spontaneous pain (immediately, 2 and 24 hours, 3 days and 7 days) were analyzed. The data were analyzed using the one-way repeated measures ANOVA followed by Fisher's LSD post hoc. Compared to placebo, the medication reduced edema (3 days), pain (2 and 24 hours), and trismus (3 days). The results suggest that the preemptive use of dexamethasone is able to increase the well-being of patients undergoing oral surgeries, with the potential to reduce postoperative costs... (AU)

Las complicaciones posoperatorias como hinchazón, dolor y trismo son comunes en las cirugías orales. Las terapias, como el uso de analgésicos y antiinflamatorios, están indicadas para estas complicaciones. Sin embargo, las intervenciones preoperatorias pueden ser alternativas. Así, el presente estudio evaluó el efecto de la dexametasona sobre el edema, la intensidad del dolor y la apertura de la boca (trismo) en el postoperatorio de remoción del tercer molar inferior. Los pacientes (n = 14, 9 mujeres) se incluyeron en un estudio clínico, cruzado, ciego, aleatorizado, controlado con placebo y de boca dividida. Los pacientes recibieron aleatoriamente medicación preventiva (8 mg de dexametasona, intramuscular, músculo masetero) o placebo (solución salina) una hora antes de la primera cirugía. El procedimiento contralateral se realizó 21 días después. Se evaluó el edema y la apertura de la boca en el preoperatorio y en el tercer y séptimo días postoperatorios, además del dolor espontáneo (inmediato, 2 y 24 horas, 3 días y 7 días). Los datos se analizaron utilizando anova de medidas repetidas seguido de la prueba post hoc de LSD de Fisher. En comparación con el placebo, el medicamento redujo el edema (3 días), el dolor (2 y 24 horas) y el trismo (3 días). Los resultados sugieren que el uso preventivo de dexametasona intramuscular puede aumentar el bienestar de los pacientes sometidos a cirugía oral, con el potencial de reducir los costos posoperatorios... (AU)

Dental consultation requests to oral and maxillofacial surgery in a hospital in Brazil

Introduction: This study analyzed dental consultation requests to the division of oral and maxillofacial surgery in a Brazilian tertiary hospital. Methods: A cross-sectional study with data collected retrospectively from inpatients' electronic medical records containing dental consultation requests made between January 2013 and December 2017. Results: 327 consultation requests were analyzed. Mean (SD) patient age was 38.71 (24.4) years; 164 (50.2%) were male and 267 (81.7%) were Caucasian. Regarding systemic conditions, 34 (10.4%) were classified as ASA I, 86 (26.3%) as ASA II, 182 (55.7%) as ASA III, and 25 (7.6%) as ASA IV. Dental consultations were mostly requested by the internal medicine team (n = 42, 12.8%). The most common reason for consultation was septic teeth (n = 131, 40.1%). Complementary tests were required in 188 (57.5%) cases. Surgical intervention was required in 82 (25.0%), with tooth extraction as the most prevalent procedure (20.2%). The most demanding service was inpatient care, with 276 (84.4%) requests. Cases were resolved in 249 (76.1%). Conclusions: The division of oral and maxillofacial surgery in our hospital deals with a great amount of consultations, contributing with surgical procedures to the adequacy of patients' oral health with a high effectiveness rate. Our data illustrate the contribution of dentists in a hospital setting, assisting the medical team in providing comprehensive care for inpatients. (AU)

Evaluation of color change in acrylic and bisacrylic resin resins in different solutions

Aim: This work aimed to evaluate the color stability of an acrylic resin chemically activated (ARCA) using different handling techniques, and a bisacrylic resin when exposed to different pigmentation solutions. Material and Methods: Silicon matrixes were confectioned (10x10x3mm) to be used as specimens. The groups were designed as follows: Group Pot, Group Brush, Group Manufacturer and Group Bisacrylic (n=18). Each group was exposed to three different pigmentation solutions: distilled water, coke and chlorhexidine digluconate 0.12%. Three readings were performed for each specimen using a spectrophotometer, and the evaluations were carried out in three different time. After the color reading, three averages and the standard deviation of variation were performed after 24 hours (T1), 7 days (T2) and 14 days (T3). Data were submitted to the ANOVA and 2 criteria and Tukey (P<0.05) in the statistical software SSPS 18 for Macintosh (SPSS Inc., Chicago, USA). Results: When compared the solutions in each group of material, there was no statistically significant difference, except for T3, where the group Dencor Brush and Bisacrylic demonstrated higher color variation in all the solutions, even in the control group, and the values in Chlorhexidine higher than the other, showing greater instability after 14 days. Conclusions: With the results, bisacrylic resin used as provisory prosthesis material presents greater color instability than the ARCA, when submitted to different solutions. Bisacrylic resin and Dencor Brush present significantly visible color changes in chlorhexidine solution after 14 days. All the materials in coke solution present homogeneity in the color change after 7 days exposition to the solution, with no visible color change.