Pericoronitis treatment with antimicrobial photodynamic therapy using a new formula of methylene blue: A case report.

Pericoronitis is a common disease that impacts the quality of life of individuals during the eruption of the third molars. Among the main clinical signs and symptoms reported were the presence of gingival operculum, pain, difficulty swallowing, and trismus with functional impairment. The present study shows a case report of pericoronitis treated with antimicrobial photodynamic therapy (aPDT), using a new oral formulation (INPI BR 1020170253902) of methylene blue. A female patient, 27 years old, presenting initial pericoronitis, had her pain, mouth opening, and swelling evaluated. She was submitted to a protocol of irrigation with sterile saline and photodynamic therapy using the new MB at 0.005% concentration and irradiation with low-intensity laser λ = 660 nm, 9 J per point, and radiant exposure of 318 J/cm2. The variables were evaluated on 4th day after aPDT. There was a 100% improvement in pain and an increase of 1,3 cm in mouth opening. There was no difference in the edema before and after aPDT using the new MB formula. Although the results are based on a single case report, suggest the hypothesis that aPDT using the new MB formula is an efficient therapy in the treatment of pain and trismus caused by the early stage of pericoronitis. Well-conducted randomized clinical trials are needed to compare this new formulation with conventional aPDT for further generalization of results.

Coronectomia em terceiro molar superior: relato de caso / Maxillary third upper molar coronectomy: case report

Introdução: A extração de terceiros molares é um dos procedimentos mais realizados em cirurgias orais. As indicações para esse procedimento estão ligadas à doença cárie, doença periodontal, pericoronite, entre outras. Objetivo: O objetivo deste artigo é apresentar um relato de caso e discussão com a técnica aplicada a um terceiro molar superior com risco de comunicação oroantral, demonstrando os benefícios deste procedimento. Relato de Caso: Paciente sexo masculino, 49 anos, ausência de comorbidades, encaminhado para remoção de terceiro molar superior por dificuldade de higienização e acúmulo de placa bacteriana, ao exame tomográfico, apresentou proximidades das raízes com o seio maxilar, onde foi optado pela contra indicação de extração devido a grande chance de comunicação oroantral e sugerido coronectomia para resolução do caso. Conclusão: A coronectomia é uma técnica bastante difundida nos casos em que o terceiro molar está intimamente relacionado ao nervo alveolar inferior, com chances de parestesia. Não há relatos na literatura dessa técnica aplicada ao terceiro molar superior... (AU)

Introduction: Extraction of third molars is one of the most commonly performed procedures in oral surgeries. The indications for this procedure are linked to caries disease, periodontal disease, pericoronitis, among others. Case Report: Male patient, 49 years old, absent from comorbidities, referred for removal of the upper third molar due to difficulty in cleaning and bacterial plaque accumulation, on tomographic examination, proximity of the roots to the maxillary sinus, where it was opted for the contraindication of extraction due to great chance of oroantral communication and suggested coronectomy to resolve the case. Objective: The purpose of this article is to present a case report and discussion with the technique applied to a maxillary third molar at risk of oroantral communication, demonstrating the benefits of this procedure. Conclusion: Coronectomy is a widespread technique in cases where the third molar is closely related to the lower alveolar nerve, with chances of paresthesia. There are no reports in the literature of this technique applied to the upper third molar... (AU)

Ten reasons to not ignore the third molar

ABSTRACT Introduction: The third molars are forgotten because they are the last in the dental arch, they do not directly influence the smile and they appear only in adolescence, when they do. Objectives: 1) to provide the clinician with a "checklist" to assess and diagnose changes to be screened in the third molar region in new patients; 2) to reveal the importance of not discharging the patient submitted to any dental treatment without first analyzing the third molars region clinically and on imaging examinations, since many diseases are associated to them. Result: A list of 10 situations that cover all diagnostic possibilities involving the third molars is presented. Conclusion: Adopting this protocol is a matter of habit, since the need is fundamental. The next professional assisting your patient may ask: "Did he not request examinations for the third molars?".

RESUMO Introdução: Os terceiros molares são esquecidos por serem os últimos dentes na arcada dentária, por não influenciarem diretamente no sorriso e por aparecerem apenas na adolescência - quando aparecem. Objetivos: 1) Fornecer ao clínico um checklist de conferência e diagnóstico de alterações a serem checadas na região dos terceiros molares em novos pacientes; e 2) Destacar a importância de não dar alta ao paciente submetido a qualquer tratamento odontológico sem antes analisar, clínica e imagiologicamente, a região dos terceiros molares, pois muitas doenças estão a eles associadas. Resultado: Criou-se uma lista de 10 situações que englobam todas as possibilidades diagnósticas envolvendo os terceiros molares. Conclusão: Adotar esse protocolo é uma questão de hábito, pois a necessidade é imperiosa. O próximo profissional a atender o seu paciente vai perguntar: "Ele não solicitou exames para os terceiros molares?".

Does the third molar position influence periodontal status and overall condition of patients with acute pericoronitis? A cross-sectional study.

PURPOSE: The teeth positioning may be an important associated factor for the pericoronitis' clinical signs. Our objective was to verify the association between lower third molar position according to the Pell and Gregory classification and clinical variables in patients with pericoronitis. METHODS: Cross-sectional analysis of panoramic radiographs and medical records of patients with pericoronitis. Primary outcomes: pain and oral health-related quality of life (OHRQoL); secondary outcomes: mouth opening, edema/erythema extension, visible plaque index, bleeding on probing index, periodontal pocket probing depth, and distal alveolar bone crest height of the adjacent second molar. RESULTS: The edema/erythema extension was higher in the IIA position compared with the IA position (p = 0.03). Regarding the OHRQoL, the OHIP-14 score was 21.0 (± 9.26, range from 4 to 44). The most scored domain was physical pain (5.24), followed by psychological discomfort (4.43). Third molars in IIA position are associated with worse OHRQoL than IB and IIB positions (p = 0.03). CONCLUSIONS: There was a higher extension of edema/erythema and worse OHRQoL when the third molar was in IIA position. Prophylactic removal of mandibular third molar in position IIA may avoid the onset of mucosal edema/erythema and prevent pericoronitis from promoting impairment of individuals' quality of life.

Microbial profile of symptomatic pericoronitis lesions: a cross-sectional study.

OBJECTIVE: The microbial composition of pericoronitis (Pc) is still controversial; it is not yet clear if the microbial profile of these lesions is similar to the profile observed in periodontitis (Pd). Therefore, the aim of the present study was to describe the microbial profile of Pc lesions and compare it directly with that of subjects with Pd. METHODOLOGY: Subjects with Pc and Pd were selected, and subgingival biofilm samples were collected from (i) third molars with symptomatic Pc (Pc-T), (ii) contralateral third molars without Pc (Pc-C) and (iii) teeth with a probing depth >3 mm from subjects with Pd. Counts and proportions of 40 bacterial species were evaluated using a checkerboard DNA-DNA hybridization technique. RESULTS: Twenty-six patients with Pc and 18 with Pd were included in the study. In general, higher levels of microorganisms were observed in Pd. Only Actinomyces oris and Eubacterium nodatum were present in higher mean counts in the Pc-T group in comparison with the Pc-C and Pd-C groups (p<0.05). The microbiota associated with Pc-T was similar to that found in Pc-C. Sites with Pc lesions had lower proportions of red complex in comparison with the Pd sites. CONCLUSION: The microbiota of Pc is very diverse, but these lesions harbour lower levels of periodontal pathogens than Pd.

Microbial profile of symptomatic pericoronitis lesions: a cross-sectional study

Abstract Objective: The microbial composition of pericoronitis (Pc) is still controversial; it is not yet clear if the microbial profile of these lesions is similar to the profile observed in periodontitis (Pd). Therefore, the aim of the present study was to describe the microbial profile of Pc lesions and compare it directly with that of subjects with Pd. Methodology: Subjects with Pc and Pd were selected, and subgingival biofilm samples were collected from (i) third molars with symptomatic Pc (Pc-T), (ii) contralateral third molars without Pc (Pc-C) and (iii) teeth with a probing depth >3 mm from subjects with Pd. Counts and proportions of 40 bacterial species were evaluated using a checkerboard DNA-DNA hybridization technique. Results: Twenty-six patients with Pc and 18 with Pd were included in the study. In general, higher levels of microorganisms were observed in Pd. Only Actinomyces oris and Eubacterium nodatum were present in higher mean counts in the Pc-T group in comparison with the Pc-C and Pd-C groups (p<0.05). The microbiota associated with Pc-T was similar to that found in Pc-C. Sites with Pc lesions had lower proportions of red complex in comparison with the Pd sites. Conclusion: The microbiota of Pc is very diverse, but these lesions harbour lower levels of periodontal pathogens than Pd.

Bifid mandibular canal ­an anesthetic challenge for maxillofacial surgeons­ case report

Bifid mandibular canal is a variation of the normal anatomy. such anomalies can result in difficult anesthesia while performing surgeries of the posterior mandible under local anesthesia. moreover there is a high chance of damaging the neurovascular bundle leading to complications. here we present a case of a bifid mandibular canal which posed difficulty in achieving appropriate anesthesia. the inferior alveolar nerve is of special interest for maxillofacial and oral surgeons. its relation with mandibular third molar plays an important role while performing disimpaction surgery, in cases of bilateral sagittal split osteotomy, prosthesis placement in resorbed ridges, mandibular trauma procedures, and may be traumatized by penetration of the implant drill.

Pericoronarite: etiologia, epidemiologia, microbiota, tratamento e complicações / Pericoronitis: Etiology, Epidemiology, Microbiota, Treatments and Complications

A pericoronite é uma infecção do tecido mole associada à coroa de um dente parcialmente irrompido. É mais comumente visto em relação ao terceiro molar mandibular incompletamente irrompido, incluindo a gengiva e o folículo dental. O mucoperiósteo suprajacente e fenda resultante agem como um depósito para alimentos e detritos nos quais bactérias orais se multiplicam rapidamente. Uma reação inflamatória pode resultar de toxinas liberadas pelas bactérias. De acordo com a Classificação Internacional de Doenças, a pericoronarite pode ser classificada como pericoronarite aguda e crônica, e segundo alguns autores, as complicações podem ser de âmbito mais severo e levar a situações de risco eminente de vida. O objetivo desse estudo é fazer uma revisão literária sobre a pericoronarite, envolvendo sua etiologia, epidemiologia, microbiota, tratamentos e complicações. Pesquisa em base de dados PubMed e Bireme. De acordo com essa revisão literária, encontra-se uma posição de interessante logística sobre a pericoronarite e sua etiologia, causas, tratamento e complicações. É importante salientar a gravidade que essa condição que, aparentemente simples, pode acarretar na saúde e qualidade de vida das pessoas.

Pericoronitis is an infection of the soft tissue associated with the crown of a partially erupted tooth. It is most commonly seen in relation to the mandibular third molar incompletely erupted, including the gingiva and the dental follicle. The overlying Mucoperiosteo and resultant gap act as a deposit for food and debris in which oral bacteria multiply rapidly. An inflammatory reaction can result from toxins released by bacteria. According to the International Classification of diseases, Pericoronitis can be classified as acute and chronic pericoronitis, and according to some authors, complications may be of a more severe scope and lead to situations of imminent risk of life. The aim of this study is to do a Literary Review on Pericoronitis, involving its etiology, epidemiology, microbiota, treatments and complications. Research in PubMed and Bireme database. According to this literary review, there is a position of interesting logistics on Pericoronitis and its etiology, causes, treatment and complications. It is important to emphasize the gravity that this condition, which, apparently simple, can lead to health and quality of life.

Valoración clínico-epidemiológica de pacientes con pericoronaritis aguda de los terceros molares / Clinical-epidemiological valuation of patients with acute pericoronaritis of the third molars

Se realizó un estudio observacional, descriptivo y transversal de los 68 pacientes con pericoronaritis, atendidos en los servicios estomatológicos del Policlínico Docente Camilo Torres Restrepo y del Hospital General Docente Dr Juan Bruno Zayas de Santiago de Cuba, de junio de 2016 a enero del 2017, con vistas a caracterizarles según algunas variables de interés, mediante una amplia anamnesis y un examen clínico bucal minucioso. Los resultados de la serie mostraron que la pericoronaritis fue más frecuente en jóvenes del sexo femenino (63,2 por ciento) y de las edades de 21 a 26 años (63,2 por ciento), con predominio de su forma clínica aguda serosa (76,4 por ciento); de igual modo, el molar más afectado fue el tercero inferior (95,5 por ciento) y sobresalieron como signos y síntomas el dolor intenso (55,8 por ciento) y moderado (39,7 %), el tejido enrojecido y edematoso (100,0 por ciento) y la linfoadenopatía cervical (60,0 por ciento). Pudo concluirse que es muy importante el diagnóstico clínico-radiológico para aplicar un tratamiento más eficaz y correcto, a fin de restablecer la salud del paciente y evitar complicaciones y secuelas(AU)

An observational, descriptive and cross-sectional study of the 68 patients with pericoronaritis assisted in the stomatological services of Camilo Torres Restrepo Teaching Polyclinic and Dr Juan Bruno Zayas Teaching General Hospital in Santiago de Cuba, was carried out from June, 2016 to January, 2017, aimed at characterizing them according to some variables of interest, by means of a wide anamnesis and a meticulous oral clinical examination. The results of the series showed that the pericoronaritis was more frequent in young female patients (63.2 percent) aged 21 to 26 (63.2 percent), with prevalence in its serious acute form (76.4 percent); likewise, the most affected molar was the lower third (95.5 percent) and the most notable signs and symptoms were the moderate (39.7 percent) and intense pain (55.8 percent), red and edematous tissue (100.0 percent) and cervical lymphadenopathy (60.0 percent). It was concluded that the clinical-radiological diagnosis is very important to implement a more effective and correct treatment, in order to reestablish the patient's health and avoid complications and sequelae(AU)

Valoración clínico-epidemiológica de pacientes con pericoronaritis aguda de los terceros molares / Clinical-epidemiological valuation of patients with acute pericoronaritis of the third molars

Se realizó un estudio observacional, descriptivo y transversal de los 68 pacientes con pericoronaritis, atendidos en los servicios estomatológicos del Policlínico Docente Camilo Torres Restrepo y del Hospital General Docente Dr Juan Bruno Zayas de Santiago de Cuba, de junio de 2016 a enero del 2017, con vistas a caracterizarles según algunas variables de interés, mediante una amplia anamnesis y un examen clínico bucal minucioso. Los resultados de la serie mostraron que la pericoronaritis fue más frecuente en jóvenes del sexo femenino (63,2 por ciento) y de las edades de 21 a 26 años (63,2 por ciento), con predominio de su forma clínica aguda serosa (76,4 por ciento); de igual modo, el molar más afectado fue el tercero inferior (95,5 por ciento) y sobresalieron como signos y síntomas el dolor intenso (55,8 por ciento) y moderado (39,7 por ciento), el tejido enrojecido y edematoso (100,0 por ciento) y la linfoadenopatía cervical (60,0 por ciento). Pudo concluirse que es muy importante el diagnóstico clínico-radiológico para aplicar un tratamiento más eficaz y correcto, a fin de restablecer la salud del paciente y evitar complicaciones y secuelas

An observational, descriptive and cross-sectional study of the 68 patients with pericoronaritis assisted in the stomatological services of Camilo Torres Restrepo Teaching Polyclinic and Dr Juan Bruno Zayas Teaching General Hospital in Santiago de Cuba, was carried out from June, 2016 to January, 2017, aimed at characterizing them according to some variables of interest, by means of a wide anamnesis and a meticulous oral clinical examination. The results of the series showed that the pericoronaritis was more frequent in young female patients (63.2 percent) aged 21 to 26 (63.2 percent), with prevalence in its serious acute form (76.4 percent); likewise, the most affected molar was the lower third (95.5 percent) and the most notable signs and symptoms were the moderate (39.7 percent) and intense pain (55.8 percent), red and edematous tissue (100.0 percent) and cervical lymphadenopathy (60.0 percent). It was concluded that the clinical-radiological diagnosis is very important to implement a more effective and correct treatment, in order to reestablish the patient's health and avoid complications and sequelae

Complicaciones infecciosas relacionadas con la posición de las cordales mandibulares impactadas en paciente atendidos en el primer semestre 2013 en el Hospital Dr. Leonardo Martínez. San Pedro Sula, Honduras

El estudio se realizó en las clínicas odontológicas del Hospital Dr. LeonardoMartínez Valenzuela durante el primer semestre del año 2013. Para estainvestigación de tipo descriptivo, retrospectivo y de corte transversal cuyo objetivofue identificar las complicaciones infecciosas relacionadas con la posición de lacordal según la clasificación de Winter, se tomaron en cuenta las variables de,edad, sexo, procedencia, escolaridad, la posición de la cordal según laclasificación de Winter y las patologías infecciosas relacionadas con las cordales.Siguiendo los criterios de inclusión y exclusión del estudio, se seleccionaron yrevisaron 105 historias clínicas y se estudiaron sus respectivas radiografíaspanorámicas y periapicales, entre los resultados encontramos que la mayorasistencia a este centro hospitalario por problemas de cordales se presentó en losgrupos de edad de 21 a 30 años y más de 30 años con el 41.9% en ambosgrupos. En la distribución por sexo, fue el sexo femenino la mayoría que acudió aconsulta odontológica por afección de terceras molares mandibulares. Laprocedencia de estos pacientes que acudieron a consulta en su mayoría son delárea urbana con un nivel educativo secundario en más de la mitad.Casi la mitad de cordales mandibulares se encuentran en posición vertical y unpoco menos en posición mesioangular según la clasificación de Winter. Noobstante, la posición de cordal que presenta mayor patología infecciosa es lamesioangular seguida de la posición vertical.

Pericoronitis en pacientes del departamento de ciencias odontológicas en la universidad nacional autónoma de Honduras-Valle de Sula. 2013

Estudio descriptivo, de corte transversal. Se encontró que los pacientes con más frecuencia de presentar pericoronitis son las mujeres jóvenes, en edad comprendida entre 18 a 27. El tratamiento que más se realizó fue la intervención quirúrgica seguida de la antibioticoterapia

Comparison of buccal infiltration of 4% articaine with 1 : 100,000 and 1 : 200,000 epinephrine for extraction of maxillary third molars with pericoronitis: a pilot study.

We compared the buccal infiltration of 4% articaine with 1 : 100,000 or 1 : 200,000 epinephrine without a palatal injection for the extraction of impacted maxillary third molars with chronic pericoronitis. This prospective, double-blind, controlled clinical trial involved 30 patients between the ages of 15 and 46 years who desired extraction of a partially impacted upper third molar with pericoronitis. Group 1 (15 patients) received 4% articaine with 1 : 100,000 epinephrine and group 2 (15 patients) received 4% articaine with 1 : 200,000 epinephrine by buccal infiltration. None of the patients in group 1 reported pain, but 3 patients in group 2 reported pain, which indicated a need for a supplementary palatal injection. The palatal injections were all successful in eliminating the pain. Two additional patients in group 2 experienced pain when the suture needle penetrated their palatal mucosa. Based on these results, 4% articaine with 1 : 100,000 epinephrine was found to be more effective for the removal of upper third molars in the presence of pericoronitis than 4% articaine hydrochloride with 1 : 200,000 epinephrine when only a buccal infiltration was used.

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.

Temporal abscess after third molar extraction in the mandible.

BACKGROUND: Dental infections resulting before or after third molar removal are complications in which the maxillofacial surgeon may have to initiate an earlier management. The severe dental infections resulting before or after this procedure is one of the few life-threatening complications in which the maxillofacial surgeon may have to initiate an earlier management. Infections involving the temporal space are rare and infrequently reported. Infections in this space have also been observed secondary to maxillary sinusitis, maxillary sinus fracture, temporomandibular arthroscopy, and drug injection, although more commonly associated to third molar infections. CASE REPORT: A 22-year-old man had undergone extraction of tooth 38 secondary to pericoronaritis by a general dentist. Physical examination of his face demonstrated severe trismus, pain, and swelling in temporal region. A CT scan showed an inflammatory area into the temporal space. He was started on IV cephalosporin, but the clinical course of the patient was not satisfactory. Incision and drainage were performed from an extraoral and intraoral approach. After discharged, the antibiotic was switched to clindamycin IO 600 mg. DISCUSSION: The retromaxillary and temporal infections are quite common after maxillary molar extractions but not after mandibular third molar, the spread mechanism of ascension must be involved with the virulence of microorganisms, but more studies are necessary to clarify this occurrence.

Láserterapia y láserpuntura: alternativa de tratamiento en la pericoronitis / Laser-therapy and laser-puncture: an alternative treatment in pericoronitis

La pericoronitis es un proceso infeccioso agudo que aparece en las pacientes jóvenes, entre la segunda y tercera década de vida, por erupción de los terceros molares. Con el objetivo de demostrar la efectividad de la terapia láser en el tratamiento, se realizó un estudio longitudinal y prospectivo en una muestra de 80 pacientes que presentaron esta patología, los cuales asistieron al servicio de urgencia estomatológica del Policlínico Docente Universitario Hermanos Cruz, en el período comprendido desde Enero 2009 a Febrero 2010. Para mejor estudio y aplicación del tratamiento se conformaron 2 grupos de 40 pacientes. Un primer grupo al que se le indicó antibioticoterapia, y además, se les aplicó una terapia láser de baja potencia con un equipo de fabricación cubana LASERMED 670 DL , el cual utiliza un diodo emisor de (Ga Al As) (670nm), se utilizó técnica puntual local, alrededor del capuchón dentario con parámetros analgésico y antinflamatorio (30mw, 36seg) y se aplicó láserpuntura. Un segundo grupo al cual se le aplicó la terapia convencional, utilizando antibioticoterapia y buchadas de peróxido de hidrógeno. El tratamiento con terapia láser resultó altamente efectivo, pues se reportó una remisión marcada de los síntomas, inflamación, dolor, y además, una disminución en el número de sesiones necesarias de tratamiento; se demostró estadísticamente con la prueba de ji cuadrado de independencia. Se comprueba la eficacia del tratamiento propuesto y se recomienda como opción terapéutica...(AU)

Pericoronitis is an acute infectious process that appears in young patients between the second and third decade of life during third molars eruption. The research was aimed at showing the effectiveness of laser-therapy through a longitudinal and prospective study that was conducted with a sample of 80 patients suffering from this pathology, these patients attended to the dentist emergency room at Hermanos Cruz Teaching Outpatient Clinic through January 2009-February 2010. To a better study and application of treatment two groups of 40 patients were comprised. The first group was treated with antibiotic and laser therapy of low-power using equipments made in Cuba (LASERMED 670-DL), which uses a transmission diode (Ga Al As) (670nm), local punctual technique was used around dental cap with analgesic parameters and anti-inflammatory (30mw, 36seg) and laser-puncture. The second group underwent conventional therapy with antibiotics and mouth washes of hydrogen peroxide. The treatment with laser was very effective observing a marked remission of symptoms, as well as inflammation, pain and a reduction in figures of necessary treatment sessions; which was statistically demonstrated by a chi-square test of independence. The effectiveness of treatment was confirmed, recommending it as a therapeutic alternative...(AU)

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

PURPOSE: The aim of the present study was to adjust a multivariate model to explain each of the response variables for the occurrence of surgical difficulty during the removal of impacted lower third molars. PATIENTS AND METHODS: A prospective cohort study was carried out involving patients submitted to at least one surgical removal of an impacted lower third molar. A total of 285 patients fulfilled the eligibility criteria and 473 surgeries were performed. Preoperative variables indicative of surgical difficulty were recorded. All surgical procedures were performed under the same conditions by two surgeons who were unaware of the data collected in the pre-selection phase. Either Pearson's chi-square test or Fisher's exact test was used for the data analysis (P<5.0%). RESULTS: Root number (P((1)) < 0.004*) and morphology (P((1)) < 0.031*), tooth position (P((1)) = 0.001*), periodontal space (P((2)) < 0.004*) and second molar relation (P((1)) = 0.001*) were significant predictors of surgical difficulty, whereas patient age (P((1)) = 0.097), gender (P((1)) = 0.470), body mass index (P((1)) = 0.719), associated pathologies (P((1)) = 0.237), relation with mandibular canal (P((1)) = 0.384) and width of 3rd molar crown (P((1)) = 0.154) were not significant predictors. CONCLUSION: Many factors contribute to surgical difficulty, but considering these factors individually, some are only determinants of either difficulty or complications. Thus, not all significant predictors of surgical difficulty should be considered indicators of complications.

O que é, e como diagnosticar, a pericoronarite / What is pericoronitis and how is it diagnosed

A pericoronarite é um quadro inflamatório no tecido mole que recobre parcialmente a coroa de um dente semi-irrompido. Os terceiros molares inferiores são, geralmente, os mais acometidos; clinicamente, é observada a presença de tecido eritematoso; e, muitas vezes, pode evoluir para um estado infeccioso, apresentando coleção purulenta, drenando espontaneamente ou não...

Aplicación del OLEOZÓN en el tratamiento de las pericoronaritis / Usage of Oleozón in the treatment of pericoronaritis

La atención primaria se orienta hacia los principales problemas de salud de la comunidad, entre ellos los de urgencias estomatológicas, donde es atendida la pericoronaritis, siendo el tratamiento indicado la aplicación de sustancias cáusticas (ácido tricloroacético), que pueden ocasionar daños en los tejidos dentarios. Teniendo en cuenta las características de la pericoronaritis, se utilizó la ozonoterapia, realizando un ensayo clínico fase III, aleatorizado, controlado y abierto, lo cual permitió estudiar la evolución microbiológica después de aplicado el OLEOZÓN en el tratamiento de la pericoronaritis, en la Clínica Estomatológica Docente César Escalante, del municipio Matanzas, de enero 2003 a enero 2008. El universo de estudio fueron los pacientes con pericoronaritis, y la muestra abarcó 90 pacientes, conformándose dos grupos, uno experimental, tratado con Oleozón, y otro control, donde se empleó el tratamiento convencional. La eficacia del OLEOZÓN resultó ser alta en los pacientes tratados(AU)

Primary care is directed to the main health problems of the community, and among them stomatologic emergencies where pericoronaritis is attended, being the indicated treatment the application of caustic substances (trichloroacetic acid), that may damage dental tissues. Considering the characteristics of pericoronaritis, we used ozone therapy, carrying out a Phase III randomized, controlled and open clinical trial, that allowed studying the microbiologic evolution after applying Oleozón in the treatment of pericoronaritis, at the Teaching Stomatologic Clinic Cesar Escalante, municipality of Matanzas, from January 2003 to January 2008. The universe of study was the patients with pericoronaritis, and the sample covered 90 patients. Two groups were formed, one experimental, treated with Oleozon, and the other control, where we used the conventional treatment. The OLEOZÓN efficacy was high in the treated patients(AU)

Epidemiología y tratamiento de la pericoronaritis aguda en el Hospital Barros Luco Trudeau, Santiago, Chile / Epidemiology and treatment of acute pericoronitis at Barros Luco Trudeau Hospital, Santiago, Chile

La pericoronaritis se caracteriza por la inflamación de los tejidos blandos, que rodean la corona de un diente total o parcialmente erupcionado, acompañado por dolor. El objetivo de este trabajo es describir la epidemiología y el tratamiento de la pericoronaritis aguda, en pacientes que acuden al servicio de urgencia del Hospital Barros Luco Trudeau. Se realizó un estudio descriptivo retrospectivo. Se analizaron 9531 fichas clínicas correspondientes a pacientes atendidos en la urgencia dental del Hospital Barros Luco Trudeau, tomando como muestra 456 atenciones con el diagnóstico de pericoronaritis aguda. Se consideraron como variables la edad, el género, la pieza dentaria involucrada y el tratamiento realizado. El análisis de los resultados arrojó una edad promedio de 24 años, con una proporción aproximada de 1:2 de hombres frente a mujeres. Las piezas dentarias más afectadas fueron los terceros molares mandibulares. Respecto al tratamiento, aproximadamente el 70 por ciento de los casos se medicó con antibioterapia y analgésicos no esteroidales (AINES),mientras que sólo en un 40 por ciento se realizó el debridamiento mecánico de la zona. Independientemente del manejo inicial, la mayor parte de las piezas involucradas fueron extraídas de forma inmediata o derivadas para su remoción. Los resultados obtenidos concuerdan con la literatura disponible, en relación a las variables edad, género y piezas dentarias involucradas. Con respecto al tratamiento, la evidencia reporta que lo óptimo es la realización conjunta de una terapia mecánico-local y sistémica, medidas que fueron poco frecuente en el servicio estudiado.

Pericoronitis is characterized by inflammation of the soft tissues surrounding the crown of a tooth wholly or partially erupted, accompanied by pain. To describe the epidemiology and treatment of acute pericoronitis in patients attending the emergency department of the Hospital Barros Luco Trudeau. A descriptive retrospective study was carried out. We analized 9531 files of patients treated in the Emergency Department Dental Hospital Barros Luco Trudeau and we obtained a sample of 456 files with the diagnosis of acute pericoronitis. The variables considered were age, gender, tooth and the treatment involved. The analysis of the results showed an average age of 24 years, with an approximate ratio of 1:2 of men versus women. The most affected teeth were mandibular third molars. Regarding treatment, approximately 70 percent of cases medicated with antibiotics and analgesics nonsteroidal antiinflammatory drugs (NSAIDs), where as only 40 percent had mechanical debridement of the area. Regardless of initial treatment, most of the parts involved were immediately extracted or derived for removal. Our results are consistent with the available literature regarding the variables age, gender and teeth involved. With regard to treatment, the literature reported that the best evidence is the joint realization of a local mechanical therapy and systemic measures that were rare in the service studied.