Purpose: This study aimed to compare patient satisfaction numerically, pain and non-assisted maximal mouth opening after the use of indirect anterior repositioning splint using a protrusive record versus direct anterior repositioning splint in management of anterior disc displacement with reduction of the temporomandibular joint. Materials and methods:Twenty patients suffering disc displacement with reduction were included in the study. Each patient is asked to use the selected splint for 6 hours daily. Patient satisfaction with splint fabrication was measured by visual analog scale, pain was also measured by visual analog scale and non-assisted maximal mouth opening in mm using a caliper. Study intervals were pre-treatment, 1 and 6 months post-treatment.Results: Patient satisfaction with splint fabrication was better for group I 7.7± 0.95 compared to group II 3.3 ± 1.49 and there was statistically significant difference between the 2 groups (p value <0.001). There was no statistically significant difference between the 2 groups in pain neither through all study intervals nor in pain change between study intervals. Also, there was no statistically significant difference between the 2 groups in maximal mouth opening in mm neither through all study intervals nor in the change between study intervals.Conclusions: Fabrication of indirect anterior repositioning splint using a protrusive record is a more acceptable procedure to patients suffering disc displacement with reduction in comparison to direct anterior repositioning splint. Pain and maximal mouth opening are not significantly different when using either indirect or direct splint.
Objective: This study aimed to compare the vestibular approach versus trans-conjunctival approach in the open reduction and internal fixation of infraorbital rim fracture.Patients and Methods: This randomized controlled trial was conducted on twenty-two patients with infraorbital rim fracture associated with or without other facial fractures excluding orbital floor that require open reduction and internal fixation. Patients were randomly divided into two equal groups; trans-conjunctival group and intraoral vestibular group. The intraoperative fracture exposure time was recorded in both groups and conducted for statistical analysis. The patients were recalled for clinical assessment of post operative pain, edema, infraorbital nerve (ION) function and eye lid integrity. Results:The outcome of the studied patients showed that the intraoral vestibular group has significantly shorter exposure time but higher post operative edema that totally resolved by the second week post operatively and transient ION affection in 18.1 % of post trauma free cases while the postoperative orbital movement and eye lid integrity in the intraoral vestibular group was superior than the trans-conjunctival group. Conclusion:Intraoral vestibular approach shortens the intraoperative time and provide ideal protection of eye ball function and eyelid integrity more than the trans-conjunctival group, but it required proper relaxing dissection of the ION and careful adequate retraction for better accessibility.
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