The Experts below are selected from a list of 306 Experts worldwide ranked by ideXlab platform

Karin V Rhodes - One of the best experts on this subject based on the ideXlab platform.

  • unused opioid analgesics and drug disposal following outpatient Dental Surgery a randomized controlled trial
    Drug and Alcohol Dependence, 2016
    Co-Authors: Brandon C Maughan, Elliot V Hersh, Frances S Shofer, Kathryn J Wanner, Elizabeth Archer, Lee Carrasco, Karin V Rhodes
    Abstract:

    Background Individuals who abuse prescription opioids often use leftover pills that were prescribed for friends or family members. Dental Surgery has been identified as a common source of opioid prescriptions. We measured rates of used and unused opioids after Dental Surgery for a pilot program to promote safe drug disposal. Methods We conducted a randomized controlled trial of opioid use patterns among patients undergoing surgical tooth extraction at a university-affiliated oral Surgery practice. The primary objective was to describe opioid prescribing and consumption patterns, with the number of unused opioid pills remaining on postoperative day 21 serving as the primary outcome. The secondary aim was to measure the effect of a behavioral intervention (informing patients of a pharmacy-based opioid disposal program) on the proportion of patients who disposed or reported intent to dispose of unused opioids. (NCT02814305) Results: We enrolled 79 patients, of whom 72 filled opioid prescriptions. On average, patients received 28 opioid pills and had 15 pills (54%) left over, for a total of 1010 unused pills among the cohort. The behavioral intervention was associated with a 22% absolute increase in the proportion of patients who disposed or reported intent to dispose of unused opioids (Fisher's exact p=0.11). Conclusion Fifty-four percent of opioids prescribed in this pilot study were not used. The pharmacy-based drug disposal intervention showed a robust effect size but did not achieve statistical significance. Dentists and oral surgeons could potentially reduce opioid diversion by moderately reducing the quantity of opioid analgesics prescribed after Surgery.

Brandon C Maughan - One of the best experts on this subject based on the ideXlab platform.

  • unused opioid analgesics and drug disposal following outpatient Dental Surgery a randomized controlled trial
    Drug and Alcohol Dependence, 2016
    Co-Authors: Brandon C Maughan, Elliot V Hersh, Frances S Shofer, Kathryn J Wanner, Elizabeth Archer, Lee Carrasco, Karin V Rhodes
    Abstract:

    Background Individuals who abuse prescription opioids often use leftover pills that were prescribed for friends or family members. Dental Surgery has been identified as a common source of opioid prescriptions. We measured rates of used and unused opioids after Dental Surgery for a pilot program to promote safe drug disposal. Methods We conducted a randomized controlled trial of opioid use patterns among patients undergoing surgical tooth extraction at a university-affiliated oral Surgery practice. The primary objective was to describe opioid prescribing and consumption patterns, with the number of unused opioid pills remaining on postoperative day 21 serving as the primary outcome. The secondary aim was to measure the effect of a behavioral intervention (informing patients of a pharmacy-based opioid disposal program) on the proportion of patients who disposed or reported intent to dispose of unused opioids. (NCT02814305) Results: We enrolled 79 patients, of whom 72 filled opioid prescriptions. On average, patients received 28 opioid pills and had 15 pills (54%) left over, for a total of 1010 unused pills among the cohort. The behavioral intervention was associated with a 22% absolute increase in the proportion of patients who disposed or reported intent to dispose of unused opioids (Fisher's exact p=0.11). Conclusion Fifty-four percent of opioids prescribed in this pilot study were not used. The pharmacy-based drug disposal intervention showed a robust effect size but did not achieve statistical significance. Dentists and oral surgeons could potentially reduce opioid diversion by moderately reducing the quantity of opioid analgesics prescribed after Surgery.

Michael J Wahl - One of the best experts on this subject based on the ideXlab platform.

  • The mythology of anticoagulation therapy interruption for Dental Surgery.
    Journal of the American Dental Association, 2020
    Co-Authors: Michael J Wahl
    Abstract:

    Abstract Background Continuous anticoagulation therapy is used to prevent heart attacks, strokes, and other embolic complications. When patients receiving anticoagulation therapy undergo Dental Surgery, a decision must be made about whether to continue anticoagulation therapy and risk bleeding complications or briefly interrupt anticoagulation therapy and increase the risk of developing embolic complications. Results from decades of studies of thousands of Dental patients receiving anticoagulation therapy reveal that bleeding complications requiring more than local measures for hemostasis have been rare and never fatal. However, embolic complications (some of which were fatal and others possibly permanently debilitating) sometimes have occurred in patients whose anticoagulation therapy was interrupted for Dental procedures. Practical Implications and Conclusions Although there is now virtually universal consensus among national medical and Dental groups and other experts that anticoagulation therapy should not be interrupted for most Dental Surgery, there are still some arguments made supporting anticoagulation therapy interruption. An analysis of these arguments shows them to be based on a collection of myths and half-truths rather than on logical scientific conclusions. The time has come to stop anticoagulation therapy interruption for Dental procedures.

  • Dental Surgery in anticoagulated patients stop the interruption
    Oral Surgery Oral Medicine Oral Pathology and Oral Radiology, 2015
    Co-Authors: Michael J Wahl, Andres Pinto, Jessica Kilham, Rajesh V Lalla
    Abstract:

    In a literature review, the incidence and morbidity of bleeding complications after Dental Surgery in anticoagulated patients was compared with embolic complications when anticoagulation was interrupted. Over 99% of anticoagulated patients had no postoperative bleeding that required more than local hemostatic measures. Of more than 5431 patients undergoing more than 11,381 surgical procedures, with many patients at higher than present therapeutic intenational normalized ratio (INR) levels, only 31 (∼0.6% of patients) required more than local hemostasis to control the hemorrhage; none died due to hemorrhage. Among at least 2673 patients whose warfarin dose was reduced or withdrawn for at least 2775 visits for Dental procedures, there were 22 embolic complications (0.8% of cessations), including 6 fatal events (0.2% of cessations). The embolic morbidity risk in patients whose anticoagulation is interrupted for Dental Surgery exceeds that of significant bleeding complications in patients whose anticoagulation is continued, even when Surgery is extensive. Warfarin anticoagulation, therefore, should not be interrupted for most Dental Surgery.

  • Dental Surgery in anticoagulated patients—stop the interruption
    Oral Surgery Oral Medicine Oral Pathology and Oral Radiology, 2014
    Co-Authors: Michael J Wahl, Andres Pinto, Jessica Kilham, Rajesh V Lalla
    Abstract:

    In a literature review, the incidence and morbidity of bleeding complications after Dental Surgery in anticoagulated patients was compared with embolic complications when anticoagulation was interrupted. Over 99% of anticoagulated patients had no postoperative bleeding that required more than local hemostatic measures. Of more than 5431 patients undergoing more than 11,381 surgical procedures, with many patients at higher than present therapeutic intenational normalized ratio (INR) levels, only 31 (∼0.6% of patients) required more than local hemostasis to control the hemorrhage; none died due to hemorrhage. Among at least 2673 patients whose warfarin dose was reduced or withdrawn for at least 2775 visits for Dental procedures, there were 22 embolic complications (0.8% of cessations), including 6 fatal events (0.2% of cessations). The embolic morbidity risk in patients whose anticoagulation is interrupted for Dental Surgery exceeds that of significant bleeding complications in patients whose anticoagulation is continued, even when Surgery is extensive. Warfarin anticoagulation, therefore, should not be interrupted for most Dental Surgery.

  • Dental Surgery and antiplatelet agents bleed or die
    The American Journal of Medicine, 2014
    Co-Authors: Michael J Wahl
    Abstract:

    Abstract In patients taking antiplatelet medications who are undergoing Dental Surgery, physicians and dentists must weigh the bleeding risks in continuing antiplatelet medications versus the thrombotic risks in interrupting antiplatelet medications. Bleeding complications requiring more than local measures for hemostasis are rare after Dental Surgery in patients taking antiplatelet medications. Conversely, the risk for thrombotic complications after interruption of antiplatelet therapy for Dental procedures apparently is significant, although small. When a clinician is faced with a decision to continue or interrupt antiplatelet therapy for a Dental surgical patient, the decision comes down to "bleed or die." That is, there is a remote chance that continuing antiplatelet therapy will result in a (nonfatal) bleeding problem requiring more than local measures for hemostasis versus a small but significant chance that interrupting antiplatelet therapy will result in a (possibly fatal) thromboembolic complication. The decision is simple: It is time to stop interrupting antiplatelet therapy for Dental Surgery.

  • myths of Dental Surgery in patients receiving anticoagulant therapy
    Journal of the American Dental Association, 2000
    Co-Authors: Michael J Wahl
    Abstract:

    ABSTRACT Background Continuous anticoagulant therapy with warfarin is administered to prevent a variety of medical complications, including thromboembolisms and stroke. When patients receiving continuous anticoagulant therapy are scheduled for Dental Surgery, a decision must be made whether to continue or interrupt the anticoagulant therapy. Methods The author reviewed the literature, focusing on Dental Surgery in patients receiving continuous anticoagulant therapy and in patients whose anticoagulant therapy was withdrawn before they underwent Dental procedures. Results Of more than 950 patients receiving continuous anticoagulant therapy (including many whose anticoagulation levels were well above currently recommended therapeutic levels) who underwent more than 2,400 surgical procedures, only 12 ( Conclusions Serious embolic complications, including death, were three times more likely to occur in patients whose anticoagulant therapy was interrupted than were bleeding complications in patients whose anticoagulant therapy was continued (and whose anticoagulation levels were within or below therapeutic levels). Interrupting therapeutic levels of continuous anticoagulation for Dental Surgery is not based on scientific fact, but seems to be based on its own mythology. Clinical Implications Dentists should recommend that therapeutic levels of anticoagulation be continued for patients undergoing Dental Surgery. Practitioners should consult with the patient's physician if necessary to determine his or her level of anticoagulation before performing Dental Surgery.

Beth C Seidenberg - One of the best experts on this subject based on the ideXlab platform.

  • analgesic efficacy of the cyclooxygenase 2 specific inhibitor rofecoxib in post Dental Surgery pain a randomized controlled trial
    Clinical Therapeutics, 1999
    Co-Authors: Briggs W Morrison, Steven Christensen, Weiying Yuan, Jean Brown, Susan Amlani, Beth C Seidenberg
    Abstract:

    Abstract Previous data have suggested that rofecoxib, a cyclooxygenase (COX)-2-specific inhibitor, had analgesic effects similar to those of the nonsteroidal anti-inflammatory drugs when tested in the post-Dental Surgery pain model. The objective of this parallel-group, double-masked, randomized, placebo- and active comparator-controlled clinical trial was to assess more fully the analgesic efficacy of rofecoxib in the treatment of postoperative Dental pain. After Dental Surgery, 151 patients (50.3% women; mean age, 18.3 years; 93.4% white) experiencing moderate-to-severe pain were to receive a single dose of placebo, rofecoxib 50 mg, or ibuprofen 400 mg. Analgesic efficacy was assessed for up to 24 hours postdose using self-administered questionnaires. Tolerability was assessed using spontaneous reports of adverse experiences, physical findings, and laboratory measurements. The results of this study demonstrated that rofecoxib 50 mg was more effective than placebo on all measures of analgesic efficacy. Rofecoxib 50 mg exhibited overall analgesic effects, onset of analgesia, and peak analgesic effects that were not significantly different from those of ibuprofen 400 mg, with a significantly longer duration of action (P

Maria Lidia Elizondo - One of the best experts on this subject based on the ideXlab platform.

  • use of a gesture user interface as a touchless image navigation system in Dental Surgery case series report
    Imaging Science in Dentistry, 2014
    Co-Authors: Guillermo Martin Rosa, Maria Lidia Elizondo
    Abstract:

    Purpose: The purposes of this study were to develop a workstation computer that allowed intraoperative touchless control of diagnostic and surgical images by a surgeon, and to report the preliminary experience with the use of the system in a series of cases in which Dental Surgery was performed. Materials and Methods: A custom workstation with a new motion sensing input device (Leap Motion) was set up in order to use a natural user interface (NUI) to manipulate the imaging software by hand gestures. The system allowed intraoperative touchless control of the surgical images. Results: For the first time in the literature, an NUI system was used for a pilot study during 11 Dental Surgery procedures including tooth extractions, Dental implant placements, and guided bone regeneration. No complications were reported. The system performed very well and was very useful. Conclusion: The proposed system fulfilled the objective of providing touchless access and control of the system of images and a three-dimensional surgical plan, thus allowing the maintenance of sterile conditions. The interaction between surgical staff, under sterile conditions, and computer equipment has been a key issue. The solution with an NUI with touchless control of the images seems to be closer to an ideal. The cost of the sensor system is quite low; this could facilitate its incorporation into the practice of routine Dental Surgery. This technology has enormous potential in Dental Surgery and other healthcare specialties. (Imaging Sci Dent 2014; 44: 155-60)