Modified Cupar's method for immediate diastema closure.

Anterior maxillary osteotomy or ostectomy (AMO) is a safe, reliable, and easily adaptable procedure routinely performed in orthognathic surgery for the management of the dentoalveolar segment of the anterior maxilla. The anterior segmental maxillary osteotomy was first performed in 1921 by Cohn-Stock. Several modifications were done regarding approaches for AMO; however, Cupar's method is the most preferred approach by the surgeons and in practice since several decades. A novel midline split osteotomy is performed in combination with Cupar's method for superior and posterior repositioning of anterior maxillary segment in combination with immediate closure of diastema in this case report.

Comparison of effect of intra socket ketamine and tramadol on postoperative pain after mandibular third molar surgery.

Aim: This study compared the analgesic efficacy of intra socket application of tramadol versus ketamine for preventing pain after mandibular third molar surgery. Materials and Methods: Thirty patients who had undergone third molar surgery were randomly divided into three groups: Group T (tramadol 1 mg/kg), Group K (ketamine 0.5 mg/kg), and Group C (saline 2 mL). The treatment was applied to the extraction sockets using resorbable gel foam. Average time taken for the procedure was recorded. Pain was evaluated postoperatively using a visual analog scale (VAS) at 6 and 24 h postoperatively. Furthermore, the number of analgesics taken in the 1st24 h was recorded. The relevant information was gathered and tabulated. IBM SPSS 2.0 was used to analyze the results and one-way ANOVA test was used to determine the statistical significance. Results: The VAS scores after extraction were statistically higher in Group C than in either treatment group. Group K had the lowest pain intensity. During the 1st6 h, patients reported statistically lower pain intensity scores in Groups K and T versus Group C. At 24 h, Group K had the lowest pain intensity and Group T had less pain than Group C. The number of analgesics taken in the 1st24 h was highest in Group C. Conclusion: This study shows that intra socket use of tramadol and ketamine can be used as effective alternatives for decreasing pain after third molar surgery.