Clinical evaluation of dexamethasone versus methylprednisolone for reducing postoperative Inflammatory sequelae following third molar surgery

Ninety patients were enrolled in the study and randomly assigned to one of three groups. Thirty patients received dexamethasone [4 mg] 5-10 minutes preoperatively. Thirty patients received methylprednisolone [125 mg] 5-10 minutes preoperatively. Thirty patients served as controls [received no steroids]. The duration of facial swelling was evaluated subjectively by the patients. Severity of postoperatively pain was quantified by counting the number of analgesics that the patients took on the day of surgery and during the subsequent six days after surgery. Trismus was determined by measuring the maximal incisive opening before operation and on the seventh postoperative day. It was found that the duration of facial swelling was almost the same in the three test groups. On the day of surgery, the methylprednisolone group showed less significant pain than the other two groups, and the dexamethasone group showed less marked postoperative increase in the incisive opening over the control group. Trismus was significantly reduced in the methylprednisolone group as compared to the dexamethasone group

Blood pressure response to dental extraction

The purpose of this study was to evaluate blood pressure response to dental extraction in normotensive and hypertensive patients. 55 patients [23 normotensive and 32 mild hypertensive] were investigated. For every patient, systolic and diastolic blood pressure values were measured at 2-minutes intervals from 10 minutes before anesthesia until 10 minutes after the extraction was completed. The results showed that there is marked intraindividual variability in blood pressure response to dental treatment. Some individuals showed stable, or nearly stable blood pressure values, while others showed large up and down, systolic as well as diastolic fluctuations across the whole treatment period. Statistical analyses indicated that the observed variability is not related to patients' age, sex or blood pressure status [normotensive or hypertensive], and is not affected by the magnitude of dental intervention. Identification of those individuals with exaggerated blood pressure response might be of potential clinical significance, specially in hypertensive patients. Further investigations are needed to evaluate blood pressure response of moderate and severe hypertensive patients during dental treatment

Bone formation through collagen/HA composite implants using a membrane technique

Atrophy of the jaws is an inevitable sequel to tooth loss. Subperiosteal implantation of collagen/hydroxylapatite [HA] composite implants in block form has been used in recent years. However, collagen is subsequently resorbed and is not replaced by new bone. This study was designed to provide histologic observations on the healing pattern related to collagen/HA implants when used in conjunction with guided tissue regeneration procedures using a membrane technique. Twelve rabbits aged 12-15 months served as the experimental animals in this study. Two compressed collagen/HA implants in block form were inserted into two defects of each rabbit calvaria. One of the two implants was covered with nonresorbable expanded polytetrafluoroethylene [ePTFE] membrane, the other implant was left uncovered. Specimens were obtained at 4, 8 and 12 weeks and examined by light microscopy. While the implant specimens on the membrane side showed progressive bone formation between and around the HA particles at the subperiosteal extra-bony locations, the HA particles on the nonmembrane side were surrounded and separated by dense fibrous tissue. At intraosseous sites, HA particles were surrounded by new bone throughout the defect on the membrane side, but this occurred only along the periphery on the nonmembrane side. It was concluded that guided tissue regeneration may be used to induce new bone formation around and between implanted HA particles

Clinical evaluation of a conscious sedation technique combining oral and intravenous benzodiazepines for third molar surgery

30 patients with bilaterally symmetrical bony impacted lower third molars were included in the study. 10 mg of diazepam or placebo was given orally one hour before IV administration of diazepam. The drug choice for the first side was determined randomly. Patients were evaluated for the dosage of IV diazepam needed to reach Verrill's ptosis, profoundness of amnesia, changes in blood pressure, and patient's preference for the oral diazepam side versus the placebo side. Results demonstrated no significant effect on the dose of diazepam injected or the blood pressure response. However, amnesia was more profound on the oral diazepam side as compared to the placebo side. In addition, most patients reported better satisfaction with the oral diazepam side. It is concluded that for those patients seeking profound amnesia, the combined technique of oral and IV diazepam is clearly the superior technique