Complications of Third Molar Extraction: A retrospective study from a tertiary healthcare centre in Oman

Objectives: This retrospective study aimed to investigate complications associated with the extraction of third molars at a tertiary healthcare centre in Oman. Methods: All consecutive patients who underwent extraction of one or more impacted third molars under general anaesthesia at Sultan Qaboos University Hospital, Muscat, Oman, between January 2007 and December 2017 were included. Age, gender, indication for extraction, teeth removed, procedure and complications were recorded. Results: A total of 1,116 third molars (56% mandibular and 44% maxillary) were extracted and the majority (67.7%) were from female patients. The mean age at extraction was 24 ± 5 years and most patients (77.7%) were 20‒29 years old. The intraoperative and postoperative complication rates were 3.7% and 8.3%, respectively. The intraoperative complications included tuberosity fracture (1.2%), root fracture (1.1%), bleeding (0.7%), soft tissue injury (0.5%) and adjacent tooth damage (0.2%). Postoperative complications were sensory nerve injuries (7.2%), swelling/pain/trismus (0.6%) and dry socket (0.5%). Nerve injury was temporary in 41 patients and permanent in four cases. A statistically significant relationship was observed between those aged 30‒39 years and dry socket (P = 0.010) as well as bone removal and all postoperative complications (P = 0.001). Conclusion: Most complications resulting from third molar extractions were minor and within the reported ranges in the scientific literature. However, increased age and bone removal were associated with a higher risk of complications. These findings may help to guide treatment planning, informed consent and patient education.Keywords: Third Molar; Tooth Extraction; Complications; Lingual Nerve; Inferior Alveolar Nerve; Oman

Innovation modeling and simulation of thermal convective on cross nanofluid flow over exponentially stretchable surface

This work reported to investigate convective flow of non-Newtonian fluid effect on an exponentially stretchable surface. Effect of nanoparticle is considered in heat and mass equation. The transformation technique utilized on dimensionless equations is converted to non-dimensionless equations are solved thought numerical approach Bvp4c. Influence of approatiate analysis of velocities, heat and mass transport are scrutinized through figures. Furthermore, the comparative analysis of drag forces, Nusselt number and Sherwood number are evaluated over and done with tabulated values. It is give details that the temperature field strengthens with intensification in thermophoresis and random diffusions. Similarly, rises in thermophoresis effect parameter both temperature and concentration profile increasing

Prophylactic biological mesh reinforcement versus standard closure of stoma site (ROCSS): a multicentre, randomised controlled trial

Background: Closure of an abdominal stoma, a common elective operation, is associated with frequent complications; one of the commonest and impactful is incisional hernia formation. We aimed to investigate whether biological mesh (collagen tissue matrix) can safely reduce the incidence of incisional hernias at the stoma closure site. Methods: In this randomised controlled trial (ROCSS) done in 37 hospitals across three European countries (35 UK, one Denmark, one Netherlands), patients aged 18 years or older undergoing elective ileostomy or colostomy closure were randomly assigned using a computer-based algorithm in a 1:1 ratio to either biological mesh reinforcement or closure with sutures alone (control). Training in the novel technique was standardised across hospitals. Patients and outcome assessors were masked to treatment allocation. The primary outcome measure was occurrence of clinically detectable hernia 2 years after randomisation (intention to treat). A sample size of 790 patients was required to identify a 40% reduction (25% to 15%), with 90% power (15% drop-out rate). This study is registered with ClinicalTrials.gov, NCT02238964. Findings: Between Nov 28, 2012, and Nov 11, 2015, of 1286 screened patients, 790 were randomly assigned. 394 (50%) patients were randomly assigned to mesh closure and 396 (50%) to standard closure. In the mesh group, 373 (95%) of 394 patients successfully received mesh and in the control group, three patients received mesh. The clinically detectable hernia rate, the primary outcome, at 2 years was 12% (39 of 323) in the mesh group and 20% (64 of 327) in the control group (adjusted relative risk [RR] 0·62, 95% CI 0·43–0·90; p=0·012). In 455 patients for whom 1 year postoperative CT scans were available, there was a lower radiologically defined hernia rate in mesh versus control groups (20 [9%] of 229 vs 47 [21%] of 226, adjusted RR 0·42, 95% CI 0·26–0·69; p<0·001). There was also a reduction in symptomatic hernia (16%, 52 of 329 vs 19%, 64 of 331; adjusted relative risk 0·83, 0·60–1·16; p=0·29) and surgical reintervention (12%, 42 of 344 vs 16%, 54 of 346: adjusted relative risk 0·78, 0·54–1·13; p=0·19) at 2 years, but this result did not reach statistical significance. No significant differences were seen in wound infection rate, seroma rate, quality of life, pain scores, or serious adverse events. Interpretation: Reinforcement of the abdominal wall with a biological mesh at the time of stoma closure reduced clinically detectable incisional hernia within 24 months of surgery and with an acceptable safety profile. The results of this study support the use of biological mesh in stoma closure site reinforcement to reduce the early formation of incisional hernias. Funding: National Institute for Health Research Research for Patient Benefit and Allergan