Pre-emptive Single Dose of Intramasseteric Administration of Dexamethasone Versus Methylprednisolone in Surgical Extraction of Impacted Mandibular Third Molars: Prospective Split-Mouth, Randomised Triple Blinded Clinical Study.

Aim: The study aims to contribute in reducing postoperative sequelae and to determine the optimal corticosteroid for reducing postoperative inflammation, pain, swelling, wound healing and quality of life in patients undergoing surgical extraction of impacted mandibular third molars. Materials and Methods: The study included 191 patients who presented to the Department of Oral and Maxillofacial Surgery at Thai Moogambigai Dental College and Hospital in Chennai with bilateral impacted mandibular third molars that needed surgical removal. The effects of pre-emptive single dose of dexamethasone and methylprednisolone on pain, oedema, trismus, wound healing, and quality of life after surgical extraction of impacted lower third molars were investigated. Result: There was no statistical difference between the two steroids, with both achieving identical levels of wound healing and quality of life. On the third postoperative day, there was a statistically significant difference, with methylprednisolone providing clinically superior results in mouth opening and reduction of swelling. However, by the fifth day, both corticosteroids had exhibited identical improvement. Conclusion: Compared to 8 mg of dexamethasone, 40 mg of methylprednisolone administered as a single preemptive dosage in the intrammaseteric region was associated with enhanced quality of life, a reduction in pain and edema, and almost normal mouth opening.

Evaluation of Serum Metal Ion Levels in Dental Implant Patients: A Prospective Study.

Introduction: Titanium is the most commonly used bio-inert implant material. Nevertheless, there is a possibility of systemic release of metal ions, which could have clinical implications like implant failure and toxicity. This prospective study focuses on the evaluation of serum metal ion levels in patients receiving dental implants. The aim of the study is to evaluate the release of titanium, aluminium, and vanadium from dental implants by comparing the preoperative and postoperative serum levels of these ions. Methodology: Serum samples were collected from 30 patients undergoing dental implant placement preoperatively and postoperatively at intervals of 6 weeks, 3, 6, and 12 months. These samples were analyzed for titanium, aluminium, and vanadium levels using Inductively Coupled Plasma Optical Emission Spectrometry. The difference in preoperative and postoperative serum levels was measured and statistically analyzed using the paired t-test. Results: There was a slight difference in the postoperative levels of titanium and aluminium (2.30 and 4.07 mg/dl) as compared to the preoperative levels (2.28 and 2.30 mg/dl), which was statistically insignificant (P > 0.5). The serum levels of vanadium were too insignificant to be detected by the instrument (<0.0088 mg/dl). Discussion: Mild increase in the titanium and aluminium levels in blood serum was noted. These metallic ion levels might increase significantly due to which further clinical research with larger sample sizes and a long-term follow-up period is required to evaluate the clinical effects of metallic ion release from dental implants. There is no significant difference in the serum metal ion levels before and after the implant placement, although a little increase is observed in the aluminium ion levels after the implant placement.

Comparison of two incisions for open reduction and internal fixation of mandibular body fractures: A randomised controlled clinical trial evaluating the surgical outcome.

PURPOSE: The purpose of the study is to compare the surgical access and post-operative outcome of two intra-oral incisions used for approaching a mandibular body fracture. METHODS: This clinical trial involved 60 patients with mandibular body fractures who were randomly allocated to control and study groups. The fractures were approached using the routine vestibular incision in the control group and crevicular incision with vertical release in the study group. The effects of incision design on the post-surgical outcome variables like swelling, trismus, paresthesia, wound healing and gingival recession were statistically analysed with non-parametric tests by using SPSS 22.0 software. Comparison of continuous variables between the groups and time points was done using Mann Whitney test and Friedman test respectively. Chi-square test was used to compare proportions between groups. Dunn's test with Bonferroni correction was used for pair wise comparisons. RESULTS: The study group demonstrated favourable surgical outcome in the immediate postoperative phase as compared to the control group. The difference in mouth opening, swelling and neurosensory impairment between the two groups was found to be statistically significant (p < 0.05). CONCLUSION: Crevicular incision was found to be an ideal alternative to vestibular incision in achieving surgical access and fixation of mandibular body fractures with reduction in postoperative patient discomfort and better surgical outcome.

Concomitant "Ear Bleed and Styloid Fracture": An Unusual Complication of Impacted Mandibular Third Molar Removal.

The removal of impacted mandibular third molar is associated with potential complications such as dry socket, paresthesia, uncontrolled socket bleeding, angle fracture, etc., which are commonly encountered in dental practice. This article presents a peculiar case of "ear bleed" concomitant with "isolated styloid" fracture following removal of impacted mandibular third molar, not reported in the literature till date. Ear bleed is a bothersome clinical sign that requires thorough investigation and prompt treatment because it is frequently related to fractures of the skull base. Isolated fracture of the styloid process is rare; its diagnosis, impact on adjacent vital structures, and treatment protocol are less discussed in maxillofacial literature. The case report elucidates the etiopathogenesis of ear bleed and styloid fracture which have great clinical implications. The clinical correlation between the two entities and dental extraction is discussed in this report to guide a dental practitioner in its management.

Does Topical Ozone Therapy Improve Patient Comfort After Surgical Removal of Impacted Mandibular Third Molar? A Randomized Controlled Trial.

PURPOSE: To assess the influence of topical ozone administration on patient comfort after third molar surgery. MATERIALS AND METHODS: A single-blinded randomized controlled clinical trial was designed involving patients who required removal of bilateral impacted mandibular third molars. The predictor variable was the postoperative medication used after third molar surgery. Using the split-mouth design, the study group received topical ozone without postoperative systemic antibiotics, whereas the control group did not receive ozone but only systemic antibiotics. The 2 groups were prescribed analgesics for 2 days. The assessing surgeon was blinded to treatment assignment. The primary outcome variables were postoperative mouth opening, pain, and swelling. The secondary outcome variable was the number of analgesic doses required by each group on postoperative days 3 to 5. Data analysis involved descriptive statistics, paired t tests, and 2-way analysis of variance with repeated measures (P < .05). SPSS 20.0 was used for data analysis. RESULTS: The study sample included 33 patients (n = 33 in each group). The study group showed statistically relevant decreases in postoperative pain, swelling, and trismus. Further, the number of analgesics required was smaller than in the control group. No adverse effects of ozone gel were observed in any patient. CONCLUSION: Ozone gel was found to be an effective topical agent that considerably improves patient comfort postoperatively and can be considered a substitute of postoperative systemic antibiotics.