Pharmacological and Non-Pharmacological Methods of Postoperative Pain Control Following Oral and Maxillofacial Surgery: A Systematic Review.

Background: We aimed to investigate the pharmacological and non-pharmacological interventions used for mitigating pain. Methods: We integrated randomized controlled trials (RCTs) chosen from PubMed, Google scholar, and Scopus and aimed at assessing the effectiveness of one or multiple variants of Non-steroidal anti-inflammatory drugs (NSAIDs), as well as Narcotic analgesics, compared to corticosteroids, curcumin, hyaluronic acid, and antibiotics. In addition, trials utilizing NSAIDs, including Rofecoxib, which have been withdrawn from market circulation, were deemed ineligible for inclusion. Result: A total of 9 RCTs were evaluated in this study, and the patients' postoperative pain was assessed using the visual analog scale (VAS) and the time measurement. Moreover, there were various approaches to alleviating pain and discomfort. Conclusion: The administration of ibuprofen prior to surgery leads to a marked reduction in pain. Pharmacological interventions, such as the administration of dexamethasone and oxycodone, alongside non-pharmacological interventions, such as laser therapy, have been shown to effectively alleviate the discomfort resulting from surgical procedures on the jaw and face.

Bimaxillary Orthognathic Surgery Does Not Induce Obstructive Sleep Apnea in Skeletal Class III Patients.

PURPOSE: Since the relationship between mandibular setback surgery and obstructive sleep apnea (OSA) occurrence still remains controversial, the aim of this study was to assess the impact of bimaxillary orthognathic surgery on the probability of OSA development, using a home sleep test (HST) device. METHODS: The authors implemented a double-blinded prospective cohort study. All healthy patients with skeletal class III deformity were included in this study. Subjects were candidates for bimaxillary orthognathic surgery. OSA monitoring was performed by the pulmonologist, week 1 preoperatively (T0), 1 and 6 months postoperatively (T1, T2), with a specific brand of a HST device. The predictor variables were the amount of mandibular setback and maxillary advancement, separately. Changes in apnea-hypopnea index (AHI) and SpO2 1 and 6 months after surgery relative to T0 were the outcome variables. OSA severity was measured using AHI, and classified as mild (530). Age, sex, and body mass index were the study covariates. The outcome assessor (pulmonologist), and the data analyzer were blind in this study. The significance level was set at 0.05, using the SPSS19. RESULTS: The sample was composed of 30 patients, (15 females, 15 males) with an average age of 25.73 ± 5.26 years and a mean body mass index of 19.90 ± 3.6 kg/m2. The mean amount of mandibular setback was 4.5 ± 1.1 (ranged from 2-7 mm), while the average maxillary advancement was 2.9 ± 1.2 mm (ranged 1-5 mm). Mean AHI at T0, T1, and T2 was 1.8 ± 1.0, 3.4 ± 1.5, and 1.9 ± 0.9 events per hour events, respectively. The AHI scores increased from T0 to T1 but again decreased until T2, which were statistically significant (P < .001). The mean amount of SpO2 at T0, T1, and T2 was 96.7 ± 0.9, 94.0 ± 1.3, 96.7 ± 0.7%, respectively. Postoperative AHI in T1 and T2 had direct statistical significant relationships with the amount of mandibular setback (Rsp = .404, .574, respectively and P < .05). Postoperative AHI scores were lower in patients with <5 mm mandibular setback in comparison to subjects who underwent ≥5 mm setback (P < .05). CONCLUSIONS: Bimaxillary orthognathic surgery (concomitant maxillary advancement and mandibular setback) did not increase the incidence of OSA in young healthy non-obese class III patients, in the case of mandibular setback up to 7 mm.

The prevalence of Epstein-Barr virus infection in head and neck non-Hodgkin's lymphomas in Khorasan, northeast of Iran.

OBJECTIVES: To investigate the frequency and possible role of Epstein-Barr virus infection in non-Hodgkin's lymphomas of the oral cavity and maxillofacial region in Khorasan (Northeast of Iran). METHODS: The cross-sectional retrospective study assessed the frequency of Epstein-Barr virus infection in non-immunosuppressed non-Hodgkin's lymphoma cases of the oral cavity and maxillofacial region. Formalin-fixed, paraffin-embedded tissue sections from 34 cases of head and neck non-Hodgkin's lymphoma (17 low-grade B-cell lymphoma, 14 diffuse large B-cell lymphoma, and 3 peripheral T cell lymphoma) were selected as a case group, and 10 normal lymph node sections were considered as a control group. Polymerase chain reaction was used to detect the EBV-DNA in tissue specimens. SPSS 16 was used for statistical analysis of the data. RESULTS: EBV-DNA was detected in 26.5% of NHL samples. Among NHLs, Epstein-Barr virus was found to be positive in 50% cases with diffuse large B-cell lymphoma and 11.8% of low grade B-cell lymphomas. Epstein-Barr virus was not detected in any cases of peripheral T-cell lymphoma. CONCLUSION: Although it seems that Epstein-Barr virus appears to be an etiological factor in some subtypes of non-Hodgkin's lymphomas, especially in diffuse large B-cell lymphoma, more researches should be done to investigate the relationship between Epstein-Barr virus infection and head and neck non-Hodgkin's lymphomas.