RESUMEN
BACKGROUND: Upper third molar (U3M) removal is a common surgical procedure. The aims of this study were to assess the patient-specific, radiological and surgical factors related to the difficulty of U3M removal, and to determine the incidence of intraoperative and postoperative complications. MATERIAL AND METHODS: A prospective cohort study was carried out in adult patients undergoing U3M removal. Operative time, surgeon-reported difficulty and the Parant classification were used to assess extraction difficulty. Clinical, radiological and surgical factors were recorded to determine their relationship with surgical difficulty. A descriptive, bivariate and multivariate statistical analysis was carried out. RESULTS: A total of 250 patients were included. The mean operative time was 10.4 (±12.3) minutes, mean surgeon-reported difficulty was 3.2/10 (±2.3). The multivariate analysis showed greater impaction against the second molar and greater soft tissue and bony impaction to significantly increase operative time and surgeon-perceived difficulty. Additionally, surgeon experience was related to perceived difficulty. The overall incidence of intraoperative complications was 0.8%, and no postoperative events were recorded. CONCLUSIONS: Upper third molars in close relation with the roots of the adjacent second molar and with soft tissue and bony impaction are significantly more difficult to extract. Perceived difficulty was related to surgeon experience. This procedure appears to produce few intra- and postoperative complications.
Asunto(s)
Tercer Molar , Complicaciones Posoperatorias , Extracción Dental , Humanos , Estudios Prospectivos , Tercer Molar/cirugía , Femenino , Masculino , Extracción Dental/efectos adversos , Adulto , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Estudios de Cohortes , Adulto Joven , Persona de Mediana Edad , Complicaciones Intraoperatorias/epidemiología , Complicaciones Intraoperatorias/etiología , AdolescenteRESUMEN
Se presenta un caso de Hiperplasia Angiolinfoide con Eosinofilia en una paciente de 37 años de edad con caracteres clínicos e histopatológicos típicos. Se describe el tratamiento realizado y se destacan los ragos más importantes de esta entidad nosológica
Asunto(s)
Persona de Mediana Edad , Humanos , Femenino , Hiperplasia Angiolinfoide con Eosinofilia/cirugíaRESUMEN
Presentamos un paciente masculino, blanco, de 53 años, conocido diabético. Consultó a nuestro hospital por anemia, ictericia, hepato-esplenomegalia y pérdida de 10 kgrs. en los últimos 2 meses. Las radiografías de tórax mostraron una masa en mediastino anterior e inferior de 8x11 cms. Las pruebas de laboratorio rebelaron reticulocitosis, elevada sedimentación globular, hiperbilirrubinemia indirecta, Coombs fuertemente positivo, complemento C3 y C4 normales y ANA negativo. El tratamiento inicial con prednisona mejoró sus cifras hematológicas y se practicó toracotomía. Después de la remoción del tumor que resultó ser un timoma lifo-epitelial, el paciente se recuperó totalmente desde el punto de vista hematológico, con negativización del Coombs. Hacemos enfásis en la rara asociación de timoma con anemia hemolítica, (menos del 1// en las grandes series) y que el tratamiento definitivo de esta condición es la cirugía