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At least 271 records · Page 15Linked to original sources
PubMed1979

Jawbone cavities and trigeminal and atypical facial neuralgias.

The possible role of dental and oral disease in the etiology of idiopathic trigeminal and atypical facial neuralgias has been examined. Among thirty-eight patients with idiopathic trigeminal neuralgia and twenty-three patients with atypical facial neuralgia, there was in nearly all instances a close relationship between pain experienced and the existence of cavities in alveolar bone and jawbone of the patients. The cavities were at the sites of previous tooth extractions and, although at times more than 1 cm. in a given diameter, were usually not detectable by x-rays. A new method for their detection and localization was developed empirically, based on the observation that peripheral infiltration of local anesthetic into or very close to the bone cavity rapidly abolished trigger and pain perception by patients during persistence of the anesthetic action. Histopathologic examination of bone removed from cavities by curettage revealed, in both idiopathic trigeminal and atypical facial neuralgias, a similar pattern characterized by a highly vascular abnormal healing response of bone. Some lesions presented a mild chronic inflammatory (lymphocytic) infiltration. Preliminary microbiologic studies of material from the walls of the cavities showed the existence within them of a complex, mixed polymicrobial aerobic and anaerobic flora. Treatment consisted of vigorous curettage of the bone cavities, repeated if necessary, plus administration of antibiotics to induce healing and filling-in of the cavities by new bone. Responses of patients to the above treatment consisted of marked to complete pain remissions, the longest of which has been for 9 years. Complete healing leads to complete and persistent pain remissions. It was concluded that in both idiopathic trigeminal and atypical facial neuralgias, dental and oral pathoses may be major etiologic factors.

Adult↗
PubMed1983

Influence of polylactic acid mesh on the incidence of localized osteitis.

A biodegradable polylactic acid surgical implant, designed to facilitate dental extraction wound heading, is described. Animal studies have proved the safety and tissue compatibility of the implanted polylactic acid material. A clinical study using this material in mandibular third molar extraction sites in human subjects is reviewed. Results of that study reveal the implant to be effective in reducing the incidence of localized osteitis following mandibular third molar extractions.

Adolescent↗
PubMed1985

Effect of antimicrobial mouth rinses on the incidence of localized alveolitis and infection following mandibular third molar oral surgery.

Mandibular third molars were removed from 400 patients who were divided into four different preoperative and postoperative rinsing groups using either normal saline solution, chloramine-T, povidone iodine, or sodium bicarbonate. The overall incidence of localized alveolitis and infection was 4.5% and 1.7%, respectfully. The incidence of the two postoperative problems proved not to be statistically significant when the four groups were compared with each other. There seems to be no apparent advantage to the preoperative and postoperative use of an antimicrobial mouth rinse in place of normal saline solution in reducing the incidence of either localized alveolitis or postoperative infections.

Adolescent↗
PubMed1992

Evaluation of intra-alveolar chlorhexidine dressings after removal of impacted mandibular third molars.

Chlorhexidine gluconate (CHX) has been investigated for its possible benefit in the prevention of alveolar osteitis complicating third molar removal. In a double-blind, placebo-controlled clinical study, 70 randomly selected healthy patients were subjected to uncomplicated mandibular third molar removal followed by CHX-gelatin sponge and saline solution-gelatin sponge intra-alveolar dressings. Each patient was followed for 6 days for postoperative discomfort and complications, and scored accordingly. The results demonstrated that patients receiving 0.2% CHX intra-alveolar dressings exhibited a significant reduction in postoperative discomfort and complications when compared with saline solution-treated control sites (p less than 0.005). Further, this phenomenon was not found to be related to patient factors including age, sex, and race, nor did any correlation exist between treated or control sites, and surgical factors including performing surgeon, surgeon's dominant hand, time of surgery, surgical site, and difficulty of the removal. These findings warrant further studies concerning the apparent clinical benefit of postextraction intra-alveolar CHX dressings for the reduction of postoperative alveolar osteitis.

Adult↗
PubMed1993

Side effects and complications associated with third molar surgery.

A retrospective analysis of complications and side effects associated with surgery for 1000 mandibular and 500 maxillary impacted third molars was performed. The analysis included 614 patients with impacted mandibular third molars and 274 with impacted maxillary third molars who were treated in a 5-year timeframe from 1987 to 1992. The incidence of intraoperative complications and side effects of mandibular third molar surgery was 1.1% and 4% for maxillary third molar surgery whereas postoperative complications were 4.3% and 1.2%, respectively.

Adolescent↗
PubMed1993

Complications of dental surgery in persons with HIV disease.

Post tooth extraction infective complications have occasionally been described in HIV-infected persons. However, there is little objective data as to the frequency of this and the need for antibiotic prophylaxis. Similarly the frequency of postextraction bleeding in patients infected with HIV, who may have thrombocytopenia, is unknown. In the present study the frequency of postextraction complications has been investigated in a group of 38 persons at stages 2 to 4 of HIV infection and 26 matched subjects from patients groups commonly at risk of HIV infection but not seropositive. During 40 clinical procedures in HIV-infected patients, 100 (range 1 to 23, median 1) teeth were extracted. Three episodes of delayed postextraction healing were recorded. During 30 procedures in the non-HIV-infected persons, 68 (range 1 to 5, median, 2) teeth were extracted, and two episodes of delayed postextraction healing were recorded. These differences were not significant. Only one HIV-infected patient had an episode of severe postextraction bleeding: this was a hemophiliac who bled despite receiving factor VIII prophylaxis. The bleeding occurred 7 days after the extraction and ceased with tranexamic acid and additional factor VIII. No control subject had severe postextraction hemorrhage. It is concluded that postextraction complications are uncommon in HIV-infected patients and that routine antibiotic prophylaxis is not indicated.

Adult↗
PubMed1995

Third molar surgery: an audit of the indications for surgery, post-operative complaints and patient satisfaction.

A prospective investigation was undertaken of 522 patients undergoing third molar surgery. Data relating to indications for surgery and quality of care were collected on both pre- and post-operative proformas. This investigation showed that over half of the patients did not have clinically sound indications for surgery. The incidence of post-operative complications was approximately the same as other studies on third molar surgery. Patient satisfaction was at a high level, although this study revealed that a percentage of symptom-free patients undergoing third molar surgery sustained nerve damage some of which remains unreported. Clear and well defined indications for third molar surgery do exist and should be adhered to. Operating on patients without good reason involves unnecessary expenditure to purchasing authorities, cost to the patient in both time off work and post-operative complications and further, may result in potentially avoidable legal problems for practitioners. A reappraisal of the impacted third molar is indicated prior to committing the patient to surgery, such that the indications for surgery are compatible with current views on quality assurance, health service economics and medico-legal common sense.

Cost of Illness↗
PubMed1985

A prospective study of complications related to mandibular third molar surgery.

A prospective study that evaluated the surgical and postsurgical problems of 9,574 patients of a wide range of ages who had had 16,127 third molars removed was performed. It was concluded that removal of mandibular third molar teeth during the teenage years resulted in decreased operative and postoperative morbidity.

Adolescent↗
PubMed1986

Complications following removal of impacted third molars: the role of the experience of the surgeon.

The incidence of complications associated with the removal of impacted third molars in a group of 500 patients treated by oral surgery faculty were compared with the incidence of complications in 208 patients treated during the same period by residents of oral and maxillofacial surgery. The results show that complications were more numerous after the removal of third molars classified as partial bony or complete bony impactions, and that less-experienced surgeons had a significantly higher incidence of such complications.

Adolescent↗
PubMed1990

Foreign body giant cell reaction related to placement of tetracycline-treated polylactic acid: report of 18 cases.

Presented are 18 cases of foreign body giant cell reaction in mandibular third molar extraction wounds previously treated with 40 mg of dry tetracycline powder carried into the wound with a biodegradable polymer dressing. The lesions vary in intensity from local, soft tissue granulomas to osteolytic, central bone pathologies. Several reports of foreign body giant cell reaction to insoluble tetracycline preparations are cited, along with a brief review of the relationship between myospherulosis and various formulations of tetracycline powder in petroleum-based carrier vehicles. The authors suggest that the foreign body giant cell lesions reported here were initiated by micron-sized particles of insoluble tetracycline powder and were further aggravated by certain hydrophobic characteristics of the associated biodegradeable polymer. The authors caution against use of dry, powdered forms of topical antibiotics in fresh dental extraction wounds.

Bone Resorption↗
PubMed1991

The effect of a chlorhexidine rinse on the incidence of alveolar osteitis following the surgical removal of impacted mandibular third molars.

A prospective randomized double-blind placebo-controlled study was conducted with 139 patients (278 bilaterally impacted mandibular third molars) to determine the effect of a perioperative 0.12% chlorhexidine gluconate rinse on the incidence of alveolar osteitis following surgical removal of impacted mandibular third molars. A statistically significant 60% reduction in the incidence of alveolar osteitis was obtained in the chlorhexidine group compared with the placebo group. In most subgroups analyzed, chlorhexidine was associated with at least a 50% reduction in alveolar osteitis compared with control groups.

Adolescent↗
PubMed1991

The relationship between the indications for the surgical removal of impacted third molars and the incidence of alveolar osteitis.

Six hundred forty-two impacted third molars were surgically removed in 412 patients. Before surgery, each patient was assessed clinically and radiographically, and the reason for the removal of each tooth was specifically recorded. One hundred eighty-two of the impacted teeth were removed for prophylactic reasons and 460 for therapeutic reasons. As much as possible, standardization of the operating procedure and environment, and of the preoperative and postoperative regimens was observed. After surgery, each case was followed to determine the absence or presence of signs and symptoms of alveolar osteitis. It was found that several factors seem to contribute to the development of alveolar osteitis; however, the most significant related finding was that the reason for the extraction, that is, whether the extraction was undertaken for therapeutic or prophylactic reasons.

Adolescent↗
PubMed1995

Germectomy or delayed removal of mandibular impacted third molars: the relationship between age and incidence of complications.

PURPOSE: To analyze and compare complications and side effects after removal of 1,500 mandibular impacted third molar teeth in three age groups. MATERIALS AND METHODS: The sample comprised 868 patients, 462 women and girls and 406 men and boys aged 9 to 67 years. The patients were divided according to age into the following three groups: group A, aged 9 to 16 years; group B, aged 17 to 24 years; group C, older than 24 years of age. RESULTS: The incidence of complications and side effects was 2.6% in group A, 2.8% in group B, and 7.4% in group C. All complications were temporary except in one instance of mandibular nerve paresthesia that occurred in a group C patient, in whom symptoms were still present 25 months after surgery. CONCLUSION: This study showed no significant difference in the complication rate between groups A and B, but complications significantly increased in group C.

Adolescent↗