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Treatment of post-operative pain.

The effectiveness of three treatments for alveolar osteitis was compared. It was found that chlorhexidine gluconate mouthwash treatment and 2.5 percent Lidocaine ointment treatment reduced the number of days a patient was symptomatic compared to the conventional eugenol-impregnated iodoform gauze treatment. With the conventional use of eugenol-impregnated iodoform gauze, the severity of the patient's symptoms were reduced more effectively than with the other two treatments, but the symptoms lasted longer.

Analysis of Variance↗

Tooth extraction in HIV sero-positive patients.

Tooth extraction is the dental treatment most commonly carried out among HIV positive patients. In this paper we propose a simple protocol for dental extractions in patients of this type, based on a review of the literature and on our own experience in this field. The factors to be considered when planning a dental extraction for HIV positive patients are: diagnosis of the lesion justifying the need for tooth extraction and medical assessment of the patient including the infection pathway, the stage of the disease, laboratory tests and drug therapy. The most frequent post extraction complications are a delay in the wound healing process, alveolitis and surgical wound infection. Fortunately, these complications tend to be rather uncommon and not too severe; they can be managed on an out-patient basis and their prevalence will probably tend to decrease with the introduction of the new anti-retroviral drugs for HIV-1.

AIDS-Related Opportunistic Infections↗

Histopathologic observation of seven removed endosseous dental implants.

Seven failed endosseous dental implants that were removed from humans were examined histologically. Results suggest that the hollow-basket portion or the vent should be located as far from the gingiva as possible, and that an adequate healing period is needed for implant placement following tooth extraction. In addition, findings also suggest that the hollow-basket implant is not suitable for a healing socket, that periodic inspection is necessary for two-stage implants to evaluate adaptation of the embedded junction between the abutment and implant in the gingiva, and that there is risk of coating separation from hydroxyapatite-coated implants and possibilities of coating resorption.

Adult↗

Effect estimates and methodological quality of randomized controlled trials about prevention of alveolar osteitis following tooth extraction: a systematic review.

OBJECTIVE: To systematically review the scientific evidence derived from randomized controlled trials (RCT) about prevention of alveolar osteitis (AO). STUDY DESIGN: Literature searches were conducted to locate RCTs about prevention of AO. The RCTs were scrutinized for methodological details and categorized according to the preventive intervention studied. Data were analyzed in relation to the frequency of AO. Absolute risk reductions (ARR), and numbers needed to treat were calculated with 95% confidence limits. RESULTS: There was a wide variation in the design and quality of the RCTs (N = 32). The greatest risk reduction for AO was seen for local treatment with tetracycline (ARR, 12%-31%). For a majority of the preventive interventions, the evidence was absent or inconclusive. CONCLUSIONS: Local treatment with tetracycline, and also 0.12% chlorhexidine rinsing preoperatively and 7 days postoperatively, seem to have significant and clinically relevant preventive effect on AO following surgical removal of lower third molars.

Anti-Bacterial Agents↗

Radiographic and histological analysis of tooth eruption through calcium phosphate ceramics in the cat.

The effect of implanting calcium phosphate ceramics (CPC) into metabolically active sites within kitten mandibles during permanent premolar tooth eruption was examined. Forty kittens, 3-4 months of age were used: the deciduous second and third mandibular premolars were extracted and their sockets implanted with autologous blood clot, autogenous cancellous marrow, and the calcium phosphate ceramics, non-porous beta-tricalcium phosphate or porous hydroxylapatite. Animals were killed at 1, 2, 3, 4 and 5 months after implantation and undermineralized sagittal sections were evaluated by light microscopy. Eighty percent of hydroxylapatite implanted mandibles showed delay in tooth eruption concurrent with distortion in crown development, and a dense cellular fibro-proliferative response within the follicle of unerupted teeth. This response occurred in only one specimen with tricalcium phosphate, whereas normal eruptive patterns and crown development were routinely noted. Both the tricalcium phosphate and hydroxylapatite were integrated into the surrounding alveolar bone without evidence of an inflammatory response. Thus hydroxylapatite initiated a dense cellular fibrous network within the dental follicle preventing formation of an eruptive pathway, delaying tooth eruption and causing crown deformation. This was rarely seen with tricalcium phosphate, and may be due to the resorbability of tricalcium phosphate when compared to hydroxylapatite. Hydroxylapatite should therefore be used with caution for implanting into areas containing unerupted teeth with a metabolically active dental follicle.

Animals↗

An immediate tooth root replacement: an implant cylinder and synthetic bone combination.

Tooth extractions in 22 cases were treated immediately with the simultaneous placement of a cylinder implant and injection of particulate synthetic bone around the neck of the implant and into the extraction socket surrounding the cylinder. Preliminary results indicate a success rate of 94.1% in those implant/synthetic bone combinations placed in function. The utilization of synthetic bone in combination with an implant creates the possibility of an immediate tooth root replacement. Besides replacing a "lost part" of the jaw immediately, this practice prevents the normal 40% to 60% bone loss that occurs in the two years post-extraction and improves both function and aesthetics for the patient. The synthetic bone, HTR Polymer, was used in combination with Steri-Oss cylinders.

Alveolar Bone Loss↗

[Brephoplasty of an inflamed alveolus with bone chips (histological research)].

Bone tissue regeneration and abatement of inflammatory processes in the well after tooth extraction were examined in experimental dogs treated with iodoform and crushed brefobone preserved in 0.5 percent formalin. Histologic study has confirmed the efficacy of crushed brefobone employment for the inflamed well plasty, for such treatment was conducive to a sooner abatement of the inflammation and regeneration of bone tissue in the well.

Animals↗

Tissue changes in immature dog teeth autotransplanted to surgically prepared sockets.

Tissue reactions in teeth autotransplanted to surgically prepared sockets were investigated by means of microangiographic, enzyme histochemical, and histologic methods. The experimental material consisted of 28 immature teeth in six mongrel dogs. In each tooth, approximately three fourths of the root was formed at the time of transplantation. Ten days after transplantation, a vascularized, well-stained connective tissue was observed in the apical area of the pulp. An ingrowing tissue had reached the pulp horn in all teeth 90 days after surgery. Odontoblasts were not found in any of the transplanted teeth. External root resorption was seen in all teeth but repair usually occurred approximately parallel to the ingrowth of new tissue into the pulp cavity. In a few teeth, however, advanced inflammatory root resorption was observed in cracks in the cervical area. When compared with the results of a previous study, the ingrowth of tissue occurred at a considerably slower rate than in teeth autotransplanted to natural sockets.

Animals↗

Factors predisposing to postoperative complications related to wisdom tooth surgery among university students.

In a retrospective study among 550 Helsinki University students 20 to 30 years old, factors predisposing to postoperative complications from removal of lower jaw wisdom teeth were evaluated. Patient records and panoramic tomograms covering the period from 1990 to 1993 were examined; 50 patients (9.1%) had postoperative complications after removal of a wisdom tooth. The most common complications were alveolar osteitis (2.9%), postoperative infection (2.6%), postoperative bleeding (1.5%), and dysesthesia of the lower lip or tongue (1.1%). Factors associated with increased postoperative complications were mesiohorizontal position of the tooth, deep impaction of the tooth, and use of oral contraceptives. Before patients undergo surgery for removal of wisdom teeth, those who use oral contraceptives or have difficult tooth impactions should be informed about the increased possibility of postoperative complications.

Adult↗

Forced orthodontic eruption of fractured teeth before implant placement: case report.

The treatment of esthetic areas with single-tooth implants represents a new challenge for the clinician. Placement of a single-unit implant is indicated for fractured or periodontally compromised teeth. In 1993, a modification of the forced eruption technique, called "orthodontic extrusive remodelling," was proposed as a way to augment both soft- and hard-tissue profiles at potential implant sites. This case report describes augmentation of the coronal soft and hard tissues around a fractured tooth, which was achieved by forced orthodontic extrusion before implant placement. This technique may be used to improve primary anchorage of a dental implant, fill the alveolar socket with bone, preserve interdental bone height and increase the amount of attached gingiva.

Alveolar Bone Loss↗