High weight standard and removal of third molars: a prospective randomized study.

OBJECTIVE: Compare the degree of exposure to adverse events during the removal of third molars between 2 groups of patients. STUDY DESIGN: Researchers designed and implemented a prospective randomized study. The study consisted of overweight and normal-weight patients subjected to the surgical removal of impacted lower third molars. A wide range of predictor variables was registered in the preoperative phase. Statistical calculations were computed. RESULTS: Five hundred sixty surgeries were performed involving 2 groups (1:1). Adverse events were found in 29.3% of surgeries in overweight patients. The same procedures performed on normal-weight patients resulted in a complication rate of 10.7%. Predictor variables significant to these events were detected. CONCLUSIONS: Overweight patients have 3 times greater risk of experiencing morbidities during the removal of lower third molars compared with patients of normal weight. Our findings have important implications for public health, given the exorbitant growth in the population of patients with high standard weight.

Is overweight a risk factor for adverse events during removal of impacted lower third molars?

Being overweight is recognised as a significant risk factor for several morbidities; however, the experience of the dentistry faculties focusing on this population is still low. The aim of the present study was to determine the occurrence of adverse events during removal of impacted lower third molars in overweight patients. A prospective cohort study was carried out involving overweight patients subjected to surgical removal of impacted lower third molar as part of a line of research on third molar surgery. Predictor variables indicative of the occurrence of adverse events during surgery were classified by their demographic, clinical, radiographic, and surgical aspects. Descriptive and bivariate statistics were computed. In total, 140 patients fulfilled the eligibility criteria, and 280 surgeries were performed. Patients' mean age was 25.1±2.2 years, and the proportion of women to men was 3:1. Eight different adverse events during surgery were recorded. These events occurred in approximately 29.3% of cases and were significantly associated with predictor variables (P<0.05). Excess weight is recognised as a risk factor for the high rate of adverse events in impacted third molar surgery. The study suggests that overweight patients are highly likely to experience morbidities.

Assessment of factors associated with surgical difficulty during removal of impacted maxillary third molars.

PURPOSE: Estimating the difficulty of removing third molars is a common dilemma. However, the estimation of the difficulty associated with maxillary third molar surgery has not yet been defined. The aim of the present study was to determine the degree of difficulty and identify predictor variables associated with the occurrence of difficulty in the removal of impacted maxillary third molars. MATERIALS AND METHODS: A prospective cohort study was carried out involving patients who underwent at least 1 surgical removal of an impacted maxillary third molar at the Oral and Maxillofacial Surgery Unit, University of Pernambuco (Pernambuco, Brazil). Predictor variables indicative of surgical difficulty were classified by their demographic, clinical, and radiographic aspects. Degree of surgical difficulty was categorized as low, moderate, or high based on the surgical technique used. Descriptive and bivariate statistics were computed. RESULTS: In total, 106 patients fulfilled the eligibility criteria and 204 surgeries were performed. Patients' mean age was 22.8 ± 2.2 years and the proportion of women to men was 3:1. Approximately 20% of patients were overweight. Surgical difficulty was generally low and 5 variables were significantly associated with the occurrence of a high degree of surgical difficulty. CONCLUSION: Surgical difficulty during the removal of impacted maxillary third molars is generally low. However, for cases with a high degree of difficulty, identification of predictor variables may be useful for students and inexperienced clinicians to consider the decision not to execute the procedure, thus avoiding complications that often require complex management.

Retrograde migration of a ventriculoperitoneal shunt to the neck after dental treatment.

The ventriculo-peritoneal shunt (VPS) is the technique most often employed for the treatment of hydrocephaly, but may present complications after placement. Retrograde migration of the peritoneal catheter to the cervical region is rarely reported. This manuscript to describes a case of migration of the distal portion of the VPS system to the neck after dental treatment in a child and discusses the possible causes for this complication.

Prevalence and predictive factors of dental anxiety in Brazilian adolescents.

PURPOSE: The purpose of this study was to determine the prevalence and predicitve factors of dental anxiety among Brazilian adolescents. METHODS: This was a cross-sectional study of a random sample of 340 Brazilian adolescents, done between 2005 and 2010. Corah's Dental Anxiety Scale and an objective questionnaire were used to determine the degree of dental anxiety. RESULTS: The prevalence of moderate to severe dental anxiety was approximately 18%. Dental anxiety was correlated with the following factors: gender (P<.05), age group (P<.001), degree of schooling (P<.001), access to newspapers and/or the Internet (P<02), oral hygiene frequency (P=.005), visits to the dentist (P<.02), reason for last visit to the dentist (P<.001), and experience with dental pain (P=.002). CONCLUSIONS: Dental fear and anxiety in Brazilian adolescents are associated with lack of economic resources, negligence of oral health, low educational level, female gender, and younger age.

Clinical study of hemodynamic changes comparing 4% articaine hydrochloride with 1:100,000 and 1:200,000 epinephrine.

OBJECTIVE: To evaluate hemodynamic changes with the use of 4% articaine and 2 different concentrations of epinephrine (1:100,000 and 1:200,000) in the surgical removal of symmetrically positioned lower third molars. STUDY DESIGN: A prospective, randomized, double-blind clinical trial was carried out involving 42 patients each undergoing 2 surgeries on separate occasions under local anesthesia with 4% articaine and either epinephrine 1:100,000 or 1:200,000. The following parameters were assessed at 4 different moments: systolic, diastolic, and mean blood pressure; heart rate; oxygen saturation; rate pressure product (RPP); and pressure rate quotient (PRQ). RESULTS: The concentration of epinephrine did not affect diastolic blood pressure or oxygen saturation during the surgeries. Significant differences between were detected for heart rate, RPP, and PRQ (P < .05). CONCLUSIONS: The epinephrine concentration (1:100,000 or 1:200,000) in a 4% articaine solution influences hemodynamic parameters without perceptible clinical changes in healthy patients undergoing lower third molar removal.

[Anxiety regarding dental treatment: prevalence and predictors among Brazilians]. / Ansiedade frente ao tratamento odontológico: prevalência e fatores predictores em brasileiros.

Considering the negative impact anxiety can exert over dental treatment, the scope of this study was to determine the prevalence of predictors of anxiety regarding dental treatment among Brazilians. A cross-sectional study was carried out using the Corah dental anxiety scale to assess the degree of anxiety regarding dental treatment among 3000 patients. The results reveal that two out of every eight Brazilian patients manifest moderate to severe anxiety regarding dental treatment. In this sample, the degree of anxiety was higher among females (p=0.007), over 20 years of age (p=0.006), without access to the Internet and/or newspapers (p=0.016), with a low frequency of oral hygiene (p=0.001), for whom the reason for the dental appointment was curative treatment, pain or another problem rather than a check up (p=0.047) and those suffering from toothache (p<0.001). Fear and anxiety regarding dental treatment indeed exist in the Brazilian population and the findings of this study suggest that, besides the lack of economic resources, negligence with respect to oral health, gender and age may increase the degree of anxiety.

Guided surgery in unusual palatal torus.

Palatine torus is a benign congenital outgrowth of bone that affects the hard palate and palatine processes, resulting from the "overworking" of osteoblasts and bone deposition along the line of the palatine fusion. Surgical excision is the only treatment for torus, and such patients are susceptible to intraoperative and postoperative complications of a traumatic, functional, or infectious nature. This article describes an atypical case of torus palatinus measuring 20.31 × 27.25 × 59.20 mm, which is the largest size ever described in the literature. This case required the use of a surgical guide in the intraoperative phase, with viable use in the postoperative phase as well. This guide proved versatile in reducing the risk of undercorrection and complications, offering greater patient comfort.

Brain abscess of odontogenic origin.

Brain abscess is a rare and threatening infection, which is in a suppuration area, caused either by trauma, neurosurgical complication, or by a secondary infection of dental origin complication. The infectious process spread from the start focus can occur in 2 ways: hematogenous or by contiguity. The treatment should ideally be based on the etiological factor excision, combined with drainage and antibiotics as adjuvant; this philosophy is not observed in the reports described in the 1960s, 1970s, and 1980s. This study's goal was to report a case of brain abscess consequent of an odontogenic outbreak, where an adequate treatment was set up, but it was already in advanced stages and had as a result the lethal outcome. Complications from the odontogenic infections have a low incidence, but should never be disregarded, because they can lead to death, as described in this manuscript.

Ameloblastic fibro-odontoma in children: report of 2 cases.

Ameloblastic fibro-odontoma is a rare, mixed, benign, odontogenic tumor of significant prevalence in the mandible, with epithelial and mesenchymal components. It usually affects pediatric patients and is associated with teeth, causing a delay in eruption chronology or an alteration in the dental eruption pathway. It is occasionally diagnosed during radiographic evaluations of these patients. The literature is unclear whether it is a distinct pathological entity or a stage of odontoma. As it is benign and has a low recurrence rate, conservative treatment is recommended. The purpose of this paper was to present 2 cases of ameloblastic fibro-odontoma in the mandibles of children.

Tooth embedded in tongue following firearm trauma: report of two cases.

Injuries caused by projectiles from firearms involve diverse patterns of dentoalveolar trauma due to the different types of wound and extent of tissue damage. This article reports two cases in which tooth fragments were embedded in the tongue following aggression from a firearm projectile in the facial region. Radiographs confirmed the presence of foreign bodies, which were surgically removed under local anesthesia. When dentoalveolar trauma occurs in facial injuries, both hard and soft tissues must be carefully examined to avoid overlooking embedded tooth fragments not located immediately in the soft tissue.

[Psychosocial aspects of teenager in Aracaju, Sergipe State, related to oral health perception]. / Aspectos psicossociais dos adolescentes de Aracaju (SE) relacionados à percepção de saúde bucal.

The objective of this article is to investigate the autoperception of teenagers, age range of 12 to 19 years old in Aracaju, Sergipe State, about their health and relate it with psychosocial aspects. The present work is a quali-quantitative study of transversal cut, carried through with 247 adolescents registered institutions of education, private or public, of the urban zone of the city of Aracaju. Most of the adolescents (85%) consider themselves healthful, while 9% have shame of the oral conditions. Seventy-one percent of the students referred to pain, however it wasn't the main cause to search dentistry services. The subjective pointers of this research may be used to guide programs directed toward education in health.

Hereditary gingival fibromatosis: a report of four cases in the same family.

Hereditary gingival fibromatosis is characterized by a slow, progressive increase in the gingival tissue that develops as either an isolated disorder or as part of the clinical characteristics of diverse syndromes. The present case report describes a Brazilian family with individuals from three generations affected. The proposed treatment was maxillary and mandibular gingivectomy with 12 months of monitoring.