ABSTRACT
This retrospective study compared the incidence of long-term inferior alveolar nerve injury for positional screws and miniplate fixation of bilateral sagittal split osteotomies carried out in 2 hospitals in Scotland. The study involved a mixture of mandibular setback and advancement surgery. The outcome of neurosensory deficit (NSD) was solely based on subjective assessment by the surgeons and patients' reported alteration in sensation. Numbness, tingling and any alterations in sensation beyond 6 months were considered long-term inferior alveolar nerve injury. This study was conducted on 28 sagittal split osteotomies (group 1) which were fixed with three upper border fixation screws and 36 sagittal split osteotomies (group 2) which were fixed with upper border sliding plate. The reported and documented neurosensory deficits were analysed. The difference in the number of cases of long-term inferior alveolar nerve injury between the 2 methods was 10.3%; the 95% confidence interval for the difference was [-2.94 to 23.5], p = 0.1612. Upper border plate was associated with more long-term NSD but there is insufficient evidence to prove that one method was more superior to the other. The need for a prospective randomized trial was highlighted.
Subject(s)
Fracture Fixation, Internal/adverse effects , Mandible/surgery , Mandibular Nerve , Osteotomy/adverse effects , Somatosensory Disorders/etiology , Trigeminal Nerve Injuries/etiology , Adolescent , Adult , Bone Plates/adverse effects , Bone Screws/adverse effects , Female , Humans , Male , Osteotomy/methods , Retrospective Studies , Young AdultSubject(s)
Alphaprodine/therapeutic use , Anesthesia, Dental , Anesthesia, General , Anxiety/drug therapy , Cardiovascular System/drug effects , Alphaprodine/administration & dosage , Child , Child, Preschool , Drug Therapy, Combination , Female , Humans , Hydroxyzine/administration & dosage , Infant , Male , Nitrous Oxide/administration & dosage , Random AllocationABSTRACT
Twenty pediatric patients were sedated with a meperidine, Promethazine and chlorpromazine drug combination prior to dental rehabilitation. Heart rate, blood pressure, and oxygen saturation were recorded throughout the procedures, as well as level of patient cooperation. There were no statistically significant changes in either heart rate or blood pressure. Forty-seven percent of subjects treated experienced a decline in oxygen hemoglobin saturation. Fifty percent of the patients were well sedated and cooperative, with another forty-five precent exhibiting moderate sedation but an increased incidence of behavioral management difficulties. All procedures were completed on 95% of patients. One case (5%) was aborted because of uncontrollable patient behavior following initiation of dental procedures.
