Tooth Extraction Research Articles

INTRAOSSEOUS EPIDERMOID CYST OF JAW – A case report

Abstract Epidermoid cysts are benign, rare which can occur all throughout the body of an individual. Their occurrence in the oral cavity is rare and is difficult to distinguish from other intraoral cysts. Method A 27-year-old female patient presented with a swelling to the oral and maxillofacial surgery department for the removal of the cystic lesion. Results Based on the clinical and radiographic features the provisional diagnosis was given as odontogenic keratocyst. But the histopathological examination revealed a stratified squamous cystic epithelium with abundant keratin suggestive of an epidermoid cyst. Conclusion This case report presents an uncommon finding in the oral cavity with a history of teeth extraction. Based on these findings even though epidermoid cyst is rare it should be included in the differential diagnosis of radiolucent lesions of the jaws.

Predicting osteoradionecrosis risk in patients with locoregionally advanced nasopharyngeal carcinoma undergoing concurrent chemoradiotherapy: The value of the CARWL index.

Osteoradionecrosis (ORN) is a severe complication that can arise in patients with nasopharyngeal carcinoma due to the aggressive nature of chemoradiotherapy treatment. The purpose of our study was to assess the utility of the recently introduced CARWL index, which integrates the C-reactive protein-to-albumin ratio (CAR) and significant weight loss (SWL), in predicting the risk of ORN in patients with locoregionally advanced nasopharyngeal cancer (LA-NPC) undergoing concurrent chemoradiotherapy (CCRT). We conducted a retrospective cohort analysis on 304 patients with LA-NPC treated with CCRT. Patients were categorized into CARWL index groups based on CAR (cut-off: 3.0) and SWL (weight loss > 5% over the past six months): CARWL-0 (CAR < 3.0, SWL ≤ 5%), CARWL-1 (CAR < 3.0 with SWL > 5% or CAR ≥ 3.0 with SWL ≤ 5%), and CARWL-2 (CAR ≥ 3.0 and SWL > 5%). The primary endpoint was the incidence of ORN in each CARWL index group. At a median follow-up of 67.2 months, 28 patients (9.2%) developed ORN. The incidence of ORN was 2.1%, 9.4%, and 16.3% in the CARWL-0, CARWL-1, and CARWL-2 groups, respectively (P < 0.001). Multivariate analysis identified smoking status (HR: 2.58, P = 0.034), N-stage (HR: 1.96, P = 0.008), T-stage (HR: 1.84, P = 0.017), pre-CCRT tooth extraction status (HR: 5.81, P < 0.001), post-CCRT tooth extraction status (HR: 6.82, P < 0.001), mandibular V55.8 Gy (HR: 6.12, P < 0.001), and CARWL score (HR: 5.67, P = 0.002) as significant predictors of ORN. The CARWL index is a reliable predictive tool for evaluating the risk of ORN in LA-NPC patients undergoing CCRT. If further validated, its use in clinical settings could aid in the early identification of high-risk patients and enable the implementation of personalized preventive strategies.

Evaluation of DIAGNOdent pen for initial occlusal caries diagnosis in permanent teeth

BackgroundTo verify the validity of diagnosing initial caries on occlusal surface of permanent posterior teeth by laser fluorescence instrument DIAGNOdent pen.MethodsPatients from School of Stomatology in Wuhan University were selected and their posterior teeth were examined using DIAGNOdent pen and the International Caries Detection and Assessment System (ICDAS II) by an experienced dentist. After teeth extraction, histological criteria were used to determine the severity of the lesions. The sensitivity, specificity, accuracy, the area under the curve (AUC), and correlation of DIAGNOdent pen and ICDAS II were analyzed compared with histological criteria. Examiners’ agreement was measured.ResultsThe sensitivity range was 0.440-1 while that of specificity was 0.750–0.994. The accuracy and AUC were above 80% and 0.7 respectively. Consistency of examiners’ kappa values of ICDAS II, DIAGNOdent pen, and histological criteria were ranged from 0.629 to 0.840.ConclusionsICDAS II and DIAGNOdent pen can be effectively used in tandem or independently for the assessment of initial caries.

Sub-Sigmoid Osteotomy for Transoral Removal of Ectopic Tooth From Mandibular Ramus and Sigmoid Region

Sub-Sigmoid Osteotomy for Transoral Removal of Ectopic Tooth From Mandibular Ramus and Sigmoid Region

EXODONTIA DE DENTES IMPACTADOS – RELATO DE CASO

Dental impaction is characterized as a situation in which a tooth cannot completely emerge in its normal functional position, and may encounter another structure. Extracting an unerupted and impacted tooth is essential to avoid complications related to this type of pathology. Although tooth extraction surgeries are common in the professional’s daily life, the extraction of an element that has not reached its functional position can be complicated; especially if the dentist is not properly qualified or does not have mastery of the techniques necessary for this procedure. Cases of impaction of the lower second molar occur due to the reduction of space between the distal of the lower first molar and the anterior edge of the ascending ramus of the mandible and may or may not present painful symptoms. Exodontia is a predilection to be considered. Therefore, the purpose of this report is to report a clinical case of extraction of an impacted second molar and its justification is to emphasize the importance of the pre- operative period, which must adequately include anamnesis and complementary exams, and present transoperative techniques that were the difference for the case. Keywords: Impacted tooth. Exodontia. Surgical complications.

Estimating the Extraction Time of an Upper Third Molar: Proposal and Validation of Results.

Background: Numerous studies in the literature have aimed to evaluate the difficulty level of removing third molars. However, most of these studies have focused on the lower third molars, which can lead to complications. There is a lack of a method to determine the complexity of upper third molar extraction. Therefore, this study's objective was to develop an equation using multiple linear regression to estimate the extraction time of an upper third molar based on its complexity. Methods: This study involved patients enrolled in the Master of Oral Surgery program at the University of Seville. To determine their relationship with surgical time, the researchers analyzed various factors, such as depth, root morphology, and the need for odontosection. They then validated their findings by studying patients treated at Palmaplanas Hospital in Mallorca. Results: The cohort analysis from the University of Seville revealed significant associations between surgical time and the identified factors. A regression equation design was performed to predict the total duration of surgical intervention for wisdom teeth extraction. This equation incorporates several independent variables, represented by Xi, together with a constant term, C, and the corresponding coefficients, Bi, which weight the impact of each variable on the intervention time. The results are as follows: -0.312 (spatial relationship), 0.651 (depth), -0.443 (bone and mucosa integrity), 0.214 (roots), -0.745 (ostectomy), 0.713 (odontosection), and -0.426 (suture). Upon application of the statistical methodology to the Palmaplanas Hospital cohort, a regression coefficient of 0.770 was determined. This indicates a strong correlation between the input data and the estimated surgical time. Conclusions: In conclusion, the proposed formula demonstrates notable validity in predicting the surgical time required to extract upper third molars.

Impact of Oral Post-Surgical Pain, Tooth Extraction, on Sleep Quality-Clinical Study

Impact of Oral Post-Surgical Pain, Tooth Extraction, on Sleep Quality-Clinical Study

Recommended procedures for managing carious lesions in primary teeth with pulp involvement—a scoping review

BackgroundManaging dental caries in primary teeth with pulp involvement is a significant challenge. Clinical guidelines offer recommendations for effective management.AimTo identify and analyze policies, guidelines, and recommendations for treating primary teeth with pulp-involved carious lesions, highlighting existing research gaps and setting the foundation for future research.MethodsA comprehensive search was conducted across databases (PubMed, Scopus, Embase, GIN, and LILACS) and grey literature sources (Trip and ProQuest) to identify guidelines, consensus, policy, and position statements on primary teeth pulp therapy and extraction thresholds. Two independent reviewers screened the abstracts and titles, followed by full-text screening.ResultsAfter removing duplication, of the 1098 records, 14 were selected for analysis. This review examined various treatments for deep caries lesions in primary teeth, including indirect/direct pulp capping, pulpotomy, pulpectomy, lesion sterilization/tissue restoration, and extraction. Time search was restricted to documents published from 30th January 2008 to 30th January 2024, offering insights into evolving clinical practices.ConclusionTreatment for carious lesions in primary teeth involving the pulp depends on clinical indications and may involve minimally invasive techniques. Recommended options are indirect pulp capping, pulpotomy, and pulpectomy, while direct capping and tooth removal are discouraged. Further research is needed to address gaps, improve guideline development, and enhance consistency of recommendations.

Immediate Implantation with Autologous Mineralized Dentin Graft versus Deproteinized Bovine Bone as Space-Filling Substitute in Maxillary Anterior Zone: Retrospective Radiological and Clinical Study.

Background/Objectives: Various bone substitutes have been recommended to augment the horizontal gap following immediate implantation. The purpose of this study was to compare the effectiveness of an autogenous mineralized dentin graft or a deproteinized bovine bone in horizontal gap augmentation following immediate implant placement in the maxillary anterior region. Methods: A total of 110 patients underwent tooth extraction followed by immediate implant placement. The patients were divided into two groups. The first group received an autogenous mineralized dentin graft (the test group) while the second group received a deproteinized bovine bone (the control group) to augment the horizontal gap. Preoperative (T0), immediate postoperative (T1), and 1-year postoperative (T2) cone beam computed tomography scans were taken from all the patients. Linear measurements were recorded 1 mm (R1) and 5 mm (R2) points apical to the implant platform at both T1 and T2 time intervals. Pink Esthetic Scores and prosthetic complications were evaluated as well. Results: There were 57 patients with a mean age of 45.42 ± 9.86 (range 24-63 years) selected as the test group and 53 patients with a mean age of 40.28 ± 11.69 (range 20-63 years) as the control group. The mean reduction in the buccal bone plate at R1 was 6.39 ± 3.78% in the test group and 6.99 ± 5.01% in the control group (p > 0.05). The mean reduction in the buccal bone plate at R2 was 5.46 ± 4.98% in the test group and 6.77 ± 7.60% in the control group (p < 0.05). The PES and prosthetic-related complications were shown to be negligible between the groups (p > 0.05). Conclusions: The efficiency of using an autogenous mineralized dentin graft for horizontal gap augmentation showed similar results in comparison to using a deproteinized bovine bone in relation to buccolingual socket reduction following immediate implantation.

A Comparative Study to Explore the Variability of Heavy Metal Concentration in the Teeth of Residents of Non-gated Versus Gated Societies.

Human populations face increasing exposure to heavy metals, which pose significant health risks. Dental tissues, such as dentin and enamel, provide a reliable biomarker for assessing long-term heavy metal exposure due to their stable nature. This study aims to explore the variability of heavy metal concentrations in the teeth dentine of residents living in gated versus non-gated societies near the Yamuna Riveraround the Jamia Millia Islamia, New Delhi, India. Sixty-nine participants were enrolled, 27 from gated societies and 42 from non-gated societies. Participants underwent elective dental extraction,following whichheavy metal concentrations were measured in extracted tooth dentine using atomic absorption spectrophotometry. Demographic data including age, gender, tooth types, and drinking water sources were recorded. Statistical analysis included Mann-Whitney's test, Spearman correlation heatmap, and principal component analysis (PCA). Residents of non-gated societies exhibited significantly (p< 0.005) higher mean concentrations of heavy metals compared to gated societies except for cadmium (p = 0.495). Subgroup analysis based on drinking water sources revealed significant (p<0.001) variations in heavy metal concentrations, suggesting the influence of water quality on environmental exposure. PCA provided insights into underlying trends and correlations among heavy metal variables. This study provides valuable insights into heavy metal contamination among residents living near the Yamuna River, highlighting disparities in exposure based on residential environment and drinking water sources. Participants from non-gated societies exhibited higher mean concentrations of heavy metals compared to those from gated societies, emphasizing the influence of socio-economic factors, urban infrastructure and environmental management practices on heavy metal accumulation. The study's findings underscore the need for targeted interventions to address heavy metal exposure across diverse population groups, improve water quality standards, and enhance access to safe drinking water.

Effect of Hyaluronic Acid on Socket Healing After Lower Impacted Third Molar Tooth Extraction in 40 Dental Patients.

BACKGROUND Surgical extraction of impacted mandibular third molars is the most commonly performed procedure in oral surgery; its associated complications include sensory nerve damage, swelling, and trismus. This study aimed to evaluate the effects of hyaluronic acid (HA) on healing of the socket following extraction of the lower impacted third molar tooth in 40 dental patients. MATERIAL AND METHODS This prospective, double-blind, randomized, controlled study was carried out on 40 adult healthy patients indicated for surgical removal of bilateral impacted mandibular third molars with equal surgical difficulty (moderate surgical difficulty according to the Koerner index. Patients with right mandibular third molars were included into the study (HA) group and those with left mandibular third molars were included into the control group. Surgical removal of impacted teeth was performed at different times for each patient for proper measurement of postoperative clinical variables, including pain, swelling, and mouth opening. RESULTS Postoperative pain evaluation results using the visual analog scale (VAS) showed reduced pain levels at all observation periods. Postoperative swelling peaked in intensity within 12-48 hours, resolving between the 5th and 7th days, and there was no significant difference in pre- and postoperative measurements of interincisal opening between both groups (P>0.05). CONCLUSIONS We found that intra-socket application of hyaluronic acid after surgical extraction of impacted mandibular third molars promoted normal wound healing, and there was a clinical benefit of reduced postoperative pain and swelling.

A Retrospective Analysis of 1311 Oral Surgery Procedures Performed in a Pediatric Hospital in Barcelona: A Study of Their Characteristics and Age-Related Diagnoses.

Background: Oral surgery involves the diagnosis and surgical treatment of diseases affecting the soft and hard tissues of the oral cavity and encompasses a wide range of surgical interventions. The aim of this investigation was to study the characteristics and age-related diagnoses of these oral surgeries, as well as to describe the surgical procedures performed in a pediatric oral and maxillofacial surgery service. Methods: A descriptive, retrospective, observational, and relational study was conducted on children and adolescents aged from 0 to 22 years who were treated in a pediatric oral and maxillofacial surgery service at a children's hospital. Results: We analyzed 1311 surgical interventions (51.4% were on boys and 48.6% on girls), consisting of 24.8% soft tissue surgeries, 65.9% bone and dental tissue surgeries, and 9.3% mixed tissue surgeries. The most common pathologies were tooth eruption disorders (65.9%), followed by ankyloglossia (20.5%). The most frequent treatment was wisdom teeth extraction (31.3%). A statistically significant association (p < 0.05) was found between surgical treatments and variables such as age, sex, tissue type, and biopsy. Conclusions: This study enhances our understanding of pediatric oral surgery, emphasizing that the most common pathology is altered tooth eruption, while the most frequent surgical intervention is the extraction of wisdom teeth at different stages of development.

Symptoms of attention deficit hyperactivity disorder and oral health problems among children in Spain.

The aim of this study was to explore the association between symptoms of attention deficit hyperactivity disorder (ADHD) and oral health in a representative sample of the Spanish population aged 6 to 14 years, we examined the contribution of several sociodemographic and behavioral determinants of children/adolescents and their family environment. A cross-sectional study involving 3,402 subjects aged between 6 and 14 years from the Spanish National Health Survey. The presence of ADHD symptoms was determined using the self-reported hyperactivity/inattention subscale of the Strength and Difficulties Questionnaire. Oral health was assessed using five indicators: caries, extraction, restorations, gingival bleeding, and presence of teeth in poor condition (e.g. broken or misaligned). Logistic regressions were used to examine the association between the presence of ADHD symptoms and oral health indicators. These models were adjusted for sociodemographic factors, lifestyle variables, and oral hygiene behaviors relating to both the children and their parents. Compared to children without ADHD symptoms, children with ADHD symptoms had a higher risk of caries (fully adjusted odds ratio: 2.16; 95% confidence interval: 1.66-2.82), extraction (1.42; 1.09-1.85), restoration (1.47; 1.19-1.82) and gingival bleeding (1.64; 1.11-2.41). The increased risk of caries was maintained when the analyses were restricted to middle/high social class families and to children with low sugar intake, good oral hygiene behaviors and regular dental visits. Children with ADHD symptoms in Spain had worse oral health indicators than those without ADHD symptoms. Our results suggest that the association of ADHD symptoms with caries was independent of socioeconomic level, cariogenic diet, frequency of toothbrushing and dental visits.

Wisdom Tooth Extraction Training for Dental Students: Step-by-Step or All-in-One?

Wisdom Tooth Extraction Training for Dental Students: Step-by-Step or All-in-One?

Immediate versus conventional loading in short and ultra-short implants: a protocol design.

After tooth extraction, inevitable resorption of the postextraction socket occurs. Placing an immediate implant does not fully preserve the bone integrity of the socket. Preservation techniques cannot avoid alveolar resorption. In residual atrophies, bone augmentation techniques are necessary for subsequent rehabilitation with implants. The aim of this study was to propose a protocol of immediate loading in short implants as an alternative to bone augmentation techniques, comparing the immediate versus conventional loading, evaluating peri-implant bone loss, the biological and prosthetic complications, the survival of the implant and prosthesis and the patient satisfaction after one year. This study consists of a randomized controlled clinical trial. For implant planning, periapical intraoral radiographs and Cone Beam Computed Tomography will be used. All patients will receive Straumann Group® (Basel, Switzerland) titanium-zirconia implants with a 4.1mm or 4.8mm diameter and a 4 mm or 6 mm length. The expected results show similar or even minor bone loss, biological and prosthetic complications, identical or even better survival of the short implants with immediate loading, and greater satisfaction. Short implants demonstrate similar survival to conventional length implants, with comparable or even minor biological and prosthetic complications and bone loss. Immediate loading gives satisfactory results similar to conventional loading, with similar biological and prosthetic complications, and generally depends on poor hygiene levels. Bone loss is even less, and the satisfaction increases.

Cognitive impairment after tooth extraction: appraising literature and recommendations for future research.

Cognitive impairment after tooth extraction: appraising literature and recommendations for future research.

Precision Extraction of Lingual Mandibular Supernumerary Teeth Using Dynamic Navigation and High-Speed Handpieces: A Case Report

Precision Extraction of Lingual Mandibular Supernumerary Teeth Using Dynamic Navigation and High-Speed Handpieces: A Case Report

The efficiency of two different synthetic bone graft materials on alveolar ridge preservation after tooth extraction: a split-mouth study

BackgroundAlveolar Bone loss occurs frequently during the first six months after tooth extraction. Various studies have proposed different methods to reduce as much as possible the atrophy of the alveolar ridge after tooth extraction. Filling the socket with biomaterials after extraction can reduce the resorption of the alveolar ridge. We compared the height of the alveolar process at the mesial and distal aspects of the extraction site and the resorption rate was calculated after the application of HA/β-TCP or synthetic co-polymer polyglycolic - polylactic acid PLGA mixed with blood to prevent socket resorption immediately and after tooth extraction.MethodsThe study was conducted on 24 extraction sockets of impacted mandibular third molars bilaterally, vertically, and completely covered, with a thin bony layer. HA/β-TCP was inserted into 12 of the dental sockets immediately after extraction, and the synthetic polymer PLGA was inserted into 12 of the dental sockets. All sockets were covered completely with a full-thickness envelope flap. Follow-up was performed for one year after extraction, using radiographs and stents for the vertical alveolar ridge measurements.ResultsThe mean resorption rate in the HA/β-TCP and PLGA groups was ± 1.23 mm and ± 0.1 mm, respectively. A minimal alveolar bone height reduction of HA/β-TCP was observed after 9 months, the reduction showed a slight decrease to 0.93 mm, while this rate was 0.04 mm after 9 months in the PLGA group. Moreover, the bone height was maintained after three months, indicating a good HA/β-TCP graft performance in preserving alveolar bone (1.04 mm) while this rate was (0.04 mm) for PLGA.ConclusionThe PLGA graft demonstrated adequate safety and efficacy in dental socket preservation following tooth extraction. However, HA/β-TCP causes greater resorption at augmented sites than PLGA, which clinicians should consider during treatment planning.

Dental caries status and treatment need among pregnant women attending antenatal clinics in Dar-Es-Salaam region, Tanzania

BackgroundLiterature shows that pregnant women are more susceptible to dental caries due to several reasons, including changes in salivary flow, reduced pH in the oral cavity, and sugary dietary cravings. The unmet need for care is of special concern, as the failure to obtain treatment can affect the health status of the mother and her unborn child.ObjectivesTo determine dental caries status and treatment needs among pregnant women attending antenatal clinics in the Dar-es-Salaam region.Materials and methodsA descriptive cross-sectional hospital-based study was conducted among 461 pregnant women aged 14–47 years. Informed consent was obtained from participants during data collection. Dental caries status and treatment need were diagnosed according to the WHO criteria. The Data collected was cleaned and analyzed using SPSS version 23.0 software for generating frequency distribution tables, chi-square tests, and logistic regression analysis. The Confidence Interval was 95% (p < 0.05).ResultsThe overall prevalence of dental caries was 69%, with a mean DMFT score of 2.86 (± 3.39). Untreated dental decay was observed in 60.5% of study participants, which needed more restorative treatment (fillings & RCT) than a tooth extraction. Caries experiences differed significantly among the pregnant women in various gravidity. In logistic regression, dental caries experience was significantly higher among multigravida respondents (p-values = 0.04) (OR: 1.840, CI 1.021–3.319).ConclusionThis study demonstrated a high level of dental caries experience and the presence of treatment needs. Multiple pregnancies were a major factor that contributed to high levels of dental caries.

Unusual odontogenic keratocyst with impacted maxillary central incisor: A diagnosis challenge

Background: Odontogenic keratocyst (OKC) is considered an odontogenic cyst, with the unique clinical characteristics of this entity being local destruction, aggressive behavior, a high recurrence rate, specific histopathologic features, and the tendency for multiple lesions when associated with syndromes. Odontogenic keratocyst accounts for 12–14% of all cysts in the jaws. Purpose: The aim of this case report is to present an unusual odontogenic keratocyst associated with impacted maxillary central incisor, case management of anterior maxilla odontogenic keratocyst involving an adjacent tooth, and its postoperative six-month follow-up. Case: A 13-year-old female patient was referred to the Universitas Airlangga Hospital with a complaint that her upper front teeth had not erupted. The parents revealed that the patient had suffered trauma from falling down the stairs at the age of four, i.e., eight years ago. Case Management: The cyst was enucleated together with the associated permanent upper right central incisor, retained deciduous upper right central incisor, the permanent upper right lateral incisor, and upper right canine. Post surgical treatment, the patient used a partial denture to increase her self-confidence. Conclusion: Enucleation of the cyst with extraction of the permanent teeth should be performed to avoid recurrence of the OKC. Periodic radiographic evaluation is required with long-term follow-up.