Inferior alveolar nerve damage following removal of mandibular third molar teeth. A prospective study using panoramic radiography.

Permanent alteration of sensation in the lip after the removal of mandibular third molar teeth is an unusual but important complication. Studies have been performed to assess the risk of nerve damage but most of these have been retrospective and poorly controlled. This prospective trial predicted the outcome of altered sensation prior to surgery based on assessment of a panoramic radiograph and correlated this with the result postoperatively in the consecutive removal of 479 third molar teeth. Results indicated that 5.2 per cent had transient alteration in sensation but only one patient (0.2 per cent) had prolonged anaesthesia. As 94.8 per cent of teeth extracted had no neurological sequelae the figures for prediction were skewed and a kappa statistical analysis of 0.27 illustrated a fair level of agreement between prediction and outcome. This study supports previously reported levels of neurological damage and confirms that panoramic radiography is the optimum method for radiological assessment for mandibular third molar teeth prior to their removal.

[Microsurgical reconstruction of fallopian tubes]. / Reconstrucción microquirúrgica de la trompa de Falopio.

A six year study of 90 women with tuboperitoneal infertility at the Hospital Barros Luco-Trudeau is presented. 32.2% of them had tubal sterilization and had distal tubal occlusion. In 62.2% the peritoneal factor was present. In 40% distal microsurgery was done and in 32.2% proximal microsurgery was performed. The pregnancy rate was 48.8% in patients with adequate follow-up. The incidence of ectopic pregnancy was 9.5%.

A massive pyogenic granuloma in the gingiva.

A large exophytic mass was seen in the oral cavity of a 22-year-old male. Repeated biopsies of the mass showed chronic inflammation with granulation tissue. An excisional biopsy confirmed the presence of pyogenic granuloma. This lesion is unusual as it attained a very large size causing considerable facial deformity. Intraoperatively, the lesion was noted to be highly vascular. This case may prove to be of great interest to otolaryngologists who often deal with oral lesions, as it demonstrates an extreme and unusual presentation of a definitely benign lesion.

Oblique facial cleft.

Oblique facial clefts (meloschisis) are the most uncommon of the facial clefts, with 78 reports in the world literature. The embryology of this congenital deformity remains a matter of controversy. Details of surgical management are emphasized in the two reports of cases.