RESUMEN
The aim of this study was to establish whether the pre-emptive use of lornoxicam (16mg) in third molar surgery ensures successful postoperative analgesia and reduces rescue analgesic intake when compared to postoperative application, and in comparison with placebo. Ninety patients were split randomly into three groups: group A received lornoxicam 60min before surgery and placebo 60min after surgery; group B received placebo 60min before surgery and lornoxicam 60min after surgery; group C received placebo 60min before surgery and placebo 60min after surgery. Postoperative pain was recorded on a visual analogue scale and on a numerical rating scale at 1, 2, 4, 6, 8, 12, and 24h after surgery. The patients recorded total dose of paracetamol intake during the 24h after the procedure. The efficacy of postoperative analgesia was greater in lornoxicam groups when compared to the placebo group; there was no difference between the two lornoxicam groups (A and B). Patients in group C took their first rescue analgesic dose earlier after surgery than patients in the two lornoxicam groups. The average dose of paracetamol taken in group C was 1000mg, while it was500 mg in the lornoxicam groups.
Asunto(s)
Antiinflamatorios no Esteroideos/administración & dosificación , Tercer Molar/cirugía , Dolor Postoperatorio/prevención & control , Piroxicam/análogos & derivados , Diente Impactado/cirugía , Adolescente , Adulto , Método Doble Ciego , Femenino , Humanos , Masculino , Mandíbula/cirugía , Persona de Mediana Edad , Dimensión del Dolor , Piroxicam/administración & dosificación , Estudios Prospectivos , Resultado del TratamientoRESUMEN
The aim of this study was to investigate the effect of the submucosal injection of 1ml dexamethasone (4mg/ml) on pain, swelling, and trismus following the extraction of retained lower third molars. Ninety patients (mean age 23.5 years) were split randomly into three equal study groups (30 patients in each): the 'before' group received dexamethasone 15min before surgery and placebo 15min after surgery; the 'after' group received placebo 15min before surgery and dexamethasone 15min after surgery; the 'placebo' group received placebo 15min before surgery and placebo 15min after surgery. Postoperative pain was recorded by the patients using a visual analogue scale, numerical rating scale, and the McGill Pain Questionnaire at 1, 2, 4, 6, 8, 12, and 24h after surgery. The patients also recorded the total number of analgesic doses consumed during the 24h after the procedure. Swelling (determined using linear measurements of the face) and trismus (determined through measurement of maximum mouth opening) were assessed at 48h, 72h, and 7 days following surgery. Better control of pain, swelling, and trismus was demonstrated for dexamethasone in comparison to placebo. Postoperative dexamethasone provided better pain control than preoperative dexamethasone. There was no difference in total rescue analgesic intake between the preoperative and postoperative dexamethasone groups.
Asunto(s)
Antiinflamatorios/administración & dosificación , Dexametasona/administración & dosificación , Edema/prevención & control , Mandíbula/cirugía , Tercer Molar/cirugía , Dolor Postoperatorio/prevención & control , Extracción Dental , Trismo/prevención & control , Método Doble Ciego , Femenino , Humanos , Inyecciones , Masculino , Manejo del Dolor/métodos , Dimensión del Dolor , Estudios Prospectivos , Resultado del Tratamiento , Adulto JovenRESUMEN
This systematic review was undertaken to determine the overall and detailed recurrence rate of keratocystic odontogenic tumour in relation to specific treatment methods. Online electronic databases were searched to identify articles published in English language from 1956 to 2010. Articles were independently appraised by two reviewers in three separate rounds. Any disagreement was settled by discussion with a third judge. Of 1568 potentially relevant articles, 168 articles related to the treatment of keratocystic odontogenic tumour/parakeratinised type of odontogenic keratocyst and its recurrence rate entered the second round for evaluation. Fourteen papers entered the third round for critical appraisal. Two retrospective reviews entered the final analysis. One hundred eight lesions were found in the material analysed. Six treatment modalities were identified. The recurrence rates were 0% for resection, 0% for enucleation with peripheral ostectomy and Carnoy's solution, 18.18% for enucleation with peripheral ostectomy, 26.09% for enucleation alone, 40% for marsupialisation, and 50% for enucleation with Carnoy's solution. The overall recurrence rate was 23.15%. The present review discusses the methodological weaknesses of many of the studies analysed. No high quality evidence was obtained to evaluate recurrence rates related to treatment modalities of keratocystic odontogenic tumour.