Concentration of some prophylactic antibiotic in blood, dentoalveolar blood and mandibular bone in impaction surgery

Surgical removal of impacted third molars might be followed by infection. To fight against such infection an adequate antibiotic concentration should be there at the local tissue before the operation. This study was conducted to identify the level of single oral dose of prophylactic antibiotic in antecuhital serum, dentoalveolar serum and mandibular bone in impaction surgery. This study included 200 patients. divided into five groups each comprised forty patients and each group received single oral dose of one antibiotic under investigation [azithromycin. clindamycin. doxycycline. erythromycin, and penicillin-V]. Each group was further subdivided into eight subgroups comprising 5 patients according to the proposed time intervals. Antibiotics were taken 30. 60, 90. 120. 150. 180. 210, and 240 minutes before the operation according to the tested subgroup. Samples of blood. dentoalveolar blood and mandibular bone were taken at the planed time intervals. The concentrations of antibiotic in these samples were assayed in vitro by the agar diffusion [cup plate] method. The result showed that penicillin-V showed the highest mean peak serum concentration followed by doxycycline and clindamycin. However. all antibiotics gave measurable level exceeding the NBC of the tested bacterial isolates. Doxycycline showed the highest concentration ratio [bone/serum]. followed by penicillin-V, clindamycin and erythromycin. Up to four hours [240 minutes] no measurable level of azithromycin concentration could be attained in bone, so a further study at a longer time period [more than 12 hours] may be indicated. The suggested time for prophylactic use of the tested antibiotic should he two hours before the operation for clindamycin [300 mg]. one and half hour before the operation for erythromycin [500 mg]. three hours before the operation for doxycycline [200mg.] and half an hour before the operation for penicillin [937.5m2]

Condylar positions in patients with temporomandibular joint dysfunction

The significance of condylar positions at centric occlusion in patients with temporomandibular joint dysfunction has been a persistent controversy. The aim of the present study was to determine whether a true correlation could be demonstrated between the signs and symptoms of temporomandibular joint dysfunction and the location of the condyle within the glenoid fossa by measuring TMJ spaces on lateral tomograms. The radiographic component of the study was completed in 36 women and 16 men allocated to 4 dysfunction groups [Helkimo clinical dysfunction index]. Statistical comparison between groups showed an almost equal distribution of abnormal joint spaces. Further, it was not possible to document a relationship between the condylar positions in the fossa and dysfunction symptoms

intraligamentary anaesthesia: the effect of vasonstrictor

The indications and contraindications of adding vasoconstrictors to local anesthesia have long been well recognized, This study was performed to assess the onset, intensity and duration of intraligamentary injection using plain local anesthesia versus those containing vasoconstrictors.Eighty healthy volunteers were participated in the study, 2% mepivacaine with 1:100.00 adrinaline 2% mepivacaine with 1:100.00 noradrinaline.3% mepivascaine and normal saline, as a control, were used. On double blind bases one solution was injected intraligmentory in the lower first molar, using the CITOJECT dental syringe.The onset of anaesthesia in the first three solutions was 10-12 seconds. No significant difference was demonstrated in the intensity of pulpal anaesthesia. Duration of actions was 47.5+7, 03, 61.4+12.27 and 31.5+6.67 minutes respectively. No anaesthesia was abtained in the subjects injected with saline. The addition of vasoconstrictor prolong the duration of anesthesia, nevertheless, within the scope of plain anaesthesia minor oral surgical procedures could be conducted

Ultrasonographic interpretation of temporomandibular joint disorders

Real-time ultrasound at a frequency of 3.5 MHz was assessed as a diagnostic mean of temporomandibular joint disorders. The clinical conditions of the nine cases under evaluation included intra-capsular ankylosis, mandibular dislocation, and clicking jaw. The results of this preliminary examination indicated that ultrasonography could be compared with radiography and that temporomandibular disorders may be evaluated in this manner