The corticosteroids have been used for preemptive management of surgical sequelae after mandibular third molar extraction. The aim of this article was to review the efficacy of methylprednisolone versus dexamethasone in the management of postsurgical pain, swelling, and trismus after mandibular third molar surgery. Randomized, double-blinded studies from PubMed, CINAHL, Scopus, DOSS, Cochrane central, and Web of Science were identified by using a search strategy. Randomized controlled trials evaluating the efficacy of use of dexamethasone versus methylprednisolone for mandibular third molar extraction were only considered. The studies involving the use of any other corticosteroid agent were excluded. Outcomes assessed were postoperative pain, the number of rescue analgesics required, swelling, trismus, and adverse events. The search strategy yielded 1046 articles for title and abstract screening, out of which only seven studies were included in the systematic review after full text screening. There was considerable heterogeneity between the studies with regards to the method as well as the parameters assessed. Risk of bias was low in three studies and unclear in other four studies. On pooled analyses, there was no significant difference with respect to pain, rescue analgesics, and swelling in the test and the control group. Forest plot analysis showed that dexamethasone had lesser trismus in early postoperative period (postoperative day 2) as compared to methylprednisolone. None of the included studies reported any adverse effects. Both the corticosteroids have similar efficacy in reducing the postoperative pain and swelling; however, dexamethasone showed statistically significant difference from methylprednisolone in reducing trismus (estimated standardized mean difference of −0.69 mm; 95% CI: −1.01 to −0.38; p < 0.0001 ) in the early postoperative period. However, due to statistical heterogeneity, quality of the evidence for the review was low to moderate. Hence, more studies with larger study sample and low risk of bias are needed to confirm these results.
Dislocation of mandibular condyles can occur following excessive mouth opening or traumatic injury to the temporomandibular joint. It can also occur during general anesthesia that at times may go un-noticed in the modern-day theater setup. Here, we describe a case of bilateral dislocation of mandibular condyle following orotracheal intubation for general anesthesia. Right condyle was dislocated into temporal fossa.
Objective Oro-antral communication (OAC) is one of the most frequently encountered complications during third molar extraction. Various radiographic factors, like excessive maxillary sinus pneumatization, long periods of edentulism, periapical lesions, etc., have been considered high-risk factors for OAC. However, a panoramic radiograph has not proven to be accurate in predicting the chances of OAC. Through this retrospective study, we evaluated the efficacy of a CBCT in predicting the incidence of OAC after maxillary third molar extraction. Materials and Methods We conducted a retrospective study in our department, which included the patients who had undergone extraction of a maxillary third molar over five years with the presence of panoramic X-rays and/or CBCT scans prior to extraction. Primary outcomes assessed from the case files were intra-operative complications like OAC, root fracture, tuberosity fracture, pterygoid plate fracture, etc. The incidence of these complications was correlated with the presence or absence of CBCT before extraction. Results Out of 920 extracted maxillary third molar, only 148 teeth (16.1%) had a CBCT record before extraction. The most commonly encountered complication was broken inaccessible root piece/s (4.9%), followed by OAC (3.5%). An inter-group comparison showed that a significantly higher percentage of patients (p < 0.001) with CBCT records had an incidence of OAC (11.5%) as against the group of patients with no CBCT record (1.9%). Conclusion A CBCT scan prior to cases with high-risk factors for OAC can be a valuable tool in accurately predicting the chances of OAC after maxillary third molar extraction.
Presurgical infant orthopaedics (PSIO) appliances are used in the management of cleft lip and palate. Frequently, among all PSIO appliances utilized is presurgical nasoalveolar molding (NAM) appliance. In this review, we looked for the application of the NAM appliance, its efficacy, and biomechanics. A comprehensive search strategy was performed in two databases (Google Scholar and PubMed) for articles using NAM in the treatment plan of patients with cleft lip and palate. Six articles were included in this study with one randomized control trial, two retrospective, and three case reports studies. The studies reveal the NAM is efficient as a presurgical modality treatment for complete cleft lip and palate with multiple benefits, including reducing surgical scars and alveolar gap, used as feeding plate, improve nasal contour, and decreased the number of rectifying surgical procedure.
Flavonoids are a large group of naturally occurring polyphenolic compounds that are almost universally present in various plant parts such as fruits, berries, leaves, and tubers. These compounds are synthesized in plants in reaction to environmental stressors such as microbial infections. The antioxidant properties in these flavonoids provide us with numerous health benefits. They can be extracted from said natural sources via methods such as maceration and boiling all the way to advanced methods such as microwaves and ultrasounds.Numerous studies have been conducted to research the protective role that flavonoids can play in preventing infectious diseases in humans. The present modalities of treating such infectious diseases rely solely on chemotherapeutic agents and adjunctive therapies such as palliative and supportive care. These chemotherapeutic agents, primarily antibiotics, cause a degeneration of our immunity and an increased susceptibly to several other diseases. Thus, it is crucial that our methods in dealing with infections focus on prevention. This can be achieved by strengthening our immune system, which is the primary line of defense against such diseases. Flavonoids can help boost our immunity, fight infections, and decrease the incidence of antibiotic resistance.Hence, these natural compounds are being largely studied and used as nutraceuticals to supplement our daily diet and successfully reduce the occurrence of major infectious diseases in our body.
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