Does the Lag Time Between Injury and Treatment Play a Role in Recovery of Inferior Alveolar Nerve Neurosensory Disturbances Following Mandibular Body Fracture?

BACKGROUND: The lag time between injury and treatment (LTIT) plays an important role in reduction of complications in mandibular fractures. The aim of this study was to measure the effect of LTIT on recovery of the inferior alveolar nerve (IAN) neurosensory disturbances (NSDs) following surgical management of mandibular body fractures. METHODS: This was a prospective cohort study. Patients who had a unilateral mandibular body fracture with paresthesia were studied. Paresthesia was evaluated by 2-point discrimination (TPD) test, brush stroke test and self-reporting before and 6 months after the surgical procedure. RESULTS: Forty-five patients were studied. There was a correlation between LTIT and TPD test result and self-reported paresthesia at 6 months, postoperatively (P = 0.001). Fifteen patients (33.3%) had complete improvement in NSD 6 months after treatments (group 1) and 30 patients (group 2) had hyposthesia (N = 17, 37.77%) and paresthesia (N = 13, 28.88%). There was a significant difference in LTIT between groups 1 and 2 at 6 months postoperatively (P = 0.001). Cox regression model demonstrated the hazard ratio increased significantly for self-reported NSD when treatment was done 10 days after trauma (P = 0.001, confidence level = 95%). CONCLUSION: It seems that conduction of open reduction with internal rigid fixation shortly after mandibular fracture may shorten the recovery time of NSDs of the IAN following mandibular body fractures.

Does oral clonidine premedication decrease bleeding during open rhinoplasty?

This uni-blind randomized clinical trial study investigated the effect of clonidine premedication on preoperative blood loss during open rhinoplasty. The subjects were randomly divided into 2 groups. The members of the first group received oral clonidine as a single dose (0.2 mg) 2 hours before the induction of general anesthesia, whereas the members of the second group received a placebo. All subjects underwent open rhinoplasty without septoplasty. One anesthetic protocol was followed for all subjects. Variable factors include the subjects' weight, age, sex, and blood pressure during the surgery as well as blood loss during rhinoplasty. Group 1 consisted of 22 women and 11 men, whereas group 2 was composed of 16 women and 17 men. The mean for blood loss amounted to 68.03 ± 22.49 mL for group 1 and 132.12 ± 78.53 mL for group 2. An assessment demonstrated a significant difference in blood loss between the 2 groups (P < 0.001.) Oral clonidine premedication thus may decrease preoperative bleeding during open rhinoplasty.

Do angulated implants increase the amount of bone loss around implants in the anterior maxilla?

PURPOSE: The aim of this study was to evaluate the relation between angulated implants and the bone loss around implants in the anterior maxilla. MATERIALS AND METHODS: The subjects studied had a missing tooth in the anterior maxilla and a bone deficiency that required restoration with an angulated dental implant. After mounting the casts on the articulator, the amount of direction was measured with a facebow by calculating the difference between the mean buccopalatal angulation of the 2 adjacent natural teeth and the buccopalatal angulation of the implant abutment to the occlusal plane. Radiography was performed in each patient immediately after loading and repeated a minimum of 36 months after loading. RESULTS: Fifty-eight subjects who received delayed-loading angulated implants were studied. The results showed that the mean implant angulation was 15.2° and the mean bone resorption was 0.87 mm. Analysis of the data showed a significant correlation between implant follow-up time and bone loss. No correlation was seen between the implant angulation and bone loss. An assessment of predictive factors showed a relation between the implant type and bone loss. The follow-up time had a significant effect on bone loss. The implant angulation did not change bone resorption on the mesial and distal surfaces of the implants. CONCLUSIONS: The angulation of implants was not associated with an increased risk for bone loss, and angulated implants may be a satisfactory alternative to vertical implants to avoid grafting procedures. The type of implant may be an important factor that affects bone resorption, although follow-up time was the strongest predictive factor.