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PubMed2002

Sympathetic activity-mediated neuropathic facial pain following simple tooth extraction: a case report.

This is a report of a case of sympathetic activity-mediated neuropathic facial pain induced by a traumatic trigeminal nerve injury and by varicella zoster virus infection, following a simple tooth extraction. The patient had undergone extraction of the right lower third molar at a local dental clinic, and soon after the tooth extraction, she became aware of spontaneous pain in the right ear, right temporal region, and in the tooth socket. At our initial examination 30 days after the tooth extraction, the healing of the tooth socket was normal; however, the patient had a tingling and burning sensation (dysesthesia) and spontaneous pain of the right lower lip and the right temporal region, both of which were exacerbated by non-noxious stimuli (allodynia). The patient also showed paralysis of the marginal mandibular branch of the facial nerve, taste dysfunction, and increased varicella zoster serum titers. A diagnostic stellate ganglion block (SGB) 45 days after the tooth extraction using one percent lidocaine markedly alleviated the dysesthesia and allodynia. These symptoms are characteristic of neuropathic pain with sympathetic interaction. The patient was successfully treated with SGB and a tricyclic antidepressant.

Aged↗
PubMed2003

Spatial and temporal localization of transforming growth factor-beta1, bone morphogenetic protein-2, and platelet-derived growth factor-A in healing tooth extraction sockets in a rabbit model.

PURPOSE: The purpose of this study was to test the hypothesis that spatial and temporal localization of growth factors transforming growth factor (TGF)-beta1, bone morphogenetic protein (BMP)-2, and platelet derived growth factor (PDGF)-A in a rabbit tooth extraction model correlate with the histologic events contributing toward healing. MATERIALS AND METHODS: Twenty-four male New Zealand White rabbits were used in the study. Incisor teeth were extracted from both jaws, and the healing extraction socket with the surrounding jaw bone was harvested at 48 hours, 4 days, and 1, 2, 4, 8, 12, and 16 weeks. Tissues were fixed, decalcified, and processed for hematoxylin and eosin and immunohistochemical staining. The sections were stained to detect TGF-beta1, BMP-2, and PDGF-A. Stained sections were then imaged, and an automated computer program was used to detect the brown 3,3'-diaminobenzidine regions representing the location of growth factors of interest. The data were collected in terms of percentage area and intensity of stain, and an analysis of variance was conducted (Tukey-Kramer and Scheffe's test) for statistical comparison between different time points, jaws, and growth factors. These results were also compared with hematoxylin and eosin-stained histologic specimens obtained at similar time points. RESULTS: Spatial and temporal differences in localization of TGF-beta1, BMP-2, and PDGF-A were observed across all time frames in both jaws. Statistically significant differences in percentage area and intensity of brown diaminobenzidine stain were detected temporally between TGF-beta1, BMP-2, and PDGF-A (P < or =.0001). CONCLUSION: The results of this study showed positive correlation between histologic events and the spatial and temporal localization of TGF-beta1, BMP-2, and PDGF-A in a rabbit tooth extraction model.

3,3'-Diaminobenzidine↗
PubMed2002

Early bone healing events in the human extraction socket.

The tooth extraction socket is unique in terms of a bone-healing defect in that it contains the remnants of periodontal ligament fibroblasts attached to the socket wall. Although these cells have an osteogenic potential in vitro, the origin of cells populating the human extraction socket is unknown and may include bone marrow, periosteum and pericytic cells. Recently, monoclonal antibodies (AML-3, SB-10 and SB-20) have become available which can identify cells undergoing osteogenic differentiation. The aim of this work was to investigate the pattern of osteoblast differentiation in the human extraction socket using these markers. Immunolocalization was used to identify the osteoprogenitor cell population in the extraction sockets of three patients. Runx2 was most strongly expressed by the osteoblasts at the socket margin and in the surrounding marrow spaces. Osteoprogenitor, pre-osteoblast and osteoblast cells surrounded the newly formed trabeculae, and expressed on their cell surface antigens which reacted with the SB-10 and SB-20 antibodies. In a specimen with the tooth and periodontium present, both osteo-blasts and periodontal ligament fibroblasts were immunoreactive with SB-10, and SB-20 and also expressed Runx2. There was heterogeneity of expression of these osteogenic markers e.g. not all osteoblasts expressed Runx2. We have shown that osteoprogenitor cells in the residual periodontal ligament and bone marrow may contribute to bone regeneration following tooth extraction.

Activated-Leukocyte Cell Adhesion Molecule↗
PubMed2002

Histometric study of socket healing after tooth extraction in rats treated with diclofenac.

The purpose of the present study was to investigate if diclofenac administration interferes with the time course of alveolar wound healing in rats. Forty-two Wistar rats were used, 21 rats received 10 mg/kg/day of diclofenac one day before and 4 days after extraction of the right maxillary incisors and 21 rats received saline. The animals were sacrificed 7, 14 and 21 days after tooth extraction. Progressive new bone formation and a decrease in the volume fraction of blood clot and connective tissue from 1 to 3 weeks after tooth extraction was quantified using the histometric point-counting method. Diclofenac treatment caused a significant delay in new bone formation in association with an impairment of blood clot remission/organization.

Alveolar Process↗
PubMed2005

Disseminated intravascular coagulopathy: manifestations after a routine dental extraction.

Clinical signs and symptoms of acute disseminated intravascular coagulopathy (DIC) include bleeding from body orifices, such as the nose, mouth, or ear, bleeding from an intravenous (IV) site, areas of ecchymosis, or blood in the urine or stool. The underlying disease triggering DIC usually determines the clinical presentation. However, patients with chronic DIC (compensated DIC) may possess subclinical signs and symptoms, and the bleeding disorder may only be identified through laboratory findings. In this compensated form, the triggering factor is exposed slowly and in small amounts (seen in malignancies and vasculitis), allowing replenishing of the augmented factors by the liver, adequate reticuloendothelial clearance of fibrin degradation products, and increased production of platelets, which prevent secondary fibrinolysis and the signs of bleeding. 1,4 We report a case of an 82-year-old male who presented to the emergency room 24 hours after a routine dental extraction with bleeding from the tooth socket, severe hypotension, and presence of ecchymosis on his chest. Clinical and radiographic exam revealed multiple thoracic and abdominal aortic aneurysms, as well as infrarenal and iliac aneurysms, continuous oral hemorrhage, and a unique presentation rarely documented in the literature: a bleeding tooth socket as the initial clinical sign and presentation of DIC.

Aged↗
PubMed1993

Reactivated herpes simplex virus infection as a possible cause of dry socket after tooth extraction.

This study was designed to evaluate a possible association between reactivated herpes simplex virus type 1 (HSV-1) infection after lower third molar extraction and development of dry socket (DS). The HSV-1 antibody response was analyzed before and after tooth removal by enzyme-linked immunosorbent assay and immunoblotting in 208 patients. History of previous possible oral herpes reactivation was evaluated by a questionnaire that was based on self-rated frequency of oral cold sores. Tobacco users were identified. The anatomic proximity of the root apex to the mandibular nerve canal was classified radiographically before extraction. Fifteen patients (7%) developed DS after tooth extraction. Eleven of the 15 DS patients (73%) were HSV seropositive as compared with 7 of 15 (47%) in the matched control group. Seven of the 11 seropositive DS patients have shown HSV-1 reactivation by an increase of specific polypeptides, predominantly gB, gC, gD and ICP 4 and 6, in the immunoblot test. No change in HSV-1 reactivity was observed in control sera. DS patients reported a high frequency of oral cold sores (64%) compared with the controls (33%). Tobacco use was not found to influence the frequency of cold sores or the development of DS. A close radiographic proximity between the mandibular canal and root apex was more common (P < .05) in DS patients. The results indicate that extraction of a mandibular third molar could be a possible cause of reactivation and recurrence of an HSV-1 infection.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1978

Dental implant fixation by electrically mediated process. II. Tissue ingrowth.

The effect of electrical stimulation on the interfacial strength of the porous polymethylmethacrylate implant/oral tissue union and the amount of tissue growth was investigated in the fourth premolars of dogs. The study indicates the interfacial strength peaks at about three weeks and decreases thereafter for both control and the stimulated specimens. The stimulated side showed consistently higher strength than its paired control. There was a positive relationship between implant period and amount of tissue in the pores although the latter was not correlated with the interfacial strength. Microradiographs showed a different pattern of new bone formation on the stimulated side when compared to the control. On both sides, bone formation occurred upward from the bottom of the tooth socket while on the stimulated side, new bone also developed from the sides of the tooth socket which was minimal in the controls. It is proposed that the direction of oral tissue formation is responsible for the different results obtained in this study compared with a similar study on long bones.

Animals↗
PubMed1986

Investigation of dressings designed for treatment of alveolitis sicca dolorosa ("dry socket"). Part 3: Influence of mannitol and sorbitol on properties of tablets and dressings comprising acetylsalicylic acid, mefenamic acid and aseptin P.

In the dressings for dry tooth sockets, mannitol and sorbitol as solid hydrophilizers have been applied. Increase of concentrations of these hydrophilizers in the tablets results in dressings with increased swelling ability and pharmaceutical availability but decreased viscosity and resistance to washing out. These properties of the dressings are also influenced by medicinal substances present. The dressing fills the tooth socket within several min, removes pain and remain there for 24-48 h.

Anti-Infective Agents↗
PubMed1998

[A method of measuring eruptive movement of the rat incisor using a non-contacting displacement detector].

The axial movements of rat incisors were recorded continuously for over 20 hr. The rats were anesthetized with halothane delivered by intratracheal intubation using an artificial respirator. A hemostatic clamp was used to immobilize the jaw. The displacement detector that detects changes in the electric eddy current exhibited high resolution, good linearity and low drift. The average eruption rates of the rat incisor were estimated to be 406 and 516 microns/ 24 hr at 34 and 37 degrees C of the rectal temperature, respectively. The values were within the normal range. We also measured the force needed to restrain eruptive movement of the rat incisor using the same apparatus combined with a load cell. The maximum pushing force was estimated to be 9 mN or 29 mmHg (converted value) on average. Then the effects of adrenaline on axial movement of the incisor and arterial blood pressure were examined. Adrenaline caused a rapid extrusive tooth movement with a nearly simultaneous increase in the blood pressure, followed by a marked intrusive tooth movement and a decrease in blood pressure. These results support the view that the systemic arterial blood pressure and vasculature in the tooth socket play important roles to determine the position of teeth. We assume that our method would be useful to clarify the precise relationship between tooth displacement and vascular change in the tooth socket.

Alveolar Process↗
PubMed1988

Investigation of dressings designed for treatment of alveolitis sicca dolorosa. Part 4: Analysis of the mechanism of liberation of drugs from dressings in vivo.

Analysis of liberation of medical substances from dressing for treatment of dry tooth-socket proved that this process proceeds simultaneously to two receiving compartments. Liberation to saliva proceeds as in vitro conditions, whereas liberation to tissue of the tooth-socket is limited by the absorption rate. Based on measurements carried out in vitro one can predict the period of effectiveness of the dressings in vivo. It is evident that results of measurements in vitro can be correlated with those in vivo.

Bandages↗
PubMed1983

A new look at the mineralized and unmineralized components of intraosseous fibers of the interdental bone of the mouse.

The degree of mineralization of deeply embedded intraosseous fibers has been the subject of speculation. However, there were few available descriptive morphological studies addressing this question. The present study demonstrated that morphological differences were evident between intraosseous fibers of different levels of the interdental septum. It also revealed that the degree of mineralization of intraosseous fibers was often different at the wall of the tooth socket in comparison to that at deeper levels of interdental bone. Except in the superior crestal third, intraosseous fibers became less mineralized as they passed from the wall of the tooth socket to the midline of the interdental septum. They were surrounded by sheaths throughout their distribution. It was concluded that there might be significant differences in the morphology of intraosseous fibers of the mouse in comparison to the morphology of intraosseous fibers of the dog, which have previously been described in detail.

Alveolar Process↗
PubMed1992

The efficacy of locally applied aspirin and acetaminophen in postoperative pain after third molar surgery.

This study evaluated the efficacy of and investigated the site of action of aspirin and acetaminophen placed directly into tooth sockets after bilateral third molar surgery under local anaesthesia. On completion of surgery, 12 patients received in random, blind order either a suspension of aspirin in a methyl cellulose gel (100 mg/ml) in their tooth sockets and an oral placebo or the methyl cellulose alone in their sockets and an oral dose of aspirin (50 mg). The remaining 12 patients were treated in the same fashion with use acetaminophen. Patients were asked to record their pain, at intervals, over an 8-hour period on a 10 cm visual analog scale. Significantly less pain (p less than 0.05) was recorded throughout the 8-hour investigation period after both locally placed drugs than after placebo. There was no adverse effect on healing. The peripheral activity of aspirin is confirmed, and our findings suggest that acetaminophen has a significant peripheral effect in mediating its analgesic properties in postoperative pain after third molar surgery.

Acetaminophen↗