A preliminary study on the assessment of pain using figures among patients administered with dental local anesthesia for mandibular third molar extraction.

The aim of this study was to clarify or determine any possible association between pain reports with a visual analogue scale (VAS) and a figures based scale. This research was a preliminary study aimed at developing a new pain scale without any verbal description. Healthy Japanese patients aged 20 to 39 years who received anesthetic injections for mandibular third molar extraction at our department were enrolled. Regarding pain from dental local anesthetic injections, we recorded figures selected by participants (among options of a circle, triangle, square, bar, and cross), and VAS scores. Overall, 29 men and 31 women participated in the study. Pain caused by local dental anesthesia tended to remind both men and women of the triangle among the suggested figures. Furthermore, patients who chose a cross also reported higher VAS scores than those who chose other figures. Acute pain caused by local dental anesthesia was associated with triangles, and patients who selected a cross were associated with higher VAS scores. The results of this study provide clinicians with important information for dental practice, and could prove useful in developing new pain scales.

Collaboration with an infection control team promoted appropriate antibiotic use for third molar extraction at a Japanese hospital.

Oral antibiotic therapy is routinely administered when a third molar (M3) is extracted to prevent infectious complications after surgery. Oral third-generation cephalosporins are frequently used after M3 extraction in Japan but at the expense of an increased risk of antimicrobial resistance. Therefore, the infection control team (ICT) at our institution recommended a reduction in use of these agents after M3 extraction. In this study, we compared the types of antibiotic agents prescribed for patients undergoing M3 extraction before and after this recommendation. We investigated the relationship between type of antibiotic used and the likelihood of infectious complications as well as cost savings in patients who underwent M3 extraction in the 6 months before and after the ICT recommendation in July 2018. There was a marked reduction in use of oral third-generation cephalosporins after M3 extraction (P < 0.0001) and increased use of oral penicillins and first-generation cephalosporins after the ICT recommendation. Moreover, surgical site infection (SSIs) were significantly less common after the ICT recommendation (P = 0.0099); however, the SSI rate was higher in patients who received a third-generation cephalosporin than in those who received penicillin (8.8% vs 0.5%). There was also a significant saving in per-patient antibiotic costs after the ICT recommendation (269.5 ± 282.0 JPY vs 454.7 ± 376.6 JPY; P < 0.0001). These findings suggest that collaboration with an ICT promotes appropriate antibiotic use, decreases the risk of an SSI, and improves the cost-benefit ratio in patients undergoing M3 extraction.

Assessment of migrated foreign bodies in the maxillae by x-ray fluorescence spectrometry.

Two cases of foreign bodies that were incidentally observed on orthopantomographs are reported in this study. The foreign bodies were analyzed using an x-ray fluorescence spectrometer to identify what the migrated foreign bodies were and what migration pathways they had taken. The removed metallic foreign bodies from the maxillae of 2 patients, who were referred to the Department of Dentistry and Oral Surgery of the University of Fukui Hospital, were analyzed using an x-ray fluorescence spectrometer in the Department of Dental and Biomedical Materials Science, Nagasaki University. The major component of foreign body in patient 1 was silver, and that in case 2 was iron. On the basis of the imaging results and the patients' clinical history, the foreign bodies were considered to be caused by iatrogenic migration. Understanding the existence of foreign bodies and their migration pathway into the jaw bone can thus make clinicians more aware of such migrations and can thereby contribute to reducing iatrogenic accidents.