The influence of flap design on patients’ experiencing pain, swelling, and trismus after mandibular third molar surgery: a scoping systematic review

Third molar removal surgery usually comes accompanied by postoperative discomfort, which could be influenced by the surgical approach chosen. This scoping systematic review aimed at compiling the available evidence focused on the influence of flap design, including envelope flap (EF), triangular flap (TF), and modified triangular flap (MTF), on postoperative pain, swelling, and trismus, as primary outcome measures, and any result mentioning healing promotion or delay, as secondary outcome measure, after mandibular third molar extraction surgery. An electronic search, complemented by a manual search, of articles published from 1999 to 2020 was conducted in the Medline (PubMed), EMBASE and Web of Science databases including human randomized controlled trials, prospective, and retrospective studies with at least 15 patients. The risk of bias of the included studies was assessed either with the Cochrane’s Risk of Bias tool or with the Newcastle-Ottawa scale. Every step of the review was performed independently and in duplicate. The initial electronic search recovered 2102 articles. After applying the inclusion criteria, 12 articles were included. For patient’s perceived postoperative pain, TF and MTF frequently reported better results than EF. For swelling, the literature is divided, despite a trend favoring EF. For trismus, data showed that its occurrence is mostly associated with the duration of the surgery rather than with the chosen flap. For healing, the limited data is inconclusive. Finally, randomized studies showed a high risk of bias, whereas nonrandomized studies were mostly of good quality and low risk of bias. Although there was no clear consensus regarding the influence of different flap designs for third mandibular molar extraction on postoperative clinical morbidities; the surgeon’s experience, estimated surgical difficulty, molar position and orientation, and surg ery duration should be considered when choosing among the different flap designs

ERGONOMIC CONCEPTS IN DENTAL MEDICINE

Dental medicine is an extremely complex medical field, comprising several specialties (orthodontics and dentofacial orthopedics, prosthodontics, dental surgery, endodontics etc.), which in most cases also require the assistance of a dental nurse. Purpose. In this paper, we have tried to present a number of very interesting ergonomic aspects in the dental office, which aim at simplifying work at this level. Material and method. This study was conducted between May and July 2018 using a questionaire applied to a number of 69 dental practitioners from Bucharest. Results and discussions. Results obtained in this study give us an image about how current dental practitioners understand ergonomics in daily practice. Conlclusions. All the aspects discussed in this study have an important role in the ergonomy of daily activity of a dental office. More important is that the majority of dentists involved in the stuty understand and apply the ergonomic concepts underlined by this study

Presurgical Cone Beam Computed Tomography Bone Quality Evaluation for Predictable Immediate Implant Placement and Restoration in Esthetic Zone

Despite numerous advantages over multislice computed tomography (MSCT), including a lower radiation dose to the patient, shorter acquisition times, affordable cost, and sometimes greater detail with isotropic voxels used in reconstruction, allowing precise measurements, cone beam computed tomography (CBCT) is still controversial regarding bone quality evaluation. This paper presents a brief review of the literature on accuracy and reliability of bone quality assessment with CBCT and a case report with step-by-step predictable treatment planning in esthetic zone, based on CBCT scans which enabled the clinician to evaluate, depending on bone volume and quality, whether immediate restoration with CAD-CAM manufactured temporary crown and flapless surgery may be a treatment option

Digital Workflow in Maxillofacial Prosthodontics—An Update on Defect Data Acquisition, Editing and Design Using Open-Source and Commercial Available Software

Background: A maxillofacial prosthesis, an alternative to surgery for the rehabilitation of patients with facial disabilities (congenital or acquired due to malignant disease or trauma), are meant to replace parts of the face or missing areas of bone and soft tissue and restore oral functions such as swallowing, speech and chewing, with the main goal being to improve the quality of life of the patients. The conventional procedures for maxillofacial prosthesis manufacturing involve several complex steps, are very traumatic for the patient and rely on the skills of the maxillofacial team. Computer-aided design and computer-aided manufacturing have opened a new approach to the fabrication of maxillofacial prostheses. Our review aimed to perform an update on the digital design of a maxillofacial prosthesis, emphasizing the available methods of data acquisition for the extraoral, intraoral and complex defects in the maxillofacial region and assessing the software used for data processing and part design. Methods: A search in the PubMed and Scopus databases was done using the predefined MeSH terms. Results: Partially and complete digital workflows were successfully applied for extraoral and intraoral prosthesis manufacturing. Conclusions: To date, the software and interface used to process and design maxillofacial prostheses are expensive, not typical for this purpose and accessible only to very skilled dental professionals or to computer-aided design (CAD) engineers. As the demand for a digital approach to maxillofacial rehabilitation increases, more support from the software designer or manufacturer will be necessary to create user-friendly and accessible modules similar to those used in dental laboratories

Case Definition in Chronic Periodontitis: the Reliability of Half-Mouth Protocols

Aim of the study To compare half-mouth with whole-mouth examinations, based on clinical attachment loss (CAL) and periodontal pocket depth (PPD) assessments. Material and methods This pilot investigation was designed as a cross-sectional, pretreatment study. Twenty-one adult subjects with moderate and severe periodontal disease and no systemic diseases were recruited from a private dental clinic, Bucharest, Romania. All patients had at least 20 teeth. A total of 2040 interproximal sites were examined. Obtained data were expressed as number of sites with a specific measurement, per quadrant and per mouth. Finally, based on the percentage of patients, the results were compared between couples of quadrants and full-mouth recordings. Results No statistical significant differences between two-quadrant and full-mouth assessments were recorded, in terms of PPD and CAL measurements. Conclusions In the present study, random half-mouth protocols were considered reliable to reproduce full-mouth examination, giving good estimations for case prevalence

An Exploratory Approach of the Current Public Relations Framework in the Romanian University Environment

The opportunity to study such a subject is granted by the need identified in Romanian universities to align to the standards of the international academic environment. As far as the Romanian university environment is concerned, public relations can be a valid strategic option since the communication resource exploitation processes are supported by university management by means of initiating and carrying out actions in which the interests of the institution and the principles of university ethics are harmoniously combined. The causal configurations presented in the results of the present study may represent a decision-making support for the public relations/communication managers who have the chance to understand how they can exploit the social media interactions in their strategies regarding university reputation developmen

A Predictable Approach of a Rare and Frequently Misdiagnosed Entity: Laryngeal Nerve Schwannoma

(1) Background: Schwannoma, a mesenchymal neoplasm derived from Schwann cells that line peripheral nerve sheaths, has a challenging diagnosis, due to the non-specific medical history and clinical examination. Nowadays, virtual reality (VR) is increasingly more used for enhancing diagnosis and for preoperative planning of surgical procedures. With VR, the surgeon can interact, before any surgery, with a virtual environment that is completely generated by a computer, offering them a real experience inside a virtual 3D model. (2) Methods and Results: The aim of the present paper was to present a case of surgically removal of a schwannoma, which originated from the fibers of the superior laryngeal nerve, in a predictable and minimally invasive fashion, upon using VR for diagnosis and surgical procedure planning. (3) Conclusions: The current clinical report attracted the attention of including schwannoma in the possible differential diagnosis of a swelling in the anterior cervical region, mainly when a nonspecific radiological appearance is noticed, even with the use of multiple imaging modalities. Virtual reality can increase the predictability and success rate of the surgical procedure, being in the meantime a good tool for communication with the patient

Noţiuni anatomice privind procesele alveolare şi structurile vecine din perspectiva reabilitării implanto-protetice

Reabilitarea implanto-protetică reprezintă o metodă de tratament extrem de complexă şi în acelaşi timp extrem de completă. Totuşi, pentru abordarea unei soluţii de tratament de reabilitare implanto-protetică este nevoie de o profundă cunoaştere a anatomiei regiunii oro-maxilo-faciale, fără de care această soluţie de tratament poate fi sortită eşecului, încă din faza de debut. De aceea, în continuare, vom încerca o explicitare a noţiunilor de anatomie, care intervin în abordarea acestei soluţii de tratament

Implantologia orală corelată cu reconstrucţia crestelor alveolare deficitare

În general, majoritatea profesioniştilor sunt de acord cu faptul că, implantologia orală reprezintă o mixtură de chirurgie, protetică şi gnatologie, amestec, ce a revoluţionat medicina dentară în general şi protetica dentară în special. Astfel, reconstituirile protetice s-au extins în egală măsură în ultimele trei decenii şi jumătate, atât în Europa, cât şi în S.U.A. Concret, în lume, foarte multe implanturi dentare sunt inserate în clinicile de chirurgie oro-maxilo-facială, dar poate cel mai mare număr de implanturi este inserat de către profesioniştii stomatologi in cabinetele private de medicină dentară