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References: 1. “Modern Physical Organic Chemistry” by E. Anslyn and D. Dougherty, 2005, University Science 1 Mar 2006 Abstract: This chapter presents style conventions for citing references within a manuscript and for listing complete reference citations.
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Proposed job description with original signatures from the employee and Study Center. Director (Percentages of time spent on each function should be listed on the job. Briefly explain how instruction operations in 8086 can be classified. The arithmetic operations in the 8086 can be categorized as follows: - Data transfer instructions: These types of instructions involve transfer data using commands such as MOV etc. - Arithmetic instructions: As their name suggest these instructions are used An ISA may be classified in a number of different ways. A common classification is by architectural complexity.
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• Muraoka, Arata; Konishi, Hiroaki; Kaminishi, Yuichiro; Misawa, Yoshio 2011-10-01 We experienced a case with a remnant of a fractured guidewire in the coronary artery. Surgical removal of the total wire by manual traction was unsuccessful.
The wire was then cut near the right coronary orifice, and its proximal portion was removed. Cardiac interventionists should recognize that percutaneous coronary intervention is associated with the risk of various cardiovascular accidents. Patients should be informed of such risks.
• Kwon, Young-Min; Antoci, Valentin; Eisemon, Eric; Tsai, Tsung-Yuan; Yan, Yu; Liow, Ming Han Lincoln 2016-12-01 Contemporary 'dual-taper' modular femoral neck-stem designs have been associated with taper corrosion-related adverse local tissue reaction (ALTR) requiring revision surgery and stem removal. Extended trochanteric osteotomy is recognized as the workhorse procedure for revision hip surgery. The aim of our study is to describe our 'top-out' stem removal surgical technique and identify preoperative radiographic risk factors associated with periprosthetic fractures when using this technique.
This is a single-center, single-surgeon, retrospective case series. Operative and clinic records were reviewed for patients with dual-taper modular femoral neck-stem junction who underwent revision surgery for taper tribocorrosion-related ALTR.
Eighty-three patients (36 men and 47 women; mean age, 61.8 ± 10.3; body mass index, 30.2 ± 8.6) were revised using the top-out technique. Significant improvements in postoperative Harris hip score (P =.004), EuroQol 5-dimension questionnaire (EQ-5D; P.05). Timing of pain appearance and of first drug consumption was significantly lower in the mepivacaine group (P 60 microg/24 h, cortisol after 1-mg dexamethasone suppression test (1 mg-DST)>3.0 microg/dl, ACTH levels5.4 microg/dl. Two months after surgery, HPA axis function was assessed by low dose ACTH stimulation test or insulin tolerance test when needed: 39 patients were affected (Group B) and 21 were not affected (Group A) with hypocortisolism. The accuracy in predicting hypocortisolism of pre- surgical HPA axis parameters or their combinations was evaluated. The presence of >2 alterations among 1 mg-DST>5.0 microg/dl, ACTH. • Eberhardt, Doris; Berg, Almuth; Fleischer, Steffen; Langer, Gero 2013-08-01 An appropriate postoperative wound management helps to prevent surgical site infections.
However, ideal timing of dressing removal is an unresolved issue in current practice. The objective of this systematic review therefore was to provide a comprehensive synthesis of existing evidence concerning the efficacy of different periods of postoperative dressing removal in surgical wounds which are healing by primary intention. We searched MEDLINE, EMBASE, CINAHL, The Cochrane Library (all in August 2011), and hand-searched additional sources. All randomised controlled trials that were comparing different periods of leaving dressings in place, including not dressing the surgical site at all, and covering wounds until suture removal were included.
We conducted our systematic review and meta-analysis in accordance with the recommendations of the Cochrane Collaboration. Eight trials with a total of 2097 participants were included in our meta-analysis. All studies were at high or unclear risk of bias. This meta-analysis did not show a higher rate of wound infections or other wound complications associated with an early dressing removal in wounds that are healing by primary intention: risk difference (RD) -0.01; 95%-confidence interval (CI) -0.03, 0.01. However, conclusions are limited due to bad study quality of included studies. Finally more sound research is needed. • Payne, Alan G T; Tawse-Smith, Andrew; Wismeijer, Daniel; De Silva, Rohana K; Ma, Sunyoung 2017-01-01 To determine implant survival and prosthodontic maintenance of implant-assisted mandibular removable partial dentures in a multicentre prospective study up to 10 years.
Forty-eight participants with mandibular distal extension partial dentures were selected. A control group of 12 New Zealand participants had new conventional mandibular partial dentures made. Three test groups of 36 participants in New Zealand (n = 12), the Netherlands (n = 12) and Colombia (n = 12) had bilateral distal implants placed. Surgical and prosthodontic outcomes were documented with only healing caps placed (Stage 1) and with an attachment system (Stage 2). No implants failed after 3 years. Four late implant failures in three participants occurred in New Zealand (two unilateral implant failures after 5 and 8 years and two bilateral implant failures in the same participant after 6 and 10 years); two unilateral late implant failures occurred in the Netherlands and no late failures in Colombia. Implant survival rate was 92% by 10 years.
Resonance frequency measurements were taken at surgery implant stability quotient (ISQ) 62.44 ± 7.46; range 40 - 79), baseline (ISQ 63.22 ± 6.17; range 50 - 74) and after 3 years (ISQ 66.38 ± 6.77; range 55 - 83). In New Zealand and Colombia, measured crestal bone levels were 2.03 ± 0.71 mm and 2.20 ± 0.81 mm, respectively, at baseline and 3 years. For Stage I, principal prosthodontic maintenance issues were loose healing caps among 10 New Zealand participants, four Colombian participants and one Netherlands participant. For Stage 2, matrix activation and overdenture puncture fractures resulted in 41 events (25 participants) in New Zealand over 10 years, whilst over 3 years, there were 14 events in nine Colombian participants and six events in five Netherlands participants.
This clinical multicentre research complements previous case reports, case series, retrospective and prospective studies on the notion of implant • Shruthi, R; Kedarnath, NS; Mamatha, NS; Rajaram, Prashanth; BhadraShetty, Dinesh 2013-01-01 Aim: Articaine is an amide local anesthetic that differs from other agents of its group due to the presence of thiophene ring instead of a benzene ring. Some researchers claim that articaine is superior to lidocaine in its biologic profile. The aim of the study is to compare the efficacy of articaine with that of lidocaine which has proven efficacy. Materials and method: This study was done on 50 subjects; 25 of them received 4% articaine HCl with 1:100000 epinephrine and the next 25 received 2% lignocaine HCl with 1:100000 epinephrine. Time of injection, onset of anesthesia, amount of anesthetic injected were recorded. Efficacy was determined using visual analog scale. The values were statistically analyzed.
Results: The mean onset time of anesthesia in study group was 2.07 ± 0.22 and 2.18 ± 0.26 minutes in comparison group. A mean duration of 4.28 +0.78 hours was seen with articaine group and 3.51 + 0.45 hours with the lignocaine group. No statistical difference between the two groups with regard to pain experience. Conclusion: Articaine has similar efficacy as that of lignocaine with slightly longer duration and can be used as an alternative to lignocaine in third molar surgeries. Clinical Significance: Increased availability of local anesthetics has improved interest in research about dental pain control. A quest for new methods of pain reduction is always justified. How to cite this article: R Shruthi, S N Kedarnath, S Mamatha N, Rajaram P, Dinesh B.
Articaine For Surgical Removal of Impacted Third Molar; A Comparison With Lignocaine. J Int Oral Health 2013; 5(1):48-53. PMID:24155578 • Bortoluzzi, Marcelo Carlos; Guollo, Andre; Capella, Diogo L 2011-07-01 The aim of this prospective study was to evaluate the pain course after surgical removal of third molars.
The sample consisted of 100 consecutive patients. Pain intensity was assessed by means of a visual analog scale (VAS). At day 1, moderate and severe pain were observed predominantly in patients who had surgery in the mandible (p. • Passacantilli, E; Anichini, G; Delfinis, C P; Lenzi, J; Santoro, A 2011-06-01 Since the early 1980s, CO(2), neodymium-doped yttrium aluminum garnet (Nd:YAG), and other laser prototypes have been widely used in neurosurgery as an intraoperative aid along with the cavitron ultrasonic surgical aspirator (CUSA), bipolar forceps, and microdissection. However, the English literature contains almost no reports on the use of thulium lasers during neurosurgical procedures. We report our experience with a thulium laser during the surgical removal of a tentorial meningioma.
The intraoperative technique utilized, as well as the clinical and radiological results of the procedure, are described. The thulium laser proved to be a useful tool during coagulation, shrinking, and resection of the basal implant of the tumor.
Use of the laser made the surgical procedure faster and easier, and no intraoperative bleeding was noted. No side effects were observed. Our experience indicates that thulium lasers are a valid aid during resection of benign intracranial tumors under microscope magnification. Driver Speed Awareness Course Carrington. Additional studies are required to define fully the role of these lasers in neurosurgical procedures.
• Lipkin, D; Colli, A; Somerville, J 1985-01-01 An isolated aneurysmal dilatation of the left atrial appendage was found in an 18 year old girl who presented with atrial fibrillation and an unusual cardiac shadow on routine chest radiographs. The diagnosis was made by cross sectional echocardiography. The giant appendage was excised to remove the risk of systemic embolism and the need for life long anticoagulation.
Images PMID:3966953 • 2017-01-01 Sialolithiasis, the most common salivary gland pathology, is caused by calculi in the gland itself and its duct. While patients with small sialoliths can undergo conservative treatment, those with standard-size or larger sialoliths require sialolithotomy. In the present case study, we removed two sialoliths located beneath the mucosa in the posterior and anterior regions of Wharton's duct, respectively. For the posterior calculus, we performed sialolithotomy via an intra-oral approach; thereafter, the small anterior calculus near the duct orifice was removed by hydraulic power. This method has not previously been reported. There were no complications either during the operation or postoperatively, and the salivary function of the gland remained normal. PMID:28770160 • Smith, W P 2013-01-01 The aim of this study was to identify the relative risk of damage to the inferior dental (ID) and lingual nerves in patients undergoing lower third molar removal.
A single surgeon reviewed 1,000 patients. Temporary ID neurosensory deficit was highest (11%) when root apices were intimate to the ID nerve and lowest (0.9%) when close or distant from the nerve. Permanent ID neurosensory deficit was 0.4% per tooth but only when intimate to the canal. Bone removal, tooth division, and lingual split technique increase the risk of excessive hemorrhage which appears to be linked to the highest risk of temporary ID neurosensory deficit (20%). Permanent lingual nerve injury was rare (0.06%) and not related to lingual retraction.
Preoperative warning for lower third molar removal can be individually tailored depending on the intimacy of the ID canal to the root apices and the anticipated surgical technique. Crown Copyright © 2013. Published by Mosby, Inc. All rights reserved. • Marconato, L 2006-09-01 An 8-year-old crossbreed dog presented after one episode of acute collapse due to rupture of a splenic haemangiosarcoma.
Following splenectomy the dog recovered well. Two days after discharge the dog re-presented because of gastric dilatation-volvulus (GDV) that eventually led to his death. Splenectomy to remove a voluminous splenic tumour may predispose to GDV and dogs may benefit from concurrent prophylactic gastropexy. • Lux, E A; Wahl, G; Erlenwein, J; Wiese, C; Wirz, S 2017-03-17 The application of ear acupuncture can contribute to a reduction of acute pain. Data on the application of ear acupuncture following oral surgery in odontology is insufficient. This study investigated the effectiveness of ear acupuncture as an auxiliary analgesic treatment in addition to local anesthesia for operative tooth removal. In this prospective open non-randomized pilot study (in accordance with the CONSORT publication) 2 cohorts of 50 patients each with the indications for an operative tooth removal either with or without the application of ear acupuncture in addition to local anesthesia with articain were observed.
Patients were allocated to the groups according to their preference. Pain intensity while resting and while chewing was recorded as the primary parameter for a period of 10 days. The secondary parameters were the subjective experience of anxiety and symptoms, such as headaches, dizziness and nausea.
The two groups did not differ significantly with respect to demographic variables or the use of local anesthetics. At the various measurement intervals, pain intensity while resting or chewing differed significantly between the two groups (ANOVA, p = 0.004, p = 0.007, respectively).
Furthermore, the experience of anxiety (ANOVA, p = 0.0001), the number of patients taking analgesics (χ(2)-test, p = 0.017) and the total postoperative consumption of analgesics (t-test, 0.001) revealed significant differences. In both groups the numerical rating scales (NRS) for postoperative headaches, dizziness and nausea were low. Despite a potential bias and methodological limitations of the study design, the results of this investigation suggest that ear acupuncture influences the experience of pain and anxiety in the postoperative period after tooth removal. As a treatment method with low adverse effects ear acupuncture can contribute to postoperative pain control, especially in patients with preoperative anxiety. • Kim, Junhwan; Lee, Danbi; Oh, Kyunghwan; Lee, Mingee; So, Seol; Yang, Dong Hoon; Kim, Chan Wook; Gwon, Dong Il; Chung, Young Hwa 2017-01-25 Jejunal variceal bleeding is less common compared with esophagogastric varices in patients with portal hypertension. However, jejunal variceal bleeding can be fatal without treatment. Treatments include surgery, transjugular intrahepatic porto-systemic shunt (TIPS), endoscopic sclerotherapy, percutaneous coil embolization, and balloon-occluded retrograde transvenous obliteration (BRTO).
Percutaneous coil embolization can be considered as an alternative treatment option for those where endoscopic sclerotherapy, surgery, TIPS or BRTO are not possible. Complications of percutaneous coil embolization have been reported, including coil migration.
Herein, we report a case of migration of the coil into the jejunal lumen after percutaneous coil embolization for jejunal variceal bleeding. The migrated coil was successfully removed using surgery. • Ye, Guozhu; Zhu, Bin; Yao, Zhenzhen; Yin, Peiyuan; Lu, Xin; Kong, Hongwei; Fan, Fei; Jiao, Binghua; Xu, Guowang 2012-08-03 The objective of present study was to offer insights into the metabolic responses of hepatocellular carcinoma (HCC) to surgical resection and the metabolic signatures latent in early HCC recurrence (one year after operation). Urinary metabolic profiling employing gas chromatography time-of-flight mass spectrometry (GC-TOF MS) was utilized to investigate the complex physiopathologic regulations in HCC after operational intervention. It was revealed that an intricate series of metabolic regulations including energy metabolism, amino acid metabolism, nucleoside metabolism, tricarboxylic acid (TCA) cycle, gut floral metabolism, etc., principally leading to the direction of biomass synthesis, could be observed after tumor surgical removal. Moreover, metabolic differences between recurrent and nonrecurrent patients had emerged 7 days after initial operation. The metabolic signatures of HCC recurrence principally comprised notable up-regulations of lactate excretion, succinate production, purine and pyrimidine nucleosides turnover, glycine, serine and threonine metabolism, aromatic amino acid turnover, cysteine and methionine metabolism, and glyoxylate metabolism, similar to metabolic behaviors of HCC burden.
Sixteen metabolites were found to be significantly increased in the recurrent patients compared with those in nonrecurrent patients and healthy controls. Five metabolites (ethanolamine, lactic acid, acotinic acid, phenylalanine and ribose) were further defined; they were favorable to the prediction of early recurrence.
• Muir, W W; Lerche, P; Robertson, J T; Hubbell, J A; Beard, W; Miller, T; Badgley, B; Bothwell, V 2000-09-15 To evaluate anesthetic effects of 4 drug combinations used for total intravenous anesthesia of horses undergoing surgical removal of an abdominal testis. Clinical trial. 32 healthy cryptorchid horses. Horses were sedated with xylazine and butorphanol and were randomly assigned to 1 of 4 groups: induction of anesthesia with ketamine and diazepam and maintenance with bolus administration of ketamine and xylazine (KD/KX); induction and maintenance of anesthesia with bolus administration of tiletamine-zolazepam, ketamine, and detomidine (TKD); induction and maintenance of anesthesia with continuous infusion of xylazine, guaifenesin, and ketamine; and induction and maintenance of anesthesia with continuous infusion of guaifenesin and thiopental. Horses that moved 3 consecutive times in response to surgical stimulation or for which surgery time was >60 minutes were administered an inhalant anesthetic, and data from these horses were excluded from analysis. Quality of induction was not significantly different among groups.
Muscle relaxation and analgesia scores were lowest for horses given KD/KX, but significant differences among groups were not detected. Horses anesthetized with TKD had a significantly greater number of attempts to stand, compared with the other groups, and mean quality of recovery from anesthesia for horses in the TKD group was significantly worse than for the other groups. Anesthesia, surgery, and recovery times were not significantly different among groups.
Results suggest that all 4 drug combinations can be used to induce short-term anesthesia for abdominal cryptorchidectomy in horses. However, horses receiving TKD had a poorer recovery from anesthesia, often requiring assistance to stand. • Joshi, Sanjay; Ansari, Arsalan Shakil Ahmed; Mazumdar, Sima; Ansari, Sidra 2016-01-01 Purpose: The aim of this study was to evaluate and monitor the changes in vital parameters of patients during surgical removal of impacted mandibular third molars.
Methods: This was an in vivo study conducted in Oral and Maxillofacial Surgery Department of Terna Dental College. Sixty patients were randomly selected. Thirty patients were given a preoperative single dose of oral tablet alprazolam 0.5 mg as premedication (test group), whereas the other thirty were treated without any premedication (control group). Results: It was found that the mean systolic blood pressure during surgical removal of impacted mandibular third molar was raised in the control group and exhibited minimal fluctuation in the test group.
Conclusion: The use of tablet alprazolam as premedication before surgical removal of impacted mandibular third molars resulted in stability of vital parameters, secondary to reduced patient anxiety. PMID:27994412 • Hasegawa, Takumi; Tachibana, Akira; Takeda, Daisuke; Iwata, Eiji; Arimoto, Satomi; Sakakibara, Akiko; Akashi, Masaya; Komori, Takahide 2016-12-01 The relationship between radiographic findings and the occurrence of oroantral perforation is controversial. Few studies have quantitatively analyzed the risk factors contributing to oroantral perforation, and no study has reported multivariate analysis of the relationship(s) between these various factors. This retrospective study aims to fill this void. Various risk factors for oroantral perforation during maxillary third molar extraction were investigated by univariate and multivariate analysis. The proximity of the roots to the maxillary sinus floor (root-sinus [RS] classification) was assessed using panoramic radiography and classified as types 1-5. The relationship between the maxillary second and third molars was classified according to a modified version of the Archer classification.
The relative depth of the maxillary third molar in the bone was classified as class A-C, and its angulation relative to the long axis of the second molar was also recorded. Performance of an incision (OR 5.16), mesioangular tooth angulation (OR 6.05), and type 3 RS classification (i.e., significant superimposition of the roots of all posterior maxillary teeth with the sinus floor; OR 10.18) were all identified as risk factors with significant association to an outcome of oroantral perforation. To our knowledge, this is the first multivariate analysis of the risk factors for oroantral perforation during surgical extraction of the maxillary third molar. This RS classification may offer a new predictive parameter for estimating the risk of oroantral perforation.
• Love, R M; Firth, N 2009-03-01 To determine the types of periapical lesions associated with root filled teeth with persistent periapical pathosis that required surgical treatment based on specific inclusion and exclusion criteria. Periapical lesions from a consecutive clinical sample of 100 patients were examined histopathologically to determine a definitive diagnosis. Females were more represented (n = 56), the average age was 46.5 years and there were no age differences between gender or lesion type.
A diagnosis of periapical granuloma was the most common finding with a similar number present in females (n = 40) and males (n = 37). A cyst was present in 18% of the cases with a majority of females (n = 12) represented in the sample. Evidence of foreign material, with an appearance consistent with endodontic sealer materials, was seen in 25 periapical granulomas, two cysts and one scar. Two periapical scars were seen, one had a history of apicectomy and amalgam root-end filling while the other was associated with extruded root filling material. By using defined clinical inclusion and exclusion criteria a predictable clinical diagnosis of a persistent periapical lesion due to endodontic origin can be reliably made. Periapical granulomas and cysts were the most common periapical lesions of endodontic origin associated with persistent periapical pathosis with the overall incidence of periapical cysts similar to previous studies.
The presence of endodontic material in a high proportion of periapical lesions suggests a cause-effect association with the inference that clinicians should employ canal preparation techniques that limit apical extrusion of material. • Leskovar, Alenka; Coates, Joan R; Russell, Karen E; Walker, Michael A; Storts, Ralph W 2003-01-01 A 2-year-old, spayed female, mixed-breed dog was presented for evaluation of a progressive asymmetric tetraparesis and cranial nerve deficits with a 3-week duration. Computed tomography showed a contrast-enhancing lesion along the left side of the junction of the medulla and the cervical spinal cord. An exploratory surgery determined the presence of an intramedullary lesion of the first cervical spinal cord segment. The mass was removed through a dorsal midline myelotomy. Microscopic examination identified a foreign body granuloma that contained a dense, anisotropic outer wall, supporting the conclusion that the foreign body was of plant origin.
The dog recovered to a more improved ambulatory status than prior to surgery. • Monsanto, Stephany P.; Edwards, Andrew K.; Zhou, Juhua; Nagarkatti, Prakash; Nagarkatti, Mitzi; Young, Steven L.; Lessey, Bruce A.; Tayade, Chandrakant 2016-01-01 Objective To determine the impact of endometriotic lesion removal on local and systemic inflammation. Design Multiplex cytokine analysis on samples from endometriosis patients before surgery, 2 weeks after surgery, and 3 months after surgery. Setting Academic teaching hospital and university. Patient(s) A total of 43 endometriosis patients before and after excision of lesions by means of laparoscopic surgery, and 25 normal women.
Intervention(s) None. Main Outcome Measure(s) Plasma, eutopic and ectopic tissue, and peritoneal fluid cytokine levels. Result(s) Compared with presurgery plasma samples, levels of granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin (IL) 2, IL-8, and IL-10 decreased significantly by 2 weeks after surgery in endometriosis patients. Interestingly, levels began to rise at 3 months after surgery in most cases. In tissue, levels of GM-CSF and IL-15 were lower in eutopic tissue, while levels of basic fibroblast growth factor, interferon-inducible protein 10, IL-1 receptor antagonist, granulocyte colony–stimulating factor, macrophage inflammatory protein 1β, IL-7, and IL-5 were higher in eutopic than in ectopic tissue.
In peritoneal fluid, levels of IL-5 and IL-12 were higher in early versus advanced stages of endometriosis. Compared with normal women, plasma from endometriosis patients had higher levels of inflammatory cytokines. Conclusion(s) Endometriotic lesion removal significantly alters the inflammatory profile both locally and systemically in women with endometriosis. Our findings indicate that ectopic lesions are the major drivers of systemic inflammation in endometriosis. The transitory nature of the change may reflect the recurrence of the condition and the influence of systemic factors in its onset. PMID:26698677 • Monsanto, Stephany P; Edwards, Andrew K; Zhou, Juhua; Nagarkatti, Prakash; Nagarkatti, Mitzi; Young, Steven L; Lessey, Bruce A; Tayade, Chandrakant 2016-04-01 To determine the impact of endometriotic lesion removal on local and systemic inflammation. Multiplex cytokine analysis on samples from endometriosis patients before surgery, 2 weeks after surgery, and 3 months after surgery.
Academic teaching hospital and university. A total of 43 endometriosis patients before and after excision of lesions by means of laparoscopic surgery, and 25 normal women. Plasma, eutopic and ectopic tissue, and peritoneal fluid cytokine levels. Compared with presurgery plasma samples, levels of granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin (IL) 2, IL-8, and IL-10 decreased significantly by 2 weeks after surgery in endometriosis patients. Interestingly, levels began to rise at 3 months after surgery in most cases.
In tissue, levels of GM-CSF and IL-15 were lower in eutopic tissue, while levels of basic fibroblast growth factor, interferon-inducible protein 10, IL-1 receptor antagonist, granulocyte colony-stimulating factor, macrophage inflammatory protein 1β, IL-7, and IL-5 were higher in eutopic than in ectopic tissue. In peritoneal fluid, levels of IL-5 and IL-12 were higher in early versus advanced stages of endometriosis. Compared with normal women, plasma from endometriosis patients had higher levels of inflammatory cytokines.
Endometriotic lesion removal significantly alters the inflammatory profile both locally and systemically in women with endometriosis. Our findings indicate that ectopic lesions are the major drivers of systemic inflammation in endometriosis. The transitory nature of the change may reflect the recurrence of the condition and the influence of systemic factors in its onset. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved. • Bystedt, H; Nord, C E; Nordenram, A 1980-06-01 Treatment of osteitis after surgical removal of the third molar of the mandible is still a clinical problem.
A total of 140 patients undergoing operations for removal of an impacted third molar of the mandible, were included in a double-blind study. Placebo or antibiotics - azidocillin, erythromycin, clindamycin and doxycycline - were given to the patients preoperatively and for the following 7 days. The concentrations in serum, alveolar serum and mandibular bone were measured and the postoperative courses - pain, trismus, swelling and wound-healing - were recorded. No correlation was obtained between the antibiotic concentration and the postoperative complaints, except in the azidocillin group on day 2, in which fewer complaints were noticed in patients with high concentrations of the drug at the time of operations. The 80 patients in the antibiotic groups responded significantly better with respect to wound-healing than the 60 patients in the placebo groups. Only 15 operations lasted more than 15 min and the three of them which subsequently resulted in alveolitis were in the placebo groups. Antibiotics significantly reduced pain on day 7 postoperatively.
In general, no statistically significant differences in trismus and swelling could be demonstrated between the patient groups. However, there was a significant difference between the placebo and doxycycline groups with respect to swelling (day 2 postoperative, P.