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1.
BMJ Case Rep ; 13(12)2020 Dec 18.
Artículo en Inglés | MEDLINE | ID: mdl-33370928

RESUMEN

We describe a case of a 71-year-old otherwise healthy man who presented to the dental clinic with the chief complaint of mobility involving his upper left molar teeth. The patient was a febrile, and clinical oral examination revealed localised grade II mobility and absence of gingival swelling, erythema or sinus tract. Orthopantogram revealed a poorly defined radiolucency involving the upper left second and third molar teeth. Surgical exploration of the involved area was performed and revealed the presence of a 'jelly like' brown tissue that fragments easily. Pathological examination confirmed the diagnosis of diffuse large B cell lymphoma.


Asunto(s)
Antineoplásicos Inmunológicos/administración & dosificación , Linfoma de Células B Grandes Difuso , Tercer Molar , Radioterapia/métodos , Movilidad Dentaria , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Biopsia/métodos , Diagnóstico Diferencial , Humanos , Linfoma de Células B Grandes Difuso/complicaciones , Linfoma de Células B Grandes Difuso/patología , Linfoma de Células B Grandes Difuso/terapia , Masculino , Tercer Molar/diagnóstico por imagen , Tercer Molar/fisiopatología , Tercer Molar/cirugía , Radiografía Panorámica/métodos , Extracción Dental/métodos , Movilidad Dentaria/diagnóstico , Movilidad Dentaria/etiología , Resultado del Tratamiento
2.
Med. oral patol. oral cir. bucal (Internet) ; 25(6): e720-e727, nov. 2020. ilus, tab
Artículo en Inglés | IBECS | ID: ibc-197178

RESUMEN

BACKGROUND: Few studies have reported the outcomes of immediate placement at infected post-extraction sites. The aim of this study was to compare clinical and radiological outcomes of immediately placed implants with im-mediate prosthetic provisionalization in sockets with or without acute periapical pathology. MATERIAL AND METHODS: A total of 100 patients with immediately placed implants with immediate provisionalization and 1- year of follow up were included (50 patients with acute periapical pathology and a control group of 50 patients without acute periapical pathology). Clinical parameters (bleeding on probing, buccal keratinized mucosa width, clinical recession, and probing depth) and radiological parameters (distance from implant shoulder to first point of bone-to-implant contact [IS-BIC]) were assessed. RESULTS: Clinical parameters showed no significant differences between the study and control groups after 1-year follow up (p > 0.05). IS-BIC presented the following values: 0.35 ± 0.51 mm (study group) and 0.15 ± 0.87 mm (control), without significant differences between the groups (p = 0.160). None of the 50 radiographs of immediate implants placed in sockets with periapical pathology revealed retrograde peri-implantitis. CONCLUSIONS: Immediate placement of implants with immediate prosthetic provisionalization at sites with acute periapical pathology can be a successful treatment modality for at least 1-year


No disponible


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Implantación Dental Endoósea/métodos , Extracción Dental/métodos , Implantes Dentales , Estudios Prospectivos , Factores de Tiempo , Estudios de Seguimiento , Periimplantitis/cirugía , Resultado del Tratamiento
3.
Med. oral patol. oral cir. bucal (Internet) ; 25(6): e762-e768, nov. 2020. tab
Artículo en Español | IBECS | ID: ibc-197184

RESUMEN

BACKGROUND: The different indications for extraction of the lower third molars, require resources to manage pain and discomfort, such as, for example, adequate anesthetic techniques, and the type of anesthetic used can influence the management of pain in tooth extractions. Few studies in the literature compare the anesthetics 4% articaine hydrochloride and 2% mepivacaine hydrochloride showing evidence that both allow for successful pain management. This study sought to compare the volume, efficacy and safety of these two anesthetic drugs, both associated with epinephrine at a ratio of 1:100,000, used in the extraction of lower third molars. MATERIAL AND METHODS: A controlled, clinical, split-mouth compared these both local anesthetics in a sample of 20 patients requiring bilateral extraction of teeth. Pain was the main parameter to be assessed by means of the visual analogue scale (VAS) applied during and immediately after the surgery. Hemodynamic parameters, adverse events, presence of paresthesia and satisfaction of patients and surgeon were also analysed. RESULTS: Pain management was more effective with mepivacaine up to two hours after surgery (p = 0.014), whereas the surgeon was more satisfied with the use of articaine during divulsion and suture (p < 0.05). However no statistically significant differences were found between both anesthetics regarding pain perception. CONCLUSIONS: It was observed that both anesthetics are efficient and safe in the management of pain for extraction of third molars, in which less amount of mepivacaine is needed. The satisfaction of patients and surgeon was the same for both anesthetics, with articaine being highlighted during divulsion and suture


No disponible


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Extracción Dental/métodos , Tercer Molar/cirugía , Carticaína/administración & dosificación , Anestésicos Locales/administración & dosificación , Mepivacaína/administración & dosificación , Método Doble Ciego , Dimensión del Dolor , Estadísticas no Paramétricas , Factores de Tiempo , Hemodinámica , Valores de Referencia , Resultado del Tratamiento
4.
Niger J Clin Pract ; 23(10): 1407-1413, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33047698

RESUMEN

Aims: In this study, using Beck depression inventory (BDI), we aimed to determine alterations in the emotional state of patients who had impacted third molars (M3) extracted owing to postoperative pain, edema, and trismus.In this prospective clinical trial, which was conducted at Tokat Gaziosmanpasa University, Faculty of Dentistry, Department of Maxillofacial Surgery Clinic, we studied 60 patients (30 males and 30 females), who were 18-47 years old (the mean of 25.6 years of age). The patients with M3 with moderate preoperative pain intensities, edema, and maximal mouth opening (MMO) data were recorded, and BDI was applied to determine their emotional states. The patients were re-evaluated using BDI to detect alterations in their emotional state owing to pain intensity, edema, and trismus on postoperative second and seventh day. Subjects and Methods: Descriptive statistical analysis, Chi-square, and independent t-test were utilized to interpret the obtained data. Results: According to our findings, a statistically significant relationship was observed between BDI scores and gender on the second postoperative day (P = 0.004), and between MMO and BDI scores on the second and seventh postoperative day (P = 0.012, P = 0.045). Pain intensity scores on the postoperative sixth hour and seventh day were significantly correlated with BDI scores on the postoperative second and seventh day (P = 0.000/ P = 0.000/P = 0.002/P = 0.004/P = 0.010/P = 0.017/P = 0.001/P = 0.000). Conclusions: Our results suggest that the pain and trismus owing to the M3 surgery were significantly correlated with an increase in the postoperative BDI scores.


Asunto(s)
Depresión/diagnóstico , Edema/psicología , Tercer Molar/cirugía , Dolor Postoperatorio/psicología , Extracción Dental/psicología , Adolescente , Adulto , Caries Dental/epidemiología , Depresión/epidemiología , Depresión/psicología , Edema/epidemiología , Emociones , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dolor Postoperatorio/epidemiología , Complicaciones Posoperatorias/epidemiología , Periodo Posoperatorio , Estudios Prospectivos , Escalas de Valoración Psiquiátrica , Extracción Dental/métodos , Extracción Dental/estadística & datos numéricos , Trismo/epidemiología , Trismo/psicología , Turquia/epidemiología , Adulto Joven
5.
Rev. esp. cir. oral maxilofac ; 42(3): 119-126, jul.-sept. 2020. graf
Artículo en Español | IBECS | ID: ibc-196627

RESUMEN

OBJETIVO: Evaluar el efecto antinflamatorio de la asociación dexametasona con diclofenaco y la asociación dexametasona con ketorolaco en cirugía de tercer molar mandibular. MATERIAL Y MÉTODO: Ensayo clínico aleatorizado doble ciego que incluyó 75 pacientes que se dividieron aleatoriamente en tres grupos: el grupo DK recibió la asociación dexametasona con ketorolaco; el grupo DD, la asociación dexametasona con diclofenaco y el grupo control D, solo dexametasona; todos por vía intramuscular, treinta minutos antes de la cirugía. El efecto antinflamatorio se determinó por la evaluación del dolor y la tumefacción postquirúrgicos. El dolor se evaluó mediante la escala visual análoga y el consumo total de analgésicos. La tumefacción se evalúo mediante las medidas de tumefacción facial y la apertura bucal. RESULTADOS: El grupo DD evidenció menor intensidad de dolor a las 4, 6, 12, 24 y 48 horas en comparación a los otros grupos de tratamiento (p < 0,05). El consumo total de analgésicos fue significativamente menor en el grupo DD (1,20 ± 0,3) en comparación con los otros grupos de tratamiento (p = 0,002). La tumefacción facial fue similar en todos los grupos de estudio (p > 0,05). El grupo DD evidenció una significativa mayor apertura bucal solamente a las 48 horas postoperatorias en comparación a los otros grupos de estudio (p = 0,01). CONCLUSIONES: La administración preoperatoria de la asociación dexametasona con diclofenaco presenta una significativa mayor actividad analgésica en comparación a la administración preoperatoria de la asociación dexametasona con ketorolaco. Sin embargo, no hay diferencia significativa con relación a la tumefacción facial


OBJECTIVE: To evaluate the antiinflammatory effect of the association dexamethasone with diclofenac and the association dexamethasone with ketorolac in mandibular third molar surgery. MATERIAL AND METHOD: Randomized double blind clinical trial that included 75 patients who were randomly divided into three groups: the DK group received the dexamethasone association with ketorolac; the DD group, the dexamethasone association with diclofenac and the control group D, only dexamethasone; all intramuscularly, thirty minutes before surgery. The anti-inflammatory effect was determined by the evaluation of postoperative pain and swelling. The pain was evaluated by means of the analogous visual scale and the total analgesic consumption. Swelling was assessed by measures of facial swelling and mouth opening. RESULTS: The DD group showed less pain intensity at 4 h, 6 h, 12 h, 24 h and 48 h compared to the other treatment groups (p < 0.05). Total analgesic consumption was significantly lower in the DD group (1.20 ± 0.3) compared to the other treatment groups; p = 0.002. Facial swelling was similar in all study groups (p > 0.05). The DD group showed a significant greater oral opening only at 48 hours postoperatively compared to the other study groups (p = 0.01). CONCLUSIONS: The preoperative administration of the dexamethasone association with diclofenac has a significantly greater analgesic activity compared to the preoperative administration of the dexamethasone association with ketorolac. However, there is no significant difference in relation to facial swelling


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Tercer Molar/cirugía , Extracción Dental/métodos , Dolor Postoperatorio/tratamiento farmacológico , Inflamación/tratamiento farmacológico , Ketorolaco/farmacocinética , Diclofenaco/farmacocinética , Dexametasona/farmacocinética , Antiinflamatorios/farmacocinética , Complicaciones Posoperatorias/prevención & control , Quimioterapia Combinada/métodos , Premedicación/métodos
6.
Med. oral patol. oral cir. bucal (Internet) ; 25(5): e565-e575, sept. 2020. tab, graf
Artículo en Inglés | IBECS | ID: ibc-196511

RESUMEN

BACKGROUND: Many studies have addressed socket preservation, though fewer publications considering buccal wall loss can be found, since the literature typically considers sockets with four walls. A systematic review was made on the influence of type II buccal bone defects, according to Elian's Classification, in socket grafting materials upon volumetric changes in width and height. MATERIAL AND METHODS: An electronic and manual literature search was conducted in accordance to PRISMA statement. The search strategy was restricted to randomized controlled trials (RCTs) and controlled clinical trials (CCTs) describing post-extraction sockets with loss of buccal wall in which alveolar ridge preservation (ARP) was carried out in the test group and spontaneous healing of the socket (SH) was considered in the control group. RESULTS: The search strategy yielded 7 studies. The meta-analysis showed an additional bone loss of 2.37 mm in width (p > 0.001) and of 1.10 mm in height (p > 0.001) in the absence of ARP. The reconstruction of the vestibular wall was not evaluated in any study. The results also showed moderate to great heterogeneity among the included studies in terms of the changes in width and height. CONCLUSIONS: Despite the heterogeneity of the included studies, the results indicate a benefit of ARP versus SH. Further studies are needed to determine the volumetric changes that occur when performing ARP in the presence of a buccal bone wall defect


No disponible


Asunto(s)
Humanos , Proceso Alveolar/cirugía , Extracción Dental/métodos , Boca/cirugía , Alveolo Dental/cirugía , Ensayos Clínicos como Asunto , Sustitutos de Huesos/uso terapéutico , Preservación Biológica
7.
Med. oral patol. oral cir. bucal (Internet) ; 25(5): e644-e651, sept. 2020.
Artículo en Inglés | IBECS | ID: ibc-196520

RESUMEN

BACKGROUND: The aim of this study was to evaluate and compare the postoperative effect of a topic gel containing chlorhexidine, chitosan, allantoine and dexpanthenol versus a placebo for pain and inflammation control after third molar surgery. MATERIAL AND METHODS: A gel combining 0.2% chlorhexdine, 0.5% chitosan, 5% dexpanthenol, 0.15% allantoin and 0.01% sodium saccharin was selected for this split mouth randomized controlled and double-blind trial including 36 patients with bilaterally and symmetrically impacted lower third molars. The teeth (n = 72) were randomly divided into two groups before surgical removal: control group (CG; in which a placebo was given) and experimental group (EG). Swelling, trismus, postoperative pain, wound healing and complications were measured and recorded in order to evaluate differences between the placebo and experimental product. RESULTS: Five patients suffered from an alveolitis in the CG (13.9%), and none in the study group (0%), but no statistically significant difference was found (p = 0.063). From day 0 to day 7, trismus and swelling were significantly less pronounced in the EG, and wound healing was considered 'good' in 22.2% for the CG and 97.2% for the EG (p < 0.001). Mean VAS scores during the seven postoperative days were statistically lower in the study (2.56 ± 1,19) compared to the placebo group (3.25 ± 1.6) (p = 0.002). The mean consumption of analgesic pills during the first 92 hours was also statistically lower in the EG (0.26 ± 0.51) in comparison to the CG (0.56 ± 0.67) (p = 0.003). CONCLUSIONS: The use of an experimental gel containing chlorhexidine, chitosan, allantoine and dexpanthenol seems to significantly reduce postoperative pain, trismus and signs of inflammation. Future studies should further evaluate, if the gel is effective in dry socket preventing after third molar removal


No disponible


Asunto(s)
Humanos , Masculino , Femenino , Adulto Joven , Adulto , Tercer Molar/cirugía , Extracción Dental/métodos , Dolor Postoperatorio/prevención & control , Quitosano/uso terapéutico , Clorhexidina/uso terapéutico , Alantoína/uso terapéutico , Ácido Pantoténico/análogos & derivados , Complicaciones Posoperatorias/prevención & control , Antiinflamatorios/uso terapéutico , Administración Tópica , Geles/uso terapéutico , Estadísticas no Paramétricas , Resultado del Tratamiento , Dimensión del Dolor , Factores de Tiempo , Trismo/prevención & control , Método Doble Ciego
8.
Med. oral patol. oral cir. bucal (Internet) ; 25(5): e660-e667, sept. 2020. ilus, tab, graf
Artículo en Inglés | IBECS | ID: ibc-196522

RESUMEN

BACKGROUND: The extraction of third molars is one of the most common procedures in oral and maxillofacial surgery clinic. Surgical extraction involves the manipulation of both soft and hard tissues, so the patient usually experiences pain, swelling, and trismus in the immediate post-operative period. Several studies have been conducted using different types of surgical flaps to provide access with the least possible damage of soft tissues. Designing and implementing an optimum flap, which provides easier technique, better visibility, minimal post-operative complications, and best healing, is an aspired goal of every oral surgeon. This study aimed to compare lingual-based four-cornered flap with conventional triangular flap, and to evaluate its effect on post-operative pain after surgical extraction of impacted lower third molars. MATERIAL AND METHODS: Seventeen patients (age ranged from 19 to 26 years) with bilateral, symmetrical impacted lower third molars (n=34) were included in the study. This was a randomized clinical trial with a split-mouth design. The impacted molars were assigned randomly, by coin flipping, to two groups: Case side with lingual-based four-cornered flap (Group A), and control side with conventional triangular flap (Group B). Away from the incision, the prognosis, surgical intervention, and postoperative procedures were exactly the same for the two groups. Postsurgical pain was assessed for 5 days using visual analogue scale (VAS) and by recording patients need for analgesics on a daily basis. Patients were also evaluated via a self-reporting questionnaire, i.e. Postoperative Symptoms Severity (PoSSe) scale, administered on the seventh postoperative day. RESULTS: Pain scores recorded in Group A were found to be significantly lower as compared to pain scores in Group B in the 5 postoperative days (P < 0.05). Total analgesic intake in Group B was significantly higher (P < 0.05). PoSSe scores were lower in Group A, however, this difference was insignificant (P > 0.05). CONCLUSIONS: According to the data of the current study and within its limits, it appeared that lingual-based four-cornered flap design was superior to the conventional triangular flap regarding the postsurgical discomfort and pain


No disponible


Asunto(s)
Humanos , Masculino , Femenino , Adulto Joven , Adulto , Tercer Molar/cirugía , Extracción Dental/métodos , Colgajos Quirúrgicos/cirugía , Lengua/cirugía , Dolor Postoperatorio/prevención & control , Diente Impactado/cirugía , Dimensión del Dolor , Resultado del Tratamiento , Factores de Tiempo , Tempo Operativo , Reproducibilidad de los Resultados , Autoinforme
9.
Ann R Coll Surg Engl ; 102(9): 733-736, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32808802

RESUMEN

Children provided with general anaesthesia for dental extractions at East Surrey Hospital were audited to determine the percentage of children who were prescribed adequate pain management in accordance with guidance published by the Association of Paediatric Anaesthetists of Great Britain and Ireland. Three audit cycles were completed. Data were collected retrospectively through case note review. The results from the first cycle showed that only 47% of children were prescribed with a recommended analgesic regimen. Implementation of change included the development of a protocol for analgesic delivery, which was disseminated to the anaesthetic and dental teams. Full compliance with the audit standards was then demonstrated in the second and third cycles. This audit demonstrates the importance of multidisciplinary collaboration in order to provide high standards of care for children undergoing dental extractions under general anaesthesia. The protocol developed could be applied to other surgical day case procedures for children to improve the patient experience.


Asunto(s)
Anestesia Dental/métodos , Anestesia General/métodos , Manejo del Dolor/métodos , Mejoramiento de la Calidad , Extracción Dental/métodos , Analgésicos/uso terapéutico , Anestesia Dental/normas , Anestesia General/normas , Niño , Protocolos Clínicos , Adhesión a Directriz , Humanos , Manejo del Dolor/normas , Dimensión del Dolor , Estudios Retrospectivos , Encuestas y Cuestionarios , Extracción Dental/efectos adversos , Extracción Dental/normas
10.
Cochrane Database Syst Rev ; 7: CD004345, 2020 07 26.
Artículo en Inglés | MEDLINE | ID: mdl-32712962

RESUMEN

BACKGROUND: Pathology relating to mandibular wisdom teeth is a frequent presentation to oral and maxillofacial surgeons, and surgical removal of mandibular wisdom teeth is a common operation. The indications for surgical removal of these teeth are alleviation of local pain, swelling and trismus, and also the prevention of spread of infection that may occasionally threaten life. Surgery is commonly associated with short-term postoperative pain, swelling and trismus. Less frequently, infection, dry socket (alveolar osteitis) and trigeminal nerve injuries may occur. This review focuses on the optimal methods in order to improve patient experience and minimise postoperative morbidity. OBJECTIVES: To compare the relative benefits and risks of different techniques for surgical removal of mandibular wisdom teeth. SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health Trials Register (to 8 July 2019), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library; 2019, Issue 6), MEDLINE Ovid (1946 to 8 July 2019), and Embase Ovid (1980 to 8 July 2019). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials. We placed no restrictions on the language or date of publication. SELECTION CRITERIA: Randomised controlled trials comparing different surgical techniques for the removal of mandibular wisdom teeth. DATA COLLECTION AND ANALYSIS: Three review authors were involved in assessing the relevance of identified studies, evaluated the risk of bias in included studies and extracted data. We used risk ratios (RRs) for dichotomous data in parallel-group trials (or Peto odds ratios if the event rate was low), odds ratios (ORs) for dichotomous data in cross-over or split-mouth studies, and mean differences (MDs) for continuous data. We took into account the pairing of the split-mouth studies in our analyses, and combined parallel-group and split-mouth studies using the generic inverse-variance method. We used the fixed-effect model for three studies or fewer, and random-effects model for more than three studies. MAIN RESULTS: We included 62 trials with 4643 participants. Several of the trials excluded individuals who were not in excellent health. We assessed 33 of the studies (53%) as being at high risk of bias and 29 as unclear. We report results for our primary outcomes below. Comparisons of different suturing techniques and of drain versus no drain did not report any of our primary outcomes. No studies provided useable data for any of our primary outcomes in relation to coronectomy. There is insufficient evidence to determine whether envelope or triangular flap designs led to more alveolar osteitis (OR 0.33, 95% confidence interval (CI) 0.09 to 1.23; 5 studies; low-certainty evidence), wound infection (OR 0.29, 95% CI 0.04 to 2.06; 2 studies; low-certainty evidence), or permanent altered tongue sensation (Peto OR 4.48, 95% CI 0.07 to 286.49; 1 study; very low-certainty evidence). In terms of other adverse effects, two studies reported wound dehiscence at up to 30 days after surgery, but found no difference in risk between interventions. There is insufficient evidence to determine whether the use of a lingual retractor affected the risk of permanent altered sensation compared to not using one (Peto OR 0.14, 95% CI 0.00 to 6.82; 1 study; very low-certainty evidence). None of our other primary outcomes were reported by studies included in this comparison. There is insufficient evidence to determine whether lingual split with chisel is better than a surgical hand-piece for bone removal in terms of wound infection (OR 1.00, 95% CI 0.31 to 3.21; 1 study; very low-certainty evidence). Alveolar osteitis, permanent altered sensation, and other adverse effects were not reported. There is insufficient evidence to determine whether there is any difference in alveolar osteitis according to irrigation method (mechanical versus manual: RR 0.33, 95% CI 0.01 to 8.09; 1 study) or irrigation volume (high versus low; RR 0.52, 95% CI 0.27 to 1.02; 1 study), or whether there is any difference in postoperative infection according to irrigation method (mechanical versus manual: RR 0.50, 95% CI 0.05 to 5.43; 1 study) or irrigation volume (low versus high; RR 0.17, 95% CI 0.02 to 1.37; 1 study) (all very low-certainty evidence). These studies did not report permanent altered sensation and adverse effects. There is insufficient evidence to determine whether primary or secondary wound closure led to more alveolar osteitis (RR 0.99, 95% CI 0.41 to 2.40; 3 studies; low-certainty evidence), wound infection (RR 4.77, 95% CI 0.24 to 96.34; 1 study; very low-certainty evidence), or adverse effects (bleeding) (RR 0.41, 95% CI 0.11 to 1.47; 1 study; very low-certainty evidence). These studies did not report permanent sensation changes. Placing platelet rich plasma (PRP) or platelet rich fibrin (PRF) in sockets may reduce the incidence of alveolar osteitis (OR 0.39, 95% CI 0.22 to 0.67; 2 studies), but the evidence is of low certainty. Our other primary outcomes were not reported. AUTHORS' CONCLUSIONS: In this 2020 update, we added 27 new studies to the original 35 in the 2014 review. Unfortunately, even with the addition of these studies, we have been unable to draw many meaningful conclusions. The small number of trials evaluating each comparison and reporting our primary outcomes, along with methodological biases in the included trials, means that the body of evidence for each of the nine comparisons evaluated is of low or very low certainty. Participant populations in the trials may not be representative of the general population, or even the population undergoing third molar surgery. Many trials excluded individuals who were not in good health, and several excluded those with active infection or who had deep impactions of their third molars. Consequently, we are unable to make firm recommendations to surgeons to inform their techniques for removal of mandibular third molars. The evidence is uncertain, though we note that there is some limited evidence that placing PRP or PRF in sockets may reduce the incidence of dry socket. The evidence provided in this review may be used as a guide for surgeons when selecting and refining their surgical techniques. Ongoing studies may allow us to provide more definitive conclusions in the future.


Asunto(s)
Tercer Molar/cirugía , Extracción Dental/métodos , Diente Impactado/cirugía , Adulto , Sesgo , Drenaje/métodos , Alveolo Seco/etiología , Humanos , Labio , Mandíbula , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología , Ensayos Clínicos Controlados Aleatorios como Asunto , Trastornos de la Sensación/etiología , Colgajos Quirúrgicos , Infección de la Herida Quirúrgica/etiología , Irrigación Terapéutica/métodos , Lengua , Extracción Dental/efectos adversos , Técnicas de Cierre de Heridas , Adulto Joven
11.
Med. oral patol. oral cir. bucal (Internet) ; 25(4): e461-e467, jul. 2020. ilus, tab
Artículo en Inglés | IBECS | ID: ibc-196497

RESUMEN

BACKGROUND: As third molar surgery is the most commonly procedure performed in Dentistry and has been accompanied by serious postoperative disorders such as pain, edema and trismus, the study aimed to evaluate if ultrasound device would be able to reduce such postoperative features. The aim of this study was to assess the effects of soft tissue flap elevation, osteotomy and odontosection using piezosurgery versus conventional technique in mandibular third molar extractions. MATERIAL AND METHODS: Twenty patients with impacted mandibular third molars underwent tooth extractions using two different methods. Ten patients were included in the Piezo Flap Group (PFG - the flap was elevated using piezosurgery) and ten patients were part of the Piezo Ostectomy Group (POG - osteotomy and odontosection were carried out with ultrasound tips). The contralateral tooth was included in the Control Group (CG - conventional technique). The patients were evaluated at postoperative periods of 1, 3, 7 and 14-days. The measured parameters were duration of surgery, pain, trismus and swelling. RESULTS: The mean duration of surgery for the PFG was 17.21 minutes (CG 10.07 minutes) and POG was 40.09 minutes (CG 15.97 minutes). There was no statistically significant difference in pain and trismus for any of the postoperative periods evaluated in PFG and POG (p > 0.05). There was a statistically significant difference in swelling between the PFG and POG, presenting less swelling at the 3-day postoperative period (p = 0.038; p < 0,05). However, for the remaining analyzed periods there was no difference (p > 0.05). CONCLUSIONS: Piezosurgery for tissue elevation of the surgical flap, osteotomy and dental sectioning in mandibular third molar extraction surgery promoted less edema in the early postoperative stages in mandibular third molar extractions despite the longer surgical duration


No disponible


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Tercer Molar/cirugía , Ultrasonografía Intervencional/métodos , Colgajos Quirúrgicos/cirugía , Osteotomía/métodos , Extracción Dental/métodos , Piezocirugía/métodos , Resultado del Tratamiento , Tempo Operativo , Dolor Postoperatorio , Análisis de Varianza , Estadísticas no Paramétricas , Reproducibilidad de los Resultados , Escala Visual Analógica , Trismo/etiología
12.
Rev. esp. cir. oral maxilofac ; 42(2): 69-75, abr.-jun. 2020. ilus, graf
Artículo en Español | IBECS | ID: ibc-189943

RESUMEN

OBJETIVO: Evaluar el efecto antinflamatorio de la administración preoperatoria de la asociación de dexametasona con vitaminas B en cirugías de tercer molar mandibular. MATERIALES Y MÉTODOS: Estudio experimental conformado por 54 pacientes de 18-25 años, que se asignaron en dos grupos: al grupo control se le administró 4 mg de dexametasona y al grupo experimental la asociación de 4 mg de dexametasona con vitaminas B1, B6 y B12; ambos por vía intramuscular antes de la cirugía. El efecto antinflamatorio se determinó por la evaluación del dolor y la tumefacción. El dolor se evaluó mediante la escala visual análoga, el tiempo para analgesia de rescate y el consumo total de analgésicos. La tumefacción se evaluó mediante mediciones del contorno facial. RESULTADOS: Se demostró que la intensidad máxima de dolor apareció a las 24 horas, siendo este significativamente menor en el grupo experimental (4,0 vs. 5,8 cm), p < 0,05; luego los valores fueron disminuyendo progresivamente a las 48 horas, siendo significativamente menor el valor en el grupo experimental (3,3 vs. 5,4 cm), p < 0,05. El grupo experimental demostró un mayor tiempo para analgesia de rescate (2,48 vs. 2,08 h), p > 0,05; y menor consumo de analgésicos (8,5 vs. 9,4 tab), p < 0,05. La tumefacción facial se incrementó progresivamente hasta el tercer día, sin diferencia significativa entre los grupos (45,4 vs. 46 cm), p > 0,05. CONCLUSIONES: Se evidenció una significativa mayor actividad analgésica y un significativo menor consumo total de analgésicos en el grupo experimental en comparación con el grupo control. No se evidenció diferencia significativa en la tumefacción


OBJECTIVE: To evaluate the antiinflammatory effect of the preoperative administration of the dexamethasone associated with B vitamins in mandibular third molar surgeries. MATERIALS AND METHODS: Experimental study, which consisted of 54 patients aged 18-25 years, who were assigned in two groups: control group was administered dexamethasone 4 mg and the experimental group, the association of dexamethasone 4 mg with vitamins B1, B6, B12; both intramuscularly before surgery. The anti-inflammatory effect was determined by the evaluation of pain and swelling. The pain was evaluated by means of the analogous visual scale, time for rescue analgesia and total analgesic consumption. The swelling was assessed by facial contour measurements. RESULTS: It was demonstrated that the maximum intensity of pain was at 24 hours, being this significantly lower in the experimental group (4.0 vs. 5.8 cm), p < 0.05; then the values were gradually decreasing at 48 hours, with the value in the experimental group being significantly lower (3.3 vs. 5.4 cm), p < 0.05. The experimental group showed a longer time for rescue analgesia (2.48 vs. 2.08 h), p > 0.05; and lower analgesic consumption (8.5 vs. 9.4 tab), p < 0.05. The facial swelling increased progressively until the third day, without significant differences between the groups (45.4 vs. 46 cm), p > 0.05. CONCLUSIONS: There was a significant higher analgesic activity and a significantly lower total analgesic consumption in the experimental group compared to the control group. There were no significant differences in swelling


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Dexametasona/administración & dosificación , Antiinflamatorios/uso terapéutico , Tercer Molar/cirugía , Extracción Dental/métodos , Complejo Vitamínico B/uso terapéutico , Resultado del Tratamiento
13.
Cochrane Database Syst Rev ; 5: CD003879, 2020 05 04.
Artículo en Inglés | MEDLINE | ID: mdl-32368796

RESUMEN

BACKGROUND: Prophylactic removal of asymptomatic disease-free impacted wisdom teeth is the surgical removal of wisdom teeth in the absence of symptoms and with no evidence of local disease. Impacted wisdom teeth may be associated with pathological changes, such as pericoronitis, root resorption, gum and alveolar bone disease (periodontitis), caries and the development of cysts and tumours. When surgical removal is performed in older people, the risk of postoperative complications, pain and discomfort is increased. Other reasons to justify prophylactic removal of asymptomatic disease-free impacted third molars have included preventing late lower incisor crowding, preventing damage to adjacent structures such as the second molar or the inferior alveolar nerve, in preparation for orthognathic surgery, in preparation for radiotherapy or during procedures to treat people with trauma to the affected area. Removal of asymptomatic disease-free wisdom teeth is a common procedure, and researchers must determine whether evidence supports this practice. This review is an update of an review originally published in 2005 and previously updated in 2012 and 2016. OBJECTIVES: To evaluate the effects of removal compared with retention (conservative management) of asymptomatic disease-free impacted wisdom teeth in adolescents and adults. SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 10 May 2019), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2019, Issue 4), MEDLINE Ovid (1946 to 10 May 2019), and Embase Ovid (1980 to 10 May 2019). The US National Institutes of Health Trials Registry (ClinicalTrials.gov)and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. . SELECTION CRITERIA: We included randomised controlled trials (RCTs), with no restriction on length of follow-up, comparing removal (or absence) with retention (or presence) of asymptomatic disease-free impacted wisdom teeth in adolescents or adults. We also considered quasi-RCTs and prospective cohort studies for inclusion if investigators measured outcomes with follow-up of five years or longer. DATA COLLECTION AND ANALYSIS: Eight review authors screened search results and assessed the eligibility of studies for inclusion according to the review inclusion criteria. Eight review authors independently and in duplicate conducted the risk of bias assessments. When information was unclear, we contacted the study authors for additional information. MAIN RESULTS: This review update includes the same two studies that were identified in our previous version of the review: one RCT with a parallel-group design, which was conducted in a dental hospital setting in the United Kingdom, and one prospective cohort study, which was conducted in the private sector in the USA. Primary outcome No eligible studies in this review reported the effects of removal compared with retention of asymptomatic disease-free impacted wisdom teeth on health-related quality of life Secondary outcomes We found only low- to very low-certainty evidence of the effects of removal compared with retention of asymptomatic disease-free impacted wisdom teeth for a limited number of secondary outcome measures. One prospective cohort study, reporting data from a subgroup of 416 healthy male participants, aged 24 to 84 years, compared the effects of the absence (previous removal or agenesis) against the presence of asymptomatic disease-free impacted wisdom teeth on periodontitis and caries associated with the distal aspect of the adjacent second molar during a follow-up period of three to over 25 years. Very low-certainty evidence suggests that the presence of asymptomatic disease-free impacted wisdom teeth may be associated with increased risk of periodontitis affecting the adjacent second molar in the long term. In the same study, which is at serious risk of bias, there is insufficient evidence to demonstrate a difference in caries risk associated with the presence or absence of impacted wisdom teeth. One RCT with 164 randomised and 77 analysed adolescent participants compared the effect of extraction with retention of asymptomatic disease-free impacted wisdom teeth on dimensional changes in the dental arch after five years. Participants (55% female) had previously undergone orthodontic treatment and had 'crowded' wisdom teeth. No evidence from this study, which was at high risk of bias, was found to suggest that removal of asymptomatic disease-free impacted wisdom teeth has a clinically significant effect on dimensional changes in the dental arch. The included studies did not measure any of our other secondary outcomes: costs, other adverse events associated with retention of asymptomatic disease-free impacted wisdom teeth (pericoronitis, root resorption, cyst formation, tumour formation, inflammation/infection) and adverse effects associated with their removal (alveolar osteitis/postoperative infection, nerve injury, damage to adjacent teeth during surgery, bleeding, osteonecrosis related to medication/radiotherapy, inflammation/infection). AUTHORS' CONCLUSIONS: Insufficient evidence is available to determine whether asymptomatic disease-free impacted wisdom teeth should be removed or retained. Although retention of asymptomatic disease-free impacted wisdom teeth may be associated with increased risk of periodontitis affecting adjacent second molars in the long term, the evidence is very low certainty. Well-designed RCTs investigating long-term and rare effects of retention and removal of asymptomatic disease-free impacted wisdom teeth, in a representative group of individuals, are unlikely to be feasible. In their continuing absence, high quality, long-term prospective cohort studies may provide valuable evidence in the future. Given the current lack of available evidence, patient values should be considered and clinical expertise used to guide shared decision-making with people who have asymptomatic disease-free impacted wisdom teeth. If the decision is made to retain these teeth, clinical assessment at regular intervals to prevent undesirable outcomes is advisable.


Asunto(s)
Tercer Molar/cirugía , Extracción Dental/métodos , Diente Impactado/cirugía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Enfermedades Asintomáticas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Ensayos Clínicos Controlados Aleatorios como Asunto , Espera Vigilante
14.
J Appl Oral Sci ; 28: e20190690, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32348445

RESUMEN

Objective To investigate the effects of intro-oral injection of parathyroid hormone (PTH) on tooth extraction wound healing in hyperglycemic rats. Methodology 60 male Sprague-Dawley rats were randomly divided into the normal group (n=30) and DM group (n=30). Type 1 diabetes mellitus (DM) was induced by streptozotocin. After extracting the left first molar of all rats, each group was further divided into 3 subgroups (n=10 per subgroup), receiving the administration of intermittent PTH, continuous PTH and saline (control), respectively. The intermittent-PTH group received intra-oral injection of PTH three times per week for two weeks. A thermosensitive controlled-release hydrogel was synthesized for continuous-PTH administration. The serum chemistry was determined to evaluate the systemic condition. All animals were sacrificed after 14 days. Micro-computed tomography (Micro-CT) and histological analyses were used to evaluate the healing of extraction sockets. Results The level of serum glucose in the DM groups was significantly higher than that in the non-DM groups (p<0.05); the level of serum calcium was similar in all groups (p>0.05). Micro-CT analysis showed that the DM group had a significantly lower alveolar bone trabecular number (Tb.N) and higher trabecular separation (Tb.Sp) than the normal group (p<0.05). The histological analyses showed that no significant difference in the amount of new bone (hard tissue) formation was found between the PTH and non-PTH groups (p>0.05). Conclusions Bone formation in the extraction socket of the type 1 diabetic rats was reduced. PTH did not improve the healing of hard and soft tissues. The different PTH administration regimes (continuous vs. intermittent) had similar effect on tissue healing. These results demonstrated that the metabolic characteristics of the hyperglycemic rats produced a condition that was unable to respond to PTH treatment.


Asunto(s)
Hormonas y Agentes Reguladores de Calcio/farmacología , Diabetes Mellitus Experimental/fisiopatología , Hormona Paratiroidea/farmacología , Extracción Dental/métodos , Alveolo Dental/efectos de los fármacos , Cicatrización de Heridas/efectos de los fármacos , Animales , Glucemia/análisis , Calcio/sangre , Hidrogeles , Masculino , Osteogénesis/efectos de los fármacos , Osteogénesis/fisiología , Distribución Aleatoria , Ratas Sprague-Dawley , Reproducibilidad de los Resultados , Herida Quirúrgica/tratamiento farmacológico , Factores de Tiempo , Alveolo Dental/diagnóstico por imagen , Resultado del Tratamiento , Microtomografía por Rayos X
15.
Medicine (Baltimore) ; 99(15): e19397, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32282695

RESUMEN

A considerable number of patients with prominent mandibular angle have mandibular third molar impaction that needs surgical removal. Mandibular reduction is a popular and effective surgery to correct prominent mandibular angle, but it has been rarely performed simultaneously with impacted third molar extraction. In order to decrease the number of operations and suffering of patients, safely performing these 2 operations together is necessary and important. From January 2016 to June 2018, patients received mandibular reduction and impacted mandibular third molar extraction together were retrospectively reviewed. Forty-seven patients receiving long-curve mandibular reduction (n = 12) or simple mandibular reduction (n = 35) were included in this study. A total of 65 impacted mandibular third molars were extracted during mandibular reduction. One patient had hematoma within facial soft tissue which reabsorbed spontaneously. Seven patients who underwent long-curve mandibular reduction reported transient inferior lip numbness for several weeks. No infection or poor wound healing was reported. No immediate or delayed mandibular fracture occurred. All the patients were satisfied with both the aesthetic result of mandibular reduction and the unnecessity of receiving a secondary surgery to extract the impacted third molar. Simultaneously performing mandibular reduction and impacted mandibular third molar extraction can effectively reduce the number of operations and patients' suffering. It is also safe with adequate pre-op assessment, professional surgical knowledge, proper use of surgical instruments, meticulous surgical procedures, and correct post-op care.


Asunto(s)
Osteotomía Mandibular/métodos , Tercer Molar , Extracción Dental/métodos , Adulto , Femenino , Humanos , Estudios Retrospectivos , Adulto Joven
16.
Med. oral patol. oral cir. bucal (Internet) ; 25(2): e154-e160, mar. 2020. tab, graf, ilus
Artículo en Inglés | IBECS | ID: ibc-196244

RESUMEN

BACKGROUND: Hyaluronic acid is widely used in the medical field. However, there is a lack of research about its effect on patients with certain risks, such as compromised wound healing commonly found in patients with poorly controlled type 2 diabetes. The aim of this study is to investigate the efficacy of hyaluronic acid on the post-extraction wound healing and pain in patients with poorly controlled type 2 diabetes. MATERIAL AND METHODS: The randomized controlled split-mouth study was designed, which included 30 patients with poorly controlled type 2 diabetes with a bilaterally same teeth in the lower jaw for extraction. The sockets treated with 0.8% hyaluronic acid represented the study group, while the sockets where hyaluronic acid was not applied represented the control group. Wound closure rate (WCR), clinical scores in wound healing scale (WHS) and pain intensity in Visual analogue scale (VAS) were recorded. Patients were followed up on 5th, 10th, 15th, 20th, 25th day after tooth extraction. RESULTS: The results showed a higher WCR at the extraction site where hyaluronic acid was applied. Also, statistically significant difference was found (p < 0.001). In regards to WHS, the sockets treated with hyaluronic acid showed better healing, especially on day 10 (p = 0.006) and day 15 (p = 0.021). However, there were no statistically significant differences in VAS scores between groups. CONCLUSIONS: Hyaluronic acid placed in post-extraction socket in patients with poorly controlled diabetes may improve wound healing, especially in the first days after application


No disponible


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Extracción Dental/métodos , Cuidados Posoperatorios/métodos , Ácido Hialurónico/uso terapéutico , Diabetes Mellitus Tipo 2/fisiopatología , Cicatrización de Heridas/efectos de los fármacos , Herida Quirúrgica/tratamiento farmacológico , Resultado del Tratamiento , Dimensión del Dolor , Factores de Tiempo , Valores de Referencia , Reproducibilidad de los Resultados , Análisis de Varianza
17.
Med. oral patol. oral cir. bucal (Internet) ; 25(2): e217-e223, mar. 2020. graf, tab
Artículo en Inglés | IBECS | ID: ibc-196251

RESUMEN

BACKGROUND: A single-blinded randomized controlled trial among patients requiring an upper third molar extraction was performed to evaluate the anxiety degree after receiving information or not about the functioning of The Wand system. Secondarily, perceived pain and the need of re-anesthesia were assessed. MATERIAL AND METHODS: Patients were randomly assigned to the experimental group (detailed explanation about The Wand) or control group (no specific information). Local anesthesia with The Wand consisted in a supraperiosteal infiltrative technique injection 1.6 mL at the buccal and 0.2 mL at the palatal side. Distinct questionnaires for assessing dental anxiety and 100-mm visual analog scales to assess pain were delivered. Demographic data, radiological parameters, operative time and type of intervention were also registered. A descriptive bivariate analysis by non-parametric tests to detect differences in anxiety, pain and re-anesthesia was performed by SPSS 22.0 (SPPS Inc. Chicago, USA). RESULTS: A total of 85 patients were assessed for eligibility but 17 participants were lost due to the cancellation of the visit for the surgical intervention. Finally, sixty-eight patients were included (34 participants in each group), 47 women (69.1%) and 21 men (30.9%), with an average age of 28.8 (± 9.3) years. CONCLUSIONS: Patients that received a detailed explanation of The Wand did not have a significant reduction of the anxiety degree and perceived pain during the anesthetic act compared to patients that received no information. The need of re-anesthesia was not related to the anxiety level but was significantly related to increasing operative time


No disponible


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Extracción Dental/métodos , Extracción Dental/psicología , Ansiedad al Tratamiento Odontológico/psicología , Anestesia Local/instrumentación , Método Simple Ciego , Estadísticas no Paramétricas , Anestesia Local/psicología , Escala de Ansiedad Manifiesta , Escala Visual Analógica , Valores de Referencia , Resultado del Tratamiento , Tempo Operativo
18.
Med. oral patol. oral cir. bucal (Internet) ; 25(2): e233-e239, mar. 2020. tab, graf, ilus
Artículo en Inglés | IBECS | ID: ibc-196253

RESUMEN

BACKGROUND: To review the literature on the effect of different surgical flaps upon patient morbidity (pain perception, trismus, swelling and osteitis) after impacted third molar extraction. MATERIAL AND METHODS: An electronic and complementary search of main databases and grey literature was performed up to January 2019 to retrieve randomized clinical trials. The Cochrane risk of bias assessment tool was used for methodological appraisal. A random-effects meta-analysis was conducted of pain perception and trismus. RESULTS: From the initially 1314 screened studies, only 11 were included in the qualitative synthesis, and 5 in the meta-analysis. There were no statistically significant differences in pain between the envelope and triangular flap designs over time, except on the sixth postoperative day, when the envelope flap proved more painful. Regarding trismus, statistically significant differences were observed on the seventh postoperative day, with greater mouth opening in the envelope flap group than in the triangular flap group. There were no clear differences in swelling and osteitis among the flap designs. CONCLUSIONS: Despite its limitations, the present meta-analysis found no clear differences in patient morbidity between the different flap designs


No disponible


Asunto(s)
Humanos , Diente Impactado/cirugía , Extracción Dental/métodos , Colgajos Quirúrgicos , Tercer Molar/cirugía , Diente Impactado/complicaciones , Extracción Dental/efectos adversos , Morbilidad , Resultado del Tratamiento , Percepción del Dolor , Trismo/etiología , Alveolo Seco/etiología
19.
Life Sci ; 248: 117460, 2020 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-32092331

RESUMEN

AIM: This study determined the optimum gamma irradiation dosage to sterilize sodium hyaluronate (HY), single-walled carbon nanotubes (SWCNT), multi-walled carbon nanotubes (MWCNT) and CNT functionalized with HY (HY-SWCNT and HY-MWCNT), evaluated the structural integrity of the materials and assessed whether sterilized materials kept biological properties without affecting renal function. MAIN METHODS: Materials were submitted to dosages of 100 gγ to 30 Kgγ and plated onto agar mediums for colony forming units (CFUs) counting. Sterilized samples were inoculated with 107Bacillus clausii, submitted again to gamma irradiation, and plated in agar mediums for CFUs counting. Scanning electron microscope was used for structural evaluation of sterilized materials. Tooth sockets of rats were treated with sterilized materials for bone formation assessment and renal function of the animals was analyzed. KEY FINDINGS: The optimum gamma dosage for sterilization was 250 gγ for HY and 2.5 Kgγ for the other materials without meaningful structural changes. Sterilized materials significantly increased bone formation (p < 0.05) and they did not compromise renal function and structure. SIGNIFICANCE: Gamma irradiation efficiently sterilized HY, SWCNT, MWCNT, HY-SWCNT and HY-MWCNT without affecting structural aspects while maintaining their desirable biological properties.


Asunto(s)
Materiales Dentales/efectos de la radiación , Rayos gamma , Ácido Hialurónico/efectos de la radiación , Nanotubos de Carbono/efectos de la radiación , Osteogénesis/efectos de los fármacos , Alveolo Dental/efectos de los fármacos , Animales , Bacillus clausii/efectos de la radiación , Recuento de Colonia Microbiana , Materiales Dentales/química , Materiales Dentales/farmacología , Humanos , Ácido Hialurónico/química , Ácido Hialurónico/farmacología , Pruebas de Función Renal , Masculino , Diente Molar/cirugía , Nanotubos de Carbono/química , Nanotubos de Carbono/ultraestructura , Ratas , Ratas Wistar , Esterilización/métodos , Extracción Dental/métodos , Alveolo Dental/microbiología , Alveolo Dental/fisiología , Alveolo Dental/cirugía , Cicatrización de Heridas/efectos de los fármacos
20.
Braz Oral Res ; 34: e003, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32022222

RESUMEN

This retrospective study evaluated facial profile pleasantness determined by two protocols of Class II treatment. The sample comprised facial profile silhouettes obtained retrospectively from the pretreatment (T1) and posttreatment (T2) cephalograms of 60 patients (42 males and 18 females) divided into two groups. One group of 30 patients (mean age of 12.84 years) was treated with the extraction of maxillary first premolars (mean treatment time of 2.7 years), and the other group of 30 patients (mean age of 12.81 years) was treated with a mandibular advancement appliance (Forsus) (mean treatment time of 2.49 years). The facial profile silhouettes (T1 and T2) were randomly distributed in an album containing one patient per sheet. The examiners consisted of 60 orthodontists and 60 lay individuals, who analyzed the profiles in regard to facial pleasantness, using the Likert scale. A comparison between stages T1 and T2 of the two treatment protocols and between the examiners was performed by mixed-design analysis of variance at a significance level of 5%. The results demonstrated a significant difference between T1 and T2 (greater scores for T2 compared to T1), and between lay individuals and orthodontists (orthodontists assigned higher scores), but with no significant difference between the treatment protocols. Both protocols produced positive effects on the facial profile esthetics, from the standpoint of lay individuals and orthodontists.


Asunto(s)
Estética Dental , Cara/patología , Maloclusión de Angle Clase II/patología , Maloclusión de Angle Clase II/terapia , Extracción Dental/métodos , Adolescente , Análisis de Varianza , Diente Premolar/cirugía , Cefalometría , Niño , Femenino , Humanos , Masculino , Variaciones Dependientes del Observador , Aparatos Ortodóncicos Fijos , Ortodoncia Correctiva/métodos , Ortodoncistas , Percepción , Estudios Retrospectivos , Estadísticas no Paramétricas , Resultado del Tratamiento
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