Comparative efficacy and safety of different corticosteroids to reduce inflammatory complications after mandibular third molar surgery: a systematic review and network meta-analysis protocol

Review question / Objective: This systematic review aims to compare the effects of different corticosteroids to reduce postoperative inflammatory complications (pain, edema, and trismus) after mandibular third molar surgery by applying a frequentist network meta-analysis approach. To this end, the proposed study will answer the following questions: 1) Among diverse corticosteroids currently available, what is the best preoperative option to control postoperative inflammatory complications? 2) What is the optimal dose and route of administration of corticosteroids prior to mandibular third molar surgery to control the pain, edema, and trismus induced by the surgery? Condition being studied: Inflammatory complications after mandibular third molar surgery (Pain, edema, and trismus).

Comparative efficacy and safety of pharmacological interventions to reduce inflammatory complications after mandibular third molar surgery: a systematic review and network meta-analysis protocol

Review question / Objective: This systematic review aims to compare the effects of different drugs to reduce postoperative inflammatory complications (pain, edema, and trismus) after mandibular third molar surgery by applying a frequentist network meta-analysis approach. To this end, the proposed study will answer the following questions: 1) Among diverse drugs currently available, which postoperative pharmacological regimen is the most efficient to reduce pain after mandibular third molar surgery? 2) Is the pre-emptive analgesia effective in reducing pain immediately after the mandibular third molar surgery? In this case, 3) Which preoperative pharmacological regimen is the most efficient? 4) Among diverse corticosteroids currently available, what is the best option to control the edema induced by the surgery? 5) What is the optimal dose and route of administration of corticosteroids prior to mandibular third molar surgery to control the pain/ edema induced by the surgery? Condition being studied: Inflammatory complications after mandibular third molar surgery (Pain, edema, and trismus).

USING A «DIRECTA» LUXATOR FOR DENTAL EXTRACTION OPERATION

Reducing the trauma of the operation of dental extraction and preservation of the intact bone tissue of the alveolar process of the jaw after surgery to allow subsequent dental implantation. Dental extraction operations were carried out in 60 patients for two months in the surgical department of the dental medical center of Bogomolets national medical university. 25 of patients have their teeth removed using traditional instruments – elevators and forceps, 35 patients have tooth extraction using only the «Directa» Luxator or in combination with traditional instruments. Local complications during the dental extraction by an elevator: a fracture of the tooth crown, rupture of the mucous membrane of the alveolar process, a fracture of the wall of the hole occurred in 30% of cases. The results of study indicate that by using luxator to remove teeth, the listed local complications were not observed. In cases of fracture of the crown of the root of the tooth, using luxator, it was possible to avoid traumatic atypical extraction of the fractured root. Reducing the time of surgical intervention using «Directa» Luxator compared to the use of an elevator and forceps allowed us to minimize postoperative inflammatory complications. The advantages of using luxator are: shorter time of a dental extraction operation, less traumatic damage to the periodontal and tooth cavity walls, no complications during the operation and after its completion, creating favorable conditions for carrying out a single-stage implant after dental extraction.

SURGICAL TREATMENT OF NECROTIZING INFECTION OF THE SOFT TISSUES OF THE NECK

Summary. Early diagnosis and timely surgical treatment of necrotizing soft tissue infection of the neck is an urgent problem of modern medicine, far from a definitive solution. The purpose of the work is to optimize the surgical treatment of patients with necrotizing infection of the soft tissues of the neck. Materials and methods. The results of surgical interventions of 76 patients with odontogenic phlegmon of the neck that were treated at the surgical ward were analyzed. Results and discussion. The essential condition for successful treatment of phlegmon neck is immediate surgery. Indications for surgery in the mediastinum should be considered in the total involvement in the necrotic process of the deep and superficial cell spaces of the neck. Preventive antibiotic therapy in patients after surgery on the neck helps to reduce the incidence of postoperative inflammatory complications and improve the quality of life of patients. Conclusions. Mortality in acute purulent odontogenic mediastinitis depends on timely hospitalization, diagnosis and early surgical treatment using extracorporeal detoxification methods.

The impact of infectious complications on long-term prognosis after curative resection for gastric cancer.

122 Background: Several studies have reported that postoperative complications such as anastomotic leakage affect long-term prognosis after gastric cancer surgery. This study aimed to determine whether or not long-term outcomes were affected by the postoperative inflammatory complications in patients who underwent curative resection for gastric cancer. Methods: The patients were retrospectively selected from the medical records of consecutive patients who underwent curative gastrectomy with nodal dissection for gastric cancer at Yokohama City University and Kanagawa Cancer Center from January 2000 to August 2015. Inflammatory complications were evaluated according to the Clavien-Dindo classification. Overall survival (OS) was compared between postoperative inflammatory complications (IC) and no-complication (NC) groups. Results: A total of 2,254 patients were eligible for inclusion in the present study. One hundred seventy-five patients had IC group, while 2,079 patients had not. Operation time (p < 0.001), blood loss (p < 0.001) was significantly greater in the IC group. The incidence of postoperative inflammatory complication grade 2 or higher was 8.5% in which, pancreatic fistula (2.8%), anastomotic leakage (1.8%) were occurred. The mortality rate was 0.18%. The five-year OS rates of the IC and NC groups were 74.9% and 83.2%, respectively. The difference was statistically significant (p = 0.015). Multivariate Cox’s proportional hazard analyses demonstrated that the postoperative inflammatory complications were a significant prognostic factor for OS. Conclusions: Postoperative inflammatory complications have an obvious impact on the OS in curatively resected gastric cancer patients. It is necessary to reduce the incidence of postoperative complications.