Clinical and radiological outcome of arthrocentesis followed by autologous blood injection for treatment of chronic recurrent temporomandibular joint dislocation

This study was conducted to evaluate the functional outcome and MRI findings of arthrocentsis followed by autologous blood injection (ABI) into the joint space for management of chronic recurrent TMJ dislocation. Total ten patients with bilateral chronic recurrent condylar dislocation were included in the study. Arthrocentesis of both TMJ was performed on each patient, followed by the injection of 2 ml of autologous blood into the superior joint compartment and 1 ml onto the outer surface of the joint capsule. Preoperative and postoperative assessment included; thorough history, clinical examination of TMJ, maximal mouth opening, frequency of dislocation, TMJ radiographs (open and closed mouth position), MRI, recurrence and presence of facial nerve paralysis. At the end of 3 months follow-up 8 patients (80%) had successful outcome with no further episodes of dislocation, whereas two patients reported with recurrence. Post-operative MRI showed significant improvement after ABI, compared to pre-operative MRI. There were no degenerative changes to the bony and soft tissue components of TMJ. ABI is a simple, safe, minimally invasive and cost-effective technique for treatment of chronic recurrent TMJ dislocation. MRI evaluation showed an improvement in the anatomical and spatial relationship of the osseous and soft tissue components of the TMJ

Comparative evaluation of platelet rich plasma in socket healing and bone regeneration after surgical removal of impacted mandibular third molars

Background. Surgical removal of mandibular third molars results in pain, swelling and bony defects, causing prolonged postoperative recovery. The growth factors present in platelet-rich plasma (PRP) can accelerate the healing, thereby shortening postoperative recovery period. This study was undertaken to evaluate the role of PRP in postoperative socket healing, pain, swelling and bone regeneration following surgical removal of impacted mandibular third molars. Methods. The present case‒control study was conducted on 20 patients with identical bilateral mandibular third molar impaction. PRP was placed randomly on one side of 3rd molar extraction socket and the contralateral side was used as control. Evaluation of soft tissue healing, pain, swelling and radiologic bone density was carried out. Results. Soft tissue healing was better in the PRP compared to the control site. Immediate postoperative assessment of pain scores showed no significant difference between the two groups (Mann-Whitney U test). On the 7th day, pain scores were lower in case site compared to the control site. Measurement of swelling on the 1st, 3rd and 7th day showed statistically significant differences between the case and control sites (P<0.0001). Postoperative mean bone density at the 3rd and 6th postoperative months was significantly higher in the case site compared to the control site (P=0.00001). Conclusion. The results showed an improvement in wound healing and swelling and an increase in the bone density at PRP site. The growth factors in PRP would improve the hard and soft tissue healing 3 months after molar surgery

Comparison of clinical efficacy of methylprednisolone and serratiopeptidase for reduction of postoperative sequelae after lower third molar surgery

Background: Surgical removal of mandibular third molars results in some degree of post-operative pain, swelling and trismus. These can be controlled by proper administration of local anesthesia, careful bone removal, minimal trauma to adjacent soft tissues and administration of methylprednisolone and serratiopeptidase drugs. The aim of the present study was to compare the efficacy of methylprednisolone and serratiopeptidase in controlling post- operative pain, swelling and trismus after surgical removal of impacted mandibular third molars. Material and Methods: The subjects were divided into two groups of 50 patients each undergoing surgical removal of mandibular third molars. Group A was given methylprednisolone 4mg orally every 8th hourly and Group B was given serratiopeptidase 10 mg every 12th hourly orally. Post-operatively pain, swelling and trismus were evaluated at the end of 1st, 3rd and 5thday. Results: The results of this study showed that methylprednisolone is an effective analgesic, while serratiopeptidase has moderate analgesic activity. Serratiopeptidase is more effective than methylprednisolone in controlling post surgical swelling and trismus. Hence combination of these two drugs would be very effective than individual drug when widespread post-operative sequelae are expected after surgical removal of impacted lower third molars. Conclusions: We conclude that methylprednisolone affords better pain relief while serratiopeptidase exerts better anti-inflammatory and anti-swelling effects in the post-operative period. Synergistic combinations of these two drugs would however prove to be more effective when extensive post-operative sequelae are expecte