ABSTRACT
OBJECTIVE: To compare the outcomes of 2 different bone graft materials: autogenous bone grafts from mandibular symphysis and bovine bone grafts associated with platelet-rich plasma (PRP). METHODS: Twenty individuals met the inclusion criteria and accepted to participate in the study. Group A patients underwent alveolar bone grafting using autologous bone and group B patients using a bovine bone graft associated with PRP. Cone beam computed tomography scans were taken and reconstructed 3-dimensionally for all patients preoperatively and 1 year postoperatively. RESULTS: A significant reduction was detected for area and volume within group A and group B. Between groups, no significant difference was found for area or volume. CONCLUSIONS: Bovine grafts associated with PRP are a good option for the reconstruction of alveolar clefts and provide good results such as autologous bone grafts.
Subject(s)
Bone Transplantation , Cleft Palate , Platelet-Rich Plasma , Animals , Cattle , Cleft Palate/surgery , Humans , Pilot ProjectsABSTRACT
The aim of this randomized, double-blind clinical trial was to investigate the effect of preemptive analgesia with a combination of tramadol+dexamethasone or tramadol+diclofenac sodium. The study included 30 patients (age range: 16-30 years), who were randomly assigned to 2 groups by the split-mouth method. Postoperative pain was assessed with a visual analogue scale at 4, 6, 12, 24, and 48 h postoperatively (p.o.h.). Swelling was measured at 48 p.o.h. Maximal interincisor distance was measured at 48 p.o.h. and 7 postoperative days (p.o.d.). Significant differences in postoperative pain intensity were detected between the drug combinations at 4, 6, and 12p.o.h., suggesting the importance of preemptive analgesia. Patients treated with tramadol+dexamethasone showed lower pain scores compared to the tramadol+diclofenac sodium combination, larger postoperative mouth opening, and less swelling. The tramadol+dexamethasone combination also was more effective than tramadol+diclofenac sodium at reducing inflammation.
Subject(s)
Analgesics, Opioid/administration & dosage , Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Anti-Inflammatory Agents/administration & dosage , Dexamethasone/administration & dosage , Diclofenac/administration & dosage , Molar, Third/surgery , Premedication , Tramadol/administration & dosage , Acetaminophen/administration & dosage , Administration, Oral , Adolescent , Adult , Analgesics, Non-Narcotic/administration & dosage , Cross-Over Studies , Double-Blind Method , Drug Combinations , Edema/prevention & control , Female , Follow-Up Studies , Humans , Male , Pain Measurement , Pain, Postoperative/prevention & control , Postoperative Complications/prevention & control , Range of Motion, Articular/drug effects , Tooth Extraction/methods , Tooth, Impacted/surgery , Young AdultABSTRACT
O óxido nitroso, primeiro gás inalatório utilizado na sedação consciente, foi indentificado por Joseph Priestley. Esse composto ficou conhecido como gás hilariante, porém só em 1844 teve sua primeira aplicação em pacientes. Tem como características farmacológicas metabolização lenta no organismo, início e término de ação rápidos, mas alcançando concentrações cerebrais eficientes. Sua técnica baseia-se na administração de O2 seguida de N2O, até alcançar o nível de sedação ideal. Essas técnicas são indicadas para pacientes ansiosos, tensos e situações em que não existam contra-indicações, porém essas são técnicas apenas relativas e não absolutas, e estão relacionadas principalmente ao risco de hipóxia, aumento de volume ou pressão em espaços fechados, alterações hematológicas e neurológicas. Os benzodiazepínicos servem também como método de sedação consciente devido a sua ação ansiolítica: vale destacar o midazolam, diazepam, alprazolam, triazolam e lorazepam. Os efeitos colaterais são variados abrangendo degeneração da medula óssea, náuseas, teratogênese, entre outros. O objetivo deste trabalho é realizar uma revisão da literatura para mostrar a importância da sedação consciente nos procedimentos odontológicos.
Nitrous oxide, the first inhaled gas used in conscious sedation, was identified by Joseph Priestley. This compound was known as laughing gas, but only in 1844 had its first application in patients. Its pharmacological characteristics are don?t be metabolized in the body, beginning and ending of fast action, but reaching effi cient concentrations in the brain. Its technique is based on the administration of O2 followed by N2O, to achieve the optimal level of sedation. Such techniques are indicated for anxious and tense patients, and situations that have no contraindications, but these are only relative and not absolute, and are due mainly to the risk of hypoxia, volume or pressure increase in enclosed spaces, hematological and neurological changes. The benzodiazepines also serve as a conscious sedation method because of their anxiolytic action, highlight the valley midazolam, diazepam, alprazolam, triazolam and lorazepam. Side effects are varied covering bone marrow degeneration, nausea, teratogenesis, among others. The aim of this article is to realize a review in order to show the value of conscious sedation to dental procedures.
