Third molar extraction is one of the most commonly performed minor surgical procedure in any dental practice worldwide, often accompanied by various postoperative sequelae such as swelling pain and trismus which intern affects the quality of life of a patient. Over the past few decades, different methods have been proposed in the literature and were clinically evaluated to reduce the postoperative discomfort after mandibular third molar impaction and out of which corticosteroids, have shown promising results. Dexamethasone (administered either orally, submucosally, IV or IM), methylprednisolone acetate and methylprednisolone sodium succinate (IV or IM or submucosal) are most commonly preferred corticosteroids in oral and maxillofacial surgery. The main objective is to systematically review the comparison of the effectiveness of submucosal administration of dexamethasone with methylprednisolone following mandibular third molar impaction in reducing the postoperative sequelae, and its discomfort and searches were performed in the PubMed, Medline, Scopus, and Cochrane Library databases. Two articles were most relevant, and the results of the comparison of the selected articles were analysed. From this deliberate audit, it is very well may be inferred that submucosal injection of dexamethasone plays a promising role in reducing the postoperative sequelae which includes swelling, pain and trismus and its discomfort following mandibular third molar impaction when compared with that of methylprednisolone.
Mandibular third molar surgery is one of the most common minor oral surgical procedures performed by oral and maxillofacial surgeons. It is vital to provide the most comfortable postoperative phase to the patient and for this reason dexamethasone, a corticosteroid, is popularly used in various routes. The intraspace injection of dexamethasone mixed with 2% lignocaine and 4% articaine named, Twin Mix and Modified Twin Mix respectively is gaining increasing popularity. 0.5% Centbucridine is a safe alternative to 2% lignocaine with more cardio stable properties. In this study we aimed to evaluate the comparability of Twin Mix(TM) and Revamped Twin Mix(RTM) (mixture of dexamethasone and centbucridine) with respect to its anesthetic properties and its effectiveness in managing postoperative sequelae following mandibular third molar surgery. For this, a randomised controlled double blinded study was conducted among patients reporting to the Out Patient Department of a dental college. The sample size of the population studied was 32, 16 in Group A (RTM) and 16 in Group B (TM). The primary outcomes measured were facial swelling and mouth opening on postoperative day(POD) 1, 3 and 7. The secondary outcomes were VAS score during the surgical procedure, duration and latency of anesthesia. The data were analysed descriptively and using Student’s t Test. Representations were given in graphical and tabular forms. The mean postoperative mouth opening and facial swelling on POD 1, 3 and 7 were comparable and did not show any statistically significant difference. Similarly, the VAS score during procedure, latency and duration of anesthesia were comparable with no statistically significant difference. In conclusion, RTM can be used as an alternative to TM due to its comparable properties.
Rhinoplasty is one frequent surgical procedure of many technical variations that only a few surgeons are considered to have mastered its broad scope. Operative site bleeding is considered to be an exasperating issue in the surgical procedure of rhinoplasty. Over the past few decades, the strategy of lowering patient's blood pressure during anaesthesia or "Hypotensive anaesthesia" has been practised to reduce the blood loss during surgeries. Clonidine is an antihypertensive drug and is suggested to have advantageous effects in controlling the intraoperative blood loss. The objective of this systematic review was to explore and study the existing literature and determine the efficacy of oral clonidine as a premedication in reducing the intraoperative blood loss in rhinoplasty surgeries. Data was gathered from electronic databases like PubMed, Medline and Cochrane central library. An additional manual search was performed with various journals to look for available articles to include in the systematic review. Only those studies which met the criteria for inclusion were selected. All studies and reports that evaluated oral clonidine with placebo in reducing bleeding during rhinoplasty surgery were included. Pertinent literature abstracts and full-text articles pertaining to the query were analysed. Two articles in total were taken in for qualitative analysis, both of which were randomised clinical trials. Oral clonidine shows significantly more efficient in reducing intraoperative bleeding than the placebo group. Premedication with oral clonidine is significantly effective in controlling blood loss during the surgical procedure of rhinoplasty.
The surgical removal of third molar is the commonly performed procedure in oral and surgery. It takes several days to recover from the complications following removal of the third molar. The common postoperative complications are pain, swelling, , alveolar after third molar removal The aim of this systematic review was to thoroughly the existing literature to evaluate the effect of socket versus extra socket application of acid gel in management of postoperative complications after third molar removal. The objective of this systematic review is to assess the efficacy of socket versus extra socket application of acid gel compared to placebo or no treatment in management of post-operative complications after removal of third molar.The data bases of PubMed, and google scholar were searched for the related topics along with a complimentary manual search of all oral surgery journals till October 2018.The data collection form was based on analysis of included studies for their quality assessment and publication bias.The primary outcome measure was post-operative pain and the secondary outcome measures were post-operative swelling & post-operative mouth opening. Three articles were selected based on the inclusion criteria. The included studies were randomized controlled trials. The clinical evidence from this review shows acid gel application is found to be beneficial in reducing pain, swelling & after surgical removal of third molar. After contemplating its pivotal role in various anti- inflammatory diseases, it is prudent to consider as an alternative in managing postoperative of third molar removal.
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