Pattern of bacteraemia after non-surgical extraction of tooth

Objective: The objective of this study was to assess the pattern of bacteraemia after non surgical extraction of teeth. Methods: This prospective descriptive study was conducted at an out-patient setting at Karachi Medical and Dental College, Dental Hospital Karachi, over a period of six months [January 2007 to June 2007] on fifty patients. A pre designed performa was used to collect the relevant information from the patients. All cases of bacteremia [diagnosed on culture media] after non-surgical extraction of tooth/ teeth were included in the study. Total seven culture samples were taken from each patient pre and post extraction. Results: Thirty-four [68%] patients were male and sixteen [32%] were female. Mean age of patients was 32.14 +/- 11 years. The commonest reason for tooth extraction was dental caries. The preextraction intravenous blood culture was negative in all fifty patients. The post extraction intravenous culture after one minute was negative in 60% of patients, after five minutes it was negative in 18% of patients. After fifteen minutes post extraction, 99% of blood cultures were positive for bacterial growth, while 56% of blood cultures were negative for any bacterial growth after thirty minutes. Peptostreptococci and Streptococcus viridians species were the commonest bacterial isolates. Conclusion: Highest level of bacteraemia occurred after fifteen minutes of non-surgical tooth extraction. Peptostreptococci and Streptococcus species were found to be the commonest isolates

Apical gingival margin movement in response to maxillary incisor intrusion with fixed orthodontic therapy

To determine the proportion of apical gingival margin movement in response to maxillary incisor intrusion, with fixed orthodontic therapy, in patients requiring maxillary incisor intrusion. Descriptive study was carried out in the Orthodontics department of Alvi Dental Hospital, Karachi, from June to December 2009. Forty five subjects requiring maxillary incisor intrusion were included in the study, who received 2x2 segmental 17x25 stainless steel archwire therapy, for 3 months. Maxillary incisor intrusion measured on cephalogram, and crown length, measured on cast and clinically, were used to compute the proportion of apical gingival margin movement in response to maxillary incisor intrusion. Out of 45 patients, 20 subjects showed proportion of gingival margin movement in apical direction to be 71 to 80% in response to maxillary incisor intrusion, 18 subjects showed 61 to 70% and 12 patients demonstrated 81 to 90%. The mean reduction in clinical crown length was found to be 0.45 +/- 0.21 mm which was statistically significant [p <0.05]. With maxillary incisor intrusion, the gingiva moves in the same direction as the tooth, yet considerably less. Hence incisor clinical crown reduces in length, resulting in unsatisfactory appearance of anterior teeth. This may indicate the need for gingival correction after intrusion therapy