Optimal application of compressive palatal stents following mesiodens removal in pediatric patients: A Randomized Controlled Trial / Aplicación óptima de stents palatinos de compresión después de la extracción del mesiodens en pacientes pediátricos: un ensayo controlado aleatorio

Background: There is no scientific evidence supporting the choice of a palatal stent in patients who underwentremoval of an impacted supernumerary tooth. We aimed to investigate the effects of palatal stents in patients whounderwent supernumerary tooth removal through a palatal approach and to suggest the optimal stent thicknessand material.Material and Methods: We recruited 144 patients who underwent extraction of a supernumerary tooth between themaxillary anterior teeth. Subjects were assigned to a control group (CG) or one of four compressive palatal stentgroups (CPSGs) classified by the thickness and material of the thermoplastic acrylic stent used. Palatal gingivalswelling and objective indices (healing, oral hygiene, gingival, and plaque) were evaluated before surgery and onpostoperative days (PODs) 3, 7, and 14; pain/discomfort and the Child Oral Health Impact Profile (COHIP) wereassessed as subjective indices of the effects of the stent.Results: The CPSGs showed faster healing than did the CG on PODs 7 (P<0.001) and 14 (P=0.043); swelling wasmeasured by 1.64±0.88 mm and 4.52±0.39 mm, respectively. Although swelling was least in the 4-mm hard group(0.92±0.33 mm), the difference compared with that in the 2-mm hard group (1.01±0.18 mm) was not significant(P=0.077). The CPSGs showed better COHIP (P<0.001-0.036) and pain scores (P<0.001) than did the CG onPODs 1-3. Conclusions: Compressive palatal stents reduce discomfort by decreasing pain and alleviating swelling. Althougha stent is effective regardless of its thickness and material, 2-mm hard stents maximized such positive effects withminimal discomfort.(AU)

[Effect of psychological nursing based on relaxation training for the psychological state in patients with impacted third molar removal surgery].

Objective: To discuss the effect of psychological nursing based on relaxation training for the psychological state in patients with impatced third molar removal surgery. Methods: A total of one hundred patients with impacted third molar removal surgery were selected from June 2015 to June 2017 in People's Liberation Army No. 105 hospital. According to the nursing method, all patients were divided into psychological intervention group and the control group, 50 cases in each group, the control group was given routine nursing intervention and the psychological intervention group was given psychological nursing intervention based on relaxation training. Results: The after intervention Corah's modified dental anxiety scale (6.3±1.2), Stouthard dental fear scale (62.9±6.5) scores and heart rate [(76.4±5.2) bpm], systolic blood pressure [(102.5±6.3) mmHg], diastolic blood pressure [(75.3±3.1) mmHg] levels of psychological group were significantly lower than those of the control group. The once removal success rate, intraoperative relaxation sense rate of psychological group were significantly higher than those of the control group, the teeth extraction time of psychological group was significantly lower than that of the control group, the difference was statistically significant (P=0.013, P=0.003). Conclusions: Psychological nursing intervention based on relaxation training can effectively improve the mental state and stress state of patients with impacted third molar removal surgery, which is beneficial to the process of the surgery.

Propofol-remifentanil TCI sedation for oral surgery.

BACKGROUND AND OBJECTIVES: To investigate the safety and efficacy of a propofol-remifentanil target controlled infusion (TCI) sedation technique for oral surgery. METHODS: This prospective study involved patient and registered nurse (RN) questionnaires to assess the efficacy of sedation during surgery. Outpatients having dental extractions in a private office-based practice with TCI sedation were monitored with a Sleep Apnoea Monitor (SAM) to measure the number of Oxygen Desaturation Events (ODEs), defined as a drop in blood oxygenation to below 94%. RESULTS: Patient- and RN-assessed questionnaires showed a high standard of perceived sedation efficacy, independent of patient BMI. The proportion of patients having one or more ODEs was greater in higher BMI categories: underweight (20.0%), normal (47.9%), overweight (68.2%) and obese (81.8%). The odds of at least one ODE was estimated to be 1.2 times greater for each unit increase in BMI (OR 1.2; 95% CI 1.1-1.3), and at a fixed BMI, the odds of at least one ODE was estimated to be 2.6 times as great for a male as a female (OR 2.6; 95% CI 1.2-5.52). Age, patient nervousness and American Society of Anesthesiologists (ASA) classification were not associated with ODEs. CONCLUSIONS: The TCI technique had a high standard of efficacy, and there were no adverse safety outcomes. Higher BMI and male sex were found to be independently associated with predictors of ODEs during oral surgery under propofol-remifentanil TCI sedation.

EXTRACCION DEL PRIMER MOLAR PERMANENTES EN DENTINCION MIXTA

Introducción, Generalidades, Exodoncia segín la técnica propuesta, Esquemas del maxilar inferior y del 1er. molar inferior, Extracción del 1er. molar inferior permanentes en niños, Conclusiones, Bibliografia