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A biochemical study of aminopeptidases in the palatal mucosa of the rat following tooth extractions.

Aminopeptidase activities were studied biochemically from the supernatants of the homogenates prepared from the normal and post extraction palatal mucosa of the rat. The determinations were carried out at 0.5, 1, 2, 4, 8 and 16 hours and 1, 2, 3, 5 and 7 days following extraction using N-L-aminoacyl-2-naphthylamines of arginine, glycine, leucine, proline and valine as the substrates. In addition, in the second part of the study the hydrolysis of N-L-aminoacyl-2-naphthylamines of alanine, histidine, isoleucine, lysine, phenylalanine, serine, threonine, tyrosine and valine was tested at 1, 3 and 5 days following extraction. The effect of chloride ions (0.2 M NaCl) on the hydrolysis of arginine and lysine derivatives was also tested. The specific activities of aminopeptidases obtained from the extraction-wound side were compared to those of the control side at each time interval. Tooth extraction caused a considerable reduction in the specific activities of aminopeptidases in the surrounding palatal mucosa immediately after extraction (at 0.5 hr.). The specific activities in the wound tissue remained generally below the control levels for 24 hours and reached their maximum within 5 days following extractions. The highest relative increase was obtained with N-L-valyl-2-naphthylamine. Arginine aminopeptidase was activated by chloride ions on an average 20 per cent more in the wound tissue than the control. This effect can be considered suggestive of the activation of aminopeptidase B in the post extraction palatal mucosa.

Aminopeptidases

Painful, nonhealing, tooth extraction socket.

The oral signs and symptoms of acute leukemia include gingival hypertrophy, gingival hemorrhage, petechiae and ecchymoses, mucosal ulceration, paresthesia, tooth pain, and oral infections. This case was unusual in that the diagnosis of acute leukemia was made only after a biopsy specimen of tissue protruding from the socket of a recently extracted tooth disclosed malignant cells suggestive of leukemia or lymphoma. The diagnosis of epulis granulomatosa should be made only after clinical, radiographic, and microscopic studies have been performed to rule out a malignant process.

Diagnosis, Differential

Reasons for tooth extraction among Tanzanians.

In 1988 a study was carried out among Tanzanians of different age groups to determine the reasons for tooth extraction. The major reason was found to be dental caries or its associated complications (81%) while periodontal diseases was the runner-up (13%). The molars teeth were the most commonly extracted. The results of this study are important in planning resources for and provision of emergency oral health care especially for the rural population.

Adolescent

Protein synthesis in wound after tooth extraction in pancreatectomized diabetic rats.

The incorporation of alanine C14 in protein synthesis was analyzed in recently formed alveolar tissue after tooth extraction in partially-pancreatectomized diabetic rats. The incorporation of alanine C14 was higher in diabetic animals than in treated diabetic and control groups. The results can be explained by a delay in bone tissue repair.

Alanine

[Tooth extraction in patients suffering from hemophilia A under the cover of cryoprecipitates and epsilon-aminocaproic acid].

Tooth extractions were carried out in 75 patients with haemophilia A after infusion of a single dose of cryoprecipitate and 4 g of epsilon-aminocaproic acid. During the 7-10 day period of follow-up, the patients received epsilon-aminocaproic acid by mouth. In 32 of 44 patients with severe or moderate haemophilia and in 22 of 31 patients with mild haemophilia, healing was uneventful and no bleeding complications occurred. Only in 5 patients with severe haemophilia and in 1 patient with mild heamophilia bleeding from tooth sockets was extensive enough to require further replacement therapy. The results show that epsilon-aminocaproic acid in conjunction with a single infusion of cryoprecipitate can insure hemostasis after dental extraction in patients with haemophilia A.

Adolescent

The application of a frequency oscillation method for tooth extraction in dogs.

A tooth-grasping forceps with a gas-driven oscillating headpiece was designed for dental extractions in the dog, Compared with the conventional method, the extraction time was shortened considerably, and preliminary results indicate it may cause less trauma to alveolar bone and periodontal ligament.

Anesthesia, General

Tooth extraction in patients with heart disease.

A combination of fear and declining compensation may induce cardiovascular accidents in the elderly with heart disease. An accurate cardiac diagnosis and relief of stress and pain during tooth extraction are important. The range of cardiac abnormalities and the regime followed in two clinics in the People's Republic of China are reviewed, together with the precautions which are taken to avoid emergencies or manage them should they arise.

Adolescent

Effects of various antiseptics on bacteremia following tooth extraction.

The effect of local irrigation of the gingival sulcus, which is considered an important source of bacteremia following dental procedures, with three different antiseptic solutions including hydrogen peroxide, chlorhexidine and povidone iodine, on the frequency of bacteremia after tooth extraction was determined, and the efficacies of the three antiseptics were compared. Although all the antiseptic solutions reduced the frequency of bacteremia to various degrees, povidone iodine was the most effective, and seemed to be the best choice since the decrease was statistically significant. Local administration of antiseptic solutions is therefore recommended as an adjuvant to systemic antibiotic prophylaxis.

Adult

Studies on the enhanced effect of acupuncture analgesia and acupuncture anesthesia by D-phenylalanine (2nd report)--schedule of administration and clinical effects in low back pain and tooth extraction.

D-phenylalanine (DPA) is known to block the activity of carboxypeptidase, an enzyme which degrades enkephalins, endogenous morphine-like substances. Therefore, it is considered that DPA administered as an inhibiting drug of this degrading enzyme might prolong analgesia induced by acupuncture. 1) Thirty patients suffering from chronic low back pain were treated with acupuncture 30 minutes after the oral administration of 4.0 grams of DPA. The results were: excellent in 7 cases, good in 11, fair in 6 and poor in 6. Cases graded excellent and good were then compared with a placebo group. The effect was increased 26% in the DPA-acupuncture group, which shows no statistically significant difference (P less than 0.1). 2) In 56 patients, tooth extraction was performed under acupuncture anesthesia: 18 had received 4.0 gram of DPA (P.O.) 30 minutes earlier. The results were excellent in 8, good in 6, fair in 3, and poor in 1. The excellent and good cases were compared with 38 placebo group cases. The effect in the DPA-acupuncture anesthesia group was significantly increased by 35% (P less than 0.01). 3) In order to determine the optimum time for the administration of DPA, two schedules of administration were compared. [1] DPA was given on the previous day in three 0.5 gram doses (26 cases). [2] A single 4 gram dose was administered 30 minutes before treatment (30 cases). The results from the "excellent", "good" and "fair" cases showed a 16% increase in effectiveness when DPA was administered the day before, not a statistically significant difference (P less than 0.1), but a clear tendency to increase was observed. The above findings show that DPA has an enhancing effect on acupuncture analgesia and anesthesia in clinical practice.

Acupuncture Analgesia

[Study of structural changes in canine maxillary trabecular bone after tooth extraction].

All teeth on the right side of the upper and lower jaws were extracted from canine specimens; and changes in maxillary trabecular-bone structure caused by the resultant reduction in functional pressure were studied by means of image analysis of trabecular-bone density, width, specific length (which indicates bone length to unit area), and trabecular-bone orientations. Results 1. Trabecular-bone density Over the 13-month period, in comparison with the normal side, trabecular-bone density on the experimental side dropped to 69.4% in the incisor region, 82.2% in the premolar region, and from 60.0 to 68.0% in the molar region. The greatest reduction occurred in the molar region. 2. Trabecular-bone width Over the 13-month period, in comparison with the normal side, trabecular-bone width on the experimental side dropped to 86.9% in the incisor region, 86.1% in the premolar region, and from 66.4 to 71.4% in the molar region. The greatest reduction occurred in the molar region. 3. Specific length Over the 13-month period, in comparison with the normal side, specific length on the experimental side dropped to 81.9% in the incisor region, 82.9% in the premolar region, and from 65.6 to 70.5% in the molar region. The greatest reduction occurred in the molar region. 4. Orientation No regular trabecular-bone orientation was observed in the tooth-extraction sockets. In the incisor region, trabecular bone was often distributed at from 100 degrees to 120 degrees in relation to the dental roots. As time passed after extraction, the amount of bone with this orientation gradually decreased. At 13 months, amounts with bone orientation of from 40 degrees to 60 degrees had increased. In the premolar region, a great deal of trabecular bone was oriented at from 140 degrees to 150 degrees in relation to the dental roots. As time passed after extraction, the amount of bone with this orientation gradually decreased. At 13 months, amounts with bone orientation of from 110 degrees to 130 degrees had increased. In the molar buccal region, trabecular bone was often distributed at from 20 degrees to 40 degrees, and 90 degrees in relation to the dental roots. In the molar palatal region, trabecular bone was often distributed at from 120 degrees to 140 degrees in relation to the dental roots. At 13 months, the amount of trabecular bone oriented at about 90 degrees had increased.

Alveolar Bone Loss

Frequency of tooth extraction in orthodontic treatment.

Orthodontic extraction frequency describes the percentage of an orthodontic patient population experiencing extractions of one or more permanent teeth, excluding third molars. It is a useful statistical measure of the many variables associated with the extraction-nonextraction decision. For a study sample of 537 North American white orthodontic patients, the frequency of tooth extraction was determined as 42.1 percent. This is compared with a range of 6.5 percent to 83.5 percent reported in the world dental literature. Factors responsible for the enormous differences in orthodontic extraction frequency are explored. The study of extraction frequency offers a simple, valuable aid for the clinician to understand better the nature of his patient population, his treatment methods, and his rationalizations.

Adolescent

The effect of tooth extraction on periodontal ligament mechanoreceptors represented in the mesencephalic nucleus of the cat.

When a force is applied to a tooth, mechanoreceptors in the periodontal ligament are stimulated. When teeth are extracted the remnants of the periodontal ligament break down and disappear, but it is not known what happens to the mechanoreceptor neurones that innervated it. The present study seeks to determine the effect of tooth extraction on the population of periodontal ligament mechanoreceptor neurones represented in the mesencephalic nucleus of the fifth cranial nerve. The incisor and canine teeth were extracted from adult cats; terminal experiments were performed between 7.5 months and 2 yr later. Recordings were made in the mesencephalic nucleus with microelectrodes, and neurones were identified in the inferior alveolar nerve that previously innervated the periodontal ligament of one of the extracted mandibular teeth. The majority of these neurones responded only to electrical stimuli applied to the edentulous ridge of the mandible in the area where the incisor or canine teeth had previously been. It was not possible to stimulate them mechanically, despite the use of large forces. A small number had reinnervated new soft-tissue sites. They could be mechanically stimulated and were found adjacent to the area in which the mandibular incisor and canine teeth had been. Thus the population of periodontal ligament mechanoreceptor neurones represented in the mesencephalic nucleus do not all degenerate after tooth extraction. As the majority of those still present do not appear to reinnervate new tissues in which they can be mechanically stimulated, it is unlikely that they have any functional role after tooth loss.

Animals