Efficacy of Tenoxicam, Paracetamol, and Their Combination in Postoperative Pain After Double-Jaw Surgery.

Introduction Orthognathic surgical procedures include a series of surgical operations in which interventions are applied to the maxilla, mandible, or both for occlusal or aesthetic concerns due to facial skeletal development deformities. Double-jaw surgeries have the highest pain scores, in which both maxilla and mandible bones are intervened. This study aimed to compare the efficacy of individual applications of paracetamol and tenoxicam with their combined application on postoperative pain and opioid consumption in patients undergoing double-jaw surgery. Methods In this randomized, double-blind study, 60 patients undergoing double-jaw surgery were allocated into three groups, with each having 20 patients: the paracetamol group, the tenoxicam group, and the paracetamol-tenoxicam combination group. Pain intensity was evaluated using the visual analogue scale (VAS) at intervals of 30 minutes, 60 minutes, 120 minutes, and again at the 24th postoperative hour. Additionally, the consumption of opioids and other rescue analgesics was documented over the 24-hour postoperative period. Results The VAS values at 30 minutes, 60 minutes, and 24 hours were lower in the paracetamol-tenoxicam group compared to the other groups (p<0.001). The need for a rescue analgesic drug in the first 24 hours was not observed in the tenoxicam and paracetamol-tenoxicam groups. Conclusion It was concluded that both tenoxicam and paracetamol-tenoxicam combinations, especially the tenoxicam-paracetamol combination, were good options for postoperative analgesia in patients with double-jaw surgery.

Is supraperiosteal infiltration anesthesia safe enough to prevent inferioralveolar nerve during posterior mandibular implant surgery?

Objectives: There is no agreement on using inferior alveolar nerve (IAN) block or supraperiosteal infiltrationanesthesia during dental implant surgery in the posterior mandibular region. The aim of this study was to evaluatethe effectiveness of supraperiosteal infiltration anesthesia on posterior mandibular region during dental implantsurgery. Materials and Methods: In this study 52 implants were inserted under supraperiosteal infiltration anesthesiain 29 patients. After the surgery, patients were instructed to note their pain and/or painless dyscomfort on thevisual analogue scale (VAS). Their pressure pain threshold (PPT) scores were evaluated by mechanical algometer.The distance between the apical end of the implants and IAN was measured by using calipers on postoperatif panoramicradiographs. Results: 50 implants to 27 patients had been able to place without pain under supraperiostealinfiltration. Implants which were placed at the mandibular second premolar and first molar region had been ableto place with free of pain with supraperiosteal infiltration. There was no relationship among the distance betweenthe apical ends of the implants and IAN with intraoperative discomfort of the patients. VAS scores during implantplacement at the second premolar region were relatively higher than at the first and second molar region. Conclusion:Supraperiosteal infiltration anesthesia is a safe and effective method for posterior mandibular implant surgery.However the length of the implant should be determined carefully to avoid possible damage to IAN duringimplant placement under supraperiosteal infiltration anesthesia (AU)

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Is supraperiosteal infiltration anesthesia safe enough to prevent inferior alveolar nerve during posterior mandibular implant surgery?

OBJECTIVES: There is no agreement on using inferior alveolar nerve (IAN) block or supraperiosteal infiltration anesthesia during dental implant surgery in the posterior mandibular region. The aim of this study was to evaluate the effectiveness of supraperiosteal infiltration anesthesia on posterior mandibular region during dental implant surgery. MATERIALS AND METHODS: In this study 52 implants were inserted under supraperiosteal infiltration anesthesia in 29 patients. After the surgery, patients were instructed to note their pain and/or painless dyscomfort on the visual analogue scale (VAS). Their pressure pain threshold (PPT) scores were evaluated by mechanical algometer. The distance between the apical end of the implants and IAN was measured by using calipers on postoperatif panoramic radiographs. RESULTS: 50 implants to 27 patients had been able to place without pain under supraperiosteal infiltration. Implants which were placed at the mandibular second premolar and first molar region had been able to place with free of pain with supraperiosteal infiltration. There was no relationship among the distance between the apical ends of the implants and IAN with intraoperative discomfort of the patients. VAS scores during implant placement at the second premolar region were relatively higher than at the first and second molar region. CONCLUSION: Supraperiosteal infiltration anesthesia is a safe and effective method for posterior mandibular implant surgery. However the length of the implant should be determined carefully to avoid possible damage to IAN during implant placement under supraperiosteal infiltration anesthesia.