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At least 1,153 records · Page 64Linked to original sources
PubMed1994

The prevention of localized ridge deformities using guided tissue regeneration.

Healing of extraction sockets where the buccal plate of bone has been destroyed often results in localized ridge deformities. This is most likely due to the ingrowth of extraskeletal connective tissue into the space originally occupied by the tooth which then fills with a combination of bone and soft tissue. Techniques for managing these defects have been described, but it would be preferable to prevent them from occurring at all. Using the principles of guided tissue regeneration, a surgical technique is described that can be applied to post-extraction sites that are deficient in alveolar bone thereby preventing localized ridge deformities. Representative cases are presented illustrating the technique.

Alveolar Bone Loss↗
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↗
PubMed1997

Prophylactic removal of impacted third molars: an assessment of published reviews.

OBJECTIVE: To evaluate published reviews of the appropriateness of prophylactic removal of impacted third molars. DESIGN: Systematic review and critical appraisal of relevant reviews. METHODS: Computerised databases (Medline and Embase), the Index to Dental Literature, and the references of articles were searched to identify relevant reviews. MAIN OUTCOME MEASURES: Pathologies associated with impacted third molars and outcomes following surgical removal of third molars. RESULTS: Twelve published reviews were assessed. Major methodological problems in these include that authors did not describe review methods such as literature search strategy and criteria for inclusion of primary studies. Reviews with similar aims included different sets of primary studies as evidence. Details of primary studies quoted were seldom sufficient for readers to judge the reliability of the evidence. With the exception of two reviews with poorer quality, the reviews concluded that there is a lack of evidence to support the prophylactic removal of impacted third molars. Two decision analyses also concluded that, on average, patients' long-term wellbeing is maximised if extraction is confined to those impacted third molars with pathology. CONCLUSIONS: In the absence of good evidence to support prophylactic removal, there appears to be little justification for the removal of pathology-free impacted third molars.

Contraindications↗
PubMed2000

Time to onset of analgesia and analgesic efficacy of effervescent acetaminophen 1000 mg compared to tablet acetaminophen 1000 mg in postoperative dental pain: a single-dose, double-blind, randomized, placebo-controlled study.

This randomized, double-blind, placebo-controlled study compared the time to onset of analgesia and the analgesic efficacy of two formulations of acetaminophen 1000 mg--an effervescent solution and tablet--in 242 patients with moderate or severe pain following dental surgery. Onset of analgesia was determined using a two-stopwatch procedure. Analgesia was assessed over a 4-hour period. Treatments were compared using standard indexes of pain intensity and pain relief and summary measures. Both acetaminophen formulations were significantly more effective than their corresponding placebo for all efficacy assessments. The median time to onset of analgesia was significantly shorter with effervescent acetaminophen (20 minutes) compared to tablet acetaminophen (45 minutes). During the first 45 minutes after administration, effervescent acetaminophen was significantly more effective at each scheduled assessment time than tablet acetaminophen. The median time to meaningful pain relief was significantly shorter with effervescent acetaminophen (45 minutes) compared to tablet acetaminophen (60 minutes). At 4 hours after administration, the pain relief was significantly better with tablet acetaminophen than with effervescent acetaminophen. No other significant differences were observed between the active treatments. In conclusion, effervescent acetaminophen produces a significantly faster onset of analgesia than tablet acetaminophen.

Acetaminophen↗
PubMed2000

The prevalence of post-extraction complications in an outpatient dental clinic in Kuala Lumpur Malaysia--a retrospective survey.

The aim of this retrospective study is to report on the prevalence of post-extraction complications among patients attending the Oral Surgery outpatient clinic of the Faculty of Dentistry, University of Malaya over a 12-month period from January to December, 1992. The prevalence of post-extraction complications which required further treatment was only 3.4% (n = 100), out of a total of 2968 patients who had extraction of one or more permanent teeth. Analysis based on complete clinical reports (n = 79) showed that dry socket accounted for nine out of ten cases of post-extraction complications. However the aetiology was largely unknown. No obvious association with medical history could be made. Lower teeth were more likely to have complications. The most common teeth associated with dry socket were the molars (76%) and premolars (19%). The most common molars to be affected are the first, followed by the third and lastly the second molars. A brief review of current aetiological factors of dry socket was discussed.

Adolescent↗
PubMed2004

Bilateral anesthesia into Spix's spine. Ten years' experience.

AIM: This study examines 10.112 cases in 10 years of bilateral block anaesthesia to Spix's spine. The aim of this study is therefore to eliminate any doubt about executing a bilateral anaesthesia to Spix's spine for the extraction, in inclusion and impacted of the inferior wisdom teeth. METHODS: A retrospective study was carried out on 10,112 operations (59% females, 41% males,) regarding the removal of the lower 3 molar teeth undertaken in the past 10 years. Locoregional anaesthesia and standard instruments and protocol were applied to all operations. The anaesthetic used was mepicavina at 2% with epinefrine 1:100,000 with a 4 x 25 mm, 27 Gauge needle. In order to completely anaesthetize the areas subject to surgery a quantity of approximately 3-ml on each side was injected. Local anaesthetics used were the same throughout the study; all the patients were in good health and not undergoing any pharmaceutical treatment. RESULTS: The onset of complications was 3 times less when using local anaesthesia (LA) compared to general anaesthesia (GA). It was also proven that local anaesthesia was advantageous, as the operation time was considerably less (24 min for LA and 46 min for GA). CONCLUSIONS: The paper shows that LA offers a significant reduction in complications, psychological advantages for the patients and facilitation of the operational position too, so that GA is to be preferred only for non-cooperative patients.

Adult↗
PubMedDate not supplied

A retrospective study of 1925 consecutively placed immediate implants from 1988 to 2004.

PURPOSE: The purpose of the present study was to evaluate implant survival rates with immediate implant placement (IIP) into fresh extraction sockets and to determine risk factors for implant failure. MATERIALS AND METHODS: A retrospective chart review was conducted of all patients in whom IIP was performed between January 1988 and December 31, 2004. Treatment required atraumatic tooth extraction, IIP, and mineralized freeze-dried bone allograft with an absorbable barrier to cover exposed implant threads. Implant failure was documented along with time of failure, age, gender, medical history, medications taken, postsurgical antibiotic usage, site of implant placement, and reason for implant failure. Statistical analysis was performed using chi-square and logistic regression analysis methods. RESULTS: A total of 1925 IIPs (1398 machined-surface and 527 rough-surface implants) occurred in 891 patients. Seventy-one implants failed to achieve integration; a total of 77 implants were lost in 68 patients. The overall implant survival rate was 96.0% with a failure rate of 3.7% prerestoration and 0.3% postrestoration. Machined-surface implants were twice as likely to fail as rough-surface implants (4.6% versus 2.3%). Men were 1.65 times more likely to experience implant failure. Implants placed in sites where teeth were removed for periodontal reasons were 2.3 times more likely to fail than implants placed in other sites. Patients unable to utilize postsurgical amoxicillin were 3.34 times as likely to experience implant failure as patients who received amoxicillin. CONCLUSIONS: With a 1- to 16-year survival rate of 96%, lIP following tooth extraction may be considered to be a predictable procedure. Factors such as the ability to use postsurgical amoxicillin and reason for tooth extraction should be considered when treatment planning for IIP.

Adolescent↗
PubMed1993

Local anesthesia during surgery: when is the best time to give it?

Patients undergoing third molar extractions while under general anesthesia were given local anesthesia either before (group 1) or after (group 2) surgery. The medication intake and pain scores were studied for 7 days but showed no difference between the two groups. It is suggested that timing of local anesthesia alone may not prevent or reduce the postoperative pain experience.

Adult↗
PubMed1981

Short - term effects of occlusal hypofunction following antagonist tooth extraction upon periodontal tissues in the rat.

This histological study was designed to observe the early effects of occlusal hypofunction on periodontal tissues. Eighteen Wistar rats were used. Hypofunction was induced by extracting the right maxillary molars. Histological observations were reported on the right lower jaws which were embedded in methyl-metacrylate, sectioned at 4 micrometer without decalcification and stained with toluidine blue. The periodontal ligament disorganization began after 2 days and continued until 16 days. The outstanding observation was a considerable increase in bone formation, which was responsible for ligament narrowing as no change in cementoblastic activity was observed. At the top of the interradicular septa, the osteoblastic proliferation began at 24 hours, and bone mineralization increased until 4 days creating osteophytic bone, and then decreased. On the modelling sides of the sockets, a great amount of osteoid tissue deposited by osteoblasts set around large vessels was present at 4 days, and mineralization extended between 4 and 8 days. On the remodelling sides, bone formation extended at 4 days and osteoclastic resorption fell of except along oblique roots sockets; then the remodelling sides returned to nearly normal aspect at 16 days. The biological significance and clinical implications of these findings are discussed.

Animals↗
PubMed1993

Treatment of moderate localized alveolar ridge defects. Preventive and reconstructive concepts in therapy.

A conscious effort should be made at the time of tooth extraction to eliminate or lessen the creation of a defect within the residual alveolar ridge. This objective can be achieved if teeth are extracted in an atraumatic manner and appropriate implant materials are placed into the sockets to prevent the eventual collapse of the ridge. Guided tissue regeneration procedures also may be used to prevent collapse within the ridge or augment an existing defect. In many instances, deformed ridges can be augmented to their former dimensions by the use of pouch, interpositional, or onlay graft procedures. Case reports are presented to show the effectiveness of these procedures.

Alveolar Bone Loss↗
PubMed1994

Osseoretention? Comparative assessment of particulate hydroxyapatite inserted beneath immediate dentures.

This paper presents the results of a study to observe the effect on bone resorption and residual alveolar ridge form, of placement of dense non-resorbable hydroxyapatite granules into fresh canine sockets, at the time of immediate denture provision. Thirty five subjects were randomly divided into two groups cross matched for age and sex. All subjects required bilateral extraction of at least a lower canine and an adjacent tooth. Results demonstrate that six months post-extraction the control group had lost four times more bone than the implant group. These results were highly significant (P=0.000, LHS and P=0.001, RHS).

Adult↗
PubMedDate not supplied

Epulis granulomatosa: extraction sequellae.

Epulis granulomatosa is a post-surgical lesion emanating from an extraction socket. It can be misdiagnosed with lesions of similar appearance, for example, foreign body or pyogenic granulomas, or as a herniation of the maxillary sinus. Based on clinical appearance and microscopic description, granulomas all appear to represent essentially the same lesion. However, pathonomonically, the epulis granulomatosa emanates only from an extraction socket; the other granulomas can be found anywhere in the body.

Female↗
PubMed1992

A review of dry socket: a double-blind study on the effectiveness of clindamycin in reducing the incidence of dry socket.

This double blind clinical study was undertaken to evaluate the effectiveness of locally applied clindamycin in Gelfoam in reducing the incidence of dry socket formation after third molar surgery. A total of 1,021 third molar extractions were performed, and 520 mandibular third molar extractions of varied surgical difficulty were evaluated. The results indicated that this technique was effective. This study also demonstrates that the incidence of dry socket after third molar surgery is significantly higher in the mandible than the maxilla, in smokers than in non-smokers, and in females currently on oral contraceptives.

Adult↗
PubMed1989

[Changes in the microvascular patterns during the osseous healing of the tooth extraction wounds].

Successive changes in the vascular pattern during the osseous healing of extraction wounds were investigated by studying microvascular casts under a scanning electron microscope. The casts were prepared utilizing the plastic injection method, after the extraction of the upper four incisors of the Japanese monkey (Macaca fuscata). Five days after extraction, vascular buds have sprouted from a pre-existing blood vessel on the alveolar wall into the blood clot, and leakage of the plastic injected was found from the tips of these buds. One week after extraction, newly-formed vessels have extended widely to the socket center, and dilated vessels have arborized towards the socket opening. Two weeks after extraction, the socket was filled with thick, newly-formed vessels. In the socket fundus, the woven bone was formed between irregular vascular networks, but was arranged different in the socket wall. Four weeks after extraction, the new bone forming on the socket wall became thickened and converted to a lamella-like bone. Inside it the woven bone was raised from the fundus, and blood vessels leaving it were decreased in their thickness and passed toward the socket center. Five weeks after extraction, the new bone structures came up to the level of the socket opening, the surface of which appeared as a shallow concavity (pivot), from which vascular bundles were directed to the socket opening. A beginning of the bone-remodeling was seen in osseous trabeculae in the socket fundus. Six weeks after extraction, almost all of the socket became filled with new trabeculae, between which, fine vascular networks were sorted out and communicated with the periosteal vascular network beyond the socket margin. The interalveolar septum between the extraction sockets was thickened by deposition of the lamella-like bone to be remodeled to a cancellous bone. It can be said that microvascular patterns formed through all stages of the osseous healing of the extraction wounds contributed to a woven bone formation and its development.

Alveolar Process↗
PubMed1985

The effect of procedures intended to alter the interstitial fluid pressure in the sockets of resected rat incisors on their eruption rate.

Eruption rates of resected incisors were measured while their sockets were kept open to the mouth. In other resected incisors, hypertonic solutions were placed in the pulp cavity, with the intention of drawing fluid by osmosis across the membrane separating the pulp cavity from the socket, to lower the pressures within the socket. These procedures slowed eruption when control resected incisors were erupting rapidly but not during their initial and final slow phases of eruption. The findings are consistent with there being two factors making resected incisors erupt, tentatively identified as the periodontal ligament and, when eruption is rapid, the interstitial pressures of the tissues in the socket.

Albumins↗