Does preventive single dose of intravenous dexketoprofen reduce pain and swelling after orthognathic surgery? A prospective, randomized, double blind clinical trial

The purpose of this study was to evaluate the effect of a single-dose intravenous dexketoprofen administration for preventive analgesia on postoperative pain and reducing swelling in double jaw surgery. The authors designed a prospective, randomized, and double-blind cohort study. Patients who have Class III malocclusion were randomly divided in two groups. 50 mg intravenous dexketoprofen trometamol were administrated 30 minutes before incision in treatment group, while intravenous sterile saline was administrated 30 minutes before incision in placebo group. The primary predictor variable was treatment group. Primary outcomes were pain, swelling and 24-hour opioid intake. Patient- controlled analgesia with tramadol was given for management of postoperative pain. Other variables were demographic and operation related parameters. Visual analogue scale was used to evaluate postoperative pain. 3dMD Face System (3dMD, USA) was used to measure postoperative swelling. Data were analysed using two independent samples t test and Mann Whitney U test. The study sample was composed of 30 patients with a mean age of 20,63 years and 21 were female. Preemptive dexketoprofen administration decreased postoperative tramadol consumption by 25.9% compared to placebo group, and there was a statistically significant decrease in VAS scores (p0,05). Preventive administration of intravenous dexketoprofen provides adequate analgesic effect in the postoperative 24-hour period and reduces opioid consumption in orthognathic surgery

Modification of Closed Reduction Technique to Manage Unilateral Displaced Condylar Fractures: A Case Report

Objective: Mandibular condyle fractures are the most common injures of maxillomandibular trauma.It causes decreased mouth opening, facial asymmetry and interferencases at affected side. Surgical or Non- surgical method is used in this case. The aim of this case was to presentation treatment of medial displaced condylar fracture with closed reduction techniqueCase: The following protocol was used in the Oral and Maxillofacial Surgery Clinic in Erciyes University for treatment, the patient had low interincisal distance and deflection to the affected side after a motorcycle crash. A 17-year-old boy was referred to our clinic about significant facial asymmetry and pain, he had a mouth openning of 29 mm. After cone beam tomography evaluation the author has seen a medial displaced condylar fracture and for treatment a closed reduction with acrylic bite block was chosen. Occlusal appliance has 8 mm premature contact on the affected side. After two weeks intermaxillary fixation application the patient was called three times in a week to eradicate the appliances acrylic area step by step. After 6 weeks of IMF the angle of the fractures has checked and Interincisal mouth opening was 23 mm. The patient was given physiotherapy to prevent ankylosis and was called monthly to check the mouth opening and deviation. The last clinical examination a maximum mouth opening of 41 mm and no deviation was detected.Conclusion: Open reduction isn’t a definite indication treatment for a displaced condyle fracture because it has many complications.This modified technique will manage unilateral displaced condylar fractures successfully.Keywords:&nbsp;condyle fractures, closed reduction, intermaxillary fixation, mouth opening</div