Radiographic Detection Rate of Distal Surface Caries in the Mandibular Second Molar in Populations with Different Third Molar Management Strategies: A Multicenter Study.

Background: Distal surface caries (DSC) has been associated with partially erupted impacted third molars. The purpose of this study was to compare the rates of DSC between populations that had undergone different third molar management strategies. Methods: Radiographs that had been taken during routine examinations of 1012, 251 and 250 patients in Manchester, Bucharest and Amsterdam, respectively, were evaluated. The following parameters were assessed: the state of the distal surface in the second mandibular molar, loss of periodontal support, impaction type of the third molar, contact point localization, and patients' genders, ages and their cumulative history of dental health. Results: The rate of DSC in the second mandibular molar was 63.9%, 19.9% and 26.0% in the Manchester, Bucharest and Amsterdam populations, respectively. A loss of lamina dura of ≥2 mm, increased percentages of decayed, missing or filled teeth and male gender were risk factors in all three populations. All assessed parameters apart from the site of the mandible reached statistical significance in the Manchester sample (p < 0.001). The DSC rate was cumulative with increasing age in the Manchester population, in which third molars were strategically retained. Conclusions: The UK population, treated according to strict guidelines that limit the removal of third molars, had a statistically significant higher DSC prevalence rate (p < 0.001) than the Romanian or Dutch populations. The active surgical management of mandibular third molars seems to have the potential to reduce the DSC rate in the adjacent second molar.

Acute cellulitis as local reaction to orthopedic implant - case presentation.

Due to increasing number of arthroplasties and osteosynthesis, foreign body reaction to implants is a major problem for orthopedic surgeons, since it is considered to be responsible for severe complications impairing the outcome of the treatment and requiring multiple surgery. Different mechanisms have been described as being involved, and research is focused on finding biomaterials with increased biocompatibility in order to minimize these complications. The clinical aspect of this reaction is usually dominated by chronic pain, with mild functional deficits, and the diagnosis results from excluding other causes of chronic pain, such as infection, osteoarthritis, peripheral neuropathies or angiopaties. The authors present a case with unusual clinical aspect, that of acute cellulitis, when early proper treatment, represented by implant removal, allowed healing without the onset of infection or other complications; histological evaluation confirmed the reaction to implant, thus concluding that surgical treatment when intolerance to implant is suspected is the only method to prevent future negative events.