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PubMed1993

Phantom tooth diagnosis and an anamnestic focus on headache.

The cause of atypical odontalgia has been related to many factors, including psychological ones. Animal experiments indicate that tooth pulp extirpation provokes a deafferentation, which may or may not induce pain, depending on unknown factors. The research described here showed that human tooth avulsion induces atypical odontalgia when it is carried out in migraine and cluster headache sufferers. Conversely, no sensation is reported by personally and familiarly headache-exempt subjects who underwent the same type of tooth extraction.

Case-Control Studies↗
PubMed1984

A clinical investigation into the incidence of dry socket.

A clinical investigation was undertaken to find the incidence of dry socket as a post-operative complication of dental extraction on an out-patient basis. Two thousand three hundred and sixty three extractions were carried out under local anaesthesia by clinical staff and students over a four month period. The results are presented and their significance discussed, the incidence of dry socket being found to be dependent upon the site of the tooth extracted, the relative difficulty of the extraction and upon the integrity and size of the blood clot in the extraction socket.

Adolescent↗
PubMed2004

Hard-tissue alterations following immediate implant placement in extraction sites.

BACKGROUND: The marginal gap that may occur following implant installation in an extraction socket may be resolved by hard-tissue fill during healing. OBJECTIVE: To study dimensional alterations of hard tissues that occur following tooth extraction and immediate placement of implants. MATERIAL AND METHODS: Eighteen subjects with a total of 21 teeth scheduled for extraction were included. Following flap elevation and the removal of a tooth and implant installation, clinical measurements were made to characterize the dimension of the surrounding bone walls, as well as the marginal defect. No membranes or filler material was used. The flaps were subsequently replaced and secured with sutures in such a way that the healing cap of the implant was exposed to the oral environment. After 4 months of healing a re-entry procedure was performed and the clinical measurements were repeated. RESULTS: Fifty-two marginal defects exceeding 3 mm were present at baseline: 21 at buccal, 17 at lingual/palatal, and 14 at approximal surfaces. At the re-entry eight defects exceeding 3.0 mm remained. During the 4 months of healing, the bone walls of the extraction underwent marked change. The horizontal resorption of the buccal bone dimension amounted to about 56%. The corresponding resorption of the lingual/palatal bone was 30%. The vertical bone crest resorption amounted to 0.3+/-0.6 mm (buccal), 0.6+/-1.0 mm (lingual/palatal), 0.2+/-0.7 mm (mesial), and 0.5+/-0.9 mm (distal). CONCLUSION: The marginal gap that occurred between the metal rod and the bone tissue following implant installation in an extraction socket may predictably heal with new bone formation and defect resolution. The current results further documented that marginal gaps in buccal and palatal/lingual locations were resolved through new bone formation from the inside of the defects and substantial bone resorption from the outside of the ridge.

Adult↗
PubMed1988

Bacteremia following intraoral suture removal.

Following dental extractions, prophylactic antibiotic protection of patients at high risk of cardiovalvular infection is usually discontinued before suture removal. To determine whether bacteremia is created upon removal of intraoral sutures, twenty healthy patients who required extractions of at least five erupted teeth and placement of several sutures were selected without regard to sex, age, or race. Blood samples were drawn preoperatively, immediately after the extractions, before suture removal, and immediately following removal of the intraoral silk sutures. The samples were cultured in prereduced and aerobic media suitable for quantitative colony counts. Fourteen of 16 patients yielded positive blood cultures following tooth extractions. One of 20 patients yielded a positive blood culture following suture removal. Even though the incidence of bacteremia following intraoral suture removal is relatively low (5%), this study suggests that intraoral suture removal is not a benign procedure for those persons who are considered high-risk cardiac patients.

Bacteria↗
PubMed1999

Subcutaneous emphysema and pneumomediastinum after dental extraction.

Pneumomediastinum, pneumothorax, and subcutaneous emphysema can occur occasionally after a surgical procedure. Facial swelling is a common complication of dental management. The occurrence of subcutaneous emphysema, pneumothorax, and pneumomediastinum after dental procedures is rare. We present a case with subcutaneous emphysema of the upper chest, neck, chin, and pneumomediastinum after a tooth extraction and discuss the possible mechanism of subcutaneous emphysema. To prevent these complications during dental procedures, dental hand pieces that have air coolant and turbines that exhaust air in the surgical field should not be used.

Adult↗
PubMed1993

An analysis of primary and contributing reasons for extraction of permanent teeth given by the dentist.

The aim of the present study was to collect information about primary, secondary, and tertiary reasons that dentists gave for extracting permanent teeth and to determine whether and how dentist-associated characteristics might influence the relative emphasis on clinical diagnosis versus non-disease considerations given as reasons. A national random sample of Norwegian dentists (n = 500) recorded reasons for tooth extraction during a period of 2 weeks in 1988 (response rate, 70%). Nine hundred and eight-five teeth were extracted from 692 patients. Disease-/condition-related diagnoses topped the list for primary and secondary reasons for extraction, whereas patients' wishes, economy, and esthetics came to the forefront among tertiary reasons. Logistic regression analysis showed that the choice between clinical diagnosis and non-disease considerations as primary and secondary reasons for extraction was significantly but moderately influenced by variables associated with the dentist.

Chi-Square Distribution↗
PubMed2005

Malignant tumours presenting after dental extraction: a case series.

OBJECTIVE: To present the clinical spectrum of malignant neoplasms detected after extraction of teeth. DESIGN: Retrospective study. SETTING: Department of Oral and Maxillofacial Surgery, University of Benin Teaching Hospital, Nigeria. MAIN OUTCOME MEASURES: Demographic and clinical data of patients diagnosed with malignant neoplasms related to a history of tooth extraction. RESULTS: Twelve patients with histopathologically confirmed tumours detected after extraction of teeth were studied. There were 11 males and one female giving a male to female ratio of 11:1. They ranged in age from 15-85 years with a mean age of 53 years. Pain and swelling were the most common presenting complaints. The mandible was more often involved seven (58.3%) cases while five (41.7%) cases occurred in the maxilla. Squamous cell carcinoma (in 9 cases) was the most common malignant neoplasm among these patients. CONCLUSION: Malignant tumours can mimic periapical infections necessitating a high index of suspicion when faced with toothache of uncertain cause.

Adolescent↗
PubMed1993

In vitro determination of the forceps level for extraction of teeth for periodontal reasons.

The aim of the present study was to validate dentists' periodontal reasons for extraction by comparison with the in vitro periodontal status of extracted teeth. A national systematic random sample of Norwegian dentists (n = 500) was requested to record primary, secondary and tertiary reasons for tooth extraction for a period of 2 weeks in 1988. The response rate was 70%. The extracted permanent teeth from the first 2 patients of each dentist were collected. Of the 365 teeth, 329 satisfied the criteria for assessment of periodontal attachment after staining. Using a dissecting microscope (10x), 4 to 8 linear measurements were recorded per tooth. 159 of the 329 teeth had loss of periodontal support. Of the 93 teeth for which the dentists' reason for extraction included periodontal considerations, 1% had 1-10% loss of attachment, 59% had 11-50% loss and 40% had 51-76% loss of periodontal support. There was a significant correlation between in vitro measurements of attachment loss and a ranking of teeth on a scale from 1 to 3 based on the dentists' emphasis on periodontal reasons for extraction (The Spearman Rs = 0.29, p < 0.01). The results suggest that the forceps level for removal of teeth for periodontal reasons was set at a relatively early stage of the disease process by Norwegian dentists, and that there was a weak association between attachment loss and the dentists' emphasis on periodontal reasons for extraction.

Age Factors↗
PubMed1993

Persistent fever due to occult dental infection: case report and review.

Dental sepsis is one potential cause of persistent fever that can escape detection. A patient with febrile episodes due to an occult tooth abscess of 2 years' duration is described. A search of the English-language literature revealed 20 other cases of fever of obscure origin arising from dental sources. This diagnosis may be suggested by repeated questioning of the patient about his or her medical history, repeated physical examination, an elevated erythrocyte sedimentation rate, or a history of failure to respond to antibiotic therapy. Dental infection is unlikely in patients who have a white blood cell count of > 11 x 10(9)/L, a temperature of > 39.5 degrees C, or positive blood cultures. The diagnosis may be made by repeated focused clinical examination, dental roentgenography, or radiolabeled leukocyte scintigraphy. Detection of dental sepsis is worthwhile since the febrile condition can be cured in all instances by tooth extraction and abscess drainage, with or without concurrent antibiotic therapy.

Erythromycin↗
PubMed1990

Dental extraction for patients on oral anticoagulant therapy.

Dental extraction in patients receiving long-term oral anticoagulant therapy is a controversial issue. Continuation of anticoagulation exposes the patient to serious hemorrhage, whereas cessation of therapy increases the risk of thromboembolism. Forty patients treated by coumarin underwent 63 tooth extractions, without a change in the therapeutic protocol of anticoagulation. The biologic adhesive Beriplast was used successfully to achieve local hemostasis at the site of the surgical wound. Apart from one patient who had mild oozing, there were no incidences of postsurgical hemorrhage.

Administration, Oral↗
PubMed1975

The bony residual ridge in man.

The bone which fills in the socket after tooth extractions was investigated in 120 dry skull specimens and 100 radiographs in which one or more teeth had been missing for at least three months. The bony content of the socket was of the trabecular type. This trabecular bone was well differentiated from the adjacent cortical bony plates. In buccolingual sections, the residual crest was formed by dense trabecular bone, clearly differentiated from the cortical plates as well as from the less dense trabecular bone that was deeper within the former sockets. From the occlusal aspect, the crest of the edentulous surface had shifted lingually when compared to the original position of the teeth before extractions. From the lateral aspect, the residual ridge formed a concavity or went straight between the alveolar crests of the adjacent remaining teeth. When several teeth were missing, the concavity was more pronounced than when a single tooth was missing.

Adult↗
PubMed1987

Laser acupuncture anaesthesia and therapy in People's Republic of China.

Laser acupuncture anaesthesia has been utilized for operations on thyroid and stomach, and Caesarean sections since 1978 in China. Recently, satisfactory results were reported in stomatology for the extraction of teeth. Laser beams directed at predetermined acupoints produce insensibility in a few minutes without any side effects such as allergy, intoxication, haemorrhage, or infection. This method has been used successfully on more than 5,000 patients for tooth extractions and minor oral and facial operations. Until now, the mechanism of classical acupuncture anaesthesia has been more or less elucidated by the neural or neuro-humoral hypothesis, which states that deep receptors or minute nerve fibres are stimulated mechanically by the needle. But laser irradiation as a stimulant is something different, since it has only low power and short penetration depth, and arouses almost no sensation compared with the acupuncture needle. The mechanism of anaesthesia due to laser irradiation of acupoints on superficial parts of the body should be investigated in further detail. The methods of laser acupuncture anaesthesia, the selection of laser irradiation acupuncture points, the distance and duration of irradiation, and the results of clinical application will be introduced.

Acupuncture Therapy↗
PubMed1981

[Dental surgery in hemorrhagic diatheses and anticoagulant therapy (author's transl)].

Patients with hemorrhagic diatheses occupy a special position in dental surgical treatment. For hemorrhagic diatheses of vascular origin, no special measures are necessary. The most severe hemorrhagic complications are to be reckoned with in all coagulopathies. Even if the majority of those affected are capable of carrying out substitution therapy for themselves, hospitalization is essential for the most severe types. Local measures cannot be dispensed with, especially in inhibitor hemophilias. Hemorrhage scarcely occurs after tooth extraction in patients on anticoagulant therapy who are adjusted to a Quick value of 25%.

Anticoagulants↗
PubMed1995

Maintenance of new attachment 1 and 4 years following guided tissue regeneration (GTR).

The aim of the present study was to evaluate periodontal tissue alterations during the maintenance phase following GTR therapy. 18 patients (average age 54 years, range 39-79 years) with 19 local periodontal defects were monitored longitudinally using clinical periodontal parameters and radiographic assessments of bone level changes. 6 out of originally 24 patients were not available at the 4-year examination (2 patients were unwilling to participate and in 4 patients root amputations or tooth extractions had to be performed). Evaluations were performed at baseline, 3 months, 1 year and 4 years following GTR therapy (using non-resorbable Gore-Tex Periodontal Material). The changes observed at the deepest site of each tooth treated by GTR were compared to those encountered in the entire dentition. Supportive periodontal therapy was performed according to the patient's individual needs between 3 and 12 times between the 1 and 4 years examination. The plaque index and the gingival index at the 4 years examination were assessed and had increased to almost double the value of baseline, although the BOP remained lower compared to baseline data. Between the 1 and 4 years examinations, 1.27 mm of clinical attachment was lost as a mean. Regarding the site of each tooth treated with GTR with the initially deepest probing pocket depth, 1.42 mm of clinical attachment was lost during the maintenance phase. However, compared to baseline data, 1.37 mm of new attachment could be maintained. The clinical attachment level was maintained within +/- 1 mm in 12 out of 19 sites during the 4 years of maintenance.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

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↗
PubMedDate not supplied

Immediate postextraction implant placement with root-analog stepped implants: surgical procedure and statistical outcome after 6 years.

The present study investigated 124 stepped-screw implants (gritblasted and acid-etched surface) placed in 104 patients immediately after tooth extraction or implant explantation and followed between August 1990 and December 1996. Implants of varying diameters and lengths were used to cover a wide range of indications in both the maxilla and mandible; 68% of the implants supported single-tooth replacements. The study parameters included Plaque Index, Gingival Index, probing depth, Periotest values, and peri-implant bone loss. Statistical analysis according to Kaplan-Meier revealed a 97% survival rate.

Acid Etching, Dental↗
PubMedDate not supplied

Cervical and mediastinal emphysema secondary to third molar extraction.

BACKGROUND: A dramatic case of infected emphysema involving multiple deep cervical and mediastinal fascial planes following surgical extraction of a lower third molar in an otherwise healthy man is presented. METHODS: The differential diagnosis and management of this condition are discussed, specifically contrasting it to necrotizing fasciitis. RESULTS: The direct cause of this complication was the use of an air turbine handpiece and air syringe for the tooth extraction. CONCLUSIONS: It is advised that air turbine handpieces and air syringes not be used during minor oral surgical procedures.

Adult↗