Evaluation of effect of submucosal administration of depomedrol in management of postoperative sequelae in mandibular fractures: A randomized clinical trial study.

Introduction: The mandible is a commonly fractured bone in the face, a fact related to its prominent and exposed position. Open reduction and internal fixation (ORIF) of mandibular fractures has been associated with trauma to the surgical site and the surrounding tissues. Purpose: The purpose of this study is to evaluate the effects of immediate postoperative submucosal depomedrol administration on postoperative pain, edema, and trismus after ORIF for mandibular fractures. Materials and Methods: We conducted a prospective, randomized, controlled, double-blind study of forty patients who required ORIF for mandibular fractures under general anesthesia. The patients were divided into two groups, an experimental group who received immediate postoperative submucosal 40 mg of depomedrol injection through the surgical incision site, and a control group who did not receive any drug. Pain was assessed using a Visual Analog Scale score and the frequency of analgesic consumption at various postoperative intervals. The maximum interincisal distance and facial measurements were compared before surgery and at 24, 48, 72 h, and 7 days after surgery. Results: Statistical analysis of the data indicated a significant decrease in edema, trismus, and pain in the depomedrol group. No clinically apparent infection, disturbance of wound healing, or other corticosteroid-related complications were noted. Conclusion: The results of our study suggest that submucosal administration of depomedrol injection after ORIF for mandibular fractures is effective in reducing postoperative pain, edema, and trismus.

A comparative assessment of maxillary perfusion between two different Le Fort I osteotomy techniques.

Compromised maxillary perfusion following Le Fort I osteotomy is a potentially serious complication resulting in hard and/or soft tissue loss. The aim of this study was to compare the change in perfusion between two techniques of posterior maxillary disjunction by intraoperative measurement of maxillary gingival blood flow (GBF). Further, we sought to correlate the association of the movement of the maxilla and estimated blood loss as factors. The study population comprised 38 individuals, divided equally into two groups: a pterygoid disjunction group and a third molar socket disjunction group. GBF was measured using Doppler flowmetry. A P-value of <0.05 was considered significant. There was a significant drop in GBF in both groups. However, there was no significant difference between the groups based on magnitude of blood flow drop. Superior repositioning of the osteotomized maxilla caused the greatest drop in GBF, which was statistically significant. There was significantly less blood loss in the pterygoid disjunction group. In conclusion, Le Fort I osteotomy causes a significant decrease in GBF. The technique used for posterior maxillary disjunction does not influence the magnitude of drop in perfusion. There is a significant correlation of other factors such as the effect of superior repositioning of the maxilla and blood loss with the osteotomy techniques.

Langerhans cell histiocytosis of the mandible in a six-year-old child.

Histiocytosis is a term applied to a group of rare disorders of the reticuloendothelial system. Eosinophilic granuloma, the most benign and localized of the three Langerhans cell histiocytosis entities, may be solitary or multiple. Eosinophilic granuloma can affect almost any bone, but commonly involves the mandible when the jaws are affected. Conventional treatment of LCH is with surgery, radiotherapy, chemotherapy and steroid injections, alone or in combination. Spontaneous regression of localized disease has also been reported. We report a six and a half-year-old patient with Langerhans cell histiocytosis--solitary eosinophilic granuloma of the mandible that initially regressed but rapidly recurred even after radical treatment and had a fatal outcome.