Navin Shah

Preemptive analgesia in third molar impaction surgery

Introduction: We have evaluated efficacy of diclofenac sodium as pre-emptive analgesia agent in a prospective triple blind placebo controlled randomized clinical trial in a patients undergoing third molar impaction surgery. Materials and Methods: Randomization of groups was done by randomization software and two groups were constituted one group receiving placebo pre operatively and then the drug for next five days while the other group was given diclofenac sodium pre operatively and then for five days. Results: Results were achieved with help of measurement of outcome variables like postoperative tenderness, swelling and trismus on a visual analogous scale (VAS) and other personalized scale. Collected data shows that there is a significant reduction in the score of postop tenderness in experimental group (P = 0.00), while there is a minimal difference between score of postoperative swelling and tenderness (P > 0.04). Conclusion: So, we can conclude that use of diclofenac sodium as a preemptive analgesic agent is beneficial for better pain control in third molar impaction surgery.

Unicystic ameloblastoma arising from a residual cyst.

Intraoral swellings involving alveolar ridges in edentulous patients are clinically diagnosed as residual cysts, traumatic bone cysts, Stafnes jaw bone cavity, ameloblastoma and metastatic tumours of the jaw. This case report describes a residual cyst in a 68-year-old edentulous male patient which was enucleated and histopathologically confirmed as a unicystic ameloblastoma.

A questionnaire survey on postoperative intermaxillary fixation in mandibular trauma: Is its use based on evidence?

Context: This questionnaire survey was conducted to ascertain if the practice of the routine use of postoperative intermaxillary fixation (IMF) in mandibular trauma (of the dentate segments only) was based on evidence available in the literature. Settings and Design: This study was designed as a questionnaire survey that would be conducted among surgeons operating on mandibular fractures in the state of Gujarat. Materials and Methods: A typed questionnaire was sent to oral maxillofacial surgeons and plastic surgeons of Gujarat state for their feedback by post. Approval of the ethical committee of the university was obtained. All the feedback forms received back were included for this survey which included 25 oral and maxillofacial surgeons and 25 plastic surgeons. Results: Although majority of the surgeons use open reduction and internal fixation (ORIF), 25% of the surgeons still prefer using only IMF as the sole modality of treatment for the said group of mandibular fractures. According to our survey, the majority of surgeons use IMF routinely in the postoperative setting even after using ORIF. Occlusion seems to be the critical factor among 72% of surgeons in deciding on the use of IMF as an adjunct after ORIF. Seventy-eight percent of surgeons vary their period of IMF based on the site of fracture. Conclusion: The routine use of postoperative IMF in cases of mandibular fractures seems to find favor among surgeons despite lack of sound scientific evidence supporting its use. There is also no evidence to suggest that if IMF is not used, it would have deleterious effects on occlusion or otherwise.

A comparative clinical evaluation of analgesic efficacy of Tapentadol and ketorolac in mandibular third molar surgery

Introduction: The surgical removal of impacted mandibular third molars is one of the most commonly performed dentoalveolar procedures in oral and maxillofacial surgery and is associated with varying degrees of postoperative discomfort. Pain, trismus, and swelling are the most common postoperative complaints, and these influence a patients quality of life in the days after surgery. Materials and Methods: A comparative study of the 32 patients, 16 were allocated to receive ketorolac and 16 patients were allocated to receive tapentadol. As the data for this study were collected at different time points, analysis for the longitudinal study was done. The main outcome variable, pain level was measured in five-ordered categories. As we had ordinal data in our study, we first checked for marginal homogeneity through Cochran–Mantel–Haenszel test. Results: In the present study, the results show that there is no statistically significant difference between the two treatment groups (P = 0.1184). According to results, there is no significant group by time interaction, which means both drugs have shown almost equal efficacy at different time points. Similarly, there is no difference in efficacy of the two drugs across gender level. Conclusion: The present findings showed that there is no statistically significant difference between the two treatment groups, although ketorolac is more effective for immediate pain reduction than tapentadol. However, the overall reduction of pain using both groups has no significant difference.

Knowledge, attitude and awareness of speciality of oral and maxillofacial surgery amongst medical consultants of vadodara district in gujarat state.

Background and AimAim of this study was to survey the knowledge, attitude and awareness of the subject of oral and maxillofacial surgery speciality amongst the consultants and practitioners of medicine in district of Vadodara.Materials and MethodsList of members of various specialities in medical faculty were obtained from Indian Medical Association, Baroda branch and staff members of medical colleges of Vadodara district. A questionnaire survey was made which was distributed and their options were noted.ResultsSurgical removal of third molar, oral submucous fibrosis and implants were the problems where oral surgeons were preferred. For maxillofacial trauma plastic surgeons and orthopaedic surgeons were preferred than oral surgeons. For maxillofacial pathology E.N.T surgeons were mostly preferred. There is low awareness regarding oral and maxillofacial surgery amongst the general practitioners and medical consultants in Vadodara district.ConclusionSurvey shows that our training needs to be upgraded and revamped so that our trainees (post graduates in oral surgery) and have a greater “hands-on” exposure during their postgraduate training. They will then be able to handle increasingly complex cases in a multispecialty setup when they graduate and earn the mutual respect of the medical and dental fraternity and also the general public. MBBS students during their dental postings should be made aware of the depth and scope of oral surgery branch.

Comparison of Healing of Extraction Socket in Nonsurgical Extraction Cases with Use of either Sterile or Clean Gloves

Aim: to compare and evaluate the healing of extraction socket with the use of sterile and clean gloves during nonsurgical dental extractions. Materials and Methods: Patients who satisfy the inclusion and exclusion criteria were randomly selected into two groups as specified. In Group A extractions has been carried out by the surgeon wearing a pair of sterile gloves and in Group B extractions have been carried out by the surgeon wearing a pair of clean gloves. Information of the study has provided to the patients of the both the groups in a vernacular language and informed consent has been obtained. Extractions of the patients has been carried out by religiously following the principles of aseptic and atraumatic exodontia. Assessment of the results and observations will be done by coinvestigator who will be kept blind about the group of the patients. Results: There is no significant difference found in observations in any of the group. Conclusion: The study concluded that the use of sterile surgical gloves does not offer an advantage over clean gloves.

Immediate Implantation into extraction socket, a case report

(Reader, Department Of Oral & Maxillofacial Surgery, Peoples Dental Academy, Peoples University, Bhopal, Madhya Pradesh, India.) (Ex. Lecturer, Oral Medicine & Radiology, Peoples Dental Academy, Peoples University, Bhopal, Madhya Pradesh, India.) (Professor, Department Of Oral & Maxillofacial Surgery, K.M.Shah Dental College & Hospital, Vadodara, Gujarat, India) (Professor, Department Of Oral & Maxillofacial Surgery, K.M.Shah Dental College & Hospital, Vadodara, Gujarat, India) (Reader, Department Of Oral & Maxillofacial Surgery, Peoples Dental Academy, Bhopal, India.) (Post graduate Student, Department Of Oral & Maxillofacial Surgery, Peoples Dental Academy, Bhopal, India.) (Consultant Dental Surgeon, Govt. District hospital, Mungeli.)