Analgesic and Anti-Inflammatory Effects of Articaine and Perineural Dexamethasone for Mandibular Third Molar Surgery: A Randomized, Double-Blind Study.

PURPOSE: We aimed to investigate the effectiveness of articaine and perineural dexamethasone (DX) in reducing postoperative sequelae such as swelling and maximum mouth opening that are harming the quality of life of patients after impacted mandibular third molar (IMTM) surgery. PATIENTS AND METHODS: We implemented a randomized clinical trial composed of patients undergoing IMTM extraction. The predictor variable was the treatment group. The patients were randomly assigned to 1 of 3 groups: Group A was administered 3.6 mL of articaine mixed with 2 mL of saline solution; group B, 3.6 mL of articaine and 1 mL of DX (4-mg/mL solution) with 1 mL of saline solution; and group C, 3.6 mL of articaine with 2 mL of DX (8-mg/mL solution). The primary outcome variables were swelling (determined by anatomic facial landmarks), pain, and maximum mouth opening. Other variables comprised the duration of surgery, number of analgesics taken in the postoperative period, hygiene, and petechiae. RESULTS: The sample was composed of 60 patients (20 per treatment group), with a mean age of 25.18 ± 5.22 years; 53.3% were women. Postoperative swelling was significantly reduced in groups B and C (P < .05). Maximum mouth opening was significantly increased in groups B and C (P < .05). CONCLUSIONS: The results of this study suggest that combining DX with articaine improves the management of discomfort after IMTM surgery. The use of articaine via a mandibular block was not associated with neural damage in our study.

Investigation of the effects of semaphorin 3A on new bone formation in a rat calvarial defect model.

PURPOSE: This study investigates the effects of semaphorin 3A on new bone formation in an experimental rat model. MATERIALS AND METHODS: Cortical bone defects, 5 mm, were created in the calvaria of 40 Wistar rats, which were then separated into three groups: empty defect (control) group, collagen group, collagen + semaphorin 3A group. The bone blocks were harvested after 4 and 8 weeks. New bone formation was assessed by micro-computed tomography (micro-CT), histology, histomorphometry, transmission electron microscope (TEM) and immunohistochemistry. RESULTS: Increased bone formation was observed in collagen + semaphorin 3A groups both histologically and with micro-CT. In the histomorphometic analysis, the control group had significantly less bone formation compared to both the collagen and collagen + semaphorin 3A group at 4 weeks (p = 0.0001) and 8 weeks (p = 0.0001). The collagen group had significantly less bone formation compared to collagen + semaphorin 3A group both at 4 weeks (p = 0.002) and 8 weeks (p = 0.005). Immunohistochemical analysis revealed that semaphorin 3A inhibited receptor activator of nuclear factor-kB ligand (RANKL) expression and increased the expressions of osteoblastic bone markers at 4 weeks. In TEM analysis, the collagen + semaphorin 3A group had an increased proliferation and bone formation rate at 4 weeks, whereas bone quantity and maturation were enhanced at 8 weeks. CONCLUSION: Locally applied semaphorin 3A increases callus formation at 4 weeks and bone formation at 8 weeks. Semaphorin 3A prevents bone resorption by inhibiting osteoclasts and increases bone formation by inducing osteoblasts.

The prevelance of mesiodens in a group of non-syndromic Turkish children: a radiographic study.

PURPOSE: The aim of the present study is to determine the prevelance and clinical status of mesiodens in a group of non-syndromic Turkish children, with an analysis of the associated clinical-eruptive complications. MATERIALS AND METHODS: This study sample consists of 58142 pediatric patients'. Standard equipment and films were used in the suspected patients. The examination of all radiographs was performed under standard conditions by two pediatric dentists with over 10 years experience. Age, gender, number of mesiodens, morphology and clinical status were recorded in forms. RESULTS: A total of 83 mesiodentes were diagnosed in 59 children with ages ranging from 6-14 years. The prevelance of mesiodens was estimated as 0.1%. Males were more frequently affected than females in the ratio of 2.3:1. Of the 83 mesiodentes, 48.2% were conical, 31.3% were tuberculate and 20.5% were incisor like, 22.9% were inverted, and 68.7% were fully impacted. The number of mesiodens was one in 36 cases (61.0%), two in 22 cases (37.3%) and three in one case (1.7%). The mean age at the time of diagnosis of the mesiodens was 9.5 years. The main complication associated with the mesiodens was displacement or rotation of the permanent teeth (73.3%). CONCLUSION: This study presents 0.1% prevelance of mesiodens in a group of Turkish children sample. The majority of the mesiodentes were unilateral located in the premaxillary region, were conical shaped, and remained unerupted. The mean age at the time of diagnosis of the mesiodens in this study was 9.5 years, with this period being later than the eruption time of the maxillary central incisor.

Reliability and validity of the Modified Dental Anxiety Scale (MDAS) in a Turkish population.

OBJECTIVES: Fear of dentistry is a common obstacle to obtaining dental care in Turkey. The aim of this study was to assess the reliability, validity and psychometric characteristics of the Turkish translation of the Modified Dental Anxiety Scale (MDAS) and compare it to the Dental Fear Survey (DFS) scores obtained in the same population. METHODS: The Turkish translated version of the MDAS was administered to 115 dental patients; 21 subjects who suffered from dental phobia, requiring general anesthesia for dental procedures, and 94 who did not have dental anxiety, in addition to 442 subjects from the general population. RESULTS: The Turkish translated version of the MDAS was internally consistent and reproducible. The patients with dentist phobia had the highest score. The Turkish MDAS correlated with the DFS (r = 0.80, P < 0.001). The MDAS scale correlated inversely (r = -0.14, P < 0.005) with level of education; however, it did not correlate with economic status. Women scored higher than men on the scale (mean = 12.3, SD = 5.2 vs. mean = 10.9, SD = 4.5, P < 0.005). At a cut-off point > or = 15, sensitivity was 0.80, specificity 0.74, positive predictive value 0.41 and negative predictive value 0.94. CONCLUSION: Although the specificity values were low, the Turkish MDAS demonstrated acceptable sensitivity, positive and negative predictive values. Thus, high reliability and validity of the MDAS supports its cross-cultural validity and indicated that it may be a valuable tool in quantifying fear of dentistry among Turks.