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Language Medicina oral, patología oral y cirugía bucal. Ed inglesa. 2010. Vol. 15, no. 6
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- Effects of saliva and nasal secretion on some physical properties of four different resin materials(2010) Kurtulmus, Huseyin; Kumbuloglu, Ovul; Aktas, Rahime Tuzunsoy; Kurtulmus, Aylin; Byacioglu, Hayal; Oral, Onur; User, AtillaObjective: Aim of this study was to evaluate possible effects of saliva and nasal secretion on some physical properties, such as sorption, solubility, surface hardness and colour change on four different resin-based materials over a certain time period. Materials and Methods: A total of 128 disc-shaped specimens with a diameter of 50mm and thickness of 0.5mm were tested to evaluate sorption and solubility (ISO-1567). The specimens were stored in different solutions prior to testing. Surface hardness measurements were performed by using a Vickers hardness testing machine. A total of 20 cylindershaped test specimens with a diameter of 13 mm and thickness of 1 mm were prepared to evaluate colour change (?E). Analysis of variance was used to determine significant differences among groups. Paired t and Tukey Post-Hoc tests were performed to investigate significant differences among subgroups at all time intervals (p<0.05). Results: It was found that while the percentage absorption value at T7(7 days) of the auto-polymerizing (A) groups storaged in artificial saliva + nasal secretion were the highest (0.057±0.119), the percentage absorption value at T15(15 days) of the D groups storaged in artificial nasal secretion were the lowest (0.013±0.09). Besides, it was found that the percentage solubility value at T30(30 days) of visible ligth-cusing resin (VLC) groups storaged in artificial nasal secretion were the highest (0.016±0.003), and the percentage solubility value at T1(1 day) of the D groups storaged in distilled water were the lowest (0.01±0.02). While the highest hardness value was of T0(Dry) in group heat-polymerizing (H) (36.19±1.35), the lowest hardness value was of T0 in group D (9.83±2.48). When ?E values analysed for each group, VLC group showed the highest values (23.78±5.05) (p<0.05), group D showed the lowest values (9.06±2.82) in time (between the T0 and T30). Conclusion: The new polyamide resin was observed to show better physical properties when compared with other materials.
- Dentifrices : an update(2010) Davies, Robin; Scully, Crispian; Preston, Antony J.Objectives; The objective of this paper was to review the published evidence concerning the efficacy and potential for adverse reactions of modern dentifrices toothpastes. Data sources; Publications cited on MEDLINE since 1990. Some further pre-1990 publications are also referenced. Data selection; Studies concerning the efficacy of dentifrices and their components and any related putative adverse incidents. Data extraction; Papers were scrutinised for scientific and trial data. Data synthesis; Data concerning the efficacy of dentifrice components were summarised. Conclusions; The efficacy of fluoride salts in dentifrices in reducing dental caries is well established. Toothpastes, containing triclosan, are effective in improving plaque control, gingivitis and periodontal health. Other toothpaste formulations are effective in reducing the formation of calculus, extrinsic tooth stain, dentine sensitivity and oral malodour. The consumer now has available a range of toothpastes which deliver oral health benefits. Adverse reactions to toothpastes are rare but should be considered in unexplained skin or respiratory allergies and gingival or lip lesions.
- The effect of light curing units and modes on cytotoxicity of resin-core systems(2010) Ergün, Gülfem; Egilmez, Ferhan; Cekic Nagas, IsilObjective: The aim of this study was to compare the cytotoxic effects of various resin-based core materials that were cured with three light curing units (LCUs) in different modes on L?929 mouse fibroblast cells over 24 h and 72 h periods. Study design: Eighty-four cylindrical discs (2 mm in thickness and 6 mm in diameter) of each material (Rebilda, Voco; Build-It FR, Pentron; Clearfil DC Core, Kuraray and Bis-core, Bisco) were cured by QTH LCU (soft-up and high-power modes), LED LCU (exponential and standard modes) and PAC LCU (normal and ramp-curing modes). Then the samples were aged for 24 and 72 hours in Dulbecco?s Modified Eagle Medium/Ham?s F12 (DMEM/F12). After each ageing interval, cytotoxicity of the extracts to cultured fibroblasts (L 929) was measured by MTT assay. The degree of cytotoxicity for each sample was determined according to the reference value represented by the cells with a pure culture medium. Statistical significance was determined by a multifactorial analysis of variance followed by one-way ANOVA and Tukey?s post-hoc test or independent t tests. Results: Data showed that there are significant differences among resin based core materials, LCUs, curing modes and time factors (p < 0.001). The test materials cured with the QTH and LED demonstrated statistically higher cell survival rates when compared with those cured with the PAC (p < 0.001). Conclusions: Differential toxic effects of the resin-based core materials cured with QTH, LED and PAC on the fibroblast cells may prove to be very important when suitable resin-core systems, LCUs and curing modes are used for operative restorations.
- Knowledge, attitude and practice towards droplet and airborne isolation precautions among dental health care professionals in Udaipur, Rajasthan, India(2010) Jain, Manish; Sawla, Leena; Mathur, Anmol; Nihlani, Tarun; Ayair, Uttara; Prabu, Duraiswamy; Kulkarni, SuhasAims and Objective- The purpose of this study is to obtain comprehensive information about the knowledge, attitude and practices in regard to droplet and airborne infection related precautions among faculty member and the undergraduate students in Udaipur, Rajasthan, India. Material and Methods- A cross sectional survey was conducted among 311 dental faculty and the undergraduate students under clinical training in Udaipur, Rajasthan. A self-assessment questionnaire composed of queries on three levels, namely knowledge, attitude and practices with respect to airborne and droplet isolation precautions was used. The data was collected and analyzed by using SPSS software. Results- Frequency distribution scores of knowledge, attitude and practice in relation to droplet and airborne isolation precautions were revealed that even the students under training along with the faculty member were quite aware of the precautions and the principles of airborne and droplet isolation. Mean score for knowledge was 9.17±2.07; Mean scores for attitude and practice were 48.65±7.47 and 6.88±3.51 respectively. There were no significant difference in all groups regarding knowledge, attitude and practice. In addition, a positive linear correlation was found between two items of survey including knowledge- attitude, knowledgepractice and attitude- practice (P<0.01). Conclusion- The results highlighted that though the professionals had good knowledge and attitude but the practice levels for the same were low. The study confirms from the findings that the infection control measures among the health care professionals are fairly good and an educational programme on isolation precautions can further enhance these levels and thereby, reducing the risk of infection transmission risks.
- Assessment of periapical status : a comparative study using film-based periapical radiographs and digital panoramic images(2010) Ríos Santos, José Vicente; Ridao Sacie, Cristina; Bullón, Pedro; Fernández Palacín, Ana; Segura-Egea, Juan J.Aim: To compare the use of film-based periapical radiographs and digital panoramic images displayed on monitor and glossy paper in the assessment of the periapical status of the teeth. Methodology: A total of 86 subjects were examined. All participants underwent a full-mouth radiographic survey (14 periapical radiographs) and a digital panoramic radiography. The periapical status of all appraised teeth was assessed. Results: Periapical radiographs allowed the assessment of the periapical status of a significantly higher percentage of teeth (87.4%) Digital radiography had a significantly reduced potential to allow assessment of the periapical status (p<0.01). Only 58.0% and 34.3% of teeth could be appraised using digital panoramic images displayed on monitor and glossy paper respectively (p<0.01). The total percentage of teeth with periapical pathosis was four-fold higher when assessed with digital panoramic images displayed on glossy paper compared with periapical radiographs (p<0.01). Conclusions: Periapical radiographs allowed the assessment of a significantly higher percentage of teeth when comparing to digital radiography, which had a significantly lower potency in the assessment of periapical status of the teeth. Digital panoramic images displayed on a monitor resulted in a significantly higher percentage of appraised teeth compared to digital images displayed on glossy paper. Apical periodontitis was scored more often on paper than on screen, and more often on screen than in periapical radiographs.
- Mineral trioxide aggregate in primary teeth pulpotomy. A systematic literature review(2010) Simancas Pallares, Miguel; Díaz Caballero, Antonio José; Luna, Luz MaidaEvidence-based dentistry is a critical evaluation, awareness of the available evidence to improve decision making about the care of individual patients and / or communities. Objective: To systematically analyze the available scientific literature on clinical and radiographic results of two materials used in pulpotomy in primary teeth: formocresol and mineral trioxide aggregate. Materials and methods: It was identified relevant publications through a search of electronic databases such as MEDLINE (Ovid) and The Cochrane Library. To be included in the review, studies had to define the material used in child patients with pulp exposure by caries or tooth-alveolar trauma. Results: Of the 21 articles obtained in the initial phase of the review, only 19 were available in full text and of these only met the requirements for inclusion 6 items, which were confronted, analyzed and discussed later. Conclusions: The clinical evidence available showed significant differences regarding the use of a material or another. In addition to the findings of clinical follow - radiographic and taking into account the potential toxicity of formocresol suggest the use of mineral trioxide aggregate pulpotomy of primary teeth.
- High resistance against clindamycin, metronidazole and amoxicillin in Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans isolates of periodontal disease(2010) Ardila Medina, Carlos Martín; López, Mayra A.; Guzmán, Isabel C.Objectives: To test the antimicrobial sensitivity of two periodontal pathogens to a panel of five orally administrable antibiotics in periodontal disease. Study design: A total of 69 isolates of Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis were processed using culture and biochemical tests. Selected colonies of A. actinomycetemcomitans and P. gingivalis were used to evaluate the antibacterial activity of clindamycin, metronidazole, amoxicillin, moxifloxacin and amoxicillin/clavulanic acid. Results: Susceptibility testing revealed a sensitivity of 100% of A. actinomycetemcomitans and P. gingivalis to moxifloxacin and amoxicillin/clavulanic acid but moderate susceptibilities were found for the rest of antibiotics agents evaluated. Conclusions: The widespread use of antibiotics is reflected in the level of resistance of A. actinomycetemcomitans and P. gingivalis in patients with periodontal infections. This suggests that antibiotic susceptibility testing is necessary to determine efficacy of antimicrobial agents. Clinical studies with antibiotics should take these differences into account.
- Long-term sealing ability of GuttaFlow versus Ah Plus using different obturation techniques(2010) Savariz Martins, Aline; González Rodríguez, Mª Paloma; Ferrer Luque, Carmen MaríaObjective. To compare the long-term sealing ability of GuttaFlow® using different obturation techniques. Study Design. Three hundred teeth, prepared with a crown-down technique, were divided into thirty experimental groups (n=10) to evaluate the apical and coronal leakage, at 3, 30 and 120 days, of lateral compaction gutta-percha + AH Plus?, lateral compaction gutta-percha + GuttaFlow®, single cone + AH Plus?, single cone + GuttaFlow®, and GuttaFlow® only. Results. Both coronal and apical leakage, at the three times of measurement, no significant differences were found among GuttaFlow® + lateral compaction gutta-percha and GuttaFlow® + single cone groups, whereas the only GuttaFlow® reached the highest leakage values at 30 and 120 days. AH Plus?, using both techniques, showed high levels of leakage after 120 days to the coronal leakage and after 30 days to the apical leakage when compared silicon based sealer. Conclusion. GuttaFlow®, using with lateral compaction and single cone techniques, shows a greater apical and coronal sealing ability than AH Plus? over time. GuttaFlow® when used as only creates a poorer sealing than when used with lateral compaction gutta-percha or single cone techniques.
- Movement evaluation of overerupted upper molars with absolute anchorage : an in-vitro study(2010) Romeo, Alejandro; Esteves, Miguel; Garcia, Valentín; Bermúdez Mas, JordiIntroduction: The overeruption of upper molars due to the premature loss of antagonist teeth can be treated with the help of miniscrews. The aim of this study was to evaluate the movement of a typodont molar according to the biomechanical approach used with miniscrews. Study design: The study was conducted with four plaster models filled with typodont wax. In each model we used one absolute anchorage on the palatal side and another on the buccal side in different positions, thus generating four different biomechanical systems. A force of 150 g was applied to each side of the resin tooth. Periapical radiographs were taken preintrusion and immediately after completion of the intrusion. Photographs were taken in both the sagittal and occlusal planes every 3 min. The radiographic films and photographs were measured and compared. Results: A vertical movement of the molar was observed in all the models, with system 4 showing the greatest movement. Rotation in the occlusal plane only occurred in system 2, while in system 1 there was a change in the axial axis of 37 degrees. Conclusions: The anchorage site and the combination of forces applied may determine the resulting tooth movement.
- Effect of orthodontic treatment on saliva, plaque and the levels of Streptococcus mutans and Lactobacillus(2010) Lara-Carrillo, Edith; Montiel Bastida, Norma Margarita; Sánchez Pérez, Leonor; Alanís Tavira, JorgeObjectives: The aim of this study was to identify changes in the oral environment with clinical, salivary and bacterial risk markers after placement of fixed orthodontic appliances on permanent dentition. Material and Methods: With ethical approval, we used different techniques to analyzed clinical, salivary and bacterial risk markers in 34 patients (mean age, 16.7 ± 5.2 years), 14 males and 20 females; before starting orthodontic treatment and 1 month after. Clinical risk markers (decayed, missing, and filled surfaces [DMFS], O?Leary´s plaque index, and plaque pH); salivary markers (unstimulated and stimulated saliva flow rate, buffer capacity, pH, and occult blood in saliva) and bacterial counts (Streptococcus mutans and Lactobacillus). Data were analyzed by paired t-test and ?2 test. Results: This study showed that orthodontic appliances increased the stimulated salivary flow rate (p=0.0001), buffer capacity (p=0.0359), salivary pH (p=0.0246) and occult blood in saliva (p=0.0305). Bacterial levels increased slightly after 1 month of treatment, without statistical significance. Between genders, initially we observed differences in: stimulated saliva (p=0.0019), buffer capacity (p=0.0381) and plaque pH (p=0.0430); after treatment the unstimulated saliva (p=0.0026) showed differences. Conclusions: Orthodontic treatment changes the oral environmental factors, promotes an increase in stimulated flow rate, buffer capacity and salivary pH, which augment the anti caries activity of saliva. In contrast, increased occult blood indicated more gingival inflammation, apparently because augmented the retentive plaque surfaces and the difficult to maintain a good oral hygiene, rinsed the bleeding in saliva by periodontal damage.
- Histologic evaluation of thermal damage produced on soft tissues by CO2, Er,Cr:YSGG and diode lasers(2010) Cercadillo Ibarguren, Iñaki; España Tost, Antonio Jesús; Arnabat Domínguez, Josep; Valmaseda Castellón, E.; Berini Aytés, Leonardo; Gay Escoda, CosmeObjective: The aim of this in vitro experimental study was to perform histological evaluation of the thermal effect produced on soft tissue irradiated with CO2 , Er,Cr:YSGG or diode lasers. Study design: Porcine oral mucosa samples were irradiated with Er,Cr:YSGG laser at 1 W with and without water / air spray, at 2 W with and without water / air spray, and at 4 W with water / air spray, with CO2 laser at 1 W, 2 W, 10 W, 20 W continuous mode and 20 W pulsed mode and diode laser at 2W, 5W, and 10W pulsed mode. The thermal effect was evaluated measuring the width of damaged tissue adjacent to the incision, stained positively for hyalinized tissue with Hematoxylin-Eosin and Masson Trichrome stains. Besides, histological changes in the irradiated tissue were described using subjective grading scales. Results: The evaluated lasers developed a wide range of thermal damage with significant differences between groups. The samples with lowest thermal effect were those irradiated with Er,Cr:YSGG laser using water / air spray, followed by CO2 and diode lasers. Conclusions: Emission parameters of each laser system may influence the thermal damage inflicted on the soft tissue, however, the wave length of each laser determines the absorption rate characteristics of every tissue and the thermal effect.
- Bond strength evaluation of the veneering-ceramics bonds(2010) López Mollá, María Victoria; Martínez González, Amparo; Mañes Ferrer, José Félix; Amigó Borrás, Vicente; Bouazza Juanes, KheiraObjective: The purpose of this study was to determine whether the bond of veneering porcelain to a ceramic core in bilayered ceramics was similar to that of the metal ceramic control of well known behaviour. Study design: Six groups of nine specimens each were fabricated, whose dimensions were 15 mm long and 8 mm in diameter at the core, and 2 mm long and 8 mm in diameter for the veneer. The groups were GR. 1 (control group): CrNi alloy/d.SIGN (Ivoclar), GR. 2: IPS e.maxPress/IPS e.maxCeram (Ivoclar), GR. 3: IPS e.maxZirCad/ IPS e.maxZirPress (Ivoclar), GR. 4: IPS e.maxZirCad/IPS e.maxCeram (Ivoclar), GR. 5: Lava Frame (3M ESPE)/ Lava Ceram (3M ESPE) and GR. 6: Lava Frame (3M ESPE)/IPS e.maxCeram (Ivoclar). A shear strength test was used in all samples with a universal testing machine. The chosen crosshead speed was of 0.50 mm/min. The obtained results were analyzed using a one way analysis of variance test (ANOVA) to determine whether significant differences existed between the groups (p<0.05). A Student Newman-Keuls multiple comparisons test was used. Results: GR. 1: 13.45 MPa, GR. 2: 24.20 MPa, GR. 3: 12.70 MPa, GR. 4: 7.86 MPa, GR. 5: 10.20 Mpa and GR. 6: 4.62 Mpa. Conclusions: The bond strength of group 1 (control) was similar to groups 3 and 5. Group 2, whose core and veneer are both porcelains with a similar chemical composition, with silica as their main component, achieved the best adhesive results between both porcelains. The technique on zirconia cores that showed the higher results was the pressed technique. The lowest results were for the group using porcelains from different manufacturers.
- Ergonomic factors that cause the presence of pain muscle in students of dentistry(2010) Díaz Caballero, Antonio José; Gomez Palencia, Isabel Patricia; Díaz Cárdenas, ShyrleyObjective: To identify the ergonomic factors and the presence of muscular pain in dental students of VIII, IX, X semesters presently practicing at the clinics of the College of Dentistry of university of Cartagena, Colombia, South America. Materials and methods: This is a descriptive study carried out in dental students of the VIII, IX, and X semesters which were undergoing clinical practice at the College of Dentistry of University of Cartagena. A convenience sample of 83 students who met the inclusion criteria was taken and those who agreed to participate signed an informed consent. Data collection was obtained by means of a structured questionnaire for ergonomic factors and the presence of pain was identified palpating the muscles object of the study by a physical therapist. The variables evaluated were: presence of pain, affected muscles, affected zones, gender, postures and work environment. Results: The adoption of inadequate postures such as exaggerated flexions or cervical torsions could generate a higher frequency of muscular pain in dental students. The approximating muscle of the thumb showed 11% frequency of pain. The presence of muscular pain was higher for the female group participating in this study. Conclusions: Dentists are prone, since the beginning of their clinical practice as students, to lesions of the skeletal muscle system due to the clinical exercise of the profession, being the most common, muscle pain in the back, neck, shoulders and hands. This would imply initiating an occupational health program promoting healthy lifestyles in their academic environment and their future professional life, at the beginning of their clinical practice in dental school.
- Application of ultrasound in bone surgery : two case reports(2010) Escoda Francolí, Jaume; Rodríguez Rodríguez, Araceli; Berini Aytés, Leonardo; Gay Escoda, CosmeThe present study describes some of the applications of ultrasound in bone surgery, based on the presentation of two clinical cases. The Piezosurgery® ultrasound device was used (Tecnología Mectron Medical, Carasco, Italy). In one case the instrument was used to harvest a chin bone graft for placement in a bone defect at level 1.2, while in the other case a bony window osteotomy was made in the external wall of the maxillary sinus, in the context of a sinus membrane lift procedure. The Piezosurgery® device produces specific ultrasound frequency modulation (25-29 kHz), and has been designed to secure increased precision in application to bone surgery. This instrument produces selective sectioning of the mineralized bone structures, and causes less intra- and postoperative bleeding. One of the advantages of the Piezosurgery® device is that it can be used for maxillary sinus lift procedures in dental implant placement. In this context it considerably lessens the risk of sinus mucosa laceration by preparing the bony window in the external wall of the upper maxilla, and can be used to complete the lifting maneuver. The use of ultrasound in application to hard tissues can be regarded as a slow technique compared with the conventional rotary instruments, since it requires special surgical skill and involves a certain learning curve.
- Pathological mandibular fracture after simple molar extraction in a patient with osteogenesis imperfecta treated with alendronate(2010) Gallego, Lorena; Junquera Gutiérrez, Luis Manuel; Pelaz, A.; Costilla García, SerafínOsteogenesis imperfecta (OI), is a heterogeneous group of inherited disorders of connective tissue characterized by bone fragility. Patients with this disease frequently suffer fractures, over 80% of the extremities due to the more intensive mechanical load. Fractures of the facial bones occur very infrequently. Several studies have proved that bisphosphonate therapy may be effective in reducing fracture risk in OI patients. We report here an unusual case of pathological mandibular fracture following simple molar extraction in an adult patient with OI type I and oral alendronic acid treatment. Extraction was atraumatical and without bone removal . Fracture was treated by internal fixation by plate osteosynthesis and additional mandibulomaxillary fixation (MMF). Bone healing after fracture treatment was completely normal and no clinical signs of osteoneocrosis were observed. To the best of our knowledge, this is an unusual complication even in this type of patients. Particular care is necessary is these patients during oral surgery, even when they have been treated and controlled.
- Analysis of familial incidence of non-syndromic cleft lip and palate in a Brazilian population(2010) Martelli, Daniella Reis; Bonan, Paulo Rogério Ferreti; Soares, Matheus Carvalho; Paranaíba, Lívia M. R.; Martelli Júnior, HercílioBackground: The purpose of this study is to follow the familial incidence of non-syndromic or isolated cleft lip, with or without cleft palate (NSCL/P), and to analyze the relationships between the type of NSCL/P in the affected individual and his/her parent, looking at children in the first grade. Material and Methods: To investigate the familial incidence of NSCL/P we analyzed the records of 185 patients from 2004-2008, retrospectively. Detailed histories were collected regarding the familial incidence of NSCL/P. For the 185 individuals, the relationship between the type of NSCL/P and the sociodemographic and personal characteristics of the affected person and her/his cleft relatives was obtained. Results: The individuals were 42 carriers of CL, 109 with CLP (joined in one group) and 34 with CP (p<0.001). Of the total of participants, 65 (35.13%) presented a positive history of cleft in their families and 120 (64.86%) presented a negative history (p<0.001). There were differences between the cleft groups according to types of cleft and positive familial history (p<0.001). In both groups, the relatives with higher incidence of NSCL/P were cousins, with the same pattern of distribution between the two groups (p=0.175). Conclusions: Most frequently, fissures result from CL/CLP with no familial history. However, CL/CLP was found in familial cases and cousins were the relative type more likely to be affected.
- Efficacy of eminectomy in the treatment of prolonged mandibular dislocation(2010) Klüppel, Leandro Eduardo; Olate, Sergio; Serena Gómez, Eduardo; de Moraes, Márcio; Fernandes Moreira, Roger WilliamSurgery of the temporomandibular joint is indicated for different clinical situations, including internal derangements, hipomobility, hipermobility, pathology and trauma. Mandibular dislocation is an acute painful condition that causes severe functional limitation. Manual reduction, with or without pharmacological assistance, is the treatment of choice and should be performed as early as possible. On rare situations mandibular dislocation may not be perceived by the patient and remain undiagnosed or misdiagnosed for a long period. This may include severe illness, neurological diseases and prolonged intensive care hospitalization with oral intubation and sedation. Treatment of prolonged mandibular dislocation is different. Morphological changes of the joint and associated structures will prevent successful manual reduction even with the patient under general anesthesia. Basically, two types of surgery may be indicated: elimination of the articular eminence (eminectomy) or reestablishment of a new condyle - ramus relationship, that can be achieved by condilotomy. This article reports a case of prolonged mandibular dislocation that was treated surgically with success. A review of the literature is performed by authors and advantages and disadvantages of each type of treatment are discussed.
- Radiographic signs associated with inferior alveolar nerve damage following lower third molar extraction(2010) Palma Carrió, Cristina; García Mira, Berta; Larrazabal Morón, Carolina; Peñarrocha Diago, MaríaThe aim was to carry out a literature review of preoperative radiographic signs in orthopantomography (OPG) and computed tomography (CT) related with the risk of inferior alveolar nerve damage during the surgical extraction of lower third molar (LTM). A search was made on PubMed for literature published between the years 2000 and 2009. In the reviewed literature, radiographic signs in the OPG that indicate a relationship between the LTM and the inferior alveolar canal are considered a risk factor for nerve damage. These signs are darkening and deflection of the root, and diversion and interruption in the white line of the canal. In the majority of these studies, the routine use of CT is not justified, and is only recommended when radiographic signs appear in the OPG that demonstrate a direct anatomical relationship between the LTM and the canal. In the CT, the absence of cortical bone in the canal implies a contact between the root of the LTM and the canal, and is related with the presence of some radiographic signs in the OPG. Some studies demonstrate that despite the absence of cortical bone, the risk of lesion or exposure of the nerve during the extraction of LTM was low.
- Evaluation of bleeding risk and measurement methods in dental patients(2010) Cañigral, Aranxa; Silvestre Donat, Francisco Javier; Cañigral Ferrando, Guillermo; Alós Almiñana, Manuel; García Herraiz, Ariadna; Plaza Costa, AndrésObjective: The present study explores bleeding manifestations in routine dental surgical procedures, evaluates the influence of antithrombotic drugs upon bleeding risk, and validates the efficiency of a clinical method for the measurement of bleeding. Material and method: A prospective observational study was made involving a cohort of 99 patients in the setting of normal clinical practice, with the added conduction of prior hematological tests including baseline hemostasis and platelet function, based on a new method (Multiplate System®). For evaluation of the bleeding manifestations, a clinical method was selected that evaluates bleeding on the basis of its duration and the hemostatic measures needed to resolve the problem. Results: Almost one-third of the patients (27.3%) were receiving treatment with oral antiplatelet drugs, while 19.2% received oral anticoagulants and 9% received combined therapy with acetylsalicylic acid plus clopidogrel. In turn, an 8% incidence of moderate bleeding episodes was detected correlated to the ASPI platelet function test and to advanced patient age. Conclusion: The incorporation of platelet function tests increases the safety of oral surgery in elderly patients subjected to antiplatelet treatment, particularly with acetylsalicylic acid and clopidogrel.
- Evaluation of the surgical difficulty in lower third molar extraction(2010) Barreiro Torres, José; Diniz Freitas, Márcio; Lago Méndez, Lucía; Gude Sampedro, Francisco; Gándara Rey, José Manuel; García García, AbelThe ability to predict the surgical difficulty of lower third molar extraction facilitates the design of treatment plans by minimizing complications and improving the preparation of patients and assistants in terms of the postoperative management of inflammation and pain. The aims of this study were to evaluate the value of panoramic radiographs in predicting lower third molar extraction difficulty and technique and to determine if the experience of the practitioner had any influence on this predictive ability. Fourteen dental practitioners with varying levels of experience evaluate the difficulty of lower third molar extraction in a group of patients using a 100-mm visual analog scale (VAS) and a modified version of a surgical difficulty scale. The results were then compared to postoperative scores calculated using the same scale. A tendency to underestimate the difficulty of procedures that was more pronounced in observers with greater levels of experience was observed. A low level of agreement between preoperative and postoperative evaluations using the surgical difficulty scale as well as an association between difficulty assessed preoperatively using the VAS and difficulty assessed postoperatively using the surgical difficulty scale was also found. The use of panoramic radiographs does not allow practitioners to accurately predict lower third molar extraction difficulty and technique, regardless of their level of experience.
