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[Analgesic effect of Pilostigma reticulatum (nguiguis)].

Mankind has always given himself means to fight pain by using at first, means offered to him by his environment particularly the plants. African pharmacopoeia is rich of thousand of plants. It changes in term of its ecosystem and its vegetation. Decocted leaves of pilostigma reticulatum (nguiguis in ouolof) are used in western Africa, because of its analgesic properties in case of "borom bop" literally meaning headache associated to odontalgias and mumps. In our study we used lyophilisate obtained from dry leaves of the plant which has been used for experimentation while the decocted dry leaves have been used for clinical application. So, it appeared that leaves of pilostigma reticulatum are almost atoxic when administrated by oral tract (DL50 = 17 g/kg) according to GLEASON classification which recognizes as atoxic every substance having a DL50 higher to 15 g of lyophilisate by kilogram of corporal weight. Elsewhere the study of the peripheric analgesic activity (according to the acetic acid test) has shown a very significant peripheric analgesia since the dose of 750 mg/kg which climbs with it. The clinical survey carried out at the dental community center of Pikine Icotaf based on the usual method of the utilization of the decocted (as mouth rinse) has shown that, this plant procures pain sedation in 97% of the patients having undergone dental avulsion and in 78% of the cases of desmondontal syndromes. This inaugural report must be continued in order to certify the pharmacologic or toxic effects of that plant and define clinical doses from experimental doses we have cleared.

Acetic Acid↗

Reimplantation and immediate loading of an accidentally avulsed beaded implant: case report.

We present a case of reimplantation of an accidentally avulsed beaded Endopore (Innova Corp., Toronto, Canada) implant. The technique of immediate splinting and pharmacotherapy is described together with the clinical and radiologic evaluation for reosseointegration. This single case of reimplantation with immediate functional loading would suggest that, contrary to the manufacturer's recommendation, the Endopore implants can be successfully loaded immediately, functionally or nonfunctionally.

Accidents↗

Replantation and transplantation following avulsion of two maxillary incisors.

Here we describe replantation and transplantation as a treatment conducted in a 16-year-old patient following a bicycle accident. An avulsed left central incisor in maxilla was replanted after extra-oral root canal treatment, and the lost right central incisor of the maxilla was replaced by a left lateral incisor of the mandible in the region of the fracture fissure. Follow-up examination at 34 months showed validity of treatment, although slight evidence of replacement resorption in the transplanted and replanted teeth was revealed.

Adolescent↗

[Evaluation of the therapeutic efficacy and tolerance of a new thiamine compound (benzoyloxymethylthiamine) in the treatment of postoperative pain symptomatology in odontostomatological surgery].

The therapeutic effectiveness of benzoyloxymethyl-thiamin in controlling post-operative pain in odontostomatological surgery has been examined. The double blind study used a placebo and concerned 100 patients subjected to avulsion of the third molar in dysodontiasis on an out-patient basis. The results point to the effectiveness of benzoyloxymethyl-thiamin in the symptomatic treatment of post-operative pain symptomatology both as regards its duration and intensity; the drug also proved to be very well tolerated and its administration was not accompanied by any unwanted side-effects.

Adult↗

Endosseous implant and autogenous bone graft reconstruction of mandibular discontinuity: a 12-year longitudinal study of 31 patients.

Surgical, medical, and prosthodontic records of 61 consecutively treated patients with mandibular discontinuity were reviewed retrospectively. All 61 patients had undergone discontinuity reconstruction with autogenous bone grafts; 31 of 61 had also received endosseous dental implants and a dental osseoprosthesis. Of these 31 implant-reconstructed patients, 23 had free autogenous nonvascularized and 8 had vascularized bone grafts. The surgical-prosthetic protocol consisted primarily of secondary, free autogenous nonvascularized bone graft reconstruction and secondary root-form endosseous implant and fixed prosthesis dental reconstruction. Vascularized bone (8 patients) or soft tissue (4 patients) grafts were utilized selectively for severely compromised patients after extensive oncologic resection, avulsive trauma, or after previous radiation treatment. Endosseous implant survival (95.5% in 31 patients), autogenous bone graft success (98.4% in 61 patients), and dental osseoprosthesis success (100% in 31 patients) were favorable. A high incidence (9.1%) of nonfunctioning (sleeping) implants was recorded for this patient population. The need to remove the titanium mesh tray for various reasons (17.6%) and the need to reconstruct soft tissue in the irradiated patient (12%) were noteworthy.

Adolescent↗

[Oral injuries in cases of child abuse].

Child abuse is more common than previously supposed, and non-accidental injuries may also present in the oral cavity. Results of physical abuse are most commonly diagnosed as such, but injuries from sexual abuse and results of neglect may be observed in the mouth. Bruises are the most common types of non-accidental injuries, the lips and frena being specially exposed, through burns may be cause by over-hot food or caustic liquids. The teeth may fracture, be avulsed, displaced or discoloured as a result of non-accidental injury. Sexually transmitted diseases in children's mouths are strong indications of sexual abuse. Children exposed to oral sexual activities over a considerable period of time may develop higher caries rates and erosion on the palatal surface of the maxillary teeth. Dental neglect may be part of general neglect. The dentist's role is to treat the oral injuries and take appropriate action to prevent continued abuse.

Child↗

[A polymorphism study of the DNA extracted from dental tissues].

Often teeth are the only items which can be used for personal identification in forensic medicine. In the present work we describe a method to extract and amplify DNA from dental elements ranging from 2 weeks to 5 year from the avulsion. PCR (polymerase chain reaction) was used to amplify VNTR sequences; the alleles products were electrophoresed, visualized by traditional methods and compared to the amplified products obtained from the matching blood sample. Our results give a new and powerful investigative tool for personal identification in the field of forensic odontostomatology, since such a procedure can be successfully applied both to recent and to ancient teeth.

Apolipoproteins B↗

[A new "light" maxillomandibular fixation system].

BACKGROUND: A new "light" maxillo-mandibular fixation system for treatment of mandibular fractures, based on use of special pins, is proposed. METHODS: Fifteen patients with non-displaced mandibular fractures (angle, body and symphysis), have been treated at the Department of Maxillofacial Surgery, S. Paolo University Hospital, Milan. The system is based on pins formed by a no. 1 metal wire and a bead. The free end of the pin is threaded around a tooth and then wound three or four times around the bead to fix it in place and, at the same time, separate it from the gingiva. One pin is usually positioned on each quadrant. Once the pins are in place they are tied to each other using a loop no. 0 to complete the maxillo-mandibular fixation. Particular attention was paid to maintain a correct individual occlusion. The time of maxillo-mandibular block was 10-15 days. RESULTS: Results were good with complete healing of all fractures, restoration of individual occlusion, minimal periodontal lesions and a good compliance for the treatment by the patients. CONCLUSIONS: It is suggested to use this system routinely because quick, economic, easy on periodontium and relatively comfortable for the patients. The contraindication include an unstable occlusion, the absence of a suitable pair of teeth on both sides of the jaws, avulsion or trauma or periodontopathy of one of the teeth needed for the fixation system.

Bone Nails↗

Storage of experimentally avulsed teeth in milk prior to replantation.

Extracted monkey teeth were endodontically treated, stored in milk or saliva for two or six h, and then replanted. Periodontal conditions were evaluated after eight wk. Teeth that had been stored for two or six h in milk or for two h in saliva showed periodontal healing almost as good as that of immediately replanted teeth. Teeth that had been kept in saliva for six h or bench-dried for one h showed extensive replacement resorption. Milk may thus be recommended as a storage medium for ex-articulated teeth prior to replantation in cases when immediate replantation is not possible.

Animals↗

An alternative method for splinting of traumatized teeth: case reports.

Injuries to the dentoalveolar complex are fairly common and can be caused by a number of reasons. There are many techniques for repositioning and stabilizing traumatically luxated or avulsed teeth. Many of the splinting techniques previously advocated were time-consuming. Not only were the splints difficult to fabricate and difficult to remove, they also contributed to injury of the soft and hard supporting tissues. Ribbond (Ribbond Inc., Seattle, Wash) is basically a reinforced ribbon which is made from ultrahigh molecular weight polyethylene fiber having an ultrahigh modulus. It is used in dentistry for various purposes. The use of Ribbond appears to be an adequate and easy method for stabilization and fixation. It can be used in the treatment of dental injuries. In this article the use of Ribbond for the treatment of dentoalveolar injuries is described.

Child↗

[Platelet aggregation inhibitors and vitamin K antagonists in stomatology and maxillo-facial surgery].

Anti-thrombin, anti-platelet and anti-vitamin K agents are common treatments given for the prevention of thrombotic or embolic events. In oral or maxillofacial surgery, the question is whether oral anticoagulants or anti-platelets should be discontinued or not: temporary interruption could limit the risk of bleeding, but would increase the risk of thrombosis, and inversely. The best risk/benefit ratio must be achieved, but in many cases anti-platelet agents or even anti-vitamin K agents can be continued. In case of "potentially hemorrhagic" oral surgery, anti-platelet agents should be interrupted about ten days before the intervention. Anti-vitamin K agents should be interrupted four days before surgery and if required, replaced by low-molecular weight heparin at preventive or curative doses. In the very large majority of patients however, surgery (avulsion for example) can be performed without interrupting anticoagulation. Data in the literature have demonstrated that despite the theoretical risk of hemorrhage, bleeding is minimal and can be easily controlled by local treatments; the risk of thrombotic or thromboembolic events after discontinuing anticoagulation is much greater. A close collaboration between the dentist, the stomatologist, and the clinician is required to determine whether anti-thrombosis prevention should be continued and whether the anticoagulation level is adapted to the thrombotic risk. Good surgical technique and local anti-hemorrhagic treatment are essential in oral surgery, particularly in patients taking anti-platelets or oral anticoagulants.

Administration, Oral↗

Clinical evaluation of antibiotic-supplemented bone allograft.

Antibiotic-supplemented bone allograft (ASBA) was originally developed for treatment of combat-acquired, avulsive defects of the oral and maxillofacial skeleton. Earlier findings in experimental wound models showed that ASBA resulted in significantly improved wound repair of infected osseous defects when compared with conventional treatment. In this study, ASBA was evaluated in paired, comparable, mandibular third molar sockets and compared with the findings following conventional surgical removal. The results of this assessment showed that wound healing was significantly improved with the use of ASBA. Evidence produced by this clinical evaluation of ASBA suggests its potential use for other surgical bone defects when grafting is precluded by the risk of infection as a result of contamination by oral flora.

Adult↗

Orthodontic extrusion of single-rooted teeth affected with advanced periodontal disease.

Orthodontic extrusion of teeth with advanced periodontal disease was evaluated in beagle dogs. Surgical destruction of one third to one half of the attachment apparatus and the inducement of chronic periodontal disease was accomplished on the hemisected mesial roots of the mandibular premolars. The roots on one side of the mandible were extruded toward a cemented stainless steel bridge by means of elastics providing 20 to 25 gm of force. The force was examined daily. When extruded teeth came into contact with the bridge, they were ligated in place for 21 days of stabilization. Clinical results showed that control teeth maintained their position and signs of advanced periodontitis. Extruded teeth had shallower pocket depths, less gingival inflammation, and no bleeding on probing. Radiographic evaluation showed no demonstrable changes in the control teeth. Early in the extrusion process, the teeth appeared to be avulsed, with more than three fourths of the root coronal to the alveolar crest. After stabilization, approximately 2 mm of new bone was seen coronal to the original alveolar crest, and the periapical areas had filled in as well. This bone formation was verified histologically. The extruded teeth had an intact attachment apparatus with all components in the same relative position on the teeth as in the controls. However, a shallower sulcus and less gingival inflammation were noted in the extruded teeth. There were statistically significant findings of a wider periodontal ligament space, greater cementum width, and increased bone height in the crestal areas of extruded teeth. Extruded teeth also had less cementum width and greater new bone formation at the apex.(ABSTRACT TRUNCATED AT 250 WORDS)

Alveolar Process↗

[Reimplantation and autotransplantation of teeth. Review of the literature].

The most important factor for a favorable long-time prognosis of replanted and autotransplanted teeth is a short extra-alveolar periode. Implanted teeth should be followed radiographically with special attention to external resorptions as these correspond well with the histological picture. Avulsed teeth replanted within 30 minutes have a fairly good long-time prognosis. A little less than half of the teeth are still in place after five years. In international replantation the procedure can be performed with a short extraalveolar periode. By using the methods giving the shortest extraalveolar periods during autotransplantation a favorable long-time prognosis is to be expected in most of the cases. Implantation can be performed with all teeth at any developmental stage. However, a favorable long-time prognosis can only be expected where the teeth are removed from their alveoli without severe damage to the periodontal membrane. Compared to the altenative treatments which often are removable or fixed appliances or artificial implants, the prognosis for implanted teeth is sufficient good to accept the treatment as lege artis.

Animals↗

Morphometric and microscopic evaluation of the effect of solution of acetazolamide as an intracanal therapeutic agent in late reimplanted rat teeth.

The use of substances that inhibit root resorption may be an alternative for cases of unsuccessful reimplants. Hence, the purpose of this study was to test a solution of acetazolamide, a resorption inhibitor, as an intracanal therapeutic agent for late reimplanted teeth. Thirty rat maxillary right central incisors were avulsed and kept dry for 30 min. The teeth were instrumented, and the root surfaces treated with 1% hypochlorite solution followed by application of 2% sodium fluoride. Thereafter, the teeth were divided into two groups according to the intracanal dressing: Group I, solution of acetazolamide and Group II, calcium hydroxide paste. Teeth were then reimplanted in their respective sockets. The animals were killed at 15, 30, and 60 days after reimplantation and the samples processed for morphometric and microscopic analysis. The results showed that calcium hydroxide paste limited root resorption, even though not avoiding it. In contrast, no root resorption was observed after 60 days in the acetazolamide group, confirming the efficacy of the substance in inhibiting root resorption.

Acetazolamide↗

Using composite bonding in oral and maxillofacial surgical office practice.

OBJECTIVE: Composite bonding plays a significant role in all phases of dental practice from orthodontics to restorative dentistry and even endodontics, yet, at the present time has had limited use by the oral and maxillofacial surgeon. The purpose of this article is 3-fold: to recommend a material for bonding and the method of application for composites; to describe the requirements of the orthodontist when referring a patient for the uncovering of teeth because this is usually the surgeon's primary, if not only, experience with bonding; and to describe situations that may present in the office that will benefit with the use of composite bonding. PATIENTS AND METHODS: Patients with various problems requiring the stabilization of teeth are presented and in a number of cases the effectiveness of the wired bar and the bonded bar is compared. These cases include the management of dentoalveolar fractures, avulsed or displaced teeth, its application to porcelain restorations without ill effects, and other situations that may arise in the office where fixation and stabilization of teeth is mandatory for success. RESULTS: Composite bonding provides the most effective method of stabilizing and immobilizing teeth with successful results in almost all cases. On the other hand, the wired arch bar and other wire combinations, which at the present time is the primary, if not the only treatment for these cases, are second to it from all aspects. CONCLUSION: The successful results with composite bonding along with its case of placement without pain or bleeding or psychological stress on the patient or operator warrants consideration by the oral and maxillofacial surgeon for greater utilization of this material in his office.

Composite Resins↗

[Non-invasive evaluation of an injectable bone substitute].

Despite the increasing number of techniques for the preservation of bone ridges after dental avulsion, no precise evaluation of alveolar filling has been performed to date. The criteria of available measurement techniques (probes, retroalveolar or panoramic radiography, and lateral teleradiography) are not sufficiently reliable and precise. This study investigated the reliability of evaluation based on CT images in comparison with retroalveolar radiography (the most precise radiographic technique, providing standardised images), direct measurements, and images obtained in scanning electron microscopy. After a preliminary investigation ex vivo, a study was performed in vivo on three beagles. Mandibular premolars were extracted, and the corresponding alveoli were filled with an injectable bone substitute composed of a calcium phosphate mineral load associated with hydroxypropyl methylcellulose. Measurements performed on CT images relative to visual and automatic detection of density changes and studies of density curves provided better precision than those obtained by retroalveolar radiography.

Animals↗

A study into dentists' knowledge of the treatment of traumatic injuries to young permanent incisors.

OBJECTIVE: The aims of this study were to evaluate dentists' knowledge of the emergency treatment of traumatic injuries to young permanent incisors, and to investigate barriers to treatment. DESIGN: A closed-ended questionnaire was sent to 1023 general dental practitioners (GDPs) and community dental officers (CDOs) in West/North Yorkshire and Humberside, UK. METHODS: The questionnaire comprised 17 questions. Six questions asked for general information about the participants (i.e. profession, age, gender, year of graduation, training or education on dental trauma, and willingness to provide emergency care), 10 were relevant to the emergency treatment of crown fractures, root fractures, luxation and avulsion injuries, and the last question queried any perceived barriers to treatment. Results. Seven hundred and twenty-four questionnaires were returned, a response rate of 71%, and these indicated that dentists' knowledge of the emergency treatment of dentoalveolar trauma in children was inadequate. The CDOs were significantly more knowledgeable than the GDPs, as were younger and more recently graduated dentists compared with older ones. The GDPs regarded the difficulty of treating children and the inadequate fees of the UK National Health Service as important barriers to treatment. Dentists who attended continuing dental education courses on dental traumatology had a more thorough knowledge than those who did not. CONCLUSION: Overall, the dentists' knowledge of the emergency treatment of dentoalveolar trauma in children was inadequate. Greater emphasis on undergraduate and postgraduate education in this area is indicated.

Adult↗