Haemostasis in Oral Surgery with Blue-Violet Light

BACKGROUND: The invasive dental procedures usually result in wounds accompanied by physiological bleeding. Even though the bleeding is easily manageable, it is still one of the major concerns of the patients and a reason for their subjective discomfort. Recently, a novel approach with light-emitting diode (LED) was introduced to control the bleeding. This study aims to examine the effectiveness of the irradiation with blue-violet light LEDs on the haemostasis.MATERIAL AND METHODS: The study included 40 patients with an indication for tooth extraction, divided into two groups: examination group (n = 30) and a control group (n = 10). The site of the extraction socket in the examination group was irradiated with LED (410 nm) until the bleeding stopped. The patients from the control group were treated by conventional gauze pressure to stop the bleeding (control group). The duration of irradiation and gauze pressure was measured and compared. The statistical analysis was performed with Student T-test.RESULTS:  The examination group showed the shorter duration of bleeding compared to the control group for 13.67 seconds and 156 seconds, respectively. The most of the cases in the examination group were irradiated in 10 seconds (70%), followed by irradiation of 20 seconds (23.3%) and 30 seconds (6.6%). In the control group, the average time to stop the bleeding by the conventional method was 156 second.CONCLUSION: The blue-violet LED light shortens the bleeding time from the extraction socket after tooth extraction and may be a promising method for achieving haemostasis

The Effect of Dexamethasone in Reducing Pain and Swelling after Oral Surgical Interventions

In case of tissue injury that leads to inflammation.Symptoms of inflammation can be prevented by careful and atraumatic workup and by anti-inflammatory drugs. Dexamethasone as an antiinflammatory drug is very often used because of its higher potency, low sodium retention ability and longer half-life. The aim of the paper is to determine the impact of dexamethasone depending on the method ofapplication on postoperative morbidity after surgical extraction of impacted third molars. Interventions were performed in third molars, after which ampoules of Dexamethasone 4mg wereadministered as ananti-inflammatory drug. In all studied groups, a statistically significant difference in the degree of pain between the two time intervals was found for p<0.05, i.e. pain was significantly lower on the seventhpostoperative day compared to the first postoperative d ay in all groups. In all studied groups, a statistically significant difference in the degree of swelling between the two time intervals was found for p<0.05, i.e. swelling was significantly lower on the seventh postoperative day compared to the first postoperative day in all groups.Locally applied dexamethasone immediately after surgical intervention has a positive effect in reducing swelling and pain in the first postoperative days, resulting in faster healing of the surgical wound, and thus faster recovery of the patient's comfort. Keywords: Anti-inflammatory drug, Dexamethasone, swelling, pai

Surgical treatment of an unusually large mandibular residual cyst: a case report

Residual cysts are common after the extraction of a third impacted molar. Many of them are usually asymptomatic and can be detected incidentally on routine radiography before symptoms appear. Lately, 3D CBCT is the most common diagnostic method for detecting them. We present a case of a residual cyst that exists 20 years after extraction of the right lower third molar. Cysts can vary in size, and over the years can grow and disrupt bone continuity. In this case, a 53-year-old patient has painless swelling that manifests extra-orally in the buccal and masseteric regions. It has been recurring in recent years but the condition was improving with the administration of antibiotic therapy. Surgical treatment is the method of choice. Diagnosis and management of the patient are discussed. Keywords: odontogenic cyst, residual cyst, operative extraction, third lower molar

Brown Tumour in the Mandible and Skull Osteosclerosis Associated with Primary Hyperparathyroidism – A Case Report

BACKGROUND: The hyperparathyroidism (HPT) is a condition in which the parathyroid hormone (PTH) levels in the blood are increased. HPT is categorised into primary, secondary and tertiary. A rare entity that occurs in the lower jaw in association with HPT is the so-called brown tumour, which an osteolytic lesion is predominantly occurring in the lower jaw. It is usually a manifestation of the late stage of the disease. Osteosclerotic changes in other bones are almost always associated with renal osteodystrophy in secondary HPT and are extremely rare in primary HPT. This article reports a rare case of a brown tumour in the mandible as the first sign of a severe primary HPT, associated with osteosclerotic changes on the skull.CASE REPORT: A brown tumour in the mandible was diagnosed in 60 - year old female patient with no previous history of systemic disease. The x - rays showed radiolucent osteolytic lesion in the frontal area of the mandible affecting the lamina dura of the frontal teeth, and skull osteosclerosis in the form of salt and pepper sign. The blood analyses revealed increased values of PTH, calcitonin and β – cross-laps, indicating a primary HPT. The scintigraphy of the parathyroid glands showed a presence of adenoma in the left lower lobe. The tumour lesion was surgically removed together with the lower frontal teeth, and this was followed by total parathyroidectomy. The follow - up of one year did not reveal any signs of recurrence.CONCLUSION: It is critical to ensure that every osteolytic lesion in the maxillofacial region is examined thoroughly. Moreover, a proper and detailed systemic investigation should be performed. Patients should undergo regular check-ups to prevent late complications of HPT

Geranylgeraniol Reverses the Toxicity Induced by Clinical Doses of Zoledronic Acid on Gingival Epithelial Cells and Gingival Fibroblasts

BACKGROUND: Medication-related osteonecrosis of the jaw (MRONJ) is of considerable concern among clinicians and researchers, with no clear pathology mechanism, preventive, or treatment protocols. AIM: This study aimed to assess the effects of geranylgeraniol (GGOH) on the toxicity induced by clinical doses of zoledronic acid (ZOL) on gingival epithelial cells and gingival fibroblasts in vitro. METHODS: Human gingival fibroblasts and gingival epithelial cells were treated with 5, 25, or 50 μM ZOL ± 50 μM GGOH for 3 days. Viability of the cells was determined using the 3-[4, 5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide assay. Calculation of percentage of the control group, analysis of variance and Tukey post-hoc comparisons were performed to test the significance between groups, which was set at p = 0.05. Cell morphology was evaluated using light microscopy. RESULTS: ZOL significantly reduced the viability of both epithelial cells and fibroblasts at all concentrations (p &lt; 0.05), with the exception of fibroblasts at concentration of 5 μM (p = 0.44). GGOH had positive effects on the viability of the cells treated with ZOL at all concentrations. However, statistically significant improvement was obtained only in epithelial cells at 5 and 25 μM ZOL. The cell morphology of both types of cells was improved after addition of GGOH. CONCLUSION: GGOH reverses the toxic effects of clinical doses of ZOL on gingival epithelial cells and has slightly positive, but not significant effects on gingival fibroblasts. This study suggests that GGOH may be effective in the prevention and treatment of MRONJ

Laser analgesic during orthodontic therapy

Introduction: Most of the patients feel pain 4 hours after the arch applying, gaining the highest level after 24 hours and its lowering in the next few days. Literature reports show that the fear of pain is a very important reason for discouraging the patient to agree for this kind of orthodontic treatment The aim of this study was to evaluate the effectiveness of the biostimulative laser treatment in pain reduction in patients with fixed orthodontic appliances. Materials and methods. Fifteen patients were treated with low energy level biostimulative diode laser, used 2 minutes per quadrant immediately after placement of fixed orthodontic appliances and in the following four days. The control group of 15 patients received analgesic therapy for period of five days. The pain was assessed subjectively as strong, medium or no pain. The pain disappeared in 20% of the subjects in the examined group after the first day, while in 60% and 26.6% of the subjects medium and isolated pain was still present at day 2 and 3, respectively. Results. The pain disappeared in all the patients treated with laser at day 5. In the control group, strong pain was present in all the subjects the first day, decreasing to 60% of strong pain and 20% medium pain the second day. After day three, the control group demonstrated medium localized pain in 40% of the cases, which dropped to 26.6% after the fourth day, suggesting delayed pain reduction, compared to the laser treated group. Conclusion. Our results suggest that the low energy laser treatment can successfully be used for pain reduction during the initial discomfort period after placing fixed orthodontic appliances

The Levels of Serum Immunoglobulin A, G and M in Oral Inflammatory Cysts before and after Surgical Therapy

Background/Aim: Cysts which appear in the orofacial region are represented as common pathological changes which underlying mechanism of development is still not fully clear. In recent years, a dominant role in the pathogenesis of cysts belongs to the immunopathological reactions. It is assumed that the loss of bone in cysts is due to the presence of complementary cascades, prostaglandins synthesis and numerous neutrophil granulocytes. The main objective was to determine the levels of Ig G, A and M in serum and saliva of patients with radicular, residual and periodontal cysts before and after the surgical treatment

Osteoradionecrosis of the Mandible: A Case Report

Osteoradionecrosis (ORN) of the jaws is a serious complication of radiotherapy of head and neck malignancies. Different assumptions about its occurring, risk factors and possible therapeutical modalities exist, but the clinical outcome of such patients is still not on the desired level. This article presents a clinical case of ORN of the mandible, occurring with exposed and infected bone, necrotic process that extended through all the mandible body, as well as cutaneous fistula. The first site of ORN was detected 2 years after radiotherapy for oral cancer, with the second one detected 3 and a half years after radiotherapy. In both, the reason for exposing the bone was local trauma due to tooth extraction. Due to the stage of the condition, a decision for surgical treatment accompanied with antibiotics was made