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Post-operative dental pain and analgesic efficacy. Part I.

Two groups, each of 100 adult patients who had undergone either a periodontal or oral surgical procedure were asked to record their pain experience over a three day investigation period. The results show that post-operative dental pain is variable in its nature and intensity, but reaches its maximum intensity in the first 12 hours post-operatively. Women appear to be more sensitive to post-operative pain than men. Significant differences in the pain experience after different operative procedures were noted. Removal of impacted lower third molars and retained roots result in more post-operative pain than the various other operative procedures. The incidence and severity of post-operative pain showed no clear relationship to the duration of the surgical procedure.

Adult↗

The continuous brushing acid-etch technique.

The continuous brushing of an acid-etching agent onto the enamel surface of an extracted tooth resulted in a more debris-free surface. SEM photomicrographs showed dissolution of some of the apatite crystals and a reduction in size of the remaining crystals, thus increasing the potential space between them for retention of unfilled composite.

Acid Etching, Dental↗

Residual alveolar ridge maintenance with a new endosseous implant material.

In an effort to maintain the height of the residual alveolar ridge, Bioglass cones were placed in fresh sockets after tooth extraction. Today the emphasis is on maintaining the residual alveolar ridge instead of letting it resorb and subsequently resorting to heroic efforts for augmentation. To date, 242 cone implants have been placed in 29 patients. Implant follow-up observation time ranged from 12 to 32 months with an average of 19.9 months. Twenty-seven patients have been fitted with dentures. To date seven implants (2.9%) have been lost. The Bioglass implants appear to be highly biocompatible as evidenced by absence of infection, normal mucosal healing, and radiographic evidence of bone healing around the implants. Evaluation of several implants reexposed surgically revealed new bone in direct contact with the immobile implants circumferentially. The problem of implant dehiscence that started to occur after approximately 10 months in other investigations had not manifested itself in the Bioglass implant patients who have been wearing their dentures for at least 12 months.

Alveolar Process↗

Clinical applicability of the radiographic method for determining the thickness of calcified crown tissues.

A previously developed radiologic method for determining the thickness of the mineralized crown tissues was applied clinically to 10 teeth diagnosed for extraction. The thickness of the mineralized crown tissues as measured radiographically was compared with that measured directly on the extracted tooth. A statistical analysis indicated accuracy of 4.46%, equivalent to an error of 0.12 mm.

Dental Cementum↗

An alternative immediate complete denture impression technique.

An alternative immediate denture impression technique for extremely mobile teeth, utilizing amalgam condensers, has been presented. The apically applied pressure on the mobile teeth minimizes the risk of accidental tooth extraction during impression removal.

Alginates↗

Stimulated parotid gland flow rates in healthy, elderly dentulous and edentulous individuals.

The use of dentures has been associated with increased stimulated parotid salivary flow rates (SPFR). A comparison of SPFRs was made between dentulous subjects having 20+ teeth (n = 190) and edentulous individuals (n = 67). Two different populations were selected, a white group from the Baltimore Longitudinal Study of Aging and an African-American group from the Washington Village Medical Center in Baltimore. Each group was healthy and unmedicated and had a mean age of 70.2 years. SPFR was determined with a Carlson-Crittenden cup and 2% citrate for stimulation. The edentulous subjects did not wear their dentures during salivary collection. The results indicated a significantly lower SPFR in dentate individuals compared with edentulous subjects (p < 0.01). Dentulous men also had a lower SPFR than edentulous men (p < 0.04). In addition, a pre- and postsurgical evaluation of 10 individuals who underwent full mouth tooth extractions revealed no differences in SPFR. These results suggest that edentulism per se does not have a deleterious effect on stimulated parotid salivary flow rates.

Aged↗

Reduction of post-operative swelling by a placebo effect.

A placebo effect on post-operative swelling was investigated as a possible model for studying psychological influences on recovery from surgery. 79 patients undergoing removal of impacted third-molars received one of five different procedures shortly after emerging from general anaesthetic. These included dentist-administered or placebo ultrasound (the latter given in two different ways to control for massage effects), untreated controls and a group instructed to apply facial massage to themselves. Pre- and post-operative measurements included trait and state-anxiety, coping style, emotional state, pain, plasma cortisol and facial swelling. Cortisol levels correlated with anxiety and avoidant coping. Post-operative anxiety was negatively correlated with pre-operative arousal. Neither coping nor emotional state was affected by the treatments, but swelling was reduced by a placebo effect of ultrasound. Cortisol levels also responded, apparently to an effect of massage. The coping and emotional factors which we measured here cannot, therefore, explain the effects of this psychological procedure on post-operative recovery.

Adaptation, Psychological↗

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