Comparison of alvogyl, SaliCept patch, and low-level laser therapy in the management of alveolar osteitis.

PURPOSE: The aim of the present randomized prospective clinical trial was to compare the effects of alvogyl, the SaliCept patch, and low-level laser therapy in the management of alveolar osteitis. PATIENTS AND METHODS: The study population included 104 patients who had been referred to our clinic with a complaint of alveolar osteitis. The patients were randomly assigned to 1 of 4 groups: group 1, curettage and irrigation alone; group 2, curettage and irrigation followed by alvogyl applied directly to the socket; group 3, curettage and irrigation followed by a SaliCept patch applied directly to the socket; and group 4, curettage and irrigation followed by continuous-mode diode laser irradiation (808 nm, 100 mW, 60 seconds, 7.64 J/cm(2)). The treatment procedures were repeated after 3 days. The clinical signs and symptoms for each patient were recorded at diagnosis, at 3 days after the diagnosis, and at 7 days after the diagnosis. In addition, the pain intensity levels for each patient were recorded at diagnosis and daily for 7 days after the initial treatment. RESULTS: No statistically significant differences in the management of alveolar osteitis were observed between groups 2 and 3. However, the management of alveolar osteitis was significantly better in group 4 than in the other 3 groups. CONCLUSION: Within the limitations of the present study, it can be concluded that acemannan in the form of the SaliCept patch is an acceptable alternative to alvogyl as a dressing for the management of alveolar osteitis. However, low-level laser therapy treatment at 7.64 J/cm(2) (0.1 W × 60 seconds = 6 J) performed superiorly to both SaliCept and alvogyl in managing alveolar osteitis in our study population.

Soft tissue pathosis associated with asymptomatic impacted lower third molars.

OBJECTIVE: The aim of this study was to identify the prevalence of pathological changes in the pericoronal tissue of asymptomatic impacted lower third molars and to assess the correlation between pathological changes and patient demographic, radiographic and morphological characteristics. STUDY DESIGN: Follicles associated with fully impacted lower third molars were submitted for histological examination after surgical extraction from 50 patients. The correlation between pathological changes in the dental follicle and age, gender, depth of impaction, angular position, and coverage and tooth development was analyzed. RESULTS: Cystic changes were observed in 10% of specimens and inflammatory changes in 62%. Incidence of pathological changes was significantly higher in Class B impacted teeth when compared to Class C impacted teeth. A significant correlation was found between epithelial cell activity and the completion of tooth development. CONCLUSION: We recommend monitoring all third molars whether or not they are symptomatic and conducting histopathological analyses on all surgically extracted follicle tissue.

Prevalence of impacted premolars in a Turkish population and considerations for surgical treatment.

OBJECTIVE: The aim of this study was to identify the prevalence, associated pathology and symptoms, and treatment of impacted premolars in a Turkish population. STUDY DESIGN: This retrospective study examined panoramic radiographs and clinical records of 9,000 patients who presented consecutively at our oral and maxillofacial surgery clinics between January 1998 and January 2009. In addition to demographic data (patient sex and age), data was compiled on the number and location of impacted missing maxillary and mandibular premolars, retained deciduous molars, associated pathologies and symptoms, and treatment methods. RESULTS: A total of 105 impacted maxillary or mandibular premolars were observed in 93 patients (1.03%). Of these, 48 (51.6%) were female (age range: 13-57 years) and 45 (43.4%) were male (age range: 13-58 years). Impacted mandibular second premolars accounted for 55.2% (n=58) of all impacted premolars. Migration was observed in only 11.83% of patients (n=11). Pathological changes and symptoms were noted in 15.05% of patients. CONCLUSION: Our results suggest that the prophylactic extraction of non-migrated impacted premolars may not be necessary. If the patient is cooperative, a "wait and see " approach may be preferable. Orthodontic or prosthetic treatment options should also be considered when planning treatment of non-migrated impacted premolars. Migrated impacted premolars should be kept under observation and should only be removed if they are associated with pathology or if extraction is required for prosthetic or orthodontic treatment.

Non-syndromic supernumerary premolars.

OBJECTIVE: The objective of this study was to estimate the incidence of non-syndromic supernumerary premolars, to classify them and to identify the complications related to them. STUDY DESIGN: This retrospective cohort study was composed of 8400 panoramic radiographs of patients who presented at our Oral and Maxillofacial Surgery Services from January 1998 to May 2008. The number of supernumerary premolars, their localization, the ages and the sex of the patients, any associated complications and treatment methods were estimated. RESULTS AND CONCLUSION: A total of 20 supernumerary premolar teeth were found in 10 of the 8400 patients (0.24%) with 7 of those being females and three males. Three patients had pain localized to the mental foramen and one patient had resorption in the root of the adjacent tooth. In these series, 18 supernumerary premolar teeth were extracted. In contrast with previous studies, this study suggested that this phenomenon is more frequently encountered in females than in males. The presence of complications associated with the supernumerary premolars in 4 patients necessitated consideration of surgical intervention as a treatment choice for these teeth. Otherwise, they should be kept under observation.