Comparison of the efficacy of low doses of methylprednisolone, acetaminophen, and dexketoprofen trometamol on the swelling developed after the removal of impacted third molar.

BACKGROUND: The aim of the present study was to compare the efficacy of low doses of methylprednisolone, acetaminophen and dexketoprofen trometamol, which are among the drug groups used in our clinic, on postoperative swelling developing after removal of impacted third molar. MATERIAL AND METHODS: The three group of patients received either 40 mg methylprednisolone or 300 mg acetaminophen or 12.5 mg dexketoprofen trometamol one hour before the procedure, according to the patient groups. The patients in the methylprednisolone group were injected with methylprednisolone at a dose of 20 mg 24 hour after the procedure and prescribed 300 mg acetaminophen as rescue analgesic. During the postoperative period, the doses that were given before the procedure were continued 3 times a day for 2 days in the acetaminophen and dexketoprofen trometamol groups. Maximal swelling was assessed preoperatively and at the postoperative 48 hours by ultrasound images. RESULTS: Swelling was 34% lower in the methylprednisolone than in the other groups; however, no statistically significant difference was found between the groups. The acetaminophen and dexketoprofen trometamol groups exhibited clinical results close to each other. CONCLUSIONS: Combination of low doses of methylprednisolone and acetaminophen provide a safe and adequate clinical success on swelling.

Stability of dental implants with sandblasted and acid-etched (SLA) and modified (SLActive) surfaces during the osseointegration period.

Background. The surface properties of implants are effective factors for increasing the osseointegration and activity of osteoprogenitor cells. This study compared the stability of dental implants with sandblasted and acid-etched (SLA) and modified surfaces (SLActive) using the resonance frequency analysis (RFA). Methods. In a split-mouth design, 50 dental implants with either SLA surface properties (n=25) or modified (SLActive) surface properties (n=25) were placed in the mandibles of 12 patients with a bilateral posterior edentulous area. Implant stability was measured using RFA (Osstell) at implant placement time and every week for 1, 2, and 3 months before the conventional loading time. Results. One week following the implantation, implant stability increased from 70 to 77.67 for SLA and from 71.67 to 79 for SLActive (P < 0.05). Stability improved each week except in the 4th week in SLActive surface measurements. No significant differences were observed between the groups at 2 and 3 months (P > 0.05). Conclusions. For both implant surfaces, increased stability was observed over time, with no significant differences between the groups.

A preferable technique for protecting the inferior alveolar nerve: coronectomy.

PURPOSE: The aim of this study was to evaluate the effectiveness of coronectomy for teeth whose root apices are very close to the inferior alveolar canal. PATIENTS AND METHODS: The 43 patients of this study needed removal of their lower third molar, whose root apices were very close to the inferior alveolar canal. These patients underwent 47 coronectomies. RESULTS: The mean follow-up period was 9.3 months (range, 1 to 48 months). The mean total amount of root movement was 3.4 mm at 6 months, 3.8 mm at 12 months, and 4.0 mm at 24 months. CONCLUSIONS: The technique of coronectomy is defined as removing the crown of a tooth but leaving the roots untouched, so that the possibility of nerve damage is reduced. Coronectomy is a preferable technique for patients who run a risk of injury to the inferior alveolar nerve during third molar surgery.

The use of autogeneous mandibular bone block grafts for reconstruction of alveolar defects.

OBJECTIVE: Purpose of this retrospective study was to evaluate outcomes autogenous bone block grafts obtained from mandible for different indications. The healing of the donor and recipient sites in the postoperative period, morbidity and the resorption of the graft were investigated. PATIENTS AND METHODS: Twenty-nine patients grafted with mandibular bone block graft were participated in the present study. Grafting was applied in these patients for three indications; reconstruction of alveolar cleft, lateral crest augmentation before dental implantation and sinus floor augmentation. All operations were performed under local anesthesia and in some cases sedation was used as well. RESULTS: Minimal exposure of the block graft occurred in three alveolar cleft patients. Secondary epithelization was achieved in all cleft patients with no symptoms of infection. In one patient infection was seen in donor site 1-week after the operation. The region was curetted and antibiotics administrated again. Two patients showed an infection of recipient site, after 4 weeks the grafts were removed. In all the patients, as the screw head became apparent until 1 thread, amount of the resorption were considered <1.5 mm. CONCLUSION: The usage of mandibular block grafts is a simple and effective treatment modality for reconstruction of different types of alveolar defects and it also reduces cost of treatment.

Eruption of impacted permanent teeth after treatment of a dentigerous cyst: a case report.

Dentigerous cysts are the most common developmental odontogenic cysts. It is a benign and asymptomatic intraosseous lesion that affects the bones of the maxillofacial complex, interfering with tooth eruption. Although enucleation is the treatment of choice, marsupialization is the better option for large cysts involving unerupted permanent teeth. The purpose of this article is to report the eruption of impacted permanent mandibular right canine and first and second premolars after marsupialization of an infected dentigerous cyst. Two years after marsupialization and orthodontic treatment, the cyst disappeared and the canine and premolars erupted uneventfully.

Comparison of the efficacy of low doses of methylprednisolone, acetaminophen, and dexketoprofen trometamol on the swelling developed after the removal of impacted third molar

BACKGROUND: The aim of the present study was to compare the efficacy of low doses of methylprednisolone, acetaminophen and dexketoprofen trometamol, which are among the drug groups used in our clinic, on postoperative swelling developing after removal of impacted third molar. MATERIAL AND METHODS: The three group of patients received either 40 mg methylprednisolone or 300 mg acetaminophen or 12.5 mg dexketoprofen trometamol one hour before the procedure, according to the patient groups. The patients in the methylprednisolone group were injected with methylprednisolone at a dose of 20 mg 24 hour after the procedure and prescribed 300 mg acetaminophen as rescue analgesic. During the postoperative period, the doses that were given before the procedure were continued 3 times a day for 2 days in the acetaminophen and dexketoprofen trometamol groups. Maximal swelling was assessed preoperatively and at the postoperative 48 hours by ultrasound images. RESULTS: Swelling was 34% lower in the methylprednisolone than in the other groups; however, no statistically significant difference was found between the groups. The acetaminophen and dexketoprofen trometamol groups exhibited clinical results close to each other. CONCLUSIONS: Combination of low doses of methylprednisolone and acetaminophen provide a safe and adequate clinical success on swelling

Conservative Treatment Protocol for Keratocystic Odontogenic Tumour: a Follow-up Study of 3 Cases.

BACKGROUND: The keratocystic odontogenic tumour is classified as a developmental cyst derived from the enamel organ or from the dental lamina. The treatment of keratocystic odontogenic tumour of the jaw remains controversial. The aim of this study was to report the outcome of our conservative treatment protocol for keratocystic odontogenic tumour. METHODS: Three patients with different complaints referred to Oral and Maxillofacial Surgery Clinic, Faculty of Dentistry, Selçuk University. Initial biopsy was carried out in all patients and keratocystic odontogenic tumours was diagnosed subsequent to histopathological examination. The patients with keratocystic odontogenic tumours were treated by enucleation followed by open packing. This conservative treatment protocol was selected because of existing young aged patients. The average follow-up duration of the cases was 2 years. RESULTS: Out of 3 cases, 2 lesions were present in mandible and 1 lesion in maxilla. There was no evidence of recurrence during follow-up. All the cases were monitored continuously with panoramic radiographs, computed tomography and clinical evaluations. CONCLUSIONS: This conservative treatment protocol for keratocystic odontogenic tumours, based on enucleation followed by open packing would be a possible choice with a view of offering low recurrence rate and low morbidity rate particularly in young patients.

Evaluation of the biocompatibility and osteoproductive activity of ostrich eggshell powder in experimentally induced calvarial defects in rabbits.

The purpose of this study was to investigate the beneficial effects of particulate ostrich eggshell grafting on the healing of experimentally induced skull defects. The clinical, radiological, histological, and histomorphometrical findings of this material were compared with the results of commercially available demineralized bone matrix (DBM). The study was conducted on 18 adult New Zealand rabbits. One defect served as a control and the remaining ones either were filled with different sized eggshell particles or DBM, in each animal. Clinical and radiological inspections and histologic investigations of the animals were done at the 1st, 3rd, and 6th months of postoperative period. Radiologically, minimal bone regeneration was observed at the empty, control defect sites. The most advanced bone regeneration was in the DBM grafted defects. The eggshell particle grafted defect sites displayed weak bone regeneration at earlier stages, at 1st and 3rd months after operation when compared with demineralized bone matrix. Nevertheless, ossification was satisfactory at 6th month after operation when compared with the control defects. Within the limitations of this study, it was concluded that Ostrich eggshell powder (OSP) is a worth-while bone substitute because it is a safe, cheap, and easily available material. Long-term studies will clarify its possible role in maxillofacial surgery. Further sophisticated experiments should be undertaken before human implantation concerning its osteoproductive activity alone or in combination with other materials.

Pathologic changes in soft tissues associated with asymptomatic impacted third molars.

OBJECTIVE: The aim of this study was to examine the need for routine removal of asymptomatic impacted third molars under the prophylactic indication, based on the incidence of pathologic changes. The frequency and type of pathologic conditions associated with impacted third molars were also evaluated. STUDY DESIGN: One hundred twenty impacted third molar dental follicles were submitted for histopathologic examination. The association between dental follicles and pathologic changes, age, gender, and angular position were statistically evaluated. RESULTS: Among these dental follicles, pathologic conditions were found in 23%. The relation between pathologic changes and angular position was not statistically significant (chi(2) = 2.040; P > .05). Pathologic changes were seen mostly in women who were > or = 20 years old. CONCLUSIONS: Cystic changes may be developed in asymptomatic impacted third molars. Asymptomatic impacted third molars should be removed before pathologic changes can occur.