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JR Ibm
JR Ibm
Only Mesioangular
impacted mandibular
Asymtomatic young third molars
adults in the age ( Accordance with
group 20 -40 years Winter’s Classification )
Exclusion
Criteria
• Patients with any systemic problem
• Pregnant or lactating mothers
• Operative procedure.
Patients Treatment
Local anasthesia
2% lignocaine
hydrochloride
& Postoperative
Semi-recline 1 : 100,000 medications included
positioin Adrenaline amoxicillin 500 mg
tid, metronidazole 400
mg tid a day, and
Interincisal Surgical removal a combination of
distance between of third molars ibuprofen 400 mg and
maxillary and was done by paracetamol 325 mg
mandibular first chisel and mallet tid, a day for 5 days.
incisors was noted with intermittent
in mm saline irrigation
Evaluation
Postoperative assessment was done on the 5th
day of the surgical procedure
Depict the severity of trismus was calculate by the
difference between the pre‑ and post‑interincisal
maximum distanced in milimeters.
Pain evaluation was done by calculating the number of
analgesic pills consumed in the 4 postoperative days.
It was seen to be almost similar in all the groups. The swelling altogether lasted
for 4–5 days. However, it was noted that significantly lesser
medication was used in Group A during surgery than that of Group B and Group C
There was a significant improvement in maximum mouth opening on the 7 th
postoperative day in Groups A and B as compared to Group C
Its rapid action and almost complete absorption, repeated doses are
necessary for the maintenance of optimal or adequate blood
concentration throughout the immediate postoperative period.
In this Study
Expected that repository effect similar to
intramuscular route can be obtained by local infiltration of
steroid in the submucosa around the surgical site chosen.
Berinteraksi dgn
respon unsur
Menembus sel Heat-shock glukokortikoid
membran protein dilepas pd berbagai gen
& protein
pengatur lain
Peran Kortikosteroid sebagai
Analgetik/Anti Inflamasi (Metabolisme
Asam Arakidonat)
Membrane Phospolipids
Phospolipase A2
Lipoxygenase
Arachidonic Acid Leukotrienes
Non-Selective Cox
Physiological Regulation Inhibitors Inflammatory response by
Preformed by COX-1 newly expressed COX-2
Cox-2 Selective
NSAID’s
PGE2 PGI2 TXA2 PGE2, PGI2, TXA2, Other
GI Chemical Mediators
GI Protection Platelet fuction
Protection Platelet Fuction Regulation of Inflammation
Regulation of blood flow Pain
blood flow
Fever
Kidney Fuction
Yang Harus Diperhatikan Dokter Gigi
dalam Memberikan Steroid
• Kortikosteroid bila digunakan dalam dosis
tinggi & jangka panjang penekanan fungsi
kelenjar adrenal, penekanan sistem imun,
sarkoma kaposi, miopati, efek pada mata &
gangguan psikiatrik diperlukan penurunan
dosis secara bertahap (tapering off)