Comparison of Depth of Anesthesia in Different Parts of Maxilla When Only Buccal Anesthesia Was Done for Maxillary Teeth Extraction

Objective. Recently, some authors reported that maxillary teeth could be extracted without using palatal anesthesia, but they did not clearly specify the extracted teeth. This is important, because apparently the local anesthetic solution infiltrates the maxilla and achieves a sufficient anesthesia in the palatal side. Thus, thickness of the bone may affect the depth of anesthesia. The aim of this study was to compare the depth of anesthesia in different parts of the maxilla when only a buccal infiltration anesthesia was done. Patients and Method. The maxilla was divided into anterior, premolar, and molar regions. In each region, 15 teeth were extracted with a single buccal infiltration. The patient marked the pain level on a numerical rating scale. Results. Anesthesia depth was sufficient and was not significantly different (P > 0.05) among three maxillary regions. Conclusion. Except for surgical interventions, all maxillary teeth can be extracted using only a buccal infiltration anesthesia

The assesment of relationship between the angulation of impacted mandibular third molar teeth and the thickness of lingual bone : a prospective clinical study

Our purpose was to investigate the relationship between the angulation of mandibular third molars and the thickness of the lingual bone, which can affect the risk of lingual nerve damage during lower third molars surgical extraction. This study consisted of 104 patients (42 males and 62 females), aged between 18-42 years (24.67 ± 6.11 years). Cone Beam Computed Tomography (CBCT) images were taken for preoperative assessment. The teeth were divided into four groups according to their positions: mesioangular, distoangular, vertical and horizontal. Lingual bone thickness around impacted teeth were measured at three points: cementoenamel junction (CEJ) of the mandibular second molar, mid-root of the impacted third molar, and apex of the impacted third molar root. Two predisposing factors of lingual nerve damage were recorded: lingual bone perforated by the impacted tooth and lingual bone thinner than 1 mm. Additionally, buccolingual angulations of the teeth in each group were measured. Impacted mandibular third molars were removed in usual way. One week after surgery, the patients were evaluated regarding lingual nerve paresthesia. None of the 104 patients experienced paresthesia, including the ones who had teeth with close proximity with lingual nerve. The mean thickness of bone was 1.21±0.63 mm at CEJ of the second molar; 1.25±1.02 mm at the mid-root; and 1.06±1.31 mm at the apex. Horizontally impacted teeth had thinner lingual bone at mid-root level (p=0.016). Buccolingual angulated teeth were more often associated with perforated lingual bone (p=0.002). Buccolingual and mesial/distal angulation had negative correlation with lingual bone thickness (p<0.05). As the buccolingual and mesiodistal angulations increase, lingual bone thickness decreases. Horizontally impacted teeth seemed to compromise the integrity of the lingual bone more than impacted teeth in other positions. During the surgery, thin or perforated lingual bone may result in displacement of the impacted tooth lingually

Binaural beats or 432 Hz music? which method is more effective for reducing preoperative dental anxiety?

The aim of this prospective clinical study was to investigate the effectiveness of binaural beats and music at a frequency of 432 Hz and compare which method is more effective for reducing preoperative dental anxiety in impacted third molar surgery. Ninety patients were randomly selected to the binaural beats group, music group and control group. Visual analog scale used to evaluate dental anxiety before the local anesthesia in the first measurement. Local anesthesia was applied to the all patients. Patients in the music group listened to 432 Hz tuned music using earphones for 10 minutes. Patients in the binaural beats group listened to binaural beats using earphones (for the right ear, 220 Hz and for the left ear 210 Hz) for 10 minutes. No special treatment was applied to the patients in control group. In the second measurement, dental anxiety was measured again in all three groups. For analysis of differences between three groups was used One way Anova and Kruskal Wallis test. Twenty seven male and 53 female patients included the study. In the first measurement, the same level of anxiety was recorded in all three groups. (p=0.811) There was a significant decrease in anxiety in both the binaural beats and music group in the second measurement. (p<0.001). Binaural beats and 432 Hz tuned music are a valid non pharmacological adjuvant to reduce dental anxiety in impacted third molar surgery. They have a positive effect to reduce the dental anxiety

Cerebrospinal fluid flow dynamics in patients with multiple sclerosis: a phase contrast magnetic resonance study

Cerebrospinal fluid (CSF) flow dynamics, which supposedly have a strong relationship with chronic cerebrospinal venous insufficiency (CCSVI), might be expected to be affected in multiple sclerosis (MS) patients. In this study, CSF flow at the level of the cerebral aqueduct was evaluated quantitatively by phase contrast magnetic resonance imaging (PC-MRI) to determine whether CSF flow dynamics are affected in MS patients. We studied 40 MS patients and 40 healthy controls using PC-MRI. We found significantly higher caudocranial(p=0.010) and craniocaudal CSF flow volumes(p=0.015) and stroke volume (p=0.010) in the MS patients compared with the controls. These findings may support the venous occlusion theory, but may also be explained by atrophy-dependent ventricular dilatation independent of the venous theory in MS patients

Acutely infected teeth: to extract or not to extract?

Abstract: Not only laymen but also dentists generally believe that extraction of acutely infected teeth should be avoided until the infection subdues by using systemic antibiotics. The aim of this study was to compare perioperative complications in routine extractions of acutely infected teeth with extractions of asymptomatic teeth. This prospective study was performed with 82 patients. Severe pain on percussion of the relevant tooth was considered as basic criteria for acute infection. The acutely infected teeth were labeled as the study group (n = 35) and the asymptomatic teeth as the control group (n = 47). The extractions were done using standard procedures. The amount of anesthetic solution used and duration of extractions were recorded. Postoperative severe pain and exposed bone with no granulation tissue in the extraction socket were indications of alveolar osteitis (AO). The level of statistical significance was accepted as 0.05. Symptoms that could indicate systemic response, including fever, fatigue, and shivering were not found. There was no statistically significant difference between groups in terms of AO, amount of anesthetic solution used, and duration of extraction. The presence of an acute infection characterized by severe percussion pain is not a contraindication for tooth extraction. Infected teeth should be extracted as soon as possible and the procedure should not be postponed by giving antibiotics

The use of stereophotogrammetry in oral surgery: Measurement of area changes after secondary epithelization and grafting vestibuloplasties

Objective: Stereophotogrammetry (SPT) is a method in which three-dimensional coordinates are calculated from multiple two-dimensional projections. The purpose of this study was to compare the surface area changes between the secondary healing and grafting vestibuloplasty techniques in the mandible by using a stereophotogrammetric technique (SPT). Patients and Methods: Thirteen patients were included in this study: six patients were managed by using full-thickness skin or palatal mucosa grafts (two full-thickness palatal mucosal grafts and four full-thickness skin grafts); the remaining seven patients, who did not accept a second surgery for graft harvesting, underwent secondary epithelization vestibuloplasties. Postoperative changes of surgical areas were measured by using SPT. Statistical Analyses: The Wilcoxon (intragroup comparisons) and Mann-Whitney U (intergroup comparisons) tests were used for analysis of data. Results: In the grafting vestibuloplasty group, the surface area gain was statistically significant (P 0.05), with even decrease of surface area being noted in some cases. Conclusion: SPT is a valid method for measurement of intraoral soft tissue changes