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1.
Braz. J. Pharm. Sci. (Online) ; 58: e201041, 2022. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1420465

RESUMO

Abstract Curcumin is a plant-derived compound with polypharmacological properties that are hampered by its poor solubility, fast degradation, etc. Wound closure complications that follow tooth extraction are numerous, and relatively frequently additional treatment is needed to prevent unwanted process chronification. The present study aims to compare the effects of free and the nanoliposome-encapsulated curcumin on tooth extraction wound closure. The experiments were performed on Wistar rats where both forms of curcumin were applied topically on a tooth extraction wound for seven days. Changes in tissue oxidative stress (malondialdehyde and oxidized proteins concentrations, and catalase activity) and inflammation (nitric oxide levels and myeloperoxidase activity) related parameters were studied three and seven days following the tooth extraction. Also, the extent of pathohistological changes and osteopontin immunohistochemical expression were studied. The obtained results indicate that both forms of curcumin prevent an increase in oxidative stress and inflammation-related parameters in the studied samples at 3-and 7-day time points. Additionally, we found that curcumin diminished tissue inflammatory response and osteopontin expression, while at the same time it caused faster granulation tissue maturation. The encapsulation of curcumin in nanoliposomes proved to be better in improving the extraction wound healing process than the free curcumin, giving this formulation a potential in the pharmaceutical industry.


Assuntos
Animais , Masculino , Feminino , Ratos , Extração Dentária/classificação , Infecção dos Ferimentos/classificação , Ferimentos e Lesões/tratamento farmacológico , Curcumina/análise , Técnicas de Fechamento de Ferimentos/classificação , Inflamação/tratamento farmacológico , Cicatrização/efeitos dos fármacos , Estresse Oxidativo
2.
Quintessence Int ; 49(9): 745-753, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30027171

RESUMO

OBJECTIVE: Surgical time prediction is an important factor to plan both clinical and organizational aspects of mandibular impacted third molar extraction. Many classifications have been proposed over the years, but their accuracy in surgical time prediction remained questionable. The present study introduced a modification of Juodzbalys and Daugela (JD) classification, and had the aim to validate its effectiveness in predicting the duration of the surgery. METHOD AND MATERIALS: Three centers treated patients needing impacted mandibular third molar extraction, following inclusion and exclusion criteria. Extractions were performed following a standardized approach, and surgical time was recorded. A blinded assessor assigned scores to each extracted tooth, according to original and modified JD classifications. Differences among the operators were evaluated though Kruskal-Wallis test, and backward multiple linear regressions were performed to evaluate the variables associated with surgical time, considered as the main outcome of the study. RESULTS: 124 patients were treated with mandibular third molar extraction. Mean surgical time was 24.1 ± 22.2 minutes, with significant differences among the centers (P = .001). Surgical times among groups derived from both former and modified JD classifications were significantly different (P = .002 and P = .001, respectively). In the multivariate analysis, the statistical model including modified JD score was more efficient than the model with former JD score in predicting surgical time (R2 = .204 and R2 = .126, respectively). CONCLUSION: Modified JD classification resulted in a reliable tool for predicting surgical time of impacted mandibular third molar extraction; this could represent an adjunctive tool for clinician and patient in the decision-making process.


Assuntos
Mandíbula/cirurgia , Dente Serotino/cirurgia , Duração da Cirurgia , Extração Dentária/classificação , Dente Impactado/cirurgia , Adulto , Feminino , Humanos , Itália , Lituânia , Masculino , Modelos Estatísticos , Estudos Prospectivos
3.
Med. oral patol. oral cir. bucal (Internet) ; 22(6): e767-e773, nov. 2017. graf, tab
Artigo em Inglês | IBECS | ID: ibc-168753

RESUMO

Background: The number of patients using direct oral anticoagulants (DOACs) instead of vitamin K antagonists (VKA) is increasing and there is limited data on the safety of tooth extractions in patients taking DOACs. The aim of this study was to compare the amount of bleeding (AOB) and postoperative complications after tooth extractions between patients taking VKAs and patients taking DOACs without altering the anticoaguation therapy. Material and Methods: The study consisted of four groups: Direct thrombin inhibitor group, factor Xa inhibitor group, warfarin group and a control group. A single tooth was extracted in each patient and routine coagulation test values were recorded prior to extraction. AOB was measured for 20 minutes after tooth extraction. The patients were evaluated on 2nd and 7th days after extraction for bleeding. Status of bleeding was classified as no bleeding, mild bleeding controlled by gauze pads, moderate bleeding controlled by hemostatic agents and severe bleeding required hospitalization. Analysis of variance, chi square test and correlation analysis were used for statistical analysis of data. Results: A total of 84 patients (48 male, 36 female) were included in this study. The mean age of patients was 57 (38-87) years. Mean AOB was 1388.6±913.0, 1909.29±1063.1, 3673±1415.4, 1593.33±672.5 mg for direct thrombin inhibitor, factor Xa inhibitor, warfarin and control groups respectively. Mean AOB was significantly higher for warfarin group, compared to other groups (p=0.001). No bleeding was occurred in control group on 2nd and 7th postextraction days and no bleeding was occurred in direct thrombin inhibitor group on 7th postextraction day. The number of bleeding events among groups was not statistically significant on 7th postextraction day (p=0.251). Conclusions: Patients taking warfarin had more bleeding compared to patients taking direct oral anticoagulants after tooth extractions. In patients taking direct oral anticoagulants simple tooth extractions can be safely carried out without altering the anticaogulant regimen with the use of local hemostatic agents (AU)


No disponible


Assuntos
Humanos , Adulto , Extração Dentária/métodos , Anticoagulantes/uso terapêutico , Complicações Pós-Operatórias/tratamento farmacológico , Grupos Controle , Procedimentos Cirúrgicos Bucais/métodos , Resultado do Tratamento , Complicações Pós-Operatórias/prevenção & controle , Extração Dentária/classificação
4.
J Craniofac Surg ; 25(6): e515-9, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25377979

RESUMO

OBJECTIVES: This article proposes a simple preoperative score to evaluate the complexity of tooth extractions of the third mandibular molar and to estimate the time involved. STUDY DESIGN: We consider 11 factors (demographic, anatomic, and radiologic) that favor the surgery and that can be identified through standard clinical and radiologic examinations. The number of favorable factors (NFF) relative to each patient constitutes his/her score. The analysis of 1500 extractions performed by various surgeons with experience from 2 to 25 years evidences a quadratic inverse correlation between NFF and the time required for the surgery. RESULTS: The shape of the time distribution suggests the existence of 3 major classes of patients characterized by time of 4 to 10 minutes, 11 to 20 minutes, and 21 to 40 minutes. The corresponding NFF brackets, as identified by their frequency distributions and validated by the receiver operating characteristic curve method, are 5 to 11 (mean [SD], 6.8 [1.6]), 2 to 4 (3.3 [1.3]), and 0 to 1 (0.8 [1.0]), respectively. CONCLUSIONS: Our results show the good performance of this score as a predictor of the surgical time and its applicability in daily practice regardless of operator experience, background, and level of surgical ability.


Assuntos
Dente Serotino/cirurgia , Duração da Cirurgia , Extração Dentária/classificação , Extração Dentária/métodos , Dente Impactado/classificação , Dente Impactado/cirurgia , Adulto , Fatores Etários , Feminino , Humanos , Masculino , Mandíbula/cirurgia , Dente Molar/cirurgia , Pontuação de Propensão , Estudos Prospectivos , Reprodutibilidade dos Testes , Fatores Sexuais
5.
Prog Orthod ; 15(1): 44, 2014 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-25033988

RESUMO

BACKGROUND: Extraction has now been accepted widely in various malocclusions including Angle's class II division 1. However, the levels of scientific evidence in orthodontic treatment planning have been weak, and it is unlikely to systematically provide a rationale and consistent basis in decisions of extraction. This study was retrospectively designed to investigate the initial morphologic characteristics of class II division 1 subjects involving four different extraction strategies, to determine the relevant influential factors when choosing extraction strategies with the most commonly used mechanics and the principle of simplicity in orthodontic treatment based on cases diagnosed and treated by an experienced orthodontist. METHODS: One hundred and ten samples of Angle's class II division 1 malocclusion with good facial and occlusal outcomes after orthodontic treatment were selected and divided into four groups according to different extraction patterns. For each case, pretreatment models and the lateral radiographs were analyzed. Significant variables of models and craniofacial structures of each group were identified by comparing the measurements using one-way analysis of variance (ANOVA) at a significance level of P < 0.05. Then, binary logistic regression analysis was used and a regression equation was established to quantify the correlations among the significant variables and their contributions to the extraction decisions. RESULTS: Molar relationship, lower anterior crowding, anterior Bolton index, and anterior overjet measured from models, as well as ANS-Xi-Pm, NBa-PtGn, Li-NsPog', U1-NPog and L1-NPog measured from lateral radiographs were found to be statistically significant. Binary logistic regression analysis revealed that lower anterior crowding, molar relationship, and growth pattern were the three most relevant influential factors with a declining impact contributing to the extraction decisions for Angle's class II division 1 malocclusions. CONCLUSIONS: Angle's class II division 1 malocclusions exhibit various morphological characteristics. Orthodontists should comprehensively consider the reciprocal impact of multiple factors when choosing different extraction strategies for Angle's class II division 1 malocclusions.


Assuntos
Má Oclusão Classe II de Angle/terapia , Planejamento de Assistência ao Paciente , Extração Dentária/classificação , Adolescente , Dente Pré-Molar/cirurgia , Cefalometria/métodos , Criança , Arco Dental/patologia , Humanos , Incisivo/patologia , Má Oclusão Classe II de Angle/patologia , Mandíbula/patologia , Maxila/patologia , Modelos Dentários , Dente Molar/patologia , Osso Nasal/patologia , Odontometria/métodos , Sobremordida/patologia , Sobremordida/terapia , Estudos Retrospectivos , Resultado do Tratamento
6.
Am J Orthod Dentofacial Orthop ; 145(5): 595-602, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24785923

RESUMO

INTRODUCTION: The aim of this study was to compare the orthodontic clinical outcomes of 2 maxillary premolar extraction, 4 premolar extraction, and nonextraction treatment protocols. METHODS: The sample for this retrospective study was selected randomly from the archives of postgraduate orthodontic clinics in various cities in Turkey. Posttreatment records including dental casts and panoramic radiographs of 1098 patients were divided into 3 groups: group 1 comprised 269 patients treated with 2 maxillary first premolar extraction, group 2 comprised 267 patients treated with 4 premolar extraction, and group 3 comprised 562 patients treated with a nonextraction protocol. Only 1 researcher evaluated all subjects using the American Board of Orthodontics objective grading system. RESULTS: There were no statistically significant differences among the 2 maxillary premolar extraction, 4 premolar extraction, and nonextraction treatment groups for alignment, marginal ridge height, buccolingual inclination, overjet, and interproximal contact measurements. Statistically significant differences were found in occlusal contacts, occlusal relationships, and root angulation measurements between the 4 premolar extraction and the nonextraction groups. CONCLUSIONS: The nonextraction patients had more teeth in occlusion than did the 4 premolar extraction patients. The nonextraction patients finished with more satisfactory sagittal dental relationships. The 4 premolar extraction group had the least satisfactory sagittal dental relationships. The nonextraction patients finished with better root angulations.


Assuntos
Dente Pré-Molar/cirurgia , Ortodontia Corretiva/normas , Extração Dentária/classificação , Adolescente , Processo Alveolar/patologia , Protocolos Clínicos , Oclusão Dentária , Feminino , Humanos , Masculino , Má Oclusão/terapia , Maxila/patologia , Modelos Dentários , Sobremordida/classificação , Radiografia Panorâmica , Estudos Retrospectivos , Fatores de Tempo , Dente/patologia , Raiz Dentária/patologia , Resultado do Tratamento
7.
Br J Oral Maxillofac Surg ; 52(1): 54-7, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24029441

RESUMO

Our aim was to investigate the correlation among antibiotic prophylaxis, difficulty of extraction, and postoperative complications in the removal of lower 3rd molars. A total of 1222 such extractions in 890 patients between January 2010 and January 2012 were analysed retrospectively. The difficulty of extraction measured by Pederson's index, antibiotic prophylaxis with cefditoren, and postoperative complications were recorded. The difficulty of extraction was significantly associated with postoperative complications (p=0.03). There were no significant associations between antibiotic prophylaxis and postoperative complications in groups of equal difficulty ("easy" group (class I) p=1.00; "moderate" group (class II) p=1.00; and "difficult" group (class III) p=0.65). There was a small but insignificant increase in the number of dry sockets and infections in class III cases. In conclusion, this study provides further evidence that antibiotic prophylaxis for the prevention of postoperative inflammatory complications is unnecessary for extraction of 3rd molars.


Assuntos
Antibioticoprofilaxia , Mandíbula/cirurgia , Dente Serotino/cirurgia , Complicações Pós-Operatórias , Extração Dentária/métodos , Adolescente , Adulto , Idoso , Anestesia Dentária/métodos , Antibacterianos/uso terapêutico , Cefalosporinas/uso terapêutico , Alvéolo Seco/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Bloqueio Nervoso/métodos , Osteotomia/métodos , Dor Pós-Operatória/etiologia , Estudos Retrospectivos , Retalhos Cirúrgicos/cirurgia , Infecção da Ferida Cirúrgica/etiologia , Extração Dentária/classificação , Trismo/etiologia , Adulto Jovem
8.
J Oral Maxillofac Surg ; 71(9): 1484-9, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23866782

RESUMO

PURPOSE: To measure the association between the menstrual cycle and the frequency of alveolar osteitis (AO). MATERIALS AND METHODS: In a study with a single-blind design, patients with bilateral impacted third molar teeth underwent randomized surgical extraction: one tooth during the menstrual period and one during the middle of the cycle. The postoperative examiner was unaware of the menstrual cycle status of the patients. The predictor variable was the timing of the menstrual cycle and was grouped as mid-cycle and menstrual period. The outcome variable was AO, which was measured (without knowledge of the menstrual cycle timing) at 2 to 7 days postoperatively. Other study variables included oral contraceptive (OC) use, smoking status, irrigation used during surgery, extraction difficulty, surgeon experience, number of local anesthetic cartridges used, and patient age. Appropriate bi- and multivariate statistics were computed, and the level of statistical significance was set at P < .05. RESULTS: A total of 145 female patients, with a mean age of 24 years, underwent 290 third molar extractions. The overall frequency of AO was 23.45%. The frequency of AO was significantly greater in the middle of the cycle than during the menstrual period inboth the OC users and nonusers (P < .05). Although OC users revealed a significantly greater frequency of AO compared with nonusers (P < .05), no statistically significant differences were found between the 2 groups during the menstrual period (P > .05). CONCLUSIONS: According to the results of the present study, the menstrual cycle could be a determinant risk factor in the frequency of AO. We recommend that elective procedures be performed during the menstrual period in both OC users and nonusers to eliminate the effect of cycle-related hormonal changes on the development of AO.


Assuntos
Alvéolo Seco/etiologia , Ciclo Menstrual/fisiologia , Dente Serotino/cirurgia , Dente Impactado/cirurgia , Adolescente , Adulto , Fatores Etários , Anestésicos Locais/administração & dosagem , Competência Clínica , Anticoncepcionais Orais/uso terapêutico , Feminino , Seguimentos , Humanos , Cuidados Intraoperatórios , Lidocaína/administração & dosagem , Mandíbula/cirurgia , Menstruação/fisiologia , Ovulação/fisiologia , Fatores de Risco , Método Simples-Cego , Irrigação Terapêutica , Extração Dentária/classificação , Dente Impactado/classificação , Adulto Jovem
9.
Int J Oral Maxillofac Implants ; 28(3): 911-6, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23748327

RESUMO

Dental implants may be successfully placed immediately into fresh extraction sockets when primary implant stability can be attained. This article presents a new classification system for molar extraction sites that describes extraction sockets based upon the bone available within the socket for stabilization of an immediately placed implant. Three categories--types A, B, and C--are employed: the type A socket, which allows for the implant to be placed completely within the septal bone, leaving no gaps between the implant and the socket walls; the type B socket, which has enough septal bone to stabilize but not completely surround the implant, leaving gaps between one or more surfaces of the implant and the socket walls; and the type C socket, which has little to no septal bone, thus requiring that the implant engage the periphery of the socket. Treatment protocols and relevant clinical examples are presented based upon the characterization of the socket according to this classification system.


Assuntos
Implantação Dentária Endóssea/métodos , Carga Imediata em Implante Dentário , Dente Molar/cirurgia , Extração Dentária/classificação , Alvéolo Dental , Implantes Dentários , Humanos , Ilustração Médica , Osseointegração , Alvéolo Dental/cirurgia
11.
J Oral Maxillofac Surg ; 70(6): 1280-5, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22310456

RESUMO

PURPOSE: Postoperative inflammatory conditions, including alveolar osteitis, surgical site infections, and abscess, are frequent complications after surgical removal of impacted mandibular third molars and multiple associated risk factors have been identified. However, few studies have evaluated the influence of extraction difficulty according to anatomic variables on postoperative inflammatory complications. PATIENTS AND METHODS: A retrospective study was performed of 585 surgically removed lower third molars. All molars were classified by a difficulty score (range 3 to 10) according to the anatomic parameters. RESULTS: For 109 third molars (19%), the extraction difficulty was rated noncomplex (score 3 to 4); for 341 (58%), moderate (score 5 to 7); and for 135 (23%), difficult (score 8 to 10). Molars rated as moderate or difficult for extraction were more often accompanied by postoperative infection than molars rated noncomplex (odds ratio 5.3 and 3.9, respectively, P < .0001). CONCLUSIONS: The results from the present study revealed a highly significant correlation between the level of difficulty for surgical removal of lower third molars (predicted by the anatomic variables) and postoperative inflammatory complications.


Assuntos
Alvéolo Seco/etiologia , Dente Serotino/patologia , Dente Serotino/cirurgia , Infecção da Ferida Cirúrgica/etiologia , Extração Dentária/efeitos adversos , Dente Impactado/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Mandíbula , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Extração Dentária/classificação , Dente Impactado/cirurgia , Adulto Jovem
12.
J Periodontol ; 83(8): 981-7, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22166163

RESUMO

BACKGROUND: Previous studies assessed bone remodeling after a single tooth extraction; however, the effect of multiple contiguous teeth extractions around immediate implant remains unknown. The aim of this microcomputed tomographic investigation is to analyze the alveolar bone remodeling around immediate implants placed in accordance with the extraction socket classification (ESC). METHODS: Under general anesthesia, 10 beagle dogs underwent atraumatic tooth extractions. Animals were randomly divided into three groups, with 16 sites per group: 1) ESC-1, single tooth extraction; 2) ESC-2, two contiguous teeth extraction; and 3) ESC-3, more than two contiguous teeth extractions. Immediate implants were inserted in each socket, and postoperative plaque control measures were undertaken. After euthanasia, the jaw segments were evaluated for bone thickness, marginal bone loss (MBL), and bone-to-implant contact (BIC) using microcomputed tomography. RESULTS: The mean buccal bone thickness (P <0.05) and MBL (P <0.05) was compromised in jaws in ESC-3 compared to those in ESC-1 and ESC-2. The BIC was significantly higher among jaws in ESC-1 compared to those in ESC-2 and ESC-3 (P <0.05). There was no significant difference in the buccal bone thickness, MBL, and BIC among the groups in the maxilla and mandible. Lingual bone remodeling did not reveal any significant differences among the groups in either jaw. CONCLUSION: Buccal bone remodeling is significantly more extensive around immediate implants placed in multiple contiguous tooth extraction sites compared to immediate implants placed in single tooth extraction sites.


Assuntos
Processo Alveolar/fisiologia , Remodelação Óssea/fisiologia , Implantes Dentários , Imageamento Tridimensional/métodos , Carga Imediata em Implante Dentário , Extração Dentária/classificação , Alvéolo Dental/cirurgia , Microtomografia por Raio-X/métodos , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/fisiopatologia , Processo Alveolar/diagnóstico por imagem , Animais , Dente Pré-Molar/cirurgia , Implantes Dentários para Um Único Dente , Cães , Feminino , Processamento de Imagem Assistida por Computador/métodos , Mandíbula/diagnóstico por imagem , Mandíbula/fisiologia , Maxila/diagnóstico por imagem , Maxila/fisiologia , Osseointegração/fisiologia , Distribuição Aleatória
13.
Eur Arch Paediatr Dent ; 11(3): 122-30, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20507809

RESUMO

AIM: This was to analyse the tooth types extracted and the reasons for extractions in 3-8 year-old Swedish children. Another aim was to determine what treatments and attendance patterns preceded the caries-related extractions. STUDY DESIGN AND METHODS: A retrospective study of all 5,045 dental records of the 3-8 year-olds at six public dental clinics in a Swedish county was performed to find all extractions performed during one year and the reason for each extraction. The dental records, that included a caries related extraction of a primary molar, were further analysed to find possible non-attended dental visits and treatments preceding the extraction. STATISTICS: The data were analysed using Pearson correlation test, Mann-Whitney U test, and Chi-2 test. RESULTS: 309 (4 permanent and 305 primary) extractions were performed in 206 (119M, 87F) (4.1%) of the patients. The primary molar was the tooth type most frequently extracted, while the central primary incisor was the tooth most frequently extracted. Reasons for extractions were; caries: 60.5%, orthodontics: 11.3%, trauma: 10.4%, other reasons: 17.8 %. Dental records from 100 children with caries-related extractions of primary molars were analysed. A previous treatment had been performed in 51.0% of the caries-related extractions of primary molars, but only 24.0% had any long term restoration material with glass ionomer cement, composite resin or compomer. Non-attendance frequency prior to caries-related extraction of primary molar was higher (P=0.004) among the non-treated children, but 40.1% of the non-treated children had no missed appointments. Caries-related extractions were more common among boys (p=0.0315). CONCLUSIONS: Every 25th child in the age group 3-8 years had extractions performed during a one-year period. Only every second primary molar had received any treatment before caries-related extraction, and only (1/4) had received long-term restorations. A considerable number (40%) of the non-treated children had no missed appointments before the caries related extractions. The routines for dental care and caries treatment in the primary dentition need a revision.


Assuntos
Cárie Dentária/terapia , Procedimentos Cirúrgicos Bucais/estatística & dados numéricos , Extração Dentária/estatística & dados numéricos , Dente Decíduo/cirurgia , Criança , Pré-Escolar , Cárie Dentária/cirurgia , Feminino , Humanos , Masculino , Dente Molar/patologia , Estudos Retrospectivos , Distribuição por Sexo , Estatísticas não Paramétricas , Suécia/epidemiologia , Extração Dentária/classificação
14.
J Oral Maxillofac Surg ; 68(3): 628-33, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20031288

RESUMO

PURPOSE: The aim of the present study is to suggest a convenient way to classify the position of the impacted third mandibular molar relative to the mandibular canal and to suggest indications for the use of each surgical approach for mandibular third molar extraction. MATERIALS AND METHODS: The presented new typing system, Third Molar Classification (TMC), is a simple and easy-to-apply method for the surgical management of mandibular third molars and can be extended for any ectopic or impacted mandibular tooth. There are 3 major types of third molar positions. The second type is subdivided further into 2 subtypes. In the present study, 9 patients with high-risk mandibular third molars were treated according to the present classification and are presented and discussed. Patients typed as TMC IIb were treated with a sagittal split osteotomy approach and patients typed as TMC III were treated with an extraoral approach. RESULTS: The operative classification was successfully implemented in very rare cases of deeply impacted mandibular third molars. In 3 of 9 cases (33%) minor complications included some degree of hypoesthesia using the extraoral approach; these complications resolved spontaneously without the need for any intervention. CONCLUSIONS: The present study describes the use of a new surgical classification system for treatment planning in all types of mandibular third molar extractions. We believe that the present classification could help the oral and maxillofacial surgeon in decision-making and limit the possible risks that are present when attempting to extract impacted mandibular third molars.


Assuntos
Dente Serotino/cirurgia , Extração Dentária/métodos , Dente Impactado/classificação , Dente Impactado/cirurgia , Adulto , Fístula Dentária/cirurgia , Cisto Dentígero/cirurgia , Humanos , Masculino , Mandíbula/cirurgia , Nervo Mandibular/anatomia & histologia , Pessoa de Meia-Idade , Dente Serotino/diagnóstico por imagem , Radiografia , Extração Dentária/classificação , Dente Impactado/complicações
15.
Niger Postgrad Med J ; 16(2): 105-8, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19606189

RESUMO

AIM: This study was intended to assess the clinical reliability of the Pederson index as an instrument for preoperative determination of surgical difficulty in third molar surgery. METHODS: Pederson index was used to predict the difficulty of 79 cases of impacted mandibular third molar extractions. The predictions were compared with actual surgical difficulty determined by operation time. The reproducibility as well as the reliability of the index was determined. RESULTS: The index was found to be highly reproducible (P=0.00). The sensitivity and specificity were 94.9% and 45% respectively. The Positive predictive value (PPV) was 67.2% and the negative predictive value was 90% while the accuracy was 69.6%. CONCLUSION: The Pederson index though reproducible is not a reliable instrument for predicting surgical difficulty of third molar surgery when compared with actual surgical difficulty as determined by the operation time. There is a definite need to derive an index that could be used for preoperative prediction of difficulty; however it is much more important that any index so employed should provide accurate information as the consequence of wrong judgments could be quite deleterious to the patients and embarrassing to the surgeon. While it is not completely unimportant, the Pederson index should not be employed as a sole instrument for preoperative assessment of difficulty in third molar surgery.


Assuntos
Dente Serotino/cirurgia , Extração Dentária , Dente Impactado/cirurgia , Feminino , Previsões , Hospitais de Ensino , Humanos , Masculino , Mandíbula/diagnóstico por imagem , Mandíbula/cirurgia , Dente Serotino/diagnóstico por imagem , Nigéria , Valor Preditivo dos Testes , Radiografia Panorâmica , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Fatores de Tempo , Extração Dentária/efeitos adversos , Extração Dentária/classificação , Dente Impactado/diagnóstico por imagem
16.
Eur J Dent Educ ; 13(1): 52-7, 2009 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-19196294

RESUMO

The aim of this work was to determine the structure, mode of delivery, mode of assessment and staffing of the oral surgery undergraduate curriculum within UK dental schools. A questionnaire was distributed by e-mail in January 2006 to each of the 15 dental schools with undergraduate dental degree programmes in Ireland and the UK. Those providing feedback then met to clarify any areas as required. Thirteen completed questionnaires were returned. There were a total of 55 academics involved in the teaching of oral surgery at these 13 institutions. Over the three clinical years the mean number of clinical sessions was 51. The mean staff student ratio for supervision of forceps exodontia was 1:5. On average 51 teeth were extracted by each student in the clinical years. The mean staff student ratio for surgical extractions was 1:2. The mean number of surgical extractions for each student was 6. All schools formatively assessed competency in forceps exodontia and 9 of 13 assessed surgical extractions. Summative assessment of exodontia was done in six schools and surgical extractions in 4 of 13 schools. All 13 schools deliver teaching programmes designed to meet the requirements of the frameworks governing the central curriculum. There were, however, variations between individual schools in the content and delivery of the oral surgery clinical teaching programmes. There were dramatic variations in the numbers of academic staff involved and some institutions relied on their NHS colleagues to deliver the clinical teaching.


Assuntos
Currículo , Educação em Odontologia , Cirurgia Bucal/educação , Ensino , Competência Clínica , Educação Baseada em Competências , Avaliação Educacional/métodos , Europa (Continente) , Docentes de Odontologia/estatística & dados numéricos , Retroalimentação , Humanos , Irlanda , Admissão e Escalonamento de Pessoal , Preceptoria , Faculdades de Odontologia/organização & administração , Odontologia Estatal , Estudantes de Odontologia/estatística & dados numéricos , Inquéritos e Questionários , Ensino/métodos , Extração Dentária/classificação , Extração Dentária/instrumentação , Extração Dentária/métodos , Reino Unido
18.
J Oral Maxillofac Surg ; 65(5): 979-83, 2007 May.
Artigo em Inglês | MEDLINE | ID: mdl-17448851

RESUMO

PURPOSE: To investigate the influence of surgical difficulty on postoperative pain after extraction of mandibular third molars. MATERIALS AND METHODS: A prospective study was performed of 139 patients who underwent a total of 157 mandibular third molar extractions. For evaluation of surgical difficulty, a 4-class scale was completed after surgery: I, extraction with forceps only; II, extraction requiring osteotomy; III, extraction requiring osteotomy and coronal section; IV, complex extraction (root section). The duration of surgery was also recorded. Postoperative pain was evaluated using a visual analog scale that each patient completed daily until day 6 postsurgery, at which time the sutures were removed. RESULTS: A statistically significant relationship was observed between surgical difficulty (as rated on the scale) and postoperative pain. Longer interventions generally produced more pain. CONCLUSIONS: Pain after extraction of a mandibular third molar increases with increased surgical difficulty and duration of the intervention.


Assuntos
Mandíbula/cirurgia , Dente Serotino/cirurgia , Dor Pós-Operatória/etiologia , Extração Dentária/efeitos adversos , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Estudos Prospectivos , Estatísticas não Paramétricas , Extração Dentária/classificação , Extração Dentária/métodos , Resultado do Tratamento
19.
Br J Oral Maxillofac Surg ; 45(1): 23-6, 2007 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-16434132

RESUMO

We report a consecutive series of 105 extractions of impacted lower third molars, in each of which operative difficulty was predicted preoperatively using the Pederson scale (radiographic appearance of the anatomical position of the lower third molar), and postoperative difficulty was scored with a modified version of the Parant scale (operative manoeuvres that were needed for extraction of the third molar). Preoperative classification as "difficult" on the Pederson scale was not an accurate predictor of true difficulty (postoperative classification as "difficult" on the modified Parant scale). There was no significant association between the Pederson score and duration of operation, but high Parant scores were significantly associated with longer operations. We suggest that scales for the prediction of operative difficulty in the extraction of impacted lower third molars should take into account factors other than the anatomical position of the tooth.


Assuntos
Dente Serotino/cirurgia , Extração Dentária , Dente Impactado/cirurgia , Adulto , Feminino , Previsões , Humanos , Masculino , Mandíbula/diagnóstico por imagem , Mandíbula/cirurgia , Dente Serotino/diagnóstico por imagem , Radiografia Panorâmica , Sensibilidade e Especificidade , Fatores de Tempo , Extração Dentária/classificação , Extração Dentária/métodos , Dente Impactado/diagnóstico por imagem
20.
J Periodontol ; 76(11): 1910-8, 2005 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-16274310

RESUMO

BACKGROUND: Several risk indicators for periodontal disease severity have been identified. The association of these factors with tooth loss for periodontal reasons was investigated in this cross-sectional comparative study. METHODS: All extractions performed in 21 general dental practice clinics (25% of such clinics in Kuwait) over a 30-day period were recorded. Documented information included patient age and gender, medical history findings, dental maintenance history, toothbrushing frequency, types and numbers of extracted teeth, and the reason for the extraction. Reasons were divided into periodontal disease versus other reasons in univariate and binary logistic regression analyses. RESULTS: A total of 1,775 patients had 3,694 teeth extracted. More teeth per patient were lost due to periodontal disease than for other reasons (2.8 +/- 0.2 versus 1.8 +/- 0.1; P <0.001). Factors significantly associated with tooth loss due to periodontal reasons in logistic regression analysis were age >35 years (odds ratio [OR] 3.45; 95% confidence interval [CI] 2.79 to 4.26), male gender (OR 1.42; 95% CI 1.17 to 1.73), never having periodontal maintenance (OR 1.48; 95% CI 1.23 to 1.78), never using a toothbrush (OR 1.81; 95% CI 1.49 to 2.20), current or past smoking (OR 1.56; 95% CI 1.28 to 1.91), anterior tooth type (OR 3.23; 95% CI 2.57 to 4.05), and the presence of either of the following medical conditions: diabetes mellitus (OR 2.64; 95% CI 2.19 to 3.18), hypertension (OR 1.73; 95% CI 1.41 to 2.13), or rheumatoid arthritis (OR 4.19; 95% CI 2.17 to 8.11). CONCLUSION: Tooth loss due to periodontal disease is associated with the risk indicators of age, male gender, smoking, lack of professional maintenance, inadequate oral hygiene, diabetes mellitus, hypertension, rheumatoid arthritis, and anterior tooth type.


Assuntos
Doenças Periodontais/complicações , Perda de Dente/etiologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Artrite Reumatoide/complicações , Estudos Transversais , Assistência Odontológica , Complicações do Diabetes , Feminino , Humanos , Hipertensão/complicações , Kuweit , Masculino , Anamnese , Pessoa de Meia-Idade , Fatores de Risco , Fatores Sexuais , Fumar , Extração Dentária/classificação , Escovação Dentária
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