Extraction of Impacted Mandibular Third Molars

Extraction of Impacted Mandibular Third Molars INTRODUCTION The extraction of impacted mandibular third molars is a common  procedure in oral and maxillofacial surgery. The reasons for extracting  these teeth include acute or chronic pericoronitis, presence of cysts or a  tumour, periodontal problems and presence of a carious lesion on the  second or third mandibular molar. In some cases, extraction is performed  in preparation for orthodontic treatment or orthognathic surgery  In most cases, the removal of third molars will lead to a significant degree  of tissue trauma that causes an inflammatory reaction. Thus, the patient  develops the common postoperative symptoms and signs of pain, facial  swelling, dysfunction, and limited mouth opening (trismus). The pain is typically brief and will peak in intensity in the  early postoperative period.The facial swelling and trismus will reach their  characteristic maximum 48 to 72 hours after surgery. Those symptoms are  major disadvantage and affect the patients quality of life. The  inflammatory process is necessary if healing of traumatic tissue has to  occur, but often excessive inflammation lead to unnecessary pain, trismus  and swelling. The impact of these symptoms affect the quality of life in the  days following surgery. Injured tissues immediately release local inflammatory mediators, like histamine, that produce vasodilatation leading to extravasations resulting in edema and sensitize the peripheral noci-receptors resulting in hyperalgesia. Although these inflammatory mediators are released immediately after the trauma, these symptoms are not observed immediate after the surgery but rather begin gradually, peaking 1 3 days after the surgery. Pain has been an indispensible part of all surgical procedures and minor oral surgical procedures are not an exclusion. Through ages mankind has been in constant quest for various methods to control pain . The specificity theory proposed in 17th century by Descartes R explains pain as the activity of highly specific peripheral nerve endings that receive sensory information from the environment, which is then transmitted by nerve fibres through the spinal cord to the pain centre, or the pineal body, in the forebrain. However it is merely a biological explanation and does not address the multidimensional, complex process of pain as we understand today.1 Various factors contribute to determine the intensity of post-operative complications such as host defense mechanism, type of healing, duration of the procedure, 4-8extent of reflection of the mucoperiosteal flap, types of flaps, bone removal, need for tooth sectioning, 5and experience of the surgeon.9,10 To increase patients satisfaction after third molar surgery it will be necessary to avoid the inconvenience associated with tooth extraction and minimize the subsequent side effects. Methods to reduce the side effects is to prescribe medications such as corticosteriods , non-steroidal anti-inflammatory drugs , a combination of corticosteroids and non-steroidal anti- inflammatory drugs or enzyme preparation. Synthetic inflammation inhibitors which are active at certain points during the course of the inflammatory reactions are available. They are sometimes associated with undesirable side effects such as insomnia, depression, systemic fungal infection, increased calcium excretion, gastrointestinal irritation, visual complaints, fever and fatigue. These inflammation inhibitors are divided mainly into two groups: Steroids, i.e., cortisone and its derivatives, and the Non-Steroids, which are usually salicylic acid derivatives such as butazolidine, indomethacin and others. The side effects of prolonged corticosteroids use are well known, and are fundamentally dependent upon the dose employed and the duration of treatment. These effects include peptic ulcer, immune suppression, water and electrolyte balance metabolic effects, muscle atrophy, osteoporosis, increased fatty tissue (full moon facial appearance), Cushing syndrome, avascular osteonecrosis, lessened resistance to infection, hirsutism, amenorrhea, acne, hyperglycemia or hypertension. Systemic glucocorticoids , which are frequently used as anti-inflammatory agents, are well-known to inhibit wound repair via global anti-inflammatory effects and suppression of cellular wound responses, including fibroblast proliferation and collagen synthesis. Systemic steroids cause wounds to heal with incomplete granulation tissue and reduced wound contraction. Glucocorticoids also inhibit production of hypoxia-inducible factor-1 (HIF-1), a key transcriptional factor in healing wounds Non-steroidal anti-inflammatory drugs (NSAID) have been used since many years for their analgesic and anti-inflammatory properties. Although these drugs have been proven efficient in management of post operative pain, adverse effects and associated morbidity pose a serious problem. It has long been known that NSAID may have a range of side effects, of which the commonest are gastrointestinal.5 Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are widely used for the treatment of inflammation and rheumatoid arthritis and for pain management. Low-dosage aspirin, due to its anti-platelet function, is commonly used as a preventive therapeutic for cardiovascular disease, but not as an anti-inflammatory drug. In contrast to chemical inhibitors of inflammation such as nonsteroidal anti-inflammatory drugs (NSAIDs), enzyme preparations support and accelerate the natural inflammatory process without contributing to pain, redness and swelling. This is accomplished by helping degrade and remove plasma proteins and fibrin that invade the interstitial space within tissues at the site of inflammation. Improved microcirculation and removal of inflammatory products results in an analgesic effect and complaint relief. Proteolytic systemic enzymes (proteases), such as those found in bromelain, papain and pancreatin, cleave protein compounds by hydrolysis. That is, they split their substrate by incorporating water. These enzymes are absorbed from the gastrointestinal tract into the bloodstream and travel to specific sites where they break down cell debris, fibrin and toxins. They also stimulate phagocytosis within the immune system and accelerate elimination by way of the lymphatic system and blood vessels. This translates into improved circulation and reduced inflammation. Proteolytic enzymes, which when taken with a meal is used to help digest food. Proteolytic enzymes are known as systemic enzyme supplements and are taken on an empty stomach, 45 minutes to one hour before meals or 3 hours after a meal, to digest proteinaceous or fibrous waste material throughout the body including the outer coating of bacteria, necrotic tissue and immune complexes. The only negative effects are for people with rare cases of protein allergies. Purpose of this randomized , single blind study is to compare the efficacy of proteolytic enzyme such as bromelain , trypsin and rutoside as an alternative to corticosteroids in pre and post- operative swelling , pain and trismus after removal of third molar.

Metal Lab Essay

Data Analysis: 1. What was the temperature change for the water in the calorimeter (ΔTwater)? 3 °C 2. What was the temperature change for the metal sample (ΔTmetal)? Assume the intial temperature of the metal was the same as the temperature of the water it was boiled in. 70 °C 3. What was the specific heat of water in J/g °C? 4.186 J/g °C 4. Using the following equation, your answers to questions 1-3, and your data table, determine the specific heat of the metal sample you tested. 5. Identify you metal using the list of specific heat values provided. The metal that was identified was Zinc. 6. Calculate the percent error in the specific heat value that you determined experimentally. Conclusion: The purpose of this experiment was to determine the identity of a mystery metal by finding the specific heat of the metal and comparing it to a list of specific heat values for different metals. Before beginning the lab and during the lab, the mass of the metal sample and water sample was taken. This information was later used to help determine the specific heat of the mystery metal. The temperature of the boiling water, the temperature of the water in the calorimeter without the metal, and the temperature of the water and metal in the calorimeter were also collected to help determine the mystery metal. After this, the temperature changes for the water in the calorimeter and the metal sample were collected. After all the data was gathered, an equation was used to find the specific heat of the mystery metal and determine its true identity. The calculated specific heat of the metal was 0.231 J/g °C. Even though this was close to the specific heat of Cadmium, the actual metal was Zinc , which had a specific heat of 0.390 J/g °C. The purpose of the lab was met, but not very well. There was a percent error of 40%, which is ridiculously high. Many things could’ve gone wrong in the lab such as reading the thermometer wrong, miscalculating the specific heat of the â€Å"mystery† metal, or not following the procedure. One thing that could’ve gone wrong is the possibility of reading the thermometer wrong. Reading the thermometer wrong could’ve resulted in the failure of the entire lab. Another possible error was miscalculating the specific heat. This is very plausible and easy to achieve. It is no surprise if it happened during the lab. One final error could’ve been not following the procedure. Not following the procedure could’ve easily messed up the entire lab. Following directions is a very crucial part of any lab. Despite these errors, there are ways to fix them. One solution is to use a digital thermometer instead. This would eliminate the possibility of reading the thermometer wrong. Another solution is to explain the equation more clearly. Making the equation as clear as possible to anyone who may use it could definitely almost completely erase the misunderstanding of an equation. One last solution is to read the procedure thoroughly multiple times before starting the lab. This would ensure that no direction has been skipped or skimmed, and the lab will run smoothly.

Lincoln Electric Venturing Abroad Essay - 3538 Words

Lincoln Electric Executive Summary Michael Gillespie, The Lincoln Electric Company’s new president for the Asia Region, was â€Å"encouraged to develop plans to open welding consumables factories in several Asian countries† by the new CEO, Anthony Massaro, and Gillespie had specifically â€Å"turned his attention to plans for Indonesia [O’Connell,[1] main reference, p 1].† We worked with Gillespie to prepare for the September 1996 meeting with Massaro and the presidents of the other worldwide regions. We analyzed Lincoln’s current capabilities and its past experiences and prepared a transformative plan based on business concept innovation [Hamel[2], ch 3], documented by this report, with a three pronged approach for the Asia Region. The first†¦show more content†¦2. Lincoln needed continued organizational development just as Lincoln’s equipment needed continued maintenance to remain viable. James Lincoln was a principled visionary and an organizational development inn ovator[d]. However, he did not prepare successors for assuming the critical role that continued organizational development. Neither of his successors, first William Irrgang and later Georges Willis, had contributed anything of note in developing the organization to meet Lincoln’s changing environmental demands. In particular, during Willis’s tenure, Lincoln did not even practice organizational maintenance: â€Å"By 1992, nearly all of the newly acquired plants, plus France, were operating in the red [and corporate executives] paid little attention [p 7].†Lincoln needed to develop the Asian organization and to develop the entirety ofLincoln as a wholly integrated organization in order to meet the demands of its expansion effort. 3. Lincoln’s culture could not be imposed but must be nurtured. â€Å"Willis retained the existing managers of most of the acquired companies to take advantage of their local knowledge, but directed them to implement [underlined by author]Lincoln’s incentive and manufacturing systems [p 6].† While Willis appreciated the benefits of implementing Lincoln’s systems, he did not consider James Lincoln’s caveat that â€Å"All those involved must be satisfied that they are properly recognized or they will not cooperate – andShow MoreRelatedCase Study Analysis Lincoln Electric: Venturing Abroad1533 Words   |  7 PagesLincoln Electric (LE) has been a producer of electrical and welding technology products since the late 1800s. The company remained primarily a family and employee held company until 1995, then approximately 40% of its equity went to the public. James Lincoln, one of the founders, developed unique management techniques that effectivel y motivated the employees. These management techniques were implemented as an unusual (for the era) structure of compensation and benefits called incentive managementRead MoreLincoln Assignment Essay749 Words   |  3 Pagesï » ¿Lincoln Electric: Venturing Abroad Discussion Questions: 1. How was Lincoln able to grow and prosper for so long in such a difficult commodity industry that forced out other giants such as General Electric, Westinghouse, and BOC? What is the source of Lincoln’s outstanding and enduring success? 2. Given this outstanding success, why did the internationalization thrust of the late 1980s and early 1990s fail? 3. What is your evaluation of the company’s internationalization strategy underRead MoreLincoln Electric 873 Words   |  4 PagesIntroduction Lincoln Electric (LE) is a worldwide leader in production of welding equipment with more than US$1 billion in sales and 6,000 workers. John C. Lincoln designed and made an electric motor with a $200 investment in 1895. Today, members of the Lincoln family own more than 60 percent of the stock. The Lincoln Management System Lincoln Electric’s management system is so successful that other businesses use it as a benchmark. They have effectively used feedback type control to achieve theirRead MoreStrategy Assignment : Lincoln Electric2135 Words   |  9 PagesStrategy Assignment : Lincoln Electric: Venturing Abroad 1. Lincolns competitive advantage lies mainly in its effective compensation and benefits system which put forth three main elements to spearhead the companys efforts. The trinity of elements comprised of piecework, bonus system and guaranteed employment. Piecework provided workers with a sense of autonomy in that now, workers can earn as much as they are willing to work for. The bonus levels in Lincoln far exceeded those of industry peersRead MoreKeeping Google googley3957 Words   |  16 Pages45(4): 20-34. 2. Lincoln Electric: Venturing Abroad (HBS case #9-409-039) 3. Infosys (A): Strategic Human Resource Management (HBS case #9-412-029) California PREPARATION QUESTIONS FOR LINCOLN ELECTRIC CASE ï‚ · ï‚ · ï‚ · ï‚ · ï‚ · How has Lincoln sustained success in a highly competitive, commodity industry? Why did Lincoln’s internationalization efforts in the 80s and 90s fail? Will Massaro’s internationalization strategy be more successful? Why or why not? Should Lincoln proceed with the investmentRead MoreCase Studies: Sas Airline Ryanair80169 Words   |  321 Pages5 Sinha, D. (1999) The Regulation and Deregulation of US Airlines, The Journal of Transport History, 20(1), p. 46 6 Sine, W. David, R. 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Early Civilizations Matrix Essay examples - 2440 Words

Ancient Civilizations Matrix HUM/100 INTRO TO THE HUMANITIES THE ANCIENT WORLD TO MEDIEVAL TIMES Early Civilizations Matrix Using your readings and outside sources complete the following matrix. Be sure to address the following in your matrix: †¢ Provide names, titles, dates, brief descriptions of important events, and other details as necessary. †¢ Note the details of key political, socioeconomic, technological, artistic, musical, architectural, philosophical, and literary developments for each civilization listed in the table, which were evidenced in the humanities. Be sure to properly cite the sources that you use in completing this matrix. Civilization Politics Society/ Economics Technology Art Music Architecture Philosophy†¦show more content†¦In these periods many tools were used as Surgery tools for the preservation of bodies also called mummification which made bodies embalmed and preserved to lifelike images. Art consisted on doing portraits of the pharaohs and drawings of the Gods they also illustrated life in every aspect of how they cultured and lived by geroglyphs. Many statues were made and tombs with beautiful gold and jewelry made for the Gods and pharaohs. Music was made bu thoth since their beliefs and they used flutes double clarinets and harps music was used in rituals and many festivities for the pharaoh These is a part of Egypt that was bar none the most impressive part of the civilization the pyramids made of stone with a perfect laser like cut is still to these day a mystery this is a very impressive way of displaying art for the Gods and for the pharaoh. People who was not noble lived in c lay made homes with stone which sheltered them and Nobles lived in temples and beautifully carved with gold and many jewels Egyptians were ruled by the pharaoh’s mentality and his point of view which made philosophy a way of following the pharaohs critical thinking and of course the Gods which were the ones that guided the pharaohs. Poems, Geroglyphs, arts and written prayers even drawings that depicted life were part of every day reading.Show MoreRelatedEarly Civilization Essay621 Words   |  3 PagesEarly Civilizations Matrix Using your readings and outside sources complete the following matrix. 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Note the details of key political, socioeconomic, technological, artistic, musical, architectural, philosophical, and literary developments for each civilization listed in the table, which were evidenced in the humanities. Properly cite the sources youRead MoreArt : The Art Of Art1631 Words   |  7 Pagescentury, and occasionally till the very early 16th. The end of this period of art is notably marked by the untimely arrival of the notorious western explorer Christopher Columbus’ landing in the Americas. The European discovery and exploration, or conquests of the Americas pre-Columbian art flourished all throughout both the northern and southern continents. This for many of the cultures was their primary form of visual expression, because many but not these early American cultures dished not yet developedRead MoreAnalysis Of Alain Lockes The New Negro1646 Words   |  7 Pagesbehave with respect to the dominant (primarily white) societies in which they live and function. 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