Evaluation of Head Position in Static and Dynamic Three-Dimensional Imaging:a review of the Literature

Background: The interest in three-dimensional imaging in orthognathic treatment planning has been growing, especially for evaluation of the natural head position. Several three-dimensional devices are available on the market. Three-dimensional evaluation of the patient will probably soon be a standard tool/method in orthognathic treatment planning.Purpose: The purpose of the study was a clarifi cation of the literature for studies regarding the natural head position in three-dimensional imaging.Materials and methods: A systematic search of the literature was conducted through PubMed to identify studies that evaluate head positions in three-dimensional imaging. Following search syntax was used: “3d imaging”, “three-dimensional”, “natural head position”, and “imaging head position”.Results: Only four studies have investigated the reproducibility and accuracy of head positions in three-dimensional imaging. The studies show that the natural head position is reproducible with the use of three-dimensional photography.Conclusion: Three-dimensional imaging to register the natural head position in orthognathic treatment planning shows promising results. Only four studies have evaluated its reproducibility. Future studies regarding its accuracy and reproducibility are essential.</p

The Use of Cryotherapy in Conjunction with Surgical Removal of Mandibular Third Molars: a Single-Blinded Randomized Controlled Trial

OBJECTIVES: Cryotherapy is frequently used to diminish postoperative sequelae following mandibular third molar surgery. The objective of this single-blinded randomized controlled trial was to assess the therapeutic efficiency of 30 minutes continuous cryotherapy on postoperative sequelae following surgical removal of mandibular third molars compared with no cryotherapy. MATERIAL AND METHODS: Thirty patients (14 male and 16 female) including 60 mandibular third molars were randomly allocated to 30 minutes of immediately cryotherapy or no cryotherapy. Outcome measures included pain (visual analogue scale score), maximum mouth opening (trismus) and quality of life (oral health impact profile-14). Outcome measures were assessed preoperatively and one day, three days, seven days and one month following surgical removal of mandibular third molars. Descriptive and generalized estimating equation analyses were made. Level of significance was 0.05. RESULTS: No cryotherapy following surgical removal of mandibular third molars revealed a statistically significant lower visual analogue scale score of pain compared to thirty minutes of continuous cryotherapy after one day (P < 0.05). However, no statistically significant difference in trismus or oral health-related quality of life were revealed at any time point compared with no cryotherapy. CONCLUSIONS: The therapeutic effect of 30 minutes continuous cryotherapy following surgical removal of mandibular third molars seem to be negligible. Thus, further randomized controlled trials assessing a prolonged application period of cryotherapy, alternative devices or use of intermittent cryotherapy are needed before definite conclusions and evidence-based clinical recommendations can be provided

Different Dosages of Corticosteroid and Routes of Administration in Mandibular Third Molar Surgery:a Systematic Review

Objectives: The objective of the present systematic review was to test the hypothesis of no difference in facial swelling, pain and trismus after surgical removal of mandibular third molar with different dosages of corticosteroids and administration routes. Material and Methods: A MEDLINE (PubMed), Embase database and Cochrane Library search in combination with a hand-search of relevant journals was conducted by including randomized controlled trials published in English until 1st December 2017. Results: Seven studies fulfilled the inclusion criteria. Considerable variation in the included studies prevented meta-analysis from being performed. Preoperative submucosal injection of corticosteroids significantly diminishes facial swelling, pain and trismus compared with placebo. However, different dosages of corticosteroid and administration routes reveal contrary results indicating that administration of a higher dosage of corticosteroids do not necessarily cause a further decrease in facial swelling, pain and trismus. Conclusions: Consequently, the optimal dosage of corticosteroids and administration route for diminishing postsurgical morbidity and improve quality of life after surgical removal of mandibular third molar is presently unknown. Therefore, further well-designed randomized clinical trials including a standardised protocol, patient-reported outcome measures and three-dimensional analysis of facial swelling is needed