The plight of the plaintiff.
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Biomedical subjects
Publications and source records attributed to D M Laskin.
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The safety record of local anaesthetic agents is high but complications do occur. These may be systemic reactions to the local anaesthetic itself or to the vasoconstrictor. The former may be allergic or toxic in nature. Psychomotor reactions, often attributed erroneously to the vasoconstrictor, are more common. Regional complications, usually due to faulty technique, may be immediate or delayed. Among the former are pain, haematoma formation, tissue blanching, facial paralysis, amaurosis, diplopia and needle breakage. The delayed regional complications include pain, prolonged anaesthesia or paraesthesia, trismus, infection, sloughing and ulceration. The management of these complications is described.
Indomethacin (100 mg. per day for 3 days) was tested for its prophylactic effects on the postsurgical complications of pain, swelling, and trismus after removal of impacted teeth. The drug resulted in a significant reduction of the swelling and an analgesic effect which was equal to that of acetaminophen and codeine. Only two minor side effects were encountered.
The effectiveness of intramuscular indomethacin was compared with that of hydrocortisone succinate for the control of edema resulting from experimentally induced surgical trauma in rats. Both drugs produced a significant reduction in tissue water, but no difference could be detected between the effects of the two drugs. These findings indicate the advisability of clinical trials of indomethacin in the control of postsurgical swelling and pain.
Autogenous oral mucosa and skin grafts have been used clinically in vestibuloplasty to limit sulcus regression. However, these procedures require an additional surgical site and therefore increase morbidity. This study was designed to determine whether fresh porcine skin grafts would be as effective as skin or palatal mucosal grafts for controlling oral wound contraction. Standard sized experimental wounds were produced in dogs and, after grafting, were studied grossly and histologically for five to 60 days. All of the grafted sites showed less contraction than the control wounds, which were allowed to heal by secondary epithelialization. These findings suggest that porcine skin could serve as an effective biologic oral dressing following vestibuloplasty.
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This paper reports the short-term and long-term results of conservative reversible treatment used in 175 patients with MPD syndrome. These results are compared with those from ten published papers in which investigators used either irreversible treatment methods, reversible methods, or a combination of both approaches. The treatment outcome results in this study were similar to those in all of the previously reported studies. These findings suggest that conservative reversible therapies are both sufficient and appropriate for management of MPD syndrome in most patients. Major alterations of mandibular position or dentoalveolar relationships do not appear to be necessary for obtaining either short-term or long-term success, and therefore they can be generally regarded as inappropriate treatment for this disorder.
As a result of major advances in the management of disease, life span has been greatly extended and with it there has been a significant increase in the geriatric population requiring oral surgery. Of major concern to the practitioner is the proper treatment of such patients. Modifications in preoperative, intraoperative and postoperative care are required for the management of these individuals and have to be related to the physiologic, psychologic and pathologic changes occurring in the elderly. When appropriate precautions are taken age should not be a barrier to successful oral surgery.