Effect of drain application on postoperative complaints after surgical removal of impacted wisdom teeth—a randomized observer-blinded split-mouth clinical trial

11030 Background: Treatment (trt) options for metastatic OST are scarce. Following failure of standard 1st line therapy pts who relapse present a challenging trt dilemma, and have poor prognosis. Surgical removal of all mets is essential. Currently, there are no standardized 2nd line trt options in relapsed OST. Methods: Pts were identified from 2 sarcoma databases; Netsarc and ConticaBase. Clinical data prospectively registered in the databases were supplemented with retrospective review of the medical records. Results: From January 2009 to December 2016, we identified 99 pts, in 12 FSG centers; 30 with synchronous (SC) and 69 with metachronous (MC) mets, with 62 males. Median age was 25 years (18-53). Total number of mets was 1 for 31 pts, 2-5 for 26 and > 5 for 42. Mets sites were lung, bone and other in 77, 14 and 22 pts respectively. Median time to first MC mets was 22 months (mo) (4-97). All pts except 10 with MC mets received a 1st line systemic trt for relapse, 65 a 2d-line, 38 a 3d-line, and 20 a 4th line, with 27 pts included in a clinical trial. Sixty five pts had local trt of distant mets (surgery for 54, irradiation for 5 and radioablation for 6). Eighteen pts had repeated thoracotomies (2 for 13 pts, 3 for 5, 1 for 1 pt). Nine of 10 MC mets pts (with ≤ 5mets) who never received any systemic trt had complete mets resection, 1 had mets radioablation, all were alive at last follow-up (FU). Median FU was 16.5 mo (2-132). Median progression free survival (PFS) and overall survival (OS) were 5.5 (95%CI 4-7) and 16.5 mo (95%CI 10-25) respectively. In multivariate analysis; > 5 mets, time to 1st mets < 24 mo, were negative prognostic factors on OS and PFS (p= 0.03, 0.01 and p=0.013, 0.00 respectively). Bone mets and absence of mets surgery were negative prognostic factors on OS only (with p=0.012, 0.008). Conclusions: Adult OST pts with distant mets are heterogeneous with poor prognosis. Complete surgery of distant mets remains essential. In reference sarcoma center, OST pts at relapse with > 1 mets commonly receive >1st line of systemic trt, and are included in clinical trial. Multidisciplinary trt combining complete mets local trt and systemic therapy seems to be rational.

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COMPARISON BETWEEN DEXAMETHASONE AND COOL JAW WRAP ON POSTOPERATIVE PAIN AFTER SURGICAL REMOVAL OF LOWER WISDOM TEETH

International Journal of Current Pharmaceutical Research ◽

10.22159/ijcpr.2017v9i4.20754 ◽

2017 ◽

Vol 9 (4) ◽

pp. 33

Author(s):

Nasma M. Al-fahad ◽

Wael Sheet Shallawe

Keyword(s):

Quality Of Life ◽

Postoperative Pain ◽

Third Molar ◽

Control Group ◽

Surgical Removal ◽

Life Questionnaire ◽

Quality Of Life Questionnaire ◽

Surgical Extraction ◽

Wisdom Teeth

Objective: The aim is to compare between the effect of cool jaw wraps and dexamethasone injection on postoperative pain and evaluate the quality of life after surgical removal of lower wisdom tooth.Methods: Extraction of impacted lower third molar will surgically operate (by the same difficulty of surgical extraction and same operator) on 30 patients, which divide into three groups, each group have 10 patients.We will instruct the patients in cool jaw wrap group to put cool jaw wrap after the operation. While the second group give dexamethasone injection after the operation. The last group which is the control group will left them with the usual instruction postoperatively.This study evaluates the facial pain, swelling, and trismus on days 1,2 and 7 postoperatively. Objective measurements of swelling, pain, and trismus were undertaken at days 1, 2 and 7. The quality of life questionnaire was estimated at day 7 postoperatively.Results: Cool jaw wrap showed no significant differences on the postoperative pain when it used after surgical removal of the lower third molar BUT have significant differences on the Quality of life of patients.Conclusion: Cool jaw face wrap can be recommended as a safe method that participates in some degree to reduce postoperative pain, it easy to handle, comfort, avoiding damage by freezing due to the barrier between cool jaw and skin and the patient can avoid the side effect of dexamethasone and the phobia from the injection.

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