Prevalencia de Complicaciones de Post Exodoncia de Terceros Molares / Prevalence of Post-Extraction Complications of Third Molars

El Centro de Salud Familiar (CESFAM) de San Pedro de Atacama, es el único establecimiento de Atención de salud en la comuna y alrededores, se hace imperativo para los Cirujanos Dentistas ser resolutivos y entregar una solución efectiva a la demanda local. El objetivo de este trabajo consistió en determinar prevalencia de complicaciones postexodoncia de terceros molares de pacientes atendidos en CESFAM San Pedro de Atacama entre enero y octubre de 2020. Estudio descriptivo de corte transversal entre enero y octubre 2020, se realizó revisión retrospectiva de fichas clínicas manuales y base de datos electrónica de atenciones odontológicas realizadas en CESFAM. Se incluyeron en el estudio pacientes mayores 18 años, sistémicamente sanos o ASA II compensados, que se hayan realizado exodoncia de tercer molar superior o inferior y que hayan asistido a control clínico a los 7 días. Se excluyeron fichas clínicas ilegibles o sin evolución, pacientes que tuvieran antecedentes de pericoronaritis hasta 7 días previos y pacientes inmunocomprometidos. La frecuencia de complicaciones postoperatorias se relacionó según dificultad de la intervención (leve/moderada/alta) y si el diente era maxilar o mandibular. Se realizó un análisis descriptivo y estadístico de los datos obtenidos mediante prueba exacta de Fisher para evaluar asociación entre las variables utilizando programa estadístico STATA v. 15. Entre enero y octubre de 2020 se realizaron 146 exodoncias de terceros molares; 61 fueron de dificultad leve (41,7 %), 58 dificultad moderada (39,8 %) y 21 dificultad alta (18,5 %). El total de complicaciones postexodoncia alcanza 5,4 % (n=8) donde la complicación más frecuente es alveolitis. Las complicaciones postexodoncia se relacionan significativamente con el nivel de dificultad leve (p0,05).

The Communnity Health Center (CESFAM) of San Pedro de Atacama, is the only establishment of health assistance in the community and surroundings, it is imperative for Dental Surgeons to be decisive and deliver an effective solution to local demand. Determinate the prevalence of post-extraction complications of third molars in patients treated at CESFAM San Pedro de Atacama between January and October 2020. Descriptive cross- sectional study between January and October 2020. It has been done a retrospective review of manual clinical records and electronic database of dental care performed at CESFAM. Patients over 18 years old, systemically healthy or compensated ASA II, who had extracted an upper or lower third molar and who had attended a 7-day clinical check-up were included in the study. Were excluded Illegible or no follow up clinical records, patients with a history of pericoronitis up to 7 days previously, and immunocompromised patients. The frequency of postoperative complications was related to the difficulty of the intervention (mild / moderate / high) and whether the tooth was maxillary or mandibular. A descriptive and statistical analysis of the data obtained by Fisher's exact test was carried out to evaluate the association between the variables using the statistical program STATA v. 15. Between January and October 2020, 146 third molar extractions were performed; 61 were of mild difficulty (41.7 %), 58 of moderate difficulty (39.8 %) and 21 of high difficulty (18.5 %). The result of post-extraction complications reached 5.4 % (n = 8), where the most frequent complication was alveolitis. Post-extraction complications are significantly related to the level of mild difficulty (p 0,05).

Effectiveness of different socket dressing materials on the postoperative pain following tooth extraction: a randomized control trial.

We aimed to prospectively evaluate and compare the effectiveness of Alvogyl and Cutanplast as intra-alveolar dressings for managing pain associated with extraction and incidence of dry socket. All patients who underwent maxillary and mandibular teeth extraction and fulfilled our inclusion and exclusion criteria from Feb 2021 to Oct 2021 were included in our study. Patients who were diagnosed with postoperative pain after tooth extraction were randomly allocated to three groups: Group A (Alvogyl), Group B (Cutanplast), and Group C (placebo). Pain relief and healing of the socket were compared between these groups. The collected data were analyzed using the Chi-square test and Z test of proportionality. Alvogyl was superior to the other medication for providing initial pain relief, and the incidence of dry socket was significantly lower than in the Cutanplast and placebo groups (p<0.05). However, wound healing was statistically non-significant among groups A, B, and C (p>0.05). Alvogyl is still the material of choice in terms of pain relief, wound healing, and low incidence of dry socket. Furthermore, no statistically significant difference was detected between the groups in the biographic information, location, and condition of the extracted tooth, presence of a radiologic pathology, or type of extraction procedure. Moreover, whether it is the first extraction or not, Alvogyl and Cutanpast are comparable in postoperative pain management as intra-alveolar dressing materials.

Clinical management of alveolar osteitis. A systematic review / Manejo clínico de la osteítis alveolar. Una revisión sistemática

Background: Alveolar Osteitis (AO) is one of the most common complications of tooth extraction. Several thera-peutic interventions have been described for the treatment of AO, however, there are no treatment standardizedprotocols. The aim of this study was to conduct a systematic review on the efficacy in pain control of the differenttreatments for AO. The feasibility of the application of these interventions is also discussed.Material and Methods: A structured electronic and hand search strategy was applied to PubMed, Scopus, Co-chrane Library, OpenGrey, and Google Scholar between January 2010 and July 2020 to identify studies accordingto PRISMA guidelines. The inclusion criteria were original English and Spanish clinical trials that analyzed pain-control parameters according to visual analog scale (VAS, 0-10 scale), or pain relief patients’ percentages. Thosetreatments that reach VAS ≤ 4 on day 2 or before; or ≥ 85% of patients with absence of pain symptoms at day 7 orbefore were considered acceptable for their recommendation.Results: The final review included 17 clinical trials. Among them, there were analyzed a total of 39 different AOtreatments. 53,8% of the treatments fulfill the proposed parameters for pain control.Conclusions: Treatment alternatives are multiple, heterogeneous, and difficult to compare. The management ofAO is summarized in basic (intra-alveolar irrigation) and specific procedures (Alveogyl®, Neocones®, SaliCeptPatch®, Low-Level Laser, Platelet-Rich Fibrin) that reach pain control success. They could be selected accordingto their availability and advantages or disadvantages.(AU)

Guaiacol/ß-cyclodextrin for rapid healing of dry socket: antibacterial activity, cytotoxicity, and bone repair-an animal study.

PURPOSE: Dry socket (DS) is one the most common and symptomatic post-extraction complications; however, no consensus on its treatment has been reached. This study aimed to develop a novel dressing material for DS containing the phenolic agent guaiacol and evaluate its biological properties. METHODS: An inclusion complex of guaiacol and ß-cyclodextrin (Gu/ßcd) was prepared by freeze-drying. Its antibacterial activity over six oral bacteria was analyzed using the microdilution method, and its cytotoxicity in osteoblasts was assessed with the MTT assay. The alveolar healing process induced by Gu/ßcd was evaluated histologically after the treatment of DS in rats. RESULTS: ßcd complexation potentiated Gu's antibacterial effect and reduced its cytotoxicity in osteoblasts. Bone trabeculae were formed in the alveolar apices of rats treated with Gu/ßcd by day 7. On day 14, woven bone occupied the apical and middle thirds of the sockets; on day 21, the entire alveolus was filled by newly formed bone, which was in a more advanced stage of repair than the positive control (Alvogyl™). CONCLUSION: The improvement in Gu's biological properties in vitro and the rapid alveolar repair in comparison with Alvogyl™ in vivo demonstrated the benefits of the Gu/ßcd complex as a future alternative for the treatment of DS.

La alveolitis dental en pacientes adultos del Policlínico René Bedia Morales. Municipio Boyeros / Dental Alveolitis in adult patients in René Bedia Morales policlinic at Boyeros municipality

RESUMEN Introducción: la alveolitis dentaria es una complicación pos-textracción dental, local, dolorosa y reversible del alveolo. Objetivo: caracterizar la alveolitis dental en pacientes adultos del Policlínico "René Bedia Morales", perteneciente al municipio Boyeros. Mareriales y métodos: se realizó un estudio descriptivo de corte transversal, en el Policlínico "René Bedia Morales", municipio Boyeros, provincia La Habana, en el periodo comprendido de septiembre de 2016 a septiembre de 2017. El universo estuvo constituido por 250 pacientes, de ambos sexos. Diagnosticados con alveolitis dental tras haberse realizado exodoncia durante ese periodo. La muestra quedó conformada por 187 pacientes que cumplieron con los criterios de inclusión y exclusión. Se estudiaron las variables: edad, sexo, tipo de alveolitis y factores asociados a las mismas. La información fue recogida en un modelo de recogida de datos, bajo su consentimiento informado. Resultados: el grupo de edad más afectado fue el de 35-59 años, con 47,59 %. Predominó el sexo femenino, con un 66,84 %. Prevaleció la alveolitis seca, en un 55,08 %. Relacionado con las conductas inadecuadas del paciente, la afectación fue de un 40,64 %. El no cumplimiento de las indicaciones postoperatorias y fumar, luego de la exodoncia, fueron los factores más asociados a la alveolitis seca; con un 53,48 % y un 41,18 %, respectivamente. Conclusiones: la alveolitis afectó fundamentalmente a los pacientes de 35-59 años de edad, del sexo femenino. Con mayor frecuencia predominó la alveolitis seca relacionada a las conductas inadecuadas del paciente (AU).

ABSTRACT Introduction: Dental alveolitis is a local, painful dental pos extraction complication which is reversible. Objective: Provide a characterization of dental alveolitis in René Bedia Morales policlinic at Boyeros Municipality. Materials and methods: A descriptive transversal study was performed in René Bedia Morales policlinic at Boyeros Municipality, in Havana Province. The study was performed in a time span between September 2016 to September 2017. The study universe was constituted by 250 patients of both sexes diagnosed with dental alveolitis after have made extractions in that period of time and the sample remained formed for 187 patients , that met with the criteria of inclusion and exclusion. Age, sex, type of alveolitis and associated factors were the variables considered in the present study. The data was collected in a input data form, under the patients concern. Results: The most affected age group was from 35 to 59 years old which represents a 47,59 %, being the feminine sex the predominant group which represents a 66,84 %. Dry alveolitis was predominant in 55,08 % related to inadequate behaviors within a 40,64 % The most frequent factors associated to the non-fulfillment of the pos operatory orders, such as smoking after having performed the procedure of exodontia with a 53,48 % and 41,18 % respectively. Conclusions: Alveolitis mainly affects patients within 35-59 years old, feminine sex, and also related to inadequate behaviors of the patients (AU).

La alveolitis dental en pacientes adultos del Policlínico René Bedia Morales. Municipio Boyeros / Dental Alveolitis in adult patients in René Bedia Morales policlinic at Boyeros municipality

RESUMEN Introducción: la alveolitis dentaria es una complicación pos-textracción dental, local, dolorosa y reversible del alveolo. Objetivo: caracterizar la alveolitis dental en pacientes adultos del Policlínico "René Bedia Morales", perteneciente al municipio Boyeros. Mareriales y métodos: se realizó un estudio descriptivo de corte transversal, en el Policlínico "René Bedia Morales", municipio Boyeros, provincia La Habana, en el periodo comprendido de septiembre de 2016 a septiembre de 2017. El universo estuvo constituido por 250 pacientes, de ambos sexos. Diagnosticados con alveolitis dental tras haberse realizado exodoncia durante ese periodo. La muestra quedó conformada por 187 pacientes que cumplieron con los criterios de inclusión y exclusión. Se estudiaron las variables: edad, sexo, tipo de alveolitis y factores asociados a las mismas. La información fue recogida en un modelo de recogida de datos, bajo su consentimiento informado. Resultados: el grupo de edad más afectado fue el de 35-59 años, con 47,59 %. Predominó el sexo femenino, con un 66,84 %. Prevaleció la alveolitis seca, en un 55,08 %. Relacionado con las conductas inadecuadas del paciente, la afectación fue de un 40,64 %. El no cumplimiento de las indicaciones postoperatorias y fumar, luego de la exodoncia, fueron los factores más asociados a la alveolitis seca; con un 53,48 % y un 41,18 %, respectivamente. Conclusiones: la alveolitis afectó fundamentalmente a los pacientes de 35-59 años de edad, del sexo femenino. Con mayor frecuencia predominó la alveolitis seca relacionada a las conductas inadecuadas del paciente (AU).

ABSTRACT Introduction: Dental alveolitis is a local, painful dental pos extraction complication which is reversible. Objective: Provide a characterization of dental alveolitis in René Bedia Morales policlinic at Boyeros Municipality. Materials and methods: A descriptive transversal study was performed in René Bedia Morales policlinic at Boyeros Municipality, in Havana Province. The study was performed in a time span between September 2016 to September 2017. The study universe was constituted by 250 patients of both sexes diagnosed with dental alveolitis after have made extractions in that period of time and the sample remained formed for 187 patients , that met with the criteria of inclusion and exclusion. Age, sex, type of alveolitis and associated factors were the variables considered in the present study. The data was collected in a input data form, under the patients concern. Results: The most affected age group was from 35 to 59 years old which represents a 47,59 %, being the feminine sex the predominant group which represents a 66,84 %. Dry alveolitis was predominant in 55,08 % related to inadequate behaviors within a 40,64 % The most frequent factors associated to the non-fulfillment of the pos operatory orders, such as smoking after having performed the procedure of exodontia with a 53,48 % and 41,18 % respectively. Conclusions: Alveolitis mainly affects patients within 35-59 years old, feminine sex, and also related to inadequate behaviors of the patients (AU).

An unusual microscopic pattern of foreign body reaction as a complication of dry socket management.

Foreign body reactions in the oral cavity are relatively common, frequently resulting from iatrogenic causes. Depending on the nature of the foreign material, various microscopic patterns may be observed, causing diagnostic difficulties. Recognition of the ensuing unusual microscopic pattern, especially for cases in which the possibility of a foreign body reaction is not entertained in the clinical differential diagnosis, necessitates sufficient degree of suspicion, familiarization with the spectrum of microscopic appearances, and careful clinicopathologic correlation. Medicated dressings of various compositions are commonly placed for prevention or management of dry socket (or alveolar osteitis, a common postoperative complication of tooth extraction) and may be a cause of foreign body reaction. Here, we report a foreign body reaction to a medical dressing material in a postextraction socket, with an unusual microscopic pattern bearing resemblance to parasitic infestation.

Características clínico-epidemiológicas de la osteítis alveolar / Clinical-epidemiological characteristics of alveolar osteitis

Introducción: la osteítis alveolar es una complicación postoperatoria que acontece tras la extracción dentaria, se realizó la investigación por la frecuencia de esta enfermedad en el servicio de urgencias y la manipulación errónea de los casos. Objetivo: describir las características clínico-epidemiológicas de la osteítis alveolar en pacientes que acudieron al servicio de urgencia de la Clínica Estomatológica Docente de Güines. Métodos: se realizó un estudio descriptivo transversal de marzo del 2014 a marzo del 2015; la población objeto de estudio estuvo integrada por 94 pacientes, de 19 y más años, de diferentes sexos, con osteítis alveolar. Se realizó interrogatorio y examen clínico bucal. Se confeccionó una planilla de recolección de datos. Se empleó como medida resumen el porciento, se presentaron tablas de doble entrada, la prueba estadística se realizó usando la tabla de contingencia a través de la dócima X2, en los casos en que se alcanzó diferencias significativas se aplicó la dócima de comparación Múltiple de Duncan. Resultados: predominaron las féminas (64.89 por ciento) y el grupo de 19-34 años (46.81 por ciento). Resultó más común la osteítis seca (69.15 por ciento) con mayor frecuencia en arcada inferior (63.83 por ciento) y en molares (50.0 por ciento). Conclusiones: la osteítis alveolar predominó en féminas y en el grupo de 19-34 años. El tipo más común fue la osteítis seca con mayor frecuencia en el grupo de molares de la arcada inferior. Los factores de riesgo más frecuentes fueron la higiene bucal deficiente y el hábito de fumar y como causa de la extracción dentaria, la enfermedad pulpar(AU)

Introduction: alveolar osteitis is a postoperative complication that occurs after tooth extraction, the investigation was performed due to the frequency of this disease in the emergency department and the wrong handling of the cases. Objective: to describe the clinical and epidemiological characteristics of alveolar osteitis in patients who attended the emergency department of the Güines Clinical Stomatology Clinic. Methods: a cross-sectional descriptive study was carried out from March 2014 to March 2015; The study population consisted of 94 patients, aged 19 and over, of different sexes, with alveolar osteitis. We performed a questionnaire and oral clinical examination. A data collection sheet was made. A summary measure was used, double entry tables were presented, the statistical test was performed using the contingency table through the 12th decimal point, in The cases where significant differences were reached were applied the Duncan Multiple comparison decimal. Results: women predominated (64.89 percent) and the group aged 19-34 (46.81 percent). Dry osteitis (69.15 percent) was more common, with lower frequency in the lower arch (63.83 percent) and molars (50.0 percent). Conclusions: alveolar osteitis predominated in females and in the group of 19-34 years. The most common type was dry osteitis most frequently in the group of molars of the lower arch. The most frequent risk factors were poor oral hygiene and smoking and as a cause of tooth extraction, pulp disease(AU)

Efectividad de la antibioticoterapia en la reducción de la frecuencia de alveolitis seca postexodoncia simple. Ensayo clínico aleatorizado de grupos en paralelo, controlado y ciego simple / Efficacy of antibiotic therapy in reducing the frequency of dry socket single post exodontia. Randomized, controlled, single-blind clinical trial

Objetivo. Evaluar la eficacia de la antibioticoterapia en la reducción de la frecuencia de alveolitis seca postexodoncia simple. Material y métodos. El presente ensayo clínico paralelo aleatorizado, controlado, ciego simple, se desarrolló en la Clínica Estomatológica de la Universidad Católica los Ángeles de Chimbote (Trujillo, Perú), entre abril y agosto de 2010. Los pacientes que requerían exodoncia simple fueron distribuidos aleatoriamente en 2 grupos: el grupo de estudio de 87 pacientes recibió antibioticoterapia (amoxicilina 500mg) y el grupo control de 87 individuos recibió placebo con las mismas características físicas en dosis y frecuencia similar. Ambos grupos recibieron como terapia analgésica paracetamol 500mg. Se evaluó la presencia de alveolitis hasta los 7 días posteriores y se analizaron como covariables género, grupo etario y grupo de piezas dentarias. El análisis estadístico se realizó mediante el análisis multivariado de regresión logística, en cuya evaluación se aisló el efecto de las covariables, determinándose el odds ratio e intervalo confidencial del 95%. Resultados. Se encontraron solo 4 (2,3%) casos de alveolitis, 3 casos pertenecieron al grupo que recibió placebo y uno al grupo de estudio (OR=0,326), sin embargo no hubo diferencias significativa (p=0,335). Conclusión. La antibioticoterapia no reduce la frecuencia de la alveolitis postexodoncia simple (AU)

Objective. To evaluate the efficacy of antibiotic therapy in reducing the frequency of dry socket single post exodontia. Material and methods. This parallel randomized, controlled, single-blind, was developed in the dental clinic of Universidad Los Angeles de Chimbote (Trujillo, Peru), between April and August 2010. Patients who required single exodontia were randomized into 2 groups: The study group of 87 patients received antibiotic therapy (amoxicillin 500mg) and the control group of 87 subjects received placebo with the same physical characteristics and similar doses and frequency. Both groups received paracetamol 500mg as analgesic therapy. The presence of dry sockets was assessed for 7 days and analyzed as covariates gender, age and group of teeth. Statistical analysis was performed using multivariate logistic regression, determining the odds ratio and 95% of confidence interval. Results. We found only four cases (2.3%) of dry sockets, 3 cases in the placebo group and 1 in the study group (OR=0.326), however there were no significant differences (p=0.335). Conclusion. Antibiotic therapy does not reduce the frequency of dry socket (AU)

Peripheral Facial Nerve Paralysis Triggered by Alveolar Osteitis.

Peripheral facial nerve paralysis is the most common cranial nerve disorder; it is determined by the branches of the seventh cranial nerve and results in a characteristic facial distortion that is determined in part by the nerve branches involved. Peripheral facial nerve paralysis during dental treatment is very rare; when it does occur, it can be associated with the injection of local anesthetic, prolonged attempts to remove a mandibular third molar, and subsequent infection. Our article presents the case of a patient admitted with unilateral peripheral facial nerve paralysis occurring simultaneously with alveolar osteitis.

Complexação de guaiacol com ß-ciclodextrina para tratamento de alveolite seca: avaliação in vitro e in vivo / ß-cyclodextrin complexation of guaiacol for the treatment of dry socket: in vitro and in vivo evaluation

A alveolite seca (AS) é uma das complicações pós-operatórias mais comuns e sintomáticas na odontologia, porém, até o momento não há um protocolo de tratamento definido. O composto fenólico guaiacol (Gu) é um dos materiais utilizados para revestimento intra-alveolar devido às suas propriedades analgésicas, antioxidantes e antimicrobianas. Contudo, sua desvantagem é a dificuldade de manipulação decorrente da sua baixa estabilidade, alta volatilidade e sensibilidade à oxidação. Para melhorar suas propriedades e aumentar sua aplicabilidade clínica, um complexo de inclusão de Gu com ß-ciclodextrina (ßcd) foi desenvolvido. A formação do complexo supramolecular de Gu:ßcd foi caracterizada mediante a ressonância magnética nuclear (RMN), nos experimentos de 1H e 2D ROESY. A atividade antibacteriana do Gu e Gu:ßcd frente a Escherichia coli, Staphylococcus aureus, Streptococcus mitis, Streptococcus mutans, Streptococcus sanguis e Aggregatibacter actinomycetemcomitans foi analisada pelo método da microdiluição e sua citotoxicidade em osteoblastos de calvária de rato, foi estudado com o ensaio do MTT. O processo de reparo alveolar induzido pelo Gu:ßcd foi avaliado histologicamente após tratamento de alveolite seca em molares inferiores de ratos. A RMN mostrou correlações espaciais entre os hidrogênios internos (H3 e H5) da ßcd e os hidrogênios aromáticos, H(a) e H(b) do Gu, confirmando a formação do complexo. A complexação do Gu na ßcd potencializou seu efeito antibacteriano e reduziu sua citotoxicidade em osteoblastos. O estudo in vivo evidenciou a ocorrência de ossificação no ápice alveolar dos ratos tratados com Gu:ßcd, no 7o dia. No 14o dia, as trabéculas ósseas ocuparam também o terço médio do alvéolo e no 21o dia, todo o alvéolo se encontrava preenchido por osso neoformado. Estes resultados foram similares ao controle negativo e superiores ao controle positivo (Alvogyl®). Os benefícios obtidos pela inclusão do Gu na ßcd foram demonstrados pela melhora das...

Dry socket is one of the most common and symptomatic complications in dentistry, however, there is still not a settled treatment for this condition. The phenolic compound guaiacol (Gu) is one of several alveolar dressings used in dry socket because it has analgesic, antioxidant and antimicrobial properties. Nevertheless, its disadvantage is the difficulty of manipulation due to its low stability, high volatility and sensitivity to oxidation. To improve its properties and increase its clinical applicability, an inclusion complex of Gu with ß-cyclodextrin (ßcd) was developed. The Gu:ßcd supramolecular complex was characterized by Nuclear Magnetic Ressonance (NMR), in the 1H and 2D ROESY experiments. The antibacterial activity of Gu and Gu:ßcd over Escherichia coli, Staphylococcus aureus, Streptococcus mitis, Streptococcus mutans, Streptococcus sanguis and Aggregatibacter actinomycetemcomitans was analyzed using the microdilution method and its cytotoxicity in rat calvaria-derived osteoblast was evaluated with the MTT assay. The alveolus repair process induced by Gu:ßcd was histologically studied after the treatment of dry socket in rat mandibular molars. The NMR showed spatial correlations between internal hydrogens (H3 and H5) of ßcd and aromatic hydrogens, H(a) and H(b), of Gu confirming the inclusion complex formation. Gu:ßcd complex potentiated Gu antibacterial effect and reduced its cytotoxicity in osteoblasts. The in vivo study revealed that ossification occurred in the alveolar apex of rats treated with Gu:ßcd, by day 7. In the 14th day, the trabecular bone occupied the apical and middle thirds of the socket and on the 21st day, the entire alveolus was filled by newly formed bone. These results were similar to the negative control and superior to the positive control (AlvogylTM). Benefits gained from inclusion of Gu in cyclodextrin have been particularly demonstrated by the improvement in Gu biological properties in vitro and the appropriate alveolus...

Alveolitis seca: una revisión de la literatura / Dry socket: a literature review

La alveolitis seca es la complicación posoperatoria más frecuente como resultado de la alteración en la cicatrización de la herida alveolar después de una extracción dental. El manejo de esta afección tiene por objetivo el control del dolor durante el periodo de curación del cuadro, lo cual se logra fundamentalmente mediante medidas paliativas. El objetivo de esta revisión de la literatura es obtener suficiente información sobre las causas y otros factores que podrían estar involucrados en esta complicación postoperatoria, así como las opciones de tratamiento que existen actualmente (AU)

Dry socket is the most common postoperative complication, due to problems in alveolar wound healing after tooth extraction. The management of this condition aims to control pain during the healing period, and is mainly achieved with palliative drugs. The aim of this literature review is to obtain sufficient information on the causes and any other factors that could be involved in this post-operative complication, as well as the currently available treatment options (AU)

Differential diagnosis of orofacial pain and temporomandibular disorder.

When a patient complains of orofacial pain, health care providers must make a correct diagnosis. Doing this can be difficult, since various signs and symptoms may not be specific for 1 particular problem or disorder. One initially should formulate a broad differential diagnosis that can be narrowed after analysis of the history and examination. In this article, orofacial pain is categorized as being caused by: intracranial pain, headaches, neuropathic pain, intraoral pain, temporomandibular disorder, cervical pain, pain related to anatomically associated structures, referred pain, or mental illness.

Pain levels after third molar surgical removal: an evaluation of predictive variables.

AIM: The aim of this prospective study was to evaluate the pain course after surgical removal of third molars. MATERIALS AND METHODS: The sample consisted of 100 consecutive patients. Pain intensity was assessed by means of a visual analog scale (VAS). RESULTS: At day 1, moderate and severe pain were observed predominantly in patients who had surgery in the mandible (p < 0.001) and for patients younger than 24 years (p = 0.009), while more patients who weekly consumed mate tea (Ilex paraguariensis) showed pain classified as none or light (p = 0.017). At day 2, the profile of pain moderate/severe was more prevalent for patients who had surgery in the mandible (p < 0.001) with the report of difficult surgery (p = 0.042) and with odontotomy performed (p = 0.033). In the third postoperative day, severe/moderate pain was associated with surgery in the mandible (p < 0.001) and with odontotomy (p = 0.021) and ostectomy (p = 0.028) performed, with report of long and difficult procedure (p = 0.023), surgeries which last more than sixty minutes (p < 0.026), and for those patients who developed postoperative inflammatory complications (p < 0.001). CONCLUSION: Higher pain complains could be expected for patients who have long and difficult mandibular third molar surgery characterized by odontotomy and ostectomy. CLINICAL SIGNIFICANCE: Pain after third molar surgery is a common sequele. It is indispensable for the dentists to be apt in handling and preventing it as far as possible and know possible variables that may influence or increase these pain levels. It can be a clinical advantage. Better understanding the pain characteristics may guide the dentist through preoperative decisions.

Oronasal fistula in a 53-year-old hippopotamus (Hippopotamus amphibius).

An oronasal fistula is described in a 53-year-old captive hippopotamus, the animal having shown a nasal discharge, consisting mainly of food particles, during and after feeding for at least 15 years. Necropsy of the emaciated animal revealed an oronasal fistula, measuring 4.5 x 3.5 cm, adjacent to the third left molar tooth, the first and second molars being missing. The fistula was thought to have been caused by an earlier necrotizing alveolitis and osteitis. There was no evidence of rhinitis or aspiration pneumonia. Unrelated findings consisted of a follicular thyroid adenoma and generalized muscle atrophy.

Complicaciones post alveolitis seca / Complications Post dry socket

Se describe el reporte de cuatro casos inusuales de alveolitis seca en los cuales el tratamiento fue inadecuado debido a la introducción accidental de cemento quirúrgico hasta el ápice del alveolo dentario. Esto ocasionó un cuadro severo de irritación ósea asociado con un dolor intenso en la zona alveolar. Después del endurecimiento del material dentro del alveolo, fue necesario realizar el fresado del cemento quirúrgico ocasionando un severo cuadro de irritación alveolar. A partir de estos hallazgos clínicos se sugiere evitar la colocación directa de cualquier cemento quirúrgico diluido, sino más bien, acompañarlo de una gasa para facilitar el retiro atraumático.

Immediate and late mandibular fractures after third molar removal.

PURPOSE: In this retrospective study, we analyzed immediate and late mandibular fractures after impacted lower third molar surgery. PATIENTS AND METHODS: One hundred fifty oral and maxillofacial surgeons in the north of- France were questioned about their experience with intraoperative and late mandibular fracture after third molar surgery. Cases were examined clinically and radiographically. RESULTS: Thirty-seven fractures were reported in about 750,000 extractions (incidence of 0.0049%). Only 27 cases could be precisely described: 17 intraoperative and 10 late fractures. The patients were 19 to 75 years of age, with an average age of 37 years for intraoperative fractures and 47 years for late fractures. All grades of tooth impaction were included. Only 2 patients did not have full dentition. CONCLUSIONS: The major incidence of immediate and late mandible fractures occurs in patients older than over 25 years. Men may be more likely to have late fractures (8 of 10 cases).

Alveolitis: revisión de la literatura y actualización / Alveolitis: revision of the literature and bring up to date

La alveolitis es la complicación más frecuente de la extracción dentaria. Su frecuencia varía del 1 al 4 y puede llegar del 20 al 30 por ciento en extracciones de terceros molares mandibulares. Se describen algunos factores de riesgo que aumentan su incidencia, aunque se habla de un origen multifactorial. La clínica y los síntomas subjetivos nos permiten su diagnóstico y clasificación. Para tratar las alveolitis se han utilizado localmente distintos productos para inducir la formación del coágulo: antibióticos, anestésicos, analgésicos y antiinflamatorios, asociados o no con corticoides, analgésicos y antibióticos sistémicos. También la medicina natural y tradicional ocupa un lugar importante en el tratamiento de esta urgencia estomatológica, y se destacan terapéuticas como: la apiterapia, la acupuntura y la ozonoterapia, además tecnologías de avanzada como los soft láser(AU)