The effect of alendronate on resorption of the alveolar bone following tooth extraction.

Maintenance of alveolar bone width and height following tooth loss is essential with regard to the restoration of missing teeth with endosseous dental implants or prosthodontics approaches. A various amount of alveolar ridge resorption is likely to occur after tooth extraction at the buccal and lingual alveolar bone plates. Bisphosphonates, alendronate, is well known for its potent inhibition of osteoclast-mediated bone resorption. The objective of this study was to examine the inhibitory effect of alendronate on alveolar bone resorption following tooth extraction in rats. Male Wistar Albino rats were divided into three groups: baseline group, saline-treated group and alendronate-treated group. The saline-treated group was administered with daily saline solution for 2 and 4 weeks respectively while the alendronate-treated group was given a daily amount of 0.25 mg/kg alendronate subcutaneously for the same periods. The level of urinary calcium, creatinine, and serum calcium, alkaline phosphatase and phosphate were measured. Serum alkaline phosphatase level was measured as a marker of osteoblastic activity. Histopathological sections of 4 microm thickness were obtained from the right first mandibular molar region in a bucco-lingual direction. The number of osteoclasts, osteoblasts, and haversian canals, the number and size of resorptive lacunae, and osteoid formation were evaluated histopathologically. The mean thickness of buccal and lingual alveolar bone was measured. In the alendronate-treated group, both buccal and lingual alveolar bone volume reduction was significantly less than the saline treated group. Significant reduction in serum and urinary calcium levels and the number of osteoclasts revealed the pronounced suppression of bone resorption in the alendronate-treated group.

Classification and premedication of uncooperative children.

Forty-three uncooperative children ranging in age from 4-12 yr were pretreated with diazepam, acepromazine or a placebo, depending on their anxiety situations. The results showed that diazepam has a significantly more powerful effect on the successful termination of the dental procedure and on encouraging the cooperation and compliance of patients than acepromazine or placebo. The placebo was also found to be effective for increasing the cooperation of patients with negative anxiety. No significant difference was established between the actions of premedicants on pain reaction and amnesia. In the light of the present findings, it is suggested that drugs with sedative and also anxiolytic effects will be more beneficial for increasing the cooperation of children with mild or high anxiety than drugs with a sedative effect alone.

Antibacterial effects of ofloxacin, clindamycin and sultamicillin on surgical removal of impacted third molars.

This study examined the bacteraemia following surgical removal of impacted mandibular third molars and evaluated the antibacterial effects of Ofloxacin, Clindamycin, Sultamicillin, used as prophylactic medications. The study involved a hundred healthy patients whose mandibular third molars were impacted horizontally. These patients were divided into four groups each including 25 individuals. One of the four groups was the control group. The other groups were those to which Ofloxacin, Clindamycin, and Sultamicillin were administered one hour before the operation and in the following 4 days postoperatively. Blood samples were taken before and immediately after the operation, and then, 1 and 24 hours postoperatively. Following the incubation of the samples under aerobic and anaerobic conditions, the samples were examined microbiologically. Preoperative samples were found to be negative. In the immediate postoperative samples, bacteraemia was found in 44% of the control group, 40% of Ofloxacin and Clindamycin groups and 36% of the Sultamicillin group. In the samples taken 1 hour after the operation, bacteraemia was found in 28% of the control group, 20% of the Ofloxacin group and 24% of the Clindamycin and Sultamicillin groups. In the control group, only 2 cases showed positive culture in the blood samples taken 24 hours after the operation. In conclusion, the antibiotics, Ofloxacin, Clindamycin, Sultamicillin have a significant effect in decreasing the risk of postoperative infection and bacteraemia.