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1.
Rev. Odontol. Araçatuba (Impr.) ; 41(2): 45-51, maio-ago.2020. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1102698

RESUMO

Dentes impactados são caracterizados pela falha na erupção dentro do tempo cronológico. O termo ''dente invertido'' se refere ao mau posicionamento do dente, caracterizando-se pelo dente na direção contrária à usual. A inversão de dente impactado é considerada um fenômeno raro. Em casos mais complexos de impacção dentária, há a necessidade de um tratamento conservador, específico e procura-se prevenir possíveis danos às estruturas anatômicas adjacentes. Por essa razão, a técnica cirúrgica denominada coronectomia, também conhecida como odontectomia parcial intencional, tem, em alguns casos, indicação de uso, pois realiza-se a exérese da porção coronária do dente, sepultando as suas raízes, quando estas se encontram em contato com estruturas nobres. Dessa forma, este trabalho tem como objetivo apresentar um caso raro da utilização da técnica de coronectomia para um terceiro molar superior invertido em paciente do sexo feminino, 26 anos, que compareceu ao serviço de Cirurgia Buco-Maxilo-Facial apresentando um terceiro molar superior, assintomático, impactado em posição invertida no lado esquerdo. Ao exame tomográfico, apresentou íntimo contato do dente 28 com as raízes do 27. A porção coronária se encontrava em posição superior, em direção a parte posterior do seio maxilar. A técnica da coronectomia foi escolhida como planejamento cirúrgico, a fim de proteger o dente 27 das possíveis consequências traumáticas que a luxação e extração completa do dente 28 poderia ocasionar. O acompanhamento clínico demonstrou que a técnica foi bem indicada, com evolução de neoformação óssea completa na região da coroa removida e o dente adjacente com vitalidade e em função mastigatória(AU)


Impacted teeth are characterized by eruption failure within chronological time. The term 'inverted tooth' refers to the mispositioning of the tooth, characterized by the tooth in the opposite direction to the usual one. Impacted tooth inversion is considered a rare phenomenon. In more complex cases of dental impaction, there is a need for conservative and specific treatment, and attempts are made to prevent possible damage to adjacent anatomical structures. For this reason, the surgical technique called coronectomy, also known as intentional partial odontectomy, has, in some cases, indication of use, where the coronary portion of the tooth is excised, burying its roots when they are in contact with noble structures. Thus, this paper aims to present a rare case of the use of the inverted upper third molar coronectomy technique in a 26-year-old female patient, who attended the Buccomaxillofacial Surgery Service presenting a superior third molar, asymptomatic, impacted in inverted position on the left side. At tomographic examination, the patient presented close contact of tooth #16 with the roots of tooth #15. The coronary portion was in the superior position, towards the posterior part of the maxillary sinus. The coronectomy technique has been chosen as a surgical planning in order to protect tooth #15 from the possible traumatic consequences that dislocation and complete extraction of tooth #16 could cause. Clinical follow-up showed that the technique was successfully indicated, with complete bone neoformation in the removed crown area and the adjacent tooth with vitality and masticatory function(AU)


Assuntos
Humanos , Feminino , Adulto , Dente Impactado/cirurgia , Dente Serotino/cirurgia , Extração Dentária , Dente Impactado , Dente Serotino
2.
Cochrane Database Syst Rev ; 7: CD004345, 2020 07 26.
Artigo em Inglês | MEDLINE | ID: mdl-32712962

RESUMO

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.


Assuntos
Dente Serotino/cirurgia , Extração Dentária/métodos , Dente Impactado/cirurgia , Adulto , Viés , Drenagem/métodos , Alvéolo Seco/etiologia , Humanos , Lábio , Mandíbula , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Transtornos das Sensações/etiologia , Retalhos Cirúrgicos , Infecção da Ferida Cirúrgica/etiologia , Irrigação Terapêutica/métodos , Língua , Extração Dentária/efeitos adversos , Técnicas de Fechamento de Ferimentos , Adulto Jovem
3.
Rev. esp. cir. oral maxilofac ; 42(2): 69-75, abr.-jun. 2020. ilus, graf
Artigo em Espanhol | IBECS | ID: ibc-189943

RESUMO

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


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Dexametasona/administração & dosagem , Anti-Inflamatórios/uso terapêutico , Dente Serotino/cirurgia , Extração Dentária/métodos , Complexo Vitamínico B/uso terapêutico , Resultado do Tratamento
4.
Cochrane Database Syst Rev ; 5: CD003879, 2020 05 04.
Artigo em Inglês | MEDLINE | ID: mdl-32368796

RESUMO

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.


Assuntos
Dente Serotino/cirurgia , Extração Dentária/métodos , Dente Impactado/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Assintomáticas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto , Conduta Expectante
5.
BMC Oral Health ; 20(1): 77, 2020 03 18.
Artigo em Inglês | MEDLINE | ID: mdl-32183831

RESUMO

BACKGROUND: The purpose of this study was to compare the effectiveness of absorbable collagen sponge insertion in tooth extraction sites for socket healing of the impacted mandibular third molar. METHODS: Thirty-six patients with bilateral mandibular impacted third molars based on Pell-Gregory and Winter classification were included in this study. This study was a randomized clinical trial utilizing a split-mouth design with one side assigned as collagen sponge insertion and the other side assigned as the control. Post-operative clinical complications, periodontal integrities, and radiographic outcomes were assessed at 1, 2, and 14-weeks post operatively. RESULTS: Five patients were excluded during the follow-up period due to loss of follow-up. The study was conducted on 31 patients in total. The mean VAS score of collagen sponge insertion side at 1 week post operation was 1.42 ± 1.26, which was significantly lower than the control side (P < 0.05). The mean probing depth of collagen sponge insertion side at 2-week post operation was 5.55 ± 2.28 mm, which was significantly lower than the control side (7.13 ± 1.86; P < 0.05). Other various measurements including radiographic outcomes showed no significant group differences. CONCLUSIONS: Placement of collagen sponge after extraction of mandibular impacted third molar reduced early stage post-operative complications and enhanced initial healing of soft tissues and periodontal defects. TRIAL REGISTRATION: This study was retrospectively registered at the WHO ICTRP platform and Clinical Research Information Service, KCT0003363. Registered 21 Sep 2018.


Assuntos
Materiais Biocompatíveis/administração & dosagem , Colágeno/administração & dosagem , Dente Serotino/cirurgia , Tampões de Gaze Cirúrgicos , Extração Dentária , Dente Impactado/cirurgia , Adulto , Feminino , Humanos , Masculino , Mandíbula/cirurgia , Resultado do Tratamento , Técnicas de Fechamento de Ferimentos , Cicatrização
6.
BMC Oral Health ; 20(1): 41, 2020 02 05.
Artigo em Inglês | MEDLINE | ID: mdl-32024498

RESUMO

BACKGROUND: This study aimed to evaluate the efficacy of ozonized water on pain, oedema and trismus after impacted third molar mandibular surgeries when compared to double distilled water. A randomized triple blind trial was conducted. METHODS: Patients with third molars class II-B of Pell-Gregory were included, and surgical extraction was performed. Irrigation was done with ozonized (group 1) or double distilled water (group 2). The type of irrigation and the side to be operated were randomized. Neither the patients nor the operator or evaluator were aware of the irrigation solution. Pain, oedema and trismus were evaluated at baseline, 24-h, 48-h, 72-h and 7-days after treatment. The data were evaluated by Friedman, Wilcoxon, Mann-Whitney tests, and size effect. RESULTS: It was included 8 men and 12 women, with a mean age of 20.9y.o. The initial pain mean was 7.94 (±12.81) (group 1) and 5.50 (±9.12) (group 2) (p > 0,05). There was a statistically significant reduction of pain, oedema and trismus in intragroup analysis (p < 0.05). There was no statistically significant difference (p > 0.05) when comparing the oedema and trismus between groups. The size effect ranged from small (0.23) to large (1.29). CONCLUSIONS: It was concluded that ozonized water was compatible as irrigation method, not inferior to double distilled water, and had satisfactory effects on management of pain, oedema and trismus after surgical removal of the third molar. TRIAL REGISTRATION: This clinical trial was registered in ClinicalTrials.gov NCT03501225 on April 18, 2018.


Assuntos
Edema/terapia , Dente Serotino/cirurgia , Ozônio/uso terapêutico , Dor Pós-Operatória/terapia , Extração Dentária/efeitos adversos , Dente Impactado/cirurgia , Trismo/terapia , Água/farmacologia , Método Duplo-Cego , Edema/etiologia , Feminino , Humanos , Masculino , Dor Pós-Operatória/etiologia , Resultado do Tratamento , Trismo/etiologia
7.
Medicine (Baltimore) ; 99(7): e19177, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32049850

RESUMO

RATIONALE: Tooth extraction is a common dental surgical procedure. There is a possibility that various complications often occur during third molar tooth extractions. PATIENT CONCERNS: The authors report herein 2 cases of migration of a high-speed dental hand-piece bur during mandibular third molar extraction-one case with the iatrogenic foreign body migrating into the mandibular body and another case with the iatrogenic foreign body migrating into the floor of mouth are reported. DIAGNOSIS: The patient was diagnosed with the iatrogenic foreign body associated with mandibular third molar extraction by imaging examinations. INTERVENTIONS: The authors performed elective surgery to remove the foreign body under general anesthesia in Case 1, and performed emergency surgery to remove the foreign body under local anesthesia in Case 2. OUTCOMES: The foreign bodies were removed, and complete removal of the foreign bodies was confirmed by postoperative x-ray examination. The patients' postoperative courses were uneventful. LESSONS: The selection of adequate surgical procedures and instruments will prevent the occurrence of iatrogenic foreign bodies. If migration accidents occur, their positions should first be confirmed by imaging examinations. Dentists and/or oral surgeons should perform removal operations considering the degree of emergency based on the results of imaging examinations.


Assuntos
Migração de Corpo Estranho/etiologia , Dente Serotino/cirurgia , Extração Dentária/efeitos adversos , Adulto , Feminino , Migração de Corpo Estranho/cirurgia , Humanos
8.
Plast Reconstr Surg ; 144(6): 1393-1402, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31764658

RESUMO

BACKGROUND: Mandibular angle fractures are common and frequently involve a tooth in the fracture line. Despite trends toward more conservative indications for tooth extraction during open repair, the literature remains heterogeneous. This review aims to ascertain the effect of tooth extraction/retention on patient outcomes following mandible open reduction and internal fixation and to evaluate the evidence surrounding indications for extraction. METHODS: PubMed, EMBASE, the Cochrane Library, Elsevier text mining tool database, and clinicaltrials.gov were queried through March of 2018 for English language publication on adults with traumatic mandibular fractures. The review protocol was not registered online. Quality of evidence was assigned using the Grading of Recommendations Assessment, Development and Evaluation methodology. Meta-analyses were performed when definitions of outcomes were deemed similar. RESULTS: Overall, 26 of 1212 identified studies met inclusion criteria. Indications for tooth extraction and rates of extraction varied considerably across studies. The quality of evidence was low or very low for all outcomes. Tooth retention was associated with lower overall complications (OR, 0.54; 95 percent CI, 0.37 to 0.79), major complications requiring readmission or reoperation (OR, 0.47; 95 percent CI, 0.24 to 0.92), and malocclusion (OR, 0.56; 95 percent CI, 0.32 to 0.97); there was no difference in wound issues or nonunion. Removal of asymptomatic teeth was associated with inferior alveolar nerve injury (39.4 percent versus 16.1 percent). CONCLUSIONS: The literature is limited by retrospective study deign and poor follow-up; however, when indicated, tooth extraction is not associated with an increased risk of infection or nonunion. Removal of asymptomatic teeth was associated with a risk of inferior alveolar nerve injury. Additional high-quality studies are needed to evaluate potentially expanded indications for tooth extraction.


Assuntos
Fixação Interna de Fraturas/métodos , Fraturas Mandibulares/cirurgia , Redução Aberta/métodos , Extração Dentária/métodos , Humanos , Mandíbula/cirurgia , Dente Serotino/cirurgia , Complicações Pós-Operatórias/etiologia , Reoperação/estatística & dados numéricos , Infecção da Ferida Cirúrgica/etiologia
9.
Med. oral patol. oral cir. bucal (Internet) ; 24(6): e746-e751, nov. 2019. ilus, tab, graf
Artigo em Inglês | IBECS | ID: ibc-192234

RESUMO

BACKGROUND: The aim of this study was to compare the anti-inflammatory effects of dexamethasone and etoricoxib after third molar extraction. MATERIAL AND METHODS: A prospective, randomized, controlled, split-mouth study was conducted. 19 volunteers were allocated randomly to receive 90mg etoricoxib 1 hour prior to the procedure or 4mg intramuscular dexamethasone immediately after anesthesia. Baseline measurements were obtained preoperatively, and subsequent assessments were made on immediate postoperative, at 72 hours and 7 days after surgery to measure postoperative facial swelling by use of linear measurements, interincisal mouth opening width and visual analog scale score for pain. The amount of analgesics consumed was recorded. Descriptive statistics and the independent-samples t-test were used to compare the two groups at P < 0.05. RESULTS: Dexamethasone was effective in the control roasted edema for measurements of the mandibular angle - wing of the nose and mandibular angle - labial commissure 72 hours after surgery. And for the measurement mandibular angle - mentum, in the time of 72 hours and 7 days. There was no statistically significant difference in relation to pain and trismus. CONCLUSIONS: Considering significant results for some measures of the variable edema for the group that used intramuscular dexamethasone and the difference without statistical significance between groups for the other variables studied, we seem to reflect the intramuscular indication of the corticosteroid in a single dosage in relation to the use of etoricoxib as pre-emptive medication


No disponible


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Dente Serotino/cirurgia , Dente Impactado/cirurgia , Dexametasona/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Etoricoxib/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Método Duplo-Cego , Edema/prevenção & controle , Medição da Dor , Dor Pós-Operatória/prevenção & controle , Estudos Prospectivos , Extração Dentária , Trismo
10.
J Radiol Case Rep ; 13(2): 1-8, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31565166

RESUMO

Retropharyngeal abscess is potentially associated with high morbidity and mortality as a result of its direct anatomical connection with the mediastinum. Therefore, knowledge of the relevant anatomy is essential for recognizing the presence and extent of disease in a timely manner. In this case report, we aim to review the pertinent anatomy and patterns of spread of infection from a full blown deep neck space infection to result in mediastinitis and empyema.


Assuntos
Mediastinite/diagnóstico por imagem , Dente Serotino/cirurgia , Pescoço/diagnóstico por imagem , Abscesso Retrofaríngeo/diagnóstico por imagem , Extração Dentária/efeitos adversos , Empiema/diagnóstico por imagem , Empiema/etiologia , Feminino , Fluoroscopia , Humanos , Mediastinite/etiologia , Complicações Pós-Operatórias/diagnóstico por imagem , Abscesso Retrofaríngeo/etiologia , Tomografia Computadorizada por Raios X , Adulto Jovem
11.
Rev. ADM ; 76(5): 267-271, sept.-oct. 2019. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-1053026

RESUMO

Introducción: La odontectomía del tercer molar produce una respuesta metabólica al trauma quirúrgico caracterizada por una importante infl amación del área, por lo que para su control se cuenta con diferentes opciones terapéuticas como la farmacoterapia, crioterapia y laserterapia, así como otras alternativas como la compresión de la región, cuya propuesta presentada en este trabajo es a través de la utilización de un apósito adhesivo facial. Objetivo: Evaluar la efi cacia de la aplicación de un apósito adhesivo facial para el control de la infl amación postquirúrgica de la odontectomía del tercer molar. Material y métodos: Se realizó un ensayo clínico controlado de fase I multicéntrico. Se conformó un grupo de estudio experimental y de control con 10 participantes en cada uno, de ambos sexos, de 18-30 años de edad, sanos y que presentaron un tercer molar inferior izquierdo retenido vertical o mesioangular, clase I o II, posición A o B (Pell y Gregory). Se efectuaron las odontectomías bajo anestesia local y sólo en el grupo experimental se utilizó un apósito adhesivo transparente marca Tegaderm® de 3M, el cual se colocó sobre la mejilla de los pacientes durante 48 horas. La evaluación de la infl amación se realizó con el método de Laskin modifi cado previo al procedimiento, a las 48 horas y en el quinto día postoperatorio. Resultados: El promedio de la longitud de la línea 1 a las 48 horas y al quinto día postoperatorio en el grupo experimental fue menor que en el grupo control siendo las diferencias estadísticamente signifi cativas. En el resto de las líneas, la longitud promedio también fue menor en el grupo experimental; sin embargo, no se encontraron diferencias estadísticamente signifi cativas. Conclusión: Este ensayo clínico no es concluyente respecto a la efi cacia del apósito adherible facial para reducir la infl amación postquirúrgica de la odontectomía del tercer molar (AU)


Introduction: The third molar odontectomy produces a metabolic response to surgical trauma characterized by an important infl ammation of the area, so that, for its control, it has diff erent therapeutic options as the pharmacotherapy, cryotherapy and laser therapy, as well as other alternatives such as compression of the region, whose proposal presented in this work is using a facial adhesive dressing. Objective: Evaluate the eff ectiveness of the implementation of a facial adhesive dressing for the control of postsurgical infl ammation of the third molar odontectomy. Material and methods: It has been made a controlled clinical trial of phase I multicentric. It formed a group of experimental and control study with 10 participants in each one, of both sexes, 18- 30 years of age, healthy and that presented a lower left third molar retained vertical or mesioangular, class I or II, position A or B (Pell and Gregory). Odontectomy were performed under local anesthesia and only in the experimental group used a transparent fi lm dressing Tegaderm® by 3M which was placed on the cheek of the patients for 48 hours. The evaluation of the infl ammation was performed with the method of Laskin modifi ed prior to the procedure, at 48 hours and on the 5th postoperative day. Results: The average of the length of the line 1 to 48 hours and at the 5th postoperative day was lower in the experimental group than in the control group, the diff erences being statistically signifi cant. In the rest of the lines, the average length was also lower in the experimental group, however, there were no statistically signifi cant diff erences. Conclusion: This trial is not conclusive as to the eff ectiveness of the dressing stick coating facial to reduce the postsurgical infl ammation of the third molar odontectomy (AU)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Osteotomia , Dor Pós-Operatória/prevenção & controle , Bandagens , Inflamação/prevenção & controle , Dente Serotino/cirurgia , Complicações Pós-Operatórias/prevenção & controle , Análise Estatística , México
12.
Rev. ADM ; 76(5): 287-293, sept.-oct. 2019. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-1053323

RESUMO

Los terceros molares heterotópicos son órganos dentarios que se encuentran en un sitio anatómico fuera de lo habitual, pueden ser supernumerarios, deciduos o un diente permanente, el cual ha sido reportado en diferentes posiciones, incluyendo la región coronoidea, cavidad nasal, seno maxilar, región orbitaria, palatina, cóndilo mandibular. La etiología de la erupción heterotópica/ectópica es desconocida, aunque hay varias teorías como la discrepancia óseo-dentaria por la evolución. Los órganos dentarios heterotópicos/ectópicos son comunes en la mandíbula y en el género femenino y pueden ocurrir en ambas denticiones. Algunos terceros molares heterotópicos/ectópicos son asintomáticos durante el periodo de vida y son usualmente detectados en hallazgos clínicos y radiográficos de manera incidental. Existen casos documentados desde 1887 hasta la actualidad cuya localización es en el reborde orbitario. En el presente artículo se expone un caso clínico de una extracción quirúrgica de un tercer molar superior heterotópico en el reborde orbitario descrita bajo el protocolo de las retenciones dentales. Dicho caso fue establecido en el Hospital Regional «General Ignacio Zaragoza¼ del ISSSTE en la Ciudad de México, con el que se obtuvieron resultados favorables, fue el primer reporte de la literatura en México. Se realizó una revisión aleatoria de la literatura en páginas como PubMed, ScienceDirect y Springer, Cochrane Library y se desarrolló el reporte de caso clínico de una paciente con un tercer molar superior heterotópico ubicado en el piso de órbita derecho (AU)


Heterotopic third molars are dental organs that are in an anatomical site out of the ordinary, can be supernumerary, deciduous or a permanent tooth, which has been reported in different positions, including the coronoid region, nasal cavity, maxillary sinus, orbital region, palatal, mandibular condyle. The etiology of the heterotopic/ectopic eruption is unknown, although there are several theories such as bone-dental discrepancy due to evolution. The heterotopic/ectopic teeth are common in the jaw and in the female gender and can occur in both dentitions. Some heterotopic/ectopic third molars are asymptomatic during the lifetime and are usually found incidentally in clinical and radiographic findings. There are documented cases from 1887 to the present that its location is in the orbital rim. In the present article we present a clinical case of a surgical extraction of a third upper molar heterotopic in the orbital rim and that is described under the dental retention protocol established in the Regional Hospital «General Ignacio Zaragoza¼ of the ISSSTE in the City of Mexico, with which they obtain favorable results, first report of the literature in Mexico. A randomized review of the literature was made on pages such as PubMed, ScienceDirect and Springer, Cochrane Library and the clinical case report of a patient with a heterotopic upper third molar located on the floor of the right orbit was developed (AU)


Assuntos
Humanos , Feminino , Adolescente , Órbita , Erupção Ectópica de Dente/cirurgia , Dente Serotino/cirurgia , Dente Serotino/patologia , Extração Dentária , Unidade Hospitalar de Odontologia , México
13.
Am J Orthod Dentofacial Orthop ; 156(3): 355-364, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31474265

RESUMO

INTRODUCTION: The aim of this work was to analyze data of patients with failed or delayed eruption of first and second permanent molars, to assess the effectiveness of the treatment methods used. METHODS: Epidemiologic and clinical data of 125 patients (mean age 14.08 ± 4.04 years) with 197 affected molars (30 first and 167 second molars) were retrospectively analyzed. The treatment outcome was known in 161 molars after patient drop-out (20 patients with 36 molars). The cases were categorized into 8 groups according to the choice of treatment: orthodontic uprighting, surgical-orthodontic uprighting, surgical uprighting, surgical repositioning, surgical exposure, first or second molar extraction, third molar extraction, or removal of pathologic conditions. RESULTS: The overall treatment outcome was positive in 141 molars (87.6%). It was positive in all cases treated with orthodontic uprighting (7 molars), surgical exposure (10 molars), surgical uprighting (38 molars), and surgical repositioning (8 molars), but it was significantly lower for surgical-orthodontic uprighting (34/48 molars, 70.8%). The positive outcome was significantly lower for inclusion (52/68 molars, 76.5%) than for early-diagnosed condition (11/11 molars, 100%) and retention (78/82 molars, 95.1%), and for total bone crown coverage (21/28 molars, 75.0%) than for osteomucosal or mucosal crown coverage (120/133 molars, 90.2%). CONCLUSIONS: This study demonstrates that an early diagnosis results in a better outcome regardless of the treatment used, with the number of cases with a positive outcome being higher in younger patients.


Assuntos
Dente Molar/patologia , Anormalidades Dentárias , Erupção Dentária , Técnicas de Movimentação Dentária/métodos , Dente Impactado/terapia , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Itália , Modelos Logísticos , Masculino , Dente Molar/cirurgia , Dente Serotino/cirurgia , Estudos Retrospectivos , Dente Impactado/diagnóstico , Dente Impactado/cirurgia , Resultado do Tratamento , Adulto Jovem
15.
J Biol Regul Homeost Agents ; 33(3 Suppl. 1): 169-172, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31538464

RESUMO

Mandibular third molars (MM3s) are responsible for pericoronitis, primary and/or secondary crowding of the dentition, odontogenic tumors and cysts, periodontal defects associated with the posterior part of mandibular second molars. Tooth extraction is indicated for prophylactic and therapeutic purpose in patients with problems caused by impacted teeth. Common postoperative complications associated with third molar extraction are alveolitis (0.5e32.5%), infection (0.9e4.2%), postoperative bleeding (0.2e1.5%), transient dysfunction of the inferior alveolar nerve (0.6e5.5%), and permanent dysfunction of the inferior alveolar nerve (0.1e0.9%). A literature review reveals number of individual case reports of accidental displacement to various anatomical locations, namely, the infratemporal fossa, pterygomandibular space, lateral pharyngeal space, submandibular space, and sublingual space.


Assuntos
Dente Serotino/cirurgia , Extração Dentária/efeitos adversos , Dente Impactado/cirurgia , Humanos , Mandíbula
16.
Niger J Clin Pract ; 22(9): 1189-1195, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31489852

RESUMO

Aim: The aim of the present study was to determine whether the use of advanced platelet rich fibrin based on the low speed+ centrifugation concept (A-PRF+) might improve the pain management and healing of delayed wound healing among cases of alveolar osteitis following mandibular third molar extraction. Materials and Methods: The patients (N = 40) with a complaint of alveolar osteitis following third molar extractions were divided into two groups: Group I (control; saline only); and Group II (use of A-PRF+). Pain was evaluated using the visual analogue scale (VAS). Soft tissue healing was assessed by the modified Index of Landry, Turnbull and Howley and bone density was assessed with the i-Dixel 2.1.8.2 software. Inter-group comparisons were analyzed by means of a student t-test and the Mann Whitney U test to identify group samples. Analysis of variance and the Friedman test were applied for repeated measurements. The Wilcoxon test and Bonferroni's test for multiple comparisons were conducted at the time-factor level. Yates Correction was used to compare qualitative data. Results: In regard to pain, A-PRF+ application demonstrated rapidly and continually reduced pain intensity at each respective time in comparison to the control. Statistically, the healing rates of epithelium and hard tissue were significantly faster in the A-PRF+ application group (p: 0.000, P < 0.05). Conclusions: The results show that A-PRF+ might represent an improved and accelerating therapeutic development for hard and soft tissue healing in management of alveolar osteitis that is also effective in reducing pain.


Assuntos
Alvéolo Seco/terapia , Adesivo Tecidual de Fibrina/administração & dosagem , Dente Serotino/cirurgia , Fibrina Rica em Plaquetas , Complicações Pós-Operatórias/terapia , Extração Dentária/efeitos adversos , Cicatrização/fisiologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Mandíbula , Manejo da Dor , Estudos Prospectivos , Extração Dentária/métodos , Escala Visual Analógica
17.
Rev. esp. cir. oral maxilofac ; 41(3): 120-125, jul.-sept. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-191775

RESUMO

OBJETIVO: Determinar la efectividad antinflamatoria de la dexametasona más complejo B en la cirugía de terceros molares inferiores. MÉTODOS: El presente es un ensayo clínico controlado aleatorizado a doble ciego y de diseño en paralelo. Se llevó a cabo en la Clínica Estomatológica de la Universidad Privada Antenor Orrego (UPAO) de Trujillo durante el año 2010. La muestra estuvo conformada por 36 pacientes divididos de forma aleatoria en dos grupos. Cada paciente firmó un consentimiento informado. Una hora antes de la cirugía se administró al grupo control (A) una dosis intramuscular de dexametasona y al grupo experimental (B) una dosis intramuscular de dexametasona más complejo B. El efecto antinflamatorio se determinó por la medición horizontal de la intersección de los puntos anatómicos: trago-pogonión de tejidos blancos y gonión-ángulo externo del ojo. Las medidas se realizaron a las 24, 48 y 96 horas después de la cirugía. RESULTADOS: Al comparar los grupos se observó que, al administrar dexametasona más complejo B, existía una menor inflamación postoperatoria que al administrar dexametasona sola a las 24, 48 y 96 horas (p = 0,03; p = 0,002; p = 0,001). Los mismos resultados se observaron para el género masculino (p = 0,01), femenino (p = 0,00001), los menores de 25 años (p = 0,011) y los mayores o iguales a 25 años (p = 0,029). CONCLUSIÓN: La administración intramuscular de dexametasona más complejo B antes de la cirugía de terceros molares produce una menor inflamación postoperatoria y es independiente del género y la edad


OBJECTIVE: To determine the antiinflammatory effectiveness of dexamethasone plus complex B in lower third molar surgery. METHODS: The present study is a double-blind randomized controlled trial of parallel design. It was carried out in the Stomatologic Clinic of the Universidad Privada Antenor Orrego (UPAO) of Trujillo during 2010. The sample consisted of 36 patients randomly divided into two groups. Each patient signed an informed consent. One hour prior to surgery, an intramuscular dose of dexamethasone and an intramuscular dose of dexamethasone plus complex B were administered to the control group (A). The anti-inflammatory effect was determined by the horizontal measurement of the intersection of the dots anatomical: tragus-white tissue pogonion and gonion-external angle of the eye. Measurements were performed at 24, 48 and 96 hours after surgery. RESULTS: When comparing the groups, it was observed that the administration of dexamethasone plus B complex showed a lower postoperative inflammation than that of dexamethasone alone at 24, 48 and 96 hours (p = 0.03; p = 0.002; p = 0.001). The pivotal results were observed for males (p = 0.01), females (p = 0.00001), those under 25 years (p = 0.011) and greater than or equal to 25 years (p = 0.029). CONCLUSION: Intramuscular administration of dexamethasone plus B complex prior to third molar surgery produces less post-operative inflammation and is independent of gender and age


Assuntos
Humanos , Dexametasona/uso terapêutico , Dor Pós-Operatória/tratamento farmacológico , Dente Serotino/cirurgia , Extração Dentária/métodos , Complexo Vitamínico B/uso terapêutico , Manejo da Dor/métodos , Analgesia/métodos , Analgésicos/administração & dosagem , Sinergismo Farmacológico , Resultado do Tratamento , Quimioterapia Combinada/métodos , Anti-Inflamatórios/farmacocinética
18.
Am J Case Rep ; 20: 1148-1151, 2019 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-31378777

RESUMO

BACKGROUND Dentigerous cysts are slow-growing odontogenic cysts that usually develop unilaterally as part of a pre-existing syndrome. Non-syndromic bilateral dentigerous cysts are extremely rare, but clinicians should be aware of this condition to ensure prompt diagnosis and management and to prevent complications. CASE REPORT A case is presented of bilateral mandibular dentigerous cysts that were discovered incidentally in a 44-year-old man who presented for extraction of a retained maxillary deciduous tooth. Histological examination of the tissue specimens following bilateral enucleation confirmed the diagnosis of bilateral dentigerous cysts. CONCLUSIONS In this case, incidental bilateral dentigerous cysts were identified and treated by enucleation. The absence of an associated syndrome should not exclude the possibility of the diagnosis of dentigerous cysts, which should be removed to prevent future complications.


Assuntos
Cisto Dentígero/etiologia , Achados Incidentais , Doenças Mandibulares/patologia , Dente Serotino/patologia , Dente Impactado/complicações , Adulto , Cisto Dentígero/diagnóstico por imagem , Cisto Dentígero/cirurgia , Humanos , Masculino , Doenças Mandibulares/diagnóstico por imagem , Doenças Mandibulares/cirurgia , Dente Serotino/diagnóstico por imagem , Dente Serotino/cirurgia , Radiografia Panorâmica , Dente Impactado/diagnóstico por imagem , Dente Impactado/cirurgia
19.
J Med Life ; 12(2): 150-155, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31406516

RESUMO

Pain control during and after any surgical procedure, is extremely essential for the comfort of patients. Pain killers used routinely act by inhibiting cyclooxygenase to control pain and inflammation. Cox-1 is constitutively expressed in most cell types, including platelets, whereas Cox-2 is absent from most healthy tissues but is induced by pro-inflammatory or proliferative stimuli. Cox-1 plays a role in the production of prostaglandins involved in protection of the gastric mucosal layer and thromboxanes (TX) in platelets. Cox-2 generally mediates elevations of prostaglandins associated with inflammation, pain, and pyresis. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen are generally nonselective inhibitors of Coxs. This lack of selectivity has been linked to their propensity to cause gastrointestinal side effects. The new Cox-2 selective inhibitors, or coxibs, show the same anti-inflammatory, analgesic, and antipyretic effects as nonselective NSAIDs but are supposed to have reduced side-effect profiles. This study evaluates whether rofecoxib (50 mg) given one hour pre-operatively or the same drug given one hour post-operatively is more effective in controlling the pain and swelling in mandibular third molar surgery.


Assuntos
Inibidores de Ciclo-Oxigenase 2/uso terapêutico , Mandíbula/cirurgia , Dente Serotino/cirurgia , Adolescente , Adulto , Anti-Inflamatórios não Esteroides/efeitos adversos , Anti-Inflamatórios não Esteroides/uso terapêutico , Proteína C-Reativa/metabolismo , Feminino , Humanos , Lactonas/farmacologia , Masculino , Cuidados Pós-Operatórios , Sulfonas/farmacologia , Adulto Jovem
20.
Cient. dent. (Ed. impr.) ; 16(2): 111-116, mayo-ago. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-183721

RESUMO

Introducción: La extracción de los terceros molares es una práctica habitual en la consulta odontológica. Es muy común la aparición postoperatoria de respuestas fisiológicas como el dolor, inflamación, hematomas y trismo, y cuyo tratamiento de elección sigue siendo la farmacología. La hiloterapia es un tratamiento alternativo complementario que forma parte de la medicina física terapéutica. Se trata de una unidad conectada a una máscara preformada de contorno facial que, mediante la reducción de la termperatura tisular de manera constante, persigue conseguir la disminución del flujo sanguíneo, la inflamación, el dolor y el edema. Caso clínico: Se presenta el caso clínico de una mujer de 22 años de edad, sin antecedentes médicos de interés, que acudió al Hospital Virgen de la Paloma por presentar dolor en el tercer molar inferior izquierdo. Una vez realizada la exploración clínica y radiológica de la paciente, se propuso como plan de tratamiento la extracción de los cuatro cordales, bajo anestesia general. Inmediatamente después de la cirugía se colocó a la paciente la máscara facial de Hilotherm(R), programada a una temperatura constante de 15ºC. Se revisó a las 24h y a los 8 días tras la intervención. Conclusiones: La terapia con la máscara facial Hilotherm(R) ha demostrado ser de utilidad en la disminución del dolor y la inflamación postoperatorios derivados de la extracción quirúrgica de los terceros molares, probablemente debido a la posibilidad de un control constante de la temperatura y a la mayor colaboración del paciente. No hay evidencia científica suficiente que respalde su posible participación en la reducción de hematomas. Asimismo, este sistema sugiere un aumento significativo de la calidad de vida de los pacientes, así como una buena aceptación por parte de éstos otorgando más comodidad y satisfacción


Introduction: The extraction of third molars is common practice in the dental practice. The postoperative appearance of physiological responses such as pain, inflammation, bruising and trismus is very common, for which the treatment of choice is still pharmacology. The hilotherapy is a complementary alternative treatment that is part of the therapeutic physical medicine which consists on a unit connected to a preformed face contour mask that, by constantly reducing tissue temperature, aims to achieve decreased blood flow, inflammation, pain and edema. Clinical case: A clinical case of a 22-year-old woman is presented, with no interesting medical record, who went to the Virgen de la Paloma Hospital with pain in the left lower third molar. Once the clinical and radiological examination of the patient had been carried out, a treatment plan for the extraction of the four wisdom teeth, under general anesthesia, was proposed. Immediately after the surgery, the patient was placed the facial mask of Hilotherm(R) on, programmed at a constant temperature of 15ºC. It was reviewed twice, 24h and 8 days after the intervention. Conclusions: Hilotherm(R) facial mask therapy has been shown to be useful in the reduction of postoperative pain and inflammation derived from the surgical extraction of third molars, probably due to the possibility of constant temperature control and greater patient collaboration. There is not enough scientific evidence to support its possible participation in the reduction of bruising. Likewise, this system suggests a significant increase in the quality of life of patients, as well as a good acceptance from patients, providing them with more comfort and satisfaction


Assuntos
Humanos , Feminino , Adulto , Dente Serotino/cirurgia , Edema/prevenção & controle , Dor Pós-Operatória/prevenção & controle , Crioterapia/métodos , Máscaras , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Procedimentos Cirúrgicos Bucais , Equimose/prevenção & controle , Hematoma/prevenção & controle , Cuidados Pós-Operatórios
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