1,720,988 research outputs found
Quality of life after microscopic periradicular surgery using two different incision techniques : a randomized clinical study
No full textAim: To monitor the quality of life of patients after periradicular surgery when two different flap designs were used. Methodology: Forty patients with teeth having a periradicular lesion of endodontic origin were included according to specific selection criteria. Patients were randomly assigned to two groups. In one group a sulcular incision (SI) with complete papilla mobilization was made, and in the other group a papilla-base incision (PBI) was used. Periradicular surgery was performed using a surgical microscope. Parameters related to life quality were recorded daily in the first week post-surgery using a questionnaire. Pain was evaluated with a 0–100 visual analog scale (VAS). Other symptoms (swelling, bleeding and nausea), plus functions (chewing, speaking, sleeping, daily routine and work) were assessed using a five-point scale. Analgesic intake was recorded. Fisher’s test and unpaired t-test were used to assess the difference between groups. Results: The VAS score for pain, and the scores for swelling, chewing and phonetic impairment, peaked on days 1 and 2 postoperatively. A significant difference in favour of the PBI group was found for chewing and swelling in the first 4 days. Starting from day 3 post-surgery, the PBI group reported a significantly more rapid decrease in pain levels and analgesics use than the SI group (P < 0.05). The other parameters were similar in the two groups.
Conclusions: The papilla-base incision technique may be preferred as reduction of pain levels, swelling and drug intake were more rapid in the first week postoperatively compared with cases in which a sulcular incision was used
Endoscopic endodontic microsurgery: 2-year evaluation of healing and functionality
Get PDFThis prospective clinical study aimed to evaluate the benefits of the endoscope as an aid to root-end management, and to assess the treatment outcome during 2 years following surgery. Forty-three endodontic surgical procedures in 30 patients were performed with the aid of an endoscope and followed for a period of 2 years. Radiographic criteria and clinical evaluation were used to assess the outcome. All cases were evaluated in terms of healing and functionality. 91.1% and 90.7% of the teeth evaluated after 1 and 2 years, respectively, were classified as successful. We found no statistically significant differences for both healing and functionality between the 1- and 2-year evaluations. No difference related to tooth type or tooth location was found at the 2-year follow-up. Fisher's exact test was used to statistically assess the difference between successful and unsuccessful cases for each of the variables considered. The endoscope can be an aid for endodontic surgical procedures in terms of both periapical healing and functionality up to 2 years follow-up
Effects of ultrasonic root end preparation on resected root surfaces : SEM evaluation
No full textObjective: The purpose of this study was to investigate the in vitro effect of ultrasonic retrotips on root end surfaces.
Study design: Root end resection was performed on 45 single-root teeth endodontically treated after extraction. Setting the ultrasonic device at full power, a retrograde cavity was made by a stainless steel tip in 9 specimens (SS-FP). In another 9 samples a diamond tip was used (D-FP). Setting the intensity of the ultrasonic device at half power, 9 specimens were treated using stainless steel tips (SS-HP) and 9 using diamond tip (D-HP). Nine teeth were only apically resected and used as controls. Histologic serial sections were examined by scanning electron microsope to assess the number of root-face
cracking, the marginal quality, and the crack type.
Results: No significant difference between diamond and stainless steel groups was found at a given power setting. Significant differences were found between SS-FPand SS-HP group for both the number of cracks and the marginal quality
Inverse knot : a personal sliding knot for arthrosopic surgery
No full textThe development of arthroscopic reconstructive procedures has resulted in the creation of dedicated knots, sliding or not, to be used without skin incision and passed through the cannulas. Most of the recent studies are dedicated to realize and develop slip knots because they are easier and faster to use. The authors report their experience in use of a personal slip knot we called Inverse knot, due to the peculiar characteristic that is closed by the "post" strand
Endoscopic management of a lateral root lesion. A case report
No full textThe aim of this study was to obtain periradicular tissue healing of a lateral root lesion using a microsurgical technique. The case report concerns a 52-year-old female patient, in general good health (ASA1), presented with the left maxillary canine (2.3) exhibiting acute, specific symptoms. A radiographic examination revealed the presence of a circumscribed radiolucent lesion associated with the mesial mid-root area of the 2.3 and the distal mid-root area of 2.2, both endodontically treated. Using an endoscope as a magnification device a surgical inspection of the middle-third of the root of 2.2 and 2.3 was made. A pathway between the periodontium and root-canal system was detected with an endodontic file on the middle-third of 2.3 root wall. A root-lateral cavity was prepared using retro-tips. An EBA cement was used as the root-end filling material. Following clinical and radiographic assessment at 36 months post-surgery, the case was classified as successful. This case report showed the utility of using an endoscope and micro-surgical instruments for diagnosis and surgical treatment of micro-anatomical root structures
Maxillary sinus vascularization : a cadaveric study
No full textThe goal of this study was the investigation of the arterial blood supply to the maxillary sinus to give clinicians the basis for a better understanding of the origin of vascular complications that can derive from surgical procedures at this level. The study consisted of 30 sinuses from 15 human cadavers with an age range of 59 to 90 years. To define the complex vascularization of the maxillary sinus, the afferent vascular network was injected with liquid latex mixed with red india ink through the external carotid arteries. An intraosseous anastomosis between the dental branch of the posterior superior alveolar artery, also known as alveolar antral artery, and the infraorbital artery was found in 100% of cases. Such an anastomosis seemed to guarantee the blood supply to the sinus membrane, to the periosteal tissues, and especially to the anterior lateral wall of the sinus. Moreover, the gingival branch of the posterior superior alveolar artery was found to anastomose an extraosseous branch of the infraorbital artery in 10 sinuses. The examination of the maxillary sinus also showed a close anatomic relationship among the sinus posterior wall, the descending palatine artery, and the sphenopalatine artery in all 30 sinuses. Small branches deriving from the posterior lateral nasal arteries have been found to perforate the nasal wall laterally and reach the mucosa of the maxillary sinus. A sound knowledge of the maxillary sinus vascularization is essential to prevent vascular complications during surgical operations involving this region
Microscope versus endoscope in root-end management : a randomized controlled study
No full textThe purpose of this prospective, randomized, clinical study was to monitor the outcome of periradicular surgery, in which either a surgical microscope or an endoscope was used as a magnification device. A total of 113 teeth in 70 patients were included in the study, according to specific selection criteria. The choice of endoscope or surgical microscope was made using a randomized table. One hundred cases were followed for at least 2 years. Of these, 59 root-end management procedures were performed using a microscope and 41 using an endoscope. At the 2-year follow-up they were classified into three groups (success, uncertain healing and failure) according to radiographic and clinical criteria. After a 2-year follow-up, 91 teeth (91%) healed successfully. In the group using an endoscope 90% of successful healing was achieved, while 92% of success was recorded for the group using a microscope. No statistically significant difference was found in the treatment results relating to the type of magnification device. The type of magnification device used did not seem to affect the outcome of endodontic surgery
Ligation of an unusually large vessel during maxillary sinus floor augmentation. A case report
No full textPURPOSE: The purpose of the present case report was to document a maxillary sinus floor augmentation procedure involving ligation of a blood vessel with a nearly 3-mm diameter in the lateral wall of the maxillary sinus.
MATERIALS AND METHODS: A bilateral maxillary sinus floor augmentation procedure was performed in a 51-year-old healthy man. The preoperative computed tomography scan revealed a bony canal within the lateral maxillary sinus wall of the right as well as the left side close to the alveolar ridge.
RESULTS: A vessel with a diameter of nearly 3 mm was identified during the sinus floor augmentation on the left side. The vessel was exposed and ligated. A vessel with a diameter of approximately 1 mm was identified on the right side and the sinus floor augmentation was performed without ligation. No complications were observed and the postoperative healing was uneventful.
CONCLUSIONS: Although accidental laceration of vessels with an unusually large diameter during maxillary sinus floor augmentation is not life-threatening, impaired visualisation may compromise the augmentation procedure, including the elevation of the Schneiderian membrane. Moreover, postoperative bleeding and formation of a haematoma may occur. Therefore, ligation of vessels with an unusually large diameter is recommended during maxillary sinus floor augmentation to minimise intra- and postoperative complications
Implant survival rates after maxillary sinus augmentation
Get PDFImplant therapy in the atrophic posterior maxilla becomes challenging in the presence of reduced maxillary bone height. Sinus augmentation can be performed for resolving this condition prior to implant placement. The aim of this article was therefore to evaluate implant survival rates in the grafted sinus taking into account the influence of the implant surface, graft material, and implant placement timing. A systematic review of the literature was performed. Articles retrieved from electronic databases were screened using specific inclusion criteria, and data extracted were divided according to: graft material (autogenous, non-autogenous, composite graft), implant surface (machined or textured), and implant placement (simultaneous with grafting or delayed). Fifty-nine articles were included. Survival rates for implants placed in grafts made of bone substitutes alone and grafts of composite material were slightly better than the survival rates for implants placed in 100% autogenous grafts. Over 90% of implants associated with non-autogenous grafts had a textured surface. Textured surfaces achieved better outcomes compared with machined surfaces, and this was independent of the graft material. Simultaneous and delayed procedures had similar outcomes. It may be concluded that bone substitutes can be successfully used for sinus augmentation, reducing donor-site morbidity. Long-term studies are needed to confirm the performance of non-autogenous grafts. The use of implants with a textured surface may improve the outcome in any graft type
Immediate implant placement into fresh extraction sites with chronic periapical pathologic features combined with plasma rich in growth factors : preliminary results of single-cohort study
No full textPURPOSE:
The purpose of this prospective study was to evaluate the clinical outcome of implants immediately placed into fresh extraction sockets of teeth affected by chronic periapical pathologic findings, using plasma rich in growth factors (PRGFs) as an adjunct during the surgical procedure.
MATERIALS AND METHODS:
A total of 30 partially edentulous patients with teeth requiring extraction and chronic periapical lesions were included in the present study. A total of 61 transmucosal implants were installed immediately after extraction and careful debridement combined with PRGF placement into the socket. Before insertion, the implant surface was bioactivated by humidification with liquid PRGFs. The prosthetic phase occurred 3 to 4 months after surgery. The implant success and survival and radiographic bone loss were evaluated after 1 year of function. Patient satisfaction for mastication function, phonetics, and esthetics was assessed using a questionnaire.
RESULTS:
Of the 61 implants, 1 had failed 2 months after insertion because of infection. No additional complications were recorded. The overall implant success and survival rate was 98.4% at 1 year of function. The mean follow-up was 18.5 months (range 10 to 21). All prostheses were successful. The peri-implant bone loss after 1 year averaged 0.41 +/- 0.22 mm. All patients reported full satisfaction for mastication function, phonetics, and esthetics.
CONCLUSIONS:
The use of PRGFs combined with an immediate implant placement procedure can be considered a safe, effective, and predictable treatment option for the rehabilitation of fresh postextraction infected sockets
- …
