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PubMed1985

The shear strength between bone and porous ceramic root implants in the guinea pig incisor socket.

Porous alumina and apatite implants have been placed in 67 guinea pig incisor tooth sockets after tooth extraction under anaesthetic. Bone readily grew into the spaces of the implant, and reduced the fibrous connective tissue between implant and bone. 'Pushout' tests have monitored the shear strength of the interlock between bone and implant. Despite considerable variation in the interlock strength, apatite produced the strongest bone interlock. The interlock with alumina tended to be more fibrous. The relative merits of fibrous and bone interlocks in immediate root implants are considered for the augmentation of the alveolar ridge and prosthetic treatment.

Aluminum Oxide↗
PubMed1979

Skeletal scintigraphy following incidental trauma.

The significance of antecedent trauma in skeletal scintigraphy was assessed in 503 patients, of whom 241 (46%) had prior fracture or tooth extraction. In patients with sufficiently accurate histories for site-by-site analysis, 33 of 131 fracture sites and 16 of 83 dental-procedure sites were positive scintigraphically. In general, the frequency of scan positivity diminished as the interval between trauma and scanning increased, but a significant number of patients showed prolonged uptake at fracture sites. Several patterns of uptake suggested trauma rather than metastatic disease. Knowledge of a history of trauma is often critical in bone scan interpretation.

Bone Neoplasms↗
PubMed1998

[A biomechanical study of dental implants using a method for 3-dimensional volumetric mathematical modelling].

Biomechanics of the dental implants introduced into alveoli immediately after tooth extraction has been investigated. The programme ANSYS has been used. Three-dimension volume mathematical models were calculated, with the help of which the tense-deformed state of the supportive biological tissues has been investigated in the area of direct implantation. On the grounds of the results obtained a conclusion has been made that there is an essential improvement of the load distribution under investigation of the inner bone modified biologically designed implants for direct implantation.

Alveolar Process↗
PubMed2003

Management of oral surgery in patients with hereditary or acquired angioedemas: review and case report.

Angioedemas are a rare but significant event in simple oral surgery because they can cause an acute life-threatening laryngeal edema. We report a case of a tooth extraction in a patient with hereditary angioedema, for which the C1-inhibitor (C1-INH) concentration administered effectively controlled edema during and after extraction. We also review case reports of oral surgery management in patients with hereditary and acquired angioedemas. In 2 of 36 cases, laryngeal edema occurred after teeth extraction. One was considered to be a type 2 acquired angioedema, which tolerates replacement therapy with fresh frozen plasma. The other case was managed only with danazol, and it was suggested that this was on occasion insufficient. Safety of oral surgery on patients with angioedema depends on the type of angioedema and the availability of C1-INH concentration. An exact diagnosis of the type of angioedema is needed to know the effect of replacement therapy with C1-INH.

Angioedema↗
PubMed1985

Evaluation of hydroxylapatite root implants in baboons.

To determine if there is a need for close conformation of a hydroxylapatite implant to the root socket for successful prevention of alveolar ridge resorption after tooth extraction, second premolars and lateral incisors of six mature baboons were extracted bilaterally, and custom-fitted root replicas or half-length, plug-shaped forms of hydroxylapatite were implanted in the fresh sockets. Results showed that precise fit, as achieved by a custom-fitted implant, was not necessary for success. All implants were completely accepted, with evidence of new bone formation continuing for up to six months, the duration of the study. No resorption of the alveolar ridge was observed by gross or microscopic examination.

Alveolar Process↗
PubMed1989

Clinical effectiveness of desmopressin in a case of acquired von Willebrand's syndrome associated with benign monoclonal gammopathy.

A case of acquired von Willebrand's syndrome (avWs) secondary to benign monoclonal gammopathy, is described, in which desmopressin (DDAVP) has proven effective repeatedly in preventing bleeding after tooth extraction. The laboratory pattern was similar to that of congenital type IA von Willebrand's disease. After DDAVP, prolonged bleeding time and factor VIII/von Willebrand factor activities were normalized. The disappearance rate of the elicited activities was similar to that observed in patients with congenital disease. This report adds to the scarce data concerning the haemostatic effectiveness of DDAVP in avWs and suggests that this agent might also be used in controlling or preventing bleeding in patients with the acquired disease, selected on the basis of their biological responsiveness to a test-infusion.

Deamino Arginine Vasopressin↗
PubMed1989

Ludwig's angina: an analysis of 14 cases.

Ludwig's angina remains a potentially lethal disease entity as it causes rapidly progressive airway obstruction, although the current mortality rate is low. Early surgical intervention should be carried out in severe cases which show signs of fluctuation, abscess formation or other serious complications. We report our experience with 14 cases of Ludwig's angina, 12 of which (86%) were of dental origin. Only one case was complicated with Klebsiella pneumoniae septicemia which resolved upon treatment. There were no deaths. Surgical procedures including incision and drainage and tooth extraction were performed in 11 cases (78%). Antibiotics were administered to all patients. Most of them were treated with crystalline penicillin with or without an aminoglycoside. Only one patient received a tracheostomy in this series. The number of tracheostomies or intubations carried out was much lower than in previous reports. We suggest that an aggressive antimicrobial therapy, early surgical intervention and careful monitoring of the respiratory symptoms would reduce both the need for tracheostomy and the mortality rate.

Adult↗
PubMed2006

[Bisphosphonates and maxillo-mandibular osteo(chemo)necrosis].

INTRODUCTION: Maxillo-mandibular osteonecrosis is exceptional outside a context of cervico-facial radiotherapy. Bisphosphonates are non-metabolized pyrophosphate analogues which inhibit osteoclastic activity. Bisphosphonates are prescribed for the treatment of malignant hypercalcemia, osteolysis associated with metastatic bone disease, Paget's disease and osteoporosis. Maxillomandibular osteonecrosis with bisphosphonates can be observed in 1/10000 patients, but is probably underestimated due to lack of dental examination. MATERIAL AND METHODS: We describe six cases of mandibular necrosis associated with bisphosphonates: five of them as part of their treatment regimen for a neoplastic condition and one for osteoporosis. RESULTS: Two patients developed spontaneous bone necrosis. In two others, tooth extraction preceded the onset of osteonecrosis. In the last two patients, we noted a preexisting dental infection. All the histopathological examinations showed necrotic bone colonized by Actinomyces. DISCUSSION: Bisphosphonate-induced osteonecrosis is only found in the maxillomandibular area because the jaws are the only bone in the skeleton exposed to the external environment. The mandible is rendered particularly prone to necrosis even after minor trauma because of its terminal vascularization. Careful oral examination is recommended before prescribing bisphosphonate therapy.

Actinomycosis, Cervicofacial↗
PubMed1999

Hyperbaric oxygen in the prevention of osteoradionecrosis of the jaws.

Patients who have had their jaws irradiated as part of management of head and neck malignancy are at risk of osteoradionecrosis (ORN) following tooth extraction. Thirty-seven patients with a history of irradiation to the jaws were managed during a four year period. Twenty-nine patients received hyperbaric oxygen therapy (HBO) consisting of 20 treatments before surgery and ten treatments after. Only one (4 per cent) developed ORN. Seven patients who did not have HBO and one who did (15 per cent) developed ORN. The need for prophylactic treatment with HBO is discussed. It is recommended that prophylactic HBO is used prior to surgery for irradiated facial bones.

Adult↗
PubMed1989

[10 years of dental care of hemophiliacs].

Increased consciousness of oral hygiene, improvement of sanitation degree and decrease of the number tooth extractions have been proved a success and an expression of high compliance within the scope of long-term interdisciplinary care of haemophilic patients. At the same time both patients registration and concentration at an out-patient department facilitate cooperation with the paediatricians and internal specialists being in charge of them, in addition a change-over from children to adult dispensary care is ensured. Haemophilic patients suffering from hepatitis B or HTLV-III/HIV antibodies carrier may be registered immediately. All patients undergoing dispensary care are subject to preventive test obligations.

Adult↗
PubMed2003

Increased prevalence of dental caries and poor oral hygiene in juvenile idiopathic arthritis.

OBJECTIVES: Recent decades have seen a trend to treat juvenile idiopathic arthritis (JIA) with increasing immunosuppression to improve the long-term outcome. Poor oral hygiene and dental decay cause significant morbidity, and patients with chronic disease (who may be further immunocompromised by treatment) are at greater risk. This study investigated patients with JIA using standard measures of oral health. METHODS: One hundred and forty-nine patients with JIA were included. The children were attending a regional paediatric rheumatology service and the adults were attending an adult rheumatology clinic. Random age- and sex-matched healthy controls were recruited from a dental teaching hospital. The structured dental examination included standard epidemiological indices of oral hygiene (gingival index, plaque index, oral cleanliness index) and dental decay [DMFT (decayed, missing or filled teeth) index]. RESULTS: JIA patients, at all ages, had increased levels of dental decay and poor oral hygiene. This increased level of decay was statistically significant in the patients aged 0-11 yr. Significant levels of untreated caries and increased levels of missing teeth were found in JIA, suggesting that patients with JIA had less restorative dental treatment, with tooth extraction often the chosen option for the treatment of dental decay. CONCLUSIONS: This is the largest study of oral health in JIA and is cross-sectional with non-diseased controls. It shows significantly increased levels of poor oral hygiene and dental decay in patients with JIA. The high levels of untreated dental decay suggest barriers to dental care. These results emphasize the role of regular dental care in the multidisciplinary management of JIA.

Adolescent↗
PubMed1995

[Isolated iliac artery aneurysms associated with disseminated intravascular coagulation (DIC)].

An 84-year-old man was referred to our hospital on December 3, 1993, because of excessive bleeding after tooth extraction. Coagulation studies revealed thrombocytopenia (2.2 x 10(4)/microliter), increased serum levels of FDP-E (3172 ng/ml) and D dimer (42.6 micrograms/ml), and increased plasma levels of thrombin-atithrombin III complex (48.0 ng/ml) and plasmin-alpha 2-plasmin inhibitor complex (6.8 micrograms/ml). Computed tomography showed bilateral common iliac artery aneurysms. A diagnosis of DIC due to bilateral common iliac artery aneurysms was made. Heparin (10,000 U/day) administered to treat DIC resulted in good control, and operative repair of the aneurysms was successful. This is the second reported case of isolated iliac artery aneurysms associated with DIC.

Aged↗
PubMed1979

[Treatment of haemorrhages in a haemophiliac with factor-VIII inhibitor (author's transl)].

In a 33-year-old man with haemophilia A, due to the presence of a factor VIII inhibitor, severe bleeding followed a tooth extraction. It could not be stopped by ordinary factor-VIII substitution or administration of activated prothrombin complex. Before starting substitution treatment it was necessary to decrease the inhibitor concentration in plasma. This was possible by plasma exchange with a blood-cell separator: an exchange volume of 4 litres proved to be sufficient. The inhibitor-containing plasma was replaced by fresh plasma and cryoprecipitate. It was possible to increase the haemostatic activity of the transfused factor VIII by combination with activated prothrombin complex. The inhibitor kinetics remained uninfluenced. A delayed plasmapheresis was without effect as a result of an antibody booster by previous factor-VIII substitution.

Adult↗
PubMed1987

Haemodynamic changes under emotional stress following a minor surgical procedure under local anaesthesia.

The influence of 4 ml lidocaine 2% without vasoconstrictor, and with epinephrine 0.001%, or with norepinephrine 0.005% on the heart rate and blood pressure was investigated in one group of patients (n = 30) during a minor surgical procedure (tooth extraction) and in an age-matched group of volunteers (n = 30) with injection only and without any intervention. The difference between the 2 groups underlines the presence of emotional stress. Lidocaine without and with a vasoconstrictor changes the heart rate and blood pressure differently. These haemodynamic changes are superposed by alterations caused by emotional stress and are similar in all test series. The so-called epinephrine-collapse often seems to have its cause in an abrupt relative deficiency of epinephrine after stress. It is possible to significantly influence the cardiovascular system in connection with a local anaesthesia with the choice of vasoconstrictor.

Adult↗
PubMed2004

Use of pedicled buccal fat pad in the closure of oroantral communication: analysis of 75 cases.

OBJECTIVE: This report evaluates the use of pedicled buccal fat pad for closure of oroantral communications. METHOD AND MATERIALS: Seventy-five patients were treated with pedicled buccal fat pad. Fifty-two were treated immediately after tooth extractions. The remaining 23 had chronic oroantral communication and were treated similarly after irrigation of the maxillary sinus with saline for 7 days. RESULTS: The 6-month follow-up revealed uneventful healing in all of the patients. Though partial necrosis of the flap was observed in three patients, this did not effect the final healing. Total necrosis of the flap was not noted. CONCLUSION: The use of pedicled buccal fat pad is an acceptable and reliable alternative in acute or chronic oroantral communications management and may even be used as a first treatment choice by experienced surgeons.

Acute Disease↗
PubMed2006

[Microbiological study on the prognosis of immediate implant and periodontal disease].

AIM: The aim of the present study was to investigate the prevalence of periodontal marker organisms and specific interleukin-1 (IL-1) gene polymorphisms (which show a close association with periodontitis) and their effect on the success of immediate implant placement postextraction in the patient with periodontal disease. PATIENTS AND METHODS: A group of 59 patients (22 men and 37 women aged 20-81 years, median age 55 years, 18 smokers) with chronic adult periodontitis participated in the study which included a 1-year observation period postoperatively. Prior to tooth extraction two DNA samples were obtained for the microbiological diagnosis of five anaerobic gram-negative pathogens (Haemophilus actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythensis, Prevotella intermedia sensu stricto, Treponema denticola) and to identify the IL-1 gene polymorphisms. Patients were treated with a total of 95 immediate dental implants (26 Ankylos/Friadent and 69 Camlog Root-Line/Camlog Biotechnologies) placed into extraction sites, 78 of which were loaded immediately. After 1 year four failures were observed; all of these patients were smokers. RESULTS: None of these patients showed a positive IL-1 genotype; periodontal marker organisms were only found in one patient. No significant difference was seen in the microbiological pathogens between smokers and nonsmokers. Of 59 patients, 23 (39%) tested positive for IL-1 genotype polymorphism. Smoking was shown to increase the risk of implant failure. No association was observed between failures and the IL-1 gene polymorphisms or pathogens. CONCLUSION: In conclusion, our study shows that periodontally infected sites do not seem to be a contraindication for immediate implantation.

Adult↗
PubMedDate not supplied

Intraoral vascular malformation and airway management: a case report and review of the literature.

A patient with a large airway venous malformation underwent anesthesia for a tooth extraction. The procedure was uneventful until extubation, immediately after which complete airway obstruction resulted. After unsuccessful attempts to relieve the problem, the patient's trachea was reintubated. Laryngoscopy showed that the venous malformation in the airway had enlarged and was responsible for the airway obstruction. Another attempt at extubation after corrective maneuvers was again unsuccessful. A tracheostomy was required, which was eventually removed after a complete recovery. Anesthesiologists must be concerned with any airway vascular abnormality. Most abnormalities involving the airway are either hemangiomas or venous malformations. The anesthesiologist must diagnose the problem correctly because even minor manipulation of a venous malformation may result in exsanguination, or the malformation may become engorged and compromise the airway.

Adult↗
PubMed2006

Comparison of the Wand with a conventional technique.

OBJECTIVE: The objective of the present study was to compare the Wand computer-controlled anesthetic delivery system with a conventional technique as to pain of needle insertion and the pain during injection according to the patient's dental anxiety levels. STUDY DESIGN: The study sample comprised 52 healthy patients about to undergo routine tooth extraction. A dental anxiety scale was used to determine anxiety levels before anesthetic administration. Anesthesia technique selection was made according to the patients' anxiety level. After each injection, patients completed pain rating score and visual analog scale to rate their pain perception during needle insertion and injection. RESULTS: The patients receiving the Wand system reported significantly less pain of needle insertion and less pain during injection (P < .05). CONCLUSION: Under the conditions of this study, although the anxiety levels of patients were higher in Wand injection than conventional syringe injection, the Wand seemed to be less painful. However, the mean ratings of pain were mostly mild or no pain for both injections.

Adolescent↗