Oral Region Research Articles

Gene-Activated Materials in Regenerative Dentistry: Narrative Review of Technology and Study Results.

Treatment of a wide variety of defects in the oral and maxillofacial regions requires the use of innovative approaches to achieve best outcomes. One of the promising directions is the use of gene-activated materials (GAMs) that represent a combination of tissue engineering and gene therapy. This approach implies that biocompatible materials will be enriched with gene-carrying vectors and implanted into the defect site resulting in transfection of the recipient's cells and secretion of encoded therapeutic protein in situ. GAMs may be presented in various designs depending on the type of material, encoded protein, vector, and way of connecting the vector and the material. Thus, it is possible to choose the most suitable GAM design for the treatment of a particular pathology. The use of plasmids for delivery of therapeutic genes is of particular interest. In the present review, we aimed to delineate the principle of work and various designs of plasmid-based GAMs and to highlight results of experimental and clinical studies devoted to the treatment of periodontitis, jaw bone defects, teeth avulsion, and other pathologies in the oral and maxillofacial regions.

Poor Management Odontogenic Infection Complications in Non-Medically Compromised Maxillofacial Patients in Salah Alden General Hospital

Odontogenic infections one of the most common diseases in the oral and maxillofacial region. Precise &careful management of such patients very important. Poor management of odontogenic infection may leads to serious Complications in the maxillofacial region. Aims of the study. Hasten & facilitate patient recovery. Evaluate the most common poor management complication in maxillofacial region. Patients and methods. Sample of 20 patients complaining of poor management odontogenic infections. The data obtained from patients attending maxillofacial clinic. Same data collection formula for all patients. Results. The complications was, (10%) Buccal space abscess. (45%) Submandibular abscess. (10%) Submassetric abscess. (20%) Ludwig’s angina. (10%) Supra sternal abscess. (5%) Necrotizing fasciitis Pt no. complaining according to Poor type of treatment was (35%) Antibiotics only. (15%) Aspiration of abscess &Antibiotics. (35%) Inadequate abscess drainage &Antibiotics. (10%) Remove the cause only without fallow up. (5%) Extraction of non-causative tooth. Conclusion. Poor education, patient careless (neglected& poor oral hygiene), inadequate& poor management planning of cases May leads to these complications results.

Breastfeeding in children with cleft lip and palate and its effect on surgical outcomes

Breastfeeding is a fundamental aspect of infant nutrition and development. However, children born with cleft lip and palate face unique challenges in breastfeeding due to structural anomalies in their facial and oral regions. This study explores the intricate landscape of CLP, covering its epidemiology, complex etiology involving genetic and environmental factors, and the specific challenges breastfeeding children with CLP and their mothers encounter. This review emphasizes the critical role of surgical interventions in CLP management, discussing the timing, techniques, and outcomes of these procedures. While surgical repair of CLP can enhance breastfeeding outcomes, it may also introduce temporary complications, including feeding difficulties, pain, and discomfort. Addressing these challenges requires a multidisciplinary approach involving healthcare professionals, specialized feeding equipment, emotional support, and targeted interventions. Moreover, the emotional well-being of mothers of infants with CLP is highlighted as an essential component of breastfeeding success. Maternal stress and emotional distress can hinder breastfeeding, emphasizing the importance of emotional support and counseling services. Successful breastfeeding in children with CLP is achievable with the right strategies and support systems, like comprehensive care, which acknowledges the complexity of CLP and emphasizes the need for a collaborative healthcare approach to ensure that children with CLP receive optimal nutrition and care during their critical early developmental stages.

Detailed findings of videofluoroscopic examination among patients with Parkinson's disease on the effect of cervical percutaneous interferential current stimulation.

Parkinson's disease (PD) leads to various types of swallowing disorders. We investigated the effect of cervical percutaneous interferential current stimulation on dysphagia. By conducting detailed qualitative and quantitative analysis of videofluoroscopic examination, we aimed to understand dysphagia in patients with PD and investigate its effects on swallowing function. Patients received cervical percutaneous interferential current stimulation for 20 min twice a week for 8 weeks. In this exploratory study, we evaluated aspiration/laryngeal penetration, oral cavity residue, vallecular residue, and pharyngeal residue. In addition, we performed temporal analysis. Twenty-five patients were completely evaluated. At baseline, the proportions of laryngeal penetration/aspiration, oral cavity residue, epiglottic vallecula residue, and pharyngeal residue were 40.0, 88.0, 72.0, 60.0, and 16.0%, respectively. Conversely, pharyngeal transit time, laryngeal elevation delay time, pharyngeal delay time, and swallowing reflex delay were nearly within the normal ranges. Cervical percutaneous interferential current sensory stimulation improved only oral cavity residue at the end of the intervention, from 88.0 to 56.0%. Patients with PD demonstrated remarkably high frequencies of residues in the oral and pharyngeal regions. The usefulness of cervical interferential current stimulation was partially demonstrated for oral cavity residue. Considering that PD exhibits diverse symptoms, further accumulation of cases and knowledge is warranted. jRCTs062220013.

A New Material For Detecting Submerged Implants: An Animal Experiment

Objective: There are difficulties in determining the location of submerged implants when cover screws and healing screws are to be replaced. Because of this, a new implant cover screw has been designed. The purpose of this study was to investigate the properties of a novel implant cover screws in rabbits.
 Methods: 10 New Zealand White rabbits were randomly divided into two groups. Diastema regions behind the incisor teeth were used for the placement of cover screws. In the control group, the screws (n=20) that received no processing were placed whereas, in the experimental group, the screws (n=20) that top surfaces were coated with europium and dysprosium doped strontium aluminate were placed to the diastema regions. Animals were sacrificed after 6 weeks. Dental LED curing light was applied to the oral mucosa regions in which screws were placed in the experimental group just after sacrification and the visibility of the screws was evaluated. To determine the biocompatibility of the coated screws, oral mucosas which contacted with the screws, livers and kidneys were removed and examined histopathologically.
 Results: After light application, only the screws in the upper jaws of the experimental group became visible (n=10). Histopathological examinations performed on the kidneys, livers and oral mucosa tissues which contacted with the screws. There were no significant differences between the experimental and control groups regarding these tissues.
 Conclusion: According to the results of this study, it can be concluded that the titanium implant cover screws coated with europium and dysprosium doped strontium aluminate were biocompatible for rabbits.

Stem-Cell Therapy: Filling Gaps in Oro-Maxillofacial Region.

How do stem cells function? Why should we, as dentists, care about stem cells? How might dental procedures be substituted by stem cells? Are stem cells capable of regenerating a tooth or temporomandibular joint (TMJ)? Although the ability to regenerate a destroyed tissue has been known for a while, research into regenerative medicine and dentistry has made significant strides in molecular biology. A paradigm shift in the therapeutic toolbox for dental and oral diseases is likely to result from a growing understanding of biological concepts inthe regeneration of oral/dental tissues along with stem cell research, leading to an intense search for "biological solutions to biological problems." Among other tissues, orofacial tissues effectively separate stem cells from human tissues. Because they can self-renew and produce different cell types, stem cells offer novel techniques for regenerating damaged tissues and curing illnesses. A number of significant milestone successes have shown their practical applicability, traditional biomaterial-based treatments in regenerative dentistry as therapeutic alternatives that offer regeneration of damaged oral tissues rather than merely "filling the gaps." In order to use these innovative accomplishments for patient well-being, the ultimate goal of this ground-breaking technology, well-designed clinical studies must be implemented as a crucial next step. The review's objective is to briefly synthesize the literature on stem cells in terms of their traits, subtypes, and uses for dental stem cells. It has been highlighted that stem cell therapy has the ability to treat craniofacial abnormalities and regenerate teeth in the oral and maxillofacial regions.

Applicative Assessment of a Selective Laser Melting 3D-Printed Ti-6Al-4 V Plate with a Honeycomb Structure in the Reconstruction of a Mandibular Defect of a Beagle Dog.

The most challenging problem in oral and maxillofacial surgery is the reconstruction of defects for the oral and maxillofacial complex. Transfer of different autografts is known as the "gold standard" for the reconstruction of bone defects in the oral and maxillofacial region. Graft harvesting, however, can lead to many complications, such as donor-site morbidity, surgical time-consuming, etc. Three-dimensional (3D) printing technology is an innovative technique that allows the fabrication of personalized plates and scaffolds to fit the precise anatomy of an individual's defect. In this study, a selective laser melting 3D-printed Ti-6Al-4 V plate with a honeycomb was designed, and its physical and biological features were characterized. The personalized 3D-printed scaffold and commercialized titanium reconstruction plate were applied to reconstruct a 4 cm mandibular defect in a beagle dog. Effects of the treatment were analyzed radiologically and histologically. Our results showed that the application of a 3D-printed plate with a honeycomb achieved good biocompatibility and osseointegration and has potential clinical application.

Association of personality traits with dental visit procrastination by Japanese university students

BackgroundProcrastination is a psychological trait that causes individuals to put off doing things that need to be done. It has recently shown to result in the worsening of symptoms due to delays in seeking medical care. However, it is not clear how perception of dental disease influences dental visits. This study examined the associations of procrastination and personality traits with delayed dental visits for both acute and chronic conditions.MethodsOf 599 university students queried, the data of 549 subjects (mean age 19.7 years) were analyzed. A general procrastination scale (GPS), the Big Five personality traits, and oral hygiene habits were used for analysis. The participants were asked about illness awareness conditions related to dental disease, perception of pain in the oral region due to acute oral symptoms and chronic symptoms. The participants were asked the number of days until they decided that treatment was required. Based on the bimodal shape of the distribution, those who answered at least eight days for acute or chronic conditions were classified as the procrastination (P) group and the others as the non-procrastination (Non-P) group.ResultsSignificant differences in GPS scores were found between the groups for both acute and chronic conditions, with significant differences in the Big Five traits of extraversion, agreeableness, and neuroticism for an acute condition and extraversion, openness, and neuroticism for a chronic condition. There were no significant differences regarding oral hygiene habits between the groups for either condition. Next, using a Bayesian network, the probabilistic causal relations among procrastination, the Big Five traits, and delays in dental visits for both acute and chronic conditions were analyzed. Among the Big Five traits, conscientiousness and neuroticism were directly related to GPS score. Interestingly, agreeableness was directly related to delays in dental visits only for an acute condition and showed a negative effect, while dental student status had a positive effect on delays in dental visits.ConclusionsThe results showed that procrastination and dentistry department are factors that directly influence delays in dental visits, while agreeableness, a Big Five trait, has a negative effect on individuals with an acute condition.

E-cigarette explosion injuries in the oral and maxillofacial region and a protocol for their management.

MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials, Embase and Web of Science along with the reference lists from select articles. Retrospective or prospective cohort studies, randomised controlled trials, case series, case-control studies and case reports on e-cigarette explosion-related facial injuries published in the English language were included. Review articles, nonclinical studies, commentaries, published abstracts and editorials were excluded. Also were excluded, those studies which did not specify injury location or if the injury did not pertain to the maxillofacial region. Data pertaining to bibliographic information, device characteristics, patient details, facial injuries, factors precipitating explosion, complications at follow-up, management and other injuries were extracted. An association between the predictor variables of injury type and location with outcomes of surgical management and intubation was determined by utilising a Chi-squared analysis. A total of 28 studies met the inclusion criteria. A total of 105 facial injuries in 32 patients from 32 e-cigarette explosions were recorded. 73.3% of the injuries were projectile in nature with 26.7% being characterised by burns. 43.8% of all patients suffered both burn and projectile injuries. The eye (10.7%), oral cavity (25%) and face (64.3%) were involved with burn injuries. Projectile injuries mostly involved the lower third of the face (81.8%). 62.5% of patients suffered from a tooth or bone fracture. A 44.4% rate of complications was reported amongst the studies which reported on follow-ups. Surgical management or intubation were found to have no statistically significant relationship with explosive oral injuries. No other statistically significant associations were observed between outcomes and other injury types. There is a risk of spontaneous combustion with e-cigarettes, which can cause injuries of a serious nature to the oral and maxillofacial region, specially the lower third of the face, commonly necessitating surgical management. Increased regulation along with user education are required in order to improve the safety profile of these devices.

Oral Cavity Cancer Tissues Differ in Isotopic Composition Depending on Location and Staging.

The aim of this paper was to characterise the isotopic composition of oral squamous cell carcinoma (OSCC) specimens of different areas of the oral cavity. Secondly, we assessed whether there was a correlation between clinical stages of OSCC and isotopic abundance. The IRMS procedure was performed on 124 samples derived from 31 patients with OSCC of 15 N and 13 C to assess the isotopic composition. From each individual, four samples from the tumour, two from the margins, and two samples of healthy oral mucous membranes were derived. The two samples from the tumour and two samples from the margin were additionally subjected to histopathological assessment. Then, statistical analysis was conducted. Tumour infiltration tissues of the lower lip were characterised by higher mean δ13C values compared to samples derived from cancers of the other oral cavity regions (-23.82 ± 1.21 vs. -22.67 ± 1.35); (p = 0.04). The mean percentage of nitrogen content in tumour tissues was statistically higher in patients with the most advanced cancers (11.89 ± 0.03%) versus the group of patients with II and III stage cancers (11.12 ± 0.02%); (p = 0.04). In patients at stage IV, the mean δ13C value in the cancer samples equalled -22.69 ± 1.42 and was lower than that in patients at less severe clinical stages (p = 0.04). Lower lip cancer tissues differed in the isotopic abundance of carbon in comparison with tissues derived from the group of combined samples from other locations. Values of δ13C observed in specimens derived from lower lip cancers were similar to those observed in healthy oral mucous membranes. Cancer tissues obtained from patients in the last stage of OSCC had a different isotopic composition in comparison with those obtained from earlier stages. To confirm these observations, further research on larger groups of patients is needed.

Maxillary Fibromatosis: A Rare Clinical Report and Its Review of Literature.

Fibromatosis is a rare locally aggressive benign tumour which arises from the musculoaponeurotic structures throughout the body. In the oral and maxillofacial region, It has been described under a variety of synonyms, including 'extra articular desmoids', 'desmoids tumours', 'grade-1 fibrosarcomas','non metastasizing fibrosarcoma'and 'aggressive fibromatosis'. The pecularity of this entity in paranasal sinuses is that it is rare in this location and are locally aggressive with higher rates of recurrence in a relatively restricted area.The purpose of this study is to present a rare case report and reviewing the literature of this entity.

Extraskeletal myxoid chondrosarcoma of the gingival: a rare case report and review of the literature

BackgroundExtraskeletal myxoid chondrosarcoma (EMC) is a rare malignant tumor described in the head and neck region, especially in the gingival. We present one case arising in the gingival of right mandible, and briefly reviewed the related literature.Case presentationA 24-year-old male patient with a lesion of 3.5*2.0 cm in buccal gingival of right posterior mandible for 2 months. The tumor was composed of cartilaginous structures and myxoid matrix. Immunohistochemical(IHC) showed that the tumor cells to be positive for vimentin, focally positive for S-100, negative for calponin, SMA, SOX10. The Ki-67 labelling index was 80%. Fluorescent in situ Hybridization (FISH) was positive for NR4A3 rearrangement.ConclusionsDue to its unusual site and low incidence in the oral region, a combination of histological findings, immunohistochemistry, and molecular pathology as well as differential diagnosis with other diseases should be taken into consideration in the process of clinical diagnosis and treatment.

Optimization of 3D dynamic speech MRI: Poisson-disc undersampling and locally higher-rank reconstruction through partial separability model with regional optimized temporal basis.

To improve the spatiotemporal qualities of images and dynamics of speech MRI through an improved data sampling and image reconstruction approach. For data acquisition, we used a Poisson-disc random under sampling scheme that reduced the undersampling coherence. For image reconstruction, we proposed a novel locally higher-rank partial separability model. This reconstruction model represented the oral and static regions using separate low-rank subspaces, therefore, preserving their distinct temporal signal characteristics. Regional optimized temporal basis was determined from the regional-optimized virtual coil approach. Overall, we achieved a better spatiotemporal image reconstruction quality with the potential of reducing total acquisition time by 50%. The proposed method was demonstrated through several 2-mm isotropic, 64 mm total thickness, dynamic acquisitions with 40 frames per second and compared to the previous approach using a global subspace model along with other k-space sampling patterns. Individual timeframe images and temporal profiles of speech samples were shown to illustrate the ability of the Poisson-disc under sampling pattern in reducing total acquisition time. Temporal information of sagittal and coronal directions was also shown to illustrate the effectiveness of the locally higher-rank operator and regional optimized temporal basis. To compare the reconstruction qualities of different regions, voxel-wise temporal SNR analysis were performed. Poisson-disc sampling combined with a locally higher-rank model and a regional-optimized temporal basis can drastically improve the spatiotemporal image quality and provide a 50% reduction in overall acquisition time.

Pearls and pitfalls in the diagnosis of small oral biopsies

Pathologic processes affecting the oral and maxillofacial region include a heterogenous group of diseases with widely variable biologic behaviors. Proper patient management begins with the establishment of an accurate diagnosis, which often relies on histopathologic interpretation of small tissue samples from oral lesions. While confident diagnosis of small oral biopsies can be challenging, an understanding of oral and maxillofacial disease and consistent clinicopathologic correlation can help pathologists recognize inflammatory confounders and overcome common errors in specimen management, including insufficient sample size and non-representative biopsy samples.

Osteogenic differentiation of 3D-printed porous tantalum with nano-topographic modification for repairing craniofacial bone defects.

Introduction: Congenital or acquired bone defects in the oral and cranio-maxillofacial (OCMF) regions can seriously affect the normal function and facial appearance of patients, and cause great harm to their physical and mental health. To achieve good bone defect repair results, the prosthesis requires good osteogenic ability, appropriate porosity, and precise three-dimensional shape. Tantalum (Ta) has better mechanical properties, osteogenic ability, and microstructure compared to Ti6Al4V, and has become a potential alternative material for bone repair. The bones in the OCMF region have unique shapes, and 3D printing technology is the preferred method for manufacturing personalized prosthesis with complex shapes and structures. The surface characteristics of materials, such as surface morphology, can affect the biological behavior of cells. Among them, nano-topographic surface modification can endow materials with unique surface properties such as wettability and large surface area, enhancing the adhesion of osteoblasts and thereby enhancing their osteogenic ability. Methods: This study used 3D-printed porous tantalum scaffolds, and constructed nano-topographic surface through hydrothermal treatment. Its osteogenic ability was verified through a series of in vitro and in vivo experiments. Results: The porous tantalum modified by nano-topographic surface can promote the proliferation and osteogenic differentiation of BMSCs, and accelerate the formation of new bone in the Angle of the mandible bone defect of rabbits. Discussion: It can be seen that 3D-printed nano-topographic surface modified porous tantalum has broad application prospects in the repair of OCMF bone defects.

Nerve Injury and Photobiomodulation, a Promising Opportunity: A Scoping Review on Laser Assisted Protocols for Lesions in the Oral Region

The currently available therapeutic options for restoring function and sensitivity in long-term nervous injuries pose challenges. Microsurgery interventions for direct nerve repair often lead to serious complications and limited success. Non-surgical methods, although somewhat effective, have limited benefits. These methods involve drug administration, such as with analgesics or corticosteroids. Photobiomodulation therapy (PBMT) has emerged as a promising approach based on clinical and laboratory studies. PBMT stimulates the migration and proliferation of neuronal fiber cellular aggregates, as reported in the literature. Experimental studies on animal models with peripheral nerve compression injuries have shown that PBMT can enhance the functionality of damaged nerves, preserving their activity and preventing scar tissue formation. The mechanism of action depends on the wavelength, which can positively or negatively affect photo acceptor resonances, influencing their conformation and activities. These findings suggest that photobiomodulation may accelerate and improve nerve regeneration. This review explores various methodologies used in photobiomodulation for regenerating nerve sensitivity after surgical trauma involving nerve structures, in the oral and peri-oral region. Research was conducted to evaluate which laser-assisted therapeutic protocols are used to improve the recovery of nervous sensitivity, using the JBI methodology for scoping reviews and following the PRISMA methodology.

Expert consensus on the biobank development of oral genetic diseases and rare diseases and storage codes of related biological samples from craniofacial and oral region

The biological samples of oral genetic diseases and rare diseases are extremely precious. Collecting and preserving these biological samples are helpful to elucidate the mechanisms and improve the level of diagnose and treatment of oral genetic diseases and rare diseases. The standardized construction of biobanks for oral genetic diseases and rare diseases is important for achieving these goals. At present, there is very little information on the construction of these biobanks, and the standards or suggestions for the classification and coding of biological samples from oral and maxillofacial sources, and this is not conducive to the standardization and information construction of biobanks for special oral diseases. This consensus summarizes the background, necessity, principles, and key points of constructing the biobank for oral genetic diseases and rare diseases. On the base of the group standard "Classification and Coding for Human Biomaterial" (GB/T 39768-2021) issued by the National Technical Committee for Standardization of Biological Samples, we suggest 76 new coding numbers for different of biological samples from oral and maxillofacial sources. We hope the consensus may promote the standardization, and smartization on the biobank construction as well as the overall research level of oral genetic diseases and rare diseases in China.

Molecular Diagnosis and Application of Combined Alternative Treatment in Lesions Developing in the Oral Region due to Orf Virus in Sheep and Goats

Background: Orf virus (ORFV) is a zoonotic pathogen that infects sheep and goats, causing significant economic losses. The infection results in proliferative and self-limiting crustal lesions, commonly seen on the skin of the lips and around the nostrils of sheep and goats and occasionally on their feet and teats. ORFV infection is prevalent worldwide and endemic in regions where sheep and goats are raised. Vaccines are widely used to protect against ORFV-induced ecthyma in these animals. However, the disease has become increasingly prevalent throughout the year in small ruminants, necessitating the development of new approaches to treat it. Methods: Crust samples were taken from ORFV lesions in the mouth (lips, gingiva) of 29 sheep and 29 goats aged two years or older from various barns in Burdur-Center and its districts. Conventional polymerase chain reaction was used to investigate the presence of the ORFV genome in the samples, using seven different types of primers (GIF/IL-2, PPP1-PPP4, Orf1-Orf2, VIR1-VIR2, vIL-10-3, vIL-10-4, B2L and Alpha tubulin). Additionally, samples from oral mucosa lesions were examined using histopathological and immunohistochemical methods. As an alternative treatment approach, PAPILENDTM,®cream was applied and Ivermectin was administered subcutaneously twice every 15 days, along with 10 grams of AlquermoldTM premix powder daily for 10 days to all animals with a detected ORFV viral genome. Result: The presence of viral genomes was determined in 10 (34.48%) of 29 sheep and 14 (48.28%) of 29 goats using 7 different types of primers, which have been detected intensively in our region before. In sheep the GIF/IL-2, PPP1-PPP4 and B2L primers detected viral genome (10/29 positive) while in goats Orf1-Orf2 and B2L primers (14/29 positive). Histopathological examination showed epidermal hyperplasia, hyperkeratosis, parakeratosis and crust formations at the epidermal layer. Both epithelial and dermal cells expressed orf virus antigen throughout the immunohistochemical investigation. The alternative treatment of PAPILENDTM,®cream + Ivermectin + AlquermoldTM premix powder triple combination applied to sheep and goats with ORFV genome determined was successful in treating oral lesions caused by ORFV. PCR tests provide rapid and reliable results in the diagnosis of ORFV. The use of triple combined alternative treatments, in addition to ORFV preventive vaccinations in sheep and goats, was found to be successful in treating ORFV infections. The animals showed recovery or regression within a range of 5 to 21 days.

Retrospective evaluation of the clinical utility of reconstructed computed tomography images using artificial intelligence in the oral and maxillofacial region

The aim of this study was to convert medical images stored in 3 mm slices in the picture archiving and communication system (PACS) to 1 mm slices, using artificial intelligence (AI), and to analyze the accuracy of the AI.The original 1.0 mm CT slices of the facial bone were obtained from 30 patients and reformatted to a rough CT slice of 3.0 mm. CT slices of 1.0 mm were subsequently reconstructed from those of 3.0 mm using AI. The AI and rough CT images were superimposed on the original CT images. Fourteen hard-tissue and five soft-tissue landmarks were selected for measuring the discrepancy.The overall average differences in values for the hard-tissue landmarks were 1.31 ± 0.38 mm and 0.81 ± 0.17 mm for the rough and AI CT images, respectively. The values for the soft-tissue landmarks were 1.18 ± 0.35 mm and 0.54 ± 0.17 mm for the rough and AI CT images, respectively. The differences for all the landmarks, excluding point A and pogonion, were statistically significant. Within the limitations of the study it seems that CT images reconstructed using AI might provide more accurate clinical information with a discrepancy of less than 1.0 mm.

Evaluation of Anaesthetic Efficacy of Ropivacaine for the Removal of Impacted 3rd Molars- A Randomised Control Study

This study involved 20 healthy patients (ASA 1) with bilaterally impacted mandibular third molar were randomly selected of both Sexes between age group of 20-40 years. Purpose: This study was done to evaluate the efficacy of Ropivacaine in comparison with Lignocaine for mandibular anaesthesia for bilaterally impacted mandibular third molars in aspect of onset, duration of anaesthesia, analgesia and postoperative requirement of analgesics. Method: Patients received 2ml of 2% Lignocaine with adrenaline on one side and 2ml of 0.75 % plain ropivacaine on the other side at two different appointments. Pain experiences were measured by Visual Analogue Scale (VAS) and Verbal Rating Scale (VRS). Results: In ropivacaine group, the means of onset of anesthesia, duration of anaesthesia, duration of post-operative analgesia and requirement of post-operative analgesics were 5.8±2.33 min, 533.3±142.2 min, 539.6±114.7 min and 4.2±0.8 no’s respectively and there was a significant difference between these group (<0.001). Conclusion: The efficacy of plain ropivacaine 0.75% is superior to 2% lignocaine with adrenaline 1:1,00,000 in terms of duration of anaesthesia and analgesia, intraoperative and post-operative pain control but the onset of action of plain ropivacaine is slightly higher. We conclude that Plain Ropivacaine 0.75% can be used as an alternative to lignocaine in third molar surgeries and other minor surgical procedures which necessitates longer duration of anaesthesia and analgesia in oral and maxillofacial region.