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At least 253 records · Page 14Linked to original sources
PubMed2001

Post-extraction complications seen at a referral dental clinic in Dar Es Salaam, Tanzania.

AIM: To investigate the types and magnitude of post extraction complications. SETTING: A referral hospital in Dar es Salaam, Tanzania. SUBJECTS: All dental patients who had their teeth extracted at the Muhimbili Medical Centre dental outpatient clinic during the study period (May September 1999). A total of 3,818 extractions were performed under local anaesthetic in 3,732 patients. METHOD: Oral examination of all patients who reported back with post-extraction problems. RESULTS: The frequency of post extraction complications was low (1.1 per cent), and was mainly due to; infected sockets (48.7 per cent), followed by bleeding sockets (41.0 per cent) and retained roots (10.3 per cent). There were eight 'other' complications suffered by 11 patients: necrotising fasciitis (n=l), herpes zoster (n=l), Ludwig's angina (n=l), infections of the submandibular (n=l), parapharyngeal (n=2), masticator (n=2) and submasseteric spaces (n =2), and reaction to local anaesthesia (2ml of 2 per cent lignocaine hydrochloride) (n=1). CONCLUSION: The results of this study indicate that post-extraction complications are few, mostly minor, self-limiting and easily treatable. The study does not support routine antibiotic prophylaxis or special pre-extraction procedures, even in this patient population with poor oral hygiene and high HIV seroprevalence.

Abscess↗
PubMed1998

Exogenous estrogen may exacerbate thrombophilia, impair bone healing and contribute to development of chronic facial pain.

A 32 year old white female, in apparently good health, failed to respond to conservative wound care for alveolar osteitis after a routine mandibular first molar extraction. Curettage and biopsy of necrotic alveolar bone from the #30 socket escalated her pain such that hospitalization was necessary for pain management with intravenous morphine. Twelve months prior to admission she had been placed on exogenous estrogen (Premarin, 0.625 mg/day) after a partial oophorectomy. While hospitalized, she was found to have resistance to activated protein C (APCR). Premarin was discontinued. After discharge, weekly changes of an antibiotic impregnated dressing allowed for progressive regeneration of bone and epithelium with gradual reduction in her pain. She was found to be heterozygous for the mutant Factor V Leiden, a heritable factor for increased tendency to form thrombi, so-called thrombophilia. We speculate that the exogenous estrogen administration exacerbated the thrombophilia associated with the Factor V Leiden mutation by compounding the patient's resistance to activated protein C thereby contributing to her development of osteonecrosis and severe alveolar neuralgia.

Adult↗
PubMed1979

Tranexamic acid in alveolar sockets in the prevention of alveolitis sicca dolorosa.

The effect of trans-4-amino-methyl-cyclohexane acid (AMCA) and a placebo preparation on the development of alveolitis sicca dolorosa (ASD) was investigated in a double-blind designed experiment. The preoperative registrations were age, sex, use of oral contraceptives, menstrual cycle, smoking, degree of impaction and operation time. The study included 120 healthy persons. Each person had bilateral impacted mandibular molars removed surgically at one session. AMCA (160 mg/extraction site) or placebor was applied in each socket after the operation. The postoperative course was evaluated on average 5 days later by the use of 13 different variables describing local and general discomfort. The incidence of ASD was 7.5% in the AMCA side and 5.0% in the placebo side. The result shows that a local inhibition of plasminogen activation by AMCA is insufficient to prevent the development of ASD. The occurrence of ASD and postoperative discomfort was not increased in women operated during the menstrual period. The usage of oral contraceptives is known to be associated with a high frequency of ASD. Women taking oral contraceptives may therefore postpone the operation to the withdrawal period of the pill, to reduce the risk of developing ASD. Postoperative pains and the consumption of analgetics were significantly increased in patients who were habitual smokers.

Adolescent↗
PubMed2004

[Antimicrobial photodynamic therapy for prevention of alveolar ostitis and post-extraction pain].

AIM: Alveolar ostitis occurs with an incidence of 3-25% after tooth extraction. Antimicrobial photodynamic therapy (aPDT) with HELBO Blue and TheraLite laser enables local decontamination of the extraction socket. The aim of the study was to evaluate the possibility of aPDT with HELBO Blue and diode soft laser to reduce the prevalence of alveolar ostitis. MATERIAL AND METHODS: In an intraindividual study with 100 patients in 130 jaws, one or multiple contralateral teeth were removed at 1-week intervals. Randomly each side was treated with or without aPDT with a standardized protocol. At recall the evaluation of the extraction socket was performed by the investigator and the postoperative pain sensation was judged by the patient on an analog pain scale (0-100). RESULTS: In the group with aPDT alveolar ostitis occurred at one extraction site and in the control group without aPDT in 13 cases. The subjective pain assessment on the day after tooth removal was scored with 11.2+/-9.8 in the aPDT-group and with 19.0+/-12.2 in the control group. One week after extraction the pain sensation in the aPDT group was scored with 2.4+/-9.2 and in the control group with 13.1+/-25.2. The difference was significantly lower with p=0.000 for the 1st and 8th post-surgical days in the aPDTgroup. CONCLUSIONS: The significantly lower incidence of alveolar ostitis after antimicrobial photodynamic therapy seems to be a new and promising possibility for the prevention of alveolar ostitis.

Bacterial Infections↗
PubMed1995

Evaluation of topical viscous 2% lidocaine jelly as an adjunct during the management of alveolar osteitis.

PURPOSE: This study evaluated the efficacy of topical viscous 2% lidocaine jelly for the alleviation of pain experienced during the instrumentation of mandibular third molar extraction sites diagnosed with alveolar osteitis and for pain relief during the postinstrumentation period. PATIENTS AND METHODS: Thirty adult patients with a diagnosis of alveolar osteitis in a mandibular third molar extraction site were included in this prospective, double-blind study. Each patient had their sutures removed, the socket irrigated, and 2% lidocaine jelly placed on the tip and side of the tongue to blind the patient against the test substances. The subjects were then randomly distributed into two groups. Group 1 had a nonactive jelly base placed into the socket 2 minutes prior to the placement of a standard obtundant dressing. Group 2 had viscous 2% lidocaine jelly placed into the socket in the same manner. Patients subjectively quantified their pain intensity pretreatment, during instrumentation, immediately postmanipulation, at 5-minute intervals to 30 minutes, and at 45 and 60 minutes. They also subjectively quantified their pain relief at each of the time intervals following instrumentation. RESULTS: There was no statistical difference between the pretreatment pain experienced by both groups. The use of 2% lidocaine jelly had a measurable (P = .056), but not statistically significant, effect on pain due to instrumentation. At every time interval thereafter, the use of 2% lidocaine jelly elicited a statistically significant (P < .05) decrease in pain perception, and a statistically significant increase in pain relief when compared with the inactive jelly. CONCLUSION: Topical viscous 2% lidocaine jelly is a useful adjunct during the treatment of alveolar osteitis, especially in the early (< or = 60 minutes) postinstrumentation period.

Adult↗
PubMed1998

The effect of locally applied gauze drain impregnated with chlortetracycline ointment in mandibular third-molar surgery.

A prospective randomized crossover, within-patient, controlled study was performed in 26 healthy patients to test the effect of the prophylactic local use of gauze drain impregnated with chlortetracycline (Aureomycin 3%, Lederle) ointment on postoperative alveolitis formation after surgical removal of 52 bilaterally impacted mandibular third molars. The teeth were removed on two separate occasions; on one side drain was inserted in the socket, and on the other side no drain treatment was used for control. The influence on postoperative pain, swelling, and mouth opening ability was investigated. The results indicated a statistically significant reduction (P = 0.02) in the incidence of postoperative inflammatory complications, defined as postoperative alveolitis, from 35% in the no-drain group to 4% in the drain group. No statistically significant difference was found between the two treatment methods with regard to pain and mouth opening reduction. There was a significant difference between the drain and no-drain treatment with regard to swelling on the 1st postoperative day in favor of the no-drain method. It is concluded that insertion of a chlortetracycline-impregnated drain may be an effective method for reducing postoperative alveolitis formation but has no beneficial effect on pain, swelling, and mouth opening reduction after impacted mandibular third-molar surgery.

Administration, Topical↗
PubMed1987

Fibrinolytic alveolitis and its prevention.

This study aimed at testing the clinical efficacy of a topical prevention of FA, the sample comprising 300 cases of extractions. A sponge was inserted in the socket of each of them, dividing the sample into 3 equal groups: group A (gelatine), group B (gelatine + Solcoseryl) and group C (gelatine + Solcoseryl + propyl-hydroxy-benzoic-acid). The global incidence of FA was a comparatively high, 7.6%, which could be related to the pool of patients included in the study as to the presence of teeth and techniques more prone to complications. No specific clinical characteristic has been isolated (distribution within sex, age, teeth, etc.) which could contradict data collected from other authors. The incidence was lower in the groups B (3%) and C (7%) as compared to group A (13%), but only sponges of group B demonstrated a clinical and statistical efficacy, according to the high number of lower third molar extractions. In contrast, the addition of Solcoseryl proves efficient and does not delay healing, according to previous histological studies. This last characteristic has to be confirmed in the experimental conditions described in our study, as has its mode of action. The ultimate mechanism of FA has still, in our opinion, to be better defined well before the restatement of a topical prevention of FA.

Actihaemyl↗
PubMed1977

Increased incidence of postoperative localized osteitis in mandibular third molar surgery associated with patients using oral contraceptives.

Current literature has noted the various side effects of oral contraceptives. Oral surgeons have recently encountered an increased incidence of postoperative localized osteitis occurring with removal of manidibular third molars. This article documents the occurrence of this phenomenon among 105 women participating in a recent study at the Clinical Center of the National Institutes of Health.

Contraceptives, Oral↗
PubMed1976

Effects of lavage techniques with third molar surgery.

A comparison study of 206 mandibular third-molar surgical sites, half of which were irrigated with high volumes of isotonic normal saline solution with a conventional hand syringe and half of which were irrigated with high volumes of isotonic normal saline solution by means of a mechanical pulsating lavage instrument, revealed the following: 1. No cases of localized osteitis occurred with the use of mechanical irrigation in 103 surgical sites (0%). 2. One case of localized osteitis occurred with regular irrigation in 103 surgical sites (0.97%). 3. The over-all incidence of localized osteitis was one case in 206 surgical sites (0.49%). 4. One case of infection occurred with mechanical lavage (0.97%). 5. Two cases of infection occurred with conventional lavage (1.96%). 6. The over-all incidence of infection was three cases in 206 surgical sites (1.45%). 7. No significant differences occurred at the 0.95 level of confidence when the two groups' 3- and 5-day healing were compared. 8. A fairly even distribution of postoperative infections and/or localized osteitis was noted among the cases handled by the three surgeons directly involved in the performance of the operations. 9. Three hundred fifty milliliters of isotonic normal saline solution under pressure (whether electrical or conventional) appreciably reduced the reported incidence of localized osteitis without the use of antibiotics. 10. The mechanical irrigator was less cumbersome and faster (30 seconds for 350 ml.) than the conventional hand syringe (4 to 5 minutes for 350 ml.). 11. The sterilization procedure was more complicated for the mechanical irrigator (gas autoclave) than for the conventional hand syringe (presterilized disposable type). 12. Loose (unattached) soft tissue and bony spicules were thoroughly removed by 350 ml. of irrigation.

Adolescent↗
PubMed1977

Effect of lavage on the incidence of localized osteitis in mandibular third molar extraction sites.

Four hundred twenty-two mandibular third molars were extracted in 211 patients. After extraction, one half of the surgical sites were subjected to a 175 ml. lavage with normal saline solution, and the other half received a lavage of less than 25 ml. of normal saline solution. Comparisons revealed the following: 1. The overall incidence of localized osteitis was 8.3 per cent (thirty-five of 422 sites). 2. Localized osteitis occurred at twelve of 211 (5.7 per cent) sites which were subjected to the higher-volume lavage. 3. Localized osteitis occurred at twenty-three of 211 (10.9 per cent) sites which were subjected to minimal lavage. 4. The incidence of localized osteitis was determined in the various age groups as follows: ages 15 to 20, 5.0 per cent; ages 21 to 35, 10.4 per cent; ages 26 to 30, 14.7 per cent. 5. Localized osteitis occurred at eight of 175 (4.5 per cent) partial-impaction sites, whereas it occurred at twenty-seven of 246 (11 per cent) complete-impaction sites. 6. The incidence of localized osteitis at extraction sites in female patients taking oral contraceptives was 19.4 per cent (seven of thirty-six sites). 7. Postoperative infection occurred at seven of 422 extraction sites (1.4 per cent); six of these occurred at sites which were subjected to minimal lavage. These results indicate that the use of a 175 ml. lavage with normal saline solution after extraction of mandibular third molars will significantly reduce the incidence of localized osteitis to approximately one half of that observed when only a minimal-volume lavage is used. The results also suggest that age, type of impaction, and whether the patient is taking oral contraceptives are all important factors to be considered in the incidence of localized osteitis.

Adolescent↗
PubMed1978

Predisposing and operative factors: effect on the incidence of localized osteitis in mandibular third-molar surgery.

Five hundred and four bilateral mandibular third-molar extraction sites were examined postoperatively for localized osteitis. All sites received a mechanical lavage of either 350 ml, or 175 ml. of sterile normal saline solution. No significant differences were observed relative to the effect of lavage volume on the incidence of iocalized osteitis. A preoperative antimicrobial mouthrinse of chloramine-T (sodium-p-toluene sulfonchloramide) was also used by one half of the patients. Although only slight differences were noted in healing with the different lavage volumes of the chloramine-T, certain predisposing factors contributed significant differences.

Adolescent↗