Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 3.714
Filtrar
1.
Swiss Dent J ; 131(1): 62-63, 2021 Jan 11.
Artículo en Alemán | MEDLINE | ID: mdl-33427438

RESUMEN

In order to be able to perform major oral surgery in the upper jaw, sufficient local analgesia is indispensable. While the inferior alveolar nerve is often blocked for dental treatments in the lower jaw, block anesthesia in the upper jaw is less common. This article gives pragmatic advice on how to block the infraorbital nerve. By using this method patients comfort is significantly improved and the surgeon can focus on the treatment at hand.


Asunto(s)
Anestesia de Conducción , Anestesia Dental , Bloqueo Nervioso , Anestésicos Locales , Humanos , Mandíbula , Nervio Mandibular , Maxilar
2.
Quintessence Int ; 52(2): 140-153, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33433080

RESUMEN

OBJECTIVE: The present systematic review aimed to assess the efficacy of photobiomodulation (PBM) therapy on neurosensory recovery of patients with inferior alveolar nerve injury following third molar surgery or dental implant placement. METHOD AND MATERIALS: An electronic search was carried out in Scopus, Embase, Medline, PubMed, Web of Science, Cochrane Library, and Google Scholar databases. Among 1,122 identified papers, seven articles (three RCTs, one observational study, and three case series) met the inclusion criteria.
Results: Time lapse from nerve injury to the onset of PBM therapy varied widely from 2 days to 4 years. The number of patients in each study ranged between 4 and 74. In the majority of the studies, PBM was done using a diode laser at wavelengths ?in the range of 808 to 830 nm with power of 5 to 500 mW and radiation dose of 3 to 244 J/cm2. Two out of three RCTs found significant neurosensory recovery in the patients who received PBM therapy compared to the controls. The observational study and all case series reported significant improvement in the neurosensory status following PBM therapy. The degree of neurosensory recovery was found to be greater in younger patients and those who received the treatment within 6 months following the injury.
Conclusions: Due to the limited number of well-designed RCTs and small number of patients in each study, it is not possible to make a clear conclusion about the efficacy of PBM therapy on neurosensory recovery in patients with inferior alveolar nerve injury following third molar or implant procedures. Considering the possibility of spontaneous inferior alveolar nerve recovery during this period, the conclusion based on the studies with no control group should be interpreted with caution. (Quintessence Int 2021;52:140-153; doi: 10.3290/j.qi.a45430).


Asunto(s)
Terapia por Luz de Baja Intensidad , Humanos , Láseres de Semiconductores , Nervio Mandibular
3.
Swiss Dent J ; 131(1): 10-28, 2021 01 11.
Artículo en Inglés | MEDLINE | ID: mdl-33325209

RESUMEN

The mandibular canal is a prominent anatomical structure and it is of great clinical importance since it contains the inferior alveolar nerve. The clinician is advised to proceed cautiously in the vicinity of the mandibular canal to avoid any damage to its neurovascular content. Based on observations in dry mandibles, in panoramic radiographs, and recently in three-dimensional radiography, various anatomical variations of the mandibular canals have been described. One such variant is the so-called bifid mandibular canal (BMC). Embryologically, multiple canals develop and subsequently fuse to form a single mandibular canal; however, occasionally fusion fails or is incomplete resulting in one or multiple BMCs. Clinically relevant issues with regard to the BMCs include hemorrhagic or neurological disorders following damage to these aberrant canals. This literature review presents morphological and quantitative data about BMCs from studies using three-dimensional radiography, i.e. CT and/or CBCT. The reported frequencies of BMCs per patient ranged from 9.8 - 66.5% and per mandibular side from 7.7 - 46.5%. Gender, age or side predilection is currently inconclusive with regard to the occurrence of BMCs. Various types of BMCs have been described in the literature, such as retromolar, dental, forward, or buccolingual canals. BMCs may originate from the mandibular canal along its entire course, but bifurcation appears to be more frequent in the posterior compared to the anterior canal portions. Mean BMC length was reported to range from 10.2 - 16.9 mm, and mean BMC diameter from 0.9 - 2.3 mm. In conclusion, the presence of a BMC must be taken into consideration for treatment planning and anesthetic, endodontic, or surgical interventions in the mandible.


Asunto(s)
Tomografía Computarizada de Haz Cónico , Mandíbula , Humanos , Mandíbula/diagnóstico por imagen , Nervio Mandibular/diagnóstico por imagen , Radiografía Panorámica
4.
J Oral Sci ; 62(4): 402-409, 2020 Sep 26.
Artículo en Inglés | MEDLINE | ID: mdl-32863317

RESUMEN

An inferior alveolar nerve (IAN) injury is a common clinical problem that can affect a patients' quality of life. Cellular therapy has been proposed as a promising treatment for this injury. However, the current experimental models for IAN injury require surgery to create bone windows that expose the nerve, and these models do not accurately mimic human IAN injuries. Therefore, in this study, a novel experimental model for IAN injury has been established in rats. Using this model, the effects of Schwann cells and their role in the recovery from IAN injuries were investigated. Schwann cells were isolated from rat sciatic nerves and cultured. The first molar in the mandible was extracted and the IAN was immediately injured for 30 min by inserting an insect pin. Then, the Schwann cells or culture medium were transplanted into the extracted sockets of the cell and injury groups, respectively. After the surgery, the cell group displayed significantly increased sensory reflexes in response to mechanical stimulation, regenerated IAN width, and myelin basic protein-positive myelin sheaths when compared with the injury group. In conclusion, a novel animal experimental model for IAN injury has been developed that does not require the creation of a bone window to evaluate the impacts of cell transplantation and demonstrates that Schwann cell transplantation facilitates the regeneration of injured IANs.


Asunto(s)
Traumatismos del Nervio Trigémino , Animales , Trasplante de Células , Humanos , Nervio Mandibular , Calidad de Vida , Ratas , Células de Schwann
5.
Quintessence Int ; 51(10): 864-870, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32901242

RESUMEN

OBJECTIVE: This prospective, block randomized clinical trial was conducted to evaluate the effect of aromatherapy on the success rate of inferior alveolar nerve block (IANB) in teeth with irreversible pulpitis. METHOD AND MATERIALS: In this clinical trial, 46 patients fulfilling the inclusion criteria were randomly divided into two equal groups: group I (n = 22) received IANB in a closed operatory without any fragrance, whereas group II (n = 24) received IANB in a separate closed operatory saturated with lavender fragrance using a candle warmer. The modified dental anxiety scale (MDAS) for anxiety and visual analog scale (VAS) for pain were recorded preoperatively as well as during access cavity preparation. For MDAS, a total score of more than 18 was considered as tremendously anxious or dental phobic. No or mild pain on VAS was considered as success. Data were analyzed using paired t test and independent sample t test. P < .05 was considered as statistically significant. RESULTS: Difference in mean VAS (P = .749) and MDAS (P = 1.000) between both the groups was statistically nonsignificant. However there was a statistically significant difference in mean VAS (P = .000) and MDAS (P = .001) during access opening. CONCLUSION: Lavender aromatherapy can be used successfully to alleviate dental anxiety as well as to increase the anesthetic success rate of IANB in teeth with irreversible pulpitis.


Asunto(s)
Anestesia Dental , Aromaterapia , Bloqueo Nervioso , Pulpitis , Anestésicos Locales , Método Doble Ciego , Humanos , Lidocaína , Nervio Mandibular , Estudios Prospectivos , Pulpitis/cirugía , Pulpitis/terapia
6.
Plast Reconstr Surg ; 146(4): 847-858, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32970007

RESUMEN

BACKGROUND: No consensus exists about the safest position for performing the osseous genioplasty, with 5 to 6 mm below the mental foramen being the most frequently recommended position. This study intends to generate a safe distance guide to minimize the risk of inferior alveolar nerve injury during osteotomy. METHODS: Pretreatment cone-beam computed tomography-derived three-dimensional models from adult patients with skeletal class I to III patterns and cleft lip/palate deformity who underwent orthodontic-surgical interventions (n = 317) were analyzed. A three-dimensional vertical distance between the inferior margin of the mental foramen and the lowest point of the inferior alveolar nerve canal was measured in each three-dimensional hemimandible (n = 634). Statistical analysis was performed to generate the safe distance guide in a stepwise fashion at 95, 99, and 99.99 percent confidence levels. RESULTS: Class III (4.35 ± 1.42 mm) and cleft lip/palate (4.42 ± 1.53 mm) groups presented significantly (p < 0.001) larger three-dimensional distances than class I (3.44 ± 1.54 mm) and class II (3.66 ± 1.51 mm) groups. By considering the 5- to 6-mm safe distance parameter, 6.4, 5.0, 10.6, 16, and 9.9 percent of hemimandibles were at risk of osteotomy-induced nerve injury in the class I, class II, class III, cleft lip/palate, and overall cohorts, respectively. Overall, the safe distance zone to perform the osteotomy was set at 7.06, 8.01, and 9.12 mm below the mental foramen, with risk probabilities of 2.5, 0.5, and 0.0005 percent, respectively. CONCLUSION: This study contributes to patient safety and surgeon practice by proving a safe distance guide for genioplasty.


Asunto(s)
Labio Leporino/cirugía , Fisura del Paladar/cirugía , Tomografía Computarizada de Haz Cónico , Mentoplastia/métodos , Imagenología Tridimensional , Complicaciones Intraoperatorias/prevención & control , Lesiones del Nervio Mandibular/prevención & control , Nervio Mandibular/diagnóstico por imagen , Cirugía Asistida por Computador , Adolescente , Adulto , Tomografía Computarizada de Haz Cónico/métodos , Femenino , Humanos , Periodo Intraoperatorio , Masculino , Estudios Retrospectivos , Adulto Joven
7.
Int J Oral Maxillofac Surg ; 49(11): 1421-1429, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32921555

RESUMEN

The purpose of this study was to assess the pre- and postoperative position and dimensions of the inferior alveolar canal (IAC) following sagittal split osteotomy (SSO) and identify any association with postoperative neurosensory deficit (NSD) at 1 year. This retrospective cohort study enrolled consecutive patients who had SSO performed to correct skeletal malocclusion. The pre- and postoperative cone beam computed tomography data were superimposed to visualize differences in IAC position and dimensions. Subjective and objective neurosensory tests were used to determine NSD in the inferior alveolar nerve distribution. A total of 20 subjects were included. The preoperative distance from the lateral cortex of the IAC to the inner aspect of the lateral cortex of the mandible was significantly greater in sides with NSD when compared to sides without NSD (P = 0.01). A significantly greater reduction in the postoperative distance measurement was seen in sides with NSD when compared to sides without NSD (P = 0.01). The magnitude of mandibular movement was significantly increased in sides with NSD (P = 0.02). The preoperative location of the IAC, as well as certain changes in the mediolateral and vertical positions as a result of SSO, are risk factors for postoperative NSD.


Asunto(s)
Osteotomía Mandibular , Traumatismos del Nervio Trigémino , Humanos , Mandíbula/diagnóstico por imagen , Mandíbula/cirugía , Nervio Mandibular/diagnóstico por imagen , Osteotomía Sagital de Rama Mandibular , Estudios Retrospectivos , Traumatismos del Nervio Trigémino/etiología
8.
J Oral Maxillofac Surg ; 78(11): 1886-1891, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32640205

RESUMEN

PURPOSE: Coronectomy is performed to avoid injury to the inferior alveolar nerve when mandibular third molars (M3s) in close proximity to the inferior alveolar nerve are indicated for extraction. Concern has been raised regarding the fate of submerged roots with exposed pulp tissue and whether this will serve as a nidus for infection. The study purpose was to answer the following clinical question: Among patients undergoing coronectomy, do those treated with concurrent root canal treatment (RCT), when compared with those not treated with RCT, have a decreased frequency of postoperative infections? The specific aims of this study were to 1) perform a comprehensive review to compare postoperative infection rates in M3 coronectomies with and without concurrent RCT and 2) review relevant animal and human studies pertaining to pulpal physiology as it relates to coronectomy. MATERIALS AND METHODS: The study was designed as a comprehensive review to identify controlled studies that compared outcomes of M3 coronectomies with and without concurrent RCT published through January 2020. Studies included in the sample needed to meet the following criteria: 1) studies published in English, 2) human studies, and 3) studies that reported the postoperative infection outcomes. The predictor variable was concurrent RCT at the time of coronectomy. The outcome variable was postoperative infection. RESULTS: The database search identified 107 publications for initial review. After application of the inclusion and exclusion criteria, the final sample included only 1 publication. The frequencies of postoperative infection with and without concurrent RCT were 87.5% and 12.5%, respectively. CONCLUSIONS: The one study identified for detailed review showed that RCT at the time of coronectomy does not decrease the frequency of postoperative infections. This result supports the recommendation that it is unnecessary to perform concurrent RCT on M3 roots that are retained. The finding that intentional submersion of roots does not require RCT also is supported by multiple animal and human studies.


Asunto(s)
Diente Impactado , Traumatismos del Nervio Trigémino , Cavidad Pulpar , Humanos , Mandíbula/cirugía , Nervio Mandibular , Tercer Molar/diagnóstico por imagen , Tercer Molar/cirugía , Corona del Diente/cirugía , Extracción Dental , Raíz del Diente/cirugía , Diente Impactado/cirugía
9.
Artículo en Inglés | MEDLINE | ID: mdl-32665207

RESUMEN

OBJECTIVE: The aim of this study was to evaluate the relationship between neurosensory disturbance (NSD) and the different types of bilateral sagittal split osteotomy (BSSO) lingual fracture created. STUDY DESIGN: The study group consisted of 45 patients with mandibular deformities (90 sides; 14 males and 31 females). Computed tomography (CT) scans were obtained preoperatively and 1 week postoperatively. All patients were divided into lingual fracture line groups on the basis of their postoperative scans. NSD was tested preoperatively and 1, 3, and 12 months postoperatively by using a sensory touch Semmes-Weinstein (SW) test and the 2-point discrimination (TPD) test. RESULTS: Patients were divided into 2 groups on the basis of their lingual fracture lines after mandibular BSSO; among the 45 patients, 39 sides (43.3%) had short-splits, and 51 sides (56.7%) had long-splits. The short-split group was less affected at all tested times, and the difference between the 2 groups was significant 1 month postoperatively on TPD test but not at other times on the both tests. CONCLUSIONS: The split type did not affect the NSD incidence at 3 and 12 months postoperatively.


Asunto(s)
Traumatismos del Nervio Trigémino , Femenino , Humanos , Masculino , Mandíbula/diagnóstico por imagen , Mandíbula/cirugía , Nervio Mandibular/diagnóstico por imagen , Osteotomía Mandibular , Osteotomía , Osteotomía Sagital de Rama Mandibular , Traumatismos del Nervio Trigémino/etiología
10.
J Biol Regul Homeost Agents ; 34(3 Suppl. 1): 19-26, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32618157

RESUMEN

The aim of this study is to assess the value of SSFP MRI sequence in depicting the normal anatomy of the lingual nerve (LN), particularly in the molar region, in order to help the periodontists, dentists and oral surgeons in their daily practice. The study group included 24 patients who were to undergo MR study for a reason unrelated to our purpose. All imaging was performed by using a 3.0T system with a head and neck multiarray coil. The evaluation criteria included image quality factors such as the identification of the LN, its demarcation and its contrast to surrounding tissues on a five-point scale. The LN is clearly visible throughout its course from its origin from the mandibular nerve (MN) to the mylohyoid muscle. In edentulous patients, the LN could be damaged during surgical procedures especially it during the dissection and retraction of a lingual flap and, above all, during the suture due to a direct trauma caused by the needle or indirectly during tying the knot.


Asunto(s)
Nervio Lingual , Imagen por Resonancia Magnética , Humanos , Nervio Lingual/diagnóstico por imagen , Nervio Mandibular , Diente Molar , Cuello
12.
J Oral Maxillofac Surg ; 78(11): 2073-2079, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-32717215

RESUMEN

PURPOSE: Ablative mandibular resection may result in neurosensory loss and decreased quality-of-life, yet nerve reconstruction is not performed routinely for various reasons, including increased operative time. This study aimed to determine whether immediate inferior alveolar nerve (IAN) allograft reconstruction provides functional sensory recovery (FSR) in the pediatric age group. PATIENTS AND METHODS: This multicenter retrospective cohort study included pediatric patients who underwent mandibular resection with IAN discontinuity and a nerve allograft greater than 45 mm. A positive control group also was included, comprising pediatric patients who underwent mandibular resection without nerve reconstruction. The primary predictor variable was the use of a nerve allograft; a secondary variable was the time to achieve FSR using the Medical Research Council Scale. Comparisons were made to historical adult data. Statistical analysis of the comparison of neurosensory outcomes over time was measured by weighted values, repeated-measures analysis of variance, and the McNemar test. RESULTS: The study group consisted of 32 patients, 18 in the graft group and 14 in the non-graft group, without significant differences in age, gender, or nerve gap length. By 1 year, FSR was achieved in 100% in the study group and 0% in the control group (P < .00001). The median time to FSR was 75 days in the study group and 110 days in the historical adult study group. In comparison to historical adult data, there was a significant difference at 1 year, with adults at 87% FSR (P = .01562). CONCLUSIONS: Long-span nerve allografts were effective in restoring sensation to the lip and chin in pediatric patients, with 100% reaching FSR, whereas no patients without nerve reconstruction achieved FSR. Pediatric patients recovered to a higher level of FSR than adults at 1 year. Immediate IAN reconstruction in pediatric patients should be considered strongly when the mandible requires resection with sacrifice of the IAN.


Asunto(s)
Traumatismos del Nervio Trigémino , Adulto , Aloinjertos , Niño , Humanos , Mandíbula/cirugía , Nervio Mandibular/cirugía , Estudios Retrospectivos
13.
J Oral Maxillofac Surg ; 78(10): 1813-1819, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32540322

RESUMEN

PURPOSE: Sagittal split osteotomy (SSO) of rami with fused cortices or minimal marrow space above the lingula can increase the risk of an unfavorable osteotomy split of the proximal ramus. To reduce the risk of a proximal segment fracture, a recent modification of the SSO places the medial horizontal osteotomy below the lingula. The purpose of the present study was to evaluate the outcomes of SSOs utilizing a low medial horizontal osteotomy in patients with atypical ramus morphologies. PATIENTS AND METHODS: The present study was a prospective series composed of patients with atypical proximal ramus anatomy undergoing SSOs. All patients had undergone bilateral SSO for correction of mandibular deformities. The horizontal ramus osteotomy had been placed at or slightly above the mandibular occlusal plane because of atypical ramus morphology (thin ramus with no appreciable marrow space at or above the lingula and/or narrow retromolar ramus width). The outcome variables were an unfavorable split of the proximal or distal segments, nerve location after SSO (proximal or distal segment), and neurosensory recovery of the inferior alveolar nerve (IAN). RESULTS: The sample included 25 patients who had undergone 50 SSOs using a low medial horizontal osteotomy. Their mean age was 19.6 ± 3.2 years; 14 patients were female. Of the 25 patients, 22 had a primary diagnosis of craniofacial anomaly; 23 had undergone bimaxillary surgery and 6 had received concomitant genioplasty. No unfavorable fractures of the proximal segment occurred. No intraoperative IAN injuries occurred. The IAN was contained within the proximal segment in 52% of the cases. All the patients achieved functional sensory recovery of the IAN bilaterally by 1 year postoperatively. The mean interval to functional sensory recovery was 116 days. CONCLUSIONS: The low medial horizontal osteotomy is an effective technique for reliable execution of SSOs in morphologically atypical mandibles.


Asunto(s)
Mandíbula , Nervio Mandibular , Adolescente , Adulto , Femenino , Mentoplastia , Humanos , Mandíbula/diagnóstico por imagen , Mandíbula/cirugía , Osteotomía , Osteotomía Sagital de Rama Mandibular , Estudios Prospectivos , Adulto Joven
14.
Oral Maxillofac Surg ; 24(4): 417-422, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32556618

RESUMEN

PURPOSE: The coronectomy technique is an alternative to conventional impacted tooth removal which aims to reduce the risk of damage to the inferior alveolar nerve (IAN). The technique is usually performed by senior oral surgeons or residents in training. Herein, patients were treated in a single service, in which coronectomy was performed by an undergraduate dental student on partially erupted lower third molars. METHODS: A prospective analysis was performed on 21 individuals submitted to a total of 35 coronectomies. Clinical and radiographic follow-up was performed for at least 12 months. RESULTS: Overall, healing was within normal limits, without major complications and without permanent IAN injury. However, one case showed temporary IAN paraesthesia resolved within a month and two required repetitions of coronectomy due to the remaining enamel, but with a good final result. Root migration was observed in all cases, but no other surgery was required. CONCLUSION: Coronectomy may be an important option for treating partially erupted teeth in close nerve relationships, which could also be performed by trained undergraduate dental students. This series is interesting because it can encourage oral and maxillofacial surgeons to train undergraduate students and to stimulate their attraction and passion for surgery.


Asunto(s)
Diente Impactado , Traumatismos del Nervio Trigémino , Humanos , Mandíbula , Nervio Mandibular/cirugía , Tercer Molar/diagnóstico por imagen , Tercer Molar/cirugía , Estudios Prospectivos , Estudiantes , Corona del Diente/diagnóstico por imagen , Corona del Diente/cirugía , Extracción Dental , Raíz del Diente , Diente Impactado/diagnóstico por imagen , Diente Impactado/cirugía
15.
Int J Oral Maxillofac Surg ; 49(11): 1497-1507, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32473767

RESUMEN

The aim of this study was to compare the efficacy and safety of the different local anaesthetic agents for the extraction of impacted lower third molars. A network meta-analysis was performed of all published reports of randomized controlled clinical trials assessing efficacy (anaesthetic success and absence of need for supplementary anaesthesia during the surgical procedure) and/or safety (number of adverse events) of anaesthetic agents. Three electronic databases were searched, from their earliest records up to April 2019. Additionally, the grey literature was searched to identify further potential candidates for inclusion. Anaesthesia had to be delivered by an inferior alveolar nerve block, complemented with infiltration anaesthesia of the buccal nerve. The quality of the studies was assessed using the Cochrane Collaboration tool. This study included a total of 21 trials (2021 molars) assessing the efficacy and 19 trials (1977 molars) assessing the safety of 11 anaesthetic solutions. Seven of the studies included were considered to have a high risk of bias. The most effective local anaesthetic for the extraction of impacted mandibular third molars appeared to be 4% articaine, with significant differences when compared with 2% lidocaine, 0.5% bupivacaine, and 1% ropivacaine. Lidocaine is the safest local anaesthetic, although all investigated solutions can be used safely.


Asunto(s)
Anestesia Dental , Bloqueo Nervioso , Anestesia Local , Anestésicos Locales , Carticaína , Lidocaína , Nervio Mandibular , Diente Molar , Tercer Molar/cirugía , Metaanálisis en Red , Ensayos Clínicos Controlados Aleatorios como Asunto
16.
Int J Oral Maxillofac Surg ; 49(12): 1622-1629, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32402689

RESUMEN

Inferior alveolar nerve (IAN) transpositioning is a modality utilized to manage posterior mandibular vertical deficiency. Several complications have been reported including improper implant positioning, mandibular body fracture, and neurosensory disturbance. The aim of this prospective observational study was to introduce a two-stage mental foramen distalization technique to minimize the complications associated with IAN transpositioning. Ten patients with severely atrophied mandibular ridges were included. Cone beam computed tomography was ordered to accurately locate the position of the IAN and its incisive terminal branch before designing the outline of two cortical osteotomies anterior and posterior to the mental foramen. The osteotomies were created using a piezoelectric device, followed by separation and identification of the nerve. The incisive branch was severed to freely transpose the IAN. A new foramen was created far distally and the cortical windows were repositioned and fixed with two screws. Healing was uneventful for all patients. Neurosensory recovery was assessed by MRC scale. All cases showed full recovery within 6 weeks, except for two patients who showed complete recovery after 16 weeks. Four months postoperative, all patients showed complete consolidation of the cortical windows without any signs of failure implants were placed at the pre-planned surgical sites. Histomorphometric analysis of core biopsies from seven surgical sites showed bone area percentages ranging from 46% to 63%. The two-stage mental foramen distalization technique is a predictable and safer technique for IAN transpositioning specifically in cases of vertical bone deficiency associated with limited inter-arch space.


Asunto(s)
Mandíbula , Foramen Mental , Tomografía Computarizada de Haz Cónico , Humanos , Mandíbula/diagnóstico por imagen , Mandíbula/cirugía , Nervio Mandibular/diagnóstico por imagen , Nervio Mandibular/cirugía , Estudios Prospectivos
17.
Acta Chir Plast ; 60(2-4): 48-53, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32370517

RESUMEN

OBJECTIVE: Experimental lesions in the inferior alveolar nerve (IAN) are used for the study of peripheral and central alterations. The objective of our study was to contribute to a more precise description of the approach to the IAN and creating a lesion. MATERIAL AND METHODS: Twenty-six males of Wistar laboratory rats were used for the study. The animals were divided into three groups: control group (6 rats), experimental group (12 rats - a part of the bone above the mandibular canal was removed under general anaesthesia using extraoral approach, after exposing a part of the IAN, the nerve was excised in a length of 3 mm), and a sham group (8 rats - the nerve was only dissected but not transected). Persisting denervation was verified using surgical revision and histological and immunohistochemical analysis after the observation period (4 weeks). RESULTS: No evidence of re-innervation after 4 weeks. We found no statistically significant differences in mean weight gains between individual groups during the observation period. CONCLUSION: The described technique used in the study is one of the possible ways to create a nerve lesion at the site of the main trunk of the nerve. At the same time, the study provides a more precise description of the anatomical situation and approach to the IAN in the mandibular canal.


Asunto(s)
Desnervación/métodos , Nervio Mandibular/fisiopatología , Nervio Mandibular/cirugía , Animales , Masculino , Modelos Animales , Regeneración Nerviosa/fisiología , Neuroanatomía , Ratas , Ratas Wistar
18.
J Endod ; 46(8): 1023-1031, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32470370

RESUMEN

INTRODUCTION: The aim of this prospective, randomized, double-blind clinical trial was to evaluate the effect of a preoperative, single, oral dose of diclofenac potassium (DFK) on postoperative pain and rescue analgesic intake in patients with symptomatic irreversible pulpitis in mandibular molars treated in 1 visit. METHODS: Seventy emergency patients with moderate to severe preoperative pain randomly received either 50 mg DFK or placebo tablets 1 hour before starting endodontic treatment (n = 35 per group). Patients recorded their pain level 6, 12, 24, and 48 hours after treatment on a 170-mm Heft-Parker visual analog scale. The incidence of rescue analgesic intake was also recorded. Outcome data were statistically analyzed using Mann-Whitney U, Friedman, Wilcoxon signed rank, and chi-square tests. Binary logistic regression assessed the association of predisposing factors with postoperative pain. The significance level (α) was set at 0.05. RESULTS: Of the 70 patients, 68 were analyzed (n = 34 per group). Both groups had similar baseline characteristics (P > .05). DFK showed significantly less pain incidence and intensity than the placebo at 48 hours only (P < .05). A significant decrease occurred from 24 to 48 hours with DFK (P < .05), which was not recorded with the placebo (P > .05). No difference in the incidence of rescue analgesic intake was reported between groups (P > .05). Food intake timing, sex, and rescue analgesic intake were associated with postoperative pain (P < .05). CONCLUSIONS: Premedication by a single, oral dose of 50 mg DFK could be effective in reducing postendodontic pain at 48 hours after 1-visit endodontic treatment in mandibular molars with symptomatic irreversible pulpitis.


Asunto(s)
Pulpitis , Diclofenaco , Método Doble Ciego , Humanos , Nervio Mandibular , Diente Molar , Premedicación , Estudios Prospectivos
19.
Stomatologiia (Mosk) ; 99(2): 105-109, 2020.
Artículo en Ruso | MEDLINE | ID: mdl-32441084

RESUMEN

Limited mouth opening is a common pathology in dental practice. Dental treatment of these group patients is hindered by low access to oral cavity, which complicates operative, prosthetic and surgical interventions. Local anesthesia is also difficult due to changes in anatomical landmarks, changes in bone structures and soft tissues ratio. M.M. Weisbrem and Gow-Gates technique in case with limited mouth opening 1-2 cm is ineffective. Mandibular convention block is more universal, as it is oriented to bone structures without binding to soft tissues. Variation of local anesthesia techniques at a various mouth opening degrees are offered.


Asunto(s)
Anestesia Dental , Bloqueo Nervioso , Anestesia Local , Humanos , Mandíbula , Nervio Mandibular
20.
Indian J Dent Res ; 31(2): 197-202, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32436897

RESUMEN

Background: The location of the inferior alveolar nerve (IAN) is generally constant in fully grown mandibles. If we know its average distance from the lower border of the mandible, available bone length from the crest of the edentulous ridge can be estimated by physical measurement of the whole length of mandible in that area. This study aimed to measure the superio-inferior distance of the inferior alveolar nerve (SIDIAN) from the base of the mandible in posterior regions on the right and left side based on cone-beam-computed tomography (CBCT) scans and to evaluate gender and ethnicity-related variations in the Malaysian population. Materials and Methods: A total of 100 CBCT-Digital Imaging and Communications in Medicine files of the patients of 3 ethnic populations (Malay, Chinese and Indian) between the ages of 18 and 80 years were selected for the study. The files were imported onto the iCAT software. The measurements of the SIDIAN to the lower border of the mandible in molar regions were done on both sides. The data was analysed using t-test, one-way analysis of variance test, and correlation coefficient test via the SPSS software. Results: Statistically significant positive correlations were identified between the SIDIAN from the lower border of the mandible in the first and second molar regions within the same side as well as between both sides of the mandible (r ≈ 0.8). There were no statistically significant differences between genders. However, there were statistically significant differences on both molar regions and on both sides in all three ethnic groups (P < 0.05). In general, the SIDIAN from the lower border of the mandible was greatest amongst Chinese and smallest amongst Indians. Conclusions: The strong positive correlations on both sides of the mandible indicate the presence of symmetry. Ethnicity-related variations exist in terms of the location of the IAN in the mandible.


Asunto(s)
Implantes Dentales , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Tomografía Computarizada de Haz Cónico , Femenino , Humanos , Masculino , Mandíbula , Nervio Mandibular , Persona de Mediana Edad , Diente Molar , Adulto Joven
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA