Mandibular second molar impaction - literature review and case reports

Aim: To assess the incidence of mandibular second molar impaction and the treatment methods for this condition.Materials and Methods: A retrospective review of the cases of patients diagnosed with impaction of mandibular molars at the Department of Oral Surgery of the Faculty of Dental Medicine - Plovdiv during the past 11 years was performed.Results: 962 patients with impaction of mandibular molars were operated on in the analyzed period. This diagnosis is relatively rare in second mandibular molars and represents 0.94% of all cases. Most often, diagnosis is based on clinical evidence of missing molars and on panoramic radiographs. In the cases described by us, only surgical treatment was used.Conclusion: The treatment of this condition is a challenge which requires an individual approach to each case and an assessment to determine what treatment approach is to be used - surgical or orthodontic

CLINICAL COMPARISON OF THREE METHODS FOR VESTIBULOPLASTY IN THE ANTERIOR PART OF THE MANDIBULE

Purpose: The aim of this research was to use platelet-rich fibrin membranes as an alternative to autogenous epithelial grafts for vestibuloplasty procedures and to compare the results from different vestibuloplasty techniques. Materials and methods: The study includes two patients with atrophic lower jaw who require deepening of the vestibulum in the frontal area of the mandible. The surgical site in both of the patients was divided into two equal halves. Half of the prepared bed in each patient was plastically covered with free epithelial graft. On the first patient, the second part of the surgical site included the performing of Edlan - Mejchar technique. On the second patient, the entire surgical site was plastically covered with a PRF membrane. Follow up of the healing process was performed on the 7th, 14th and 30th day. Results: The post-operative period underwent without any complications in all areas. The healing process was better in the second patient where a PRF membrane was used. Conclusion: The final result of the technique for vestibuloplasty with a PRF membrane revealed that it might be a good alternative compared to other techniques which are widely used in practice. Further research is needed to confirm our results

Minimally invasive extractions with physics forceps – clinical evaluation and comparison

Introduction: Tooth extraction is still one of the most common dental procedures, routinely performed for a variety of reasons. Tooth extraction forceps and elevators are well-known extraction instruments which have been the standard in tooth extraction procedures for well over a hundred years. Physics forceps are one possible alternative, aiming to perform less traumatic and more predictable extractions. Aim: The aim of study was to compare the effectiveness of physics forceps as an alternative, less traumatic, tool to the conventional extraction forceps. Materials and methods: All patients in the study were split into two groups: 26 patients in whom conventional extraction forceps were used (a control group) and 28 patients in whom we used physics forceps (a study group). For each group, we assessed the success of the extraction, the buccal cortical plate preservation, pain experience, and early wound healing. Results: There was no statistically significant difference in extraction success scores between the two groups. Physics forceps extractions preserved the buccal cortical plate in 81.1% of instances, while traditional forceps extractions did so in 71.8%. The patients in the study group reported less pain on the seventh day. At 10 days, the study group had a marginally higher proportion of completely healed extraction wounds. Conclusions: Atraumatic extractions preserve more hard and soft tissues at the extraction site. Physics forceps are a tool similar to the well-known conventional extraction forceps. They provide for somewhat better results in most extractions

Minimally invasive extractions with physics forceps – clinical evaluation and comparison

Introduction: Tooth extraction is still one of the most common dental procedures, routinely performed for a variety of reasons. Tooth extraction forceps and elevators are well-known extraction instruments which have been the standard in tooth extraction procedures for well over a hundred years. Physics forceps are one possible alternative, aiming to perform less traumatic and more predictable extractions. Aim: The aim of study was to compare the effectiveness of physics forceps as an alternative, less traumatic, tool to the conventional extraction forceps. Materials and methods: All patients in the study were split into two groups: 26 patients in whom conventional extraction forceps were used (a control group) and 28 patients in whom we used physics forceps (a study group). For each group, we assessed the success of the extraction, the buccal cortical plate preservation, pain experience, and early wound healing. Results: There was no statistically significant difference in extraction success scores between the two groups. Physics forceps extractions preserved the buccal cortical plate in 81.1% of instances, while traditional forceps extractions did so in 71.8%. The patients in the study group reported less pain on the seventh day. At 10 days, the study group had a marginally higher proportion of completely healed extraction wounds. Conclusions: Atraumatic extractions preserve more hard and soft tissues at the extraction site. Physics forceps are a tool similar to the well-known conventional extraction forceps. They provide for somewhat better results in most extractions

TREATMENT OF ORAL MUCOSAL LESIONS BY SCALPEL EXCISION AND PLATELET-RICH FIBRINMEMBRANE GRAFTING: A case report

Purpose: The treatment of oral mucosal lesions and mucosal hypertrophy in particular, is most often achieved by an excision with or without covering the surface of the wound. The platelet rich fibrin membrane (PRFm) is an autogenous product containing platelets and leukocytes and their secreted growth factors and cytokines. The purpose of the presented clinical case is to describe a new, recent technique used for the covering of mucosal wounds left after the removal of pathological lesions. Material and Methods: On a single patient mucosal hypertrophy was removed by an excision with scalpel and the resulting surgical wound was covered with an autogenous PRF membrane. Postoperatively the healing process was followed on the 7th, 14th and 30th day. Results: The healing period went smoothly with minimal postoperative discomfort and no complications. Conclusion: The results of the presented clinical case demonstrate that the PRF membrane can successfully be used to cover postoperative mucosal defects

A CASE OF COMPOUND MAXILLARY ODONTOMA AND MANDIBULAR HYPODONTIA

Odontomas are formations which are still classified as benign tumors by the World Health Organization. They are lesions on any odontogenic tissue – enamel, cement and dentin, which are affected in different proportions and degree. We present a case of compound odontoma on upper jaw, on a 15 year-old girl, causing retention of a permanent canine tooth. After the extirpation 16 tooth-like structures were uncovered. The mandible was diagnosed with hypodontia of both 2nd premolars. Patient’s history showed that there was a trauma in the area of the upper jaw at younger age. In this article we will present the clinical and radiographic examination, the stages of the complex surgical-orthodontic treatment and a discussion of the etiology of the diagnosis, complications and the treatment itself

ANALYSIS OF POSTOPERATIVE PAIN AFTER EXTRACTION OF IMPACTED MANDIBULAR THIRD MOLARS AND ADMINISTRATION OF PREEMPTIVE ANALGESIA

patients because of the effect of pain symptoms on the healing process and quality of life. The objective of this study is to make a quantitative and qualitative assessment of the postoperative pain in patients to whom preemptive analgesia was administered. Material and Methods: This is a randomised, placebo-controlled study in 80 patients who underwent surgical removal of impacted mandibular third molars. The patients were divided into three groups – with the preemptive administration of placebo, metamizole sodium and nimesulide. The short form of the McGill Pain Questionnaire (SF-MPQ) and the Visual Analogue Scale (VAS) were used for assessment and analysis of postoperative pain. Results: For the first 24 hours after molar extraction the comparison of the values of the various pain components showed a superior effect of the preemptive analgesia with nimesulide for the alleviation of sensory and total pain compared to metamizole sodium and placebo. In all three groups, pain intensity was highest at postoperative hour 6. Conclusion: Preemptive use of NSAIDs in the extraction of impacted mandibular third molars reduces the perception of postoperative pain and its intensity

MULTIPLE RETAINED TEETH IN MANDIBLE: A Case Report

Purpose: The aim of this science report is to show a rare case of multiple impacted teeth at adult patient and our propose clinical approach.Materials and methods: The clinical case is showed from adult man /64-year old/ with multiple impacted teeth (6 impacted teeth in the anterior place on the mandible) were not suggestive of any syndrome or metabolic disorder. The extraction of the impacted teeth was made on two stage with piezosurgery unit under local anaesthesia. For prevention of postsurgical complications, as a swelling and prevention of postsurgical resorbtion were used coneshapes from pressure xeno colagen. To base on clinical and radiological examination we will discuss the differential diagnosis and we will offer a clinical approach about decided the case.Result and Conclusion: The incidence of multiple retained teeth by literature research range from 10.9% to 40.4%, most frequently is the retention of the third molars. In the literature most rarely have clinical reports about multiple retained teeth which differ from third molars at adult patients. The rare clinical case we showed is very demonstrative and the medicative approach which we used gave excellent result