Case Of Alveolitis Research Articles

Coronectomy: A surgical option for impacted third molars in close proximity to the inferior alveolar nerve

Damage to the inferior alveolar nerve (IAN) during the extraction of impacted mandibular third molars in close proximity to the mandibular canal is a postoperative complication that most frequently occurs in patients 40 years and older. The authors evaluated the postoperative complications of 43 coronectomies of impacted mandibular third molars in 37 patients (17 men and 20 women, mean age [standard deviation] 31 [2] years). The authors used cone-beam computed tomographic images to determine that all of the teeth that underwent a coronectomy were in close proximity to the IAN. The authors did not observe neurological injuries to the IAN or to the lingual nerve. One patient complained of intermittent pain and, 10 months after undergoing the coronectomy, underwent a second operation for extraction of the root fragments. The root extraction did not result in any neurological deficits, because the root fragments had migrated from the mandibular canal. One case of alveolitis was reported that manifested 15 days after the coronectomy. Coronectomies are safer to perform than complete extractions in situations in which the third molar is in close proximity to the mandibular canal. Root migration generally is asymptomatic, but in a case in which the patient underwent a second operation, the risk of the patient's experiencing neurological injuries was reduced. Coronectomy appears to be a valid surgical alternative in patients 40 years and older who are at a higher risk of experiencing neurological deficits than are younger patients.

Efficacy of Amoxicillin Treatment in Preventing Postoperative Complications in Patients Undergoing Third Molar Surgery: A Prospective, Randomized, Double-Blind Controlled Study

The aim of the present study was to evaluate and compare the occurrence of postoperative complications in patients receiving either pre- or postoperative amoxicillin versus placebo after third molar surgery. A randomized, double-blind, placebo-controlled clinical trial was performed in 123 patients undergoing third molar surgery. The patients were randomized to 3 groups, according to the treatment regimen: preoperative amoxicillin, postoperative amoxicillin, and placebo. Both surgeon and patients were unaware of the treatment assignment. The clinical outcomes, including pain, wound infection, trismus, temperature, intra- and extraoral swelling, dysphagia, side effects, and postoperative complications, were assessed. Statistically significant differences were found in the incidence of pain, wound infection, temperature, trismus, and dysphagia between the groups receiving amoxicillin versus placebo. Suture dehiscence and infection of 5 sockets were only found in the placebo group. No cases of alveolitis were observed in the 3 groups studied. No significant differences in swelling were found among the different groups. No statistically significant differences in side effects were found between the groups. The efficacy was greatest in the group receiving postoperative amoxicillin compared with the group receiving a prophylactic preoperative dose. Amoxicillin administered pre- or postoperatively demonstrated greater efficacy than placebo in preventing postoperative complications in patients undergoing third molar surgery. The best results were obtained using the postoperative protocol.

Diffuse pulmonary alveolar fibrosis.

<b>Scadding, J. G. (1974).</b><i>Thorax</i>, <b>29</b>, 271-281. <b>Diffuse pulmonary alveolar fibrosis.</b> The problems of diagnostic categorization of diffuse pulmonary alveolar fibrosis are outlined, and attention is drawn to the different implications of categories defined aetiologically and histopathologically. The pattern of pulmonary insufficiency associated with changes of these sorts is described, and the importance of using a terminology of pulmonary insufficiency which refers unequivocally to disorders of function is emphasized. The usage of the word `interstitial9 in the context of inflammations of the lung is critically examined. It seems to be used to imply predominant involvement of alveolar walls, which in other contexts would be regarded as `parenchyma9. This unresolved conflict which accepted anatomical usage can be avoided by general acceptance of complementary conventions that `pneumonia9 refers to inflammations of the lung characterized by exudation into alveolar spaces leading to consolidation, and `alveolitis9 to those affecting predominantly alveolar walls. Some cases of alveolitis, so defined, can be shown to be due to reactions with inhaled organic dusts in the gas-exchanging part of the lungs in specifically sensitized individuals, constituting a group of aetiologically defined categories `extrinsic allergic alveolitis9. A few are due to ingested toxic substances. Many remain of unknown cause and show a strong and early tendency to alveolar wall fibrosis: they constitute a histopathologically defined category `cryptogenic fibrosing alveolitis9.