Amit Kumar Srivastava

Abstract

Introduction: Prevention of postoperative pain can be achieved by effective blockade of noxious stimuli generated during surgery that is after central sensitization. Preventive analgesia or antinociceptive treatment started before surgery in order to prevent central sensitization and limit the subsequent pain experience.1 Aim and Objective: The aim of the study was to evaluate the role of NSAIDs as preemptive analgesia in controlling pain and swelling after gingivectomy. Materials and Methods: total of 60 patients were randomly divided into 3 groups, Group A: Tab Aceclofenac 100mg given 30 minutes before gingivectomy, Group B: Tab Ibuprofen 400mg and in Group C: Placebo given to the patients 30 minutes before gingivectomy procedure. Pain intensity were recorded at 6hr, 12hrs, 24hrs, day 2 and day 3 post gingivectomy. Swelling and No. of rescue analgesic taken by the patient recorded at day 1, day 2 and day 3 after gingivectomy. Result: The result showed that postoperative pain and swelling reduction was better with Aceclofenac followed by Ibuprofen then Placebo. The distribution of pain reduction was statistically significant at 6hr postgingivectomy. Conclusion: A preoperative single dose of anti-inflammatory drugs (NSAIDs) can regulate the release of inflammatory mediators and reduce the amount of pain and swelling during postoperative period. Keywords: Nonsteroidal anti-inflammatory drugs, Chemical mediators, Gingivectomy, Preemptive analgesia, Visual analog scale.

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Abstract

Aims: The aim of this study was to evaluate the role of Dexamethasone (Steroidal anti-inflammatory drug) and Ibuprofen (Nonsteroidal anti-inflammatory drug) in controlling postoperative pain and swelling following gingivectomy procedure when administered preoperatively. Materials and Methods: It was triple blind placebo controlled clinical trial in which total of 60 patients were randomly allocated for external bevel gingivectomy. All patients were divided in three groups as follows: In Group A: Tab Dexamethasone 4mg, Group B:Tab Ibuprofen 400mg and in Group C: Placebo tab orally given to the patients 30 minutes before gingivectomy procedure. Pain intensity were evaluated using visual analog scale(VAS) at 6hr, 12hr, 24hr, day 2 and on day3 postgingivectomy period and swelling scores at day 1,day 2 and on day 3 postgingivectomy period using visual scoring system. The data collected were statistically analysed using one way analysis of variance (ANOVA) test. Result & Conclusion: At 6hr and 12hr postgingivectomy period pain intensity was almost same with Group A (Dexamethasone) and Group B (Ibuprofen) and was maximum with Placebo group. At 24hr, day 2 and day 3 postgingivectomy period, the pain intensity was least with Dexamethasone group followed by Ibuprofen then Placebo group. It was found that at day 1 postgingivectomy period swelling was significantly less with Dexamethasone group followed by Ibuprofen group then Placebo group. The present study showed that Dexamethasone is better than Ibuprofen in controlling pain and edema following gingivectomy procedure. Keywords: Steroidal anti-inflammatory drugs (SAIDs), Nonsteroidal anti-inflammatory drugs (NSAIDs), Central sensitization, Peripheral sensitization, Cyclooxygenase pathway, Phospholipase enzyme.

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Introduction: In this scientific era of high technologic advancement, lots of progress has been made in the field of dentistry. LASER is one of the most important latest additions in the existing list of advanced equipment. In the last 3-decades laser have made a mark in the field of medicine as a useful alternative to conventional method of therapy as well as in dentistry too. Aims and Objectives: The aims and objectives of present study was to evaluate the wound healing after ErCr:YSGG laser gingivectomy over conventional scalpel gingivectomy. Materials and Methods: Twenty patients (20) with a total of Forty (40) quadrants of gingival enlargements were selected for external bevel gingivectomy. Patients divided into following groups: Group-A (Test Group) After phase1 therapy remaining suprabony pocket /enlarged gingiva removed by laser gingivectomy using Er,Cr:YSGG laser in 20 patients. Group-B (Control Group): After phase1 therapy remaining suprabony pocket/enlarged gingiva removed by conventional scalpel gingivectomy in 20 patients. Wound Healing were evaluated at 1st, 2nd, 3rd, 7th, 14th, 28th day after gingivectomy. Results and Conclusion: All peroperative and postoperative records were compared between test & control groups.No statistically significant difference found in healing between laser gingivectomy and scalpel gingivectomy but to draw a definite conclusion regarding the wound healing efficacy of Er,Cr:YSGG lasers, further study involving higher number of samples are warranted. Keywords: Gingival enlargement, Er,Cr:YSGG laser, Ninhydrin, Gingival crevicular fluid, Carbonization.

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Introduction: Laser is one of the most important latest addition in the existing list of advanced equipments. However exaggerated marketing claims by clinician and manufacturers initiated falsely elevated expectations with regard to performance of laser in dentistry. Aims and Objectives: The aims and objectives of present study was to evaluate the efficacy of ErCR:YSGG laser gingivectomy over conventional scalpel gingivectomy. Materials and Methods: Twenty patients (20) with a total of Forty (40) quadrants of gingival enlargements were selected for external bevel gingivectomy. Patients divided into following groups: Group-A (Test Group) after phase1 therapy remaining suprabony pocket/enlarged gingiva removed by laser gingivectomy using Er,Cr:YSGG laser in 20 patients. Group-B (Control Group): After phase1 therapy remaining suprabony pocket/enlarged gingiva removed by conventional scalpel gingivectomy in 20 patients. The clinical evaluations were done under the following parameters: 1) Per & Post -operative bleeding 2) Postoperative pain 3) Postoperative swelling. Patients were evaluated at 1st, 2nd, 3rd, 7th, 14th, 28th day after gingivectomy. Results and Conclusion: All peroperative and postoperative records were compared between test & control groups. Following conclusions are drawn from the present study: Laser gingivectomy is superior to scalpel gingivectomy in terms of controlling per and post operative bleeding, postoperative pain and postoperative swelling as compared to scalpel gingivectomy. Keywords: Er,Cr:YSGG laser, Gingival enlagement, Gingivectomy, Acetaminophen, Visual analog scale.

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