ABSTRACT
The purpose of this study was to perform a systematic review and meta-analysis of randomized clinical trials (RCTs) investigating the efficacy of hilotherapy on postoperative pain, swelling, neurosensory impairment and patient satisfaction. The authors analyzed RCTs comparing the use of hilotherapy versus conventional cryotherapy or no cold treatment for orthognathic surgery and repair of facial trauma. The authors assessed the risk of bias and strength of evidence according to the Cochrane guidelines and GRADE rating system, respectively. Treatment effects were defined as weighted or standardized mean difference using the inverse variance method. Five RCTs were included. Postoperative pain and swelling in patients using hilotherapy were lower comparing to the control group in the postoperative day 2 (Pain: MD -1.75, CI 95% -2.69 to -0.81; Swelling: MD -21.16âmL, CI 95% -38.91 to -3.41) and in the final evaluation (Pain: MD -0.31, CI 95% -0.44 to -0.18; MD -4.45âmL, CI 95% -7.87 to -1.03). Patients reported higher satisfaction with hilotherapy, but no differences were found for neurosensory impairment. Current evidence suggests that hilotherapy is effective in reducing postoperative pain and swelling in orthognathic surgery and repair of facial fractures and may lead to improvements in patient satisfaction in the recovery phase.
Subject(s)
Facial Injuries/surgery , Orthopedic Procedures , Pain, Postoperative/therapy , Cold Temperature , Cryotherapy , Edema/therapy , Equipment and Supplies , Humans , Postoperative Period , Treatment Outcome , WaterABSTRACT
Although the incidence of broken needles in dental practice is minimal, needle breakage can occur as a result of manufacturing defects, inadequate patient management, or poor practitioner technique. Retrieval of a broken needle is justified not only because of the potential for needle migration but also because of psychological and medicolegal considerations. This case report describes the surgical removal of a dental needle that fractured during an attempt at local anesthesia. Identifying the precise location of the broken needle fragment and its relationship with the surrounding bones, vessels, and nerves is essential to designing an adequate treatment plan. If surgical retrieval is indicated, it should be performed immediately, especially in cases in which the needle fragment has not been bent or deformed. In the present case, the use of C-arm fluoroscopy aided the surgical removal while saving time and reducing the cost of treatment.
Subject(s)
Anesthesia, Dental , Equipment Failure , Foreign Bodies , Needles , Anesthesia, Local , Dental Instruments , HumansABSTRACT
PURPOSE: To report on the clinical outcome of 129 zygomatic implants placed in 37 patients with severely resorbed partially or completely edentulous maxillae. MATERIALS AND METHODS: Patients who received zygomatic implants between 2007 and 2014 were included in this retrospective analysis. All patients were treated using the same surgical protocol, the sinus slot technique. The following data were recorded: sex, age, race, medical history, etiology, addictions, degree of bone atrophy, type and size of zygomatic implants, number of implants placed, type of prosthesis, survival rate, and success of implants and complications. Follow-up included standardized clinical and tomography examinations. RESULTS: Thirty-seven consecutive patients (25 women, 12 men; mean age 55.64 years [range 40 to 77 years]) were treated. All were in need of oral reconstruction and had maxillary atrophy that warranted zygomatic implant placement. One hundred twenty nine zygomatic implants were placed in these 37 patients. Two of the implants failed, resulting in a cumulative survival rate of 98.44%. Maxillary sinusitis was the most common complication found (21.62%); however, neither of the implant failures was related to sinusitis or smoking. CONCLUSION: The zygomatic implant is a reliable option for treatment of the severely resorbed maxilla.
ABSTRACT
Esta pesquisa teve como objetivos avaliar os níveis de pH salivar presente em pacientes com saúde periodontal e doença periodontal, averiguando se há alterações entre o pH de indivíduos saudáveis comparando com o de indivíduos doentes. Tratou-se de uma pesquisa caso-controle, realizada na clínica odontológica da Faculdade Novafapi, na disciplina de Periodontia, entre os meses de junho a novembro de 2008. Utilizou-se o índice de correlação de Pearser, o teste de significância com sinal de 5% e a tabulação dos resultados; os testes foram feitos pelo programa SPSS. Foram selecionados 48 pacientes, sendo 24 saudáveis e 24 com doença periodontal. Na metodologia empregada, observou-se que a diferença dos níveis de variação de pH entre os grupos, não pode servir como base para afirmar que o pH seja um biomarcador da saliva ou correlacioná-lo como um meio de diagnóstico da doença periodontal através da saliva. O pH médio, grupo controle (pacientes com saúde periodontal) foi de 7,57, desvio-padrão de 0,45; enquanto o pH médio do grupo experimental (pacientes com doença periodontal) foi de 7,48, desvio-padrão de 0,32. E o pH médio encontrado entre as gravldades das periodontites dentro da amostra foi de 7,48 para leve, desvio-padrão de 0,26; 7,63 para moderada, desvio-padrão de 0,16; 7,44 para grave, desvio-padrão de 0,38. Por outro lado, torna-se necessário a realização de estudos adicionais sobre o assunto, para nos darem maiores subsídios científicos sobre o assunto.
