Effect of obturator nerve block during transurethral resection of bladder tumors on the disease recurrence, progression and surgery outcomes.

OBJECTIVE: In our study, we aimed to evaluate the effect of the obturator nerve block (ONB) on the operation time, duration of hospital stay, complete resection, presence of muscle tissue in the pathology, second resection, recurrence, and progression, when applied in addition to spinal anesthesia in patients with primary bladder lateral wall tumor and Transurethral Resection of Bladder Tumor (TURBT) was planned. MATERIALS AND METHODS: Seventy patients with bladder lateral wall tumors were included in the study. In addition, ONB was applied to 35 of the patients who underwent spinal anesthesia. The two groups were compared in terms of obturator reflex development, perforation, complete resection, presence of muscle tissue in pathology samples, need for second resection, need for second resection due to inadequate muscle tissue, and 1 year recurrence and progression rates. RESULTS: When the two groups were compared for obturator reflex and bladder perforation, both were found to be lower in the ONB group (p = 0.002, p = 0.198, respectively). The rate of complete resection and the presence of muscle tissue in the pathology samples were higher in the ONB group (p = 0.045, p = 0.034, respectively). The rates of second resection and second resection due to inadequate muscle tissue were found to be higher in the group without ONB (p = 0.015, p = 0.106, respectively). In the 1-year follow-up, the recurrence rate was significantly lower in the ONB group (p < 0.001), while there was no significant difference between the progression rates (p = 0.106). CONCLUSION: In our study, we found out that ONB applied in addition to spinal anesthesia increases the rate of complete and muscle tissue resection by decreasing the obturator reflex, and causes a significant reduction in the need for second resection and tumor recurrence.

Effect of concentrated growth factor (CGF) on short-term clinical outcomes after partially impacted mandibular third molar surgery: A split-mouth randomized clinical study.

PURPOSE: The aim of this study was to evaluate the effectiveness of concentrated growth factor(CGF) on soft tissue healing and postoperative side effects following third molar surgery. METHODS: This study was designed on 60 patients as a randomized single-blind clinical trial. The predictor variable was the implementation of CGF fibrin matrix, which was categorized as CGF and non-CGF. The primary outcome variable of the study was the healing of soft tissue around the extraction socket. The secondary outcome variables were pain, swelling and trismus. Data were analyzed using the non-parametric Brunner and Langer model. Statistical significance was set at P<.001. RESULTS: Sixty patients (39 female, 21 male; mean age 25.82) with impacted mandibular third molars participated in the study. Statistical analysis revealed that there were significant differences between the control and test groups with regard to soft tissue healing, postoperative pain, swelling, and trismus (P<0.001). CONCLUSION: The application of CGF accelerates soft tissue healing and is beneficial in minimising postoperative side effects, particularly pain, swelling and trismus, after extraction of mandibular third molars. CLINICAL TRIALS NUMBER: NCT03913884.

The role of concentrated growth factor on implant stability: A preliminary study.

PURPOSE: The purpose of this preliminary study was to evaluate the effect of concentrated growth factor (CGF) on dental implant stability in type 2 bone using the resonance frequency analysis (RFA) device Smartpeg®. METHODS: The researchers carried out a prospective cohort study on a sample group composed of 12 patients (mean age=67) who required dental implants. Implant socket preparation (with and without CGF) was the primary predictor variable. In each patient, two dental implants were inserted in the anterior mandible. For the test group, one dental implant socket was covered with CGF membrane, while the other socket was prepared conventionally for the control group. Implant stability, as measured by RFA, was the outcome variable. Measurements were taken using the Ostell device at the time of implant placement and at the 1st, 2nd and 4th weeks. RESULTS: Mean implant stability quotients (ISQs) were 67.00±4.573 for the study group and 64.75±5.065 for the control group. The difference between the two groups was not statistically significant. CONCLUSION: It was found that CGF did not provide beneficial effect on dental implant stability in the early healing period in type 2 bone.

Effect of tube drainage compared with conventional suturing on postoperative discomfort after extraction of impacted mandibular third molars.

The aim of this prospective randomised study was to assess the effects of tube drainage on postoperative discomfort after the extraction of impacted mandibular third molars. We studied 40 patients (11 men and 29 women) 18 years or older (mean (SD) 21 (3), range 18-29) who required extraction of mandibular third molars. We used a randomised crossover design by which if a drain was inserted on one side, then the other side was managed without a drain on a later occasion. Pain, swelling, and mouth opening were evaluated after 48 h and 7 days postoperatively in both groups. Facial swelling (p=0.001), pain p=0.001), and trismus (p=0.001) were significantly less common in the drained group compared with those not drained. We conclude that the use a tube drain is of benefit in minimising postoperative swelling, pain, and trismus after extraction of mandibular third molars.

Tuberculosis of oral mucosa.

In secondary tuberculosis, lesions of the oral cavity may accompany lesions of the pharynx, lungs, lymph nodes or miliary tuberculosis. A 35-year-old male was suffering from swelling of his right cheek, cough, weakness and weight loss. There were local hyperemia and irregular oral mucous in the inner part of the right cheek. Chest x-ray showed bilateral nodular opacifications and a cavity of 2 cm. Acid-fast bacteria were present in sputum and Lowenstein-Jensen culture was positive. The pathological signs of the biopsy taken from the buccal mucosa including multistratified squamous epithelium were: tubercle structure, Langhans' giant cells and minimal cazeation necrosis. After anti-tuberculous chemotherapy oral and pulmonary lesions were almost in remission. Following this case report of lung tuberculosis accompanied by tuberculosis of oral mucosa, the literature related is reviewed.