Despite lack of paediatric labelling, contributions to the literature on paediatric applications of dexmedetomidine have increased over recent years. Dexmedetomidine possesses many properties that are advantageous for a sedative and anaesthetic; it has been reported to provide sedation that parallels natural sleep, anxiolysis, analgesia, sympatholysis, and an anaesthetic-sparing effect with minimal respiratory depression. In addition, there is increasing evidence supporting its organ-protective effects against ischaemic and hypoxic injury. These favourable physiological effects combined with a limited adverse effect profile make dexmedetomidine an attractive adjunct to anaesthesia (general and regional) for a variety of procedures in paediatric operating rooms. A comprehensive understanding of the pharmacological, pharmacokinetic, and pharmacodynamic effects of dexmedetomidine is critical to maximize its safe, efficacious, and efficient paediatric perioperative applications. This review focuses on the current paediatric perioperative and periprocedural applications of dexmedetomidine and its limitations, with a consideration for the future.

Dexmedetomidine: review, update, and future considerations of paediatric perioperative and periprocedural applications and limitations

More than 200 studies and reports have been published regarding the use of dexmedetomidine in infants and children. We reviewed the English literature to summarize the current state of knowledge of this drug in children for the practicing anesthesiologist. Dexmedetomidine is an effective sedative for infants and children that only minimally depresses the respiratory system while maintaining a patent airway. However, dexmedetomidine does depress the cardiovascular system. Specifically, bradycardia, hypotension, and hypertension occur to varying degrees depending on the age of the child. Hypertension is more prevalent when larger doses of dexmedetomidine are given to infants. Consistent with its 2-hour elimination half-life, recovery after dexmedetomidine may be protracted in comparison with other sedatives. Dexmedetomidine provides and augments analgesia and diminishes shivering as well as agitation postoperatively. The safety record of dexmedetomidine suggests that it can be used effectively and safely in children, with appropriate monitoring and interventions to manage cardiovascular sequelae.

Review article: Dexmedetomidine in children: current knowledge and future applications.

Knowledge of the Eagle's syndrome shows that its symptoms can be very easily confused with other types of craniomandibular disorders, especially temporomandibular disorders (TMD). The aim of this study was to find a possible correlation between the presence of TMD and elongation of the styloid process as well relate to presence of calcification of the stilohyoid chain. Fifty patients with TMD, confirmed from the RDC/TMD, were examined clinically and radiographically. Radiographic documentation consisted of digital panoramic radiograph and digital lateral cephalometric radiograph. Radiocef software (Radiomemory) was used for the analysis of radiographs by means of specific cephalometric tracing and linear measurements of the styloid process. Each radiograph was traced and measured three times with intervals of 1 month to spread the error. Statistical analysis was performed by Pearson's test (p=0.001) using Biostat 4.0 statistical software. Result showed an incidence of 76% elongation of the styloid process in the sample. There was a correlation between the bilateral measures taken in panoramic radiographs (?<0.001) and also for measures of styloid process length carried out in different panoramic radiographs and lateral cephalometric radiographs (?<0.001). It was concluded that there is prevalence of elongated styloid process in patients with TMD. However, no relationship was found between measurements on the stylohyoid chain and symptoms of headache, orofacial pain, tinnitus and vertigo.

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Styloid Process Elongation and Calcification in Subjects with TMD: Clinical and Radiographic Aspects

The calcified stylohyoid ligament and the elongated styloid process (SP) are identified radiographically, are associated with several syndromes and symptoms. The aim of this study was to classify and determine the incidence of different types of stylohyoid chain patterns in Turkish population to provide a guide for the dentist and maxillofacial surgeon. The effect of menopause, on the elongation of SP was also investigated. 1,600 patients, who visited Ege University Faculty of Dentistry, were enrolled. Images were evaluated for the pattern of stylohyoid chain complex according to O’Carroll’s classification. The difference between age and gender was evaluated using χ2 and ANOVA tests. Normal SP (Patterns A, B, C, D) 68.3 %, elongated SP (Pattern E) 27.1 %, calcified stylohyoid ligament (Patterns F, G, H, I, J, K) 1.7 % and absent stylohyoid chain 2.5 % ratios were encountered. Pattern D (52.5 %) was the most prevalent stylohyoid chain pattern followed by Pattern E (27.1 %) and Pattern C (10.7 %), respectively. Among the calcified stylohyoid ligament groups studied, Pattern G (2.6 %) was most frequently observed. There was no difference in gender for the type of stylohyoid chain complex pattern (p > 0.05). No statistically significant difference was found between menopause and non-menopause group (p > 0.05). According to the results of the present study, styloid process elongation is more common in older adults with no correlation to gender. In addition, menopause had no effect on the calcification or elongation of the stylohyoid chain. The sum of the elongated SP and the calcified stylohyoid ligament was 28.8 %.

Prevalence and pattern of stylohyoid chain complex patterns detected by panoramic radiographs among Turkish population.

The aim of this investigation was to determine the impact of orthognathic surgery on quality of life in patients with dentofacial deformities at immediate presurgery and at 3-week, 3-month, and 6-month intervals following the surgery. Subjects included forty-three 18-40-year-old Iranian orthognathic patients who were referred to private offices in Isfahan. Data collection was performed using the 22-item Orthognathic Quality of Life Questionnaire (OQLQ). Participants completed the questionnaire prior to surgery and 3 weeks, 3 months, and 6 months after it. Differences and correlations were calculated by the two-tailed t-test, ANOVA with Repeated Measure test, and the Pearson correlation coefficient. The results showed significant reduction returned to baseline in OQLQ mean scores and aesthetic, awareness, and social subdomains in all 3 intervals after surgery. However oral function domain showed an increase at T2 and then a decrease at next intervals. Maximum and minimum effect size were observed in aesthetic (ES = 0.7) and oral function (ES = 0.3) domain, respectively. Based on the finding of this study, in 6-month interval after surgery, orthognathic surgery causes significant improvements in quality of life in patients with dentofacial deformities as assessed in emotional, psychological, oral function, and social domains and maximum changes occurred in emotional domain.

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Impact of Orthognathic Surgery on Quality of Life in Patients with Dentofacial Deformities

http://www.exodontia.info/files/JOMS_2007._Styloid-Stylohyoid_Syndrome_Eagle_s_Syndrome_._Literature_Review_Case_Report.pdf

Styloid-stylohyoid syndrome: literature review and case report.

Induced hypotension in orthognathic surgery: a comparative study of 2 pharmacological protocols.

The purpose of this study was to evaluate the prevalence of the several types of maxillofacial fractures correlationating gender, age ,site of injury and the evolution of the number of pacients with facial fracture underwent surgical treatment in Maringa-Pr between 1997 and 2003.The methodology used was the inductive approach with statistics and descriptive procedures,using the medical files of the pacients treated on this period. In this five year retrospective study, 1945 pacients were evaluated. The results demonstrated that 67,8% of the patients were male. The more common age was between 21 and 30 years with 28,5%, the 11-to20 group represented 25,2% and the 31-to-40 group 19,6%. The nasal bones fracture had the highest incidence, with 398cases, followed by the zygomatic-orbital complex with 390 cases and the mandibular fractures with 289 cases. Descriptors: Surgery; Maxillofacial trauma; Epidemiology

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Estudo epidemiológico dos traumatismos bucomaxilofaciais na região metropolitana de maringá-pr entre os anos de 1997 e 2003 epidemiologic study of maxillofacial trauma in maringá-pr metropolitan area between 1997 and 2003

OBJETIVO: Avaliar a resistencia a tracao de duas resinas utilizadas para colagem de acessorios para tracionamento dentario. METODOLOGIA: o presente estudo comparou a adesividade e praticidade de duas resinas destinadas ao tracionamento ortodontico de dentes impactados: a Concise® da 3M®, presente no mercado ha alguns anos e tida como referencia na realizacao deste procedimento; e a Fill Magic® da Vigodent®, cuja tecnica e julgada mais simples pelo fabricante. Foram incluidos 40 terceiros molares em corpos de prova e estes divididos em dois grupos de 20, um para cada resina. Uma vez colados os braquetes, os corpos de prova foram submetidos a forca de tracao horizontal (10 de cada grupo) e vertical (10 de cada grupo), ate que os braquetes se soltassem. Os valores obtidos na maquina universal de ensaios foram registrados e comparados por meio de medias para que fosse possivel estabelecer as vantagens e desvantagens de cada resina. RESULTADO E CONCLUSAO: apesar dos valores obtidos com a resina Fill Magic® terem sido menores que os da resina Concise®, comprovou-se que eles sao suficientes para a realizacao do tracionamento ortodontico.

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Estudo laboratorial de teste de resistência ao tracionamento da resina composta fotopolimerizável Fill Magic® destinada à colagem de braquetes para tracionamento ortodôntico de dentes retidos

Angelo José Pavan

Papers

Styloid-stylohyoid syndrome: literature review and case report.

Induced hypotension in orthognathic surgery: a comparative study of 2 pharmacological protocols.

Estudo epidemiológico dos traumatismos bucomaxilofaciais na região metropolitana de maringá-pr entre os anos de 1997 e 2003 epidemiologic study of maxillofacial trauma in maringá-pr metropolitan area between 1997 and 2003

Estudo laboratorial de teste de resistência ao tracionamento da resina composta fotopolimerizável Fill Magic® destinada à colagem de braquetes para tracionamento ortodôntico de dentes retidos

Estudo da densidade radiográfica digital do tecido ósseo face ao implante do polímero de mamona em coelhos