The IIIrd molar postextractional complications, therapeutical and surgical prophylaxis

Department of Dental Medicine, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova, The 6th International Medical Congress for Students and Young Doctors, May 12-14, 2016Introduction. Wisdom tooth pathology remains an issue in oral surgery and general dentistry because of multiple complications and contradictions regarding its treatment. According to Canopkene’s research (2004), from 785 patients aged 16-90 years with various inflammatory processes in oralmaxillofacial region, the inflammatory process of 48.2% was caused by M3. The extraction of impacted third lower molars is a common procedure in oral surgery. It involves trauma of soft and hard tissues accompanied by edema, limited mouth opening, pain, postsurgical complications etc. This is a serious impact on the quality of life. This study was done to evaluate the therapeutic effect of corticosteroids when administered two hours before surgery. Materials and methods. The study was based on clinical and paraclinical results of 23 patients (aged between 20-35 years) including 14 men and 9 women with pathology of the lower IIIrd molar. They were then divided into two groups: the study group who received oral administration of predinosolon (10 mg) and the control group who did not receive medication. To evaluate the edema, two measurements were performed pre and post surgery. The first one was the distance between the corner of the mouth and the ear lobe, and the second one was the distance between the lateral angle of the eye and the angle of the jaw. To determine the mouth opening limitation due to the muscular postoperative contraction, the initial opening of the mouth (measured with the callipers) was compared to the postoperative condition. Discussion results. After comparing the 2 groups, the study group demonstrated a significant reduction of edema and pain without limiting the mouth opening comparing to the control group. Conclusion. Anti-inflammatory steroids inhibit the prostaglandin synthesis, the thromboxanes and the conversion of phospholipids into arachidonic acid, which helps to reduce the transudate. Thus, corticosteroids should be used before surgery in order to reduce the post surgical discomfort and swelling

The effictiveness of local postextractional medication in patients with lower third molar impaction

Rezumat Necesitatea studiului respectiv a fost cauzată şi argumentată de frecvenţa crescută a adresării pacienţilor cu patologia de erupţie a molarilor de minte inferiori, care necesită un tratament chirurgical. Autorii acestui articol şi-au pus ca scop determinarea eficacităţii antibioticoterapiei, care a complementat tratamentul chirurgical radical de extracţie dentară, în combinaţie cu tratament antiinflamator postextracţional, administrat local. Această combinaţie a fost efectuată în vederea reducerii riscului de apariţie al complicaţiilor, micşorarea edemului postoperator, reducerea trismusului, dar în acelaşi moment pentru a evita utilizarea sistemică al preparatelor medicamentoase. Pentru studiul eficacităţii medicaţiei locale au fost incluşi în studiu pacienţi cu incluzia molarului de minte inferior care s-au tratat în secţia de Chirurgie dento-alveolară a Clinicii Stomatologice Universitare nr.2 şi au primit medicaţie locală comparativ cu cei pacienţi carora nu s-a administrat medicaţie postoperatorie.Summary The necessity of this study was caused and argued by the increased frequency of patients with pathological eruption of lower third molars requiring surgical treatment. The authors of this article had the purpose of determining the effectiveness of antibiotic therapy, the local administration of an antiinflammatory treatment in combination with anti-inflammatory therapy. This combination was performed to reduce the risk of complications, reduce postoperative swelling, reduce the trismus, but at the same time to avoid systemic use of medications. For the study of efficacy of local drugs, the patients with lower third molar inclusions were treated in the Dental Alveolar Surgery Department of the University Dental Clinic No. 2 and received local medication compared to patients who were not given postoperative medication

Evaluarea influenței florei microbiene în evoluția și tratamentul pericoronaritei acute

Background. Acute pericoronitis is the most common septic complication of the third molar eruption, conditioned by the association of saprophytic flora and anatomical factors. This prospective study elucidates the necessity of the antimicrobial treatment and the evaluation of microbial species. Objective of the study. To determine and analyse the specific microbial flora in acute pericoronitis, using the antibiogram, for evaluation of the antimicrobial treatment. Material and Methods. 24 patients with pathology of eruption of the lower wisdom tooth, males and females, aged between 18-29 years, were examined clinically and paraclinically, the diffusimetric antibiogram from the serous and/or purulent collections was performed for microbial species detection and sensitivity test. Subsequently, the data were analyzed by T-student and Mann Whitney tests (significance level p 0.05 Results. Following the signs and symptoms evaluation, a various degree of quality of life affectation was detected, dependent on the etiological spectrum of the microbial flora. The results of the diffusimetric antibiogram showed the presence of polymicrobial flora in 46.5% of cases - aerobic and anaerobic forms, unimicrobial - 53.5%, with the predominance of streptococcus viridans, sensitive to amoxicillin, ampicillin, erythromycin - over 30% of cases. Conclusion. The variety of symptoms detected and their severity indicate the need for an individual approach to conservative treatment, the microbial flora being mainly represented by streptococcal saprophytic strains, it is sufficient to prescribe antibiotics from the group of penicillins or cephalosporins. Introducere. Condiționată de asocierea florei polimicrobiene și a factorilor anatomici, pericoronarita acută este cea mai des întâlnită complicație septică a erupției molarului trei. Studiul prospectiv elucidează necesitatea tratamentului conservator antimicrobian în urma evaluării speciilor de microorganisme. Scopul lucrării. Stabilirea și analiza florei microbiene specifice pericoronaritei acute în urma efectuării antibiogramei și evaluarea preparatelor antimicrobiene necesare tratamentului conservator local și general. Material și Metode. 24 de pacienți cu patologie de erupție a molarului 3 inferior, cu vârsta între 18-29 de ani, au fost examinați clinic și paraclinic prin antibiograma difuzimetrică din colecțiile seroase și/sau purulente pentru depistarea speciei și a sensibilității. Datele obținute au fost analizate prin testele T-student și Mann Whitney (nivel de semnificație p 0.05). Rezultate. La evaluarea semnelor și simptomelor, s-a depistat varietatea afectării calității vieții pacienților, direct dependentă de spectrul microbian. Rezultatele antibiogramei difuzimetrice au demonstrat floră polimicrobiană în 46,5% din cazuri- forme aerobe și anaerobe, unimicrobiene- 53,5%, cu predominarea streptococului viridans, sensibilitatea la amoxicilină, ampicilină, eritromicină- peste 30% din cazuri. Concluzii. Varietatea simptomelor depistate și a severității acestora demonstrează abordarea individuală a tratamentului conservator, flora microbiană fiind preponderent saprofită streptococică, este suficientă administrarea antibioticelor din grupul penicilinelor sau a cefalosporinelor

Assessment of the influence of microbial flora on the evolution and treatment of acute pericoronitis

Rezumat Condiţionată de asocierea florei polimicrobiene şi a factorilor anatomici, pericoronarita acută este cea mai des întîlnită complicaţie septică a erupţiei molarului trei. Studiul prospectiv elucidează necesitatea tratamentului conservator antimicrobian în urma evaluării speciilor de microorganisme şi scopul de a stabilirea şi analiza florei microbiene specifice pericoronaritei acute în urma efectuării antibiogramei şi evaluarea preparatelor antimicrobiene necesare tratamentului conservator local şi general. Au fost incluşi 24 de pacienţi cu patologie de erupţie a molarului 3 inferior, cu vârsta între 18-29 de ani, au fost examinaţi clinic şi paraclinic prin antibiograma difuzimetrică din colecţiile seroase şi/sau purulente pentru depistarea speciei şi a sensibilităţii. Datele obţinute au fost analizate prin testele T-student şi Mann Whitney (nivel de semnificaţie p 0.05). La evaluarea semnelor şi simptomelor, s-a depistat varietatea afectării calităţii vieţii pacienţilor, direct dependentă de spectrul microbian. Rezultatele antibiogramei au demonstrat floră polimicrobiană în 46,5% din cazuri- forme aerobe şi anaerobe, unimicrobiene- 53,5%, cu predominarea streptococului viridans, sensibilitatea la amoxicilină, ampicilină, eritromicină- peste 30% din cazuri. Varietatea simptomelor depistate şi a severităţii acestora demonstrează abordarea individuală a tratamentului conservator, este suficientă administrarea antibioticelor din grupul penicilinelor sau a cefalosporinelor.Abstract Conditioned by the association of polymicrobial flora and anatomical factors, acute pericoronitis is the most common septic complication of the eruption of the third molar. The prospective study elucidates the need for conservative antimicrobial treatment following the evaluation of microorganism species, also establishing and analyzing the microbial flora specific to acute pericoronitis, followed by the antibiogram and evaluation of antimicrobial medication necessary for local and general conservative treatment. The study included 24 patients with pathology of eruption of the lower 3rd molar, aged 18–29 years, examined clinically and paraclinically by diffusimetric antibiogram from serous and / or purulent collections to detect the species and sensitivity. The data obtained were analyzed by T–student and Mann Whitney tests (significance level p 0.05). When evaluating the signs and symptoms, the variety of impairment of patients’ quality of life, directly dependent on the microbial spectrum, was found. The results of the antibiogram showed polymicrobial flora in 46.5% of cases — aerobic and anaerobic forms, unimicrobial — 53.5%, with the predominance of streptococcus viridans, sensitivity to amoxicillin, ampicillin, erythromycin — over 30% of cases. The variety of symptoms detected and their severity demonstrates the individual approach to conservative treatment, it is sufficient to administer antibiotics from the group of penicillins or cephalosporins

RELIGIOUS CHARACTERISTICS OF ROMANIAN PHYSICIANS: TOWARDS AN INTEGRATIVE SUPPORT OF RELIGIOUS PSYCHIATRIC PATIENTS

Background: The growing closeness between psychiatry and theology may impact positively the healthcare of the religious psychiatric patients. However, some significant divergences regarding the health care religious methods and the concept and believe in the demonic possession of psychiatric patients continue to shape the relationships between these professionals. While the religions generally admit the demonic or spirit possession as real, the current views of physicians and psychiatric patients are just taken for granted and therefore demands new investigations. In this study, we have performed a targeted survey on this subject. Subjects and methods: The survey was based on a questionnaire addressed to 216 psychiatrists and 201 non-psychiatrists, and 408 psychiatric patients. For physicians, the questionnaire was randomized sent to hospitals in Romania. The patients received the questionnaire on paper. Except for patients with dementia and those in the acute phase of a psychiatric illness, all psychiatric disorders available at the time of the investigation were randomized included in the study. Results: The results showed that about 20% of physicians and 60% of psychiatric patients considered that demonic possession might be associated to a psychiatric illness, while the later would like a priest in the therapeutic team (89.4%, CI: 0.86-0.92). In addition, the psychiatrists declared a lower attendance of religious services, although the majority would accept a priest in the therapeutic team (p>0.05, CI: 0.61-0.70). Conclusion: These findings invite to a more practical collaboration between psychiatrists, clinical psychologists, and theologians/priests with training in psychiatry for a more integrative mental care of the religious psychiatric patients. The results call as well for more efficient practical solutions for psychiatric patients, raise awareness towards the personal religious needs and critical beliefs of such patients, and finally might narrow the gap of the controversy between psychiatrists, non-psychiatrists, psychologists and theologians/priests on the addressed issues

RELIGIOUS CHARACTERISTICS OF ROMANIAN PHYSICIANS: TOWARDS AN INTEGRATIVE SUPPORT OF RELIGIOUS PSYCHIATRIC PATIENTS

Background: The growing closeness between psychiatry and theology may impact positively the healthcare of the religious psychiatric patients. However, some significant divergences regarding the health care religious methods and the concept and believe in the demonic possession of psychiatric patients continue to shape the relationships between these professionals. While the religions generally admit the demonic or spirit possession as real, the current views of physicians and psychiatric patients are just taken for granted and therefore demands new investigations. In this study, we have performed a targeted survey on this subject. Subjects and methods: The survey was based on a questionnaire addressed to 216 psychiatrists and 201 non-psychiatrists, and 408 psychiatric patients. For physicians, the questionnaire was randomized sent to hospitals in Romania. The patients received the questionnaire on paper. Except for patients with dementia and those in the acute phase of a psychiatric illness, all psychiatric disorders available at the time of the investigation were randomized included in the study. Results: The results showed that about 20% of physicians and 60% of psychiatric patients considered that demonic possession might be associated to a psychiatric illness, while the later would like a priest in the therapeutic team (89.4%, CI: 0.86-0.92). In addition, the psychiatrists declared a lower attendance of religious services, although the majority would accept a priest in the therapeutic team (p>0.05, CI: 0.61-0.70). Conclusion: These findings invite to a more practical collaboration between psychiatrists, clinical psychologists, and theologians/priests with training in psychiatry for a more integrative mental care of the religious psychiatric patients. The results call as well for more efficient practical solutions for psychiatric patients, raise awareness towards the personal religious needs and critical beliefs of such patients, and finally might narrow the gap of the controversy between psychiatrists, non-psychiatrists, psychologists and theologians/priests on the addressed issues

Inferior third molars pericoronitis frecquency in correlation with patient`s age and gender

Rezumat. Scopul acestui studiu a fost de a evalua un profil radiografic al molarilor trei inferiori în incluzie pe baza nivelului și angulării acestora în corelaţie cu vârsta și sexul pacienţilor. Analiza radiografiilor după anumite protocoale au demonstrat o corelaţie între apariţia pericoronaritei molarului 3 inferior și vârsta și sexul pacienţilor la fel și între nivelul de incluzie și de angulaţie a molarului 3 inferior. Mai mult decât atât, a fost relevat faptul dacă variabilele de mai sus influenţează simptomatologia și patologia asociată cu molarii inferiori de minte afectaţi.Summary. The purpose of this study was to evaluate a radiographic profile of the impacted third lower molars based on their level and angulation in relation to the age and sex of the patients. Radiography analysis according to some protocols demonstrated a correlation between the occurrence of lower molar pericoronitis and the age and sex of the patients as well as between the level of inclusion and angulation of the lower molar. Moreover, it has been revealed whether the above variables influence the symptoms and pathology associated with the affected wisdom lower molars

Влияние микробного фактора при возникновении острого перикоронарита

Influence of the microbial factor in acute pericoronitis occurrence. Pericoronitis is an inflammatory disease that occurs after the eruption of the lower wisdom teeth and affects the surrounding tissues, with a complex microbial and traumatic etiology, manifested by an erythematous swelling and gum hyperemia in the retromolar area. The main goal was to determine the etiological spectrum of the microorganisms involved in acute pericoronitis and to evaluate the antibiotics, antiinflammatory drugs effect on pericoronitis treatment. The study included 30 patients (18 male, 12 female), aged between 18-45 years (27,8±8,2 years) with acute pericoronitis of the lower wisdom tooth. The study determined the severity of infection related to subjective and objective clinical symptoms (pain, swelling, congestion), the incidence of various streptococci; antibiotics resistance analysis was performed for in order to determine the sensibility and the rate between monomicrobial and polymicrobial cultures. 14 references, 4 figuresPericronarita reprezintă o afecțiune de tip inflamator, apărută în urma erupției molarului de minte inferior, interesând țesuturile pericoronare ale acestuia, ce are o etiologie complexă microbiană și traumatică, manifestandu-se printr-o tumefiere eritematoasă, hiperemie a gingiei în zona retromolară. Scopul studiului a fost stabilirea spectrului etiologic microbian implicat în etiologia pericoronaritei acute, pentru evaluarea unor agenţi farmaceutici de tipul antibioticelor, antiinflamatorilor sau combinaţia lor în eliminarea focarului septic. În studiu au fost incluși 30 de pacienți (18 bărbați, 12 femei), cu vârsta cuprinsă între 18 și 45 ani (media 27,8±8,2 ani) care s-au adresat cu pericoronarită acută a molarului trei inferior. În urma studiului s-a determinat severitatea infecţiei în funcţie de semnele clinice subiective (durere) şi obiective (tumefacţie, congestie); incidența prezenței diferitelor tipuri de streptococ și antibioticograma pentru determinarea sensibilitații acestora; raportul culturilor unimicrobiene față de cele polimicrobiene, dinamica semnelor cliniceВлияние микробного фактора при возникновении острого перикоронарита. Перикоронарит – воспалительное заболевание, возникающее после прорезывания нижнего третьего моляра, поражающее окружающие ткани, имеющее сложную микробно-травматическую этиологию, проявляющееся эритематозным отеком, гиперемией десны в ретромолярной области. Целью исследования было установить микробный этиологический спектр, вовлеченный в этиологию острого перикоронарита, для оценки фармацевтических агентов, таких как антибиотики, противовоспалительные препараты или их комбинации, для устранения септической вспышки. В исследование были включены 30 пациентов (18 мужчин, 12 женщин) в возрасте от 18 до 45 лет (в среднем 27,8±8,2 года) с острым перикоронитом нижнего третьего моляра. При исследовании определялась тяжесть инфекции по субъективным клиническим признакам (боль) и объективным (отек, заложенность); частота наличия разных видов стрептококков и антибиотикограмма для определения их чувствительности; соотношение мономикробных культур к полимикробным, динамика клинических признако

Костные изменения вокруг имплантантов в период остеоинтеграции и роль позиционирова- ния платформы по сравнению с альвеолярной костью в имплантации сразу после удаления

Catedra de propedeutica stomatologică și implantologie dentară ,,Pavel Godoroja”, IP USMF „Nicolae Testemiţanu”Un rol esențial îi revine aspectului calitativ și cantitativ al țesutului osos la nivelul implantării, cât și menținerii acestuia în timp, lucru datorat și modalității de inserare a implantelor. Scopul studiului a fost de a determina infl uenţa profunzimii plasării platformei implantului asupra modelării osului periimplantar. În studiu au fost incluse implante dentare de stadiul doi instalate în două şedinţe chirurgicale în sectoarele atât frontale, cât și posterioare maxilare. Analiza rezultatelor a demonstrat că profunzimea instalării implantului are impact asupra resorbţiei osului periimplantar în perioada de vindecare. The qualitative and quantitative aspect of bone in the time of implantation and its maintenance over time have an essential role. The aim of the study was to determine the influence of the depth of implant placement platform on peri-implant bone modeling. The study included two stage dental implants installed in two surgical stages in both sectors (frontal and posterior) at the superior jaw. Analysis of the results showed that the implant installation depth impacts peri-implant bone resorbtion during the period of healing. Существенная роль заключается в качественный и количественный вид кости на имплантант и его содержание во времени из-за работы, и методика вставлении имплантантов. Цель исследования было определить влияние глубины платформы размещения имплантанта на моделирование костных тканей вокруг имплантантов. Исследование включало два этапа зубных имплантантов, установленных в два хирургических посещений в обеих сторонах передней и задней челюсти. Анализ результатов показал, как воздействует глубина установки имплантанта на резорбцию костной ткани в процессе заживления

Schimbările osoase periimplantare în perioada osteointegrării și rolul poziționării platformei implantelor față de creasta alveolară în implantarea imediat postextracțională

Un rol esențial îi revine aspectului calitativ și cantitativ al țesutului osos la nivelul implantării, cât și menținerii acestuia în timp, lucru datorat și modalității de inserare a implantelor. Scopul studiului a fost de a determina infl uenţa profunzimii plasării platformei implantului asupra modelării osului periimplantar. În studiu au fost incluse implante dentare de stadiul doi instalate în două şedinţe chirurgicale în sectoarele atât frontale, cât și posterioare maxilare. Analiza rezultatelor a demonstrat că profunzimea instalării implantului are impact asupra resorbţiei osului periimplantar în perioada de vindecare