Cox-2 inhibitors in mandibular third molar surgery.

Pain control during and after any surgical procedure, is extremely essential for the comfort of patients. Pain killers used routinely act by inhibiting cyclooxygenase to control pain and inflammation. Cox-1 is constitutively expressed in most cell types, including platelets, whereas Cox-2 is absent from most healthy tissues but is induced by pro-inflammatory or proliferative stimuli. Cox-1 plays a role in the production of prostaglandins involved in protection of the gastric mucosal layer and thromboxanes (TX) in platelets. Cox-2 generally mediates elevations of prostaglandins associated with inflammation, pain, and pyresis. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen are generally nonselective inhibitors of Coxs. This lack of selectivity has been linked to their propensity to cause gastrointestinal side effects. The new Cox-2 selective inhibitors, or coxibs, show the same anti-inflammatory, analgesic, and antipyretic effects as nonselective NSAIDs but are supposed to have reduced side-effect profiles. This study evaluates whether rofecoxib (50 mg) given one hour pre-operatively or the same drug given one hour post-operatively is more effective in controlling the pain and swelling in mandibular third molar surgery.

Are people aware of oral and maxillofacial surgery in India?

INTRODUCTION: Maxillofacial surgery is one of the most rapidly expanding specialities in India. There is however a very poor understanding of the scope of the speciality. This paper attempts to find out the awareness of the speciality in India. MATERIALS AND METHODS: A questionnaire was given to 50 medical, dental undergraduate students, 50 medical and dental practitioners, and 50 lay persons giving us a total of 250 responses. 10 common anomalies were chosen and they were asked to choose the most appropriate speciality which they would ask to treat the problem. RESULTS: While trauma and facial deformity correction were recognised to be mainly treated by maxillofacial surgeons, the other maxillofacial problems were poorly recognised to be treated by our speciality. CONCLUSION: This study highlights the need to promote our speciality among the dentists, doctors and general public. and if need be even change the name of our speciality from oral and maxillofacial surgery to a more simple but more easily understood facial surgery.

Prophylactic antibiotics in maxillofacial fractures: a requisite?

The role of prophylactic antibiotics to prevent surgical wound infection (SWI) in the management of maxillofacial fractures is controversial. We carried out a retrospective study in 67 patients with 114 maxillofacial fractures, of which 9 patients each were in group 1 (no antibiotic) and group 3 (cefotaxime) and 49 in group 2 (penicillin). We had an overall SWI rate of 16.66%, of which 3 of group 1 (33.33%), 12 of group 2 (24.48%), and 2 of group 3 (22.22%) constituted the SWIs. Statistical analysis showed no significant difference between the infection rates. A strong positive correlation was found between infection rate and the delay in treatment, and a similar correlation was found in the use of catgut and SWI. Our study suggests that prophylactic antibiotic therapy may not alter the incidence of surgical wound infection.