Evaluation of the Effects of Exogenous Melatonin in Zygomatic Complex Fractures.

Objective: The objective of this research was to evaluate the benefits of using exogenous melatonin in the preoperative period of patients with zygomatic complex fractures. Materials and methods: A randomized, triple-blind clinical trial of independent samples was carried out. The sample was divided into two groups: G1 (melatonin) and G2 (placebo). Interventions were standardized with 10 mg melatonin or placebo the night before surgery and 1 h before the start of surgery. The studied variables were level of salivary cortisol, level of anxiety, pain, and use of rescue analgesics. Descriptive and inferential statistical analysis was performed, with a margin of error considered as 5%. Results: A total of 14 patients were included, and after using the medication, the measurement of cortisol was reduced in the melatonin group (0.48 ± 0.25 to 0.43 ± 0.13 µg/100 ml) and increased in the placebo group (0.19 ± 0.12 to 0.23 ± 0.18 µg/100 ml). There was a reduction in the level of anxiety in the melatonin group and an increase in the placebo group. After two hours of surgery, the pain was statistically less in the melatonin group (4.50 ± 1.38) compared to the placebo group (6.17 ± 0.98). Six hours after surgery, pain showed regression in both groups. Patients in the placebo group (83.3%) used more rescue analgesics than melatonin group (33.3%) in the postoperative period. Conclusions: Thus, this research demonstrated that melatonin can be effective in reducing salivary cortisol and anxiety after medication, and patients in the melatonin group needed less rescue analgesics in the postoperative period.

Effect of surgical repair of the joint capsule in mandibular condyle fractures in adult rats.

PURPOSE: The aim of the present study was to assess histologic changes in the temporomandibular joint (TMJ) of adult rats subjected to unilateral fracture of the mandibular condyle and soft tissue injury. MATERIALS AND METHODS: The animals were divided into 2 groups: one had surgical treatment for soft tissue repair and the other had no soft tissue treatment. All histologic evaluations were performed according to the presence or absence of synovitis, vascularity, presence or absence of joint inflammation, and presence or absence of the articular disc. The contralateral TMJs also were evaluated. RESULTS: The results showed few histologic changes in the synovial membrane and joint disc for the 2 groups and in the synovial membrane and disc of the contralateral side, where indirect trauma occurred in the unoperated joint. CONCLUSION: This study showed that treating or not treating soft tissues does not change the treatment results of condyle fracture or interfere with TMJ pathosis.

Fracture of the atrophic mandible: case series and critical review.

PURPOSE: Atrophic mandible fracture is common among elderly patients. Such fractures present management difficulties related to anatomic and physiologic alterations in this population. The purpose of this study was to evaluate the results of this type of fracture treatment and to realize a critical review of literature on the subject. PATIENTS AND METHODS: The sample was obtained from records of patients of Restauração Hospital (Recife, Brazil) who underwent surgical treatment of atrophic mandible fracture between 2006 and 2009. Data, such as etiology, location, and degree of displacement of the fractures, as well as access, type of fixation used, and the presence of postoperative complications, were analyzed. RESULTS: Successful bone union was achieved in 100% of cases. Complications were related to those patients treated with reconstruction plates (2.4 mm). CONCLUSIONS: Open reduction and internal fixation with miniplates seem a feasible option for primary treatment of atrophic mandible fractures without comminution or loss of substance. The level of scientific evidence for the treatment of atrophic mandible fractures is low.