Effectiveness of Acupuncture in Dental Surgery: A Randomized, Crossover, Controlled Trial.

OBJECTIVES: The objective of this crossover clinical study was to evaluate the effectiveness of Energy Regulation with Acupuncture in clinical occurrences in impacted lower third molar surgeries. METHODS: The sample consisted of 22 patients with two impacted third molars, in symmetrical position; divided into two groups: Test Group (TG) with Real Energy Regulation Group and Sham Group (SG) with Acupuncture without Energy Regulation function. The extraction was performed 30 days apart. Energy flow (Ryodoraku Method) and energy regulation performed before extraction were measured. Heart Rate (HR) and Blood Pressure (BP) were evaluated before and after energy regulation and after surgery, residual edema was measured by facial measurements (angle of the mandible to tragus (A-T); angle of the mandible to labial commissure (A-LC); angle of the mandible to the wing of the nose (A-WN); angle of the mandible to the corner of the eye (A-CE); angle of the mandible to the chin (A-C); and mouth opening by the interincisal distance, before and after seven days of surgery. To quantify intraoperative bleeding (ml), blood was aspirated along with the saline solution using a portable vacuum pump adaptor. The amount of saline solution used was subtracted from the final amount of aspirated fluid. RESULTS: Mean of bleeding was lower in TG (p = 0.0392). There were significant differences between groups in facial distances: A-LC (p = 0.010), A-WN (p = 0.030) and A-C (p = 0.008). CONCLUSION: Energy regulation with real acupuncture was effective in reducing postoperative residual edema and intraoperative bleeding.

Lower third molar region / Región del tercer molar inferior

The lower third molar region is an important region for the odontostomatological practice, since it presents a great amount of pathological processes related to the development and eruption of the third molar; thus having a considerable number of surgical interventions. Despite its importance, this region is not accounted for in anatomical terminology nor is it described in topographic anatomy; and in spite of the great number of studies that analyze the surgical anatomy of the region, it is necessary to systematize the description of its boundaries, planes, content, risk elements, anatomical repairs, etc.; therefore, the purpose of the present article is to review the modern concepts related to the surgical anatomy of the lower third molar region and to establish a description based on these concepts...

La región del tercer molar inferior es una región importante para la práctica odontoestomatológica, en ella se presenta una gran cantidad de procesos patológicos relacionados con el desarrollo y erupción del tercer molar, por lo que se practican un gran número de intervenciones quirúrgicas. No obstante su importancia, esta región no se encuentra considerada en la terminología anatómica ni descrita en la anatomía topográfica y a pesar de la gran cantidad de estudios que analizan la anatomía quirúrgica de la región, es necesario sistematizar la descripción de sus límites, planos, contenidos, elementos de riesgo, puntos de reparo, etc., es por ello que el propósito de este artículo es revisar los conceptos modernos relacionados con la anatomía quirúrgica de la región del tercer molar inferior y proponer una descripción basada en estos conceptos...

The accuracy of identifying the greater palatine neurovascular bundle: a cadaver study.

BACKGROUND: The palate is a common site for harvesting subepithelial connective tissue grafts (SCTG). The size of SCTG that can be harvested is dictated by the position of the greater palatine neurovascular bundle (GPB). The aims of this cadaver study are to assess the accuracy of predicting the location of the GPB on study models and to evaluate anatomic factors that might influence the predictability. METHODS: Eleven fully dentate or partially edentulous maxillary cadavers were used. Study models were fabricated after the greater palatine foramen was identified. The GPB was recognized after dissection, from which the distance to the cemento-enamel junction of the first molar and premolar was measured. Eight periodontists and twelve periodontal residents were asked to estimate the location of the GPB on the study models and the same measurements were taken. Comparisons of the estimated and true GPB position were performed. The correlation between the palatal vault height and the variability of detecting the GPB was investigated. RESULTS: The most frequent greater palatine foramen location was between the second and third molars (66.6%). For most cases, there was an underestimation of the location of the GPB up to 4 mm. The interexaminer variability was positively correlated with the vault height. CONCLUSIONS: The estimated location of the GPB was commonly closer to the cemento-enamel junction of posterior teeth. Agreement on the location of the GPB was lowered with the presence of high palatal vaults. The results of this study could assist clinicians in planning the location for harvesting SCTG on the hard palate.

Effect of additional surgical procedures on root development of transplanted immature third molars.

The aim of this investigation was to determine the influence of additional surgical procedures on the root development of transplanted teeth. The study sample consisted of 90 immature third molars transplanted in 88 patients. All transplanted teeth were at root development stages 3 to 4. Free bone autografts were used in 23 cases (bone autograft group), mainly because of vertical atrophy of the alveolar process. A splitting osteotomy of the alveolar process was performed in 25 cases with marked horizontal atrophy (osteotomy group). Forty-two teeth transplanted into a fresh extraction site immediately after extraction of the non-retainable tooth served as controls. At root development stage 3, significant differences were determined between the osteotomy and the control groups in final root length (P<0.001) and root length increment (P=0.004). Transplants in the osteotomy group revealed a significantly lower root length increment than transplants in the bone autograft group (P=0.008). No significant intergroup differences were observed at root development stage 4. These results indicate that a splitting osteotomy of the alveolar process has a negative effect on root development of transplanted teeth at earlier developmental stages.

Expression of heat shock protein 27 in adult human third molar dental pulp.

This study is the first to define the expression of hsp 27 in the pulp of the adult human third molar. Using a monoclonal antibody against human hsp 27, immunoreactivity was demonstrated in the odontoblasts, odontoblast processes, pulp fibroblasts, and smooth muscle and endothelial cells of vessel walls. Nerves were negative. Pulp fibroblasts were characterized by cytoplasmic staining and variable nuclear staining. Odontoblasts also displayed consistent cytoplasmic staining and variable nuclear staining. Western, Northern, and RT-PCR analysis confirmed the expression of hsp 27 mRNA and protein. Hsp 27 was also shown to be present in both the unphosphorylated and phosphorylated isoforms. In general, nuclear localization and phosphorylation of hsp 27 has been correlated with cells responding to stress or other stimuli. This study demonstrates that pulp from a single human third molar provides sufficient material to support a detailed molecular analysis of gene expression.