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At least 55 records · Page 3Linked to original sources
PubMed1991

Attenuation of anxiety in ambulatory oral surgery patients with oral triazolam.

The purpose of this investigation was to determine if the preoperative administration of an oral anxiolytic agent (triazolam) is beneficial in reducing the cardiovascular response to stress and anxiety. Twelve consecutive patients, six who received the drug and six who received a placebo, were monitored from the night before surgery at home until the morning with a Holter monitor. On presentation for surgery, levels of anxiety as well as heart rate and presence of cardiac arrhythmias were determined for the two groups. Patients who received the study medication had an anxiety level on the day of surgery similar to that recorded at an earlier consultation visit, whereas the placebo group showed a tendency toward an increase in anxiety on the day of surgery. There was a significant difference for resting heart rate between the two groups at various intervals associated with the preparation for the surgery. There were no complications related to the medication and, therefore, on the basis of this study, it appears that the administration of an oral anxiolytic agent prior to the patient presenting for surgery is beneficial in reducing the stress and anxiety associated with the operation as well as in reducing some of the cardiac manifestations of this stress.

Administration, Oral↗
PubMed1982

Broader horizons and indications for use of electrosurgery in oral surgery.

Electrosurgery offers oral surgery many unique, invaluable advantages. Hemostasis obtained with fully rectified cutting current, scar-free healing of electrosurgical wounds by granulation secondary repair as well as by primary intention, the ability to perform precise tissue cutting without the use of manual pressure, and sterilization of the surgical field are especially noteworthy advantages. Atraumatic tissue cleavage and sterilization of the wound eliminate and unfavorable postoperative sequelae common to scalpel surgery and contribute materially to rapid, uneventful postoperative healing. The ability to incise tissue precisely without use of pressure and effective hemostasis make possible sophisticated oral surgery procedures that cannot be duplicated safely by scalpel surgery.

Drainage↗
PubMed1991

Haemostasis in oral surgery--the possible pathogenetic implications of oral fibrinolysis on bleeding. Experimental and clinical studies of the haemostatic balance in the oral cavity, with particular reference to patients with acquired and congenital defects of the coagulation system.

Activation and inhibition of the haemostatic system was reviewed including the interaction between the four biological systems involved in haemostasis: the vessel wall, the platelets, the coagulation system and the fibrinolytic system. The haemostatic mechanism is initiated at the site of injury through local activation of surfaces and release of tissue thromboplastin, resulting in formation and deposition of fibrin. The coagulation process is regulated by physiological anticoagulants. Activation of fibrinolysis is triggered by the presence of fibrin, and the role of tissue-type plasminogen activators (t-PA) at the site of fibrin formation in particular is emphasized. The process is regulated by physiological inhibitors, of which alpha 2-antiplasmin, histidine-rich glycoprotein and plasminogen activator inhibitor are reported to be of major physiological significance. The role of fibrinolysis in the regulation of the dynamic haemostatic balance is discussed, elucidated through examples of congenital deficiencies of the coagulation and the fibrinoytic system. Pharmacological inhibitors of fibrinolysis (i.e. epsilon-aminocaproic acid and tranexamic acid) and their possible effect on the haemostatic system are described. The systemic effects on the fibrinolytic system of surgery and oral surgery is reviewed, and it is concluded, that oral surgery has insignificant effects on blood fibrinolysis. In contrast, oral surgery induces changes of fibrinolysis in the oral environment; initially the fibrinolytic activity of saliva is reduced, due to the presence of inhibitors of fibrinolysis originating from the blood and the wound exudate. When bleeding and exudation cease, the fibrinolytic activity of the saliva will increase. Plasminogen and plasminogen activator, identified as t-PA are present in the oral environment under physiological conditions. Plasminogen is secreted in the saliva and the sources of t-PA include oral epithelial cells and gingival crevicular fluid. The presence of plasminogen and t-PA in the oral environment implies that when fibrin is present (i.e. after surgery), fibrinolysis is triggered. Haemorrhagic complications to oral surgery in patients without known defects of the coagulation system is reviewed. It is concluded that the investigations conducted to the present day do not permit final conclusions with respect to the pathophysiological role of defects in the coagulation and the fibrinolytic systems for the development of bleeding after oral surgery. Further investigations are necessary in order to clarify these aspects, and should include extensive laboratory analyses to reveal rare congenital defects such as factor XIII- and alpha 2-antiplasmin deficiencies.(ABSTRACT TRUNCATED AT 400 WORDS)

Anticoagulants↗
PubMed2003

[Oral surgery in hemophilia patients].

Oral surgery in hemophilia patients requires special arrangements in close collaboration with a hemotologist. Minor oral surgeries in not complicated cases can be done by a dentist or an oral surgeon with aid and assistance of a hemotologist. All major oral surgeries in hemophilia patients with antibodies counteracting coagulation agents should occur in a hemophilia treatment centre.

Adult↗
PubMed1988

Pharmacokinetics of a new oral antibacterial agent, ofloxacin, in dentistry and oral surgery.

The new oral antibacterial agent, ofloxacin, was administered for prophylactic purposes to a group of 12 patients with dental and oral inflammatory processes requiring oral surgery. Drug concentrations in serum, saliva and gingival mucosa were assayed at different times after administration of the drug. Good serum, salivary and gingival mucosal tissue concentrations were achieved.

Adult↗
PubMed1990

Antimicrobial prophylaxis in oral surgery.

Postsurgical infections after oral surgery in healthy patients are almost exclusively wound infections caused by aerobic and anaerobic microorganisms endogenous to the oral cavity. Available data indicate that, in otherwise healthy patients, infectious complications after dentoalveolar surgery are decreased after penicillin prophylaxis. However, prophylaxis is still not recommended as a routine procedure, because wound infections are generally mild and easy to deal with. In maxillofacial surgery evidence exists that short term prophylaxis is preferable to long term; however, no definite proof is available to indicate that prophylaxis is preferable at all. In patients with locally or systemically reduced defence mechanisms, antimicrobial prophylaxis is generally advocated. Best defined regimens for antimicrobial prophylaxis in oral surgery concern patients at the risk of endocarditis, while guidelines still have an empiric base in immunocompromised patient groups.

Anti-Bacterial Agents↗
PubMed1983

[Clinical use of cefroxadine in dentistry and oral surgery].

Cefroxadine (CXD) is an orally administered synthesized cephalosporin antibiotic developed by Ciba-Geigy Limited (Switzerland) in 1972. We have studied the clinical effectiveness of this drug in a total of 45 cases of various types of infections in the dentistry and the oral surgery. The studies resulted in showing 18 markedly effective cases, 19 effective cases, 5 slightly effective cases, 1 ineffective case, and 2 unknown cases showing an effective rate of 82.2%. Side effects manifested in 2 cases, of which 1 case was considered to be attributable to CXD, and the occurrence frequency of side effects was as low as 2.2%. In bacteriological test, there were many cases of mixed infections by Gram-positive and Gram-negative bacteria, and these infections were those which are observed in high frequency in dentistry and oral surgery infections. As a result of an overall evaluation of CXD clinical effects, the drug considered to be an antibiotic which is highly useful in dentistry and oral surgery.

Administration, Oral↗
PubMed1993

Prevention of postsurgical bleeding in oral surgery using tranexamic acid without dose modification of oral anticoagulants.

The hemostatic effect of tranexamic acid solution (4.8%) used as a mouthwash was compared with a placebo solution in 93 patients on continuous, unchanged, oral anticoagulant treatment undergoing oral surgery. The investigation was a randomized, double-blind, placebo-controlled, multicenter study. Before suturing, the surgically treated region was irrigated with 10 mL of tranexamic acid (46 patients) or placebo (47 patients) solution. The patients then performed mouthwash with 10 mL of the solution for 2 minutes four times daily for 7 days. The treatment groups were comparable regarding age, smoking habits, and surgery. Laboratory variables measuring vitamin K-dependent coagulation factors were within therapeutic ranges (international normalized ratio 4.00 to 2.10). One of the clinics used a different method for these measurements and therefore the levels of coagulation factor X in plasma obtained for the three clinics were compared. No significant difference in the range at which surgery was performed was found between clinics. In the placebo group, 10 patients developed bleeding requiring treatment, while none of the patients treated with tranexamic acid solution had bleeding. This difference was statistically significant (P < .01). The treatment with mouthwash was well tolerated. It was concluded that patients on oral anticoagulants can undergo oral surgery within the therapeutic range without reducing the dosage of anticoagulants, provided that local antifibrinolytic treatment with tranexamic acid solution is instituted.

Adult↗
PubMed2004

Drugs in oral surgery. Brief guidelines for adult patients.

Drugs administrable in oral surgery for adult patients are antiseptics-antibiotics, antiinflammatory-analgesics and sedative-hypnotics. Such drugs can be administered before, during or after oral surgery. Sedative-hypnotics can be administered before or during oral surgery in order to control the patient's anxiety. Anti-inflammatory-analgesics, on the other hand, can be administered before or after oral surgery to lower edema and pain. For this purpose, FANS are the most commonly used drugs but, in more traumatic oral surgery, the administration of a single pre-surgery dose of corticosteroids is suitable. As regards, antibiotics have to be given from 15 min to 1 h before oral surgery and continued or otherwise for 24-48 h depending on the dosage. post-surgery infection onset, in fact, is higher within 3 h after oral surgery.

Adult↗
PubMed2004

Development of a structured clinical operative test (SCOT) in the assessment of practical ability in the oral surgery undergraduate curriculum.

Competence in undergraduate oral surgery involves assessment of the students' knowledge, practical skill and attitude. The assessment of practical skills can be achieved using a formative assessment method such as the structured clinical operative test (SCOT) which uses a checklist for the assessment of a clinical task. The aim of this study was primarily to determine whether SCOTs could be integrated into the oral surgery undergraduate course, and secondarily to collect feedback from both the students and the staff on this assessment. A validated checklist was used by trained examiners to assess the performance of 49 students in their second clinical year undertaking simple exodontia. Feedback was collected from the students by questionnaire and from the staff by interview. The SCOT was well received by both students and staff. The main problem highlighted by the students was the perceived inter-examiner variability and by the staff, the disruptive effect on the clinics. The checklist must be objective enough to prevent misinterpretation. Despite these limitations, the SCOT provides a more objective assessment and serves to highlight weaker students, allowing them to be targeted for closer supervision and instruction as well as providing the students with a tool to measure their progress in oral surgery. The use of peer assessment by students may alleviate the burden on the staff.

Clinical Competence↗