Effects of co-administered dexamethasone and diclofenac potassium on pain, swelling and trismus following third molar surgery

BACKGROUND: The apparent interactions between the mechanisms of action of non-steroidal anti-inflammatory drugs (NSAIDS) and steroids suggest that co-therapy may provide beneficial inflammatory and pain relief in the absence of side effects. The aim of the study was to compare the effect of co-administered dexamethasone and diclofenac potassium (diclofenac K) with diclofenac K alone on the postoperative pain, swelling and trismus after surgical removal of third molars. PATIENTS AND METHODS: A prospective randomized double-blind study was conducted at the Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Nigeria. A total of 100 patients were randomly allocated to two treatment groups of dexamethasone (prophylactic 8 mg and postoperative 4 mg IV) and diclofenac K (50 mg Oral before and after surgery), and diclofenac K alone (as with first group). The overall analgesic efficacy of the drug combinations was assessed postoperatively by determination of pain intensity using a category rating scale. Facial swelling was measured using a tape measure placed from tragus to gonion to tragus, while interincisal mouth-opening of patients was measured using a vernier calibrated caliper pre-operatively and post-operatively. RESULTS: Co-administration of dexamethasone and diclofenac K was significantly superior to diclofenac alone for the relief of pain (P < 0.05), and facial swelling up to post-operative 48 hour (P < 0.05). However, there was no significant difference for trismus relief between the two medication protocols (P > 0.05). CONCLUSION: This study illustrates enhanced effects of co-administered dexamethasone and diclofenac K on short-term post-operative pain and swelling, compared to diclofenac potassium alone in third molar surgery

Technical aspects of CT imaging of the spine

This review article discusses technical aspects of computed tomography (CT) imaging of the spine. Patient positioning, and its influence on image quality and movement artefact, is discussed. Particular emphasis is placed on the choice of scan parameters and their relation to image quality and radiation burden to the patient. Strategies to reduce radiation burden and artefact from metal implants are outlined. Data acquisition, processing, image display and steps to reduce artefact are reviewed. CT imaging of the spine is put into context with other imaging modalities for specific clinical indications or problems. This review aims to review underlying principles for image acquisition and to provide a rough guide for clinical problems without being prescriptive. Individual practice will always vary and reflect differences in local experience, technical provisions and clinical requirements

Effect of age, impaction types and operative time on inflammatory tissue reactions following lower third molar surgery

<p>Abstract</p> <p>Background</p> <p>Postoperative mobidity following third molar surgery is affected by a number of factors. The study of these factors is essential for effective planning and limitation of morbidity. The aim of this study was to determine the effect of age, type of impaction and operative time on immediate postoperative tissue reactions following mandibular third molar surgery.</p> <p>Methods</p> <p>Consecutive patients with impacted mandibular third molar teeth were studied. All the third molars were classified according to Winter's classification. Surgical extraction was performed on all the patients by a single surgeon under local anaesthesia. The operation time was determined by the time lapse between incision and completion of suturing. Postoperative pain, swelling and trismus were evaluated.</p> <p>Results</p> <p>There were 120 patients with an age range of 19-42 years. Patients in the age range of 35-42 years recorded a lower pain score (p = 0.5) on day 1. The mouth opening was much better in the lower age group on day 2 and 5 (p = 0.007 and p = 0.01 respectively). Pain, swelling and trismus increased with increasing operative time. Distoangular impaction was significantly associated with higher VAS score on day 1 and 2 (p = 0.01, 0.0, 04). Distoangular and horizontal impaction are associated with a higher degree of swelling and reduced mouth opening on postoperative review days. Vertical impaction was associated with the least degree of facial swelling and best mouth opening.</p> <p>Conclusions</p> <p>Increasing operating time and advancing age are associated with more postoperative morbidity, likewise distoangular and horizontal impaction types.</p

Public and professional perception of oral and maxillofacial surgery (A pilot study)

No Abstract. Nigerian Quarterly Journal of Hospital Medicine Vol. 17 (1) 2007: pp. 8-1

Abnormal gag reflex treatment in dental practice - case reports

No abstract Nigerian Quarterly Journal of Hospital Medicine Vol. 13(1-2): 29-3

Bacteriology And Antimicrobial Suceptibility Profile Of Agents Of Orofacial Infections In Nigerians

A prospective study to determine the pattern of microorganisms seen in orofacial infections as well as investigating the antimicrobial susceptibility profile of the isolates was undertaken. Specimens were obtained aseptically from 25 patients presenting with orofacial infections at the Department of Oral Surgery and Pathology, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria. The specimens were transported in an anaerobically pre-reduced transport medium for processing in the laboratory. Isolation and identification were done employing standard bacteriological techniques. Antimicrobial susceptibility testing was performed by the disc diffusion method. All the 25 clinical samples obtained yielded growth of bacteria. Anaerobes were cultured from 24 (96%) specimens while 1 specimen yielded only aerobic isolates. Altogether, 44 bacterial isolates were obtained and 40 (91%) were anaerobes. Most of these anaerobes were Gram-negative rods and Gram-positive cocci. About 75-100% of the anaerobes were susceptible to commonly available antibiotics. Strikingly, sulphonamides demonstrated the weakest in-vitro activity against all isolates. The study revealed again the polymicrobial nature of orofacial infections as well as the predominance of anaerobes in the aetiology of these infections. Erythromycin and penicillin should be considered as frontline drugs in the treatment of mild orofacial infections while drugs like ciprofloxacin and clindamycin can be reserved for more severe and resistant infections. Afr. J. Clin. Exper. Microbiol. 2004; 5 (3): 272-27

Indications for extraction of permanent teeth in a Nigerian Teaching Hospital: A 16-year follow-up study

No Abstracts

Miniplate osteosynthesis of mandibular fractures at the Lagos University Teaching Hospital

No Abstract

Impacted mandibular third molars: Presentationn and postoperative complications at the Lagos University Teaching Hospital

No Abstract. Nigerian Quarterly Journal of Hospital Medicine Vol. 17 (1) 2007: pp. 26-2