RESUMEN
The aim of this study was to evaluate the effectiveness of intra-articular injection of liquid platelet-rich fibrin (I-PRF) versus hyaluronic acid (HA) following arthrocentesis in patients suffering from temporomandibular joint (TMJ) pain and dysfunction. A total of 69 patients with internal TMJ derangement were enrolled in this retrospective, matched cohort study. A total of 47 included patients (67 joints) were divided into 3 groups as follows: 16 participants in the arthrocentesis-only group; 14 patients in the arthrocentesis plus HA injection group (A+HA); and 17 participants in the arthrocentesis plus I-PRF injection group (A+I-PRF). The 2 outcome variables were TMJ pain and maximal mouth opening (MMO) which were evaluated up to 12 months postoperatively. The data were analyzed using the Shapiro-Wilk test, Kruskal-Wallis test, Mann-Whitney U test, Wilcoxon sign test, Fisher exact test, and the χ test. Statistically significant decreases in pain scores and increases in MMO values were observed in all 3 groups during the 12 months of follow-up. The significant decrease in pain values was shown in the A+I-PRF group as compared with the A+HA group at 9 months postoperatively. MMO values in the A+I-PRF group were significantly higher than in the A+HA group at 9 and 12 months postoperatively. All conventional treatment procedures can provide pain reduction and improvement to MMO. However, intraarticular injections of I-PRF in combination with arthrocentesis showed superior performance in terms of the gradual improvement in pain alleviation and range of mouth opening.
Asunto(s)
Ácido Hialurónico/uso terapéutico , Fibrina Rica en Plaquetas , Trastornos de la Articulación Temporomandibular/terapia , Artrocentesis , Humanos , Inyecciones Intraarticulares , Estudios Retrospectivos , Trastornos de la Articulación Temporomandibular/fisiopatología , Resultado del TratamientoRESUMEN
The aim of this comparative observational study was to compare the proliferative activity of dental follicles surrounding impacted maxillary canines and mandibular third molars. Following extraction, forty follicles of the impacted mandibular third molars and 40 follicles of the impacted maxillary canines were removed. Epithelial cell proliferative activity of these samples was assessed using immunohistochemical labeling for Ki-67, minichromosome maintenance 2 (MCM-2) protein and epithelial growth factor receptor (EGFR). Intensity and extent of Ki-67, MCM-2 and EGFR expressions were evaluated by a scoring formula. The lining epithelium of the maxillary canine follicles had mean scores of 4.65±0.27 for Ki-67, 1.25±0.33 for MCM-2 and 7.30±0.23 for EGFR which were not significantly different than those expressed in the mandibular third molar follicles (4.46±0.26 for Ki-67, 1.39±0.33 for MCM-2 and 7.21±0.20 for EGFR). The expression of Ki-67 and MCM-2 could not be detected in the epithelial remnants within the connective tissue in both groups. EGFR expression, detected in the epithelial remnants in both groups, was not significantly different (7.28±0.14 in the canine group as opposed to 7.21±0.16 in the third molar group). Based on these findings, it can be deduced that impacted mandibular third molars and maxillary canines carry similar risk of pathology development.
El objetivo fue comparar la actividad proliferativa de los folículos dentarios que rodean a dientes caninos maxilares y terceros molares mandibulares impactados. Luego de realizada la extracción dentaria, se removieron 40 folículos dentarios de los terceros molares mandibulares impactados y 40 de caninos maxilares impactados. Se evaluó la actividad proliferativa de las células epiteliales de estas muestras mediante marcaje inmunohistoquímico para Ki-67, para la proteína de mantenimiento minicromosoma 2 (MCM-2) y para el receptor del factor de crecimiento epitelial (EGFR). Se evaluó la intensidad y extensión de Ki-67, MCM-2 y las expresiones de EGFR mediante una fórmula de puntuación. El epitelio de revestimiento de los folículos correspondientes a los caninos maxilares presentaron valores promedios de 4,65±0,27 para Ki-67, 1,25±0,33 para MCM-2 y 7,30±0,23 para EGFR, que no fueron significativamente diferentes de los expresados en los folículos de terceros molares mandibulares (4,46±0,26 para Ki-67, 1,39±0,33 para MCM-2 y 7,21±0,20 para EGFR). La expresión de Ki-67 y MCM-2 no pudo ser detectada en los restos epiteliales dentro del tejido conectivo en ambos grupos. La expresión de EGFR, detectada en los restos epiteliales en ambos grupos, no fue significativamente diferente (7,28±0,14 en el grupo de los caninos, y 7,21±0,16 en el grupo de los terceros molares). Sobre la base de estos resultados, se puede deducir que la retención de terceros molares y caninos maxilares conlleva un riesgo similar para el desarrollo de patología.
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Diente Impactado , Antígeno Ki-67/metabolismo , Saco Dental/metabolismo , Componente 2 del Complejo de Mantenimiento de Minicromosoma/metabolismo , Receptores ErbB/metabolismo , Inmunohistoquímica , Diente Canino , Proliferación Celular , Estudio Observacional , Tercer MolarRESUMEN
PURPOSE: The present study investigated whether residents are able to estimate the degree of difficulty of mandibular third molar removal to the same extent as senior surgeons. MATERIALS AND METHODS: The study included 2 residents and 2 senior surgeons, each of whom extracted 50 mandibular third molars of similar complexity. The clinical variables evaluated included patient age, gender, body size, maximal mouth opening, and tongue interference. The radiographic variables related to the third molars examined on the panoramic radiographs included spatial positioning, tooth-bone interface, root morphology, and proximity of the tooth to the inferior alveolar canal. Before each extraction, the operating surgeon estimated the level of difficulty of the surgery after considering all the variables. The predicted length of time per operation was regarded as representative of operative difficulty. At the end of each operation, its actual duration was also recorded. RESULTS: The residents and senior surgeons both accurately predicted the difficulty of surgery in just more than one half of the cases. A 57% agreement (κ = 0.24) was found between the senior surgeons' preoperative estimations and actual difficulty, and the agreement was 52% (κ = 0.19) for the residents' estimations. No significant difference was found between the senior surgeons and residents in the accuracy of their estimations of operation length. CONCLUSIONS: The preoperative prediction of the surgical difficulty of mandibular third molar tooth removal was unreliable, not only for the residents, but also for the senior surgeons.
Asunto(s)
Internado y Residencia , Tercer Molar/cirugía , Cirugía Bucal , Diente Impactado/cirugía , Adulto , Factores de Edad , Proceso Alveolar/diagnóstico por imagen , Tamaño Corporal , Peso Corporal , Femenino , Predicción , Humanos , Masculino , Mandíbula/diagnóstico por imagen , Mandíbula/cirugía , Tercer Molar/diagnóstico por imagen , Tempo Operativo , Osteotomía/métodos , Radiografía Panorámica/métodos , Rango del Movimiento Articular/fisiología , Factores de Riesgo , Factores Sexuales , Cirugía Bucal/educación , Colgajos Quirúrgicos , Lengua/anatomía & histología , Corona del Diente/cirugía , Raíz del Diente/diagnóstico por imagen , Raíz del Diente/cirugía , Diente Impactado/diagnóstico por imagenRESUMEN
Cherubism is one of the very few genetically determined disorders that affect only jaw bones. A typical form of cherubism in an 11 years old girl with features of bilateral swelling of the cheeks and soap bubble radiographic appearance on the maxilla and the mandible was presented. Multiple members of the first and second degree relatives were also affected. The clinical presentation of the case, differential diagnosis and treatment modalities were discussed.
Asunto(s)
Querubismo/patología , Niño , Femenino , Humanos , LinajeRESUMEN
PURPOSE: The purpose of this study was to identify factors that may contribute to anxiety of patients undergoing minor oral surgery before and after the operation. PATIENTS AND METHODS: A total of 120 patients who underwent minor oral surgery were included in the study. Each patient's anxiety was measured using Spielberger's State-Trait Anxiety Inventory and Corah's Dental Anxiety Scale immediately before, immediately after, and 1 week after the operation. Anxiety levels for each given situation about the surgery were determined using visual analog scales. The effects of various factors, such as demographic variables, previous dental experience, and postoperative complaints, on anxiety were also analyzed. RESULTS: Postoperative anxiety levels were significantly lower than the preoperative anxiety levels (P<.001). Patients recorded higher anxiety levels for "jaw becoming tired" and "collection of fluid in the mouth" than for "feeling pain during the operation" both before and after the operation. There was a positive correlation between pain expectation with preoperative anxiety and pain actually experienced during surgery with postoperative anxiety (P<.001). Whereas patients' trait anxiety and previous dental experience were correlated with preoperative anxiety (P<.001 and P<.05, respectively), no relationship with postoperative anxiety was found. The difficulty of the procedure was not correlated with anxiety immediately after the operation but was correlated with anxiety during the follow-up visit (P<.05). Postoperative complaints were related to the dental anxiety levels recorded 1 week after surgery (P<.05). CONCLUSIONS: To reduce patients' anxiety, underestimated factors, such as jaw fatigue and fluid collection in the mouth, should be taken into account during oral surgery under local anesthesia. In the postoperative period, swelling and difficulty in eating, as well as pain, should also be considered in relieving patients' anxiety.
Asunto(s)
Ansiedad al Tratamiento Odontológico/psicología , Procedimientos Quirúrgicos Orales/psicología , Adulto , Factores de Edad , Escolaridad , Femenino , Humanos , Control Interno-Externo , Masculino , Mandíbula/fisiopatología , Escala de Ansiedad Manifiesta , Memoria , Fatiga Muscular , Dolor/psicología , Periodo Posoperatorio , Saliva , Factores SexualesRESUMEN
BACKGROUND: Cytokines were thought to play an important role for the expansion of odontogenic cysts. The purpose of this study was to evaluate the cytokine and chemokine levels of radicular and residual cyst fluids. METHODS: Cyst fluids were aspirated from 21 patients (11 radicular and 10 residual cysts) and the levels of interleukin-1 alpha (IL-1alpha), tumor necrosis factor-alpha (TNF-alpha), monocyte chemotactic protein-1 (MCP-1), and regulated upon activation normal T cell expressed and secreted (RANTES) were determined by ELISA using commercially available kits. RESULTS: Both radicular and residual cyst fluids contained IL-1alpha, TNF-alpha, MCP-1, and RANTES, concentrations of which were significantly higher in the radicular cyst fluids than those in the residual cysts (P < 0.001 for IL-1alpha, TNF-alpha, and RANTES; P < 0.01 for MCP-1). Compared to the other mediators, the concentration of IL-1alpha was found to be highest in both of the cyst fluids. In addition, positive correlations were found between IL-1alpha, TNF-alpha, MCP-1, and RANTES in radicular and residual cyst fluids. CONCLUSION: If the radicular cyst is inadvertently left behind following tooth extraction, some degree of inflammation may carry on. Residual cysts, although to a lesser extend than radicular cysts, have the potential to expand.
Asunto(s)
Líquido Quístico/inmunología , Citocinas/análisis , Quiste Periodontal/inmunología , Adulto , Quimiocina CCL2/análisis , Quimiocina CCL5/análisis , Líquido Quístico/química , Femenino , Humanos , Interleucina-1alfa/análisis , Masculino , Persona de Mediana Edad , Quiste Periodontal/química , Quiste Periodontal/etiología , Quiste Radicular/química , Quiste Radicular/etiología , Quiste Radicular/inmunología , Estadísticas no Paramétricas , Extracción Dental/efectos adversos , Factor de Necrosis Tumoral alfa/análisisRESUMEN
Infections of the mouth are mostly local in nature, but if left untreated, may lead to potentially life-threatening conditions. Mouth infections, such as caries, pulpitis, periodontal disease, and oral mucosal infections, such as mouth ulcers, are readily accessible and thus well suited to photodynamic therapy (PDT). Many organisms, which may cause infections in the oral cavity, have been found to be susceptible to PDT to varying degrees. Several photosensitizers have been shown to be effective against target organisms without inducing damage to the host tissues. The use of appropriate photosensitizers and light doses can eradicate virtually all organisms in the region, but in the oral cavity where there is a balance of native microflora, this would potentially be a problem leading to the overgrowth of opportunistic organisms. This may be overcome using a photosensitizer linked to an antibody recognizing the target organisms. At present, treatment of infections with PDT appears best for localized and superficial infections. Treatment of deeply seated infections, such as abscesses, may also be possible with improvements in the delivery of the sensitizer and light. PDT has the potential to become established as an alternative antimicrobial approach for oral infections and deserves further evaluation.
Asunto(s)
Infecciones Bacterianas/tratamiento farmacológico , Enfermedades de la Boca/tratamiento farmacológico , Fotoquimioterapia , Animales , Antibacterianos/efectos adversos , Caries Dental , Humanos , Fotoquimioterapia/efectos adversos , Fármacos Fotosensibilizantes/efectos adversos , Fármacos Fotosensibilizantes/uso terapéuticoRESUMEN
This case report describes mandibular fracture after the surgical extraction of fully erupted lower third molar of a 53-year-old healthy male patient. The fracture occurred 15 days after the extraction while chewing. The fracture line extended from the apex of the mesiobuccal root socket to the inferior border of the mandible. Follow-up of the patient was agreed as the patient was not willing to carry on further treatment. Bony union was observed radiologically 3 months later.
Asunto(s)
Fracturas Mandibulares/etiología , Tercer Molar/cirugía , Extracción Dental/efectos adversos , Curación de Fractura , Humanos , Masculino , Persona de Mediana EdadRESUMEN
The extent to which dental students in Suleyman Demirel University (Turkey) use the Internet during their undergraduate dental training and their attitudes towards the Internet in general were assessed in this study. Ninety-three percent of the students use the Internet in various frequencies. Seven percent stated that they do not know how to use the Internet and, in this regard, the gender proportion was higher in the female students (p=0.026). In general, male students use the Internet more often than their female counterparts (p<0.001). Although a similar proportion of students (approximately 55 percent) use the Internet to retrieve information for general and dental topics, dental topics were searched in the Internet less frequently. To obtain information on dental topics, students generally referred to lecture handouts or textbooks (76 percent) while 32 percent accessed the Internet. Students who use the Internet to obtain information on dental topics most commonly preferred the university sites (71 percent), followed by search engines by performing key word searches (47 percent). The texts are the most commonly accessed materials (83 percent). Clinical photographs were accessed by 53 percent and histopathologic and radiographic materials by 14 percent of the students.