Evaluation of dexamethasone for reduction of postsurgical sequelae of third molar removal.

Sixty patients with bilaterally symmetrical impacted third molars participated in this double-blind, within-subject study to quantify the effects of 4 mg of dexamethasone on reducing postsurgical sequelae. Each patient's surgery was staged by mouth side and completed in two appointments 5 to 6 weeks apart. A preoperative dose of dexamethasone given intravenously was randomized to mouth side and surgical appointment; sterile water served as a control. Major areas assessed in this study were facial swelling, pain, and trismus. No difference in swelling and daily pain was noted. However, trismus and global pain were significantly affected by the steroid. Patients had a daily postsurgical increase in incisal opening of 4 to 6 mm over the control side during the examination period. Patients evaluated pain by choosing the least painful side. By a greater than 4:1 margin, patients chose the steroid side as the least painful side. No increase in the rate or type of complications was detected between control and steroid sides.

Retrospective analysis of low-velocity gunshot wounds to the mandible.

A retrospective study was conducted of 32 patients with mandibular fractures resulting from low-velocity gunshot injuries. Airway management was required in 25% of the patients, and 9% sustained major vessel injury. Patients were divided into two groups, depending on site of mandibular fracture: condyle, ramus, and coronoid (n = 10), and angle, body, and symphysis (n = 22). All patients in the condyle, ramus, coronoid group achieved clinical union without infection. Average postinjury maximal mandibular opening was restricted (28 mm), but the average follow-up period was relatively short (2 months). In the angle, body, symphysis group the infection rate was 27%, and in 18% of patients a continuity defect of the mandible developed. The average length of follow-up in this group was 5.4 months with a mean maximal mandibular opening of 36 mm.

Regional odontodysplasia presenting as a soft tissue swelling.

An unusual case of regional odontodysplasia in a 13-year-old black girl is presented. Although the affected teeth displayed features characteristic of odontodysplasia, the patient appeared with significant soft tissue swelling of the buccal and palatal maxilla. Treatment consisted of extraction of affected teeth, removal of involved tissue, and histologic examination.