Delayed bleeding after implant surgery in patients taking novel oral anticoagulants: a case report

The use of novel oral anticoagulants (NOACs) has increased in recent times in an effort to overcome the shortcomings of warfarin. They are being used primarily for the prevention of thrombosis caused by atrial fibrillation and offer the advantages of having fewer drug interactions than warfarin, no dietary restrictions, and no requirement for regular blood tests. Although there is reportedly less postoperative bleeding even if the drug is not discontinued during procedures that can cause local bleeding, such as dental procedures, no well-designed clinical studies have assessed postoperative bleeding associated with the use of these drugs. This article reports a case of a 74-year-old male patient who was taking rivaroxaban. The patient underwent a dental implant procedure after discontinuing rivaroxaban for one day and subsequently suffered delayed bleeding on postoperative day 6. Accordingly, this article also reports that the use of NOACs may also lead to delayed bleeding.ope

The relationship between masseter muscle thickness measured by ultrasonography and facial profile in young Korean adults

Purpose: The purpose of this study was to evaluate the relationship between masseter muscle thickness, facial morphology, and mandibular morphology in Korean adults using ultrasonography. Materials and Methods: Ultrasonography was used to measure the masseter muscle thickness bilaterally of 40 adults (20 males, 20 females) and was performed in the relaxed and contracted states. Facial photos and panoramic radiography were used for morphological analyses and evaluated for correlations with masseter muscle thickness. We also evaluated the correlations of age, body weight, stature, and body constitution with masseter muscle thickness. Results: In the relaxing, the masseter was 9.8±1.3 mm in females and 11.3±1.2 mm in males. In the contracted state, it was 12.4±1.4 mm in females and 14.7±1.4 mm in males. Facial photography showed that bizygomatic facial width over facial height was correlated with masseter muscle thickness in both sexes in the relaxed state, and was statistically significantly correlated with masseter muscle thickness in males in the contracted state. In panoramic radiography, correlations were found between anterior angle length and posterior angle length and masseter muscle thickness in females, and between body length and posterior angle length, between anterior angle length and body length, between ramal length and body length, and between body length and condyle length in males. Conclusion: Masseter muscle thickness was associated with facial and mandibular morphology in both sexes, and with age in males. Ultrasonography can be used effectively to measure masseter muscle thickness.ope

Oral foregut cyst in the ventral tongue: a case report.

An oral foregut cyst is a rare congenital choristoma lined by the respiratory and/or gastrointestinal epithelium. The exact etiology has not been fully identified, but it is thought to arise from misplaced primitive foregut. This lesion develops asymptomatically but sometimes causes difficulty in swallowing and pronunciation depending on its size. Thus, the first choice of treatment is surgical excision. Surgeons associated with head and neck pathology should include the oral foregut cyst in the differential diagnosis for ranula, dermoid cyst, thyroglossal duct cyst and lymphangioma in cases of pediatric head and neck lesions.ope

The Cracked Tooth Syndrome

As the life span of people are longer and keeping their teeth longer, the cracked tooth syndrome (CTS) is a common occurrence in nowadays. The cracked tooth is a source of pain for patients and presents diagnostic, restorative and endodontic challenges to operators. The purpose of this article is to review the clinical features, diagnosis, treatment and prognosis of the cracked tooth syndrome (CTS).ope

The Endo-perio Lesion : A Review for the Diagnosis and Treatment of the Combined Endodontic-periodontic Disease

Despite the fact that patients present with endodontic-periodontal combined lesions are commonly seen, clinical dilemma is frequently brought up due to the difficulties in differential diagnosis and prognosis prediction. Such difficulties can be reconciled by proper diagnosis of each specific lesion, and such diagnosis can only be made through acknowledging the cause of each lesion and the interrelationship between endodontic and periodontal diseases. This article is an attempt to focus on appraising the causes and contributing factors of endodontic-periodontal lesions as well as the connections between pulpal and periodontal tissues, and to provide a rationale to diagnosis, prognosis, and treatment of these conditions.ope

Management of hyperthyroid patients in dental emergencies: a case report

The prevalence of thyroid disease, particularly hyperthyroidism, has rapidly increased in Korea in the past 10 years. Therefore, it is important to consider the complete medical history including thyroid disease in patients under dental treatment. Both the drugs used for dental treatment and psychological symptoms associated with treatment can induce emergencies in hyperthyroid patients. This case report considers emergency situations during dental treatment for hyperthyroid patients, and discusses risk factors and related concerns.ope

Computer-controlled local anesthetic delivery for painless anesthesia: a literature review

Local anesthesia is administered to reduce pain during dental treatments, but may itself cause pain and contribute to increased dental fear. Computer-controlled local anesthetic delivery (CCLAD) is one the method to reduce patient pain during local anesthesia; it is a device that slowly administers anesthetics by using a computerized device to control the injection speed. This literature review aims to provide an objective assessment of the usefulness of CCLAD for controlling pain by reviewing papers published to date that have used CCLAD.ope

Chlorhexidine and Dentin Adhesion

This review examines the fundamental mechanism of dentin-resin bond degradation, considers the factors related with this event and furthermore, describes the more practical way to prevent the degradation followed by restoration failure. In spite of rapid development of dental adhesive, dentin-resin bond stability and durability are still major challenge to clinicians. Bacause dentin has unique environments, which are humid and moist, compared to enamel, it is difficult to acquire complete bond. Also presence of endogeneous matrix-metalloproteinases (MMPs) in dentin substrate plays a crucial role in the degradation. So, in order to prevent the degradation, complete infiltration of resin monomer to moist dentin substrate and inhibition of MMPs are essential in bonding process. There are multiple in vivo and in vitro reports showing that the durability and longevity of the dentin-resin bond interface is increased when nonspecific enzyme inhibitors, especially Chlorhexidine (CHX) are used. Among many synthetic inhibitors, chlorhexidine (CHX) is the most widely used MMPs-inhibitor because of its ‘substantivity’. Via its cationic-chelation mechanism, it inhibits MMPs (especially MMP-2, -9) effectively and consequently, reduces nanoleakage and increases bond stability. Also the use of CHX does not affect the immediate bond strength overall and gives no harm to mechanical properties of following adhesive resin. To sum up, the adoption of CHX is recommended as means of improving bond stability at this time.ope

Volume change pattern of decompression of mandibular odontogenic keratocyst

Objectives: This study was aimed to analyze the reducing pattern of decompression on mandibular odontogenic keratocyst and to determine the proper time for secondary enucleation. Materials and methods: Seventeen patients with OKC of the mandible were treated by decompression. Forty-five series of CT data were taken during decompression and measured by using InVivo software (Anatomage, San Jose, Calif) and were analyzed. Results: The expected relative volume during decompression is calculated using the following formula: V(t) = V initial × exp.(at + 1/2bt 2) (t = duration after decompression (day)). There was no significant directional indicator in the rate of reduction between buccolingual and mesiodistal widths. Conclusion: The volume reduction rate gradually decreased, and 270 days were required for 50% volume reduction following decompression of OKC. The surgeon should be aware of this pattern to determine the timing for definitive enucleation. Clinical relevance: The volume reduction rate and pattern of decompression of the OKC can be predicted and clinicians should be considered when treating OKC via decompression.ope

Properties and Clinical Application of MTA

Mineral trioxide aggregate (MTA) is a calcium silicate-based cement commonly used in endodontic procedures involving pulpal regeneration and hard tissue repair, such as pulp capping, pulpotomy, apexogenesis, apexification, perforation repair, and root-end filling. Since MTA’s introduction in 1993, numerous studies have been published regarding various aspects of this material. The purpose of this paper was to review the composition, properties, biocompatibility, and to give evidence-based recommendation for the clinical use of these materials.ope