Establishing universal sectioning depth and angle for surgical coronectomy of impacted mandibular third molars: an imaging-based study.

Introduction: Coronectomy is a safer option than extraction for third molars with an increased risk of injury to the inferior alveolar nerve. However, it can still cause complications due to a lack of standardized and effective tooth sectioning techniques. We proposed a standardized protocol for third molar coronectomy involving standardized tooth sectioning parameters to minimize potential complications, surgical failure, and the need for further procedures. Methods: The study was conducted on 69 eligible archived CBCTs. The coronal sections of the mandibular at the anterior-most level of the lower third molar were used to determine various axes and reference points. This was done to establish the target angle and depth for the coronectomy sectioning. The data on the depth and angle of the sectioning was presented in means and standard deviation. A multivariate analysis of variance was used to determine the impact of study variables on drill depth and angle. Linear regression and correlation between study variables were also used to predict the drill depth and angle. Results: The samples included 46 males and 23 females aged from 21 to 47 years. The mean drill angle was determined as 25.01 ± 3.28. The mean drill depth was 9.60 ± 9.90 mm. The bucco-lingual tilt had a significant effect on the drill depth, F(1, 62) = 5.15, p < 0.05, but no significant impact on the drill angle, F(1, 62) = 29.62, p > 0.05. The study results suggest that a standardized sectioning protocol can be effective during surgical coronectomy procedures. Discussion: Drilling at a 25-degree angle to a depth of 9.5 mm is advisable to obtain the desired results. This approach will ensure no remaining enamel is left, minimize the chances of root extrusion and future eruption, and improve the outcome.

How far can we go? A 20-year meta-analysis of dental implant survival rates.

OBJECTIVE: This meta-analysis aims to investigate the long-term survival rates of dental implants over a 20-year period, providing a practical guide for clinicians while identifying potential areas for future research. MATERIALS AND METHODS: Data were sourced from recent publications, focusing exclusively on screw-shaped titanium implants with a rough surface. Both retrospective and prospective studies were included to ensure an adequate sample size. A systematic electronic literature search was conducted in the databases: MEDLINE (PubMed), Cochrane, and Web of Science. The risk of bias for all studies was analyzed using a tool by Hoy et al. RESULTS: Three prospective studies (n = 237 implants) revealed a mean implant survival rate of 92% (95% CI: 82% to 97%), decreasing to 78% (95% CI: 74%-82%) after imputation (n = 422 implants). A total of five retrospective studies (n = 1440 implants) showed a survival rate of 88% (95% CI: 78%-94%). Implant failure causes were multifactorial. CONCLUSION: This review consolidates 20-year dental implant survival data, reflecting a remarkable 4 out of 5 implants success rate. It emphasizes the need for long-term follow-up care, addressing multifactorial implant failure. Prioritizing quality standards is crucial to prevent overestimating treatment effectiveness due to potential statistical errors. While dental implantology boasts reliable therapies, there is still room for improvement, and additional high-quality studies are needed, particularly to evaluate implant success. CLINICAL RELEVANCE: Never before have the implant survival over 20 years been systematically analyzed in a meta-analysis. Although a long-term survival can be expected, follow-up is essential and shouldn't end after insertion or even after 10 years.

Anesthetic Challenges in Ameloblastoma of the Mandible: A Case Report.

Ameloblastoma is a rare, locally aggressive benign tumor primarily affecting the mandible, with an incidence of 0.92 cases per million person-years and a male predominance. A two-year-old male presented with a right mandibular mass. CT imaging and histopathology confirmed ameloblastoma. He underwent wide local excision, mandibulectomy, and pectoralis major myocutaneous flap reconstruction under general anesthesia. Preoperative assessment revealed potential airway challenges; intubation was achieved with the backward, upward, rightward pressure (BURP) maneuver, and tracheostomy was performed to secure postoperative airway patency. The surgery was uneventful, and the patient was successfully weaned off ventilatory support by postoperative day four. This case underscores the importance of careful planning and expertise in pediatric ameloblastoma management, highlighting the effectiveness of direct laryngoscopy with BURP maneuver and prophylactic tracheostomy.

Evaluation of Post-Operative Pain Management Techniques in Oral Surgery.

Objective: This prospective research directed to estimate the efficacy and safety of different post-operative pain management techniques in oral surgery subjects. Methods: Patients scheduled for various oral surgical procedures were recruited from a single oral surgery clinic between January 2022 and December 2023. Inclusion criteria encompassed adult subjects undergoing elective oral surgery under local or general anesthesia. Subjects were randomly assigned to one of three post-operative pain management protocols: Group A received standard analgesics, Group B received combination analgesics, and Group C received non-pharmacological interventions. Pain intensity scores, analgesic consumption, adverse events, and patient satisfaction were assessed at specified intervals post-operatively. Results: Non-pharmacological interventions demonstrated lower pain intensity scores and analgesic consumption compared to standard and combination analgesics. Additionally, the incidence of adverse events was lower in the non-pharmacological intervention group. Statistical analysis revealed significant differences in pain outcomes among the three groups. Conclusion: This prospective research suggests that non-pharmacological interventions may provide effective pain relief with fewer adverse events compared to traditional analgesics in post-operative oral surgery subjects. Implementation of multi-modal pain management approaches tailored to individual patient needs may improve overall pain control and enhance patient outcomes.

Wisdom Tooth Extraction Training for Dental Students: Step-by-Step or All-in-One?

Aims/Background For inexperienced dental students, impacted wisdom tooth extraction is a complex procedure involving a series of intricate steps. This study compared the effectiveness of step-by-step and all-in-one teaching methods for dental students learning impacted wisdom tooth extraction, by evaluating their practical abilities, understanding, and learning satisfaction. Methods Fifty dental students were randomly assigned to either a step-by-step teaching group (Group S) or an all-in-one teaching group (Group A) for impacted wisdom tooth extraction training. Their skills were assessed using the Assessment of Competency in Exodontia Skills (ACES) scoring system, and their theoretical knowledge was tested in a test. The students also completed a questionnaire to gauge their satisfaction regarding the teaching method received. Results The students in Group S demonstrated superior performance in clinical procedures compared to Group A, evidenced by the significantly higher ACES scores (p < 0.05). There was no significant difference in theoretical exam scores between the two groups (p > 0.05). The students in Group S reported higher general satisfaction (p < 0.05), suggesting a preference for the step-by-step approach. The results also showed that satisfaction toward hands-on practice and teaching sessions significantly contributed to general satisfaction, while satisfaction with mastery of clinical skills did not. Conclusion The step-by-step teaching method was more effective in improving students' clinical skills and augmenting their satisfaction during impacted wisdom tooth extraction training. Our findings support the use of incremental learning approaches in dental education to enhance both clinical competencies and students' learning experiences.

Public interest and seasonal peaks for wisdom teeth related web inquiries - A google trends analysis.

Objective: The study aimed to analyze the public interest in wisdom teeth-related search terms as well as regional and seasonal trends based on information from the Google search engine. METHODS: With the help of the online search query tool, Google Trends, the public interest in the primary search term "wisdom teeth" for the timeframe between January 1st, 2004 and September 31st, 2021 was analyzed. To do so, a country-specific search was conducted in English-speaking countries (the USA, the UK, Canada, and Australia) in the northern and southern hemispheres. The extracted time series was examined for reliability, and a Cosinor analysis evaluated the statistical significance of seasonal interest peaks. RESULTS: The reliability of averaged time series data on the search term "wisdom teeth" was excellent in all examined countries. In all countries analyzed, "wisdom teeth removal" was one of the most common related search terms. Significant interest peaks for wisdom teeth-related search terms were found in Canada and the USA during summer (p < .001). In Canada and the USA, significant seasonal patterns with the highest interest during the summer months, could be displayed. CONCLUSION: This phenomenon could be caused by increased wisdom teeth-related complaints induced by seasonal climate changes.

A Retrospective Analysis of 1311 Oral Surgery Procedures Performed in a Pediatric Hospital in Barcelona: A Study of Their Characteristics and Age-Related Diagnoses.

Background: Oral surgery involves the diagnosis and surgical treatment of diseases affecting the soft and hard tissues of the oral cavity and encompasses a wide range of surgical interventions. The aim of this investigation was to study the characteristics and age-related diagnoses of these oral surgeries, as well as to describe the surgical procedures performed in a pediatric oral and maxillofacial surgery service. Methods: A descriptive, retrospective, observational, and relational study was conducted on children and adolescents aged from 0 to 22 years who were treated in a pediatric oral and maxillofacial surgery service at a children's hospital. Results: We analyzed 1311 surgical interventions (51.4% were on boys and 48.6% on girls), consisting of 24.8% soft tissue surgeries, 65.9% bone and dental tissue surgeries, and 9.3% mixed tissue surgeries. The most common pathologies were tooth eruption disorders (65.9%), followed by ankyloglossia (20.5%). The most frequent treatment was wisdom teeth extraction (31.3%). A statistically significant association (p < 0.05) was found between surgical treatments and variables such as age, sex, tissue type, and biopsy. Conclusions: This study enhances our understanding of pediatric oral surgery, emphasizing that the most common pathology is altered tooth eruption, while the most frequent surgical intervention is the extraction of wisdom teeth at different stages of development.

Simple Bone Cyst Within Florid Cemento-Osseous Dysplasia: A Report of Two Cases.

Florid cemento-osseous dysplasia (FCOD) can rarely be associated with bone lesions, including simple bone cysts (SBCs). Only a few cases showing the co-occurrence of these two distinct entities have been reported in the literature. This article reports two new cases of SBCs within FCOD. The first case involves a 37-year-old Black female with a large radiolucent lesion around the apex of the right third mandibular molar, accompanied by multiple cemento-osseous lesions around the mandibular teeth. Surgical exploration revealed an empty bone cavity, confirming the diagnosis of an SBC. Curettage of the bone walls was performed to stimulate healing, with promising results observed at the nine-month follow-up. The second case concerns a 44-year-old Black female presenting with a radiolucent lesion at the site of extraction of the left third mandibular molar and a slightly painful radiolucent/radio-opaque lesion in the apical region of the right first mandibular molar. Surgical exploration confirmed an SBC in the region of the left third mandibular molar and a bone biopsy was made. Histopathological analysis confirmed FCOD. Curettage of the bone wall was again used to promote healing through increased bleeding. At the 30-month follow-up, new dysplastic lesions had appeared, the initial SBC had healed completely, and a new SBC seemed to have developed in the apical region of the left second mandibular premolar. These cases highlight the importance of considering SBCs in the differential diagnosis of well-defined radiolucent lesions and demonstrate that surgical intervention for SBC-associated FCOD can yield favorable outcomes. From these cases, we learn the critical need for accurate diagnosis to avoid unnecessary treatments and the value of regular follow-up to monitor for recurrence or new lesions.

Assessment of the Mechanical Properties of Different Suture Materials for Oral Surgery: An In Vitro Tensile Strength Study.

BACKGROUND: Sutures are essential components of wound closure in oral surgery, and the mechanical properties of suture materials play a crucial role in determining surgical outcomes. Understanding the tensile strengths of various suture materials is vital for selecting the most appropriate material for specific clinical applications. OBJECTIVE: This study aimed to assess the tensile strength of suture materials commonly used in oral surgery through an in vitro tensile strength study. METHODS: A total of 192 samples of six commonly used suture materials (polyglycolic acid (PGA), polyglactin 910 (PGLA), polylactic acid (PLA), polydioxanone (PDO), silk, and nylon) were subjected to tensile strength testing using a universal testing machine. Descriptive statistics were used to summarize the tensile strength of each suture material. A comparative analysis was conducted using appropriate statistical tests to identify any significant differences in the tensile strength among the different materials. RESULTS: Significant variability in tensile strength was observed among the suture materials in newtons (N). PGLA exhibited the highest mean tensile strength (38.7 N), followed closely by PDO (37.1 N), whereas silk displayed the lowest tensile strength (32.8 N). Comparative analysis revealed significant differences in the tensile strength among the materials (p < 0.001). CONCLUSION: This study provides valuable insights into the mechanical properties of the suture materials commonly used in oral surgery. These findings underscore the importance of considering tensile strength when selecting suture materials for specific clinical scenarios, thereby optimizing wound closure techniques and improving patient outcomes.

Intraosseous myofibroma mimicking an odontogenic lesion: case report, literature review, and differential diagnosis.

BACKGROUND: Intraosseous myofibroma of the jaw is a rare neoplasm of mesenchymal origin with limited comprehensive understanding. It typically affects patients in the first two decades of life with a male predilection. CASE PRESENTATION: This study presents a rare case of myofibroma mimicking an odontogenic lesion in a 2-year-old boy. The patient presented with an incidental finding of a painless swelling of the right mandibular ramus of unknown etiology. Imaging analysis revealed a solid, expansile lesion adjacent to the germinal zone of the right mandibular first molar. Histopathologic analysis and immunohistochemistry after incisional biopsy suggested a possible central odontogenic fibroma, and the patient underwent total enucleation, leading to the final diagnosis of intraosseous myofibroma. Follow-up examinations showed no evidence of recurrence. CONCLUSIONS: This report contributes to the understanding of myofibroma in pediatric patients and underscores the critical role of meticulous histopathologic examination for effective surgical planning and optimal patient outcomes.

Risk factors for postoperative recovery in oral cancer surgery: A retrospective cohort study.

BACKGROUND: Effective management of oral cancer necessitates a multidisciplinary approach, with surgery playing a pivotal role in treatment. However, there are many risk factors during the perioperative period that affect postoperative recovery. PURPOSE: This study aims to identify the risk factors influencing postoperative recovery in patients undergoing oral cancer surgery, thereby optimizing perioperative management. STUDY DESIGN, SETTING, SAMPLE: A retrospective cohort study was carried out in patients who underwent surgery for oral cancer at The Second Affiliated Hospital Of Zhejiang University School Of Medicine from Jan. to Dec. in 2023. Based on the median length of stay (LOS) of 20.42 days, we divided the study population into DL3W and DM3W groups (DL3W/DM3W: Discharged less/>3 weeks). PREDICTOR VARIABLE: The Predictor variables included sex, age, BMI, smoke, drink, education, settlement, surgery history, tumor history, intra-operative situation, flap details, pathologic stage, treatment and laboratory examination. MAIN OUTCOME VARIABLE: The primary outcome was length of stay (LOS) defined as the days from the start of preoperative preparation to discharge from the hospital. ANALYSES: Descriptive and inferential analyses were performed using the χ2 test, Fisher's exact test and t-test. A P value of 0.05 was deemed as an acceptable statistical significance level. RESULTS: The sample was composed of 103 subjects with a mean age of 59.45 (14.20) and 71 (68.9 %) were male. The median LOS was 20.42 ((range, 10-69) days. The baseline characteristics between the DL3W and DM3W groups were generally balanced. Factors associated with LOS were BMI (95 %CI 1.01-1.15, P = 0.046), intraoperative blood loss (95 %CI 0.;99-1.00, P = 0.002), flap source (P < 0.001), and postoperative fasting time (95 %CI 0.88-0.95, P < 0.001). In the regression model, more intraoperative blood loss and longer postoperative fasting time were associated with increased. LOS and factors BMI and the use of forearm flap were associated with decreased LOS after adjusting the confounding factors. CONCLUSIONS AND RELEVANCE: In the perioperative period for oral cancer patients, optimizing postoperative recovery may be achieved by carefully managing BMI, intraoperative blood loss, flap source, and postoperative fasting time.

Awareness of Oral and Maxillofacial Surgery as a Career Choice Among Dental Students: An Online Questionnaire Survey.

INTRODUCTION: Most dental students are interested in pursuing a postgraduate degree after completing their Bachelor of Dental Surgery (BDS). Among the various specialties, oral surgery, which bridges the fields of medicine and dentistry, is the most attractive option for many young dental professionals. This study aimed to explore the factors influencing students' choices for postgraduation in oral and maxillofacial surgery (OMFS) and to assess their knowledge, attitudes, and perceptions (KAP) towards this branch of dentistry. MATERIALS AND METHODS: An online survey was conducted with 450 third- and final-year BDS students and interns from various dental colleges. The survey included a self-administered questionnaire designed to collect demographic information and insights into students' motivations and KAP regarding postgraduation in OMFS. The questionnaire was distributed via an internet-based survey program and shared through WhatsApp Messenger accompanied by a consent form. To determine the significance between variables, non-parametric test, such as the chi-square test, was employed. The KAP scores were calculated and represented as mean ± standard deviation (SD), and intergroup comparisons were performed using the two-way independent T-test (for two groups) and two-way analysis of variance (ANOVA) test (for three groups). The level of significance was set at P ≤0.05. RESULTS: The sample comprised 320 (71%) females and 130 (29%) males. A total of 285 (63.33%) respondents wanted to pursue postgraduation after BDS, whereas 130 (28.89%) did not. Long working hours, risk and liability, and lack of skills were the main reasons for not opting for postgraduation in OMFS as a career option. The primary reasons cited for choosing OMFS included better career prospects (75.08%%) and the influence of the mentor (59.65%). The main benefits of choosing postgraduation in OMFS were advanced skills (88.77%), and high earning (85.61%). The mean KAP scores were higher for government institutions in urban areas and for males. CONCLUSION: This study revealed that a substantial number of undergraduate dental students were inclined to specialize in OMFS after graduation. The combination of medicine and dentistry significantly influences the choice of OMFS as a career option.

Empowering surgeons: will artificial intelligence change oral and maxillofacial surgery?

Artificial Intelligence (AI) can enhance the precision and efficiency of diagnostics and treatments in oral and maxillofacial surgery (OMS), leveraging advanced computational technologies to mimic intelligent human behaviors. The study aimed to examine the current state of AI in the OMS literature and highlight the urgent need for further research to optimize AI integration in clinical practice and enhance patient outcomes. A scoping review of journals related to OMS focused on OMS-related applications. PubMed was searched using terms "artificial intelligence", "convolutional networks", "neural networks", "machine learning", "deep learning", and "automation". Ninety articles were analyzed and classified into the following subcategories: pathology, orthognathic surgery, facial trauma, temporomandibular joint disorders, dentoalveolar surgery, dental implants, craniofacial deformities, reconstructive surgery, aesthetic surgery, and complications. There was a significant increase in AI-related studies published after 2019, 95.6% of the total reviewed. This surge in research reflects growing interest in AI and its potential in OMS. Among the studies, the primary uses of AI in OMS were in pathology (e.g., lesion detection, lymph node metastasis detection) and orthognathic surgery (e.g., surgical planning through facial bone segmentation). The studies predominantly employed convolutional neural networks (CNNs) and artificial neural networks (ANNs) for classification tasks, potentially improving clinical outcomes.

Transplante dentário autólogo: revisão integrativa / Dental autologous transplantation: an integrative literaturereview / Trasplante dental autólogo: una revisión integradora de la literatura

Introdução:O transplante autólogo dentário é uma técnica cirúrgica na qual há a transposição de um dente para uma nova área receptora, no mesmo paciente. É viável para o tratamento de ausências e impactações dentárias. O método apresenta benefícios como manutenção de periodonto vital, volume ósseo alveolar e papila dentária, possibilidade de movimentação dentária por forças ortodônticas ou fisiológicas e estética favorável.Objetivo:Promover uma revisão de literatura sobre o transplante dentário autólogo, visando relatar as principais indicações, benefícios e contraindicações da técnica, além de descrever o protocolo cirúrgico e os fatores que influenciam no sucesso, de modo a orientar o manejo clínico.Metodologia:Para esse fim, as bases de dados analisadas foram PUBMED, LILACS e SCIELO, sendo obtidos artigos de Revisão Sistemática e Metanálises dos anos de 2018 a 2023.Resultados:O autotransplante apresenta taxas de sobrevida entre 93% e 100% e taxas de sucesso entre 89,4% e 96,6%, o que depende dos fatores relacionados ao paciente, ao dente doador, à área receptora e à técnica cirúrgica.Dentes anteriores e com ápice aberto apresentam melhores taxas de sobrevivência e sucesso em relação aos dentes posteriores e de ápice fechado, todavia não há comprovação que os demais pontos realmente influenciam diretamente no método. Conclusões:Com isso, podemos compreender que o estabelecimento de protocolos pré,trans e pós-operatório, além de esclarecimento de todos os fatores que influenciam na técnica, devem ser foco de estudos dos Cirurgiões-Dentistas, trazendo benefícios consideráveisparao manejo cirúrgico e saúde desses pacientes (AU).

Introduction:Autologous dental transplantation is a surgical technique in which there is the transposition of a tooth to a new recipient area within the same patient. It is a viable option for treating dental absenteeism and impactions. The method offers benefits such as the maintenance of vital periodontium, alveolar bone volume, and dental papilla, the possibility of dental movement through orthodontic or physiological forces, and favorable aesthetics.Objective:To promote a literature review on autologous dental transplantation, aiming to report the main indications, benefits, and contraindications of the technique, in addition to describe the surgical protocol and factors influencing success, providing guidance for clinical management.Methodology:For this purpose, the analyzed databases included PUBMED, LILACS, and SCIELO, obtaining Systematic Review and Meta-Analysesarticles from the years 2018 to 2023.Results:Autotransplantation presents survival rates between 93% and 100% and success rates between 89.4% and 96.6%, depending on factors related to the patient, the donor tooth, the recipient area, and the surgical technique. Anterior teeth with open apices present better survival and success rates compared to posterior teeth with closed apices, however, there is no conclusive evidence that other factors directly influence the method.Conclusions:Therefore, we can understand that the establishment of preoperative, intraoperative, and postoperative protocols, along with clarification of all factors influencing the technique, should be the focus of studies for Dental Surgeons, bringing significant benefits to these individuals' health (AU).

Introducción: : El trasplante autólogo dental es una técnica quirúrgica en la que se transpone un diente a una nueva área receptora, en el mismo paciente. Es viable para el tratamiento de ausencias e impactos dentales. El método presenta beneficios como mantenimiento de periodonto vital, volumen óseo alveolar y papila dental, posibilidad de movimiento dental por parte de fuerzas ortodoncias o fisiológicas y estética favorable.Objetivo: Promover una revisión de la literatura sobre el trasplante dentario autólogo, con el objetivo de reportar las principales indicaciones, beneficios y contra indicaciones de la técnica, además de describir el protocolo quirúrgico ylos factores que influyen en el éxito, con el fin de orientar el manejo clínico.Metodología: Para este fin, las bases de datos analizadas fueron PUBMED, LILACS y SCIELO, siendo obtenidos artículos de Revisión Sistemática y Metanálisis de los años 2018 a2023.Resultados: El autotrasplante presenta tasas de sobrevida entre 93% y 100% y tasa de éxito entre 89,4% y 96,6%, lo que depende de los factores relacionados con el paciente, el donante, el área receptora y la técnica quirúrgica. Los dientes anteriores y ápice abiertos presentan mejores tasas de supervivencia y éxito con respecto a los dientes posteriores y de ápice cerrado, pero no hay prueba de que los demás puntos realmente influyen directamente en el método.Conclusiones: Con eso, podemos comprender que el establecimiento de protocolos pre, intra y postoperatorio, además de esclarecimiento de todos los factores que influyen en la técnica, deben ser foco de estudios de los CirujanosDentistas, trayendo beneficios considerables para la salud de estos individuos (AU).

Role of Sticky Bone in the Management of Various Alveolar Bone Defects: A Systematic Review.

AIM: This systematic review aimed to evaluate the effectiveness of sticky bone in managing various alveolar bone defects, examining both its benefits and drawbacks. MATERIALS AND METHODS: The review adhered to PRISMA guidelines and employed a thorough search strategy using major databases, medical subject headings (MeSH) keywords, and Boolean operators. As a result, the systematic review identified 12 studies focusing on the efficacy of sticky bone in treating alveolar bone defects. Inclusion criteria consisted of randomized controlled trials and case series reporting on the outcomes of sticky bone use for bone defect treatment. Two examiners meticulously performed screening, data extraction, and bias assessment, with the risk of bias evaluated using the Cochrane tool. RESULT: The findings indicated significant improvements in bone quality, width, height, and volume, with enhanced predictability in socket preservation and implant placement. Sticky bone was particularly effective in ridge augmentation, guided bone regeneration, and filling periodontal defects, often outperforming alternatives like concentrated growth factors (CGFs) and autologous fibrin glue (AFG). It simplified procedures and reduced resorption during healing, underscoring its value as a versatile adjunct in bone reconstruction surgery. CONCLUSION: Sticky bone demonstrated exceptional results in various oral surgeries, effectively addressing issues such as furcation defects, bone loss, and ridge augmentation, with significant clinical and radiographic improvements. Further research is needed to explore its full potential and refine protocols for broader oral surgery and periodontics applications.

Exploring the relationship between anxiety, patient characteristics and pain outcomes in oral surgery under local anesthesia: The measurement problem.

BACKGROUND: Anxiety during oral surgery can impact patient homeostasis, increase the difficulty of the procedure and create additional stress for the surgeon. Furthermore, it has been associated with more intense and prolonged pain during and after dental treatment. OBJECTIVES: The aim of the study is to evaluate the relationship between anxiety, patient characteristics and pain outcomes in oral surgery, as well as to verify the impact of anxiety on patient's perception of pain during and after oral surgery. MATERIAL AND METHODS: This is a prospective observational study. Several variables were evaluated during the course of the oral surgery. Anxiety levels were assessed using the State-Trait Anxiety Inventory (STAI), Corah's Dental Anxiety Scale (DAS), the Interval Scale of Anxiety Response (ISAR), and Patient SelfRated Anxiety (PAnx) during the procedure. RESULTS: General anxiety measures (STAI) were not associated with specific dental anxiety or external observations of anxiety. Anxiety levels varied according to gender and body mass index (BMI), and were correlated with increased heart rate (HR) (with variability among assessment tools). Odontectomy, ostectomy and an increased volume of anesthesia were associated with higher anxiety levels (with variability among the assessment tools). There was a correlation between pain and anxiety, with anxiety contributing to approx. 12% of the variability in postoperative pain. CONCLUSIONS: Dental anxiety is a complex, multidimensional mental phenomenon characterized by high variability due to the influence of several dynamic factors.

Nanosecond infrared laser (NIRL) for cutting roots of human teeth: thermal effects and quality of cutting edges.

A nanosecond infrared laser (NIRL) was investigated in cutting dental roots. The focus of the investigation was defining the preparation accuracy and registration of thermal effects during laser application. Ten teeth were processed in the root area using a NIRL in several horizontal, parallel incisions to achieve tooth root ablation as in an apicoectomy. Temperature change was monitored during ablation and the quality of the cutting edges in the roots were studied by means of micro-CT, optical coherence tomography, and histology of decalcified and undecalcified specimens. NIRL produced clearly defined cut surfaces in dental hard tissues. The automated guidance of the laser beam created regular, narrow dentin defects that tapered in a V-shape towards the ablation plane. A biologically significant increase in the temperature of the object and its surroundings did not occur during the laser application. Thermal dentin damage was not detected in histological preparations of treated teeth. Defined areas of the tooth root may be ablated using a NIRL. For clinical translation of NIRL in apicoectomy, it would be necessary to increase energy delivered to hard tissue and develop beam application facilitating beam steering for oral treatment.

Assessment of the application of a novel three-dimension printing individualized titanium mesh in alveolar bone augmentation: A retrospective study.

OBJECTIVE: To assess the clinical and radiographic outcomes of alveolar ridge augmentation using a novel three-dimensional printed individualized titanium mesh (3D-PITM) for guided bone regeneration (GBR). MATERIALS AND METHODS: Preoperative cone-beam computed tomography (CBCT) was used to evaluate alveolar ridge defects, followed by augmentation with high-porosity 3D-PITM featuring circular and spindle-shaped pores. Postoperative CBCT scans were taken immediately and after 6 months of healing. These scans were compared with preoperative scans to calculate changes in bone volume, height, and width, along with the corresponding resorption rates. A statistical analysis of the results was then conducted. RESULTS: A total of 21 patients participated in the study, involving alveolar ridge augmentation at 38 implant sites. After 6 months of healing, the average bone augmentation volume of 21 patients remained at 489.71 ± 252.53 mm3, with a resorption rate of 16.05% ± 8.07%. For 38 implant sites, the average vertical bone increment was 3.63 ± 2.29 mm, with a resorption rate of 17.55% ± 15.10%. The horizontal bone increment at the designed implant platform was 4.43 ± 1.85 mm, with a resorption rate of 25.26% ± 15.73%. The horizontal bone increment 2 mm below the platform was 5.50 ± 2.48 mm, with a resorption rate of 16.03% ± 9.57%. The main complication was exposure to 3D-PITM, which occurred at a rate of 15.79%. CONCLUSION: The novel 3D-PITM used in GBR resulted in predictable bone augmentation. Moderate over-augmentation in the design, proper soft tissue management, and rigorous follow-ups are beneficial for reducing the graft resorption and the incidence of exposure.

Investigation of Absorbable and Non-Absorbable Multifilament Suture Materials in Terms of Strength Changes Using Chlorhexidine Mouthwash and Thermal Cycling: An In Vitro Study.

Sutures are natural or synthetic biomaterials utilized to hold tissues together. Following oral surgery, the surgical site and sutures are physically affected by many different factors. This study was conducted to evaluate the effect of artificial saliva (AS) and chlorhexidine mouthwash on the tensile strength of absorbable multifilament PGLA (polyglycolide-co-l-lactide) and non-absorbable multifilament silk sutures. PGLA and silk sutures, which are commonly used in oral surgery, were used to evaluate the change in strength of the sutures. A total of 352 suture samples were divided into eight equal groups (n = 44) and used for the experiments. Tensile strength was tested on days 0, 3, 7, and 14. For the silk sutures, there was a significant decrease in tensile strength in all groups at time T3 compared to T0, T1, and T2, and at times T1 and T2 compared to T0. For PGLA sutures, there was a significant decrease in all groups at time T3 compared to T0, T1, and T2. This study shows that chlorhexidine mouthwash significantly reduces suture resistance for 14 days after surgery.