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1.
Quintessence Int ; 52(2): 132-137, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33433079

RESUMO

The extraction of a tooth with root resorption can be a complicated procedure and can result in the removal of a significant amount of alveolar bone. In the anterior maxilla, esthetic rehabilitation of damaged sites with implant-supported crown could require multiple surgeries. Patients often ask for an alternative, and minimally invasive treatments are generally preferred. In this paper, a clinical case of implant-supported crown in a site affected by root resorption is described. Immediate implant was placed leaving some root fragments in the osteotomy site, thus avoiding invasive extractive surgeries. A minimally invasive flapless technique with a computer-guided implant placement procedure was used. After ?8 years, clinical and radiologic data were stable, gingival tissues around the implant appeared healthy, no dark translucency appeared through marginal gingiva around the implant, and there was no pathologic probing pocket depth ?or bleeding on probing. In the presence of root resorption and ankylosis, computer-guided surgery could be helpful to prepare a precise implant site through various tissues, such as partially resorbed root remnants. (Quintessence Int 2021;52:132-137; doi: 10.3290/j.qi.a45432).


Assuntos
Implantes Dentários para Um Único Dente , Implantes Dentários , Carga Imediata em Implante Dentário , Computadores , Coroas , Implantação Dentária Endo-Óssea , Prótese Dentária Fixada por Implante , Estética Dentária , Humanos , Maxila/cirurgia , Extração Dentária , Resultado do Tratamento
2.
J Prosthet Dent ; 125(1): 23-28, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32067754

RESUMO

This article describes a technique for surgically extruding severely compromised roots needing prosthetic rehabilitation. Unlike previously described approaches, the technique does not require advanced clinical skills or equipment, may reduce the risk of tooth or bone fracture during the luxation maneuvers, and does not seem to interfere with the alveolar socket healing process.


Assuntos
Processo Alveolar , Alvéolo Dental , Extração Dentária
3.
Clin Oral Investig ; 25(1): 345-353, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32691298

RESUMO

OBJECTIVES: The aim of this randomized observer-blinded split-mouth-study is to objectively assess the influence of a rubber drain on postoperative swelling using 3D face scans as measurement method and additionally evaluate pain, trismus and complications after the osteotomy of lower third molars. MATERIAL AND METHODS: Seventy-two patients with symmetrically impacted lower wisdom teeth were recruited. Before the operation, patients rated pain using the visual analogue scale, the interincisal distance was measured, and 3D face scans were taken with an optical scanner. Each patient underwent two procedures which were at least 30 days apart. On one side, a rubber drain was inserted randomly before closure, the contralateral control side was closed without drainage. On the third and tenth postoperative day, face scans to quantify the swelling, pain evaluation and trismus measurements were performed. Due to loss of follow-up, 32 patients were excluded which resulted in 40 out of 72 patients remaining in the study. RESULTS: There was no statistical difference in using a drain on swelling and trismus on the third and tenth day (p > 0.05). Pain was slightly worse on the third day on the treatment side, but the difference was not significant (p > 0.05). We observed no differences in the number of wound infections. CONCLUSIONS: The insertion of a rubber drain does not have any influence on swelling, pain or trismus and has no impact on the number of wound infections. CLINICAL RELEVANCE: The use of a rubber drain cannot be recommended as no reduction of postoperative discomfort was detected.


Assuntos
Drenagem/métodos , Dente Serotino , Dente Impactado , Edema/etiologia , Edema/prevenção & controle , Humanos , Mandíbula/cirurgia , Dente Serotino/diagnóstico por imagem , Dente Serotino/cirurgia , Boca , Dor Pós-Operatória/prevenção & controle , Complicações Pós-Operatórias/prevenção & controle , Extração Dentária/efeitos adversos , Dente Impactado/cirurgia , Trismo/etiologia , Trismo/prevenção & controle
4.
J Craniomaxillofac Surg ; 49(1): 64-69, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33298388

RESUMO

OBJECTIVE: This study compared patient postoperative pain, swelling, and trismus after usage of rotary instruments, piezosurgery, and Er:YAG lasers in mandibular third-molar extraction. MATERIALS AND METHODS: This prospective study was executed with class II and position B vertically impacted mandibular third molars. Patients were divided into three groups according to the osteotomy system used to remove retentive bone: rotary instruments, piezosurgery, and Er:YAG laser. Postoperative pain was evaluated using VAS questionnaires at 12 h, 24 h, 48 h, and 7 days after procedures. Trismus was evaluated by measuring the distance between the maxillary and mandibular incisors at maximum mouth opening, and comparing preoperative measurements with those for postoperative days 2 and 7. Analyses of swelling were carried out via a stereophotogrammetry system. Operation times were measured using a digital stopwatch from the initial incision to the final suture. RESULTS: There were no statistically significant differences between the groups in terms of pain, trismus, or swelling (p > 0.05). Pain persisted more in the rotary instrument group 24 h later (0 ± 1.3; p = 0.001). The pain scores obtained after 48 h for the piezosurgery (1.81 ± 2.29) and rotary (2.2 ± 2.12) groups were observed at 24 h in the laser group (2.19 ± 1.52). The mean operation time was highest using the laser (19.1 ± 3.85 min; p = 0.001) and lowest using rotary instruments (9.88 ± 2.97 min; p = 0.001). CONCLUSION: Piezosurgery and Er:YAG laser are good alternatives to rotary instrument systems in third-molar extraction, but both systems are slower than traditional rotary instruments.


Assuntos
Lasers de Estado Sólido , Dente Impactado , Edema/etiologia , Humanos , Lasers de Estado Sólido/uso terapêutico , Dente Molar , Dente Serotino/cirurgia , Osteotomia , Dor Pós-Operatória/etiologia , Piezocirurgia , Estudos Prospectivos , Extração Dentária , Dente Impactado/cirurgia , Trismo/etiologia
6.
J Oral Maxillofac Surg ; 79(1): 57.e1-57.e12, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33058773

RESUMO

PURPOSE: Wound healing of postextraction sockets is a complex process that permits to reach the bone reformation in about 3 months, and that could be characterized by the presence of some complications, mainly dependent on the duration of the surgery. The aim of this study is to evaluate the impact of photobiomodulation (PBMT) on the healing processes of mucosa overlying postextraction alveolus and on related complications. METHODS: Twenty systemically healthy patients who needed to extract both lower third molars were selected in a private clinic and included in this prospective split-mouth randomized clinical trial. Inclusion criteria were no smokers subjects with the necessity to extract both lower third molars with surgeries overlapping for duration and difficulty. A computer-based randomization procedure was permitted to choose the side, subject to PBMT, by means of a neodymium-doped YAG (Nd: YAG) laser (test) and controls. Both surgeries were performed by the same operator with a gap of 40 days. Twenty-two days after each surgery, a biopsy in correspondence to the alveolar mucosa of the socket was obtained from both sites and observed with an optical microscope and analyzed with histomorphometric analysis and immunohistochemistry. RESULTS: Each of the 20 participants included in this study (11 women and 9 men, nonsmokers, mean age 16 years in the range of 15 to 17 years) were subjected to the extraction of both lower third molars, and a side was treated as control, the other, as the test. The histomorphometric analysis and immunohistochemistry showed that the tested sites, contrary to controls, were characterized by a lower presence of inflammatory cells, a more mature epithelium and myofibroblasts incorporated in a network of fibers parallel to the basal membrane, with little positivity to alpha-SMA antibodies and anti-myosin but positivity to anti-desmin. CONCLUSIONS: In conclusion, PBMT accelerates the healing process of postextraction alveolus after third molar extraction.


Assuntos
Extração Dentária , Alvéolo Dental , Adolescente , Feminino , Humanos , Imuno-Histoquímica , Masculino , Estudos Prospectivos , Alvéolo Dental/cirurgia , Cicatrização
7.
Clin Oral Investig ; 25(1): 275-282, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32451759

RESUMO

OBJECTIVE: To compare the clinical, radiographic, and histological healing patterns between the immediate and delayed applications of bone morphogenetic protein-2 (BMP-2) in damaged extraction sockets in dogs. MATERIALS AND METHODS: The distal roots of the fourth premolars of the mandible were extracted bilaterally in five beagle dogs, and buccal bone defects (4 mm wide and 9 mm high) were surgically created. Collagenated biphasic calcium phosphate (CBCP) soaked for 10 min in 100 µL of BMP-2 solution was applied immediately to the defect site in the control group. In the test group, the BMP-2 solution of same dose was injected into the grafted site 2 weeks after grafting with a saline-soaked CBCP. The dogs were sacrificed 2 weeks later. Clinical, histological, and radiographic analyses were followed. RESULTS: Swelling and inflammatory reactions were predominantly observed in the control group at 2 weeks. The area of new bone formation was significantly larger in the control group compared with the test group (10.8 ± 7.0 mm2 [mean ± SD] and 6.3 ± 3.1 mm2, respectively; p = 0.043). No significant difference was found in ridge width at 2 mm, 4 mm and 6 mm below the lingual bone crest between the control (2.6 ± 1.0 mm, 3.2 ± 0.9 mm and 4.5 ± 0.5 mm, respectively) and test group (3.3 ± 1.0 mm, 3.7 ± 1.3 mm and 4.2 ± 1.0 mm; all p > 0.05). CONCLUSIONS: Delayed application of BMP-2 2 weeks after surgery did not show any advantage over immediate application of BMP-2 in terms of new bone formation. CLINICAL RELEVANCE: This study suggests that it might be better to apply BMP-2 immediately in alveolar ridge preservation, instead of delayed application, in order to enhance new bone formation.


Assuntos
Perda do Osso Alveolar , Aumento do Rebordo Alveolar , Processo Alveolar/diagnóstico por imagem , Processo Alveolar/cirurgia , Animais , Cães , Ligamento Periodontal , Extração Dentária , Alvéolo Dental/diagnóstico por imagem , Alvéolo Dental/cirurgia
8.
Clin Oral Investig ; 25(1): 319-328, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32495225

RESUMO

OBJECTIVE: To evaluate an association between bone levels of inflammation/oxidative stress mediators and postoperative discomfort after third molar conventional or piezosurgery. MATERIAL AND METHODS: Twenty-six subjects with bilaterally impacted mandibular third molars, who underwent either piezo or conventional surgery, were included in a split-mouth design study. MicroRNA-21 (miR-21) expression, interleukin-1 beta (IL-1ß), and vascular endothelial growth factor (VEGF) proteins, as well as superoxide dismutase (SOD) activity in alveolar bone, were evaluated. Pain intensity, the first pain appearance, analgesic first use and total dose taken, trismus, and swelling were clinically recorded. RESULTS: MiR-21 expression was higher while VEGF protein was lower in piezosurgery vs. conventional groups. The differences in IL-1ß protein and SOD activity were not significant between groups. The pain intensity on the first day was significantly decreased in piezosurgery group. The first pain appearance and the first analgesic taken were reported sooner in conventional vs. piezosurgical group. Significantly pronounced trismus on the third day following conventional surgery was found. In conventional group, significantly increased trismus was observed on the third compared to the first postoperative day. MiR-21 showed significant correlation with the first pain appearance. CONCLUSION: Delayed onset of less pronounced postoperative pain after piezosurgical vs. conventional extraction of impacted lower third molar was significantly associated with expression of bone miR-21. CLINICAL RELEVANCE: Alveolar bone miR-21 may reflect surgical stress and is associated with third molar postoperative pain onset.


Assuntos
MicroRNAs , Dente Impactado , Edema , Humanos , Mandíbula , Dente Serotino/cirurgia , Dor Pós-Operatória , Extração Dentária , Dente Impactado/cirurgia , Trismo , Fator A de Crescimento do Endotélio Vascular
9.
Clin Oral Implants Res ; 32(1): 123-133, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33217058

RESUMO

OBJECTIVES: To compare two ridge preservation techniques and spontaneous healing in terms of hard and soft tissue changes 2 months after tooth extraction. MATERIAL AND METHODS: The study was designed as a randomized controlled trial and included 75 patients. After single tooth extraction in the maxillary incisor/premolar area, patients were randomly allocated to one of the following groups: (a) ridge preservation with a xenogeneic bone substitute covered with a collagen matrix (CM-group), (b) ridge preservation with a xenogeneic bone substitute covered with a free palatal graft (PG-group) or (c) spontaneous healing (control). Eight weeks after tooth extraction, implants were placed and clinical, profilometric and radiographic evaluations were performed. In addition, the need for further guided bone regeneration (GBR) at implant placement was assessed. The differences between the treatment groups were compared with the One-way ANOVA or Kruskal-Wallis test with the corresponding post hoc analysis. The proportions of the categorical parameters were compared with the Fisher´s exact test. RESULTS: Seventy-five patients underwent early implant placement 8 weeks after tooth extraction and were evaluated. CM-group (-0.9 SD 0.6 mm) and PG-group (-1.0 SD 0.8 mm) showed less horizontal bone resorption compared to the control group (-3.2 SD 2.1 mm) (p < .001). Moreover, the necessity of GBR at implant placement was significantly less in CM-group (32%) and PG-group (24%) when compared to control group (72%) (p = .001). Patients in CM-group experienced less pain than PG-group, one week after tooth extraction (p = .042). No significant differences were found regarding graft evaluation, post-operative complications, and soft tissue contour. CONCLUSIONS: Ridge preservation using a xenogeneic bone substitute covered with a collagen matrix or a palatal graft, results in less bone resorption and fewer GBR procedures at early implant placement compared to spontaneous healing.


Assuntos
Aumento do Rebordo Alveolar , Implantes Dentários , Processo Alveolar/diagnóstico por imagem , Processo Alveolar/cirurgia , Humanos , Extração Dentária/efeitos adversos , Alvéolo Dental/diagnóstico por imagem , Alvéolo Dental/cirurgia
10.
Acta Odontol Scand ; 79(1): 25-30, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32449864

RESUMO

OBJECTIVES: To evaluate the efficacy of single-dose antibiotic prophylaxis (AP) in the prevention of bacteraemia following tooth extractions at our clinic. MATERIAL AND METHODS: Fifty patients undergoing tooth extractions were enrolled. The need of AP was determined according to the health status and possible allergies of the patients. Blood culture samples were collected at baseline, 5 min after the first tooth extraction and 20 min after the last extraction. RESULTS: The majority (76%) received prophylactic oral amoxicillin or intravenous ampicillin (AMX/AMP) (2 g), 12% received clindamycin (CLI) (600 mg) and 12% received no prophylaxis (NO AP). All baseline blood cultures were reported negative. The prevalence of bacteraemia was significantly higher in the CLI and NO AP groups compared to the AMX/AMP group 5 min after the first tooth extraction (p < .0001 and p = .015, respectively). Twenty minutes after the last extraction positive blood cultures were reported only for CLI (p = .0015) and NO AP groups. There was no significant difference in the prevalence of positive blood cultures between CLI and NO AP groups. CONCLUSIONS: Appropriately administered AMX/AMP proved its efficacy in reducing both the prevalence and duration of bacteraemia following tooth extractions whereas CLI was not effective in preventing bacteraemia following tooth extractions.


Assuntos
Bacteriemia , Clindamicina , Amoxicilina , Antibacterianos/uso terapêutico , Antibioticoprofilaxia , Bacteriemia/tratamento farmacológico , Bacteriemia/epidemiologia , Bacteriemia/prevenção & controle , Humanos , Prevalência , Extração Dentária/efeitos adversos
11.
Med Oral Patol Oral Cir Bucal ; 26(1): e64-e70, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33037803

RESUMO

BACKGROUND: The efficacy of preemptive analgesia in managing postoperative pain remains controversial. The aim of this study was to compare the efficacy of intravenous (IV) acetaminophen administered before or immediately after the surgical extraction of an impacted mandibular third molar. MATERIAL AND METHODS: This prospective randomized clinical trial included 120 patients. The patients were assigned to one of three groups: the preoperative-treatment group (pre-group), which received 1000 mg of IV acetaminophen 20 min before surgery; the postoperative-treatment group (post-group), which received 1000 mg of IV acetaminophen after surgery; the no-treatment group (control-group), which did not receive any analgesic. Rescue analgesic (60 mg loxoprofen) was issued to each patient, with instructions on self-administration if needed. For the rescue medication usage, the time of first loxoprofen usage and the total amount of loxoprofen consumption were obtained for a 17-hour period after surgery. We measured pain using the visual analogue scale at 1 hour and at 2, 3, 4, 5, and 15 hours after surgery. RESULTS: There was no significant difference in pain level among the three groups at any time interval. However, the pre-group demonstrated significantly lower rescue analgesic consumption and longer time until initial administration. CONCLUSIONS: Administration of IV acetaminophen before third molar surgery provides more effective pain control than postoperative administration and no treatment.


Assuntos
Analgesia , Analgésicos não Entorpecentes , Acetaminofen/uso terapêutico , Analgésicos não Entorpecentes/uso terapêutico , Analgésicos Opioides , Método Duplo-Cego , Humanos , Dente Serotino/cirurgia , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/prevenção & controle , Estudos Prospectivos , Método Simples-Cego , Extração Dentária
12.
BMJ Case Rep ; 13(12)2020 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-33370928

RESUMO

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


Assuntos
Antineoplásicos Imunológicos/administração & dosagem , Linfoma Difuso de Grandes Células B , Dente Serotino , Radioterapia/métodos , Mobilidade Dentária , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Biópsia/métodos , Diagnóstico Diferencial , Humanos , Linfoma Difuso de Grandes Células B/complicações , Linfoma Difuso de Grandes Células B/patologia , Linfoma Difuso de Grandes Células B/terapia , Masculino , Dente Serotino/diagnóstico por imagem , Dente Serotino/fisiopatologia , Dente Serotino/cirurgia , Radiografia Panorâmica/métodos , Extração Dentária/métodos , Mobilidade Dentária/diagnóstico , Mobilidade Dentária/etiologia , Resultado do Tratamento
13.
Niger J Clin Pract ; 23(12): 1629-1638, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33355813

RESUMO

Dentists are often confronted with challenges concerning the determination of the treatment type for questionable teeth (retention or extraction) in their routine dental practice. The objective of this review was to explore the available literature pertaining to the factors influencing clinical decision-making and treatment strategies of dentists regarding tooth retention or extraction. Explorative analysis of the literature was conducted based on its relevance to the subjected study area and scope. Primarily, the papers were extracted from sources such as ERIC, PubMed, Scopus, and Medline. The keywords used for searching articles include Clinical Decision-Making, Treatment Strategies, Tooth Extraction, and Tooth Retention. Papers published up to 2018 were extracted and evaluated. The analyzed studies highlighted that a successful treatment plan is based on the practitioner's knowledge, abilities, and skills as well as patients' preference, which is also a determinant of treatment success in restorative dentistry. Multidisciplinary dental treatment is generally adopted for decision making in dental clinics. Overall, the treatment plan should be based on the extensive learning and keen observation of the disease and the associated factors which enable long-term success of the treatment.


Assuntos
Tomada de Decisão Clínica , Extração Dentária , Tomada de Decisões , Humanos , Preferência do Paciente , Resultado do Tratamento
14.
Eur J Paediatr Dent ; 21(4): 323-325, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33337910

RESUMO

BACKGROUND: Presence of teeth in a newborn represents a rare finding and a disturbance of biological chronology of teeth. The aim of this paper is to report two cases with neonatal teeth histologically examined. CASE REPORT: In this paper two cases of patients with neonatal teeth are reported and histological examinations of three extracted teeth are described. We report an exceptional finding in one of the neonatal teeth microscopically examined: a massive inflammatory infiltration in the pulp tissue similar to that in pulpitis. RESULTS: The management of natal and neonatal teeth usually includes the extraction in case of ulceration on the tongue or severe tooth mobility to prevent accidental inhalation or feeding disturbances. The presence of an inflammatory infiltration of pulp tissue in one of teeth histologically examined suggests to review the indications for extraction considered to date. CONCLUSION: The management of natal and neonatal teeth should consider the presence of an inflammatory infiltration of pulp tissue. An anamnestic interview is advisable in ordert to deeply investigate about possible behaviours of the child due to pain or discomfort.


Assuntos
Dentes Natais , Criança , Humanos , Recém-Nascido , Dentes Natais/cirurgia , Projetos de Pesquisa , Extração Dentária
15.
S D Med ; 73(9): 414-419, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33260281

RESUMO

Painful post-traumatic trigeminal neuropathy (PTTN), or anesthesia dolorosa, is a condition on the same continuum as trigeminal neuralgia. Unlike trigeminal neuralgia, trigeminal neuropathy is a more significant state of neural pathology resulting in constant pain opposed to the episodic nature of trigeminal neuralgia. This typically occurs after facial trauma or as a complication from some treatments for trigeminal neuralgia. Useful diagnostic features that can help distinguish PTTN are an identified trauma to the nerve and other clinical features such as facial swelling. The presented case describes a classic presentation after third molar (wisdom tooth) removal and a review of pertinent literature.


Assuntos
Extração Dentária , Doenças do Nervo Trigêmeo , Traumatismos do Nervo Trigêmeo , Neuralgia do Trigêmeo , Humanos , Dente Serotino , Dor , Extração Dentária/efeitos adversos
16.
Swiss Dent J ; 130(12): 972-982, 2020 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-33267534

RESUMO

The objective of this study was to analyze the outcome of first-time surgical closures of oroantral communications (OAC) after tooth extractions. Using a billing software, all patients treated in a surgery department were filtered for interventions of the maxillary sinus indicative of OAC therapy. Out of 221 initially eligible cases, the charts of 162 cases fulfilling the inclusion criteria were retrospectively evaluated for the outcome in terms of symptom-free OAC closure as well as possibly influencing patient and treatment factors. The analyzed cohort included 98 males (60.5%) and 64 females (39.5%) with a mean age of 48.6 years (range 17 to 86 years). The maxillary 1st molar (38.3%) was the most common site requiring OAC closure. In 60.5% of the cases, surgical OAC closure was performed immediately after tooth extraction. The Rehrmann flap (72.2%) was the most frequently used technique for surgical OAC closure. 94.4% of surgical OAC closures were successful. Gender and age did not influence the outcome. In contrast, the site of OAC and the time interval from tooth extraction to OAC closure affected the results. Furthermore, the Rehrmann flap, alone or in combination with biomaterials, was superior to the mere suturing (with or without biomaterials) of the OAC site. In conclusion, the Rehrmann flap alone or in combination with biomaterials provided high success rates for first-time surgical OAC closure. With regard to the study parameters, an OAC in the 3rd molar area and an extended interval from tooth extraction to OAC closure negatively influenced the resolution of OAC. However, results must be interpreted cautiously considering the retrospective study design and the limited number of cases.


Assuntos
Fístula Bucoantral , Extração Dentária , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Seio Maxilar , Pessoa de Meia-Idade , Fístula Bucoantral/etiologia , Fístula Bucoantral/cirurgia , Estudos Retrospectivos , Tempo , Adulto Jovem
17.
Ann Afr Med ; 19(4): 269-273, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33243951

RESUMO

Background: Surgical removal of the impacted third molar is associated with inflammatory morbidities which include swelling, trismus, and pain. Pain is the most common postsurgical morbidity associated with third molar surgery. It remains an important factor in patients' perception of recovery after third molar surgery with dental anxiety reported to exert influence on its threshold. Objective: The aim of the study was to determine if preoperative dental anxiety has any significant role on postoperative pain perception after third molar surgery. Materials and Methods: This was a cohort study involving sixty consecutive adult patients requiring extraction of impacted mandibular third molars under local anesthesia. Modified Dental Anxiety Scale Questionnaire was administered to each participant in the waiting area before the surgery. The visual analog scale was also given to each participant to be completed once daily at approximately the same time as the surgery time until day 7 after the surgery. Data collected were analyzed using SPSS version 23. Results: Sixty participants who consented to third molar surgery took part in this study. Five participants were lost to follow-up. There were slightly more males (50.9%) than females (49.1%). Nineteen participants in this study had moderate dental anxiety (34.5%) and 6 participants (11%) had severe dental anxiety with more females having moderate-to-severe dental anxiety. The correlation between pain perception at different days and dental anxiety was not significant (P > 0.05). Conclusion: Preoperative dental anxiety may not significantly influence pain perception after third molar surgery.


Assuntos
Ansiedade ao Tratamento Odontológico/psicologia , Dente Serotino/cirurgia , Percepção da Dor , Dor Pós-Operatória/psicologia , Extração Dentária/psicologia , Dente Impactado/cirurgia , Trismo/psicologia , Adolescente , Adulto , Criança , Edema/complicações , Edema/psicologia , Feminino , Humanos , Masculino , Mandíbula/cirurgia , Medição da Dor , Dor Pós-Operatória/complicações , Fatores Socioeconômicos , Extração Dentária/efeitos adversos , Trismo/complicações , Adulto Jovem
18.
Artigo em Inglês | MEDLINE | ID: mdl-33151193

RESUMO

This article aims to evaluate the effect of anatomically designed, single-unit provisional restorations on soft tissue preservation following immediate implant placement. Patients in need of a single-tooth replacement in the esthetic area were recruited for this study. An immediate provisional restoration with a transmucosal area anatomically designed to support the soft tissue was used for every patient. The horizontal volumetric tissue changes and the presence and amount of vertical recession were measured at baseline (T0) and after 1 month (T1), 3 months (T2), and 6 months (T3). Sixty-three patients received 66 implants that were placed into fresh extraction sites. The average follow-up time was 48 months (range: 24 to 60 months). All implant restorations were successful, and the cumulative implant survival rate and success of restorations was 100%. After 6 months, the mean horizontal ridge measured midbuccally had increased by 0.10 ± 0.10 mm at 1 mm from the free gingival margin, had decreased by 0.09 ± 0.10 mm at 3 mm, and had decreased by 0.20 ± 0.10 mm at 5 mm. In addition, the mean recession at the midbuccal surfaces was 0.04 ± 0.37 mm. Measurements were made clinically and compared to measurements made on the casts. According to the results of this study, the use of customized anatomically designed immediate provisional restorations following single-tooth extraction and immediate implant placement appeared to minimize the loss of tissue volume that results from postextraction bone remodeling, thus optimizing the final esthetic result.


Assuntos
Implantes Dentários para Um Único Dente , Carga Imediata em Implante Dentário , Estética Dentária , Humanos , Estudos Prospectivos , Preservação de Tecido , Extração Dentária , Resultado do Tratamento
19.
Braz Dent J ; 31(6): 640-649, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33237236

RESUMO

The purpose of this investigation was to evaluate the effects of lithium chloride (LiCl) on the socket healing of estrogen-deficient rats. Seventy-two rats were allocated into one of the following groups: Control, Ovariectomy and LiCl (150 mg/kg/2 every other day orally) + Ovariectomy. Animals received LiCl or water from the 14th day post-ovariectomy, until the completion of the experiment. On the 21st day after ovariectomy, the first molars were extracted. Rats were euthanized on the 10th, 20th and 30th days following extractions. Bone healing (BH), TRAP positive cells and immunohistochemical staining for OPG, RANKL, BSP, OPN and OCN were evaluated. The Ovariectomy group presented decreased BH compared to the LiCl group at 10 days, and the lowest BH at 20 days (p<0.05). At 30 days, the Ovariectomy and LiCl-groups presented lower BH than that of the Control (p<0.05). The number of TRAP-stained cells was the lowest in the LiCl group at 20 days and the highest in the Ovariectomy group at 30 days (p<0.05). At 10 days of healing, the LiCl group demonstrated stronger staining for all bone markers when compared to the other groups, while the Ovariectomy group presented higher RANKL expression than that of the Control (p<0.05). LiCl enhanced bone healing in rats with estrogen deficiency, particularly in the initial healing phases. However, as data on the effects of lithium chloride on bone tissue are still preliminary, more studies related to its toxicity and protocol of administration are necessary before its application in clinical practice.


Assuntos
Cloreto de Lítio , Extração Dentária , Animais , Estrogênios , Feminino , Humanos , Ovariectomia , Ratos , Ratos Wistar , Alvéolo Dental , Cicatrização
20.
Orthod Fr ; 91(3): 191-195, 2020 10 01.
Artigo em Francês | MEDLINE | ID: mdl-33146614

RESUMO

Studies about orthodontic relapse have always confirmed the occurrence of some occlusal changes after orthodontic treatment. The reopening of premolar extraction spaces is one of the most frequently observed movements and would have several origins : gingival folds, root proximities, muscular imbalance... and particularly unstable end of treatment occlusion. The aim of this systematic review was to study the correlation between quality of the occlusal finishing after orthodontic treatment with premolars extraction and reopening of extraction spaces. The review was undertaken according to PRISMA recommendations from the Cochrane Handbook through an electronic consultation of the PubMed database to identify clinical trials that responded to the PICO research question. Five studies met all the inclusion criteria. Three studies used the Peer Assessment Rating (PAR) in assessing the quality of the occlusal finishing. For two of these studies, there is a correlation between poor occlusal finishing and reopening of extraction space. For the other three studies, no cause-and-effect relationship between these two factors has been proven. The divergence of the published results was explained by the fact that the stability of an orthodontic treatment depends on multiple parameters. Further controlled clinical studies should be conducted to objectively evaluate, without interfering with other parameters, the role of occlusal finishing in the long-term stability of orthodontic treatment.


Assuntos
Oclusão Dentária , Extração Dentária , Dente Pré-Molar/cirurgia
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