DEMOGRAPHICS AND CHARACTERISTICS OF PATIENTS WITH TRAUMATIC BONE CYSTS: A RETROSPECTIVE REVIEW

Objectives:  The aim of this study was to evaluate the demographics and characteristics of the patients treated for traumatic bone cyst (TBC). Materials and Methods: A retrospective review was conducted to determine the radiological, clinical and demographic characteristics of patients with TBC who were surgically treated over a 2-year period using data retrieved from computerized databases. Results: The study sample consisted of 22 patients (24 lesions in total) with mean age of 22.9 years. All lesions were located in the mandible (16 in anterior mandible, 8 in posterior mandible) and diagnosed incidentally during routine dental examinations. There was no statistically significant difference between male and female patients in demographic characteristics. All patients were followed up for 6-18 months with uneventful healing. Conclusions: TBCs should be kept in mind during examination of radiolucent lesions of the mandible particularly in younger patients. Along with the histopathological examination, clinical and radiological findings, symptoms of the patients, and surgeon’s experience should be considered for a definitive diagnosis

Radiographic and histopathologic evaluation of radiolucent lesions involving impacted teeth: A multicenter study

Objective: The purpose of this retrospective study was to evaluate the radiographic and histopathologic features of the pathologic lesions associated with an impacted tooth in the maxilla and mandible of patients who were admitted to three different university hospitals located in different cities. Materials and Methods: One hundred one patients (36 females and 65 males) aged between 8 and 67 and who have radiolucent lesions associated with the impacted teeth were included in this study. Data related to the age and gender of the patients, and the findings of cone-beam computed tomography, and histopathologic diagnosis of the lesions were recorded and analyzed. Results: Majority of the lesions were in the posterior region of the mandible (62.4%), related to the mandibular third molars (59.4%), and were diagnosed as a dentigerous cyst. The most common features of the lesions were unilocular radiolucency (91.1%), well-circumscribed (90.1%), and expansive (85.1%). A statistically significant relationship was found between the migration of the impacted tooth/teeth related to the lesion (p<0.05) and the expansion of the lesion (p<0.01) according to gender. A statistically significant relationship was found between the migration of the impacted tooth/teeth related to the lesion (p<0.05) and the histopathological diagnosis of the lesion (p<0.01) according to age groups. Conclusion: Knowing all of the clinical, radiological and histopathological features of the lesions provide the surgeon to reach the correct diagnosis. Thus, the doctors achieve high success in treatment with the right treatment plan.Amaç: Bu retrospektif çalışmanın amacı, farklı şehirlerde bulunan üç farklı üniversite hastanesine başvuran hastaların üst ve alt çenesindeki gömülü diş ile ilişkili patolojik lezyonların radyografik ve histopatolojik özelliklerini değerlendirmektir. Gereç ve Yöntemler: Bu çalışmaya gömülü diş ile ilişkili radyolüsent lezyonu olan 8-67 yaş aralığındaki 101 hasta (36 kadın ve 65 erkek) dahil edildi. Hastaların yaşı ve cinsiyeti, lezyonların konik-ışınlı bilgisayarlı tomografi bulguları ve histopatolojik tanısı ile ilgili veriler kaydedildi ve analiz edildi. Bulgular: Lezyonların çoğu mandibula posterior bölgede (%62,4), mandibular üçüncü molar dişlerle (%59,4) ilişkiliydi ve dentigeröz kist tanısı aldı. Lezyonlarda en fazla görülen özellikler uniloküler radyolüsensi (%91,1), iyi sınırlı (%90,1) ve ekspansif (%85,1) olması idi. Cinsiyete göre lezyon ile ilişkili gömülü diş/dişlerin migrasyonu (p<0,05) ve lezyonun ekspansiyonu (p<0,01) arasında istatiksel olarak anlamlı bir ilişki bulundu. Yaş gruplarına göre lezyon ile ilişkili diş/dişlerin migrasyonu (p<0,05) ve lezyonun histopatolojik tanısı (p<0,01) arasında istatiksel olarak anlamlı bir ilişki bulundu. Sonuç: Lezyonların tüm klinik, radyolojik ve histopatolojik özelliklerinin bilinmesi cerrahın doğru tanıya ulaşmasını sağlar. Böylece hekimler doğru tedavi planı ile tedavide yüksek başarı elde ederler

Epidemiology of surgery associated acute kidney injury (EPIS-AKI): a prospective international observational multi-center clinical study

Purpose: The incidence, patient features, risk factors and outcomes of surgery-associated postoperative acute kidney injury (PO-AKI) across different countries and health care systems is unclear. Methods: We conducted an international prospective, observational, multi-center study in 30 countries in patients undergoing major surgery (&gt; 2-h duration and postoperative intensive care unit (ICU) or high dependency unit admission). The primary endpoint was the occurrence of PO-AKI within 72&nbsp;h of surgery defined by the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Secondary endpoints included PO-AKI severity and duration, use of renal replacement therapy (RRT), mortality, and ICU and hospital length of stay. Results: We studied 10,568 patients and 1945 (18.4%) developed PO-AKI (1236 (63.5%) KDIGO stage 1500 (25.7%) KDIGO stage 2209 (10.7%) KDIGO stage 3). In 33.8% PO-AKI was persistent, and 170/1945 (8.7%) of patients with PO-AKI received RRT in the ICU. Patients with PO-AKI had greater ICU (6.3% vs. 0.7%) and hospital (8.6% vs. 1.4%) mortality, and longer ICU (median 2 (Q1-Q3, 1-3) days vs. 3 (Q1-Q3, 1-6) days) and hospital length of stay (median 14 (Q1-Q3, 9-24) days vs. 10 (Q1-Q3, 7-17) days). Risk factors for PO-AKI included older age, comorbidities (hypertension, diabetes, chronic kidney disease), type, duration and urgency of surgery as well as intraoperative vasopressors, and aminoglycosides administration. Conclusion: In a comprehensive multinational study, approximately one in five patients develop PO-AKI after major surgery. Increasing severity of PO-AKI is associated with a progressive increase in adverse outcomes. Our findings indicate that PO-AKI represents a significant burden for health care worldwide

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

FARKLI FLEP TEKNİKLERİNİN YARI GÖMÜLÜ ALT ÇENE 3. MOLAR DİŞLERİN CERRAHİSİ SONRASI KOMŞU 2. MOLAR DİŞLERİN PERİODONTAL SAĞLIĞI ÜZERİNE OLAN ETKİLERİ

Oral ve maksillofasiyal cerrahide 3M diş operasyonları ağrı, ödem ve komşu 2M dişte periodontal problemler gibi birçok post-operatif komplikasyonlara neden olabilir. Postoperatif komplikasyonları azaltmak için birçok farklı flep tekniği geliştirilmiştir. Bu çalışmanın amacı 3 köşeli laterale kaydırılan flep tekniği ile birlikte uygulanan primer kapatma yöntemi (FlepI tekniği) ve zarf flep ile uygulanan sekonder kapatma yönteminin (FlepII tekniği) 3M cerrahisi sonrası komşu 2M dişin periodontal sağlığı üzerine etkilerinin karşılaştırmalı olarak incelenmesidir. Çalışmaya bilateral simetrik mesio-vertikal veya vertikal yönde yarı gömülü 3M dişleri bulunan yaşları 18-28 arasında değişen 8 erkek, 22 kadın toplam 30 hasta dahil edilmiştir. Her iki 3M dişler aynı seansta çekilirken bir tarafa FlepI tekniği, diğer tarafa ise FlepII tekniği uygulanmıştır. Pre-operatif dönemde ve post-operatif 2., 7., 30. ve 90. günlerde ölçümler yapılmıştır. Ağrı VAS yöntemi ile, ödem fasiyal bölgelerden yapılan ölçümler ile alveolit ve yara enfeksiyonu klinik parametreler kullanılarak ve yara iyileşmesi de YİS (Yara İyileşmesi skalası) ile değerlendirilmiştir. Komşu 2M dişin periodontal sağlığının değerlendirilmesinde dişeti çekilmesi, klinik ataşman seviyesi, cep derinliği, plak indeksi, gingival indeks ve kanama indeksi parametreleri klinik ölçümler yapılarak gerçekleştirilmiştir. Tüm veriler istatistiksel olarak analiz edilmiştir. Bu çalışmanın sonucunda 3M cerrahisi sonrası FlepI tekniğinde ağrı, ödem ve 2M dişte klinik ataşman seviyesinin FlepII tekniğine göre istatistiksel olarak anlamlı derecede daha fazla olduğu, 2M dişte dişeti çekilmesi, cep derinliği, plak indeksi ve kanama indeksi (+) olan yüzey sayısının ise daha az olduğu bulunmuştur (p<0,05). Gingival indeks değerleri açısından iki teknik arasında herhangi bir fark bulunamamıştır (p>0,05). Her iki teknikte plak indeksi ve gingival indeks ile cep derinliği arasında istatistiksel olarak pozitif bir korelasyon saptanmıştır (p<0,05) . Elde edilen bu veriler 3 köşeli laterale kaydırılan flep tekniğinin yarı gömülü 3M cerrahisinde komşu 2M dişin periodontal sağlığını korumak için kullanılabilecek alternatif bir yöntem olabileceğini göstermiştir.Third molar operations in oral and maxillofacial surgery may cause various postoperative complications such as pain, edema and periodontal problems in 2nd molars. Several different flap techniques have been developed to minimalize potential postoperatif complications. The aim of the present study is to eveluate the effects of 3 cornered laterally sliding flap for primary closure (FlepI) and envelope flap for secondary closure (FlepII) on periodontal health of adjacent second molar following third molar surgery. A total number of 30 patients (8 male and 22 female) aged between 18-28 years requiring symmetrically partially impacted mesiovertical or vertical lower third molar surgery were included in this study. Both 3M teeth were opereted in the same visit appliying FlepI technique to one side and FlepII technique to the other side. Measurements were conducted in the pre-operatively and on 2nd, 7th, 30th and 90th post-operative days. Pain was measured by VAS, edema was recorded using certain facial points, alveolitis and infection determined using clinical parameters and wound healing was measured by WHS ( Wound Healing Scale). Gingival recession, clinical attachment level, probing depth, plaque index, gingival index and bleeding index carried out to assess the periodontal health of adjacent 2nd molars using clinical parameters. All the values were evaluated statistically by SPSS version 12,0. As a result of statistical analysis of the data, pain, edema and clinical attacment level of adjacent 2nd molars in FlepII group were significantly better than FlepI group (p<0,05). Gingival recession, probing depth, plaque index and bleeding index of adjacent 2nd molar in FlepII were significantly worse than FlepI following 3M surgery (p<0,05). Gingival index was similar for both technigues (p>0,05). There were positive correlation between plaque index and gingival index when probing depth was assessed (p<0,05). According to the results of present study 3 cornered laterally sliding flap technique is found to be an alternative surgical method for the partially impacted 3rd molar surgery to improve the periodontal health of adjacent 2nd molars

Mandibulada bilateral dentigeröz kist: vaka raporu

&lt;p&gt;Dentigerous cysts are common developmental cysts of the jaws, most frequently associated with impacted mandibular third molar teeth. Usually they are diagnosed on routine dental radiographs and there is usually no pain or discomfort associated with the cyst unless it becomes secondarily infected. Bilateral dentigerous cyts are rare and typically occurs in association with a developmental syndrome. In addition the occurrence of bilateral dentigerous cysts in the absence of a developmental syndrome is very rare. The aim of this paper was to report on a nonsyndromic, 63 year old man who presented mandibular bilateral dentigerous cyts.&lt;/p&gt; &lt;p&gt;&lt;strong&gt; &lt;/strong&gt;&lt;/p&gt; &lt;p&gt;&lt;strong&gt;ÖZET&lt;/strong&gt;&lt;/p&gt; &lt;p&gt;Dentigeröz kistler çenelerde sık gözlenen odontojenik kistler olmakla beraber, çoğunlukla gömülü mandibular 3. molar dişlerle ilişkilidirler. Genellikle rutin dental radyografilerde tespit edilirler ve sekonder olarak enfekte olmadıkları sürece ağrı veya başka bir rahatsızlık oluşturmazlar. Bilateral dentigeröz kistler nadirdir ve tipik olarak bir gelişimsel sendromla ilişkili olarak ortaya çıkarlar. Buna ek olarak herhangi bir gelişimsel sendrom yokluğunda bilateral dentigeröz kist oluşumu da çok nadir gözlenir. Bu makalenin amacı herhangi bir sendromu olmayan, 63 yaşındaki erkek hastada gözlenen bilateral dentigeröz kist olgusunu sunmaktır.&lt;/p&gt; &lt;p&gt;&lt;strong&gt;Anahtar kelimeler: &lt;/strong&gt;Dentigeröz kist, enükleasyon, mandibuler patoloji&lt;/p&gt

Maxillofacial trauma due to a horse hoof kick: Report of a case

Horses have been identified as the major cause of animal-related farm injuries. Interaction with horses may cause severe dental and orofacial trauma, mostly caused by falls, collision with branches when riding in forests or by horse kicks. Children are uniquely prone to animal-related injuries because of inexperience, incomplete physical and cognitive development and a lack of proper training. Horse-related injuries account for a large percentage of injuries of head/maxillofacial trauma in pediatric farm populations. Although soft tissue contusions, lacerations and abrasions are the most common horse-related injures, head/maxillofacial trauma remains the predominant cause of death, especially in pediatric farm populations. The objective of this case report is to describe a case of severe maxillofacial injuries due to a horse hoof kick. [Arch Clin Exp Surg 2015; 4(1.000): 64-68

Peri-implant plastic surgery techniques to hard and soft tissue augmentation in implant rehabilitation

This report presents the clinical results of peri-implant plastic surgical approaches for hard and soft tissues before and during the implant placement in a patient with vertical ridge deformation and a shallow vestibule sulcus, and the subsequently performed prosthetic rehabilitation. The surgical approaches used in this case reduced the crown-height space and crown-to-implant ratio and ensured that the implants were placed in their ideal positions, and peri-implant tissue health was maintained. In conclusion, developments in the peri-implant plastic surgery enable the successful augmentation of hard and soft tissue defects and provide the implant-supported fixed prosthetic rehabilitation

The efficacy of low-level 940 nm laser therapy with different energy intensities on bone healing

Abstract The aim of this study was to evaluate the efficacy of low-level 940 nm laser therapy with energy intensities of 5, 10 and 20 J/cm2 on bone healing in an animal model. A total of 48 female adult Wistar rats underwent surgery to create bone defects in the right tibias. Low-level laser therapy (LLLT) was applied immediately after surgery and on post-operative days 2, 4, 6, 8, 10 and 12 in three study groups with energy intensities of 5 J/cm2, 10 J/cm2 and 20 J/cm2 using a 940 nm Gallium-Aluminium-Arsenide (Ga-Al-As) laser, while one control group underwent only the tibia defect surgery. All animals were sacrificed 4 or 8 weeks post-surgery. Fibroblasts, osteoblasts, osteocytes, osteoclasts and newly formed vessels were evaluated by a histological examination. No significant change was observed in the number of osteocytes, osteoblasts, osteoclasts and newly formed vessels at either time period across all laser groups. Although LLLT with the 10 J/cm2 energy density increased fibroblast activity at the 4th week in comparison with the 5 and 20 J/cm2 groups, no significant change was observed between the laser groups and the control group. These results indicate that low-level 940 nm laser with different energy intensities may not have marked effects on the bone healing process in both phases of bone formation

Combined Soft And Hard Tissue Peri-Implant Plastic Surgery Techniques To Enhance Implant Rehabilitation: A Case Report

This case report presents an implant-aided prosthetic treatment in which peri-implant plastic surgery techniques were applied in combination to satisfactorily attain functional aesthetic expectations. Peri-implant plastic surgery enables the successful reconstruction and restoration of the balance between soft and hard tissues and allows the option of implant-aided fixed prosthetic rehabilitation.PubMe