Prevention of trismus with different pharmacological therapies after surgical extraction of impacted mandibular third molar.

Aim To assess prevention and reduction of trismus after surgically extracted impacted mandibular third molars with individual and combined therapy with corticosteroids and anti-inflammatory analgesics. Methods The research included 60 randomly selected patients (3 groups) attended to the Dental Oral Surgery of the Public Institution Healthcare Center Zenica during the period January-December 2008. Patients of both genders, 18-45 years of age, were presented without pain and other inflammatory symptoms at the time of surgery. According to a scheme established in the research protocol, two medications were administered orally: methylprednisolone(corticosteroid) 32 mg and meloxicam (non-steroidal anti-inflammatory analgesic, NSAID) 15 mg as a single drug, or a combination of both drugs. The level of trismus is assessed on the basis of differences of preoperative and postoperative values of interincisal spaces when fully opening the mouth on the second and the seventh post-operative day. The differences between groups of patients were evaluated by means of Tukey's HSD test. Results On the second and on the seventh post-operative day significantly better results were registered in the group that received only corticosteroids and in the group that received both, corticosteroids and NSAIDs compared to the group that received only NSAIDs. A tendency of trismus reduction was present in all patient groups for the second and seventh day after surgery. Conclusion Prevention and control of postoperative trismus after surgical extraction of impacted mandibular third molars with combined therapy is effective and superior comparing to individual therapy with meloxicam-or methylprednisolone alone.

Pain relieve after impacted wisdom teeth extraction dependent on the drug therapy.

Purpose of this study was to compare the effects of combined therapy using nonsteroid anti-inflammatory analgetics and corticosteroids, and the effects of the mono-therapy with same drugs for post-operative pain after surgical removal of the impacted mandibular third molar. The study was completed at the Department of Oral Surgery and at the Department of Dental Medicine of the Public Institute Health Center Zenica in Zenica. The research included 60 patients divided into 3 groups using random selection, including both sexes. Age range was between 18 and 45 years. All participants came without any pain or other inflammatory symptoms at the time of oral surgical intervention. Two medicaments were prescribed after the impacted tooth removal: 15 mg of nonsteroid anti-inflammatory analgesic drug (Meloxicam, Bosnalijek, BiH) and 32 mg Methylprednisolone (corticosteroid, Bosnalijek, BiH). Both medicaments were applied per os, according to schedule determined by the research protocol. The level of post-surgical pain was evaluated by the 1-10 visual analog scale (VAS). One way ANOVA was made with Tuckey post-hoc tests. Statistically significant difference (p < 0.05) was found between the group treated with mono therapy and the group treated with combined therapy. Application of monotherapy using only corticosteroids or only nonsteroid anti-inflammatory pain-killers was less effective compared to the combined therapy with both medicaments after surgical removal of the impacted mandibular third molar.

[Changes in the structure and clinical significance of the positive results of pretransfusion testing during the switching from tube test agglutination to gel microcolumn technique]. / Promjene u strukturi i klinickom znacenju pozitivnih rezultata pretransfuzijskog testiranja kod prijelaza s klasicne metode aglutinacije u epruveti na metodu u gel mikrostupcu.

AIM: To investigate the changes in pretransfusion testing during the switch from the agglutination tube test to the gel test. METHODS: Clinical significance of positive results has been analyzed in 7667 pretransfusion tests (with 16610 cross-matches) performed by the tube test in 2005-2006, and in 7372 pretransfusion tests (with 17294 cross-matches) performed in 2007-2008 by the gel test. RESULTS: In both analyzed periods antibody detection was positive in 1.3% and cross-matching in 0.3% cases. At least one test was positive in 1.4% pretransfusions tested by the tube test and in 1.3% by the gel test, with >75% positive results in women. Analyzing cases with positive cross-matching but negative antibody detection, eight of ten such cases found by the tube test were caused by 'cold antibodies' whereas 'warm non-specific antibodies' caused all three cases found by the gel test. The gel test detected higher proportion of immune antibodies than the tube test (69.8% vs 41.3%, p < 0.001), with a double increase in anti-K and Rh antibodies. The tube test detected 24 cases of clinically non-significant antibodies, as compared with no cases found by the gel test (p < 0,001). 'Non-specific antibodies' more often caused positive cross-matches than antibody detection (42.6% vs. 29.9% by the tube test, 28.9% vs. 18.3% by the gel test). Despite of being close in the detection of irregular antibodies (p=0.062), the difference between the tube and gel test was not significant. 'Non-specific antibodies' were found by both tests more often in women, while clinical departments were of no significance. CONCLUSIONS: The gel test has proved to be a more optimal technique of pretransfusion testing. The detection of irregular antibodies is recommended as an obligatory part of pretransfusion testing.