Association of Oral Hygiene and Periodontal Health with Third Molar Pericoronitis: A Cross-Sectional Study.

BACKGROUND: Pericoronitis is a painful inflammatory condition commonly associated with third molar teeth. The purpose of this study was to investigate the relationship between oral hygiene and periodontal health status and the presence of pericoronitis in semi-impacted third molar teeth. METHODS: A cross-sectional study was conducted, and 54 patients having at least one mandibular vertically semi-impacted third molar tooth with or without pericoronitis were consecutively enrolled. Subjects with pericoronitis and subjects with healthy third molars were selected according to symptoms in the gingiva overlying semi-impacted third molar teeth. Periodontal health status and oral hygiene were evaluated with the measures of plaque index (PI), gingival index (GI), and total number of sites with a probing depth (PD) ≥ 4 mm. The clinical data collected in this study was analyzed with Mann-Whitney U test using SPSS 20.0 package program. RESULTS: The PI scores were found to be significantly higher in patients with pericoronitis (p < 0.05). Although the GI scores and PD scores were higher in patients with pericoronitis, the difference did not reach statistical significance when compared with those in healthy subjects (p > 0.05). CONCLUSION: The findings obtained in this study suggest that the amount of dental plaque was positively associated with third molar pericoronitis. Gingival and periodontal health conditions were similar between patients with and without pericoronitis. Improving oral hygiene and controlling dental plaque may help prevent third molar pericoronitis.

The top risk factors for endodontic flare-up: a Monte Carlo simulation.

OBJECTIVES: The aim of this study was to analyze the strength of risk factors related to endodontic flare-ups and rank them in order of their importance MATERIALS AND METHODS: A systematic literature search of PubMed, Cochrane Central Register of Controlled Trials, Scopus, and ISI Web of Knowledge, and grey literature was conducted up to November 2019. One hundred ninety-eight publications were identified. Twelve records fulfilled the eligibility criteria, and eight significant risk factors for flare-up, namely, "Periapical lesion," "multiple-visit treatment," "preoperative pain," "necrotic teeth," "female gender," "retreatment," "percussion pain," and "analgesics," were selected to construct the simulation model. The final data pool was established by the integration of data of common risk factors in the included articles. Monte Carlo method was used to analyze of combined numerical data, for simulation of the risk factor impacts. Ten thousand iterations were generated in the simulation model. RESULTS: The results of the simulation revealed that the risk estimates of the factors had varying ranges of influence and probability on the flare-up risk. "Periapical lesion" was found to be the most sensitive risk factor, following by "preoperative pain" which was ranked the second place. The third-ranked risk factor was "multiple-visit treatment." The least sensitive risk factors for endodontic flare-up were "retreatment," "female gender," "necrotic teeth," and "analgesics." CONCLUSIONS: The present study provides better comprehension on the importance of risk factors for flare-up based on their risk estimates. CLINICAL RELEVANCE: A Monte Carlo simulation was adopted to identify the most influential risk factors for endodontic flare-up with a ranking, which can be used to provide meaningful predictions and further insights into clinicians' perception of flare-up risk.

Oral Health-Related Quality of Life and the Use of Oral and Topical Nonsteroidal Anti-Inflammatory Drugs for Pericoronitis.

BACKGROUND Pericoronitis is inflammation of the tissue surrounding a third molar, or wisdom tooth. This study aimed to evaluate the effects of oral and topical analgesic nonsteroidal anti-inflammatory drugs (NSAIDs) on oral health-related quality of life (OHQoL), in terms of oral health and lifestyle, in patients with symptomatic pericoronitis. MATERIAL AND METHODS The study included 60 patients who presented with pericoronitis and who did not undergo surgery within the following seven days. The patients were randomly assigned to three groups and were treated with oral diclofenac (N=20), oral flurbiprofen (N=20), and topical benzydamine (N=20). OHQoL was assessed for all study participants with a self-reported eight-item scale that was developed to evaluate pericoronitis. The total OHQoL scores were calculated for each day during the seven-day study period. RESULTS The study group treated with topical benzydamine had a significantly greater improvement in the OHQoL scores compared with the oral diclofenac and oral flurbiprofen groups on the first four days. Comparison of patients treated with diclofenac and flurbiprofen showed no significant differences for all seven days. A significant initial improvement in OHQoL was found on day 1 for the benzydamine group, on day 2 for the flurbiprofen group, and day 3 for the diclofenac group. CONCLUSIONS In this study, topical benzydamine was found to be a more effective alternative to oral NSAID analgesics, diclofenac and flurbiprofen, in improving OHQoL in patients with pericoronitis.

Estimating the Importance of Significant Risk Factors for Early Dental Implant Failure: A Monte Carlo Simulation.

PURPOSE: The purpose of this study was to develop a probabilistic estimation of the strength of risk factors associated with early dental implant failure and rank them by importance. MATERIALS AND METHODS: A systematic literature search was performed on PubMed, Web of Knowledge, Scopus, Cochrane Central Register of Controlled Trials, and grey literature up to April 2017. A total of 368 records were identified. Following the removal of duplicate and irrelevant records, 56 were screened. Eight studies met the inclusion criteria, in which seven statistically significant risk factors for early failure were selected and used to build a conceptual simulation model. Selected risk factors were, namely, "male sex," "smoking," "bone quality," "short implants," "wide implants," "adjacent teeth," and "periodontitis." Monte Carlo simulation with 100,000 iterations and a sensitivity analysis were performed to evaluate the risk estimates of these risk factors and to identify which of the risk factors are more important in influencing the model, respectively. RESULTS: The performed simulation model has shown a significant difference in terms of estimated effects of the risk factors on early failure rate. As a result, the most sensitive risk factor was found to be "periodontitis" with the second being "adjacent teeth" and the third "smoking." The least sensitive factor for early failure was "wide implants." CONCLUSION: This study develops a better understanding of the importance of risk factors for early dental implant failure by an estimated ranking.

Displacement Patterns of the Maxilla During Parallel and Rotational Setback Movements: A Finite Element Analysis.

BACKGROUND The purpose of this analysis was to evaluate the displacement patterns of the maxilla under parallel and rotational setbacks using the finite element method (FEM). MATERIAL AND METHODS A three-dimensional (3D) finite element model of a hemimaxilla was constructed. Through a conventional Le Fort I osteotomy, 2 and 3 mm of posterior movement in a parallel and rotational manner were simulated and the displacement pattern of the maxilla in each movement type was evaluated. RESULTS Both parallel and rotational setbacks resulted in lateral and inferior displacement of the maxillary segment. The largest inferior displacement was 3.0 mm and the largest lateral displacement was 1.84 mm. All lateral displacements in the anterior region were found to be more than 1 mm. CONCLUSIONS The results of this study may provide insight into how the maxilla tends to move during total maxillary setback surgery.

Active implant periapical lesions leading to implant failure: two case reports.

Implant periapical lesion (IPL), an inflammatory lesion surrounding the apex of a dental implant, has been previously reported as a possible cause for implant failure. This article describes 2 successive cases of active IPL that were diagnosed early by clinical signs and radiologic findings. Lesions were treated surgically with implant removal and debridement. The etiology, findings, and treatment approaches for IPL are discussed in comparison with other reports.

Periorbital emphysema during dental treatment: a case report.

Periorbital emphysema is a rare complication of dental treatment. To date, there is only 1 case of periorbital emphysema during dental treatment reported in the literature. Etiologies and guidelines for the prevention of this complication during dental treatment were outlined and a rare case was presented.