Does the Low-Intensity Laser Protocol Affect Tissue Healing After Third Molar Removal?

PURPOSE: Studies have shown that laser therapy is a recommended therapy for improving the postoperative period in patients undergoing extraction of the third molars; however, there is still no definition regarding the best protocol to be used. The aim of this study was to measure and compare periodontal tissue healing using 2 different laser protocols. MATERIALS AND METHODS: A double-blinded, randomized, prospective study with patients submitted to inferior third molar extraction was performed, with the sample divided into 3 groups according to the laser application protocol and followed for 6 months: group I, 10 J/cm2; group II, 30 J/cm2; and group III, sham. The primary variable was probing depth, and the secondary variables were trismus, facial edema, and pain. RESULTS: The sample was composed of 57 patients: 19 in group I, 20 in group II, and 18 in group III. Analysis of the variables showed statistically significant differences between both groups that received laser therapy, with values of 1.46 for edema control on the third day and 0.54 on the seventh day in group I (P = .017) and 1.26 and 0.52, respectively, in group II (P = .001) compared with 0.59 and 0.49, respectively, in the sham group (P = .702), as well as a statistically significant difference for the 10-J/cm2 laser protocol for probing depth, with values of 7.58 mm preoperatively and 9.09 mm after 6 months (P = .013). CONCLUSIONS: The use of the low-intensity laser as adjuvant therapy after third molar extraction was more effective in the group undergoing the 10-J/cm2 laser protocol for improving periodontal tissue healing and in both laser therapy groups for reducing facial edema.

Arthroscopic discopexy technique with anchors for treatment of temporomandibular joint internal derangement: Clinical and magnetic resonance imaging evaluation.

PURPOSE: The objective of this study was to describe a technique of arthroscopic discopexy with anchors used to treat temporomandibular joint internal derangement. MATERIALS AND METHODS: This study involved patients with unilateral temporomandibular dysfunction refractory to conservative treatment, and whose magnetic resonance imaging (MRI) examinations showed internal derangement of the temporomandibular disc, with anterior disc displacement. Maximal interincisal opening (MIO), joint pain, joint noise, and disc position were the variables assessed by clinical examination and MRI before and 6 months after the surgery. RESULTS: The sample consisted of 20 patients. In the postoperative evaluation, MIO had increased from 33.8 ± 4.83 mm to 35.1 ± 4.08 mm (p = 0.04), while joint pain had decreased from 7.5 ± 1.42 points to 2.05 ± 1.47 points (p = 0.001). With regard to joint noise, 19 of the patients had presented with clicking or crepitation but after 6 months these were completely absent. Disc repositioning was complete in 15 of the patients and partial in the other five. CONCLUSION: The technique of arthroscopic discopexy with anchors was shown to be effective in treating temporomandibular internal derangement, with good clinical results.

Comparison of Three Anxiety Management Protocols for Extraction of Third Molars With the Use of Midazolam, Diazepam, and Nitrous Oxide: A Randomized Clinical Trial.

PURPOSE: The objective of the present study was to compare 3 sedation protocols using diazepam, midazolam, and nitrous oxide. PATIENTS AND METHODS: A total of 120 patients with an indication for extraction of third molars were selected. All 120 patients had had moderate to severe levels of anxiety according to the Corah Dental Anxiety Scale. The patients were randomly divided into 3 groups. The patients' vital signs were measured, and the results analyzed by descriptive statistical analysis and statistical tests of comparison. RESULTS: No statistically significant differences were found in the patients' heart rate. However, the differences in the systolic and diastolic blood pressure were statistically significant after 15 minutes of nitrous oxide sedation. The oximetry data showed no differences among the 3 sedation protocols. We also found no statistically significant differences in the retrograde amnesia test. The differences in anxiety from preoperatively to postoperatively were statistically significant for all techniques, demonstrating their effectiveness in anxiety control. CONCLUSIONS: All 3 preoperative sedation techniques for anxious patients undergoing extraction of third molars used in the present study were effective in controlling the anxiety, with little effect on the patients' vital signs and retrograde amnesia.

TMJ total joint prosthesis for condylar fracture malunion / Prótesis articular total de ATM para malunión de fractura condilar

In the international literatura exist some information related to temporomandibular joint (TMJ) involvement in condylar fracture malunion; the treatment is variated being executed with a bone reconstruction, ramus vertical osteotomy or condilar plate. This case demonstrates that TMJ replacement with prosthetic joint is technically possible and appropriate in the case of malunion of condylar fracture.

La literatura internacional presenta información asociada a la mal unión de fracturas condilares de laarticulación temporo mandibular; el tratamiento es variado siendo ejecutado con reconstrucciones óseas, osteotomía vertical de rama mandibular o instalación de placas con forma condilar. Este caso demuestra que el reemplazo de ATM con prótesis articular es técnicamente posible y apropiado en casos de malunion de fracturas condilares.