Evaluation of the efficacy of salmon calcitonin nasal spray on bone healing following open reduction and internal fixation of mandibular fractures - A randomized controlled trial.

The objective of this study was to assess the efficacy of calcitonin spray on bone healing following open reduction internal fixation (ORIF) of mandibular fractures. Fourteen patients were subdivided into a study group and a control group. A standardized surgical protocol for ORIF was followed. Postoperatively, salmon calcitonin nasal spray was administered to only the study group. The outcome parameters assessed were serum osteocalcin, pain, and radiographic bone healing. Serum osteocalcin was assessed pre- and postoperatively. Postoperative pain was documented using a visual analogue scale (VAS) on the 7th, 14th, 23rd, and 30th days. An orthopantomogram was used to score fracture healing at four time intervals, as follows: 1 - absence of callus; 2 - presence of minimal callus; 3 - considerable callus; and 4 - complete fusion of fracture. Pain scores were lower for the study group, with no pain from the fifth day, while the control group produced a mean score for day 5 of 2.43 ± 0.98 (p = 0.001). Mean postoperative serum osteocalcin levels were higher for the study group (67.82 ± 8.89) compared with the control group (57.69 ± 6.22; p = 0.029). Bone healing at 12 weeks postoperatively was level 4 for 28.6% of patients in the study group and level 3 for 71.4%. In comparison, 85.7% in the control group demonstrated level 3 healing, while 14.3% remained at level 2 (p = 0.462). Within the limitations of the study, it can be concluded that intranasal salmon calcitonin spray reduces postoperative pain and facilitates fracture healing, although its economic efficiency is still to be proven.

The Influence of the Mandibular Gonial Angle on the Incidence of Mandibular Angle Fracture-A Radiomorphometric Study.

PURPOSE: The aim of this radiomorphometric study was to analyze the association between the mandibular gonial angle and the risk of mandibular angle fracture. MATERIALS AND METHODS: A retrospective analysis of medical records and radiographs of patients treated for mandibular fractures was performed. The exposure studied was the presence of a high gonial angle and the outcome was fracture of the mandibular angle. The mandibular gonial angle and mandibular height at the angle were measured using Facad software (Ilexis AB, Linköping, Sweden). Data obtained were analyzed using SPSS 16 (IBM Corp, Armonk, NY). RESULTS: The study sample was comprised of 210 mandibular fractures (70 mandibular angle fractures and 140 non-angle fractures). The mean gonial angle in patients with mandibular angle fractures was 126.8 ± 7.9°, which was 4.5° larger than in patients with other mandibular fractures (P = .0001). Patients with a high gonial angle were 11.77 times more likely to sustain an angle fracture than those with normal or low gonial angles (adjusted odds ratio = 11.77; 95% confidence interval, 3.65-37.94; P < .001). There also was a statistically significant decrease in mandibular height at the angle in patients with a high gonial angle (P = .0001). CONCLUSION: This study shows that people with a high gonial angle are at an increased risk for angle fracture and presents the related clinical implications.

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.