Analgeic eficacy /certified fixed orthodontic courses by Indian dental academy


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Analgeic eficacy /certified fixed orthodontic courses by Indian dental academy

  1. 1. ANALGIC EFFICACY INDIAN DENTAL ACADEMY Leader in continuing dental education
  2. 2.    Pain resulting from surgical removal of third molars is a frequent problem and may effect patient’s postoperative quality of life. Pain reaches max intensity within 3-5 hrs of surgery. NSAID’S inhibit the synthesis of PG’S and reduce inflammatory reaction and nociceptive stimuli and thus contribute to pain control.
  3. 3.    Aceclofenac frequently used in medical practice to control rheumatic pain. Aceclofenac has anti-inflammatory properties similar to diclofenac and indomethacin and yields good results in control of dental pain. The peak of plasma concentration brtween 1h 25min and 3h, so the recommended dosage is 200 mg/day
  4. 4.  Forty patients, twenty six female and fourteen male, age 18-35 years( mean 23 yrs).  Inclusion criteria were surgical procedure requiring osteotomy and/or tooth sectioning.  Exclusion criteria:- for female pts, not pregnant or breastfeeding, other exclusion criteria were no known sensitivity to NSAID, no reported use of other nsaid, psychotropic drugs or chronic med, no ho blood dyscrasias or immunosupresion.
  5. 5.    Patients divided into two groups:group 1- 20 pts medicated with 2 tablets of 100mg aceclofenac taken orally 1 hr before surgery group 2- 20 pts medicated with 2 tablets of 100mg aceclofenac taken orally in the early postoperative period. SURGICAL TECH:- anaesthetic block of alveolar, mandibular, lingual and buccal nerves with 2% mepavacain chloride with adrenaline 1:100,000. Mucoperiosteal incision in the retromolar trigone, with a relaxing vestibular incision In the mesial aspect of second molar and raising a mp flap.
  6. 6.    Osteotomy with a rotary 702 bur and 0.9%saline irrigation, and tooth sectioning when indicated is done with 151 zekaria bur 28mm. Tooth elevated with straight and offset elevators and suturing done with monofilamentous nylon simple interrupted suture. Analgesic escape med was two 500mg paracetmol tabs administered every 6h in both groups. The assessment of pain sensitivity was conducted with two scales, a visual analogue scale and a 0-4 scale, used by the pts at 2,4,6,12 and 24h after surgery
  7. 7.    VAS SCALE:- the difference in the post op pain scores between the two groups was not significant at any of the time points. although pts in group 1 had a lower pain score at all points. Mean pain score in both groups was never greater than 2.5 0-4 SCALE:-at 6h after surgery, the difference between the groups was signifinicant. This diff is observed in both scales. The results of the t test showed that the efficacy of nsaids was greater in group 1
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  10. 10.   POST-OP pain resulting surgery of impacted mand third molars is one of the most frequent complications. Pain is moderate to severe and likely to affect the patients routine. Pain is subjective and experienced differently by each individual. Therefore only patients are able to assess the pain that they are feeling. In this study the parameters used to assess pain intensity were visual analogue scale and 0-4 scale.
  11. 11.     Results found in the vas showed that group 1 had a lower pain score at all time points in the study. In both groups, a 200mg NSAID dose was efficient in controlling pain, with mean vas score below 2.5. Mean pain score for group 1in the first 6h after surgery, the critical pain period, was lower in both the scales. These results show that NSAIDS are more efficient in controlling pain when administered before the onset of inflammatory process.
  12. 12.     The criteria that we adopted to determine the study time points were based on literature reports that indicate the greatest pain is experienced in the 3-6h period after surgery. In the present study the currently recommended max daily dose, 200mg was used. The use of a control placebo group would be ideal to evaluate the efficacy of the current drug studied here. Our results showed that, considering the first 6 postop hours, aceclofenac was more efficient in controlling pain resulting from surgery of impacted mand third molars when administered before surgery.
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  14. 14. Thank you Leader in continuing dental education