Comparison of two dosages of Submucosal Dexamethasone to control Postoperative Trismus after surgical extraction of Mandibular impacted third molar

Objective: To compare the post surgical effects of two different concentrations' i.e. 4mg [milligram] and 8mg of sub mucosal dexamethasone to decrease trismus by comparing the mean decrease in interincisal distance in patients undergoing impacted mandibular third molar surgery

Study Design: Randomized controlled clinical trial

Place and Duration of Study: Outpatient department of oral and maxillofacial surgery unit, Mayo Hospital, Lahore. The study was completed in 6 months, from Jan 2012 to Jul 2012

Material and Methods: This randomized controlled clinical trial was conducted on 150 patients. Patients were divided into two groups A and B. Mean interincisal distance of all patients was recorded pre operatively and post operatively. All patients were advised to use a mouthwash clorhexidine 0.2 percent before surgery. Group A received 4 mg dexamethasone and group B received 8 mg dexamethasone in the buccal vestibular tissues. Standard surgical procedure was performed by the same operator under same conditions. Postoperative mean interincisal distance of all patients was recorded on day 2 [after 48 hours of surgery]

Results: Average age of patients was 32.62 +/- 7.86 years with minimum and maximum ages of 20 and 50 years respectively. Gender distribution was almost equal. Average [maximum interincisal] mouth opening distance was significantly higher in group B as compared to group A i.e. [36 +/- 3.928 mm [millimeter] versus 26.04 +/- 3.097 mm] with p-value=0.000

Conclusion: Eight mg dose of dexamethasone was statistically more significant in reducing the trismus as compare to 4mg [p-value=0.000]

Pattern of maxillofacial trauma; a five years study of 3360 cases

Objectives: to determine the pattern of maxillofacial injuries in the local population

Study Design: retrospective clinical and epidemiologic study

Period: January 2009 to December 2013

Setting: tertiary care hospital

Methods: 3360 patients reported for maxillofacial injuries. A number of parameters, including age, gender, facial bone fractures, laceration on face, injury of trigeminal and facial nerve branches, sensory and motor deficit in relation to soft tissue trauma and bone fracture, were evaluated

Results: males were dominant and male to female ratio was 6.3:1. Patients of 3[rd] decade were more and constitute 63.2%. Road traffic accident was the common etiological factor [78%]. Mandible fracture was dominant and it was present in 1591 patients [47.7%]. Soft tissue laceration frequency was high in cheek region and was 13.7%. Sensory deficit [Trigeminal nerve injury] was present in 1167 patients [34.7%]. Motor deficit [Facial nerve injury] was present in 249 patients [6.83%]. Nerve injuries in relation to mandible fracture were common

Conclusion: road traffic accident was the most common etiological factor and mandible fracture was common. Trigeminal nerve injuries were common and frequency of nerve injuries was high in relation to mandible fracture