scholarly journals Effect of Single Dose Intramuscular Methylprednisolone Injection into the Masseter Muscle on the Surgical Extraction of Impacted Lower Third Molars: a Randomized Controlled Trial

2015 ◽  
Vol 12 (1) ◽  
pp. 4-8 ◽  
Author(s):  
N Vyas ◽  
S Agarwal ◽  
N Shah ◽  
D Patel ◽  
P Aapaliya

Background Lower impacted third molar surgical extraction usually causes post-surgical sequelae like pain, trismus and swelling as a result of postoperative inflammatory response.Objective The aim of this study was to evaluate and compare the efficacy of single dose 40-mg (1cc) of methylprednisolone acetate, injected into the masseter muscle, preoperatively one hour before the surgery or post-operatively, immediately following the surgical removal of impacted lower third molars, in controlling most common postoperative sequelae, i.e. trismus, pain and swelling of facial soft tissue.Methods A randomized control study was done of 60 patients. Each patient was categorized in two groups, group I and group II, according to the time of receiving methylprednisolone acetate. Group I was injected 40mg of methylprednisolone acetate into the masseter muscle via the intrabuccal approach, one hour before the surgery. Group II was injected 40mg of methylprednisolone acetate into the masseter muscle via the intrabuccal approach, immediately after suturing of the surgical wound. The washout period was one month after the first operation. Evaluation were made of postoperative pain, trismus and swelling. The numeric pain scale (NPS) was used for pain assessment.Results When the patients were administered methylprednisolone acetate preoperatively, showed superior results in terms of oral aperture, pain and all the facial swelling parameters, with statistically significant differences versus the postoperatively administered methylprednisolone acetate (p < 0.05).Conclusions A single dose of 40 mg (1cc) methylprednisolone acetate injected into the masseter muscle preoperatively is more effective in reducing pain, trismus and swelling, when compared to that administered postoperatively.Kathmandu University Medical Journal Vol.12(1) 2014: 4-8

Author(s):  
Mehrzad Moghadasi ◽  
Arash Golestaneh ◽  
Arash Ghodosi ◽  
Shayan Golestani

Introduction: The surgical removal of impacted lower third molars involves trauma to soft and bony tissue and can result in pain, swelling and trismus. The purpose of this study was to evaluate the efficacy of dexamethasone, as a single 4 mg dose injected into the masseter muscle prior to extraction of impacted lower third molars on theses postoperative sequelae.   Materials & Methods: This prospective, randomized clinical research consisted of 43 healthy patients. The study group received 4 mg dexamethasone into the masseter muscle via intrabuccal approach immediately before starting the procedure while the control group received no corticoid. 7 days after surgery. Data were analyzed using t-test (α = 0.05).   Results: The patients administered dexamethasone showed superior results after surgery in terms of oral aperture, pain and all the facial swelling parameters, with statistically significant differences versus the controls (p value<0.001). Also there was statistically significant difference in terms of patients trismus between case and controlgroups (p value<0.001).   Conclusion: The results obtained showed that 4 mg of dexamethasone injected into the masseter muscle in the immediately before starting the procedure significantly reduces swelling, trism us and pain.  


2006 ◽  
Vol 7 (2) ◽  
pp. 79-86 ◽  
Author(s):  
Ismail Şener ◽  
Murat Metin ◽  
Mustafa Tek

Abstract Principles Alveolar osteitis (dry socket) is the most common complication following the extraction of permanent teeth. This study was undertaken to compare the effect of two chlorhexidine rinse protocols on the incidence of alveolar osteitis in patients undergoing surgical removal of impacted mandibular third molar teeth. Methods A prospective randomized clinical trial was conducted among 99 subjects. Patients were randomly assigned into two groups. Subjects were instructed to rinse twice daily with 15 ml of chlorhexidine rinse 30 seconds for one week before and one week after surgery (group I) or one week after surgery (group II). Postoperatively, all patients were instructed to return in one week or sooner if bothersome pain increased or persisted. Data were collected regarding abnormal healing, presence of necrotic tissue, exposed bone, and absence of clot. Results The results indicated group I and group II were not statistically significant different in the reduction of alveolar osteitis. Conclusions To reduce alveolar osteitis after impacted third molar surgery, it was observed use of postoperative chlorhexidine rinse was adequate. The postoperative use of chlorhexidine is more feasible than both preoperative and postoperative use. Citation Metin M, Tek M, Şener I. Comparison of Two Chlorhexidine Rinse Protocols on the Incidence of Alveolar Osteitis following the Surgical Removal of Impacted Third Molars. J Contemp Dent Pract 2006 May;(7)2:079-086.


1995 ◽  
Vol 23 (6) ◽  
pp. 458-466 ◽  
Author(s):  
M S Razzaque ◽  
M Cheng ◽  
T Taguchi

Trapadil (Mochida Pharmaceuticals, Japan), an antiplatelet drug, suppresses the growth of several cell types and is thought to antagonize platelet-derived growth factor. The effects of trapidil on mesangial-cell proliferation in glomerulonephritis induced by anti-thymocyte serum in Wistar rats were investigated. Control rats were treated with phosphate-buffered saline (group I); group II rats were injected with a single dose of anti-thymocyte serum (8 ml/kg body weight), and group III rats were treated with both a single dose of anti-thymocyte serum (8 ml/kg body weight) and with trapidil (5 mg/kg body weight/day). Three rats in each group were killed on day 3, and the other three on day 10. Control rats showed no significant histological changes on day 3 or day 10. In group II, on day 3, there was a marked decrease in glomerular cell numbers, with mesangiolysis. Histologically severe mesangial-cell proliferation with expansion of mesangial areas was noted on day 10. None of the rats in group III showed mesangial alterations, histologically, indicating that mesangial-cell proliferation was suppressed by trapidil. This suppression may result from antagonism of the binding of platelet derived growth factor to the specific surface receptors in the mesangial cells. Trapidil may have clinical value in the treatment of mesangial-cell proliferative glomerular diseases.


2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Hani Arakji ◽  
Mohamed Shokry ◽  
Nayer Aboelsaad

The purpose of this study was to test the effect of the surgical removal of impacted mandibular third molars using piezosurgery versus the conventional surgical technique on postoperative sequelae and bone healing.Material and Methods.This study was carried out as a randomized controlled clinical trial: split mouth design. Twenty patients with bilateral mandibular third molar mesioangular impaction class II position B indicated for surgical extraction were treated randomly using either the piezosurgery or the conventional bur technique on each site. Duration of the procedure, postoperative edema, trismus, pain, healing, and bone density and quantity were evaluated up to 6 months postoperatively.Results.Test and control sites were compared using pairedt-test. There was statistical significance in reduction of pain and swelling in test sites, where the time of the procedure was statistically increased in test site. For bone quantity and quality, statistical difference was found where test site showed better results.Conclusion.Piezosurgery technique improves quality of patient’s life in form of decrease of postoperative pain, trismus, and swelling. Furthermore, it enhances bone quality within the extraction socket and bone quantity along the distal aspect of the mandibular second molar.


2014 ◽  
Vol 47 (03) ◽  
pp. 354-361 ◽  
Author(s):  
Sathya Kumar Devireddy ◽  
R.V. Kishore Kumar ◽  
Rajasekhar Gali ◽  
Sridhar Reddy Kanubaddy ◽  
Mallikarjuna Rao Dasari ◽  
...  

ABSTRACT Introduction: Mandibular fractures represent approximately two-thirds of all the maxillofacial fractures (nearly 70%) out of which fractures of mandibular angle represent for 26-35%. Aim of the Study: The aim of this study is to compare the transoral and extraoral (submandibular) approaches for fixation of mandibular angle fractures. Objectives of Study: The objectives of the following study are to evaluate ease of accessibility, time taken for the procedure, ease of anatomic reduction and complications. Materials and Methods: A prospective study was carried out in 30 patients reporting to the Department of Oral and Maxillofacial surgery, Narayana Dental College and Hospital, Nellore, Andhra Pradesh during the period of months from November 2011 to August 2013 who were randomly divided in two groups based on computer generated simple randomization chart. Group I patients underwent transoral reduction and fixation and Group II patients underwent extraoral reduction and fixation. The ease of accessibility was analysed by visual analogue scale by the operating surgeon, time taken from incision to closure with digital clock, difficulty level index of surgeon based on the time taken for the procedure and approach related complications. Results: The ease of accessibility in Group I was good in 53.3% while in Group II patients approached extraorally it was good in 86.7%. Group I patients approached transorally showed a mean of 49.7 min while that of Group II patients approached extraorally showed a mean of 73.4 min. Group I had a minimum difficulty level index in 60%, moderate difficulty level in 33.3% and severe difficulty level in 6.7% while Group II had a minimum and moderate difficulty level in 46.7% and severe difficulty level in 6.7%. There was 1 (6.7%) complication reported in each group. Conclusion: The statistical analysis of this study concludes that fracture line starting anterior to mandibular third molar and ending at anteroinferior border of the insertion of the masseter muscle or posterior body of mandible can be approached transorally. Fracture line starting posterior or distal to the third molar or posterior to the insertion of the masseter muscle to the angle of the mandible or fracture line extending high in the ramus, extraoral approach provides a better choice for reduction and fixation of the fractured segments with restoration of anatomical and functional occlusion.


2019 ◽  
Vol 10 (6) ◽  
pp. 653-659
Author(s):  
D.-Å. Wälivaara ◽  
I. Sjögren ◽  
N. Gerasimcik ◽  
T. Yucel-Lindberg ◽  
S. Twetman ◽  
...  

We investigated the effect of probiotic supplements on oral wound healing, swelling, pain and discomfort after surgical removal of mandibular third molars. A second aim was to evaluate if the intervention could influence the concentrations of oxytocin in saliva. Sixty-four consecutive volunteers (18-34 years) were enrolled to a double-blind randomised placebo-controlled trial with two parallel arms. Following surgery, the patients were asked to take three lozenges per day containing two strains of Lactobacillus reuteri (DSM 17938 and ATCC PTA 5289) or placebo for two weeks. The clinical healing and extra-oral swelling were scored two weeks post-operatively. Samples of wound exudate were cultivated for the presence of Staphylococcus aureus and β-haemolytic streptococci. Salivary oxytocin concentrations were analysed from pre- and post-surgery samples using ELISA technique. Compliance and the subjective perception of swelling, pain and discomfort were reported daily through visual analogue scales in a logbook. All patients except three completed the protocol and the postoperative course was uneventful in most cases. Minor extra-oral swellings were noted in five patients, but none required antibiotic treatment. At the 2-week follow-up, there were no significant differences in clinical wound healing index, extra-oral swelling, bacterial growth or salivary oxytocin levels between the groups. The self-reported data unveiled, however, a significantly reduced sense of swelling, in particular during the second week after surgery in the probiotic test group (P<0.05). Likewise, significantly fewer nights with disturbed sleep and fewer days with sick-leave from work were reported among the participants in the test group (P<0.05). No differences were found in the post-operative use of analgesics. In conclusion, we found no significant influence of probiotic supplements on objective wound healing after surgical extraction of impacted mandibular third molars. However, since the patients’ perceived significant post-operative ameliorations, further studies are needed to explore the patient’s value of the intervention.


1987 ◽  
Author(s):  
K Zawilska ◽  
A Tokarz ◽  
P Psuja ◽  
P Szymczak ◽  
S Kawczyński ◽  
...  

150 patients over 40 years old undergoing major abdominal surgery were divided into 3 groups:1/ group I - receiving a single injection of long acting anabolic steroid /nandrolone phenylpropio-nate, 50 mg intramusculary/ a day prior to surgery 2/ gropup II - receiving the same dose of anabolic steroid plus a single dose of heparin /800 U/kg of body weight/ intrapulmonary a day prior to surgery 3/ group III - receiving only a single dose of heparin /800 U/kg of body weight/ intrapulmonary a day prior to surgery.The deep vein thrombosis /DVT/ was detected using the 125 I-fibrinogen test. The occurence of DVT was:in group I - 14%in group II - 4%in group III - 8%There were no detectable haemorrhagic complications in patients of group I and III, in 6% of patients of group II a sgliht increase of intraoperative bleeding and/or wound hematoma appeared.We conclude that prophylaxis of DVT in the postoperative period with the single dose of anabolic steroid and intrapulmonary heparin is an effective, safe and easy to handle procedure.


Neurosurgery ◽  
2001 ◽  
Vol 48 (4) ◽  
pp. 756-763 ◽  
Author(s):  
Henry Dufour ◽  
Philippe Métellus ◽  
Stéphane Fuentes ◽  
Xavier Murracciole ◽  
Jean Régis ◽  
...  

Abstract OBJECTIVE To specify that postoperative radiotherapy is useful for preventing local recurrence and neuraxis recurrence of surgically treated meningeal hemangiopericytomas. METHODS We retrospectively studied 21 patients with meningeal hemangiopericytoma who were followed in our department during a 34-year period. In 17 patients, the meningeal hemangiopericytoma was intracranial, and in 4 there was an intradural extramedullary localization. These groups were studied separately. RESULTS Of the 17 patients with intracranial hemangiopericytoma, all underwent surgery; 8 also underwent radiotherapy (5000–6400 rads) (Group I), and 9 did not (Group II). The mortality rate was zero for Group I patients and 55% for Group II. The mean local recurrence rate was 52% (12.5% in Group I and 88% in Group II; P &lt; 0.05). Neuraxis recurrences occurred in two patients in Group II, and none occurred in Group I (P = 0.4). Peripheral metastasis took place in two patients (22%) in Group II and in one patient (12.5%) in Group I (P = 0.5). Of the four patients with intradural extramedullary hemangiopericytoma, all underwent surgery. Two patients received 4000 rads of radiotherapy after intervention. No patient in this group had a recurrence. CONCLUSION For patients with intracranial meningeal hemangiopericytoma, surgical removal followed by external radiotherapy reduced the risk of local recurrence. It was not demonstrated that postoperative radiotherapy protected against neuraxis metastasis. Radiotherapy did not protect against peripheral metastasis, which can occur up to several years after the first operation. It appears that radiotherapy after surgery for local or neuraxis recurrence did not avoid further recurrence. Radiosurgery is indicated for recurrent tumors measuring less than 25 mm in greatest diameter. For intradural extramedullary localizations, the value of postoperative radiotherapy is more questionable.


2021 ◽  
Vol 1 (2) ◽  
pp. 1-6
Author(s):  
Pranay Ratna Sakya ◽  
Dipti Shrestha ◽  
Reena Shrestha ◽  
Dhiraj Khadka Khadka ◽  
Ratina Tamrakar ◽  
...  

Introduction: Third molar surgery is one of the most common procedures performed by dental surgeons in clinical practice, where postoperative sequelae like pain, trismus, and swelling are often encountered. Thus, in this study, we compared medications employed to reduce such complications. Objective: To compare the effect of two different doses (4 and 8 mg) of dexamethasone in the control of swelling and trismus after the surgical extraction of mandibular impacted third molars. Methods: An experimental study consisted of twenty-seven (27) healthy adult patients of both genders with bilateral impacted lower third molars, where surgical extraction was indicated, 4 mg and 8 mg of dexamethasone were given orally to the patients 1 hour before the surgical procedure at both the surgeries. The swelling was recorded by measuring the length of 3 facial planes using a measuring tape. Trismus was evaluated by measuring the maximum interincisal distance. Recording of facial swelling and maximum interincisal distance was done preoperatively and on the 1st and 2nd days postoperatively. Results: Based on statistical analysis (Independent T-test), the results showed a difference in the measurements of the degree of swelling and trismus of the treated sample. 8 mg of dexamethasone promoted a greater reduction of symptoms than 4mg of dexamethasone though there was no statistically significant (p-value >0.05) difference between the two doses. Conclusions: 8 milligrams of the dexamethasone had better effectiveness than 4 milligrams of the dexamethasone in reducing the degree of swelling and trismus. Keywords: Dexamethasone; impacted third molars; swelling; trismus.


Sign in / Sign up

Export Citation Format

Share Document