ABSTRACT
Background: Apicoectomy is one of the procedures that are most frequently performed by specialists in oral surgery. This paper presents an analysis of Ibuprofen consumption after apicoectomy and factors such as patient's age, sex and type of resected tooth. Ibuprofen intake is treated as a quantitative indicator of pain sensation. Material and Methods: The presented data cover 89 operations with 98 resected teeth. All those apicoectomies were performed by one and the same specialist in oral surgery and all patients were scheduled for a control examination on the day following the intervention. The reported Ibuprofen intake was recorded and analyzed afterwards. Results: The mean number of consumed Ibuprofen 400 mg tablets, necessary to eliminate the pain was 1.71 (SD±1.33). Gender was not established as responsible for statistically significant differences. Poor negative statistical correlation was established between age and number of consumed tablets. Older patients used a smaller amount of analgesics. The intake after resection of mandibular molars was statistically significantly higher versus that of the other teeth groups. Eighteen of the patients did not consume any analgesic tablets, constituting 18.3% of the whole group. Two patients needed 5 tablets which was the greatest reported intake. Conclusions: Apicoectomy leads to low Ibuprofen intake. The sex is not a statistically significant factor for Ibuprofen use. Poor negative correlation is observed between age and the amount of administered analgesics. This consumption is increased at resection of mandibular molars compared to that for other teeth groups. Almost one fifth of the patients did not need analgesics during the first postoperative day. Key words:Apicoectomy, postoperative pain, Ibuprofen, oral surgery.
ABSTRACT
INTRODUCTION: Several techniques and methods have been proposed to cover alveolar bone after tooth extraction when soft tissue is lacking. Some authors recommend soft tissue flap techniques, and others advocate different types of materials for socket covering. In this article, the authors use a modified buccal inversion technique for adequate coverage of the alveolar ridge to ensure its preservation and to minimize soft tissue shrinkage and loss of keratinized gingiva after tooth extraction. This local mucogingival-periosteal plastic procedure was named by the authors the "Buccal Periosteal Inversion technique" or simply BUPI. MATERIALS AND METHODS: After extraction of a fractured, endodontically compromised lower right first molar, the BUPI technique was performed to cover the alveolus. After reflecting the two-sided full-thickness flap, the periosteum was split in the cranial direction. The inverted periosteum is used to provide tension-free defect closure of the postextractional defect. Detailed technique implementation and patient postoperative healing are presented here in detail. RESULTS: Postoperative evaluation at six weeks was presented with photos showing adequate surgical site healing, no signs of infection or dehiscence, and no crestal shift of the keratinized gingiva. CONCLUSION: The buccal periosteal inversion (BUPI) technique is a modified technique that allows full socket coverage, avoiding a keratinized gingiva shift in the crestal direction using only the periosteum as a cover material. By inverting the buccal ridge periosteum alone from its normal position, the osteoclastic effect on the buccal bony wall will be eliminated, and this procedure abolishes the need for additional alveolar coverage materials.
