Regenerative capacity of allogenic gingival margin- derived stem cells with fibrin glue on albino rats’ partially dissected submandibular salivary glands

ObjectiveTo evaluate the possible regenerative effect of allogenic gingival margin-derived stem cells (GMSCs) with or without autologous fibrin glue on partially dissected submandibular salivary glands of albino rats.MethodsForty rats were randomly divided into four equal groups. Group I, where no operation was performed, was considered the negative control. Group II rats were considered the positive control and were subjected to a rectangular cut on the outer surface of the center right of the submandibular salivary gland and received no other treatment. Groups III and IV rats were handled as those in group II, but the cut areas of group III were filled with fibrin glue and the cut borders of group IV were injected with 1 × 10⁵ cell/ml GMSCs and then glued with fibrin glue. Five animals from each group were euthanized at the end of the first postoperative week, while the remaining animals were euthanized at the end of the second postoperative week, i.e., end of the experiment.ResultsRegeneration of ductal, acinar, and myoepithelial cells was better in group IV. A two-way ANOVA for proliferating cell nuclear antigen and α-smooth muscle actin revealed an overall significant difference between the different groups (P < 0.05). In addition, an LSD post hoc test for multiple comparisons revealed a significant difference between each two groups. An independent sample t-test revealed significant differences between time periods for groups II, III, and IV, but there were no significant differences between the time periods for group I.ConclusionInjecting GMSCs at the cut borders and gluing the cut area with autologous fibrin glue ameliorates the regeneration of partially dissected submandibular salivary gland better than using fibrin glue alone.     

Buccal sulcus versus intranasal approach for postoperative periorbital oedema and ecchymosis in lateral nasal osteotomy

BackgroundLateral osteotomies are used in rhinoplasty to narrow the nasal bones, close the open roof deformity after hump removal, and achieve symmetry of an asymmetrical framework. But this procedure causes periorbital oedema & ecchymosis. Different techniques have been described for lateral osteotomy.ObjectiveTo compare the postoperative ecchymosis and oedema after buccal sulcus lateral osteotomy versus intranasal lateral osteotomy.Methods and materialsIn a prospective experimental study, buccal sulcus approach was performed on the right side and an intranasal approach performed on the left side of patients randomly. Then blind analysis of postoperative photographs was performed to determine the incidence of oedema and ecchymosis on each side.ResultsFifty patients were enrolled in the study after exclusion of unfit patients. On the right side (buccal approach osteotomies), a significantly lower incidence of upper and lower eyelid oedema and upper eyelid ecchymosis was seen on both the 2nd day and after 7th day (P < 0.05). The odds ratio of progression of ecchymosis was 2.66 (OR = 2.66, 95% CI: 1.09–5.52, p = 0.048) in intranasal group compare to buccal sulcus group. No significant complication observed.ConclusionThe buccal sulcus approach is a safe method for lateral osteotomy with a lower rate of postoperative oedema and ecchymosis and no significant complications.     

Effects of dexamethasone and nimesulide on bisphosphonate-related osteonecrosis of the jaw: An experimental study

ObjectiveTo evaluate the effects of dexamethasone (DEX) and nimesulide (NIM) on Bisphosphonate-related Osteonecrosis of the Jaw (BRONJ) in rats.DesignBRONJ was induced by zoledronic acid (ZA) infusion (0.2 mg/kg) in Wistar rats (n = 8), followed by extraction of the left lower first molar (BRONJ groups). Control groups (n = 40) received saline (IV). For eight weeks, DEX (0.04, 0.4, 4 mg/kg) or saline (SAL) were administered by gavage 24 h before each infusion of ZA or saline (IV), or NIM (10.3 mg/kg) was administered 24 h and 12 h before each infusion of ZA or saline (IV). The haematological analyses were conducted weekly. After euthanasia (day 70), the jaws were submitted to radiographic and microscopic analysis. Kidney, liver, spleen and stomach were analysed histopathologically.ResultsThe BRONJ groups showed a higher radiolucent area compared with the control groups (p < 0.05). Histomorphometric analysis revealed healing and new bone formation in the control groups, while the BRONJ groups exhibited devitalized bone with bacterial colonies and inflammatory infiltrate. The BRONJ-DEX 0.4 and 4 mg/kg groups had a greater number of bacterial colonies (p < 0.05) and an increased polymorphonuclear cell count compared to the saline-BRONJ group, while the BRONJ-NIM group had a lower polymorphonuclear count (p < 0.05). The BRONJ groups had leucocytosis, which was reduced by DEX administration. Treatments with DEX with or without ZA caused white pulp atrophy.ConclusionThus, DEX or NIM therapy was not effective in preventing radiographic and histopathologic events associated with BRONJ. Treatment with DEX attenuated leucocytosis post-infusion with ZA.     

“A comparative evaluation between single noncompression titanium miniplate and three dimensional titanium miniplate in treatment of mandibular angle fracture” – A randomized prospective study

PurposeThe aim of this study was to compare efficacy between the single non-compression titanium miniplate and single three-dimensional titanium miniplate in mandibular angle fracture treatment.Method and materialsA prospective study of 20 patients with mandibular angle fractures. Patients were randomly categorized into two groups with 10 patients in each group. Group-I patients were treated with single 2.0 mm conventional titanium miniplate, Group-II patients were treated with single 2.0 mm three-dimensional titanium miniplate according to Champy's principles. Parameters such as stability of fracture fragments, occlusion, mouth opening, additional fixation required and complications were evaluated at different time intervals.ResultsIn Group-I, about 40% (n = 4) of patients showed unstable fracture fragments on immediate postoperative day whereas in Group-II only 10% (n = 1) of patients with fracture instability. In Group-I, 30% (n = 3) had mild occlusal derangement and 20% (n = 2) had deranged occlusion on immediate postoperative day, where as in Group-II only 20% (n = 2) of patients had mild occlusal derangement. Additional fixation required in 30% (n = 3) of patients in group-I, and 10% (n = 1) in Group-II. 20% (n = 2) of patients in Group-I developed infection. All patients in both the groups had inadequate mouth opening on immediate post operative day, later resumed normal mouth opening. 10% (n = 1) in group-I and 20% (n = 2) of patients in group-II presented with postinjury/preoperative inferior alveolar nerve sensory disturbance with no incidence of postoperative sensory disturbance. None of the patients in both the groups had malunion, nonunion, plate fracture, and loosening of plates and screws.Conclusion3-D titanium miniplates showed more favorable results compared to single conventional titanium miniplate with respect to initial interfragmentary stability and complications.     

Immediate dental implant placement with a horizontal gap more than two millimetres: a randomized clinical trial

The purpose of this study was to evaluate the horizontal dimensional changes in buccal alveolar bone immediately after dental implant placement in the upper premolar area with horizontal gaps >2 mm. A total of 48 patients were enrolled in this randomized clinical trial and were randomly assigned to one of three groups. Group I (flap with graft; n = 16) patients received an immediate implant with bone graft, membrane, and primary flap closure. Group II (flap without graft; n = 16) patients received an immediate implant with primary flap closure only. Group III (flapless without graft; n = 16) patients received an immediate implant without graft, membrane, or primary closure. Cone beam computed tomography (CBCT) scans were obtained preoperatively, immediately after implant placement, and at 6 months postoperative to evaluate horizontal dimensional changes in the buccal alveolar bone. Pain intensity was measured using a numerical rating scale. CBCT examinations revealed that bone had filled the horizontal gap in all three groups. Group II showed the greatest horizontal dimensional changes in the buccal alveolar bone, followed by group I. The least amount of change was recorded for group III. Furthermore, significantly less postoperative pain was recorded in group III when compared to the other groups. Short-term results suggest that the ‘flapless without graft’ technique shows similar results to the ‘flap with graft technique’ for immediate implant placement in the maxillary premolar extraction site with a horizontal gap >2 mm, when the bone plate is intact.     

The effects of Face mask and Tongue Appliance on Maxillary Deficiency in growing patients: A randomized clinical trial

ObjectivesThe purpose of this randomized trial study was to compare the effects of facemask and Tongue appliance in treatment of Class III malocclusion with maxillary deficiency in growing patients.Materials & methods45 patients (22 males, 23 females) with maxillary deficiency were selected and randomly assigned to 2 groups. 22 patients (10 boys, 12 girls) with the mean age of 9.3 years ± 1.2 years were treated with facemask. 23 patients (12 boys, 11 girls) with the mean age of 10.1 years ± 0.7 years were treated by Tongue appliance. Lateral cephalograms obtained at the beginning and end of the study were analyzed.ResultsPaired t-tests and Wilcoxon test showed that SNA and ANB significantly increased in both groups. Mann-Whitney test showed that there were no statistically significant differences between the two groups except for Jarabak ratio and Upper 1 to SN. U1 to SN increased by 11.1 ± 6.9° in fixed facemask group and 2.5 ± 6.1° in Tongue appliance group (P < 0.001).Both treatment modalities were successful in moving the maxilla forward. However, the upper incisors had more labial inclination in the facemask group.     

Antibiotic prophylaxis for bilateral sagittal split osteotomies: a randomized,double-blind clinical study

The goal of this study was to determine the efficacy of one dose and a short course (3 doses) of amoxycillin therapy for the prevention of infection following bilateral sagittal split osteotomy (BSSO). Patients who qualified for the trial were randomly divided into two groups: group I patients were given a single injection of amoxycillin 1.0 g administered preoperatively followed by two postoperative doses of saline four hourly (single dose group); group II patients were given single injection amoxycillin 1.0 g administered preoperatively followed by two postoperative doses of amoxycillin 0.5 g four hourly. The 60 patients included in this study were divided into two groups of 30. The patients were evaluated for 2 months for postoperative infections. In the postoperative period, six patients required rescue antibiotics in the single dose group and one in the short course group (P = 0.04). There was a statistical difference in the rates of infection between the two groups (P = 0.04). The findings indicate that a short postoperative course of antibiotics is more effective than a single preoperative dose for the prevention of infection following BSSO.     

Clinical comparison of a xenogeneic collagen matrix versus subepithelial autogenous connective tissue graft for augmentation of soft tissue around implants

Dental implant placement is a predictable therapy for replacing teeth. Nevertheless, mechanical, biological, and aesthetic complications frequently occur. The aim of this study was to compare the clinical outcomes of a xenogeneic collagen matrix (XCM) used at the time of implant placement as an alternative to a subepithelial connective tissue graft (SCTG), for soft tissue augmentation. This was a prospective clinical trial with 12 months of follow-up. In the control group, soft tissue augmentation at the time of implant placement was performed with a SCTG, while in the test group, a XCM was employed. At 12 months postoperative, all xenografts showed no postoperative complications. In both groups, a significantly greater thickness was observed on the buccal and occlusal sides from preoperative to 3 months postoperative (P < 0.05). No statistically significant difference in pink aesthetic score (P = 0.379, 6 months postoperative) or marginal bone loss (P = 0.449 at 3 months postoperative, P = 0.778 at 6 months postoperative) was observed between the groups. Statistically significant differences in pain perceived by the patients (P < 0.0001) and the time to complete the surgical procedure (P = 0.0008) were detected. At 12 months after surgery, XCM provided similar clinical results in terms of soft tissue augmentation on the buccal and occlusal sides as compared with the SCTG.     

Chemopreventive potential of phenolic compounds in oral carcinogenesis

ObjectiveTo evaluate the chemopreventive potential of phenolic compounds – potassium apigenin, cocoa, catechins, eriocitrin and rosmarinic acid in oral carcinogenesis induced in hamsters by means of the topical application of 7,12-dimethylbenz(a)anthracene(DMBA).Study designAn experimental study at the University of Murcia.Methods50 male Syrian hamsters (Mesocricetus auratus) were divided into five groups of ten: Group I (control group): 0.5% DMBA; Group II: 0.5% DMBA + 1.1 mg/15 ml potassium apigenin; Group III: 05% DMBA + 2.5 mg/15 ml cocoa catechins; Group IV: 0.5% DMBA + 6 mg/15 ml eriocitrin; Group V: 0.5% DMBA + 1.3 mg/15 ml rosmarinic acid. The flavonoids were administered orally. All the animals were sacrificed after 12 weeks. Macroscopic, microscopic and immunohistochemical (PCNA and p53) analyses of the lesions were performed.ResultsAll the groups treated with phenolic compounds showed lower incidences of tumour, greater differentiation and lower scores in the tumour invasion front grading system in comparison with the control group. Potassium apigenin and rosmarinic acid achieved the best results, the former considerably reduced the carcinoma tumour volumes developed and both significantly reduced the intensity and aggression of the tumours. Immunoexpression of PCNA and p53 were significantly altered during DMBA-induced oral carcinogenesis.ConclusionsAnimals treated with phenolic compounds, particularly potassium apigenin and rosmarinic acid, showed a lower incidence of tumours.     

Effect of honey in preventing gingivitis and dental caries in patients undergoing orthodontic treatment

ObjectivesThis study was conducted to investigate the following: (1) the effects of chewing honey on plaque formation in orthodontic patients, (2) the effect of chewing honey on dental plaque bacterial counts, (3) determine if honey possesses antibacterial effects on bacteria recovered from plaques.MethodsFemale orthodontic patients (n = 20, 12–18 years of age) participated in this randomized controlled study. The effects of honey were compared to treatment with either 10% sucrose or 10% sorbitol that served as positive and negative controls, respectively. The pH of plaque was measured using a digital pH meter prior to baseline and at 2, 5, 10, 20, and 30 min after chewing honey or rinsing with control solutions and the numbers of Streptococcus mutans, Lactobacilli, and Prophymonas gingivalis in respective plaques were determined. The antibacterial activity of honey was tested against commonly used antibiotics using the disk diffusion method.ResultsSignificant differences in pH were observed in the honey and sucrose groups compared to the pH observed in the sorbitol group (p ? 0.001). The maximum pH drop occurred at 5 min in both the honey and sucrose groups; however the pH in the honey group rapidly recovered 10–20 min after exposure and did not drop below the critical decalcification pH of 5.5. On the other hand, the pH following sucrose exposure fell <5.5 and was associated with a 30 min recovery time. The pH observed for the sorbitol group did not change over time. Bacterial counts were significantly reduced in the honey group compared to the other treatment groups (p ? 0.001) and honey significantly inhibited the growth of all studied strains compared to inhibition observed with antibiotics (p ? 0.001).ConclusionsHoney can be used as an alternative to traditional remedies for the prevention of dental caries and gingivitis following orthodontic treatment.     

Impact of glycemic control on oral health status in type 2 diabetes individuals and its association with salivary and plasma levels of chromogranin A

ObjectiveTo evaluate the effect of glycemic control status in type 2 diabetes mellitus (T2DM) individuals on clinical oral health indicators and to compare the concentrations of plasma and salivary chromogranin A (CHGA) among nondiabetic subjects and T2DM patients, exploring their associations.DesignIn this cross-sectional study, 32 patients with controlled T2DM, 31 with poorly controlled T2DM and 37 nondiabetic subjects underwent a clinical and periodontal examination. CHGA concentrations were determined in saliva and plasma with ELISA.ResultsPoorly controlled T2DM group exhibited significantly higher mean buffering capacity, plaque index and bleeding on probing than other groups (P < 0.05). No difference was found to DMFT (decayed, missed and filled teeth) index between groups. Sites with clinical attachment loss (CAL) of 4 and 5–6 mm were significantly higher in both diabetic groups compared to control group (P < 0.05). Poorly controlled T2DM group had significantly higher sites with CAL ≥ 7 mm than other groups (P = 0.001). Significantly higher plasma and salivary CHGA levels were found in T2DM groups (P < 0.05). In both diabetic groups, probing depths 5–6 mm and CAL 5–6 mm were associated with higher salivary CHGA concentration (P < 0.05).ConclusionsThe findings revealed that T2DM patients were more prone to periodontal tissue damage than to caries risk. The results also provide some evidence that the degree of attachment loss deteriorates significantly with poor glycemic control in T2DM (CAL ≥ 7 mm). Moreover, the results suggest that high concentrations of salivary CHGA are associated with worse periodontal parameters and T2DM, and this could be related to the pathogenesis of both diseases.     

Complications of sevoflurane–fentanyl versus midazolam–fentanyl anesthesia in pediatric cleft lip and palate surgery: a randomized comparison study

Careful choice of anesthetic agents in pediatric patients reduces the frequency of anesthesia-related complications. The frequency and type of intraoperative and postoperative complications of sevoflurane–fentanyl versus midazolam–fentanyl anesthesia were compared in 140 consecutive children (aged 3 months to 10 years) undergoing cleft lip and palate repair. Midazolam–fentanyl anesthesia was induced with midazolam (0.05 mg/kg), fentanyl (0.005 mg/kg) and vecuronium (0.1 mg/kg), and maintained with the same agents according to the defined parametars. Sevoflurane–fentanyl anesthesia was induced and maintained with sevoflurane (5–8 vol% and 0.8–1 vol%, respectively) in an oxygen/air mixture and supplemented with fentanyl (0.005 mg/kg). Both groups were comparable in basic demographic data, hemodynamic and respiratory parameters. Difficult intubation occurred in 6 of 76 children (midazolam–fentanyl group) and 4 of 64 children (sevoflurane–fentanyl group) (P = 0.754). Ventricular extrasystole and bronchospasm occurred in one patient each in the sevoflurane–fentanyl group. Postoperatively, emergence agitation was observed in the sevoflurane–fentanyl group (17 cases; P < 0.001); postoperative nausea and vomiting occurred in 2 children (midazolam–fentanyl group) and 3 children (sevoflurane–fentanyl group) (P = 0.660). Midazolam-based anesthesia in children is safer than sevoflurane-based anesthesia regarding occurrence of emergence agitation.     

Thermo and mechanical cycling and veneering method do not influence Y-TZP core/veneer interface bond strength

ObjectivesThe purpose of this study was to evaluate the influence of thermal and mechanical cycling and veneering technique on the shear bond strength of Y-TZP (yttrium oxide partially stabilized tetragonal zirconia polycrystal) core–veneer interfaces.Materials and methodsCylindrical Y-TZP specimens were veneered either by layering (n = 20) or by pressing technique (n = 20). A metal ceramic group (CoCr) was used as control (n = 20). Ten specimens for each group were thermal and mechanical cycled and then all samples were subjected to shear bond strength in a universal testing machine with a 0.5 mm/min crosshead speed. Mean shear bond strength (MPa) was analysed with a 2-way analysis of variance and Tukey's test (p < 0.05). Failure mode was determined using stereomicroscopy and scanning electron microscopy (SEM).ResultsThermal and mechanical cycling had no influence on the shear bond strength for all groups. The CoCr group presented the highest bond strength value (p < 0.05) (34.72 ± 7.05 MPa). There was no significant difference between Y-TZP veneered by layering (22.46 ± 2.08 MPa) or pressing (23.58 ± 2.1 MPa) technique. Failure modes were predominantly adhesive for CoCr group, and cohesive within veneer for Y-TZP groups.ConclusionsThermal and mechanical cycling, as well as the veneering technique does not affect Y-TZP core–veneer bond strength.Clinical significanceDifferent methods of veneering Y-TZP restorations would not influence the clinical performance of the core/veneer interfaces.     

The effect of a ceramic coating on the cpTi–porcelain bond strength

ObjectivesTo investigate the bond strength between cpTi and low fusing porcelains after different treatments.Methods72 patterns were covered with a ceramic coating and invested with phosphate-bonded material (group A), another 72 were invested with magnesia material (group B) and all cast with cpTi. 31 solid castings were selected from each group. The castings of group B were ground and sandblasted, while the castings of group A were only sandblasted. Aluminum content of the metal surface was determined by EDS and castings were submitted to a 3-point bending test to determine the modulus of elasticity (E). The porcelains Duceratin Plus, Noritake Ti22 and Triceram were applied respectively and specimens were submitted to a 3-point bending test. The fracture mode and the remaining porcelain were determined by optical microscopy and SEM/EDS. Bond strength and fracture mode were calculated by two-way ANOVA.ResultsThe E of groups A and B was 98.3 GPa and 98.6 GPa respectively. The bond strength was 26 ± 3 MPa (Duceratin Plus), 28 ± 3 MPa (Noritake Ti22), 27 ± 2 MPa (Triceram) for group A and 24 ± 1 MPa, 29 ± 2 MPa, 27 ± 1 MPa for group B respectively. No significant differences were found for the same porcelain between the two groups (p < 0.05). A significant difference was found between Duceratin Plus and Noritake Ti22, for group B (p < 0.05). The mode of failure was mainly adhesive for all specimens. A significant reduction in aluminum was recorded in all subgroups.SignificanceThe special coating of patterns makes the Ti casting procedure inexpensive, without reducing the metal–ceramic bond strength.     

Treatment of mandibular angle fractures – Linea obliqua plate versus grid plate

ObjectivesTo compare treatment outcomes, handling and long term results between two osseo-fixation systems for mandibular angle fractures – the external oblique ridge (external oblique) plate and the grid plate.Material and methodsSixty patients with mandibular angle fracture were analyzed regarding their operative treatment: 30 patients were treated with an external oblique plate and compared to 30 patients treated with a grid plate on the vestibular cortex.The follow up period was at least 1 year for both groups and the following complications were noted: infection, abnormality in fracture healing, nonunion, pain, hypoaesthesia and dysocclusion.ResultsThe overall average operation time (from intubation to extubation) was 102.1 min (±44.1 min). Single sided fractures treated with the grid plate needed in average 81.07 min (±37.9 min) of operation time while single sided fractures treated with the external oblique plate needed 89.3 min (±42.2 min). In multiple mandibular fractures, no significant change in the operation time between either plating system was found (118.8 ± 35.2 min).After the follow up period fracture healing was considered clinically complete in all patients, but complications occurred significantly more often in the external oblique group (13.3%; N = 8) than in the grid plate group (0%; N = 0).ConclusionIsolated mandibular angle fractures can be more effectively treated using grid plates than using other osteosynthesis techniques. It is an easy to use alternative to conventional miniplate systems with good clinical outcome and fewer complications. An angulated burr and screwdriver has to be used to put on the plate laterally.     

The association of Enamelin,Lactoferrin, and Tumour necrosis factor alpha gene polymorphisms with high caries susceptibility in Chinese children under 4 years old

ObjectiveThe aim of this study was to assess the role of ENAM rs3796703, LTF rs1126478, and TNF-α rs1800629 in high caries susceptibility.DesignThe present case–control study included 1005 unrelated children under 4 years old: 505 with severe caries (dmft index ≥4) and 500 who were caries-free (dmft index = 0 and without white-spot lesions). Questionnaires were obtained from parents and gardians about the children’s diet and oral behavioural habits. All the children received dental examinations and oral swabbing for human genomic DNA collection. ENAM rs3796703, LTF rs1126478, and TNF-α rs1800629 were genotyped by Sanger sequencing.ResultsThe frequency of the ENAM rs3796703 T allele (6.7% in the caries group and 4.2% in the caries-free group), CT genotype (12.7% in the caries group and 8.4% in the caries-free group), TNF-α rs1800629 A allele (4.8% in the caries group and 6.8% in the caries-free group), and AG genotype (8.7% in the caries group and 13.2% in the caries-free group) were significantly different between the caries and caries-free groups (p < 0.05). No significant difference was found in the LTF rs1126478 allele frequency and genotype distribution between the two groups. The ENAM rs3796703 CT genotype increased caries susceptibility by 60.9% compared to the CC genotype (β = 0.746, OR = 1.609), and the TNF-α rs1800629 AG genotype reduced caries susceptibility by 47.4% compared to the GG genotype (β = −0.642, OR = 0.526). In terms of habits covariates, prolongation of night feeding time by 1 month increased caries susceptibility by 3.3% (β = 0.033, OR = 1.033); additionally, sweets and acidic drinks consumption 1–2 times per day increased caries susceptibility by 218.2% (β = 1.158, OR = 3.182), and consumption 3 or more times pe/r day increased susceptibility by 883.5% (β = 2.286, OR = 9.835) compared to non-consumption. Topical fluoride application decreased caries susceptibility by 43.0% (β = −0.562, OR = 0.570).ConclusionsThe ENAM and TNF-α genes are likely associated with caries experience in Chinese children. The ENAM rs3796703 CT genotype might be involved in caries susceptibility, while TNF-α rs1800629 AG genotype might be involved in caries protection.     

Effects of throat packs during orthognathic surgery: a double-blind randomized controlled clinical trial

Throat packs are commonly used in maxillofacial surgeries. However, the evidence to support the benefits of their use is controversial. The aim of this study was to evaluate the effectiveness of throat packs in preventing postoperative nausea and vomiting, and their influence on the incidence of sore throat and dysphagia in patients undergoing orthognathic surgery. This was a prospective double-blind randomized study with 54 patients, who were randomized to two groups: with throat pack (n = 27) and without throat pack (n = 27). Fifty patients (25 in each group) were included in the analysis; 66% female and 34% male, mean age 29.44 ± 8.53 years. Postoperative nausea and vomiting (Kortilla scale), sore throat (visual analogue scale), and dysphagia were evaluated. Statistically significant differences in favour of the without-pack group were found for the variables throat pain at 24 hours (P = 0.002) and dysphagia at 2 hours (P = 0.007) and 24 hours (P < 0.001). There was no difference between the groups regarding postoperative nausea and vomiting (P = 1.00). The results of this study indicate that throat packs as utilized here do not prevent postoperative nausea and vomiting and are associated with worse sore throats and postoperative dysphagia.     

Hydrogen peroxide induces cell proliferation and apoptosis in pulp of rats after dental bleaching in vivo: Effects of the dental bleaching in pulp

ObjectiveThis study provides an in vivo evaluation of the inflammatory response, levels of cell proliferation and apoptosis, and the presence of necrosis after dental bleaching with two concentrations of hydrogen peroxide (H₂O₂).DesignWistar rats were divided into Control (placebo gel), BLUE (20% H₂O₂, 1 × 50 min), and MAXX (35% H₂O₂, 3 × 15 min) groups. At 2 and 30 days, the rats were killed (n = 10). The jaws were processed for histology analysis and PCNA and Caspase-3-cleaved immunohistochemistry, and data were submitted to the Mann-Whitney or ANOVA test (P < 0.05).ResultsAt 2 days, the MAXX group showed necrosis and the BLUE group revealed moderate inflammation on the occlusal third of the crown (P < 0.05). At 30 days, tertiary dentin had formed and there was an absence of inflammation. The level of cell proliferation was higher in the middle third of the BLUE group (P < 0.05), and cervical of MAXX at 2 days (P < 0.05), decreasing at 30 days. The apoptosis was present at 2 days, particularly in the cervical third of the crown in the bleached groups (P < 0.05), with a decrease only at 30 days in the BLUE group (P < 0.05).ConclusionsThe concentration of H₂O₂ influences effects on the pulp tissue, where a higher concentration of H₂O₂ can cause necrosis in the pulp and a prolonged effect within the apoptotic process; lower concentrations of H₂O₂ provide moderate inflammation, cell proliferation and apoptosis with a reduction of these processes over time.     

Effects of maxillomandibular fixation and rigid internal fixation on pulmonary function in patients with mandibular fractures

Closed reduction and maxillomandibular fixation (MMF) is associated with airway obstruction. The ventilatory effect of open reduction and rigid internal fixation (ORIF) as an alternative treatment has not been determined. The aim of this study was to compare the effects of MMF and ORIF on pulmonary function (PF) in patients with mandibular fractures. Using a computer-generated simple randomization protocol, 40 eligible participants were allocated to MMF and ORIF treatment groups. PF tests were done preoperatively and at 24 hours, 1, 6, and 7 weeks postoperative in all participants in both groups, using a portable office spirometer (Spirobank G). Forced vital capacity (FVC), forced expiratory volume in one second (FEV₁), FEV₁/FVC, and peak expiratory flow rate (PEFR) were determined. At 6 weeks postoperative, PF tests were performed after the release of MMF. PF tests in the MMF and ORIF groups were similar preoperatively. At 24 hours postoperative, FEV₁/FVC was significantly lower in the MMF group than in the ORIF group (p < 0.001). Values of FEV₁ (p = 0.022), FEV₁/FVC (p = 0.001) and PEFR (p < 0.001) were significantly lower in the MMF group than in the ORIF group at 1 week postoperative. While MMF negatively impacted on PF, ORIF had no adverse effect on PF.     

Improvement in quality of life after skeletal advancement surgery in patients with moderate-to-severe obstructive sleep apnoea: a longitudinal study

Skeletal advancement surgery with sagittal split ramus osteotomy (SSRO) or mandibular distraction osteogenesis (MDO) is effective in treating patients with obstructive sleep apnoea (OSA) and may improve their quality of life (QoL). This study aimed to evaluate the longitudinal QoL changes in moderate-to-severe OSA patients after skeletal advancement surgery. Eighteen patients were randomized to receive SSRO (n = 9) or MDO (n = 9) alone or as part of the skeletal advancement surgery. Baseline QoL was compared with that of a control group (n = 36). QoL was compared between the SSRO group and MDO group over a period of 2 years postoperative. The Epworth Sleepiness Scale (ESS), Calgary Sleep Apnea Quality of Life Index (SAQLI), Functional Outcomes of Sleep Questionnaire (FOSQ), and Short Form Health Survey (SF-36) were used as instruments. The OSA group had worse ESS, SF-36, FOSQ, and SAQLI preoperatively than the control group. The MDO and SSRO groups showed significant improvements in ESS at all postoperative time points (P ≤ 0.021). The FOSQ, SAQLI, and SF-36 of both groups at 2 years postoperative were similar to those of the control group. No differences in QoL were found between the SSRO and MDO groups. This study showed QoL was improved in patients with moderate-to-severe OSA after skeletal advancement surgery by SSRO or MDO.