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
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.
Asunto(s)
Recurrencia Local de Neoplasia/patología , Tumores Odontogénicos/cirugía , Ácido Acético , Cloroformo , Etanol , Fijadores , Humanos , Tumores Odontogénicos/patología , Osteotomía/métodos , Resultado del TratamientoRESUMEN
The authors examined whether ketoprofen administered 60 min before surgical extraction of the lower wisdom teeth provides effective postsurgical analgesia and reduces rescue analgesic intake compared with ketoprofen administered 60 min after surgery or placebo. The 96 patients were placed into three groups: pre-group (ketoprofen 60 min preoperatively); post-group (ketoprofen 60 min postoperatively); and no-group (placebo). Study interventions had a significant effect on pain sensations in the 12 h after surgery. The initial onset of pain was significantly delayed only in the post-group. Pain intensity at the first onset of pain was significantly lower only in the post-group. Patients in the pre- and post-groups required significantly less rescue analgesic than those in the no-group. Ketoprofen administered after third molar surgery provides more effective pain control than ketoprofen administered before the surgery or placebo.
Asunto(s)
Antiinflamatorios no Esteroideos/uso terapéutico , Cetoprofeno/uso terapéutico , Tercer Molar/cirugía , Dolor Postoperatorio/prevención & control , Premedicación , Extracción Dental , Acetaminofén/uso terapéutico , Analgésicos no Narcóticos/uso terapéutico , Anestésicos Locales/administración & dosificación , Carticaína/administración & dosificación , Método Doble Ciego , Femenino , Estudios de Seguimiento , Humanos , Masculino , Mandíbula/cirugía , Bloqueo Nervioso , Dimensión del Dolor , Placebos , Estudios Prospectivos , Factores de Tiempo , Adulto JovenRESUMEN
The goal of this study was to evaluate the efficacy of single- and multi-dose (5-day) clindamycin therapy for the prevention of inflammatory complications in patients undergoing lower third molar surgical extraction with bone removal. Patients who qualified for the prospective, randomized, double-masked, placebo-controlled trial were randomly divided into three groups: (1) single dose of oral clindamycin administered preoperatively (single-dose group); (2) clindamycin administered preoperatively with continued therapy for 5 days (5-day group); and (3) a placebo group. The following parameters were evaluated on the first, second and seventh days postsurgery: trismus, facial swelling, body temperature, lymphadenopathy, alveolar osteitis and subjective pain sensations. There were 86 patients (31 in the single-dose group, 28 in the 5-day group and 27 in the placebo group) enrolled in the study. There were no statistically significant differences in postoperative inflammatory complications in patients during the first and second days postsurgery. A statistically significant variation in body temperature was reported on the seventh day. Analysis of the postoperative analgesic intake did not show statistically significant differences between examined groups. Clindamycin applied in a single preoperative dose of 600 mg with or without subsequent 5-day therapy does not demonstrate efficacy in prophylaxis for postoperative inflammatory complications after third molar surgery.
Asunto(s)
Antibacterianos/administración & dosificación , Clindamicina/administración & dosificación , Mandíbula/cirugía , Tercer Molar/cirugía , Complicaciones Posoperatorias/prevención & control , Infección de la Herida Quirúrgica/prevención & control , Extracción Dental , Adulto , Analgésicos/uso terapéutico , Profilaxis Antibiótica , Temperatura Corporal/efectos de los fármacos , Método Doble Ciego , Alveolo Seco/prevención & control , Edema/prevención & control , Femenino , Estudios de Seguimiento , Humanos , Linfadenitis/prevención & control , Masculino , Dolor Postoperatorio/prevención & control , Placebos , Estudios Prospectivos , Diente Impactado/cirugía , Resultado del Tratamiento , Trismo/prevención & controlRESUMEN
The purpose of the study was clinical analysis of 164 odontogenic tumours and tumour-like lesions of the jaws treated at the Department of Maxillofacial and Oral Surgery, Jagiellonian University College of Medicine between 1956 and 1996, and to evaluate early late and therapeutic results. Odontogenic tumours have a specific histological structure reflecting various stages of odontogenesis and are located mainly in the jaws, exceptionally in other parts of the skeletal system. Due to their specific structure and location they have been identified and classified by pathologists into a separate group of neoplasms differing from other tumours developing in the oral cavity and facial bones first of all in histogenesis, but also in biology, clinical manifestations and radiological sings. The currently recommended histological classification of odontogenic tumours established by the WHO in 1992 comprises a variety of odontogenic tumours and tumour-like lesions of bones of ectodermal, ecto-mesodermal and mesodermal origin as well as lesions histogenetically not associated with the dental organ, but constituting this group. They include histologically benign tumours, locally malignant and malignant tumours, the latter making up the least numerous group. Due to marked polymorphism histological diagnosis of odontogenic tumours is difficult, therefore co-operation between a clinicist, radiologist and pathologist is especially important. Treatment of choice in patients with odontogenic tumours is surgical operation: in case of benign tumours extirpation and curretage, whereas in case of malignant and locally malignant tumours--segmental resection of the jaws. Removal of extensive tumours is associated with the need of surgical tissue repair and prosthetic rehabilitation, and in young patients surgical treatment must be followed by orthodontic treatment. Clinical analysis included case histories of 164 patients admitted to the Department of Maxillofacial and Oral Surgery (Head: Professor MD S. B. Bartkowski) between 1956 and 1996. Additional control examinations were performed to analyze late results of therapy. The 40-year clinical material comprised 164 odontogenic tumours including 91 (55.5%) in women, and 73 (44.5%) in men. The mean age of the patients was 32.5 years, but about 30% of the patients were below 18. The tumour was most frequently located in the mandible i.e. in 118 (72.0%) patients, and in the maxilla in 44 (26.8%), and in both jaws in 2 (1.2%) patients. Due to tumour recurrence 19 (11.6%) patients were referred to our clinic from other centres, the remaining ones received their first treatment. The most frequent reason for patient referral was deformity of the jaws, maleruption or lack of teeth or their dislocation, and in case of extensive lesions face deformation and bulging of the tumour into the oral cavity. Radiological examination showed noncharacteristic transparencies, round or oval in shape, single- or multiventricular or foci of noncircumscribed bone densities usually in the vicinity of the teeth, frequently dislocated or unerupted. Rarely osteolysis of the roots of teeth or their amputation was found. Histological examination of the 164 tumours revealed (in order of frequency): ameloblastoma--60 (36.6%), central reparative giant cell granuloma--52 (31.7%), cementoma--15 (9.2%), odontoma--13 (7.9%), odontogenic myxoma--12 (7.3%), ameloblastic fibroma--4 (2.4%), calcifying epithelial odontogenic tumour--3 (1.8%), odontogenic fibroma--2 (1.2%), adenomatoid odontogenic tumour--2 (1.2%) and odontoameloblastoma--1 (0.6%). Of the 60 ameloblastomas three tumours were histologically malignant. Of the 164 patients 152 were selected for surgical treatment. Surgical treatment of histologically and clinically benign tumours included tumour extirpation, curettage, excision and/or electrocoagulation, whereas malignant and locally malignant tumours such as ameloblastomas, myxomas, Pindborg's tumours, invasive reparative giant c
Asunto(s)
Neoplasias Maxilomandibulares/diagnóstico , Neoplasias Maxilomandibulares/terapia , Tumores Odontogénicos/diagnóstico , Tumores Odontogénicos/terapia , Adulto , Quimioterapia Adyuvante , Femenino , Humanos , Neoplasias Maxilomandibulares/mortalidad , Masculino , Recurrencia Local de Neoplasia , Tumores Odontogénicos/mortalidad , Tasa de Supervivencia , Resultado del TratamientoRESUMEN
Immunohistochemical demonstration of S100 protein was performed in 56 cases of malignant melanoma of the facial skin and oral cavity. The depth of invasion was measured comparatively in HE sections and in sections stained for S100 protein. Comparison of measured melanoma invasion depth in S100- and HE-stained sections revealed a deeper invasion of the tumor in S100-stained slides than in slides stained routinely with HE according to Breslow's melanoma staging procedure. A reverse relationship between the intensity of immunohistochemical staining for S100 protein and survival rate was found in both melanomas of the facial skin and oral cavity. Although the presence of S100 protein has been demonstrated previously in skin melanomas, no similar investigations concerning the oral mucosa have been performed up to now.
Asunto(s)
Neoplasias Faciales/química , Melanoma/química , Neoplasias de la Boca/química , Proteínas S100/análisis , Neoplasias Cutáneas/química , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores de Tumor/análisis , Eosina Amarillenta-(YS) , Neoplasias Faciales/diagnóstico , Neoplasias Faciales/mortalidad , Neoplasias Faciales/patología , Femenino , Hematoxilina , Humanos , Inmunohistoquímica , Masculino , Melanoma/diagnóstico , Melanoma/mortalidad , Melanoma/patología , Persona de Mediana Edad , Mucosa Bucal/química , Neoplasias de la Boca/diagnóstico , Neoplasias de la Boca/mortalidad , Neoplasias de la Boca/patología , Proteínas de Neoplasias/análisis , Estadificación de Neoplasias , Pronóstico , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/mortalidad , Neoplasias Cutáneas/patología , Tasa de SupervivenciaRESUMEN
A case of incomplete Melkersson-Rosenthal (s. M-R) syndrome manifesting itself by the lower lip and cheeks' mucous membrane oedema and hyperplasia of gingivae has been described. Histopathological examination of the cheeks has demonstrated disseminated, perivascular inflammatory infiltrations of sarcoid type, whereas massive infiltration composed nearly exclusively of plasmatic cell has dominated in segments of gingivae. Electron microscopic examination has demonstrated increased migration of the cells resembling lymphocytes through the epithelium towards the surface and progressive morphological changes leading to the disintegration both lymphocytar cells and plasmatic ones and symptoms of interstitium fibrotic processes.
Asunto(s)
Hiperplasia Gingival/patología , Síndrome de Melkersson-Rosenthal/patología , Movimiento Celular , Preescolar , Humanos , Linfocitos , Microscopía Electrónica , Mucosa Bucal/patología , Mucosa Bucal/ultraestructura , Células PlasmáticasAsunto(s)
Carcinoma/cirugía , Neoplasias del Seno Maxilar/cirugía , Procedimientos Quirúrgicos Oftalmológicos , Neoplasias de los Senos Paranasales/cirugía , Adulto , Carcinoma/rehabilitación , Niño , Dentadura Parcial , Ojo Artificial , Humanos , Neoplasias del Seno Maxilar/rehabilitación , Persona de Mediana EdadRESUMEN
The authors present their own experience in the management, methods of treatment and follow-up results of 128 patients with malignant tumours of the maxilla. There were 77 males and 53 females (sex ratio 1.5: 1). Patients ages ranged from 3 to 83 years with an average of 53 years. Epithelial tumours were diagnosed in 69.5% and nonepithelial in 30.5%. In most cases the maxillary sinus was the primary focus of the tumour (40.3%). 94.4% of patients had epithelial tumours in stages III and IV (UICC classification, 1973). Radical treatment was carried out in 94 patients in 4 radiotherapy only (lymphatic tumours), in 90 patients surgery with adjuvant radio- and/or chemotherapy mainly in the postoperative stage. During the follow-up local recurrence was diagnosed in 36.5% of radically treated patients, who subsequently underwent reoperation. A five-year survival rate was obtained in 45.1% of patients with epithelial tumours and in 14.3% of patients with nonepithelial tumours. The authors carried out their own method of prosthetic rehabilitation, mainly immediate, in 82 patients operated on. Immediate prosthetic rehabilitation is a final step in the surgical procedure. This method significantly diminishes functional disturbances, mainly in speech and mastication and remarkably improves the aesthetic result.
Asunto(s)
Adenocarcinoma/terapia , Carcinoma de Células Escamosas/terapia , Carcinoma/terapia , Neoplasias Maxilares/terapia , Adenocarcinoma/rehabilitación , Adenocarcinoma/cirugía , Adolescente , Adulto , Anciano , Carcinoma/rehabilitación , Carcinoma/cirugía , Carcinoma de Células Escamosas/rehabilitación , Carcinoma de Células Escamosas/cirugía , Niño , Preescolar , Terapia Combinada , Femenino , Estudios de Seguimiento , Humanos , Masculino , Neoplasias Maxilares/rehabilitación , Neoplasias Maxilares/cirugía , Persona de Mediana Edad , Recurrencia Local de NeoplasiaRESUMEN
The interdisciplinary problem of foreign bodies in the orbit is presented on the basis of personal experience in the treatment of 20 patients. These foreign bodies often cause severe injuries to the organ of sight and even threaten life. Early removal of a foreign body is technically easy, prevents infection and facilitates anatomical reconstruction of the damaged structures. Only in exceptional cases may removal be avoided. Of the 20 patients treated, only 9 were early admissions to our Department where the foreign body was removed and primary surgery performed. The others were admitted after some delay, which made correct treatment more difficult. Data on the injuries found in 20 patients, surgical technique, follow up and results are presented. Total recovery was obtained in 7 patients, improvement in vision in 2, enucleation of the globe was necessary in 5, and in 2 loss of vision was a sequel to a lesion of the optic nerve. Depending on the indications, reconstructive plastic surgery and prosthetic rehabilitation gave good aesthetic results. The necessity for interdisciplinary collaboration in the diagnosis and treatment of patients with foreign bodies in the orbit is emphasized.
Asunto(s)
Cuerpos Extraños/cirugía , Órbita/lesiones , Adolescente , Adulto , Anciano , Niño , Femenino , Estudios de Seguimiento , Cuerpos Extraños/etiología , Humanos , Masculino , Persona de Mediana Edad , PronósticoAsunto(s)
Antibacterianos/administración & dosificación , Infecciones Bacterianas/terapia , Heparina/administración & dosificación , Osteomielitis/terapia , Estreptoquinasa/administración & dosificación , Adolescente , Adulto , Anciano , Quimioterapia Combinada , Femenino , Humanos , Infusiones Parenterales , Masculino , Persona de Mediana Edad , Cuidados PosoperatoriosRESUMEN
Observations of the incidence of MT from distant organs and tissues to the maxillofacial region are presented on the basis of 13 cases (3.2% of the total number of patients with malignant tumors). Metastatic carcinomas are most frequently found in the mandible (61.5%). The primary locus is usually the breast, kidney, bronchus, or thyroid gland (61.5%), the diagnosis of metastasis aided in localization of the primary tumor. Successful results of radical treatment were obtained in only two cases; they survived for three and 11 years. The other 11 patients died within two months to a year. The function of maxillofacial surgeons in discovering primary and metastatic tumors of the jaws and face is emphasized.
Asunto(s)
Neoplasias Maxilomandibulares/secundario , Neoplasias de la Boca/secundario , Adolescente , Adulto , Anciano , Diagnóstico Diferencial , Femenino , Humanos , Neoplasias Maxilomandibulares/diagnóstico , Neoplasias Maxilomandibulares/terapia , Masculino , Persona de Mediana Edad , Neoplasias de la Boca/diagnóstico , Neoplasias de la Boca/terapia , PronósticoRESUMEN
Clinical material of 43 patients treated for fibrous dysplasia of facial bones at the Department of Maxillofacial Surgery, Medical Academy in Cracov in the years 1956--1978 has been investigated. The author's own observations concerning diagnostics and treatment of these patients are presented. Diveristy of clinical forms and variability of the disease process dynamics likewise the difficulties in treatment resulting from unacquaintance with etiology of the disease are emphasized. The results of treatment obtained on the basis of control examination during two to fifteen-year periods of observation are described.
Asunto(s)
Huesos Faciales/cirugía , Displasia Fibrosa Ósea/cirugía , Adolescente , Hormona Adrenocorticotrópica/uso terapéutico , Adulto , Factores de Edad , Antibacterianos/uso terapéutico , Trasplante Óseo , Niño , Huesos Faciales/diagnóstico por imagen , Femenino , Displasia Fibrosa Ósea/diagnóstico por imagen , Displasia Fibrosa Ósea/metabolismo , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Radiografía , Factores Sexuales , Trasplante AutólogoRESUMEN
We present a case of a massive angioma of the face treated by radical excision and subsequent reconstruction. At present the patient feeds normally, she speaks well, and she is taking a post-graduate course in mining engineering.