[Surgical management in dentistry (2). Management of mandibular impacted wisdom teeth].
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The contemporary view of the cause of pain in case of histological lesions is discussed, i.e. the mechanisms of the formation of local high-protein oedemas in connexion with disorders of lymphatic drainage. 295 patients of an oral-surgical department were subjected to a systematic therapeutic study for investigating the possibilities of medicamentously influencing oedema and pain. Tested by way of comparison were a benzopyrone preparation (Venalot) and oxyphenbutazone. A group of control patients could only make use of an analgetic. The assessment of the reduction of oedema was done by means of anthropometric measurements. The analgetic action was judged by the need of analgetics. The result of it was that the benzopyrone preparation possesses a strong analgetic and antioedematous action which also exceeds that of the comparative therapy. The benzopyrones' clinical mechanisms of action are discussed in the light of experimental results.
After experimental demonstration of the excellent tissue tolerance with ceramics-bone contact without connective tissue in animals and because of the good resorbability of tri-calcium phosphate ceramics (TPC), TPC ceramics was used in a clinical study to fill the bony defects resulting from apicectomies and cystectomies. The patients were controlled for a period of up to six months. After an initially normal healing phase, an unusually high rate of late complications with fistula formation and rejection of the TPC ceramics was observed around the tenth postoperative week. Possible causes for these late complications were discussed.
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In the last decade, combined periodontic-endodontic techniques have been used to save many teeth previously considered to be hopeless. As knowledge of these techniques becomes more utilized by practicing dentists the next ten years hopefully will evolve into ones in which most people enjoy a lifetime with a natural dentition.
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