1,720,964 research outputs found

    Postoperative pain relief after surgical removal of impacted third molars: a single-blind, randomized, controlled study to compare levobupivacaine and mepivacaine.

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    AIM: To compare the efficacy of 0.75% levobupivacaine with that of 3% mepivacaine for pain control after surgical removal of impacted mandibular third molars. METHODS: Forty-two subjects (23 females and 19 males, mean age 23.5 +/- 4) underwent surgical removal of third molars in two separate sessions. Within each patient, levobupivacaine was used to anesthetize one extraction side and for the other side, mepivacaine. Onset of anesthesia, duration of surgery, lip numbness, timing of pain appearance and analgesic consumption were evaluated. RESULTS: There were no significant differences in onset of anesthesia, duration of surgical procedure, and lower lip numbness between the two groups (P > .05). Timing of pain appearance and of first drug consumption was significantly lower in the mepivacaine group (P < .05). Patients with levobupivacaine anesthesia had significantly lower visual analog (VAS) pain scores at 1 and 2 hours postoperatively than those with mepivacaine anesthesia. CONCLUSION: Levobupivacaine is a valid alternative to traditional local anesthetics for surgical removal of lower third molars. It presents better pain relief when compared to mepivacaine in the immediate postoperative period as evidenced by lower VAS scores

    Dens invaginatus: a qualitative-quantitative analysis. Case report of an upper second molar

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    Dens invaginatus (D.I.) is a developmental anomaly caused by the infolding of the surface of a tooth crown before calcification has occurred. Its aetiology is controversial and remains unclear. It occurs in all dentitions with a prevalence that ranges from 0.25% to 7.74% and is mostly seen in the maxillary permanent incisors, particularly in the lateral incisors. Posterior teeth are infrequently involved. The purpose of this study was to investigate the morpho-structure of a second upper molar dens invaginatus compared with a control tooth. Ground and decalcified sections were prepared and histo-morphological evaluation of dental tissues was performed by using light microscopy, microradiography, and confocal laser scanning microscopy analysis (CLSM). The mechanical behaviour was tested by means of microhardness (HV) test. The results of our investigation showed structural anomalies of hard tissues, such as a difference in enamel prism diameter, in number and diameter of peripulpal dentinal tubules and in surface and diameter of cementocyte lacunae between D.I. and control tooth

    Odontoma:retrospective study and confocal laser scanning microscope analysis of 52 cases

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    AIM: The aim of this study was to perform a retrospective analysis of 52 cases of odontoma treated at the Department of Dentistry and Surgery, University of Bari, in the period 1971-2005. METHODS: The odontogenic tumors were diagnosed as complex or compound odontoma following histological analysis and clinical radiological examination, and applying the 2005 WHO classification. The data analysis was conducted by considering the following factors: gender, age, site of the lesion, association with impacted teeth, aplasia, presence of supernumerary teeth as well as preoperative diagnosis by panoramic and periapical radiographs. Biopsy tissue samples were conventionally processed for histopathologic paraffin embedding and then were observed by optical microscopy and subsequently by confocal laser scanning microscopy (CLSM) in autofluorescence. RESULTS: Thirty specimens (57.6%) were from females and 22 (42.3%) were from males patients. The patients' age ranged from 5 to 75 years. Fifty-one percent of the specimens were excised from the mandible. In the maxilla, the most common location for odontomas was the anterior region. Most odontomas were associated with impacted teeth and only in one case there was an odontoma instead of a permanent tooth. CONCLUSION: Odontomas are considered hamartomatous malformations whose diagnosis is generally formulated by routinary radiographic examination. The CLSM analysis could help in diagnosis and histopathological analysis showing well-defined follicular area entrapped in hard tissues and pointing out ghost cells, otherwise not identifiable by traditional microscopy

    Complex odontoma: confocal laser scanning microscopy analysis of a case

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    Confocal laser scanning microscopy (CLSM) represents a recent acquisition in the study of biological samples stained for fluorescence observation. Particularly, this technique allows a bidimensional investigation of tissues and cells with the possibility to elaborate a three-dimensional model. The aim of this study is the use of this technique, as a complementary and not substitutive application of the histological examination, for the morphological and histopathological analysis in a case of mixed complex-composed odontoma. The analyzed specimen has been surgically removed in the superior frontal region in a 12 year-old boy and submitted to conventional histopathological analysis. The specimen, hematoxylin-eosin stained, has been subsequently submitted to confocal laser scanning microscopic analysis in autofluorescence by using a Nikons C1 system. This analysis has underlined not visible aspects in traditional optical microscopy, such as the mineralization of hard tissues and the morpho-structural organization of the cellular component. The presence of enamel and dentin may be observed in the different phases of odontogenesis with clear fluorescence gradients determined by the different mineralization degrees. Thus, the odontogenetic components appear strongly autofluorescent in the classical follicular configuration. Three-dimensional reconstruction is made possible by the acquisition of serial bidimensional images that are subsequently analysed by using a specific software device. This study shows the confocal laser scanning microscopy versatility in the analysis of odontogenic neoplasms with production of mineralized tissues

    Which route of antibiotic administration should be used for third molar surgery? A split-mouth study to compare intramuscular and oral intake

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    Objectives. To compare the effectiveness of two different routes of antibiotic administration in preventing septic complications in patients undergoing third molar extraction. Materials and Methods. Twenty-four healthy patients requiring bilateral surgical removal of impacted mandibular third molars were successfully enrolled for this study. Depth of impaction, angulation, and relationship of the lower third molars with the mandibular branch had to be overlapping on both sides. A split-mouth design was chosen, so each patient underwent both the first and second surgeries, having for each extraction a different antibiotic route of administration. The second extraction was carried out 1 month later. To compare the effects of the two routes of antibiotic administration, inflammatory parameters, such as edema, trismus, pain, fever, dysphagia and lymphadenopathy were evaluated 2 and 7 days after surgery. Side effects of each therapy were evaluated 48h after surgery. Results. oral and intramuscular antibiotic therapies overlap in preventing post-operative complications in dental surgery (p>0.05), even if the oral intake, seems to promote the onset of significant gastrointestinal disorders (p=0.003). Conclusions. This study could help dentists in their ordinary practice to choose the right route of antibiotic administration in the third molar surgery. At the same effectiveness, the higher cost and the minor compliance of the patient seem not to justify a routine antibiotic intramuscular therapy, reserving it for patients with gastrointestinal disorders
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