Comparison between ozone and CHX gel application for reduction of pain and incidence of dry socket after lower third molar removal.

OBJECTIVES: The aim of this study is to evaluate the efficacy between ozone gas and 1% chlorhexidine (CHX) gel in the incidence of dry socket after surgical extraction of impacted lower third molars. MATERIAL AND METHODS: Overall, 30 patients of both genders were included in the study, with indication of surgical extraction of lower third molar, positioned similarly after being clinically and radiographically checked by X-ray and orthopantomography. Each patient was subjected to both groups in separate sessions: treated with ozone gas and with CHX gel 1%. Data on pain intensity, number of taken analgesics-painkillers, and dry socket were recorded for 48 h and at Day 7. RESULTS: Ozone gas and CHX gel effectively reduced pain intensity and prevented dry socket. The number of taken analgesics 48 h and 7 days after surgery showed no statistical significance. The same was observed for the distribution of pain. Only one patient reported the occurrence of dry socket 7 days after the surgical extraction. CONCLUSIONS: Ozone gas and CHX 1% gel are both efficient in decreasing postoperative symptoms and incidence rates of dry socket, but in comparison to each other, the use of ozone gas is showing a bit better prevention capability.

The changes in levels of blood cortisol, glucose, and oxygen saturation in type 2 diabetic patients during tooth extraction.

OBJECTIVES: The extraction of a tooth exacerbates the stress in diabetic patients leading to diabetic complications so the aim was to evaluate the changes in blood cortisol, glucose, and oxygen saturation in type 2 diabetic patients during tooth extraction to pay special attention during a routine surgical procedure. MATERIALS AND METHODS: The research included 40 patients with type 2 diabetes with indications of tooth extraction. They were divided into two subgroups by 20 participants and split according to local anesthesia (lidocaine with additional adrenaline or lidocaine only). Cortisol, blood sugar, blood pressure, arterial pulse, and blood oxygen saturation were measured. Patients were also evaluated for their sensitivity to pain through the Visual Analog Scale (VAS). RESULTS: Cortisol and glucose levels scientifically increased throughout the procedure. Meanwhile, systolic, and diastolic blood pressure and saturation showed no difference between the measurements during and after tooth extraction (p = .280; p = .090; p = .590, respectively). Most patients (60.0%) felt no pain during/after the procedure. None of the subjects was feeling more pain than 30 points by VAS. The comparison between groups receiving lidocaine showed no statistical differences when adding adrenaline to lidocaine. Evaluation of pain by VAS showed that more patients felt pain when they were receiving lidocaine without adrenaline. CONCLUSIONS: Diabetic patients require a more cautious approach when undergoing teeth extractions despite it being a routine procedure.

Evaluation of Spontaneous Bone Healing After Enucleation of Large Residual Cyst in Maxilla without Graft Material Utilization: Case Report.

Cystic lesions of the jaws such as keratocysts (scientific community still continues to use the term 'odontogenic keratocyst' more favourably than 'keratocystic odontogenic tumour' although both terms remain acceptable synonyms), follicular cysts, radicular cysts, and residual cysts may reach large proportions, causing considerable bone destruction. Enucleation of cystic lesions in the jaw produces bone defects, which may recover spontaneously or with assisted healing with the use of autogenous bone graft or other bone substitute materials. This clinical study presents a spontaneous bone regeneration after residual cyst enucleation in the distal part of the maxilla. The progress of recovery is followed by clinical and radiographic examination and subjective data obtained from the patient. Bone regeneration and cystic cavity reduction was observed in the panoramic image after six months and after one year. The physiological process of coagulation provides the basic process for the spontaneous bone formation even if an osseous defect is considerably large, provided that the defect is surrounded by adequate bony walls.

Blade of Grass as an Unusual Cause of Recurrent Facial Cutaneous Sinus Tract: A Clinical Case.

The presence of an embedded foreign body in the oral and maxillofacial region is not unusual, but the impaction of a foreign body with vegetative nature is rare. Prompt diagnosis and surgical removal of these foreign bodies will minimize their associated complications. This case report presents a patient with recurrent submandibular abscess and persistent facial cutaneous sinus tract caused by a retained blade of grass inside the facial soft tissue. The fact that the plain radiograph misdiagnosed the presence of a foreign body meant that the pathology persisted for about three months, and the patient underwent hospitalization, surgical procedures, and antibiotic regimens; however all of these failed until the foreign body was detected and removed. Conclusion. To avoid misdiagnosis of foreign body presence in the orofacial region, notably suspected foreign bodies with low radiopacity, the clinician must perform careful clinical examination and use the ultrasonography. Also, in the uncertain cases where the pathology persists, despite having undertaken surgical procedures and antibiotic regimens, the clinician should pay more attention to the patient's history which may suggest the presence of the foreign body.

Sclerotherapy of Intraoral Superficial Hemangioma.

Hemangioma is the clinical term for a benign vascular neoplasm due to proliferation of the endothelial lining of blood vessels. Their most frequent location is the body skin and oral mucosa. One of the treatment modalities for hemangiomas is intralesional injection of sclerosing agents which cause the damage of blood vessels followed by their obliteration. The objective of the study was to describe the facility of application and evaluate the efficiency of sclerotherapy with aethoxysklerol 1%. Method. The case presented with intraoral submucosal hemangioma of the cheek was treated by intralesional injection of aethoxysklerol 3% diluted in water for injections at a 4 : 1 ratio (0.75%) at the first appointment and 3 : 1 (1%) at the second appointment. The effect of sclerotherapy was evaluated on the following visits in time intervals of two weeks. Results. The hemangioma disappeared without complications after the second injection of aethoxysklerol 1%. The successful results of the study were comparable to the data of literature with variations according to the used sclerosant agent, its concentration, the number of injections, and the intervals between each session. Conclusion. Since sclerotherapy is a very effective, inexpensive, and easy-to-apply treatment, it should be the treatment of choice, especially for intraoral superficial hemangiomas.

The Incidence of Impacted Maxillary Canines in a Kosovar Population.

Aim. The purpose of this study was to investigate the incidence of impacted maxillary canines in a Kosovar population. Materials and Methods. The study consisted of a retrospective analysis of the records of 8101 patients treated in the University Dentistry Clinical Center of Kosovo between August 2001 and February 2004. The chi-squared test was used to examine potential differences in the distribution of impacted maxillary canines stratified by gender, age, location (left or right), and position. P < 0.05 was accepted as statistically significant. Results. It was found that the incidence of impacted maxillary canines was 1.62%. Of the 131 impacted maxillary canines, 101 were in female patients and 30 were in male patients, a statistically significant difference. Ages were in the range of 9 to >20 years, with a mean age of 24.38 ± 8.09 years. Of these subjects, 99 (75.57%) had unilaterally impacted maxillary canines, while 32 (24.43%) had bilateral impactions, a statistically significant difference (P < 0.00002). Impacted canines in 92 subjects (70.2%) were palatally placed, and 18 (13.7%) were labially placed. This difference was also statistically significant (P < 0.00001). Conclusion. The incidence of impacted maxillary canines in the sample Kosovar population was 1.62%, which is comparable to the findings from previous studies.