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Third Molar Surgery (third + molar_surgery)
Selected AbstractsChanges in jaw muscle EMG activity and pain after third molar surgeryJOURNAL OF ORAL REHABILITATION, Issue 1 2007M. ERNBERG summary, Limited jaw-opening capacity is frequently encountered following third molar surgery and may impair function. The aim of this study was to investigate the electromyographic (EMG) activity in jaw muscles after third molar surgery to obtain more insight into the mechanisms of restrictions in jaw opening. Twenty subjects were examined before, 24 h and 1 week after surgery. Ten healthy controls were subjected to the same examination at two different occasions for intersession variability. The EMG activity of the masseter and anterior digastricus muscles was recorded at different jaw positions and during maximum voluntary clenching. Pain intensity was assessed at rest and during movements. The EMG activity in the jaw muscles increased with opening level (P < 0·01), but did not change after surgery. In contrast, the EMG activity during clenching was decreased in all muscles after surgery (P < 0·05). The pain intensity after surgery increased with jaw opening level (P < 0·001), but was in general not correlated to EMG level. Pain intensity during clenching was increased after surgery (P < 0·001), but not correlated to EMG level. The EMG activity did not change between visits in the control group. In conclusion, the results indicate that third molar surgery does not influence the EMG activity in the masseter and anterior digastricus muscles during various levels of static jaw opening, but decreases the EMG activity during clenching. However, these changes are not influenced by pain intensity. The results have implications for the understanding of the phenomenon of trismus. [source] A comparison of dexmedetomidine and midazolam for sedation in third molar surgery,ANAESTHESIA, Issue 11 2007C. W. Cheung Summary This randomised, double-blind study compared dexmedetomidine and midazolam for intravenous sedation during third molar surgery under local anaesthesia. Sixty patients received either dexmedetomidine (up to 1 ,g.kg,1) or midazolam (up to 5 mg), which was infused until the Ramsay Sedation Score was four or the maximum dose limit was reached. Intra-operative vital signs, postoperative pain scores and analgesic consumption, amnesia, and satisfaction scores for patients and surgeons, were recorded. Sedation was achieved by median (IQR (range)) doses of 47 ,g (39,52 (25,76)) or 0.88 ,g.kg,1 (0.75,1.0 (0.6,1.0)) dexmedetomidine, and 3.6 mg (3.3,4.4 (1.9,5.0)) or 0.07 mg.kg,1 (0.055,0.085 (0.017,0.12)) midazolam. Heart rate and blood pressure during surgery were lower in dexmedetomidine group. There was no significant difference in satisfaction or pain scores. Midazolam was associated with greater amnesia. Dexmedetomidine produces comparable sedation to midazolam. [source] Repair of the trigeminal nerve: a reviewAUSTRALIAN DENTAL JOURNAL, Issue 2 2010RHB Jones Abstract Nerve surgery in the maxillofacial region is confined to the trigeminal and facial nerves and their branches. The trigeminal nerve can be damaged as a result of trauma, local anaesthesia, tumour removal and implant placement but the most common cause relates to the removal of teeth, particularly the inferior alveolar and lingual nerves following third molar surgery. The timing of nerve repair is controversial but it is generally accepted that primary repair at the time of injury is the best time to repair the nerve but it is often a closed injury and the operator does not know the nerve is injured until after the operation. Early secondary repair at about three months after injury is the most accepted time frame for repair. However, it is also thought that a reasonable result can be obtained at a later time. It is also generally accepted that the best results will be obtained with a direct anastamosis of the two ends of the nerve to be repaired. However, if there is a gap between the two ends, a nerve graft will be required to bridge the gap as the two ends of the nerve will not be approximated without tension and a passive repair is important for the regenerating axons to grow down the appropriate perineural tubes. Various materials have been used for grafting and include autologous grafts, such as the sural and greater auricular nerves, vein grafts, which act as a conduit for the axons to grow down, and allografts such as Neurotube, which is made of polyglycolic acid (PGA) and will resorb over a period of time. [source] Pre-emptive ibuprofen arginate in third molar surgery: a double-blind randomized controlled crossover clinical trialAUSTRALIAN DENTAL JOURNAL, Issue 4 2009SL Lau Abstract Background:, This study evaluated the effectiveness of 400 mg ibuprofen arginate either as a pre-emptive (PRE group) or postoperative (POST group) analgesic using a common dental pain model. Methods:, A randomized double-blind crossover clinical trial involving a series of consecutive patients admitted for bilateral third molar surgery. Results were analysed according to the self-reported pain score and the pattern of rescue medication taken. Results:, The mean pain score ranged from 0.73 to 1.60 for the PRE group and 0.47 to 1.41 for the POST group among 30 included subjects. The mean time point when first rescue medication taken was 7.3 hours and 8.3 hours postoperative, respectively. Nine patients (30 per cent) in the PRE group and 12 patients (40 per cent) in the POST group took no rescue medication. There was no statistically significant difference for all parameters between groups, while a majority (53 per cent) found the drug "good" to "excellent" in both groups. Conclusions:, Ibuprofen arginate may be considered effective in reducing surgically induced moderate to severe pain when administered either pre-operatively or postoperatively due to the reported relatively low pain score, less consumption of rescue medication, delayed onset of pain, good number of pain-free patients and a high rating in the global assessment score. [source] | ||||||||||