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At least 1,135 records · Page 63Linked to original sources
PubMed2004

Postoperative prophylactic antibiotic treatment in third molar surgery--a necessity?

PURPOSE: We evaluated the need for prophylactic postoperative oral antibiotic treatment in the removal of asymptomatic third molars. MATERIALS AND METHODS: In a prospective study of more than 30 months, a total of 528 impacted lower third molars were surgically removed in 288 patients. All patients were referred to our department by a dentist or a general practitioner. No patient showed any sign of pain, inflammation, or swelling at the time of removal. Three groups were established. In the first group, antibiotic treatment with amoxicillin/clavulanic acid as an oral medication was carried out for 5 days postoperatively. In the second group, we used clindamycin. In the third group, the patients received no antibiotic treatment. Clinical and radiologic factors were recorded for each case, and the rationale for assigning the patients to the groups was strictly random. The surgical technique was the same in all cases, and the follow-up period was 4 weeks. Parameters that were evaluated were pain, differences in mouth opening, infection, the occurrence of dry socket, and adverse postoperative side effects. RESULTS: We could not find any significant difference between the 3 groups regarding the evaluated parameters, but in 69.6% of the patients with dry socket, the teeth were partially erupted, which showed a significant difference. CONCLUSIONS: The results of our study show that specific postoperative oral prophylactic antibiotic treatment after the removal of lower third molars does not contribute to a better wound healing, less pain, or increased mouth opening and could not prevent the cases of inflammatory problems after surgery, respectively, and therefore is not recommended for routine use.

Adolescent↗
PubMed2002

Reduction in the incidence of alveolar osteitis in patients treated with the SaliCept patch, containing Acemannan hydrogel.

PURPOSE: In the present study, we compared the incidence of alveolar osteitis (AO) in patients treated with either clindamycin-soaked Gelfoam (Pharmacia and Upjohn Co, Kalamazoo, MI) or SaliCept Patches (Carrington Laboratories, Inc, Irving, TX). The SaliCept Patch is a freeze-dried pledget that contains Acemannan Hydrogel (Carrington Laboratories) obtained from the clear inner gel of Aloe vera L. PATIENTS AND METHODS: A retrospective evaluation was performed of the records of 587 patients (1,031 sockets) whose extraction sites had been treated with clindamycin-soaked Gelfoam. A prospective trial was conducted in which 607 patients (1,064 sockets) had 2 SaliCept Patches placed immediately after extraction. The same surgeon treated all patients. RESULTS: Analysis restricted to mandibular third molar sites showed that 78 of 975 sites (8.0%) in the Gelfoam group developed AO, whereas only 11 of 958 sites (1.1%) in the SaliCept group developed AO (P <.0001). Further analysis of all extraction sites revealed that the incidence of AO in the Gelfoam group was 7.6% compared with 1.1% in the SaliCept-treated group (P <.0001). CONCLUSIONS: The study results suggest that the SaliCept Patch significantly reduces the incidence of AO compared with clindamycin-soaked Gelfoam.

Adolescent↗
PubMed2005

Management of inter-dental/inter-implant papilla.

OBJECTIVES: The aims of this paper are to review and compare existing techniques for creation of interdental/interimplant papillae, to address factors that may influence its appearance and to present an approach that authors developed that could help clinicians to manage and recreate the interproximal papillae. METHODS: Papers related to interdental and interimplant papillae published over the last 30 years were selected and analyzed. RESULTS: Thorough treatment planning is essential for maintenance of the height of the interproximal papillae following tooth removal. The key for achieving an esthetically pleasing outcome is the clinicians' ability of properly managing/creating interdental/interimplant papillae. Bone support is the foundation for any soft tissue existence, techniques such as socket augmentation, orthodontic extrusion, guided bone regeneration, onlay graft and distraction osteogenesis are often used for this purpose. Soft tissue grafts as well as esthetic mimic restorations can also be used to enhance the esthetic outcomes. CONCLUSIONS: An esthetic triangle is developed to address the foundations that are essential for maintaining/creating papilla. These include adequate bone volume, proper soft tissue thickness as well as esthetic appearing restorations.

Alveolar Bone Loss↗
PubMed1981

Innervation of the periodontium in the monkey.

The distribution and structure of the sensory nerves and various neural endings in the periodontium were examined in adult monkeys, Macaca irus, by means of the silver nitrate technique. 1. The nerve fibers enter the periodontium passing through the bottom and the lateral wall of the bony socket. They are accompanied by blood vessels after entering the periodontium. 2. In the whole height of the periodontium, the area of richest nerve supply is the apical one third of the tooth root, while fewer nerves occur in the upper and middle third. In the apical third periodontium, nerve bundles with blood vessels are located near the alveolar bone, whereas single nerve fibers tend to occur adjacent to the cementum and surround the root of the tooth. 3. The nerve endings in the periodontium can be classified into three types by their structure. (1) Free endings or knob-like endings which, though found in the whole area of the periodontium, are concentrated near the alveolar bone. (2) Tree- or bush-like terminations located in the central part of the periodontium and near the cementum. They occasionally send out numerous branches to the cementum. (3) Specialized endings closely resembling Meissner's corpuscles. They are fairly rare. (4) Tree- or bush-like terminations localized at regular intervals as if each takes its own share of innervation territory. This type of terminals is presumed to represent periodontal mechanoreceptors.

Animals↗
PubMedDate not supplied

Antimicrobial management of third molars: survey results for military dentists.

In a survey of military dentists to examine use of antimicrobial agents in the management of third molars, questions addressed use of antibiotics and an antimicrobial rinse in treating pericoronitis and third molar extractions. Results were compared with information from a literature review. According to the survey, a majority of clinicians use antibiotics to treat pericoronitis but not surgical extraction of asymptomatic dental impactions. About 60 percent of respondents use a preoperative rinse with chlorhexidine in treating the third molar conditions discussed. A postoperative rinse with chlorhexidine was used less frequently. Half the respondents listed medicolegal factors in their decisions.

Anti-Infective Agents, Local↗
PubMed2004

Immediate implants supporting single crown restoration: a 4-year prospective study.

BACKGROUND: The placement of implants at the time of tooth extraction has several clinical advantages, such as preservation of the alveolar ridge width and height and reduction of the restorative treatment time. The aim of this study was to evaluate the cumulative success rate of dental implants placed in fresh extraction sockets with and without guided bone regeneration (GBR) used to support a single crown restoration. All of the patients were preselected as candidates for implants. METHODS: Ninety-five patients aged 20 to 68 years with 163 implants were included. All patients were partially edentulous and participated in a personally tailored recall schedule. The follow-up period was 48 months. Patients underwent a clinical and radiographic evaluation annually. RESULTS: The 4-year cumulative success rate was 97%. Five of the 163 implants failed, two during the initial healing time, which were considered early failures and three a year after prosthetic rehabilitation, which were considered late failures. No failure of prosthetic rehabilitation was observed. CONCLUSIONS: Implants placed into fresh extraction sockets with or without regenerative procedures and used to support single crown prosthesis showed a very high cumulative success rate (97%) in a 4-year prospective study. Several observations should be made: 1) all the patients were preselected as candidates for implants and were following a strict oral hygiene regimen; 2) all efforts were made to reduce the number of cases requiring GBR procedures; 3) all the implants had an acid etched/sandblasted implant surface; and 4) all the prosthetic restorations were single crowns.

Adult↗
PubMedDate not supplied

A prospective survey of hospital ambulatory dental emergencies. Part 2: Follow-up to emergency treatment.

Two hundred and fifty-three patients treated for dental emergencies at the University Hospital dental clinic over a three-month period were surveyed by telephone 24 to 48 hours and one year after treatment. The purpose was to investigate the success of treatment in resolving the chief complaint of pain and to determine the compliance with further dental care for the original dental problem. The results of the telephone survey showed that: patients available for questioning totaled 49.1% at 24 to 48 hours and 28.9% at one year; an 80.7% success rate was recorded in resolving pain within 24 to 48 hours; and the original emergency problem did not motivate a large number of these patients to seek further dental care.

British Columbia↗
PubMed2006

Post-operative sequelae of lower third molar removal: a literature review and pilot study on the effect of Covomycin D.

Pain, swelling and dry socket formation commonly follow third molar surgery. The objective was to investigate the effect of intrasocket Covomycin D, an antibiotic/anti-inflammatory medication, on pain, swelling and dry socket following lower third molar removal. Nineteen subjects had bilateral lower third molars removed. The patients were blinded to the side of medication; the opposite side acted as the control; post-operatively a pain visual analogue scale was completed, the side of the worst swelling and the incidence of dry socket noted. The data was analysed using the Wilcoxons matched pairs signed ranks test. Results showed that the pain score was lower for the medicated side in 11 patients on day one and in 16 patients over the six day post-operative period (p < 0.6). The swelling was less on the medicated side in fourteen patients. Three dry sockets developed in non-medicated sockets. In conclusion this study shows that the use of intra-socket Covomycin D favourably influences post-operative sequelae following lower third molar removal.

Administration, Topical↗
PubMed1986

Intentional replantation of periodontally involved and endodontically mistreated tooth.

This article presents a case in which a tooth was intentionally replanted after it was endodontically mistreated; there was also a severe periodontal involvement. The unusually long period of time that the tooth survived might be attributed to a different approach to the replantation technique, such as occlusion adjustment prior to replantation, preoperative reduction of oral cavity bacteria and of the harmful aerosols commonly found in the dental operatory, placement of a noneugenol periodontal packing under the acrylic splint to prevent residual liquid monomer from seeping into the periodontal space, use of the patient's own blood and no other material to moisten the root while it was out of the socket, a short extraoral period, loose splinting, complete isolation of the operative site in the oral cavity, and completion of periodontal therapy before intentional replantation.

Adult↗
PubMed1991

Oral prosthodontic rehabilitation for traumatic sports injuries.

Sports injuries to the mouth and oral cavity may be treated with a variety of prosthetic treatment methods. These may include a temporary removable appliance, especially when adjacent teeth are unrestored and free of caries. Other traditional forms of prosthetic rehabilitation can range from conventional clasped removable partial dentures to traditional fixed prosthesis. The use of clip bar overdentures has demonstrated their clinical acceptability, especially for athletes involved in contact sports. The optimal treatment for patients suffering tooth loss, however, is the use of the osseointegrated implant. This concept, developed and refined by P.I. Branemark, permits successful replacement of single as well as multiple lost teeth. Criteria for patient selection must be evaluated carefully, especially for immediate fixture placement in sockets of avulsed teeth. Professional athletes in high-impact contact sports should receive a resilient prosthesis and protective appliance to use during the sport season, followed by a screw-retained nonremovable prosthesis to be used in the off season. Considering all forms of prosthodontic treatment available to patients with missing teeth, the use of osseointegrated implants currently appears to be the most biologically conservative approach. Retrospective studies document the effectiveness of the treatment of partially edentulous jaws, results similar or better than those reported for fully edentulous patients indicate the effectiveness of the Branemark method of osseointegration.

Athletic Injuries↗
PubMed1979

Effect of the addition of a vasoconstrictor to local anesthetic solution on operative and postoperative bleeding, analgesia and wound healing.

A clinical study of local anesthetic solutions with and without epinephrine was conducted involving 32 healthy adults requiring removal of bony impacted mandibular third molars. The time elapsing from the administration of the anesthetic solution until analgesia was obtained was significantly shorter in the vasoconstrictor group (P less than 0.001). Additional anesthetic was necessary in 44% of the patients in the control group. The blood loss in the vasoconstrictor group was significantly lower (P less than 0.001) than in the group receiving anesthetic solution without the vasoconstrictor. No statistically significant difference in operation time between the groups was found, although the profuse bleeding in the control group impeded to some extent the surgical procedure. A positive correlation coefficient between operation time and blood loss of r = 0.65 in the vasoconstrictor group (P less than 0.006) and r = 0.77 in the control group (P less than 0.001) was found. Hemorrhage occurring 24 h postoperatively was recorded in 37% of the subjects in the vasoconstrictor group, and of these 83% revealed a healing of the socket by second intention.

Adolescent↗
PubMed1991

A study on citric acid as a proposed replacement resorption inhibitor.

The material consisted of 36 one-rooted immature teeth in 6 mongrel dogs. 12 teeth were immediately replanted after extraction, while 24 teeth were extracted and stored dry for 120 min before re- or autotransplantation. Root planing and topical citric acid treatment of the root of dry-stored teeth did not prevent the development of progressive root resorption and ankylosis, not even when special care was taken to prevent damage to the superficial, demineralized layer of the root during and after the transplantation procedures in an experimental model, which included autotransplantation of teeth to sockets, which were much larger than their original sockets.

Alveolar Process↗
PubMed1996

Polylactic acid (PLA) root replica in ridge maintenance after loss of a vertically fractured incisor.

A periodontally affected tooth was prepared for a special treatment: Calcium hydroxide was introduced into the apical half of the root canal whereas its cervical part was filled with glass ionomer cement. The tooth was shortened subgingivally. After 6 weeks of epithelization over the residual root a palatal full-thickness flap was mobilized. The root was carefully extracted and chairside copy-milled from the biodegradable polylactic acid (PLA) material. The PLA-replica was implanted immediately into the socket and the flap was sutured. Aim of the treatment was to prevent the ridge collapse of the extraction area. Ridge height could be preserved during the 21 months of observation. With time the radiographic density of the cancellous bone increased in the implanted area, indicating that a PLA-replica is replaced by host's bone tissue.

Adult↗