ABSTRACT
Bleeding is a common complication after third molar extraction. Hemostatic agents can be helpful in controlling intraoperative bleeding. Infection is another common complication. Horseley's wax is frequently used for bone surgery and less often for dental surgery. We report an unusual case of abscess formation in the jaw after third molar extraction. Surgical exploration of the abscess disclosed the presence of surgical wax in the center of a foreign body granuloma. We discuss the use of surgical wax and other local hemostatic agents and the subsequent risk of complications.
Subject(s)
Granuloma, Foreign-Body/chemically induced , Hemostatics/adverse effects , Molar, Third/surgery , Palmitates/adverse effects , Tooth Extraction/adverse effects , Waxes/adverse effects , Adult , Dental Fistula/chemically induced , Diagnosis, Differential , Drug Combinations , Female , Granuloma, Foreign-Body/surgery , Humans , Oral Hemorrhage/drug therapy , Oral Hemorrhage/etiology , Periapical Abscess/chemically induced , Periapical Abscess/surgery , Periapical Granuloma/chemically induced , Periapical Granuloma/surgery , Postoperative Hemorrhage/drug therapy , Postoperative Hemorrhage/etiologyABSTRACT
Myospherulosis is a complication of wound healing which results from an action between lipids and extravasated erythrocytes. A case of myospherulosis of the mandible is reviewed with its history, histopathology and occurrence.
Subject(s)
Erythrocytes/pathology , Molar, Third/surgery , Periapical Granuloma/chemically induced , Petrolatum/adverse effects , Tooth Extraction/adverse effects , Wound Healing/drug effects , Adult , Diagnosis, Differential , Humans , Iatrogenic Disease , Male , Mandible , Periapical Granuloma/diagnosis , Tetracycline/adverse effectsABSTRACT
Although the primary etiological factor of periapical lesions is microbial, there are other independent factors that can adversely affect the outcome of endodontic treatment. In this communication, we present morphological evidence in support of the role of a foreign body reaction of periapical tissue to root-filling materials. The specimen consisted of a surgical biopsy of an asymptomatic periapical lesion which persisted after a decade of postendodontic follow-up. The biopsy was processed for correlated light and electron microscopy and was analyzed by various microtechniques. The unique feature of the lesion was the presence of vast numbers of large multinucleated cells and their cytoplasmic inclusion bodies. Morphologically, these multinucleated cells resembled foreign body giant cells. They contained characteristic birefringent cytoplasmic inclusions which on electron-probe X-ray microanalysis consistently revealed the presence of magnesium and silicon. The magnesium and silicon are presumably the remnants of a root-filling excess which protruded into the periapex and had been resorbed during the follow-up period. These observations strongly suggest that in the absence of microbial factors, root-filling materials which contain irritating substances can evoke a foreign body reaction at the periapex, leading to the development of asymptomatic periapical lesions that may remain refractory to endodontic therapy for long periods of time.