Magister Chirurgiae Dentium - MChD (Maxillo-Facial & Oral Surgery)

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Maturation of the permanent teeth in a Western Cape sample
(1974) Singh, Surandar; Lucchessi, M V
The need for in-depth knowledge of dental emergence and calcification in orthodontic diagnosis and treatment planning cannot be disputed. Serial extractions, treatment timing, bite opening and closing, expansion and various other orthodontic procedures cannot be successfully executed without an in depth knowledge of the calcification and eruption of teeth. Besides its orthodontic implications, dental calcification and eruption plays a significant role in physical anthropology, forensic odontology, endocrinology and nutrition (Demirjian, 1978). Forensic scientists are agreed that teeth constitute the most important and reliable means for determining age from approximately 10 week in utero to old age (Altini, 1983). It is a generally accepted fact that there is no correlation between biological age and chronological age (Prahl-Andersen and Van der Linden, 1972; Demirjian, 1978), an aspect, which will be discussed in further detail later in the review of the literature. Biological age is seen to be a more accurate indicator of an individuals maturity than chronological age (Moorees et al, 1963; Prahl-Andersen and Van der Linden, 1973; Oemirjian et al, 1973). However, allocating a biological age to an individual is not an easy exercise as no definite consensus has, to date, been reached regarding the best method of determining biological age (Moorees et al, 1963; Garn et al, 1967; Demirjian, 1978). Today, many different methods are being used to establish this, for example bone age, height, menarche, circumpubertal growth and dental age.
Mandibulo-facial dysostosis - An investigation of the cranio-facial and oral manifestations in South African bantu.
(University of Pretoria, 1975) Seeliger, Joachim Ernst; Knobel, D P
The subject, an adult bantu male with most of the features of the classical syndrome, is subjected to a physical investigation with the - emphasis on the cranio-facial and oral manifestations. The clinical appearance of the facies and head is discussed and the findings correlated with those of the accepted syndrome. Special attention is paid to the oral and dental manifestations and measurements are recorded and compared. A rontgenographic examination is .performed on the cranium, facial bones and the jaws. Utilising the lateral skull radiograph ·(cephalogram), a cephalometric analysis is done of the skull and jaws to determine the development that has occurred.
An osteo-radiographic study of the mandibular canal
(1982) erman, Neill Julian S; Nortjé, C.J.
Even though the mandibular nerve is of great importance to the dentist, very little research on the course of the nerve and the relationship of the mandibular canal to the adjacent anatomical structures has been carried out. From the. literature, it appears that the lateral ramus prominence (L.R.P.),or antilingula, is found to be present in from 50% to 100% of cases and is situated anterior and superior to the mandibular foramen. Most authors are in agreement on the situation of the mandibular foramen. Only one mandibular foramen is described in each ramus. The mandibular canal is described as lying inferior to the teeth. There is no agreement on the possibility of the existence of a second mandibular canal per hemimandible. Concerning the mental foramen, it is accepted that one is found on each side, but a second foramen,as well as accessory foramina, namely, the major and the minor variety, are described. In the horizontal plane, the mental foramen is found at the apex of the second premolar tooth or between the premolar teeth. In the vertical plane, the mental foramen is situated from inferior to the apex of the premolar teeth to halfway between the apex and the crown of the premolar teeth. The mylohyoid groove is converted into a canal in 16% of cases but never commences from within the mandibular canal, according to available literature.
Extraction and retention of teeth in the line of mandibular fracture: A study of a Western Cape sample
(University of the Western Cape, 1986) Hendricks, Mogamat Rushdi; Garach, Vinay
Anecdotal and controversial discussion has.always been prompted by the bias of the clinician in relation to whether teeth in the line of fracture should be extracted or retained. In recent years, it became evident to clinicians serving the Maxi 11ofaci aland Oral Surgery Clinic at Groote Schuur Hospital, Cape Town, that a tendency towards reta ining teeth in the 1ine of fractu re did not seem to increase the possi bility of infecti on, providing that circumspection was used. A retrospective analysis of these cases was conducted in order to determine the outcome of our treatment. An independent sample of the 151 patients were investigated in relation to age, sex predilection, the effect timing has on the outcome of treatment and the incidence of infection when teeth in the line of mandibular fracture were extracted or retained. The results of this study has shown that most of our patients were young (aged 20-29yrs) and therefore a tendency to retain teeth was found. In older patients, (aged 30-49yrs), the tendency was to extract teeth. Males presented more than females in a 3:1 ratio. Patients treated early « 24hrs) had most of their teeth retained while others treated after 7 days had their teeth extracted. The infecti on rate was 2 percent if teeth were retained and 5 percent if teeth were extracted. A1though the difference was not statistically significant, it appeared that the retenti on of teeth in the 1ine of fracture presented more advantages to both patient and clinician.
A photometric soft-tissue profile assessment in a Western Cape sample
(Uiversity of the Western Cape, 1986) Samsodien, Mogamat Gilmee; Sing, S
Cephalometric norms for the soft-tissue profile presently utilized in this country, are based almost entirely on North American Caucasian and Negroid studies. Orthodontists use these standards as a guide in the treatment of all sections of the South African population. Various studies have conclusively shown that the soft-tissue profile differs both racially, and from country to country. In recent years the number of patients presenting for orthodontic treatment at the University of the Western Cape has increased significantly. The need has therefore arisen for the establishment of soft-tissue profile trends in the Western Cape area.
Malignant tumors of the maxillofacial and oral region in children: A clinicopathologic study
(University of the Western Cape, 1994) Mohamed, Ashraf; Kariem, Gilmie
This is a retrospective study of malignant tumours of the maxillofacial and oral region in children that presented over a 20 year period (1973 to 1993) at the Red Cross War Memorial Children's Hospital and Groote Schuur Hospital, Cape Town. Of the 352 children that were treated for a malignant tumour arising from various anatomic sites in the head and neck region, 30 were found to have had maxillofacial and oral involvement. This represented an incidence of 8,5%. Histologically, the majority of the tumours were non-odontogenic and mesenchymal in origin. The rhabdomyosarcoma was found to be the most common neoplasm, followed by the Burkitt's lymphoma. The age range was 6 months to 13.8 years (mean age 5.7 years). Males were more commonly affected than females, with a ratio of 1.3:1. There were 26 (86,7%) black patients and 4 (13,3%) white patients, representing a ratio of 6.5:1. Fifty percent of the cases were from the Eastern Cape. The mandible and the maxilla were the most common sites to be involved, followed by the soft tissues of the face. The most common presenting symptom was a painless swelling (73,3%) of the face. Twenty percent of the patients had "floating" or loose teeth. Radiographic features in the jaws were poorly circumscribed destructive lytic lesions with displacement of teeth. Histologic type was found to be the most significant variable affecting the outcome, with the Burkitt's lymphomas having the best prognosis and the rhabdomysarcomas the worst. The most common cause of death was metastases to the lungs. It is concluded that although malignant tumours of the maxillofacial and oral region in children are rare, their prognosis is poor. Therefore, any child presenting with a facial swelling should be viewed with suspicion.
Malignant tumours of the maxillofacial and oral region in children: A clinicopathologic study
(University of the Western Cape, 1994) Mohamed, Ashraf; Kariem, Gilmie
This is a retrospective study of malignant tumours of the maxillofacial and oral region in children that presented over a 20 year period (1973 to 1993) at the Red Cross War Memorial Children's Hospital and Groote Schuur Hospital, Cape Town. Of the 352 children that were treated for a malignant tumour arising from various anatomic sites in the head and neck region, 30 were found to have had maxillofacial and oral involvement. This represented an incidence of 8,5%. Histologically, the majority of the tumours were non-odontogenic and mesenchymal in origin. The rhabdomyosarcoma was found to be the most common neoplasm, followed by the Burkitt's lymphoma. The age range was 6 months to 13.8 years (mean age 5.7 years). Males were more commonly affected than females, with a ratio of 1.3:1. There were 26 (86,7%) black patients and 4 (13,3%) white patients, representing a ratio of 6.5:1. Fifty percent of the cases were from the Eastern Cape. The mandible and the maxilla were the most common sites to be involved, followed by the soft tissues of the face. The most common presenting symptom was a painless swelling (73,3%) of the face. Twenty percent of the patients had "floating" or loose teeth. Radiographic features in the jaws were poorly circumscribed destructive lytic lesions with displacement of teeth. Histologic type was found to be the most significant variable affecting the outcome, with the Burkitt's lymphomas having the best prognosis and the rhabdomysarcomas the worst. The most common cause of death was metastases to the lungs. It is concluded that although malignant tumours of the maxillofacial and oral region in children are rare, their prognosis is poor. Therefore, any child presenting with a facial swelling should be viewed with suspicion.
A comparison of the treating mandibular fractures at the department of maxillofacial and oral surgery, Groote Schuur hospital
(1995) Rughubar, Vivesh; Kariem, G
Mandibular fractures are common facial injuries, occurring twice as frequently as fractures of the bones of the midface. Only the nasal bones are fractured more often as the result of trauma to the face (Olson eta/ 1982; Theriorletal 1987; Shepherd et al 1988; Dodson et al 1990; Lownie et al 1996). In many oral and maxillofacial units, the treatment of fractures of the mandible form the major proportion of the services rendered. Internationally it is accepted that there are two methods of treatment for fractures of the mandible, namely, closed and open reduction. Closed reductions are performed in dentate patients either under local or general anaesthesia. This method entails the placement of eyelet wires between or around teeth in both arches and then placing the patient into intermaxillary fixation. This is the method of choice when treating an undisplaced fracture of the mandible.
A retrospective anal\'sis of gunshot injuries to the maxillofacial region (1980 to 1995)
(University of the Western Cape, 1997) Kassan, Ashwin Harkison; Kariem, Gilmie
There appears to be an increase in the use of handguns amongst the civilian population with a resultant increase in the firearm related mortalities in the Cape Town metropolitan area (Lerer et al., 1997). Therefore, the aim of the study was to analyse the demographic data, patterns, management and complications of gunshot injuries to the maxillofacial region. This is a retrospective study of gunshot injuries to the maxillofacial region treated at Groote Schuur Hospital, Cape Town over a 15 year period (1980- 1995). A total number of 301 cases were analysed.
A retrospective analysis of gunshot injuries to the Maxillofacial region (1980 to 1995)
(University of the Western Cape, 1997) Kassan, Ashwin Harkison; Kariem, G.
There appears to be an increase in the use of handguns amongst the civilian population with a resultant increase in the firearm related mortalities in the Cape Town metropolitan area (Lerer et al., 1997). Therefore, the aim of the study was to analyse the demographic data, patterns, management and complications of gunshot injuries to the maxillofacial region. This is a retrospective study of gunshot injuries to the maxillofacial region treated at Groote Schuur Hospital, Cape Town over a 15 year period (1980-1995). A total number of 301 cases were analysed. Maxillofacial gunshot injuries are increasing exponentially over the years with most of these occurring post 1990. The majority of these injuries were due to civilian type low velocity handguns. A smaller percentage were due to intermediate type shotgun injuries which occurred predominantly during periods of political uprising during the early and mid 1980's. The majority of these injuries were purposefully and intentionally inflicted by others. Males within their third decade of life were most often the victims of these gunshot injuries. Most of these patients were of a lower socio-economic status and resided in the traditionally "Black" and "Coloured" residential areas. The wounding effects of these low velocity injuries were characteristic, producing small rounded entrance wounds, causing fragmentation of teeth and comminution of the underlying bone, usually without any exit wounds. Mandibular fractures were more common than the maxillary ones with fracture patterns varying from simple to comminuted type fractures. The comminuted displaced type of fracture pattern, however, were most frequently observed. The most common associated bodily injuries occurred to the head, neck and limb regions. Special investigations included plain film radiographs with more sophisticated investigations, e.g. CT-scans and angiograms being requested where indicated. Necessary airway management was constituted where required and included emergency cricothyroidotomies, oral and nasal endotracheal intubations and elective tracheostomies. The vast majority of the patients, however, required no airway management. The definitive surgical management was initiated by early soft tissue debridement (within 12-24 hrs). There was an equal distribution in both the early and delayed timing of the fracture management. Both the mandibular and maxillary fractures had more open than closed reductions done. Bone continuity defects as a result of the initial injury were usually reconstructed secondarily using free antogenous bone grafts. This, however, comprised only of a smaller number of patients. All the patients received anti-tetanus toxoid on admission and the majority received antibiotic treatment varying from one dose to a five to seven day course. This consisted of either penicillin alone or a combination of penicillin and metronidazole in most cases. The mean hospitalization stay totalled six days. Most recorded complications presented early (within one week) post-injury. The most frequent recorded complications were sepsis, ocular and neurological complications and limitation of mouth opening. The post-operative sepsis rate was high (19%). The common neurological complications consisted of varying degrees of damage to the facial and trigeminal nerves. Blindness was the most common ocular complication observed. Other complications included oro-antral, oro-nasal and parotid fistulae and bony and fibrous ankylosis. These, however, occurred less frequently.
An investigation into the role of histological parameters in the prediction of the prognosis for tl and t2 oral squamous cell carcinomas
(University of Western Cape, 1998) Roberts, Tina Sharon; Hille, Josh
TI and T2 squamous cell carcinomas of the head and neck have an unpredictable prognosis that often pose therapeutic problems. Sophisticated methods such as cytometric DNA analysis, immunocytochemistry and detection of cellular growth factors, have been applied with varying success rates for predicting recurrences, metastatic rates and overall prognoses. However, with the general lack of resources in Africa, devising a simple, reliable, reproducible and cost-effective method of predicting tumour behaviour to aid optimal treatment planning is imperative. Surgical excision specimens of forty-eight primary Tl and T2 squamous cell carcinomas of the floor of the mouth and tongue were histologically evaluated by two individual pathologists (double-blinded study) who had no prior knowledge of clinical course or outcome.
Unicystic ameloblastoma: A critical appraisal
(2000) Singh, Suvir; Shear, M
Robinson and Martinez first introduced the entity of unicystic ameloblastoma in 1977. Since then numerous case reports and series have been published. The evidence suggests that a more conservative approach can be used successfully to treat the unicystic ameloblastoma. The term unicystic is derived from the macro- and microscopic appearance of the lesion, whereas the term unilocular is used in radiological interpretation to describe a radiolucency having one loculus or compartment. Much confusion stems from the fact that a unicystic ameloblastoma might appear not only as a unilocular lesion, but also as what is often interpreted as a multilocular bone defect.
Unicystic Ameloblastoma : A critical appraisal
(University of the Western Cape, 2000) Singh, S; Shear, M
Robinson and Martinez first introduced the entity of unicystic ameloblastoma n 1977. Since then numerous case reports and series have been published. The evidence suggests that a more conservative approach can be used successfully to treat the unicystic ameloblastoma. The term unicystic is derived from the rnacro- and microscopic appearance of the lesion, whereas the term unilocular is used in radiological interpretation to describe a radiolucency having one loculus or compartment. Much confusion stems from the fact that a unicystic ameloblastoma might appear not only as a unilocular lesion, but also as what is often interpreted as a multilocular bone defect.
An in vitro study of the microleakage of a compomer (polyacid modified resin composite) bonded to enamel and dentine with different bonding systems and the effect of saliva contamination there of.
(Stellenbosch University, 2002) Saayman, Charlene Margaret; Grobler, SR
Restorative systems classified as polyacid modified composite resins, or compomers, have appeared on the market. An example of this is Dyract AP. Dyract AP must be used with the Prime & Bond NT bonding system. Prime & Bond NT can be applied without any form of prior etching, or it can be applied after application of Non Rinse Conditioner, or it can be applied after etching with 36% phosphoric acid. The purpose of the study was to determine the qualitative microleakage of Dyract AP and its bonding systems, as well as the influence of saliva contamination there of. Freshly extracted, non-carious, human premolars were randomly divided into 8 groups of 18 teeth each. Apiseetomies coated with Polivar varnish and restored with amalgam were performed on all teeth. Class V type cavities of 3 mm diameter and 1,5 mm depth were prepared on the CEJ junction on the buccal side of all teeth. Dyract AP restorations were placed using the bonding procedures indicated: Group 1: P&B NT (Prime & Bond NT); group 2: acid (36% phosphoric acid) + P&B NT; group 3: NRC (Non Rinse Conditioner) + P&B NT; group 4: P&B NT + Saliva; group 5: acid + Saliva + P&B NT; group 6: acid + P&B NT + Saliva; group 7: NRC + Saliva + P&B NT; group 8: NRC + P&B NT + Saliva. Restorations were finished with Sof-Lex discs. After 24 hours storage in distilled water the teeth were removed and coated with two layers of nail varnish, except for 1 mm around the restorations. The teeth were then thermocycled in a 0.5% basic fuchsin solution for 500 complete cycles between 8°C and 50°C, with a dwell time of 15 seconds.
Maxillofacial fractures in children attending the Red Cross War Memorial Children's Hospital
(University of the Western Cape, 2005) Aniruth, Sunildutt; Kariem, G; van AS, A.B; NULL; Faculty of Dentistry
The literature shows that maxillofacial fractures in children are uncommon. Although the Department of Oral and Maxillofacial Surgery of the Faculty of Dentistry, of the University of the Western Cape, has been providing a service to the Red Cross Children’s Hospital (RXH) for the past twenty years, no study had been undertaken to determine the age, gender, number of patients per year, aetiology, patterns, and management of maxillofacial fractures at this institution. A retrospective records based study was undertaken to determine these features. This study accessed the records of patients seen at the trauma unit at RXH, from 1994 to 2003 inclusive, and referred for maxillofacial attention. One-hundred-and-five patient records were obtained and analyzed using the SPSS statistic package. One-hundred-and-twenty-seven fractures were recorded in one hundred and five patients. The age of the patients ranged from one to thirteen. Sixty-five male and forty female patients were seen. Dentoalveolar fractures were the most common fracture seen in both the midface and mandible. Midface fractures were more common than mandibular fractures. Falls, followed by motor vehicle accidents, were the most common cause of facial fractures. Most fractures were successfully managed by closed procedures. At this institution, nasal and frontal fractures have surprisingly little or no input from the Department of Oral and Maxillofacial Surgery.
Radiographic profile of symptomatic impacted mandibular third molars in the Western Cape, South Africa
(University of the Western Cape, 2005) Qirreish, Emad Eddin Yacob Juma; Parker, M.E.; Morkel, J.A.; Norval, E.J.G; Dept. of Diagnostics and Radiology; Faculty of Dentistry
It is common practice to remove impacted mandibular third molars due to pathology associated with these impactions. Alternatively, impactions can be treated conservatively through a closely guarded follow-up regiment. However, many symptoms associated with impacted third molars may be prevented by elective removal of potentially problematic teeth. To determine the risk of developing pathology associated with impacted mandibular third molars, a ransom sample of 200 pantomographs were analyzed displaying 324 impactions from patients who presented for treatment at the Maxillo-Facial and Oral Surgery Department, Faculty of Dentistry, University of the Western Cape.
Antibiotic prophylaxis in third molar surgery
(University of Western Cape, 2007) Siddiqi, Allauddin; Morkel, Jean
The purpose of this study is to evaluate the need for prophylactic antibiotic treatment in third molar surgery and to establish specific guidelines for antibiotic prophylaxis in the department of Maxillo-Facial and Oral Surgery (MFOS) at Tygerberg Academic, Groote Schuur and Mitchells Plain Hospitals.
Survey on the management of Alveolar Osteitis ( Dry Sockets) in South Africa
(University of the Western Cape, 2009) Nokaneng, Emmy Ngoakoana; Morkel, Morkel
Exodontia remains one of the most regularly done procedures in dentistry in South Africa (SA) and alveolar osteitis (AO) is considered one of the most common complications associated with exodontia. Despite the extensive research done on this clinical entity, the management of AO still remains controversial. Various management protocols have been suggested in the literature, varying from prophylactic to symptomatic management of AO (Blum,2002). However, none of these management protocols have to date shown any conclusive evidence on the effectiveness and benefit over another protocol. The author was of the opinion that general dental practitioners (GDPs) in South Africa generally use preventative and treatment protocols based on what they were taught at their alumni dental schools or use protocols modified from their own clinical experience in practice. The aim of this study was to assess which treatment protocols are routinely used by GDPs in South Africa for the management of AO and suggest a scientifically sound treatment protocol for AO. The study was done in the form of a questionnaire and the participants were randomly selected from the Health Professions Council's register. The results showed that most of the GDPs in South Africa continued to use the same treatment protocol as their alumni dental school. They were of the opinion that these protocols were still clinically the most effective. Despite the plethora of intra-alveolar medicaments available, Alvogyl®still remains the medicament of choice of GDPs. As there is no evidence in the scientific literature that suggests that one intra-alveolar medicament or antibiotic is more effective than the other, the author does not encourage the use of the medicaments or antibiotics in the treatment of AO. However, by following simple measures such as improving patients' oral hygiene and using a pre-operative 0.2% chlorhexidine mouth rinse, the incidence of AO can be reduced significantly.
Orofacial sepsis and HIV at maxillo-facial surgery units in the Western Cape: a prospesctive study
(2009) Sarvan, Imraan; Morkel, J.A.; Bütow, K.W.
The World Health Organisation estimated that in 2002 more than 13,772 000 deaths in developing countries were caused by infections. This accounted for more than 45% of all deaths, making up 7 of the top 10 causes of death (World Health Organisation, 2004). Sub-Saharan Africa is the epicentre of the devastating HIV pandemic. The country leading with the highest HIV rate in the world is South Africa, with approximately 5.5 million people infected(UNAIDS, 2008; South Africa Country Progress Report, 2008).The development from HIV to AIDS progressively weakens the immune system, making the individual more susceptible to numerous infections, e.g.various forms of orofacial sepsis (Mindel, and Tenant-Flowers, 2001). HIVpositive individuals are eighteen times more likely to become infected with community-acquired methicillin-resistant Staphylococcus aureus than the general population. (Crum-Cianflone et al., 2006). The management of sepsis is of great concern with regard to human morbidity and mortality, as well as its financial implications, especially in cases of antibiotic resistance (Kimleck et al., 1976; Panlilo et al., 1992; Kirkland et al., 1999). Currently, there is no published peer-reviewed literature assessing the impact of HIV on orofacial sepsis. This study aimed to assess the impact of HIV on orofacial sepsis, investigating the clinical and microbiological profiles of the population. These results were used as a guide in the adaptation of current treatment protocols.The study population consisted of patients with orofacial sepsis (requiring incision and drainage or admission) who were referred to the Maxillo-Facial and Oral Surgery Units at either Groote Schuur or Tygerberg Hospitals. These patients were examined, diagnosed and treated as per standard protocol. The empiric antibiotic treatment was tailored according to microscopy and sensitivity results when it became available. The exclusion criteria of the study were refusal of HIV testing or unwillingness of patients to participate in the study.The ratio of HIV positive patients treated was much higher than the population prevalence (2.4:1.1). Odontogenic infections (71.11%), followed by septic jaw fractures (15.56%) were the most common causes of sepsis. The most common causative teeth were the mandibular posterior teeth (43.75%)(excluding the mandibular 3rd molars). The most common fascial spaces involved in the HIV positive group were the submandibular spaces (36%),followed by the submasseteric and canine spaces (27% each). In the HIV negative group, the buccal (41%) and submandibular spaces (33%) were the most common fascial spaces infected.The HIV negative group had the most multi-fascial space involvement, with 35% having more than one fascial space involved. In comparison, the HIV positive group had only 18% involvement of more than one fascial space. This was also reflected by the HIV negative group, which included five cases of Ludwig’s Angina as compared to one case in the HIV positive group. The Gram Stain showed a predominance of Gram positive cocci for both the HIV positive and negative groups. Gram positive bacilli were significantly more prevalent in the HIV negative group (p = 0.0409). Pre-treatment antibiotics were associated with sterile abscesses in 20% of the cases. No growth on culture occurred only in the HIV negative group (statistically significant with p = 0.00488).A statistically significant increased length of admission was found for the cases with penicillin-resistant bacteria (Wicoxin Rank Sum Test p =0.0072). Penicillin resistance was found in 17.78% (8 cases) with ten strains of five types of bacteria (S. aureus, K. pneumonia, Enterobacter, E. coli,Alpha-haemolytic Streptococcus). Eight percent (5) of these cases were also resistant to co-amoxiclav®.In the HIV positive group the following trends (p>0.005) were found:• The average platelet counts of this group was 112.34 x108/L (lower than the HIV negative group);• The length of admission for the HIV positive group was slightly longer by 0.25 days even though this group had fewer fascial spaces infected;• A larger number of bacteria with penicillin-resistance was more prevalent in the HIV positive group (six resistant bacteria in four cases compared to four resistant bacteria in four cases).Greater numbers of orofacial infections were seen in HIV positive subjects relative to their population prevalence rates. Added to this, was the higher rate of antibiotic resistance and longer hospital admissions.These findings may warrant further investigation of the relationship between HIV positive and negative groups with regard to orofacial sepsis.
Efficacy of two different types of throat packs
(University of the Western Cape, 2009) Parker, Ebrahim; Morkel, J.A.; Dept. of Oral Medicine and Periodontics; Faculty of Dentistry
Post-operative sore throat is a common minor complication following general anaesthesia via endotracheal intubation. Pharyngeal packing has often been implicated in this minor anaesthetic complication. In maxillo-facial and oral surgery, two types of throat packs are commonly used namely ribbon gauze and tampons. In order to establish the efficacy of these two types of throat packs a prospective, randomised, clinical study was conducted. The objectives of the study were threefold: to investigate the effect of the two different types of throat packs on the incidence of post-operative sore throat, to determine the quality of seal provided by the two different types of throat packs and finally, to formulate a faculty protocol. The study consisted of 70 patients undergoing third molar surgery. All the patients were intubated via endotracheal intubation and had a throat pack placed. Patients were also randomly selected and allocated to two groups. One group had ribbon gauze while the other group had a tampon as a throat pack. The study reflected no statistically significant difference in the incidence of postoperative sore throat between the two groups. It was interesting to note that the symptoms of sore throat resolved quicker with the use of tampons. On the other hand, the ribbon gauze provided a better pharyngeal seal.

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