Single-channel electroencephalography and its associations with anxiety and pain during oral surgery:a preliminary report

Background@#This study aimed to assess the course of anxiety and pain during lower third molar (LTMo) surgery and explore the role of mobile and single-channel electroencephalography under clinical and surgical conditions. @*Methods@#The State-Trait Anxiety Inventory (STAI), Corah’s Dental Anxiety Scale (DAS), and Interval Scale of Anxiety Response (ISAR) were used. The patient self-rated anxiety (PSA), the pain felt during and after surgery, EEG, heart rate (HR), and blood pressure (BP) were assessed. @*Results@#The Attention (ATT) and Meditation (MED) algorithms and indicators evaluated in this study showed several associations. ATT showed interactions and an association with STAI-S, pain during surgery, PSA level, HR, and surgical duration. MED showed an interaction and association with DAS, STAI-S, and pain due to anesthesia. Preclinical anxiety parameters may influence clinical perceptions and biological parameters during LTMo surgeries. High STAI-Trait and PSA scores were associated with postoperative pain, whereas high STAI-State scores were associated with more pain during anesthesia and surgery, as well as DAS, which was also associated with patient interference during surgery due to anxiety. @*Conclusions@#The findings suggest that single-channel EEG is promising for evaluating brain responses associated with systemic reactions related to anxiety, surgical stress, and pain during oral surgery.

Forensic luminol blood test for preventing cross-contamination in dentistry: an evaluation of a dental school clinic

More than 200 different diseases may be transmitted from exposure to blood in the dental setting. The aim of this study is to identify possible faults in the cross-contamination chain control in a dental school clinic searching for traces of blood in the clinical contact surfaces [CCS] through forensic luminol blood test. Traces of invisible blood where randomly searched in CCS of one dental school clinic. Forty eight surfaces areas in the CCS were tested and the presence of invisible and remnant blood was identified in 28 [58.3%] items. We suggest that the luminol method is suitable for identifying contamination with invisible blood traces and this method may be a useful tool to prevent cross-contamination in the dental care setting

Condylar hyperplasia treated by simultaneous orthognathic surgery and high condylectomy: a case report / Hiperplasia condilar tratada com condilectomia alta e cirurgia ortognática simultânea: relato de caso

Objetivo: Este artigo relata caso de hiperplasia condilar (CH) tratado com sucesso através de cirurgia ortognática e condilectomia alta realizada simultaneamente, além de revisar a literatura recente sobre a forma adequada de tratar esta associação de condições. Descrição do Caso: Uma paciente do sexo feminino, 34 anos, relatou queixa de aparência facial insatisfatória, dor sobre o côndilo esquerdo e função mastigatória comprometida. O exame clínico mostrou alongação unilateral da face, assimetria facial e altura vertical aumentada da mandíbula criando uma moderada mordida aberta com compensações dentais. Uma tomografia computadorizada 3D mostrou severa alongação o côndilo esquerdo, indicando a possibilidade de CH. O tratamento incluiu correções ortodônticas das compensações dentais, cirurgia ortognática, condilectomia alta removendo 10mm da altura do côndilo esquerdo, e reposicionamento do disco articular sem ancoramento. A cirurgia ortognática incluiu osteotomias sagitais do ramo mandibular bilateralmente para corrigir a deformidade dentofacial de Classe III moderada e para corrigir os planos mandibulares. A avaliação de controle após 24 meses mostrou bons resultados estéticos e funcionais. Não foram detectadas alterações na oclusão, indicando um resultado bastante estável com a utilização desta técnica. Conclusão: A hiperplasia condilar normalmente produz assimetria facial e algumas vezes é necessário corrigir a deformidade dentofacial resultante através de condilectomia alta e cirurgia ortognática.

Purpose: This paper reports a case of severe facial asymmetry secondary to condylar hyperplasia (CH), which was successfully treated by simultaneous high condylectomy and orthognathic surgery, and also reviews the literature concerning the current approaches for treating these combined conditions. Case description: A 34 year-old female patient reported complaints of unsatisfactory facial appearance, pain over her left condyle, and poor chewing function. Clinical examination showed unilateral elongation of the face, facial asymmetry, and increased vertical height of the mandible creating a mild open bite with dental compensations. A 3D Computed Tomography exam showed a severe elongation of the left condyle, indicating the possibility of CH. The treatment included orthodontic corrections of the dental compensations, orthognathic surgery, high condylectomy removing 10mm of the left condyle height, and articular disc repositioning without anchor placement. The orthognathic surgery included bilateral mandibular ramus sagittal split osteotomies to correct the mild Class III dentofacial deformity and the mandibular planes. A follow-up evaluation after 24 months showed good aesthetic and functional results. No changes in occlusion were noted, indicating very stable results using this technique. Conclusion: Condylar hyperplasia usually produces facial asymmetry, and in certain cases both high condylectomy and orthognathic surgery are necessary to correct the dentofacial deformity.