Objectives: There aren’t any objective methods that may help in standard evaluation of oral surgery patient’s psycho-emotional status. Without any standardized evaluation, two main problems appear: heterogeneity between studies and ineffective patient’s evaluation. Therefore, Universal Scale in Oral Surgery (USOS) for patient’s psycho-emotional status rating has previously been proposed by authors. The aim of present study is to assess the clinical effectivity and validate the Universal Scale in Oral Surgery in case of outpatient tooth extraction for adult healthy patients.
Material and Methods: Clinical trial to validate the USOS for patient’s psycho-emotional status rating was performed. In total 90 patients, that came for outpatient dental extraction to Lithuanian University of Health Sciences Oral and Maxillofacial Surgery Department ambulatory, were enrolled in clinical trial. Patients filled self-reported questionnaires before the procedure. Operating surgeon rated USOS for patient’s psycho-emotional status rating doctor’s part questionnaire after the procedure. 4 - 6 weeks later all patients were asked to fill USOS for patient’s psycho-emotional status rating questionnaire retrospectively.
Results: According to the statistical analysis, the final composition of USOS for patient’s psycho-emotional status rating that would fit to reliability coefficient should be composed from 6 patient part questions and 3 general doctor part questions.
Conclusions: Universal Scale in Oral Surgery for patient’s psycho-emotional status rating is a novel, doctor and patient rated scale which is suitable for clinical and scientific usage.
Objectives: Sialorrhea is a common health and psychosocial problem for children with neuromuscular dysfunction secondary to a variety of disorders such as cerebral palsy. Current accepted treatments include the injection of botulinum toxin into the submandibular glands for temporary symptom relief. The purpose of this study is to demonstrate the feasibility of percutaneous ethanol injection for longer lasting salivary gland ablation in an animal model.
Material and Methods: Twenty rats were used in this study. In each rat, 98% ethanol was injected into the right submandibular gland under ultrasound guidance. No intervention was performed on the left gland, which served as the control. Ten rats were sacrificed and glands evaluated at three weeks, with the remaining 10 rats sacrificed and evaluated at three months. Unpaired, 1-tailed T-tests were used to analyse the data.
Results: Ethanol injections induced a significant and sustained reduction in salivary gland size. Treated glands were 41% smaller by mass than untreated controls in the 10 rats sacrificed at three weeks (P < 0.001). Treated glands were 43% smaller by mass than untreated controls in the 10 rats sacrificed at three months (P < 0.001). Qualitative histologic analysis demonstrated extensive parenchymal damage, inflammation, and fibrosis at both three week and three month time points.
Conclusions: Using a rat model, we demonstrated dramatic and sustained submandibular gland damage after percutaneous injection of ethanol.
Bone Healing in Extraction Sockets Covered With Collagen Membrane Alone or Associated With Porcine-Derived Bone Graft: a Comparative Histological and Histomorphometric Analysis
Renzo Guarnieri, Luca Testarelli, Luigi Stefanelli, Francesca De Angelis, Francesca Mencio, Giorgio Pompa, Stefano Di Carlo
Objectives: The present paper reports data of a randomized study aimed to analyse and compare the histologic and histomorphometric aspects of bone healing in extraction sites covered with collagen membrane alone or associated with porcine-derived bone graft.
Material and Methods: Thirty patients, with single extraction sockets without severe bone wall defects in the premolar/molar region, were included. Ten extraction sockets were grafted with porcine-derived bone and covered with collagen membrane (group 1), 10 sites were covered with collagen membrane alone (group 2), and 10 sites healed spontaneously (group 3). After 4 months of healing, 26 (8 in group 1, 9 in group 2, and 9 in group 3) bone core specimens were harvested for histologic evaluation, then dental implants were placed.
Results: Sites in the group 1 and in the group 2 showed similar histologic and histomorphometric results without significantly differences in the percentage of vital bone (57.43% [SD 4.8] vs. 60.01% [SD 3.2]), and non-mineralized connective tissue 22.99% (SD 5.3) vs. 18.53% (SD 6.2). In group 1 a 16.57% (SD 3.8) of residual material was found.
Conclusions: Results showed that the use of collagen membrane alone or associated to porcine-derived bone improves the healing bone process compared to that of extraction sites spontaneously healed. Moreover, histomorphometric data related to bone quality, indicated that extraction sites without severe walls defects and with a vestibular bone thickness > 1.5 mm, treated with a low resorbtion rate collagen membrane alone, do not need more than 4 months for dental implant insertion.
Objectives: The purpose of the present study was the systematic investigation of numerical and morphological aberrations of teeth in the wisdom teeth region in neurofibromatosis type 1 patients.
Material and Methods: The panoramic radiographs of 179 patients were analysed for supernumerary molars and dysplastic wisdom teeth with special reference to facial tumour type. The results were compared to radiographic findings obtained in panoramic radiographs of age- and sex-matched controls.
Results: The total number of dysplastic or supernumerary molars was 21 (17 individuals, 4.75%) and predominantly a finding of the maxilla (maxilla: 15, mandible: 1, maxilla and mandible: 1). Differences of dental findings between neurofibromatosis type 1 (NF1) patients (n = 15) and the control group (n = 2) were statistically significant (P < 0.01). All individuals with supernumerary molars were diagnosed as being affected with NF1. This difference achieved statistical significance when it was considered that the event may occur at least once per quadrant, and thus the individual potentially needs to be considered four times (P = 0.0038).
Conclusions: This investigation revealed that supernumerary molars and aberrations in wisdom tooth form are more common in patients than in age- and sex-matched controls. There is no association between these findings and a specific feature of the disease, id est facial manifestation of a trigeminal nerve sheath tumour (plexiform neurofibroma). The cause of this phenomenon is unknown. A review of these dental findings on other neurofibromatosis type 1 study groups should be attempted.
Background: Avulsion of the permanent teeth is one of the most serious oral health problems among active children and adolescents. Traumatized patients require immediate and correct treatment in order to restore damaged structures and function that have major impact on daily patient’s life. As a result, proper guidelines and fast treatment methods are necessary. This case report discusses treatment of maxillary right central incisor with an open apex that had been avulsed and replanted. We review applied treatment procedures to manage dental avulsion and restore function and aesthetics.
Methods: A 10-year-old male presented with avulsion of his maxillary right central incisor as a result of unintentional playground injury. The tooth had been stored dry before the patient received immediate care. The avulsed tooth was reimplanted and splinted. The applied treatment procedures include endodontic and restorative treatment as well as careful follow-up visits.
Results: The patient underwent endodontic therapy of his maxillary right central incisor with calcium hydroxide as an intracanal medicament in apexification technique and the closure of apex was achieved. Canal was obturated and the tooth was restored with composite resin. Clinical and radiographic imaging follow-up showed endodontic success with closed apex. However, severe infra-position of maxillary right central incisor developed due to ankylosis.
Conclusions: Ankylosis due to tooth avulsion is a common complication of reimplanted permanent incisors and must be taken into consideration. While addressing ankylosis and its results is supported by little evidence, every case must be diagnosed correctly and treated according to its negative outcomes.