Relation between serum carbamazepine concentration and pain in dental patients with trigeminal neuralgia

The relation between changes in pain intensity, frequency and serum carbamazepine [CBZ] concentration was studied in 10 dental patients with trigeminal neuralgia. All patients included in this study were previously treated as dental patients with misdiagnosed pain. All patients were treated with a daily dose of CBZ [600 mg] for a period of 10 months. Serum CBZ concentration, blood examination and measuring pain intensity and frequency were performed every 3 months after initiation of CBZ therapy. It was found that CBZ concentration varies from period to period even within the same individual. Also, there was a fluctuation in pain intensity in most of the patients as in periods where the CBZ levels were low, pain was relatively well controlled and vice versa. There was a considerable interindividual differences in response to CBZ. However, pain frequency was found to be reduced with long-term therapy. Moreover, this study showed a correlation between CBZ levels and the particular side effects. Side effects such as ataxia, dizziness, skin rashes, and leucopenia were observed in very few elderly during high serum CBZ level periods. These effects were transient. Furthermore, this study revealed that most of the patients had transient improvement of pain after oral surgical interference which could be a provoking factor of pain as pulpitis and impacted tooth. Therefore, this study showed the importance of monitoring serum CBZ level, pain intensity, frequency and side effects during long-term CBZ therapy. Also, proper diagnosis of trigeminal neuralgia in dental patients suffering from pain should be considered. Further, the dental problems causing pain on top of TN should be treated

Osteopromotion of bony defects by osteoperiosteal flap

The use of the osteoperiosteal flap in 2 techniques was used in this study as an osteopromotive method of the bony defect resulting from enucleation of the cystic lesions. Eighteen cysts were treated in 3 groups [6 cases in each]. In group I, the repositioned osteoperiosteal flap [ROF] was used as a barrier of the defect from the soft tissue in growth into it. In group II, the collapsed osteoperiosteal flap [COP] was used for obliteration of the dead space of the bony defects. In group III, the conventional method of bone removal, enucleation and wound closure was followed as a control group. The bony defects ranged in size from 3-5.5 cm in the greatest dimension

role masseter muscle activity in zygomatic complex fracture

Thirteen patients suffering from isolated unilateral zygomatic complex fracture [ZCF] were selected in this study. Five patients were treated by reduction and fixation by 1 or 2 bone plates. Other five patients were treated by reduction and fixation by 1 or 2 intraosseous wires. Two patients were treated by only reduction with no need for fixation. In the remaining case, no surgical treatment was done. Electromyographic assessment for all patients was carried out preoperatively and at the 1st, 2nd and 4th postoperative weeks. The same assessment was done for 13 individuals as a control group. It was found that the masseter muscle activity has no effect on the post-reduction course of ZCF treated by different methods of reduction and fixation. Also, it has been found that the different methods of surgical treatment has no significant effect on the activity of masseter muscle. In addition, the masseter muscle activity has no role in the choice of the suitable method of treatment of ZCF, which should be based on the characteristics of the fracture ranging from no treatment to one or more bone plates