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1.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 39(5): 598-604, 2021 Oct 01.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-34636210

RESUMO

OBJECTIVES: This prospective study was performed to evaluate whether the distal-triangular flap was a practical alternative surgical approach for extracting mandibular third molars. METHODS: Sixty participants with impacted mandibular third molars were randomly divided into three groups: group A, distal-triangular flap; group B, Szmyd flap; and group C, envelope flap. The impacted third molars were extracted by the corresponding flapping method. During a three-month follow-up observation after the extraction, the postoperative pain, swelling, mouth opening, and periodontal status were recorded and analyzed by ANOVA and chi-square tests. RESULTS: The 60 participants had successful extraction and 3-month follow-up observation. No participant suffered from postoperative infections, lower lip disorder, or tongue sensory disorders. No statistical differences were found in the postoperative symptoms and signs of the three flap designs, such as postoperative pain, swelling, mouth opening, and periodontal status (P>0.05). CONCLUSIONS: The distal-triangular flap was as safe and reliable as the Szmyd and envelope flaps but more advantageous because of its convenient operative field exposure and low requirement for the patient's mouth opening. Thus, the distal-triangular flap is one of the alternative flap options for extracting impacted mandibular third molars.


Assuntos
Dente Serotino , Dente Impactado , Humanos , Mandíbula/cirurgia , Dente Serotino/cirurgia , Estudos Prospectivos , Extração Dentária , Dente Impactado/cirurgia
2.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 39(5): 605-611, 2021 Oct 01.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-34636211

RESUMO

OBJECTIVES: This study aims to analyze the effectiveness of platelet-rich fibrin (PRF) in mandibular third molar extraction and provide suggestions for alleviating postoperative complications. METHODS: Pubmed, EMBASE, Web of Science, and SinoMed were searched electronically on February 2020. Randomized controlled trials focusing on PRF usage in mandibular third molar extraction were included. Reviewers assessed the risk of bias in the included literature and extracted data independently using the criteria recommended by the Cochrane Collaboration. Meta-analysis was performed using RevMan 5.3 and STATA 13.0. RESULTS: Twenty-one studies were included, comprising 991 patients who had mandibular third molar extraction. The topical application of PRF effectively reduced pain after extraction [MD=-12.06, 95%CI (-21.42, -2.71), P=0.01], attenuated post-extraction swelling [MD=-1.42, 95%CI (-2.41, -0.44), P=0.005], and promoted soft tissue hea-ling [MD=0.66, 95%CI (0.34, 0.99), P<0.000 1]. PRF significantly reduced trismus and alveolar osteitis (P<0.05). However, data could not prove whether PRF has any significant positive effect on bone healing compared with the control group (P>0.05). CONCLUSIONS: Limited clinical evidence indicates that applying PRF after mandibular third molar extraction could reduce pain, swelling, trismus and the occurrence of dry socket and promote soft tissue healing. However, the effect of PRF on bone healing requires further large-scale randomized controlled trials and unified measurement criteria.


Assuntos
Fibrina Rica em Plaquetas , Dente Impactado , Humanos , Mandíbula , Dente Serotino/cirurgia , Extração Dentária
3.
JNMA J Nepal Med Assoc ; 59(239): 678-682, 2021 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-34508508

RESUMO

INTRODUCTION: Third molar impaction is a common patient complaint in dentistry. Common symptoms are localized pain, swelling, bleeding, and difficulty in mouth opening. Since dental students deal with patients early in their education, for better skill, they should have knowledge of various teeth impactions. Hence, the objective was to find out the knowledge of impacted teeth among undergraduate dental students of a medical college. METHODS: A descriptive cross-sectional study was conducted among bachelor in dental surgery students of a medical college from November 30, 2020 to April 3, 2021. Data collection was done by convenience sampling after receiving ethical clearance from Institutional Review Committee (Reference 1208202006). A structured questionnaire in Google Forms was sent to 221 participants via Viber. Out of 213 responses received, 144 were analyzed in Excel after discarding for duplication and other errors. Descriptive statistics such as mean, standard deviation, frequency, and percentage were analyzed. RESULTS: Out of the total of 144 participants, only 81 (56.3%) (47.89-91.4 at 95% Confidence Interval) had known about the term 'impacted teeth' before joining Bachelor in Dental Surgery course. The source of information was mostly the internet 27 (18.8%) followed by dentist 23 (16%). Most students 116 (80.6%) were familiar with third molar impactions, 62 (43.1%) knew about types of impacted teeth/impaction, and 100 (69.4%) were aware of the complications of not removing impacted teeth. CONCLUSIONS: Dental students should be provided with appropriate 'impacted teeth' education supported by practical experience. More detailed information regarding impacted teeth should be included in the curriculum for better understanding.


Assuntos
Dente Impactado , Estudos Transversais , Currículo , Humanos , Dente Serotino/cirurgia , Estudantes de Odontologia , Dente Impactado/epidemiologia , Dente Impactado/cirurgia
4.
J Evid Based Dent Pract ; 21(3): 101582, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34479679

RESUMO

PURPOSE: The present study aimed to assess differences in postoperative morbidity between prophylactic and symptomatic third molar removals, and to assess the effect of age on the recovery of the patient. METHODS: Patients admitted for third molar removal were prospectively followed up four times during treatment in context of the M3BE study. Data were collected through pre-, peri and postoperative surveys (days 3 and 10). Uni- and multivariable logistic regression was used to assess the probability of postoperative symptoms of discomfort on day 3 and day 10 according to several patient- and surgery-related predictive factors (age, gender, indication for removal, method of extraction, anesthesia and number of extracted maxillary and/or mandibular third molars). RESULTS: In total, 6010 patients with a mean age of 25.2 (± 11.2) underwent 6347 surgeries to have 15,357 third molars removed. Frequently observed symptoms of postoperative discomfort were pain, trismus and swelling, all of which were transient in nature with steep decreases from postoperative days 3 to 10. Increasing age was associated with an enhanced risk of persistent pain, trismus and swelling and a significantly higher risk of iatrogenic injury to the inferior alveolar nerve. Symptomatic indications for removal were more common in patients over age 25 years, but these pre-existing pathologies did not compromise the postoperative recovery process. Other factors related to postoperative morbidity were female gender, intraoperative osteotomy and the number of extractions. CONCLUSION: The results of this study suggest that there are convincing patient- and surgery-related factors that favor timely third molar removal, preferably before the age of 25, especially in order to avoid persistent morbidity and nerve complications.


Assuntos
Dente Serotino , Dente Impactado , Adulto , Feminino , Humanos , Mandíbula/cirurgia , Dente Serotino/cirurgia , Morbidade , Extração Dentária/efeitos adversos , Dente Impactado/cirurgia , Trismo/prevenção & controle
5.
Behav Neurol ; 2021: 9536054, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34539935

RESUMO

Background: The purpose of this meta-analysis was to assess the clinical efficacy of etoricoxib in comparison with traditional NSAIDs for postoperative pain after third molar surgery. Methods: The quality of studies found in PubMed and Google Scholar was evaluated with Cochrane Collaboration's risk of bias tool. Data on total consumption of rescue analgesics, number of patients using rescue analgesics, global assessment of study treatments, and adverse effects were extracted exclusively from high-quality clinical trials. Each meta-analysis was performed with the Review Manager Software 5.3 for Windows. Results: The qualitative analysis showed that etoricoxib has better analgesic activity when compared with ibuprofen (2 clinical trials) and diclofenac (1 clinical trial). A similar analgesic efficacy between etoricoxib and nonselective Cox-2 NSAIDs was informed in 3/8 studies (2 compared to ibuprofen and 1 to naproxen sodium). Moreover, the number of patients requiring rescue analgesics in the postoperative period showed a statistical difference in favor of etoricoxib when compared to NSAIDs. Conclusion: Etoricoxib significantly reduces the number of patients needing rescue analgesics compared to NSAIDs after third molar surgery.


Assuntos
Dente Serotino , Sulfonas , Analgésicos , Etoricoxib , Humanos , Dente Serotino/cirurgia , Piridinas/uso terapêutico , Sulfonas/uso terapêutico
6.
Biomed Res Int ; 2021: 7492852, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34527743

RESUMO

Background: The aim of the present study is to compare the dental anxiety levels between two outpatient clinics. Methods: Two hundred and seventy patients treated in two different clinics of minor oral surgery and dental extraction polyclinic in the Dental Faculty of Eskisehir Osmangazi University were included in the study. The impacted third molar surgery group and conventional dental extraction group consisted of 101 and 169 patients, respectively. The Modified Dental Anxiety Scale (MDAS) and Dental Fear Scale (DFS) were used to measure anxiety levels in patients treated in both clinics. Tests were made in an isolated room preoperatively. The differences in anxiety levels according to education status and gender were also evaluated. Results: The impacted third molar surgery group showed a significant increase in dental anxiety measured with DFS questionnaire (p < 0.05). However, MDAS revealed that there was no difference between anxiety levels between the impacted third molar surgery and conventional dental extraction groups (p > 0.05). There was also no difference in anxiety levels between patients with different education status (p > 0.05). Female patients demonstrated higher levels of anxiety in both MDAS and DFS indexes (p < 0.05). Conclusion: Dental anxiety may be higher in patients treated with impacted third molar surgery compared with conventional dental extraction. The education status of patients may not affect dental anxiety. Female patients may show increased levels of dental anxiety in conventional dental and impacted third molar extractions.


Assuntos
Ansiedade ao Tratamento Odontológico/psicologia , Dente Serotino/cirurgia , Dente Impactado/psicologia , Adulto , Instituições de Assistência Ambulatorial , Escolaridade , Feminino , Humanos , Masculino , Fatores Sexuais , Inquéritos e Questionários , Extração Dentária/efeitos adversos , Extração Dentária/métodos , Dente Impactado/cirurgia , Turquia
7.
Evid Based Dent ; 22(3): 104-105, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-34561661

RESUMO

Data sources The review carried out electronic searches using several online databases through November 2018, namely PubMed, Virtual Health Library, Cochrane Library and Scopus. Terms searched for on these databases included third molar, flap and variations thereof. A grey literature search was also conducted.Study selection In total, 2,455 articles were identified,1,449 being duplicates. Additionally, 1,006 articles remained for assessment which, with clear exclusion criteria listed, was reduced to 20. From the 20 incorporated into the review, 18 articles were utilised for meta-analysis. Three of the researchers were involved in assessing the articles after research management software was used to remove the aforementioned duplicates. A Cohen's kappa index was calculated to confirm inter-rater consistency using 10% of the articles.Data extraction and synthesis Data extraction followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidance.Results From their systematic review and meta-analyses, the authors found that flap design had no effect on common post-operative complications including pain, trismus, dehiscence, or osteitis. The triangular flap did, however, have greater post-operative ecchymosis but reduced periodontal probing depth on day seven when compared to the envelope flap in mandibular third molar surgeries.Conclusions Third molar surgery is carried out across all facets of dentistry, including general and specialised. Further studies must be carried out that look specifically at these variables utilising randomised controlled trials so a consensus can be achieved across the profession of which flap is of superior design.


Assuntos
Dente Serotino , Dente Impactado , Humanos , Mandíbula , Dente Serotino/cirurgia , Extração Dentária , Trismo
8.
Dent Clin North Am ; 65(4): 805-814, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34503668

RESUMO

The most common oral and maxillofacial surgical procedure in adolescents is excision of impacted third molars. Adolescent patients should be evaluated for third molars starting around age 16 years unless symptomatic at an earlier age. The dental examination should include panorex imaging to assess development, pathologic condition, and possibility of eruption versus impaction. Various classification systems are available to identify the position and difficulty of the proposed surgical procedure. Retained impacted teeth increase the patient's risk of various morbidities including recurrent infection, damage to adjacent teeth, cysts and other lesions, and unexplained pain.


Assuntos
Dente Impactado , Adolescente , Humanos , Mandíbula , Dente Serotino/diagnóstico por imagem , Dente Serotino/cirurgia , Radiografia Panorâmica , Dente Impactado/diagnóstico por imagem , Dente Impactado/cirurgia
9.
Int J Comput Dent ; 24(3): 253-262, 2021 09 23.
Artigo em Inglês | MEDLINE | ID: mdl-34553890

RESUMO

AIM: Most of the intra- and postoperative patient discomfort related to complex mandibular third molar (M3M) extraction is proportional to the invasiveness of the surgery. This can be minimized through the support of dynamic navigation (DN) technology, which can be successfully applied in dental implantology. Materials and methods: Three patients, one female (aged 25 years) and two males (aged 18 and 51 years, respectively) underwent the DN-supported extraction of partially impacted M3Ms with a flapless approach that required minimal bone removal. The patients' discomfort and the speed of recovery were considered to be proof of the quality of the adopted procedure. RESULTS: No postoperative discomfort such as pain or swelling was recorded in the immediate postoperative period, and no complications were reported within a month of the surgery. No medications were prescribed. The procedure lasted no longer than 20 min in all cases. CONCLUSION: Using DN technology, the real-time 3D monitoring of the clinical situation in each surgical phase enabled the surgeon to avoid soft tissue detachment as well as limit bone loss and intraoperative bleeding, thanks to a precise multi--section of the tooth and important nearby anatomical structures, respectively.


Assuntos
Dente Serotino , Dente Impactado , Feminino , Humanos , Masculino , Mandíbula/cirurgia , Dente Serotino/cirurgia , Tecnologia , Extração Dentária , Dente Impactado/cirurgia
10.
BMC Oral Health ; 21(1): 428, 2021 09 05.
Artigo em Inglês | MEDLINE | ID: mdl-34482829

RESUMO

BACKGROUND: Juxta-apical radiolucency (JAR) has been presented as a radiographic sign, suggestive of the IAN injury through third molar surgery. This study aimed to evaluate the relation of JAR with IAN injury in cone-beam computed tomography (CBCT) images and to determine whether the presence of JAR is related to tooth angulation, proximity to the mandibular canal, position to the IAN, and thinning of the cortical plates. METHODS: Of an initial sample of 545 mandibular third molars, a total of 75 JAR+ and 75 JAR- teeth were evaluated by CBCT. We assessed the relationship between the presence of JAR in cone-beam computed tomography (CBCT) images and the presence of IAN injury after mandibular third molar surgeries. Moreover, we investigated whether the presence of IAN injury is related to tooth angulation, proximity to the mandibular canal, position to the IAN, and thinning of the cortical plates. Descriptive statistics, Chi-square test, and Fisher's exact test were performed for statistical analysis. RESULTS: A significant relationship was found between JAR and temporary IAN injury (P = 0.036). However, there was no case of permanent IAN injury. IAN injury showed no significant relationship with the tooth angulation, position to IAN and proximity to the mandibular canal, lingual cortical plate thinning, sex, and age. CONCLUSIONS: JAR is generally in contact with the mandibular canal, and some degree of cortical thinning can be found in most cases. In this study, JAR was significantly related to temporary IAN injury. JAR may increase the risk of nerve injury during the surgical removal of third molars.


Assuntos
Dente Serotino , Dente Impactado , Humanos , Mandíbula/diagnóstico por imagem , Mandíbula/cirurgia , Dente Serotino/diagnóstico por imagem , Dente Serotino/cirurgia , Radiografia Panorâmica , Estudos Retrospectivos , Dente Impactado/diagnóstico por imagem , Dente Impactado/cirurgia
11.
Rev Med Liege ; 76(9): 648-650, 2021 Sep.
Artigo em Francês | MEDLINE | ID: mdl-34477333

RESUMO

We here describe the story of a young man who developed a major pneumomediastinum after the removal of a wisdom tooth. The patient was hospitalized in the intensive care unit for continuous monitoring and for the administration of prophylactic antibiotic therapy to avoid infectious complications. Pneumomediastinum after dental procedures has already been reported and its management, although simple, remains subject to major complications if inadequately treated.


Assuntos
Enfisema Mediastínico , Enfisema Subcutâneo , Dor no Peito/etiologia , Humanos , Masculino , Enfisema Mediastínico/diagnóstico por imagem , Enfisema Mediastínico/etiologia , Dente Serotino/cirurgia , Enfisema Subcutâneo/etiologia , Extração Dentária/efeitos adversos
12.
BMC Oral Health ; 21(1): 462, 2021 09 23.
Artigo em Inglês | MEDLINE | ID: mdl-34556118

RESUMO

BACKGROUND: How to prevent pain after the extraction of impacted teeth is a serious challenge for all patients. The purpose of this clinical trial was to investigate whether pre-emptive low dose of etoricoxib can reduce postoperative pain in patients undergoing third molars surgery. METHODS: Patients were randomised to receive etoricoxib 60 mg or placebo 30 min before surgery. Post-operative pain was recorded using a visual analogue scale during 24 h within the post-operative period. The total dose of ibuprofen rescue intake was recorded. Kaplan-Meier curves and log-rank analyses were used to evaluate the proportion of patients without rescue analgesic. RESULTS: Scores for the post-operative pain in the etoricoxib group were significantly lower than those in the placebo group during first 12 h (p < 0.05). The number of patients without analgesic rescue medication was significantly lower in the etoricoxib group than in the placebo group. The average amount of rescue medication in the etoricoxib group (0.4 ± 0.9 dose) was lower than that in the placebo group (1.1 ± 0.9 doses, p = 0.004). Etoricoxib resulted in the long-term survival of patients without rescue analgesic (p < 0.001). CONCLUSIONS: This study revealed that etoricoxib has a substantial pre-emptive analgesic effect, resulting in the reduced use of analgesics after third molar removal. TRIAL REGISTRATION: Registered on ChiCTR1900024503. Date of Registration: 13/07/2019.


Assuntos
Dente Serotino , Dente Impactado , Método Duplo-Cego , Etoricoxib , Humanos , Dente Serotino/cirurgia , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/prevenção & controle , Extração Dentária , Dente Impactado/cirurgia
13.
Artigo em Inglês | MEDLINE | ID: mdl-34443998

RESUMO

Due to the frequent development of non-infectious complications after surgical removal of the third lower impacted tooth, many techniques are used to reduce their severity. Among them is the technique of applying platelet-rich fibrin to the post-extraction alveolus. The study included 90 consecutively enrolled patients. Eligible patients were randomly assigned to two groups: patients with and without platelet-rich fibrin introduced into the postoperative alveolus. Pain, swelling, trismus, and temperature were evaluated after the procedure. Pain intensity was significantly higher in the control group than in the study group at 6 h, 1, and 3 days after surgery. PRF application did not significantly affect the intensity of swelling. Body temperature was significantly higher in the control group than the study group on day two after surgery. The trismus was significantly higher in the control group than in the study group at one, two, and seven days after surgery. Application of the PRF allows for a faster and less traumatic treatment process. It will enable for speedier recovery and return to active life and professional duties.


Assuntos
Fibrina Rica em Plaquetas , Dente Impactado , Humanos , Dente Serotino/cirurgia , Dor Pós-Operatória/prevenção & controle , Extração Dentária/efeitos adversos , Dente Impactado/cirurgia
14.
Head Face Med ; 17(1): 33, 2021 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-34389020

RESUMO

BACKROUND: This study was designed to analyse the value of preoperative Cone Beam CTs (CBCT) prior to the surgical removal of complex lower third molars. Furthermore, the aim was to assess injuries to the inferior alveolar nerve (IAN) bundle and postoperative neurological disorders depending on the position of the lower third molar and the inferior alveolar nerve bundle. METHODS: In this retrospective examination preoperative Cone Beam CTs and Orthopantomographs (OPT) of 324 patients were analysed concerning the location of the lower third molars in relation to the mandible and the inferior alveolar nerve bundle. Surgery protocols of all patients who underwent the surgical removal of at least one complex lower third molar were analysed concerning patient data, length of surgery, intraoperative haemorrhage, intraoperative exposure of the inferior alveolar nerve bundle, postoperative swelling and postoperative neurological disorders. The data was then compared to data from international studies. RESULTS: In all 324 patients a permanent neurological damage was not found. Temporary neurological damage was recorded in 13 cases (2.6%). A caudal nerve position with no measurable distance to the root of the lower third molar was associated with the highest risk of a temporal neurological damage. A vestibular touching nerve route also correlated with postoperative sensitivity impairment. If a mesioangulation (Winter) or a Pell and Gregory Type IIIC appears in the OPT, risk of neurological damage is at its highest. CONCLUSIONS: Three-dimensional radiographic imaging, in our patient group, does not significantly affect the risk for complications during the surgical removal of complex lower third molars. Therefore, it should only be utilized for risk assessment, especially in cases of symptom-free lower third molars. A preoperative orthopantomogram still can be accepted as standard for radiographic imaging. An intraoperative exposure of the IAN bundle does not necessarily predict simultaneous neurological damage. Exposure of the IAN bundle is no indication for a discontinuation of the surgery.


Assuntos
Dente Impactado , Traumatismos do Nervo Trigêmeo , Tomografia Computadorizada de Feixe Cônico , Humanos , Mandíbula/diagnóstico por imagem , Mandíbula/cirurgia , Nervo Mandibular/diagnóstico por imagem , Dente Serotino/diagnóstico por imagem , Dente Serotino/cirurgia , Radiografia Panorâmica , Estudos Retrospectivos , Extração Dentária/efeitos adversos , Dente Impactado/diagnóstico por imagem , Dente Impactado/cirurgia , Traumatismos do Nervo Trigêmeo/prevenção & controle
15.
BMJ Case Rep ; 14(8)2021 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-34344652

RESUMO

Patients with rapidly progressing periodontitis may require extractions of teeth with poor periodontal prognosis. Although replacement with a dental implant is a popular choice, teeth autotransplantation remains a viable option. Herein, we report a case of a 23-year-old patient with rapidly progressing periodontitis resulting in severe clinical attachment loss on the left maxillary first molar, which required extraction. The tooth was replaced by tooth autotransplantation of the unerupted immature left mandibular third molar, which was delivered carefully without compromising the periodontal ligament. Cone beam computed tomography and three-dimensional printing of the third molar donor tooth significantly aided the tooth autotransplantation procedure. Recovery was uneventful. At the 1-year follow-up, healthy periodontal parameters and radiographic features were noted, and the autotransplanted tooth remained vital. This case showed that tooth autotransplantation is a viable option for replacing tooth loss due to rapidly progressing periodontitis.


Assuntos
Periodontite , Dente , Adulto , Humanos , Dente Molar/diagnóstico por imagem , Dente Molar/cirurgia , Dente Serotino/diagnóstico por imagem , Dente Serotino/cirurgia , Periodontite/complicações , Periodontite/diagnóstico por imagem , Periodontite/cirurgia , Impressão Tridimensional , Transplante Autólogo , Adulto Jovem
16.
BMC Oral Health ; 21(1): 393, 2021 08 11.
Artigo em Inglês | MEDLINE | ID: mdl-34380473

RESUMO

BACKGROUND: Surgical extraction of the impacted mandibular third molar is commonly associated with postoperative pain, swelling, and trismus. Usually, rotatory instruments like burs have been used for osteotomy, while Piezosurgery is an innovative technique introduced to overcome the weaknesses related to the conventional technique. In addition, Dexamethasone administration before the extraction of impacted third molars is an efficient way to reduce postoperative pain due to robust anti-inflammatory activity. The purpose of the study is to evaluate the effect of piezo-surgery and dexamethasone injection on postoperative sequelae after the surgical extraction of impacted mandibular third molars, and ultimately to compare their effect on reducing postoperative pain. METHODS: A randomized controlled clinical trial was conducted with a sample of 80 patients. Participants were divided into four groups: Group 1 (Conventional rotatory), Group 2 (Conventional rotatory with 8 mg dose of dexamethasone 30 min before surgery), Group 3 (Piezo-surgery), and Group 4 (Piezo-surgery with 8 mg dose of dexamethasone 30 min before surgery). The outcome variables were surgical working time calculated in minutes, maximal mouth opening measured in millimeters using Vernier Caliper at baseline and day 3 and postoperative pain assessed using a Visual Analog Scale (VAS) on days 1, 3, and 7. RESULTS: The surgical working time was longer in piezo-surgery groups compared with the conventional rotatory instruments groups (15.82 ± 3.47 vs 23.33 ± 2.54; p value < 0.0001). The lowest reduction in mouth opening between baseline and 3rd-day post-op was found in the Piezo-surgery with Dexamethasone group (mean difference = 5.0, SD = 3.9, p value < 0.0001) followed by the Piezosurgery without Dexamethasone group (mean difference = 5.8, SD = 4.5, p value < 0.0001) and the highest average was reported by the Conventional rotatory without Dexamethasone (mean difference = 9.7, SD = 4.5, p value < 0.0001. In the four groups, the mean pain score was highest on the 1st day and gradually decreased over the following days. Comparison of the 1st and 3rd postoperative pain between groups revealed a lowest mean pain score in the Piezo-surgery with Dexamethasone group, followed by Conventional rotatory with Dexamethasone group and a highest mean score in the Conventional rotatory without Dexamethasone group (p value < 0.0001). CONCLUSION: The association of Piezosurgery osteotomy and Dexamethasone intramuscular injection could be an effective combination to reduce postoperative pain and trismus after impacted third molar surgery. TRIAL REGISTRATION: NCT04889781 ( https://clinicaltrials.gov/ ), Date of Registration: 17/05/2021 (retrospectively registered), https://clinicaltrials.gov/ct2/show/NCT04889781?term=NCT04889781&draw=2&rank=1.


Assuntos
Dente Serotino , Dente Impactado , Dexametasona/uso terapêutico , Edema/etiologia , Edema/prevenção & controle , Humanos , Injeções Intramusculares , Mandíbula/cirurgia , Dente Serotino/cirurgia , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/prevenção & controle , Estudos Prospectivos , Extração Dentária/efeitos adversos , Dente Impactado/cirurgia , Trismo/prevenção & controle
17.
Acta Medica (Hradec Kralove) ; 64(2): 101-107, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34331430

RESUMO

Iatrogenic mandible fracture is a rare complication of a tooth extraction with an incidence between 0.0033-0.0034%. This study retrospectively analyzes a total of 8 patients who underwent lower molar extraction associated with mandible fracture during tooth removal in the period from April 2006 to March 2019. The assessed parameters were age and sex of patients, method of tooth extraction, side distribution of fracture, type of extracted tooth, the position of a lower third molar, presence of bone pathological lesion formed in connection with a tooth, displacement of bone fragments, and sensory impairment in the innervation area of the mental nerve. The position and impaction of the lower third molars were evaluated according to Pell and Gregory's classification and Winter's classification. One fracture was left-sided, and 7 fractures were right-sided. In 6 cases, Winter's extraction elevator was used. In 7 patients, the mandible fracture was treated surgically by performing stable osteosynthesis with the plates and screws. One patient was treated conservatively. This work analyzes the causes of iatrogenic mandible fractures and provides recommendations to reduce the risk of their occurrence.


Assuntos
Fraturas Mandibulares/etiologia , Dente Serotino/cirurgia , Extração Dentária/efeitos adversos , Feminino , Humanos , Doença Iatrogênica , Masculino , Fraturas Mandibulares/terapia , Estudos Retrospectivos
18.
Clin Oral Investig ; 25(9): 5139-5148, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34297233

RESUMO

OBJECTIVE: The purpose of this study was to evaluate whether Kinesio taping (KT) can improve patient discomfort after mandibular third molar surgery. MATERIALS AND METHODS: This systematic review and meta-analysis was conducted according to the PICO strategy. We searched 4 databases for related articles. All controlled trials or randomized controlled trials that evaluated the application of KT after mandibular third molar surgery were included. Screening and article selection were carried out by two independent reviewers. The main evaluation indicators were facial swelling, pain, and trismus. All statistical analyses were conducted using Review Manager 5.3 software. RESULT: This analysis included 8 articles. The combined results showed that compared with the control group, the postoperative application of KT significantly reduced pain in the early (early stage mean difference (MD), - 2.00; 95% confidence interval (CI), - 2.40 to - 1.60; P < 0.00001) and late (late stage MD, - 1.18; 95% CI, - 2.26 to - 0.11; P = 0.03) postoperative periods and, thus, reduced the intake of painkillers. KT also reduced facial swelling in the early and late postoperative periods (early stage standardized mean difference (SMD), - 1.34; 95% CI, - 1.99 to - 0.68; P < 0.0001; late stage SMD, - 0.31; 95% CI, - 0.51 to - 0.11; P = 0.002). In addition, the postoperative application of KT improved restricted mouth opening in the early and late postoperative periods (early stage MD, - 5.03 mm; 95% CI, - 6.32 to - 3.74 mm; P < 0.00001; late stage MD, - 3.42 mm; 95% CI, - 5.31 to - 1.52 mm; P = 0.0004). CONCLUSION: KT can significantly reduce postoperative pain, swelling, and trismus after impacted mandibular tooth extraction. Additional high-quality and rigorously designed randomized controlled trials should be conducted to verify these conclusions. CLINICAL RELEVANCE: KT is a low-cost, simple, effective nondrug therapy for the postoperative management of mandibular third molar extraction and has broad prospects for clinical application.


Assuntos
Dente Serotino , Dente Impactado , Edema/etiologia , Edema/prevenção & controle , Humanos , Mandíbula/cirurgia , Dente Serotino/cirurgia , Dor Pós-Operatória/prevenção & controle , Extração Dentária , Trismo/prevenção & controle
19.
Indian J Dent Res ; 32(1): 87-91, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34269243

RESUMO

Introduction: The way postoperative care instructions are presented by the professional (verbal and/or written) is the key element that influences quality of treatment. Hence, the aim of the present study was planned to assess the patient's compliance with postoperative care instructions given in different forms following the surgical removal of impacted lower third molars. Materials and Methods: Forty patients scheduled to undergo surgical extraction of impacted lower third molars under local anesthetic were randomly assigned to one of two groups. Before surgery, basic demographic data about age, gender, deleterious habits were recorded. Group A (verbal postoperative care instructions) and Group B (verbal + pictorial postoperative care instructions) were given with a prescription of medication after the surgical removal of impacted lower third molars. Patient were recalled on 7th postoperative day for suture removal and asked to fill the closed-ended questionnaire. Results: Out of 20 patients in each group, one patient from Group A was eliminated as the patient did not turn for the follow-up visit. Therefore, result was based on 39 patients (19 males and 20 females) of age 28-41 years with a mean of 33.2 years (SD ± 3.3). The significance level was set at P < 0.05. The compliance of patients regarding gargling with lukewarm water and mouth opening exercises was seen more significantly in Group B (Pictorial + Verbal). Conclusion: Verbal instructions are inadequate due to difficulty in retention. Hence, a pictorial form of delivering postoperative instructions increases information retention which significantly increases pain relief without extending the analgesic consumption.


Assuntos
Dente Serotino , Dente Impactado , Adulto , Analgésicos , Feminino , Humanos , Masculino , Dente Serotino/cirurgia , Dor Pós-Operatória/prevenção & controle , Cooperação do Paciente , Extração Dentária , Dente Impactado/cirurgia
20.
Artigo em Inglês | MEDLINE | ID: mdl-34205078

RESUMO

Classifications of impacted teeth allow defining the type and degree of retention, as well as assessing the degree of difficulty of the procedure. The aim of this study was to conduct retrospective analysis of the degree of retention and difficulty in the surgical removal of impacted mandibular third molars in the clinical material of the Department of Oral Surgery in 2013-2018. This study included 1585 dental panoramic radiographs of patients of the Department of Oral Surgery, who reported in 2013-2018, in order to perform surgical removal of the impacted mandibular third molar. Based on dental panoramic radiographs, the degree of retention was determined based on classifications according to Winter, according to Pell and Gregory, according to Tetsch and Wagner, and according to Asanami and Kasazaki. The difficulty of the procedure was also assessed based on the Pederson index. The most common types of lower wisdom tooth impaction are as follows: in Winter's classification, mesial-angular impaction; in Tetsch and Wagner's classification, oblique medial-angular impaction; in Pell and Gregory's classification, impaction grade 2A; and in Asanami and Kasazaki's classification, 3A and anterior inclination. In most cases of surgical removal of an impacted tooth, the anticipated difficulty of the procedure was rated as very difficult.


Assuntos
Dente Serotino , Dente Impactado , Humanos , Mandíbula/diagnóstico por imagem , Mandíbula/cirurgia , Dente Molar , Dente Serotino/diagnóstico por imagem , Dente Serotino/cirurgia , Estudos Retrospectivos , Dente Impactado/diagnóstico por imagem , Dente Impactado/epidemiologia , Dente Impactado/cirurgia
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