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PubMed2004

[Complications during and after dentoalveolar surgery].

In dentistry complications are undesirable adventures provoked by oral health care delivery. If there is any risk of a complication, the patient needs to be informed before treatment. Occurrence of complications can be minimized by adequate diagnostics and planning sufficient time for treatment. The most common complications during and after dentoalveolar surgery are discussed, such as complications during or after producing local anaesthesia, nerve injuries, complications during or after tooth extraction, aspiration, jaw luxation, disturbed wound healing, and complications during or after implantation procedures.

Alveolar Process↗
PubMedDate not supplied

Day case oral surgery in pediatric patients during the year 2000 in the University of Barcelona Dental Clinic (Spain).

AIM: A study is made to show that most pediatric oral surgical interventions can be performed on a day case surgery or ambulatory basis, and to describe the activity of the Master of Oral Surgery and Implantology (Barcelona University Dental School, Spain) in the year 2000. DESIGN: The study documents the surgical activity of the Units of Oral Surgery and Laser Surgery in pediatric patients, in the context of the Master of Oral Surgery and Implantology (Barcelona University Dental School, Spain). RESULTS: Of the 3187 operations carried out in our Service in this period, 489 involved patients under 18 years of age. The surgical removal of third molars was the most common intervention (55.6%), followed by other surgical or non-surgical tooth extractions (33.6%) and other interventions (10.6%) comprising fenestration of impacted canines or other teeth, frenectomies, the removal of mucoceles, and tooth relocations. Complications after surgical third molar extraction were recorded in 15.93% of cases, the most frequent problem being the pain and swelling (4.35% each) characteristic of postoperative inflammation. CONCLUSIONS: Our experience shows that day case oral surgery can be safely performed in pediatric patients, provided the required means and health care personnel resources are available.

Ambulatory Surgical Procedures↗
PubMed2006

[The questionnaire survey to clarify correspondence of medical doctors and dentists in Fukuoka City, Japan, for warfarin therapy at the dental extraction].

PURPOSE: The questionnaire survey was performed in order to clarify correspondence of medical doctors and dentists working at hospital service for warfarin therapy at the dental extraction. METHODS: For 17 senior dentists in 17 hospitals and 142 senior physicians in 82 hospitals in Fukuoka City, we investigated using the questionnaire whether they supported dental extraction under warfarin therapy or not in patients having warfarin treatment with past history of cardioembolic stroke due to non-valvular atrial fibrillation (NVAF). Specialty and experience of stroke after withdrawal of warfarin were also asked in medical doctors. RESULT: The reply was obtained from 14 dentists (82.4%) and 66 doctors (46.5%). The number of dentists and doctors who pull out a tooth under warfarin treatment continuation were 12 persons (85.7%) and 32 persons (48.5%), respectively. The rates in doctors whose specialty was stroke, cardiovascular disease, and others were 78.6% (11/14), 36.0% (9/25), and 44.4% (12/27), respectively. The rate in stroke specialists was significantly higher than that in cardiovascular disease specialists (p = 0.019). The stroke specialists had experience of stroke after withdrawal of warfarin more frequently than the cardiovascular disease specialists (57.1% vs. 20.0%, p = 0.033). CONCLUSION: The rates of acceptance in tooth extraction under warfarin treatment continuation of the dentist were high in Fukuoka city, while that of the medical doctors were not. Rate of doctor's acceptance differed according to the specialties, and may be affected by experience of stroke after cessation of warfarin therapy.

Anticoagulants↗
PubMed2004

In vitro evaluation of a novel 6% hydrogen peroxide tooth whitening product.

OBJECTIVES: The aims of this study were to evaluate the in vitro tooth whitening effects of a novel 6% hydrogen peroxide containing tooth whitener Xtra White (XW) on extrinsic stain and intrinsic tooth colour and the effects on enamel and dentine microhardness. In addition, to determine the levels of peroxide found in tooth pulp chambers after treatment with XW in vitro. METHODS: Extrinsic stain changes were determined by measuring colour changes of tea stained hydroxyapatite discs after treatment with water, placebo gel, XW or Colgate Simply White (CSW). Intrinsic tooth colour changes were determined by treating extracted human teeth in vitro with a placebo gel, XW or CSW for a simulated two weeks use and measuring colour differences with a chroma meter. Teeth treated with placebo gel and XW were cross-sectioned and the subsurface enamel and dentine was polished and the microhardness determined. The peroxide concentration found in extracted tooth pulp chambers was determined spectrophotometrically. RESULTS: XW gave significantly more extrinsic stain removal (p<0.0001) and an increase in tooth whiteness (p<0.05) than a placebo gel, but was not significantly different to CSW. There were no significant differences in subsurface enamel and dentine microhardness values for the placebo and XW treated teeth. The mean concentration of peroxide found in the tooth pulp chambers was 0.44 mM, which is over 3000 times below the concentration reported to cause pulpal enzyme damage. CONCLUSIONS: XW has been shown to be an effective tooth whitening product in vitro with support for its safety on subsurface enamel and dentine together with its safety on tooth pulp tissue.

Color↗
PubMed2002

Treatment of replacement resorption with Emdogain--a prospective clinical study.

The present clinical study investigated the outcome of intentional replantation using Emdogain for periodontal healing following trauma-related ankylosis. Sixteen ankylosed teeth affected by replacement resorption were treated as follows: After tooth extraction, the root canal was obturated with a retrograde titanium post. Emdogain was applied to the root surface and into the extraction socket with subsequent replantation of the tooth. Evaluation parameters included horizontal and vertical Periotest scores, percussion sound and periapical radiographs. All findings were compared to those of the adjacent teeth. The mean follow-up period was 15 months (range 4-24 months). Eleven teeth showed no signs of recurrence of ankylosis: they were in full function and exhibited no pathological clinical findings. Four severely traumatized teeth demonstrated a recurrence of ankylosis after a mean period of 6 months, one tooth was lost in a second accident after 7 months. The estimated probability of 1 year without recurrence of ankylosis was P=0.66 (95% confidence interval [0.40; 0.94]). The mean survival time was 10.2 months (SD 1.1). The results indicate that treatment of replacement resorption following light to moderate trauma with replantation and Emdogain appears to prevent or delay recurrence of ankylosis in many cases.

Adolescent↗
PubMed2006

The prevention of 'dry socket' with topical metronidazole in general dental practice.

OBJECTIVE: The purpose of the study was to determine if the intra-alveolar application of topical metronidazole gel could reduce the incidence of alveolar osteitis (dry socket) following routine tooth extraction in molar and premolar extraction sites. DESIGN: This was a multicentre, double blind, randomised, placebo-controlled clinical trial. A total of 302 patients took part, of which 23 returned with alveolar osteitis. Of these, eight had received the metronidazole gel and 15 the placebo. SETTING: The study was carried out in three general dental practices by general dental practitioners working in England over the period 2000-2003. MAIN OUTCOME MEASURES: Following extraction of either a molar or premolar tooth, either a 25% metronidazole gel or KY Jelly was syringed gently into the socket. A painful post operative complication was recorded if either a dry socket was present or the patient returned with pain. RESULTS AND CONCLUSIONS: The difference in the incidence of alveolar osteitis between the placebo and the active gel groups was not significant and it was concluded that 25% topical metronidazole gel was not effective in reducing the incidence of alveolar osteitis. It was found that the incidence of alveolar osteitis reduced with increasing age and was more likely to occur in a patient with a previous history of the condition.

Administration, Topical↗
PubMed2006

[Decision making of Hebrew University and Tel Aviv University Dental Schools graduates in every day dentistry--is there a difference?].

This study was designed to evaluate decision-making among Jerusalem Hebrew-University and Tel Aviv University dental schools graduates in various restorative dentistry, endodontics and oral surgery issues. A survey was conducted among 52 dentists during a dental military convention. Most of the dentists stated they will not recommend of re-treatment of endodontic-treated tooth with asymptomatic peri-apical pathology that does not need further rehabilitation. The study reveals over treatment and over-medication in restorative and surgery decisions. More than half of the dentists decided to treat caries lesions that extend to the dentino enamel junction, in low and moderate caries risk patients. More Hebrew University graduates than Tel Aviv University graduates recommend of removal of asymptomatic horizontal fully impacted mandibular third molar and disease-free maxillary third molar antagonist. Most of Tel Aviv graduates routinely prescribe antibiotic coverage after complicated tooth extraction. This study supports the need for continuing education on daily performed dental procedures.

Antibiotic Prophylaxis↗
PubMedDate not supplied

[Prolong bleeding after extraction from green pit venom].

A case of prolonged socket bleeding after extraction is reported to have been caused by a recent green pit viper snake bite. The snake is a common tropical creature. Several cases bitten are seen in general medical clinic yearly. Pain and local symptoms lead most patient to doctor's attention; while coagulopathy, the other clinical features are usually not being aware of. The 66-year-old patient who had been bitten by the snake a day earlier, of having tooth extraction was referred to Rachaburi Hospital Dental clinic of having post-extraction delayed haemostasis. A routine heamostasis as of gel foam with adrenalin pack and vitamin K injection was unsuccessful. Further laboratory investigations confirmed that he had hypofibrinogenemia as the pathogenic cause. Fresh frozen plasma was administered, haemostatis was satisfactory within 24 hrs.

Afibrinogenemia↗
PubMed2006

Anesthetic efficacy of different ropivacaine concentrations for inferior alveolar nerve block.

This study was conducted on 72 American Society of Anesthesiologists class 1 patients scheduled for extraction of a mandibular third molar after inferior alveolar nerve block. Each patient was randomly administered one of the following ropivacaine concentrations: 0.75%, 0.5%, 0.375%, or 0.25% (18 patients per group). Onset of block (mean +/- SD) was rapid for both 0.75% (1.4 +/- 0.4 minutes) and 0.5% (1.7 +/- 0.5 minutes) ropivacaine but significantly slower for the 0.375% (4.2 +/- 2.5 minutes) and 0.25% (10.7 +/- 3.0 minutes) concentrations. Tooth extraction was performed successfully with the 0.5% and 0.75% concentrations, and supplemental injections were not required. Second injections, however, were required with 0.375% ropivacaine. Anesthesia was unsuccessful in 13 patients given 0.25% ropivacaine even after 3 injections. The mean durations of soft tissue anesthesia were 3.3 +/- 0.3 hours and 3.0 +/- 0.3 hours for the 0.75% and 0.5% concentrations, but significantly shorter with more dilute concentrations. The duration of analgesia showed a similar pattern, with the 0.75% and 0.5% concentrations producing prolonged analgesia of 6.0 +/- 0.4 hours and 5.6 +/- 0.4 hours. These results indicate that 0.5% and 0.75% concentrations were effective for intraoral nerve blockade, with both a rapid onset and prolonged duration of pain control.

Adult↗
PubMed2003

[Pain management after third molar extraction. Observations of the use of mefenamic acid and rofecoxib in the treatment of postoperative pain in the dental office].

Pain monitoring is often inadequate in the ambulant field to assure therapy results. Today NSAID take the centre in acute pain and inflammation control in dental interventions. Compared to conventional non-selective NSAID modern selective Cyclooxygenase-2 inhibitors (COX-2) provide the potential for improved compatibility and simplified medication with heightened effectiveness in acute postoperative toothaches. The aim of this study was to compare the effect of selective COX-2 inhibitors with NSAID after operative wisdom tooth extraction in 30 ambulant patients. The pain curve under mefenamine acid showed a significant increase during the first 48 hours after extraction. With rofecoxib a continuous pain decrease with the lowest stand 48 hours after intervention was registered. One week after extraction the patient's satisfaction was in favour of rofecoxib, which showed a clearly prolonged analgetic effect over 24 hours. Additionally rofecoxib as a COX-2 selective inhibitor doesn't bear the risk for severe non-anticipatable gastrointestinal side effects or prolonged bleeding after surgical intervention.

Adult↗
PubMed2002

Temperament and acceptance of dental treatment under sedation in preschool children.

The major aim of the study was to investigate whether differences concerning acceptance of dental treatment and amnesia after rectal sedation with midazolam can be explained by temperament traits in the child. Fifty children (1.5 4.0 years), consecutively referred for dental extractions because of dental trauma or caries, were sedated with midazolam 0.3 mg kg(-1) rectally. Level of sedation (state of mind) was assessed according to Wilton before and 10 min after administration of the sedative. The children's acceptance of procedures during the oral examination, the administration of the sedative, and the dental treatment were assessed according to Holst. Acceptance of an injection of local anesthesia and tooth extraction was dichotomized as satisfactory (n = 26) or unsatisfactory (n = 24). The parent assessed temperament using the Emotionality Activity Sociability (EAS) Scale of Child Temperament. Amnesia was evaluated by the parent on the following day. The relation between temperament and outcome variables was analyzed using a multiple logistic regression analysis. Children regarded as shy by the parent were at significantly greater risk of unsatisfactory acceptance of the dental treatment (P< 0.05). High scores of negative emotionality were significantly related to less amnesia (P < 0.05). We conclude that parental ratings of their child's temperament are valuable in predicting a child's acceptance of dental treatment under sedation.

Administration, Rectal↗
PubMed2002

Immediate restoration of an immediate single-tooth implant.

Traditional implant protocol specifies an unloaded healing period prior to restoration. Shorter healing times may be appropriate in some circumstances, and examples of early loading have been reported in the dental literature. This case report involves immediate implant placement at the time of tooth extraction, combined with construction of a restoration, inserted directly after implant surgery. The clinical procedures are described, and the specific indications which may permit this approach are presented.

Adult↗
PubMed2003

Concentrations of clindamycin in the mandibular bone of companion animals.

Concentrations of clindamycin in the mandible were determined in 17 dogs and 13 cats with severe plaque, gingivitis/periodontitis, and calculus that were treated orally with clindamycin (11 mg/kg) once daily for 5 days prior to professional teeth cleaning and extractions. The animals were patients at the Dental Department of the Clinic for Surgery and Ophthalmology of the University of Veterinary Medicine in Vienna, Austria. Clindamycin levels were determined during postextractional alveoloplasty. Approximately 1 to 3 mm3 of mandible was removed from the intraradicular septum in multirooted teeth and from the protruding labial/buccal alveolar rim with a small rongeur. The mean concentration of clindamycin was 8.18 microg/g in dogs (range=3.16 to 24.08 microg/g) and 17.43 microg/g in cats (range=2.45 to 51.60 microg/g). The concentration of clindamycin in the mandibles of dogs and cats may be useful to combat infections after periodontal procedures, tooth extractions, or injuries to the mandible.

Administration, Oral↗
PubMed1982

Subcutaneous facial emphysema complicating dental anaesthesia.

A 20 year-old female developed swelling and protrusions of the tongue and marked facial swelling while under general anaesthesia for dental restoration and gigivectomy. The initial diagnosis was angioedema; however x-rays showed marked subcutaneous emphysema more extensive in the perimandibular area with a minimal amount in the neck. There was no evidence of pneumomediastinum or pneumothorax. The iatrogenic subcutaneous emphysema was felt to be due to air-driven dental equipment. Tracheal intubation was maintained for 21 hours to prevent airway obstruction. The patient was treated with oxygen and antibiotics. Subcutaneous emphysema may occur following root canal therapy, tooth extraction, periodontal surgery and operative dentistry, due to the use of air-driven dental equipment. It has the potential to cause obstruction.

Adult↗
PubMed1992

Phases of dental fear for four treatment procedures among military personnel.

Dental fear is a significant problem in the delivery of dental care. This study examined the phases of dental fear in 488 military conscripts scheduled to receive four categories of dental treatment for the first time. Results showed that the level of fear increased gradually from the day before treatment and peaked while receiving it. A significant reduction occurred after completing the treatment. Among the different types of procedures, tooth extraction elicited the highest degree of fear, while having the teeth cleaned registered the lowest. Military servicemen showed a pattern of dental fear similar to those other population groups.

Adult↗
PubMed1980

[Treatment of patients at risk of hemorrhage with the aid of fibrin adhesion].

341 cases of surgery on patients with difficulties in hemostasis are reported. Therapy was the use of fibrine fixation technique, a simple and riskless method. Tooth extractions and other surgical interventions oin anticoagulated patients may be performed without interruption of the anticoagulant therapy, also patients with hemorrhages and other complications need not be expected, if the material is properly handled.

Fibrin↗
PubMed2005

[Solitary abscessing osteomyelitis of the mandibular condyle. A rarity].

CASE REPORT: We report on a rare case of secondary chronic osteomyelitis of the left condyle. Haemophilus aphrophilus could be isolated from the abscess material. The condyle was resected and reconstructed with an endoprosthesis in the same operation. DISCUSSION: Possible causes of the rare location of secondary chronic osteomyelitis are assembled in a review of the literature and compared with the actual case. CONCLUSION: We suggest the inoculation of microorganisms through the needle of a local anesthetic injection, bacterial contamination during the tooth extraction, or bacteremia following the dental extraction to be possible causes for the infection.

Abscess↗