Venous complications of intravenous diazepam

In an attempt to clarity the confusion about venous complications from intravenous diazepam, a study of 2,468 consecutive oral surgery and general dentistry cases in which diazepam was used was undertaken. It was found that 7.9% of the patients experienced local phlebitis and 4.5%, thrombophlebitis during the week after the injection. These findings were correlated with age, weight, sexual gender, dosage, type and duration of procedure, and degree of apprehension experienced by the patient.     

Amnesia,pain experience,and patient satisfaction after sedation with intravenous diazepam

Recovery time, the effect of sedation or amnesia on postoperative pain, and patients' opinions of the sedation were studied. Forty operations were performed on 20 patients. Each patient had four impacted third molars removed in two sessions, one in which a new emulsion form of diazepam (Diazemuls^®) was used, and one in which no sedation was used. The recovery from sedation was found to be very individual and not related to the dose administered, as assessed by a simple, easy-to-use method. There was no difference in postoperative pain between the sedated and unsedated groups, and we found no correlation between postoperative pain and amnesia. Eighty-five per cent of the patients preferred sedation during surgery, even though none of them had a preoperative indication for sedation.     

Comparison of sedation,amnesia, and patient comfort produced by intravenous and rectal diazepam

In a cross-over study, intravenous diazepam was compared with rectal diazepam for sedation in outpatient oral surgery. Fifty-four operations were performed on 27 patients. Recovery from sedation, experience during the postoperative course, amnesia, estimation of the sedative effect, and patient preference of method of sedation were studied. The recovery times of the sedation methods did not differ. Sedative effects after the first operation were estimated as good by 87% of patients given intravenous sedation and by 75% of those given rectal sedation. However, there was a significant relationship between the subjective experience of stronger sedative effect and preference of sedation method that favored the intravenous technique. The degree of amnesia was significantly higher during intravenous sedation, but a high degree of amnesia was not related to patients' preference for a sedation method. Neither sedation method produced any local side effects.     

An evaluation of the amnesic effects of diazepam sedation

Twenty subjects, 13 female and 7 male, aged 16 to 37 years, were studied to determine the effects on memory of intravenous sedation with diazepam (Valium). Three tests were performed: 1) the Weschler Logical Memory Scale; 2) memory of three geometric shapes; and 3) memory of three objects presented in a drawing. Logical memory items were presented before and after sedation; other tests were presented after sedation. Anterograde amnesia was produced by diazepam sedation. No retrograde amnesia was observed. A significant drug effect was found between the pre-drug and post-drug retention intervals (T+ = 2; P less than 0.005). Post-drug recognition scores were found to be approximately 42% of pre-drug recognition scores. The anterograde amnesia produced with diazepam was probably due to decreased arousal of the subject, and decreased attention to rehearsal of short-term memory stimuli, resulting in a lack of storage of the stimuli.     

Cortex-to-cortex healing after mandibular osteotomy

Cortex-to-cortex healing is frequently attempted following orthognathic surgical procedures. This paper reports the results of in vivo experiments to investigate the healing process when two cortical surfaces are conjoined and discusses the implications in relation to the surgical correction of mandibular prognathism.     

Complications after mandibular sagittal split osteotomy

Sagittal split osteotomy has been performed routinely for correction of mandibular prognathism, retrognathia, mild open bite, and asymmetry. Intraoperative and early or late postoperative complications were evaluated in 258 patients operated on by this technique. With meticulous performance of the operation and long-term maxillomandibular fixation, complications can be negligible, and relapse, the most problematic postoperative issue, can be significantly reduced.     

Wound healing after anterior and posterior subapical osteotomy

Changes in the process of wound healing and in the dental pulp were examined following anterior and posterior mandibular subapical osteotomies in pig-tailed macaque monkeys. Results of microangiographic and histologic investigations indicated that degenerative pulpal changes may occur following mobilization and repositioning of small dentoalveolar segments. The potential significance of such degenerative pulpal changes and the need for routine dental radiographic checkups following anterior and posterior mandibular dentoalveolar surgery are discussed.     

Management of bilateral fractures three weeks after mandibular skin graft vestibuloplasty

Management of bilateral fractures of the atrophic mandible is a difficult problem. A recent skin graft vestibuloplasty with lowering of the floor of the mouth compromises the blood supply to the fractured segments and jeopardizes the changes for bony union. The viability of the skin graft and the stability of the vestibular extension are also at risk. The successful management of such a case is presented and discussed.     

Comparison of silastic and proplast implants in the temporomandibular joint after condylectomy for osteoarthritis

This study was undertaken to compare the long-term stability of Silastic and Proplast when used as alloplastic implants following high condylectomy. Twelve patients with osteoarthritis of the temporomandibular joint (TMJ) were treated either unilaterally or bilaterally. The follow-up period ranged from one to four years. In all ten TMJs that received Silastic implants and in ten that received Proplast implants, there were no discernible differences relative to comfort, masticatory function, or TMJ mobility. Although Silastic and Proplast had similar functional characteristics, Proplast implants had better long-term stability than the Silastic implants.     

Prolonged bilateral mandibular dislocation

A brief review of the pathogenesis and treatment of chronic or prolonged dislocations and a case of bilateral mandibular dislocation of 13 months duration have been presented. The reduction was accomplished via bilateral eminectomy, lateral pterygoid myotomy, condylectomy, and placement of Silastic blocks to maintain ramus height. The structural changes that occurred in the condyles and articular eminences were demonstrated by tomography.     

Prilocaine-induced methemoglobinemia in a child with Shwachman syndrome

A case of methemoglobinemia after injection of prilocaine in a patient who had Shwachman syndrome (Shwachman-Diamond syndrome) is presented. The report reinforces the need to be cognizant of dose/weight/mass relationships in patients receiving medications capable of oxidizing hemoglobin.     

A prospective study of complications related to mandibular third molar surgery

A prospective study that evaluated the surgical and postsurgical problems of 9,574 patients of a wide range of ages who had had 16,127 third molars removed was performed. It was concluded that removal of mandibular third molar teeth during the teenage years resulted in decreased operative and postoperative morbidity.     

Diagnosis and treatment of lateral pharyngeal space infections

The lateral pharyngeal space is composed of an anterior and posterior compartment. Infection may involve both compartments; however, each compartment may be involved individually with distinctly different clinical findings. This article reviews infections of the lateral pharyngeal space and their treatment.     

Solitary neurofibroma of the maxilla

A case of a large central neurofibroma of the left posterior maxilla is presented. This lesion was treated by a left radical maxillectomy because of the extensive nature of the tumor. The surgical defect was reconstructed with a latissimus dorsi myocutaneous flap. The incidence and clinical features of intraosseous benign nerve sheath tumors are discussed.     

Surgical treatment of pleomorphic adenoma of the parotid gland: report of 110 cases

One hundred benign and ten malignant pleomorphic adenomas of the parotid gland were analyzed. Follow up ranged from two to 20 years. Of 54 cases of benign pleomorphic adenoma of the parotid gland, recurrence was noted in five cases (9.2%). The five-year recurrence rate was 17.2%. Of the six malignant pleomorphic adenoma, recurrence within the first ten years took place in four patients (66.6%).     

Healing of the bone incision following Le Fort I osteotomy

A histologic evaluation of punch biopsies from the osteotomy sites of five patients who had undergone a Le Fort I procedure was performed. Results of the evaluation indicated that the area between the segments healed with mature compact bone.