To Evaluate the Effect of Ketorolac Tromethamine, Tramadol and Placebo During Periodontal Surgery: A Double Blind Study

Objectives: The efficacy of single oral dose KetorolacTromethamine, Tramadol and Placebo was evaluated in paincontrol after periodontal surgery.Materials and Methods: The study design is a split mouthstudy involving three quadrants of the same patient. 20patients requiring flap surgeries in at least three quadrantswere recorded. Patients were randomly divided into threegroups as per the medications given, either 10 mg ketorolac or50 mg tramadol or placebo tablets at least 30 minutes beforeadministration of local anesthesia (LA). The duration of surgeryfrom the time of incision to the placement of the last suture isrecorded. After the completion of the surgery, patients wereasked to rate their subjective operative pain intensity using avisual analog scale.Results: Differences were statistically significant in VAS scorebetween ketorolac and placebo, and tramadol and placebogroup. Comparison of sum of pain intensity showedsignificantly greater pain levels in the placebo than in theketorolac group and tramadol group.Conclusion: The results of this single-dose, parallel-group,and double blind placebo-controlled study showed that 10-mgketorolac and 50-mg tramadol administered immediately beforeperiodontal surgery was effective for better response by thepatient during the procedure. However, ketorolac and tramadolpremedication neither affected delayed pain levels, norpostoperative analgesic consumption.

Maxillary Canine Impactions: Orthodontic and Surgical Management.

Canines are important teeth in terms of esthetic and function. The Maxillary Canines are also known as ‘Corner stone of smiles’ or ‘Eye teeth’. Impaction of canines is a common occurrence and clinicians must have a sound knowledge to manage such cases. Dachi and Howell reported that the incidence of maxillary canine impaction is 0.92%, and mandibular canine impaction is 0.35% among which 8% patients bilateral impactions. No prosthesis can match the originality of contour, shape and color of original canine. So every attempt should be made to retrieve the impacted canine. With early detection, timely interception and well managed surgical and orthodontic treatment; impacted canines can be erupted and guided to an appropriate location in the dental arch. This paper presents a literature review regarding etiology, clinical and radiographic diagnosis, as well as surgical and orthodontic management of impacted canine along with case presentations.