Empiema pleural por Parvimonas micra en un paciente inmunocompetente: reporte de un caso / Pleural empyema by Parvimonas micra in an immunocompetent patient: a case report

Se presenta el caso de un paciente joven inmunocompetente, con antecedente de tuberculosis pulmonar, que acude al hospital por un cuadro clínico subagudo de fiebre persistente, baja de peso, disnea y abolición del murmullo vesicular. La tomografía de tórax mostró un extenso empiema en hemitórax izquierdo. Se le toman muestras para detección de gérmenes comunes y se le colocan un tubo de drenaje torácico y se inicia antibioticoterapia. La prueba de MALDI-TOF MS identificó a Parvimonas micra, una bacteria anaerobia, comensal de la flora oral, asociado a periodontitis severa, escasamente reportado en empiema pleural, especialmente, en personas inmunocompetentes. En la evaluación odontológica se realizó el diagnóstico de gingivitis y pericoronaritis de la tercera molar. El paciente evolucionó favorablemente. Se sugiere que, en casos de empiemas pleurales subagudos o crónicos, se debe considerar, además de las micobacterias, como agente etiológico al Parvimonas micra, y optar por exámenes como MALDI-TOF MS o secuenciamiento del 16S rRNA, colocación de tubo de tórax, cobertura antibiótica empírica y evaluación odontológica.

We present the case of a young immunocompetent patient, with a history of pulmonary tuberculosis, who attended the hospital with a subacute clinical picture of persistent fever, weight loss, dyspnea and abolition of vesicular murmur. Chest CT scan showed an extensive empyema in the left hemithorax. Samples were taken for detection of common germs. Then, a chest drainage tube was placed and antibiotic therapy started. The MALDI-TOF MS test identified Parvimonas micra, an anaerobic bacterium, commensal to the oral flora, associated with severe periodontitis, but rarely reported in cases of pleural empyema, especially in immunocompetent patients. Gingivitis and pericoronaritis of the third molar were diagnosed during oral evaluation. The patient progressed favorably. Parvimonas micra should be considered as a possible etiological agent in cases of subacute or chronic pleural empyema, in addition to mycobacteria. Tests such as MALDI-TOF MS or 16S rRNA sequencing, chest tube placement, empirical antibiotic coverage and an adequate oral evaluation should be considered in these cases.

Prevalência das complicações em cirurgia de terceiros molares inferiores: um estudo transversal / Prevalencia de complicaciones en cirugía de terceros molares inferiores: un estudio transversal / Prevalence of Complications in Inferior Third Molar Surgery: A Cross-Sectional Study

Introdução: A extração de terceiros molares é um dos procedimentos mais comuns realizados pelos cirurgiões bucomaxilofaciais e as potenciais complicações dessa intervenção estão bem documentadas. Objetivo: O objetivo deste estudo é encontrar as associações entre essas complicações e variáveis relacionadas aos dentes ou aos pacientes e, assim, ajudar os cirurgiões a predizê-las e preveni-las. Métodos: Nosso estudo avalia a prevalência de omplicações em exodontias de terceiros molares inferiores utilizando uma amostra populacional brasileira em um período de 10 anos para estabelecer a probabilidade dessas complicações e sua associação com variáveis como idade, sexo e posição do dente na arcada . As mesmas variáveis foram usadas em relação a pericoronarite prévia. Trata-se de um estudo observacional retrospectivo transversal, seguindo as diretrizes STROBE. Resultados e Conclusões: Mil e nove pacientes tiveram 1.822 terceiros molares extraídos, sem associação detectada entre condições sistêmicas e complicações, embora esses pacientes com complicações sistêmicas tenham 1,9 vezes mais chances de ter pericoronarite. A pericoronarite foi mais prevalente em pacientes saudáveis, com classificação A e III de Pell & Gregory e posição distoangular. Esses achados corroboram a literatura atual ao comparar a classificação de Pell e Gregory e a maior prevalência de complicações... (AU)

Introducción: La extracción de terceros molares es uno de los procedimientos más comunes realizados por los cirujanos orales y maxilofaciales y las posibles complicaciones de esta intervención están bien documentadas. Objetivo: El objetivo de este estudio es encontrar las asociaciones entre estas complicaciones y variables relacionadas con dientes o pacientes y así ayudar a los cirujanos a predecirlas y prevenirlas. Métodos: Nuestro estudio evalúa la prevalencia de complicaciones en extracciones de terceros molares inferiores utilizando una muestra de población brasileña durante un período de 10 años para establecer la probabilidad de estas complicaciones y su asociación con variables como la edad, el sexo y la posición de los dientes en el arco. Las mismas variables se utilizaron para determinar pericoronitis previa. Se trata de un estudio observacional, transversal, retrospectivo, siguiendo las directrices STROBE. Resultados y Conclusiones: A mil nueve pacientes se les extrajeron 1.822 terceros molares, no detectándose asociación entre condiciones sistémicas y complicaciones, aunque estos pacientes tenían 1,9 veces más probabilidad de tener pericoronitis. La pericoronitis fue más prevalente en pacientes sanos, con clasificación A y III de Pell & Gregory y posición distoangular. Estos hallazgos corroboran la literatura actual al comparar la clasificación de Pell y Gregory y la mayor prevalencia de complicaciones... (AU)

Introduction: Extraction of third molars is one the most common procedures carried out by Oral and Maxillofacial Surgeons and the potential complications of such intervention are well documented. Purpose: The objective of this study is to find the associations between these complications and variables related either to the teeth or the patients and thus help surgeons to predict and prevent them. Methods: Our study evaluate the prevalence of complications in extractions of the lower third molars using a Brazilian population sample over a period of 10 years to establish the probability of these complications and their association with variables such as age, sex and tooth position in the arch. The same variables were used to determine previous pericoronitis. This is a retrospective cross-sectional observational study, following the STROBE guidelines. Results and Conclusions: One thousand and nine patients had 1,822 third molars extracted, with no associations detected between systemic conditions and complications, although these patients are 1.9 times more likely to have pericoronitis. Pericoronitis was more prevalent in healthy patients, with Pell & Gregory classification A and III and distoangular position. These findings corroborate the current literature when comparing Pell and Gregory classification and the higher prevalence of complications... (AU)

Factores causantes de gingivitis en jóvenes estudiantes / Causative factors of gingivitis in young students

Objetivo: Identificar la relación que mantiene el cuidado bucodental e higiene en los jóvenes de la Institución Educativa "Primero de Abril" y la presencia de gingivitis, y conocer si la dieta de los estudiantes está ligada a la presencia de esta patología. Método: Se realizó un estudio investigativo de corte transversal, cuantitativo, observacional analítico. Resultados: Un 44,4% del género femenino consume fibra como alimento principal mientras que el 55% consume vitaminas y antioxidantes, mientras que el género masculino el 62,5% de la población consume vitaminas y antioxidantes y 37,5% restante consume fibras. Conclusión: La presencia de gingivitis en la población estudiada especialmente del género femenino y de status económico bajo, es debido a la alta deficiencia en cuanto a las visitas odontológicas, el uso y acceso de kits de limpieza dental, reconociendo así la prevalencia en el desarrollo de esta.

Objective: To identify the relationship between oral care and hygiene in young people of the "Primero de Abril" Educational Institution and the presence of gingivitis, and to know if the diet of the students is linked to the presence of this pathology. Methods: A cross-sectional, quantitative, observational, analytical, cross-sectional research study was carried out. Results: 44.4% of the female gender consumes fiber as the main food while 55% consumes vitamins and antioxidants, while 62.5% of the male gender consumes vitamins and antioxidants and the remaining 37.5% consumes fiber. Conclusion: The presence of gingivitis in the population studied, especially in the female gender and of low economic status, is due to the high deficiency in dental visits, the use and access to dental cleaning kits, thus recognizing the prevalence in the development of gingivitis.

Inflamación mixta severa con pérdida del techo del canal mandibular: una variación de las infecciones odontogénicas asociada a pericoronaritis / Severe mixed inflammation with loss of the mandibular canal roof: a variation in odontogenic infections associated with pericoronaritis

Las infecciones cuando pasan a ser crónicas y recurrentes como puede ser el caso de una pericoronaritis medicada, mas no tratada una y otra vez, traen como consecuencia resistencia y proliferación bacteriana. Se da el caso de formaciones de tejidos patológicos e imágenes radiográficas que orientan a posibles diagnósticos, que hasta no ser tratadas por medio de diferentes técnicas como la marsupialización o enucleación, con el complemento de la biopsia insicional o exicional que determina el tipo de patología presente. Esto lleva al objetivo general: determinar el tipo de lesión patológica presente en el ángulo y cuerpo mandibular asociado a la ud: 48 Objetivos específicos: Identificar la lesión patológica presente en Angulo y parte del cuerpo mandibular asociada a la ud: 48. Muestra: paciente de 30 años de edad, masculino, caso clínico de una inflamación mixta severa, la clínica y sus hallazgos radiográficos, se sospechaba de un posible queratoquiste, quiste dentígeros o quiste odontogénico ortoqueratinizado, extracción dental ud: 48, retiro y legrado del tejido circundante, toma de biopsia exicional, exámenes de laboratorio, ortopantomografia, tomografía, fotografías clínicas. Metodología: paradigma positivista, enfoque cuantitativo, diseño no experimental. Modalidad de campo, tipo estudio de caso. La entrevista, el instrumento guión de las preguntas para la historia clínica fueron la técnica y el instrumento. Resultados: inflamación mixta severa, lo cual procede de una infección asociada a pericoronaritis recurrente, esto mediante resultado histopatológico. Conclusiones: el estudio histopatológico es quien determina el diagnóstico final a pesar que la clínica induzca a posibles diagnósticos diferenciales(AU)

When infections become chronic and recurrent, such as a medicated pericoronitis, but not treated repeatedly, they result in resistance and bacterial proliferation. There is the case of pathological tissue formations and radiographic images that guide possible diagnoses, which until they are not treated by means of different techniques such as marsupialization or enucleation, with the complement of the incitional or exicional biopsy that determines the type of pathology present. This leads to the general objective: to determine the type of pathological lesion present in the mandibular angle and body associated with ud: 48. Specific objectives: Identify the pathological lesion present in Angle and part of the mandibular body associated with ud: 48. Sample: 30-year-old male patient, clinical case of severe mixed inflammation, clinical symptoms and radiographic findings, suspected of a possible keratocyst, dentigerous cyst or orthokeratinized odontogenic cyst, tooth extraction ud: 48, removal and curettage of the surrounding tissue, exicional biopsy, laboratory tests, orthopantomography, tomography, clinical photographs. Methodology: positivist paradigm, quantitative approach, non-experimental design. Field modality, case study type. The interview, the instrument script the questions for the clinical history were the technique and the instrument. Results: severe mixed inflammation, which comes from an infection associated with recurrent pericoronitis, this through histopathological result. Conclusions: the histopathological study is the one who determines the final diagnosis, despite the fact that the symptoms lead to possible differential diagnoses(AU)

Microbial profile of symptomatic pericoronitis lesions: a cross-sectional study

Abstract Objective: The microbial composition of pericoronitis (Pc) is still controversial; it is not yet clear if the microbial profile of these lesions is similar to the profile observed in periodontitis (Pd). Therefore, the aim of the present study was to describe the microbial profile of Pc lesions and compare it directly with that of subjects with Pd. Methodology: Subjects with Pc and Pd were selected, and subgingival biofilm samples were collected from (i) third molars with symptomatic Pc (Pc-T), (ii) contralateral third molars without Pc (Pc-C) and (iii) teeth with a probing depth >3 mm from subjects with Pd. Counts and proportions of 40 bacterial species were evaluated using a checkerboard DNA-DNA hybridization technique. Results: Twenty-six patients with Pc and 18 with Pd were included in the study. In general, higher levels of microorganisms were observed in Pd. Only Actinomyces oris and Eubacterium nodatum were present in higher mean counts in the Pc-T group in comparison with the Pc-C and Pd-C groups (p<0.05). The microbiota associated with Pc-T was similar to that found in Pc-C. Sites with Pc lesions had lower proportions of red complex in comparison with the Pd sites. Conclusion: The microbiota of Pc is very diverse, but these lesions harbour lower levels of periodontal pathogens than Pd.

Clinical efficacy of Nd∶YAP laser in the treatment of acute wisdom tooth pericoronitis / 国际生物医学工程杂志

Objective To study the clinical efficacy of Nd∶YAP laser in the treatment of acute localized pericardial periodontitis. Methods A total of 120 patients with acute localized pericardial periodontitis were randomly divided into 3 groups, including Nd∶YAP laser group, minocycline group and control group (iodine glycerol group). All patients were underwent pretreatment of intracrevicular washing with 3.0％hydrogen peroxide and normal saline alternately. After the pretreatment, the patients in the Nd∶YAP laser group were given 3 min local Nb:YAP laser irradiation (1 time/d for 3 times), in the minocycline group were injected with minocycline hydrochloride ointment (1 time), and in the control group were treated with 2％iodine glycerol (1 time/d for 4 times) in gingival sulcus. One day after the treatment, the gingival index (GI), pain visual score (VAS), and opening degree of all patients were recorded, and the therapeutic effect was observed 5 days after the treatment. Results Compared with the minocycline group and the control group (iodine glycerol group), the GI value and VAS value of the Nd∶YAP laser group decreased and the openmouthed size increased (all P<0.05). At 5 days after the treatment, the patients in the Nd∶YAP laser group and the minocycline group had significant improvement in local gingival sulcusinflammation, and the total effective rate was 90％and 85％, which was significantly better than the control group (all P<0.05) and no significant difference in efficacy between the two groups (P>0.05). Conclusions The Nd∶YAP laser treatment inacute wisdom tooth pericoronitis can significantly reduce pain and improve openmouthed size, and has a good clinical efficacy.

Comparison of effects of two kinds of anesthetics in treatment of pregnant women with acute pericoronitis of wisdom tooth / 重庆医学

Objective To observe the anesthetic effect onset of primacaine and lidocaine in the treatment of pregnant women with acute pericoronitis of wisdom tooth.Methods.Two hundreds pregnant patients with acute pericoronitis of wisdom tooth were randomly divided into the study group and control group,100 cases in each group.The study group adopted primacaine before treatment,while the control group adopted lidocaine.The anesthetic effects were compared between the two groups.Resuits The anesthetic effect onset in the study group was faster than that in the control group,the difference was statistically significant (P＜0.01).The two groups all reached a better analgesic effect,moreover the pain degree and fear degree had no statistical difference between the two groups (P＞0.05).Conclusion The anesthetic effect of primacaine and lidocaine in the treatment of pregnant women with acute pericoronitis of wisdom tooth is favorable with high patient's satisfaction.

Clinical analysis of pericoronitis in yunnan college ethnic students / 口腔疾病防治

Objective @#To study and compare the recurrence rate of wisdom tooth pericoronitis and impacted tooth types of Yunnan college ethnic student. @*Methods @# 549 cases of pericoronitis of wisdom tooth from Yunnan college ethnic students were randomly selected by recording clinical symptom, recurrence situations and impacted tooth types by professional dentists, then clinical data was statistical analyzed.@*Results@# Most of pericoronitis (58.65%) was caused by vertical impaction of mandibular wisdom tooth. There was no significant difference (P>0.05) between Han ethnic groups and Minority ethnic groups of impacted tooth types. But there was significant difference (P<0.01) between Han ethnic groups and Minority ethnic groups of pericoronitis of wisdom tooth and recurrence rate.@*Conclusions @#There was higher rate of incidence and recurrence rate of pericoronitis of minority students.

Cross-Cultural Adaptation Of Modified Dental Pain Screening Questionnaire (M-Depaq) In A Primary Dental Care Clinic In Kuala Lumpur

A validated screening tool for patient triage based on the pain symptoms, could potentially optimize the resources and expertise available in dental pain management. The aim of this study was to translate and validate the Modified Dental Pain Questionnaire (M-DePaQ) for use in categorizing patients with pain into three groups of common dental conditions. Forward Malay and Chinese translation was performed, followed by backward English translation. The translation was reviewed by an expert panel and pre-tested on patients who are native speakers. Consecutive patients aged 18 years and older experiencing pain and attending the primary dental care clinic completed the questionnaires. Four calibrated dentists made clinical diagnoses independent of the questionnaire responses. For data analysis, the cases were split randomly into Random Sample 1 (RS1) and Random Sample 2 (RS2). Discriminant analysis was performed on RS1 to develop a model for classifying dental pain cases into three groups. The model was applied to cases in RS2, and a crossvalidated accuracy rate was obtained. Criterion validity was assessed using measures such as sensitivity, specificity, positive predictive value, and kappa. Of the 234 questionnaires distributed, 216 (92.3%) were returned. Classification rates were recorded at 73.8% for RS1, 75.0% for RS2, and 71.1% for all cases. The sensitivity values were 0.72, 0.39, and 0.43 for Groups 1, 2, and 3, respectively. The corresponding specificity values were 0.42, 0.87, and 0.94. The discriminant validity of the adapted questionnaire was satisfactory, but the criterion validity could not be established because of biases incorporated in the study.

Cambios histopatológicos de los folículos dentales en relación al espacio pericoronario y posición de terceros molares no erupcionados / Histopathological changes in dental follicles in relation to pericoronal spaces and position of the unerupted third molars

Objetivos: Determinar los cambios histopatológicos de los folículos dentales, en relación al espacio pericoronario y la posición de terceros molares no erupcionados. Material y Métodos: Se incluyeron en la investigación 128 folículos dentales, extraídos de 105 pacientes de ambos sexos. La medida de los espacios pericoronarios y la posición de los terceros molares fueron obtenidas de las radiografías panorámicas. Las muestras foliculares se enviaron para su estudio histológico; fueron fijadas en formol al 10% y coloreadas con Hematoxilina-Eosina, para posteriormente ser leídas por un Patólogo Oral. Los datos obtenidos fueron anotados en fichas para luego ser evaluadas estadísticamente mediante la prueba de chi-cuadrado. Resultados: De los participantes, 60,9% eran del sexo femenino y el 39.1% del masculino con edades entre 15 a 49 años. Se encontró un (76,6%) de cambios histopatológicos foliculares. La relación de los cambios histopatológicos y la medida de espacios pericoronarios no fue estadísticamente significativa (p=0,470), sin embargo se observó una alta prevalencia de patología folicular (75,7%) en el grupo de medidas =2,5mm, donde no debió observarse alteraciones. La relación entre cambios histopatológicos y la posición IB del tercer molar (90,9%) según la clasificación de Pell y Gregory fue estadísticamente significativa (p=0,031). Conclusiones: Los cambios histopatológicos en etapas tempranas no son observables radiográficamente, por lo que es indispensable el estudio histológico complementario. Se recomienda extraer profilácticamente los terceros molares no erupcionados, para evitar el desarrollo de patología folicular y enviar de manera rutinaria todas las muestras foliculares para su estudio histológico.

Objectives: To determine the histopathological changes of the dental follicles in relation to pericoronary space and the position of un erupted third molars. Material and Methods:128 dental follicles taken from105 patients of both sexes were included in the research. The measurement of pericoronal spaces and position of the third molars were obtained from panoramic radiographs. Follicular samples were sent for histological study; they were fixed in10% formalin and stained with hematoxylin-eosin and then were read by an oral pathologist. The data were recorded on cards and then been evaluated statistically using the chi-square test. Results: Of the participants, 60.9% were femaleand 39.1% of men aged15-49years. One (76.6%) follicular histopathological changes were found. The relationship between histopathological changes and measure spaces pericoronal was not statistically significant (p =0.470), but a high prevalence of follicular pathology (75.7%) were observed in the group of measures=2.5mm, where should not be changes. The relationship between histopathological changes and IB position of the third molar (90.9%) according to the classification of Pelland Gregory was statistically significant (p =0.031). Conclusions: Histopathological changes at early stages are not observable radiographically, so the complementary histology is indispensable. It is recommended prophylactically extract unerupted third molars to prevent follicular pathology development and routinely send all follicular samples for histological examination.

Clinical Observation of Ornidazole Combined with Jinzhi Jieyin Gargle in the Treatment of Acute Wisdom Tooth Pericoronitis / 中国药房

OBJECTIVE:To observe the efficacy and safety of ornidazole combined with Jinzhi jieyin gargle in the treatment of acute wisdom tooth pericoronitis. METHODS:110 patients with acute wisdom tooth pericoronitis were randomly divided into control group and observation group. Control group was given one Ornidazole tablet,ground into fine powder in sterile bottle. Checking oral cavity carefully before treatment,Hydrogen peroxide solution (3%) and 0.9% Sodium chloride injection were in sterile syringe to repeatedly and alternatively flushing peripheral tissue to clean the food residuals,bacteria and pus in gingival pock-et,until spilled solution was clear and no purulent. Sterile cotton swabs were used to blot up and separate it from the wet. After sep-arating gingival valve by probe,ornidazole fine powder was put into gingival pocket and pressed into deep area by tampons,and kept tampons,once a day + 2 Amoxicillin capsules,3 times a day. Observation group was additionally given 10 ml Jinzhi jieyin gargle in mouth for 3 min after the spilled solution was clear and no purulent,for 2 times,then ornidazole fine powder was put in-to blind pouch. 10 ml was taken in mouth for 3 min after three meals per day. The treatment course for both groups was 4 d. Clini-cal efficacy,main symptom and total scores of main symptoms,secondary symptom and total scores of secondary symptoms be-fore and after treatment,and incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in obser-vation group was significantly higher than control group,the difference was statistically significant (P0.05). CONCLUSIONS:Ornidazole combined with Jinzhi jieyin gargle has better efficacy than only ornidazole in the treatment of acute wisdom tooth pericoronitis,it can significantly reduce the main symptom scores and secondary symptom scores,with similar safety.

Analgesic Effect Observation of Shixin Buccal Tablets on Pericoronitis of Wisdom Tooth / 中国药房

OBJECTIVE:To observe analgesic effect and safety of Shixin buccal tablets on pericoronitis of wisdom tooth. METHODS:120 patients with pericoronitis of wisdom tooth were randomly divided into control group and observation group with 60 cases in each group. Control group received periodontal pocket irrigation combined with metronidazole;observation group was additionally given Shixin buccal tablets on the basis of control group,1 tablet/time,4 times/d. Clinical efficacy,medication compli-ance,pain score and ADR were compared between 2 groups. RESULTS:The effective rate of observation group(95.00%)was sig-nificantly higher than that of control group(73.33%),with statistical significance(P0.05);the pain score of observation group was significantly lower than that of control group,with statistically significant difference(P<0.05). No serious ADR was found in 2 groups. CONCLUSIONS:Shixin buccal tablets significantly alleviate the pain caused by pericoronitis of wisdom tooth.

Detección de microorganismos anaerobios en pacientes con pericoronaritis y sensibilidad a los antimicrobianos / Anaerobic microorganisms detection in patients with pericoronaritis and antimicrobial susceptibility

El propósito de este estudio fue la identificación de microorganismos anaerobios más frecuentemente encontrados en pericoronaritis y realizar pruebas de sensibilidad a los antimicrobianos. Se estudiaron los sacos pericoronarios del tercer molar en 20 pacientes. De las muestras recogidas en los 20 pacientes que presentaron pericoronaritis, solo en 7 (35%) hubo crecimiento de microorganismos anaerobios estrictos mientras que en los 13 restantes (65%) no se detectaron estos. En cuanto a las 12 cepas aisladas del saco pericoronario de los 7 pacientes, el microorganismo más frecuentemente encontrado fue Bifidobacterium spp en 5 casos (42%), Bifidobacterium adolescentis en 2 casos (17%), Veillonella spp en dos casos también (17%), Prevotella melaninogenica en 1 caso (8%), 1 caso Prevotella loescheii (8%) y en 1 caso a Prevotella oralis (8%). De los resultados obtenidos las bacterias anaerobias estrictas detectadas a partir de muestras de sacos pericoronarios fueron: Bifidobacterium spp., B. adolescentis, Veillonella spp, P. loeschii, P. melaninogenica y P. oralis.

Study on 632 nm He-Ne laser therapy on pericoronitis / 国际生物医学工程杂志

Objective To investigate the effects of He-Ne laser on the treatment of pericoronitis.Methods 75 clinical patients with pericoronitis were randomly divided into the experimental group and control group.Local conventional therapy was given to the two groups.The experimental group was given routine treatment with He-Ne laser local exposure for 15 minutes every day,while the control group took no other treatment.3 days and 7 days later,pain and inflammation degree were recorded by three-degree pain scoring method.Total treatment effects were evaluated under a comprehensive clinical treatment standard.Results After 3 days' treatment,78.9％ patients in the experimental group and 51.4％ patients in control group felt their pain disappeared.After 7 days' treatment,97.4％ patients in experimental group and 91.9％ patients in control group felt their pain disappeared.Treatment comprehensive evaluation showed that there were statistical significance differences between two groups (P＜0.05).Conclusion He-Ne laser treatment of pericoronitis has significant anti-inflammatory analgesic effect.

Aplicación del OLEOZÓN® en el tratamiento de las pericoronaritis / Usage of Oleozón® in the treatment of pericoronaritis

La atención primaria se orienta hacia los principales problemas de salud de la comunidad, entre ellos los de urgencias estomatológicas, donde es atendida la pericoronaritis, siendo el tratamiento indicado la aplicación de sustancias cáusticas (ácido tricloroacético), que pueden ocasionar daños en los tejidos dentarios. Teniendo en cuenta las características de la pericoronaritis, se utilizó la ozonoterapia, realizando un ensayo clínico fase III, aleatorizado, controlado y abierto, lo cual permitió estudiar la evolución microbiológica después de aplicado el OLEOZÓN® en el tratamiento de la pericoronaritis, en la Clínica Estomatológica Docente César Escalante, del municipio Matanzas, de enero 2003 a enero 2008. El universo de estudio fueron los pacientes con pericoronaritis, y la muestra abarcó 90 pacientes, conformándose dos grupos, uno experimental, tratado con Oleozón, y otro control, donde se empleó el tratamiento convencional. La eficacia del OLEOZÓN® resultó ser alta en los pacientes tratados.

Primary care is directed to the main health problems of the community, and among them stomatologic emergencies where pericoronaritis is attended, being the indicated treatment the application of caustic substances (trichloroacetic acid), that may damage dental tissues. Considering the characteristics of pericoronaritis, we used ozone therapy, carrying out a Phase III randomized, controlled and open clinical trial, that allowed studying the microbiologic evolution after applying Oleozón® in the treatment of pericoronaritis, at the Teaching Stomatologic Clinic Cesar Escalante, municipality of Matanzas, from January 2003 to January 2008. The universe of study was the patients with pericoronaritis, and the sample covered 90 patients. Two groups were formed, one experimental, treated with Oleozon, and the other control, where we used the conventional treatment. The OLEOZÓN® efficacy was high in the treated patients.

Epidemiología y tratamiento de la pericoronaritis aguda en el Hospital Barros Luco Trudeau, Santiago, Chile / Epidemiology and treatment of acute pericoronitis at Barros Luco Trudeau Hospital, Santiago, Chile

La pericoronaritis se caracteriza por la inflamación de los tejidos blandos, que rodean la corona de un diente total o parcialmente erupcionado, acompañado por dolor. El objetivo de este trabajo es describir la epidemiología y el tratamiento de la pericoronaritis aguda, en pacientes que acuden al servicio de urgencia del Hospital Barros Luco Trudeau. Se realizó un estudio descriptivo retrospectivo. Se analizaron 9531 fichas clínicas correspondientes a pacientes atendidos en la urgencia dental del Hospital Barros Luco Trudeau, tomando como muestra 456 atenciones con el diagnóstico de pericoronaritis aguda. Se consideraron como variables la edad, el género, la pieza dentaria involucrada y el tratamiento realizado. El análisis de los resultados arrojó una edad promedio de 24 años, con una proporción aproximada de 1:2 de hombres frente a mujeres. Las piezas dentarias más afectadas fueron los terceros molares mandibulares. Respecto al tratamiento, aproximadamente el 70 por ciento de los casos se medicó con antibioterapia y analgésicos no esteroidales (AINES),mientras que sólo en un 40 por ciento se realizó el debridamiento mecánico de la zona. Independientemente del manejo inicial, la mayor parte de las piezas involucradas fueron extraídas de forma inmediata o derivadas para su remoción. Los resultados obtenidos concuerdan con la literatura disponible, en relación a las variables edad, género y piezas dentarias involucradas. Con respecto al tratamiento, la evidencia reporta que lo óptimo es la realización conjunta de una terapia mecánico-local y sistémica, medidas que fueron poco frecuente en el servicio estudiado.

Pericoronitis is characterized by inflammation of the soft tissues surrounding the crown of a tooth wholly or partially erupted, accompanied by pain. To describe the epidemiology and treatment of acute pericoronitis in patients attending the emergency department of the Hospital Barros Luco Trudeau. A descriptive retrospective study was carried out. We analized 9531 files of patients treated in the Emergency Department Dental Hospital Barros Luco Trudeau and we obtained a sample of 456 files with the diagnosis of acute pericoronitis. The variables considered were age, gender, tooth and the treatment involved. The analysis of the results showed an average age of 24 years, with an approximate ratio of 1:2 of men versus women. The most affected teeth were mandibular third molars. Regarding treatment, approximately 70 percent of cases medicated with antibiotics and analgesics nonsteroidal antiinflammatory drugs (NSAIDs), where as only 40 percent had mechanical debridement of the area. Regardless of initial treatment, most of the parts involved were immediately extracted or derived for removal. Our results are consistent with the available literature regarding the variables age, gender and teeth involved. With regard to treatment, the literature reported that the best evidence is the joint realization of a local mechanical therapy and systemic measures that were rare in the service studied.

Evolución clínica de la pericoronaritis en terceros molares inferiores semirretenidos / Clinical evolution of pericoronitis in the third inferior semi-retained molars

Se realizó un estudio longitudinal, prospectivo, analítico y descriptivo, con el objetivo de determinar la evolución clínica de la pericoronaritis en terceros molares inferiores semirretenidos, patología que aqueja a un porciento elevado de la población, siendo importante su diagnóstico y tratamiento oportuno. Esta investigación se desarrolló en el Hospital General Docente Abel Santamaría Cuadrado, durante el período comprendido de enero a octubre de 2009. La muestra estuvo compuesta por 52 pacientes que asistieron a la consulta de cirugía maxilofacial, por presentar síntomas y signos clínicos propios de la pericoronaritis. Para el análisis estadístico se utilizaron como principales medidas los números absolutos y relativos, y las pruebas no paramétricas de ji cuadrado; se tomó como nivel de significación á-0,005. En los pacientes con pericoronaritis de terceros molares inferiores semirretenidos, la forma serosa fue la más frecuente con un 48%, siendo el dolor moderado el síntoma clínico de mayor incidencia en esta pericoronaritis, no así en la forma supurada, que en el 42,3% existía un dolor severo. Como otros síntomas clínicos presentes, surgieron la inflamación y enrojecimiento del tejido pericoronario en el 100% de los casos, seguido del trismo en un 86,53% y la presencia de pus en un 22%, que se hicieron más notables en la forma supurada de la pericoronaritis.

A longitudinal, prospective, analytic and descriptive study was conducted aimed at determining the clinical evolution of pericoronitis in the third inferior semi-retained molars, a pathology that affects a high percent of the population, where the diagnosis and appropriate treatment is very important. This research was carried out from January to October 2009 at "Abel Santamaria Cuadrado" University Hospital. The sample was comprised of 52 patients attending to the oral offices presenting clinical signs and symptoms of pericoronitis. Absolute and relative numbers, parametric chi-square test and the level of significance á- 0,005 were used to perform the statistical analysis. In patients presenting pericoronitis in the third inferior semi-retained molars were found: the serous form that was the most frequent with 48%, being the moderate pain the clinical symptoms that showed the highest incidence in this pericoronitis, that differed from the suppurated which presented 42,3% of severe pain. Other clinical symptoms suggested inflammation and flare of the pericoronary tissue in 100% of the cases, followed by trismus in 86, 53% and the presence of pus (22%), which were more notable in the suppurated form of pericoronitis.

Conservative infection control on acute pericoronitis in mandibular third molar patients referred from the prison

In the presence of acute pericoronitis of mandilbular third molar, antibiotic therapy and early incision and drainage are the method of choice, followed by definitive surgical extraction of the tooth as soon as it becomes subacute. If excision of the overlying tissues is decided on, it should be done adequately. All overlying tissues must be throughly excised, and the crown portion of the unerupted tooth should be completely exposed. After excision has been completed, the wound should be managed with a surgical dressing. This should be allowed to remain approximately 7 days. And then, surgical extraction of the impacted mandibular third molar can be done usually. In this operation, there are many complications, such as, postoperative bleeding, infection, trismus, dysphasia and paresthesia. The surgeon are discredited and medicolegal problem may be occurred in the presence of many distressed complications. Therefore, the relatively nonsurgical treatment is the method of choice. So, authors selected the conservative treatment methods of incision and drainage, primary endodontic drainage, operculectomy without surgical extraction of the mandibular third molars. The results were more favorable without the postoperative complication in Wonju old offender prison.

Phase Ⅱ clinical trial of Shixinyatong buccal tablets in the treatment of gastropyretic toothache(pericoronitis) / 实用口腔医学杂志

Objective: To study the effects and safety of Shixinyatong buccal tablets in the treatment of gastropyretic toothache (perico-ronitis). Methods: Randemized, double-blinded, double-imitated, parallel-controlled and multi-center clinical study was employed. 120 cases of gastropyretic toothache (pericoronitis) was enrolled in the experimental group( SBT group) and another 120 in control group(CBD group). Pericoronal pocket rinsing was performed for each case at the first visit, then the patients in SBT group were treated by Shixin buccal tablets(SBT) , 0. 6 g×2, 4/d and oral adiministration of the vehicle of cow-bezoare detoxicating tablets,0.3 g×3, 3/ d. The patients in CBD group were treated by oral adiministration of cow-bezoare detoxicating tablets ( SBD), 0. 3 g×3, 3/d and the vehicle of SBT, 0.6 g ×2, 4/d respectively. Pain, gingiva contagious tumefaction, pyorrhea of periocoronal pocket and limitation of mouth opening were scored by 0, 2, 4 and 6 as the major physical signs and symptoms(MAS); periocoronal flap and pocket, facial swelling, hot and foul breath, costipation, lymphadenectasis, thirsty and desire of cold drinks, fever by 0, 1,2 and 3 as the minor (MIS). Treatment was continued for 5 days and data were statistically analysed with SAS6. 12 software. Significant effectiveness was i-dentified by the decrease of total score of all the physical signs and symptoms(TS) ≥70% .effectiveness 30%～69% and ineffectiveness ≤29%. Routine examinations of blood, urine and stool, function of liver and kidney and electrocardiogram were conducted before and after treatment. Adverse events(AE) were observed. Results: 3 cases divorced from SBT group and 2 from CBD group. The demographic data and all the scores before treatment were not statistically different between groups (P>0.05). 3 and 5 days after treatment theTS, TSMA and TSMI were decreased(P= 0.000) in both groups, in SBT group decreased more than in CBD(P<0.001). Significant effectiveness ratio of SBT group was higher than that of CBD (P=0. 000). 5 days after treatment TS of MASs and the scores of each MAS in SBT group decreased more than in CBD( P<0.05). Vital signs were in normal range and not statisticaly different between groups(P>0.05). The clinical lab examinations showed no abnormal changes. Drug-related AE were observed in 3 cases, 1 with moderate AE in SBT group recovered after drug withdrawal, 2 with mild AE in CBD group recovered without aditional treatment. Conclusion; Shixinyatong buccal tablet is more effective in the treatment of gastropyretic toothache (pericoronitis) than cow-bezoare detoxicating tablets and with similar safety.

Correlation of pericoronitis and eruption state of the mandibular third molar

OBJECTIVES: Pericoronitis was the most common indication for mandibular third molar surgery and there are no universally acceptable predictive criteria for pericoronitis occurrence. This study was designed to analyze the correlation of the pericoronitis and the eruption state of the mandibular third molar using panoramic radiographs statistically. MATERIALS AND METHODS: 218 patients whose chief complaint was the extraction of the mandibular third molar were examined. The presence and absence of pericoronitis, age, sex, position of extraction site, angulation, impaction degree, position to the anterior border of mandibular ramus, distance between distal cementoenamel junction of second molar and mesial cementoenamel junction of the mandibular third molar were assessed. Then the correlation of pericoronitis and the eruption state of the mandibular third molar were analyzed by Student's t-test and chi-square test. RESULTS: There was no correlation between Pericoronitis and age, sex, position of the mandibular third molar. The angulation(P=0.005), impaction degree(P=0.043), relation with anterior border of mandibular ramus(P=0.003), distance between distal cementoenamel junction of second molar and mesial cementoenamel junction of the mandibular third molar(P<0.05) were correlated with pericoronitis. CONCLUSIONS: The occurrence of the pericoronitis can be predicted by the eruption state of the mandibular third molar such as angulation, impaction degree, relation with anterior border of mandibular ramus, distance between distal cementoenamel junction of second molar and mesial cementoenamel junction of third molar.