Analyses of anatomical relationship between mandibular third molar roots and variations in lingual undercut of mandible using cone-beam computed tomography

Background/purpose: Anatomical features of the lingual undercut region is a potential factor that might increase the risk of displacement of a tooth or fragment. The aim of this study was to report the normal anatomical relationship of impacted lower third molar roots to the lingual cortex and soft tissues of mandible and anatomical variations of lingual balcony in the impacted third molar region. Materials and methods: One hundred impacted third molars (54 males, 46 females) from 65 (31 men, 34 women) patients were evaluated for this study using cone-beam computed tomography. Three measurements [bone thickness, angle (Ang) 1 and Ang 2] were recorded on the coronal section slices of cone-beam computed tomography images; in these images, the impacted third molar root was closest to the lingual soft tissues. Results: The average distance between the tooth root and the lingual outer cortical bone layer (bone thickness) was 1.03 mm. The averages of Ang 1 and Ang 2 were 140.61 degrees and 153.44 degrees. Ang 1 and Ang 2 of female patients were larger than those of male patients. Conclusion: The narrow angulation of the lingual balcony region and the relationship between roots and lingual soft tissues should be noted to avoid undesirable complication of displacement of a tooth or fragment into sublingual, submandibular, and pterygomandibular spaces. There was no relation in the floor of the mouth between the position of the impacted third molar roots and different lingual undercut angulation variations. (C) 2017 Association for Dental Sciences of the Republic of China. Publishing services by Elsevier B.V

Complications related to surgically assisted rapid palatal expansion

Objective. The goals of this retrospective clinical study were to identify surgically assisted rapid palatal expansion (SARPE) complications and assess their incidence, with the aim of informing surgeons and orthodontists of the risks of this widely used procedure before they recommend it to patients. Study Design. Between June 2008 and July 2010, 60 patients (23 women and 37 men) underwent SARPE according to a defined multidisciplinary protocol at the University of Marmara, Istanbul, Turkey. Results. Twelve patients (20%) suffered from nasal bleeding. Of these 12, 2 patients suffered late-onset bleeding beginning on postoperative day 8, and in the other 10, nasal bleeding was insignificant. Three patients reported excessive lacrimation postoperatively. Minor problems related to pain and numbness were all temporary. Conclusions. SARPE procedures have traditionally been reported to be associated with low morbidity, especially in comparison with other orthognathic surgical procedures. However, many complications have been reported

Effects of hyaluronic acid on bleeding following third molar extraction

Abstract Objective To explore the effects of hyaluronic acid (HA) on bleeding and associated outcomes after third molar extraction. Methods Forty patients who had undergone molar extraction were randomly divided into two groups; 0.8% (w/v) HA was applied to the HA group (n=20) whereas a control group (n=20) was not treated. Salivary and gingival tissue factor (TF) levels, bleeding time, maximum interincisal opening (MIO), pain scored on a visual analog scale (VAS), and the swelling extent were compared between the two groups. Results HA did not significantly affect gingival TF levels. Salivary TF levels increased significantly 1 week after HA application but not in the control group. Neither the VAS pain level nor MIO differed significantly between the two groups. The swelling extent on day 3 and the bleeding time were greater in the HA group than in the control group. Conclusions Local injection of HA at 0.8% prolonged the bleeding time, and increased hemorrhage and swelling in the early postoperative period after third molar extractions