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Aim: To compare the postoperative course between the CRF patients and the control group in terms ofpostoperative pain, bleeding, and healing.Materials and Methods: Prospective cohort study. Study group: CRF patients referred for dental extraction whofit the inclusion criteria. Control group: healthy patients referred for teeth extraction. Perioperative managementwas recorded, and postoperative pain, bleeding, and healing were assessed on postoperative days 2, 4, and 7 asoutcomes.Results: forty patients were included in the study. Demographic variables were comparable between control andstudy patients; pain, bleeding, and healing were not statistically different between the two groups. Only thenumber of dialysis sessions per week was linked to improved healing in the study group.Conclusion: When prophylactic antibiotic and local hemostatic measures are used in CRF patients undergoingextraction, postoperative healing is comparable with healthy controls. Within the CRF group number ofhemodialysis sessions per week is linked to improved healing outcomes.
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Objective@# To explore the surgical design and surgical Methods for the minimally invasive extraction of embedded supernumerary teeth and to provide a reference for clinical practice.@* Methods@# A total of 87 embedded supernumerary teeth were removed from 85 patients. CBCT examination was performed before the operation. The nearest surgical approach was selected based on the distance between the embedded supernumerary teeth and the bony plate of the buccal tongue (lip and palate). The CBCT measuring ruler measured the maximum diameter of the impacted dental crown. According to the radius of the buccal and tongue directions of the crown, the upper and lower boundaries (bucco-lingual direction) of the bone to be deboned were determined with reference to the top of the alveolar crest or adjacent enamel cementum. A horizontal vertical line was made from the point to the meridian, and the length of the horizontal line was 1/2 the diameter of the impacted multiple crown. Thus, the radius determined the horizontal starting and ending points of the bone to be boneless. A trapezoidal or arcuate incision was made with an electric knife under block anesthesia and local infiltration anesthesia. The incision retained the gingival papilla. The upper and lower as well as the near and far midpoints of the bone were marked with a bone ruler. Starting from the midpoint area, the upper and lower points were connected. The mesial bone was removed in the mesial direction, and the range of the removed bone was slightly larger than the radius of the crown, showing the crown of the embedded supernumerary teeth. A surgical impact air handpiece with a 45-degree elevation angle or a piezosurgery device was used to divide the crown of the embedded supernumerary teeth into two parts. The crown and dental tissues were removed in pieces, the surgical area was cleaned and rinsed, and the wound was closed. Anti-inflammatory and swelling treatments were administered after the operation, and painkillers were prepared. The patients were revisited 7 days after the operation to check for wound healing. We asked and recorded the amount of painkillers taken by the patients. @*Results@#All patients had good wound healing 7 days after the operation, and the wounds were sutured. There was no swelling on the maxillofacial surface, and the degree of opening was basically normal. No other complications such as infection or numbness occurred. Fifty-eight patients did not take painkillers. @*Conclusion@#CBCT can be used to locate the embedded supernumerary teeth in bone. The surgical approach can be chosen based on the principle of proximity. During the surgery, the bone ruler is used to accurately locate the bone and remove the embedded supernumerary teeth in pieces, which can achieve a minimally invasive effect.
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Objective To compare the anesthetic effect of atocaine adrenaline injection and lidocaine injec -tion in wisdom tooth extraction .Methods 220 patients with wisdom teeth were selected as the research subjects . According to the random table method ,the patients were randomly divided into research group 110 cases ( a total of wisdom teeth 132,maxillary wisdom teeth 47,mandibular wisdom tooth 85) and the control group 110 cases(a total of wisdom teeth 129,maxillary wisdom teeth 51,mandibular wisdom tooth 78).The research group received atocaine adrenaline injection ,the control group received lidocaine hydrochloride injection .The effects of anesthesia ,VAS score and adverse reactions in the two groups were observed .Results The total effective rate of maxillary wisdom tooth anesthesia in the research group(100.00％) was significantly higher than that in the control group (90.20％),and the difference between the two groups was statistically significant (χ2 =6.358,P<0.05).The total effective rate of mandibular wisdom tooth anesthesia in the research group (100.00％) was significantly higher than that in the control group(92.31％),and the difference between the two groups was statistically significant (χ2 =6.788,P<0.05).The VAS score of maxillary wisdom tooth anesthesia in the research group [(2.57 ±0.65)points]was significantly lower than that in the control group [(2.87 ±0.63) points],and the difference between the two groups was statistically significant(t=2.319,P<0.05).In the control group,there was 1 case of hematoma caused by blood vessels ,and no complications occurred in the research group .Conclusion The anesthetic effects of articaine adrenaline injection in wisdom tooth extraction is better than lidocaine hydrochloride injection , without any complications , it is worthy of clinical promotion .
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<p><b>INTRODUCTION</b>Pain after wisdom teeth surgery can be moderate in severity and is compounded by preoperative anxiety in young patients. We studied the effect of melatonin premedication on postoperative pain and preoperative anxiety in patients undergoing wisdom teeth extractions.</p><p><b>METHODS</b>This randomised controlled trial recruited 76 patients at Khoo Teck Puat Hospital who were American Society of Anesthesiologists physical status I and II, aged 21 to 65 and scheduled to undergo elective extraction of all four wisdom teeth under general anaesthesia. Patients with a history of long-term use or allergy to melatonin were excluded. The patients received either 6 mg melatonin or a placebo 90 minutes before surgery. Visual analogue scale (VAS) scores at multiple time intervals for postoperative pain and preoperative anxiety, patient satisfaction and first-night sleep quality scores were obtained. Mixed-effects regression models were used for longitudinal analysis of VAS pain, anxiety and satisfaction scores.</p><p><b>RESULTS</b>Maximum VAS scores for pain and anxiety were 18.6 ± 19.1 mm at 60 minutes postoperatively and 26.2 ± 23.4 mm at 90 minutes preoperatively, respectively. After adjusting for gender, female patients who received melatonin had a faster rate of reduction of VAS pain (p = 0.020) and anxiety scores (p = 0.003) over time compared to the placebo group. No such effect was demonstrated in male patients. There was no significant difference in sleep quality or satisfaction scores.</p><p><b>CONCLUSION</b>Melatonin use did not consistently contribute to pain and anxiety amelioration in all patients. Our study demonstrated a positive effect in female patients, suggestive of sexual dimorphism.</p>