Extraction Sites Research Articles

The Impact of the Chlorhexidine Gel (WISDOM®) on Postoperative Sequelae Associated with the Surgical Removal of Impacted Mandibular Third Molars: A Randomized Controlled Clinical Trial

Background: One of the most prevalent procedures in oral surgery is the removal of impacted mandibular third molars, typically accompanied by trismus, edema, and pain. Several methods and biomaterials were implemented to mitigate or avoid these surgical problems. Objectives: To evaluate the efficiency of chlorhexidine gel (WISDOM®) in minimizing postoperative sequelae associated with the impacted mandibular third molar that will be surgically extracted and its role in promoting early soft tissue closure of the surgical site. Methods: The study design was a double-masked and randomized, controlled clinical study that included healthy patients needing the removal of a mandibular third molar through surgery. The participants were randomly assigned to two groups. The extraction site of the study group was filled with a mixture of gel foam and WISDOM®. In contrast, we filled the extraction sites of the control group patients with gel foam and sutured the surgical sites for both groups. The patients were evaluated on the first, third, and seventh postoperative days for pain, swelling, trismus, and early soft tissue healing. Results: Sixty eligible patients were enrolled in this study. The study group exhibited a statistically significant decrease in pain, edema, trismus, and early soft tissue healing on the first, third, and seventh postoperative days compared to the control group. Conclusions: WISDOM® gel can effectively reduce postoperative pain, trismus, and swelling and promote early soft tissue healing after surgical removal of an impacted mandibular wisdom tooth.

Efficient ammoximation and regeneration of degraded hydroxyoxime CP150 over TS-1 molecular sieve/H2O2 system and reuse for solvent extraction of Cu(II)

The regeneration of failed hydroxyoxime extractants in the copper hydrometallurgy industry is crucial. However, the existing regeneration system has limitations in terms of operability, yield, and environmental friendliness, which restricts its industrial application. This paper presents a clean one-pot ammoximation regeneration system for the in-situ preparation of hydroxylamine for the oximation of aldehydes, catalyzed by TS-1 with NH3 and H2O2. It was tailored based on the characteristics of the degraded organic phase produced by long-term operation at the copper solvent extraction site. The developed system demonstrates an excellent regeneration conversion efficiency (>90%) for the degraded copper-extracted organic phase. Following regeneration, the copper extraction efficiency of the organic phase reaches the same level as the fresh organic phase and maintains good copper extraction stability even after multiple extraction cycles. Moreover, the phase separation performance was improved through optimization. This regeneration system meets the demand for environmentally friendly and resourceful utilization of degraded waste organic phases in copper extraction systems.

Preliminary Assessment of Mercury and Methyl Mercury Contamination of Sediments, Water and Fish from the Bétaré-oya Gold Extraction Site (Cameroon)

The gold extraction process by mercury amalgamation is recognized worldwide as a process presenting an environmental and health risk linked to mercury contamination of the geo and biosphere close to the gold panning site. The aim of this work is to assess the risk of contamination by mercury of populations living in the locality of Bétaré-oya, which is subject to the phenomenon of small-scale artisanal mining. In order to achieve this, a small social survey was carried out on two gold extraction sites in the locality of Bétaré-oya. Samples of sediment, water and fish were also taken from these sites. After characterization, these samples underwent the total mercury was determined by an automatic mercury analyzer. Moreover, the methyl mercury was extracted from the samples and analyzed by inductively coupled plasma mass spectrometer coupled to gas chromatography and by gas chromatography coupled to an electron capture detector. The results obtained showed total mercury concentrations varying from 386 to 5072 µg/kg in sediments and from 24.6 to 8451 ng/L in water. Methyl mercury was measured at concentrations ranging from 7.62 to 165 µg/kg in sediments, from 2.54 to 15 µg/L and from 45.4 to 90.8 µg/kg in fish. Well water (15.0 ± 2.4 µg/L of methyl mercury) which is consumed by the populations of the study site, and fish contaminated with an average concentration of 68 µg/kg of Methyl mercury, represent the main vectors of the risk of direct contamination of the populations of the locality of Bétaré-oya by this pollutant.

Hierarchical Optimization Framework for Layout Design of Star–Tree Gas-Gathering Pipeline Network in Discrete Spaces

The gas-gathering pipeline network is a critical infrastructure for collecting and conveying natural gas from the extraction site to the processing facility. This paper introduces a design optimization model for a star–tree gas-gathering pipeline network within a discrete space, aimed at determining the optimal configuration of this infrastructure. The objective is to reduce the investment required to build the network. Key decision variables include the locations of stations, the plant location, the connections between wells and stations, and the interconnections between stations. Several equality and inequality constraints are formulated, primarily addressing the affiliation between wells and stations, the transmission radius, and the capacity of the stations. The design of a star–tree pipeline network represents a complex, non-deterministic polynomial (NP) hard combinatorial optimization problem. To tackle this challenge, a hierarchical optimization framework coupled with an improved genetic algorithm (IGA) is proposed. The efficacy of the genetic algorithm is validated through testing and comparison with other traditional algorithms. Subsequently, the optimization model and solution methodology are applied to the layout design of a pipeline network. The findings reveal that the optimized network configuration reduces investment costs by 16% compared to the original design. Furthermore, when comparing the optimal layout under a star–star topology, it is observed that the investment needed for the star–star topology is 4% higher than that needed for the star–tree topology.

Epidemiological profile of malaria in a rural community in the Amazon, Mato Grosso State, Brazil, 2011

BackgroundMore than 95% of malaria transmission in Brazil occurs in the Legal Amazon Region, which in 2010 recorded around 333,429 cases reported in the Epidemiological Surveillance Information System-Malaria (Sivep_malaria), presenting an annual parasitic incidence (IPA) of 13.1 cases/1000 inhabitants.MethodsThis was a descriptive study that measured the community prevalence of Plasmodium infection and its relationship with land use in Três Fronteiras District, Colniza Municipality, Mato Grosso State. Data were collected during household visits in July 2011, with blood collection from finger pricks for the preparation of thick smear slides, and completion of a standardized case notification form. A georeferenced database was analysed, with land use evaluated as categorical variables. A kernel density map was built to show the density of cases and their location.ResultsOf the 621 respondents, 68(11%) had Plasmodium infection: 39 (57.4%) with Plasmodium vivax, 27(39.7%) with Plasmodium falciparum and two (2.9%) with mixed infections. Among infected individuals, 49 (72.1%) were men. Cases of malaria were distributed over the district, with greater occurrence of cases per household in open areas close to the mining company and artisanal mining sites. The was a greater density of cases located in the gold mining region.ConclusionTransmission of malaria in Três Fronteiras District has a heterogeneous distribution. Individuals residing in mining and timber extraction sites have increased occurrence of Plasmodium infection.

The DTR Technique-Drilling through the Roots of Posterior Teeth for Anatomically Guided Immediate Implant Placement: A Cohort Study.

The present study clinically analyzes implant survival of immediate implant placement cases using the drilling through roots (DTR) technique for anatomically-guided implant site preparation, as an aid to placing immediate dental implants in multi-radicular teeth. This clinical analysis utilized patients' electronic dental records who underwent immediate implant surgery using the DTR technique. All immediately placed implants were followed up regularly every year, after restoration. Implant survival was assessed with the Albrektsson et al. criteria. Inferential statistics was performed using SPSS v 21(IBM Corp., Armonk, NY) software. The Kaplan-Meier survival analysis was done to assess the implant survival probability. A total of 250 records of dental implants placed in 227 subjects using the DTR technique were considered. Results showed that the mean survival duration of implants was found 63.29 months and the median survival duration to be 55 months. A 100% success rate was seen in implant fixed bridge cases, and about 97.6% success was seen in single crown cases. No significant difference was seen in the survival rates during the follow-up period when compared according to the quadrants/site of implant placement. The findings concluded that tooth-guided rapid implant placement is a unique strategy for convenient and safe insertion, providing accurate three-dimensional positioning. The DTR method is a novel approach that facilitates accurate positioning and angulation of the implant bed preparation by stabilizing and guiding the osteotomy drills using the retained root. As a result, it enables optimal implant positioning at multirooted extraction sites. How to cite this article: Mahesh L, Miselli A, Bhasin MT, et al. The DTR Technique-Drilling through the Roots of Posterior Teeth for Anatomically Guided Immediate Implant Placement: A Cohort Study. J Contemp Dent Pract 2024;25(5):432-439.

Osteogenic potency of dental stem cell-composite scaffolds in an animal cleft palate model

ObjectiveTo evaluate the osteogenic potency of stem cells isolated from human exfoliated deciduous teeth (SHED) in polycaprolactone with gelatin surface modification (PCL-GE) and poly (lactic-co-glycolic acid)-bioactive glass composite (PLGA-bioactive glass (BG)) scaffolds after implantation in a rat cleft model. MethodsCleft palate-like lesions were induced in Sprague-Dawley rats by extracting the right maxillary first molars and drilling the intact alveolar bone. Rats were then divided into five groups: Control, PCL-GE, PCL-GE-SHED, PLGA-BG, and PLGA-BG-SHED, and received corresponding composite scaffolds with/without SHED at the extraction site. Tissue samples were collected at 2, 3, and 6 months post-implantation (4 rats per group). Gross and histological analyses were conducted to assess osteoid or bone formation. Immunohistochemistry for osteocalcin and human mitochondria was performed to evaluate bone components and human stem cell viability in the tissue. ResultsBone tissue formation was observed in the PCL-GE and PLGA-BG groups compared to the control, where no bone formation occurred. PLGA-BG scaffolds demonstrated greater bone regeneration potential than PCL-GE over 2–6 months. Additionally, scaffolds with SHED accelerated bone formation compared to scaffolds alone. Osteocalcin expression was detected in all rats, and positive immunoreactivity for human mitochondria was observed in the regenerated bone tissue with PCL-GE-SHED and PLGA-BG-SHED. ConclusionPCL-GE and PLGA-BG composite scaffolds effectively repaired and regenerated bone tissue in rat cleft palate defects. Moreover, scaffolds supplemented with SHED exhibited enhanced osteogenic potency. Clinical significancePCL-GE and PLGA-BG scaffolds, augmented with SHED, emerge as promising biomaterial candidates for addressing cleft repair and advancing bone tissue engineering endeavors.

New Guidelines for the Treatment of the Alveolar Septum in Immediate Dentoalveolar Restoration Technique Associated with Osseodensification: A Case Series.

Achieving initial implant stability at the molar extraction site can be challenging due to bone width, quality, and anatomical limitations like the maxillary sinus and inferior alveolar nerve. The implant placement should achieve precise centralization with the interradicular septum to facilitate implant stabilization and preservation/regeneration of the alveolar ridge post-extraction with bone grafting. Immediate non-occlusal crown placement aids peri-implant tissue maturation for the desired outcome. This retrospective series introduces guidelines for treating sockets with alveolar septum types. The approach involves immediate dentoalveolar restoration (IDR) and osseodensification (OD) with an autogenous graft for bone preservation. A new protocol for the treatment of the molar interradicular septum during immediate implant placement and/or alveolar ridge preservation/reconstruction was applied in 12 cases. Preoperative and postoperative cone-beam computed tomographic examinations were performed. Socket width was measured and compared between timepoints. The mean preoperative and postoperative (mean, 23.58 ± 9.70 months) socket widths were 9.51 ± 0.40 and 11.16 ± 0.30 mm, respectively (17.35% increase; p <0.05). IDR with OD is a predictable approach to the treatment of molar sockets during implant placement.

Minimally Invasive Extraction System Benex-Clinical Evaluation and Comparison.

Tooth extraction is one of the oldest and most well-known surgical procedures in dental medicine. It is still routinely performed by general practitioners and dental undergraduates. The Benex extraction system allows for the extraction of teeth in a vertical direction, which avoids most trauma against surrounding alveolar bone and soft tissues. The study included 56 patients who were recruited from the Department of Oral Surgery, Medical University-Plovdiv. The patients were split into two groups of 28 patients-Group I (control group) and Group II (study group). For each group, the success of the extraction, buccal cortical plate preservation, pain experience and early wound healing were assessed. There was no statistical significance between the success of the extractions in both groups. The Benex extractions preserved the buccal cortical plate in 95% of the cases, whereas the forceps extractions preserved it in only 71.8%, which is statistically significant. On the seventh day, patients in Group II reported less pain, without a significant difference. There was a significantly bigger number of completely healed extraction wounds on the 10th day. Atraumatic extractions allow for more hard and soft tissues to be preserved in the extraction site. This is essential for a successful outcome and the aesthetically pleasing results of the following dental restoration.

Land Art Submerged: Betty Beaumont’s Ocean Landmark and Art History Beyond Proximity

Abstract Comprising 17,000 blocks of coal fly-ash, Betty Beaumont’s Ocean Landmark (1978–1980) is an artificial reef located off the coast of Fire Island, New York. This essay analyses the visual inaccessibility of the work and its reliance on an assemblage of media to highlight its significance for conceiving political, ecological and cultural meanings of the ocean. Land art’s fascination with the limits of visuality, the site/non-site dialectic and relationship with industry will provide a framework for this aim. Ocean Landmark’s situatedness and association with industrial ecology signals the wider juridical and political lack of transparency in industrial activity in the ocean spaces framed as sites of unseen environmental extraction. Demonstrating the political and epistemological consequences of a lack of visibility, it challenges the assumptions of total sensorial and epistemic access, highlighting the limitations of anthropocentric positions in and beyond the ocean.

Assessment of soft and hard tissue changes following micro crestal flap-Alveolar ridge preservation and augmentation at molar extraction sites in patients with stage III/IV periodontitis: A randomized controlled trial.

This study aimed to assess hard and soft tissue contour changes following micro crestal flap-alveolar ridge preservation (MCF-ARP) and natural healing (NH) in periodontally compromised molar extraction sites and to analyse the feasibility and need for bone augmentation during implant therapy. Fifty-six patients with 70 sites were randomized into two groups at the site level (35 sites from 31 patients in the test group and 35 sites from 29 patients in the control group). Among whom, four patients contributed one tooth to the control group and one tooth to the test group. Hard tissue indicators were measured using cone beam computed tomography performed before tooth extraction and 6 months after surgery. Soft tissue contour changes were assessed using intraoral scanning performed before and immediately after surgery and also 2 weeks and 1, 3 and 6 months after surgery. Six months after surgery, the MCF-ARP group showed less resorption in buccal bone height (p = .032) and greater augmentation in central bone height (p = .001) and ridge width (p = .009). The mean, vertical and horizontal collapse of buccal soft tissue contour in the MCF-ARP group were 0.95 mm (p = .010), 0.61 mm (p = .019) and 0.56 mm (p = .013) less than that in the NH group, respectively. There were significantly (p = .007) fewer sites in the MCF-ARP group than in the NH group (0% vs. 26.7%) for staged bone augmentation and more sites that could be treated with simple implant procedure in the MCF-ARP group than in the NH group (71.9% vs. 56.6%). Compared with NH, MCF-ARP reduced bone resorption in periodontally compromised molar extraction sites and maintained the buccal soft tissue contour. MCF-ARP reduces the need for complex bone augmentation procedures in implant therapy. Chinese Clinical Trial Register (ChiCTR) ChiCTR2200056335. Registered on 4 February 2022, Version 1.0.

Gingivo-Periosteal Expansion of Edentulous Jaw Crest with An Osmotic Self-Inflatable Expander: A Preclinical in Vivo Study.

This study examined the biocompatibility and expansion volume of tissue expanders utilizing rabbits and beagles as experimental models. The self-inflatable expander was provided using a Tissue balloon® (Neobiotech Co., Seoul, Korea). In 9 adult rabbits, a Tissue balloon® was placed under the lateral mandibular periosteum via an extraoral approach. After 2, 3, and 4 weeks (n=3), the expanders were removed, and soft tissue and bone samples were collected for analysis. Histomorphometric analysis and measurements of expander characteristics were performed. In 5 Beagles, all premolars were extracted. Three months after extraction, tissue expanders were placed in the maxilla and mandible, adjacent to dental extraction sites, and removed after 3 weeks. Gingival parameters were measured before and after expansion. Blood perfusion in the oral mucosa was assessed using a laser Doppler flowmeter at different time points. After three weeks, dogs were euthanized, and tissue samples were collected for histologic analysis, focusing on inflammatory response, bone formation, and gingival thickness changes. In the rabbit study, measurements of size, weight, and volume showed significant increases over 4 weeks. Swelling peaked at 2 weeks postimplantation and then gradually stabilized. Histologic examination revealed no signs of inflammation, and expanders were covered by collagen-rich capsules. Some bone resorption was noted due to pressure from the expanders, but the resorption was not significant. In the beagle study, twenty tissue expanders were implanted; 1 expander was lost, and 9 wounds dehisced during soft tissue healing. However, no signs of infection were noted. Histologic evaluation showed bone atrophy, attributed to swelling pressure, at the recipient site. Gingival thickness was not decreased. Perfusion measurements indicated that expansion did not affect microvascular circulation adversely. Overall, both studies suggest that tissue expanders demonstrate biocompatibility and successful expansion volume in vivo, with minimal adverse effects on surrounding tissues and microvascular circulation.

Effect of Specimen Extraction Site on Postoperative Incisional Hernia after Minimally Invasive Right Colectomy.

Incisional hernia (IH) is a known complication after colorectal surgery. Despite advances in minimally invasive surgery, colorectal surgery still requires extraction sites for specimen retrieval, increasing the likelihood of postoperative IH development. The objective of this study is to determine the effect of specimen extraction site on the rate of IH after minimally invasive right-sided colectomy for patients with available imaging. This is a retrospective multi-institutional cohort study at 2 large academic medical centers in the US. Adults who underwent right-sided minimally invasive colectomy from 2012 to 2020 with abdominal imaging available at least 1 year postoperatively were included in the analysis. The primary exposure was specimen extraction via a midline specimen extraction vs Pfannenstiel specimen extraction. The main outcome was the development of IH at least 1 year postoperatively as visualized on a CT scan. Of the 341 patients sampled, 194 (57%) had midline specimen extraction and 147 (43%) had a Pfannenstiel specimen extraction. Midline extraction patients were older (66 ± 15 vs 58 ± 16; p < 0.001) and had a higher rate of previous abdominal operation (99, 51% vs 55, 37%, p = 0.01). The rate of IH was higher in midline extraction at 25% (48) compared with Pfannenstiel extraction (0, 0%; p < 0.001). The average length of stay was higher in the midline extraction group at 5.1 ± 2.5 compared with 3.4 ± 3.1 days in the Pfannenstiel extraction group (p < 0.001). Midline extraction was associated with IH development (odds ratio 24.6; 95% CI 1.89 to 319.44; p = 0.004). Extracorporeal anastomosis was associated with a higher IH rate (odds ratio 25.8; 95% CI 2.10 to 325.71; p = 0.002). Patients who undergo Pfannenstiel specimen extraction have a lower risk of IH development compared with those who undergo midline specimen extraction.

Marl Mining Activity and Negative Repercussions for Two Hillside Villages (Northern Italy)

Coniolo and Brusaschetto, are two small towns located in the Monferrato area of the Alessandria Province, northern Italy. These communities have similar histories related to development and subsequent abandonment of marl quarry activity that began more than a century ago and continued until recently. Quarrying occurred until soil conditions, water infiltration, and excessive depth made cost of extracting and7 lifting material prohibitive. Quarries consisted of tunnels located directly beneath the towns at about 150 m below ground surface. Collapse of the tunnels led to surface subsidence and destruction of overlying homes and much of the municipal infrastructure. In the early Twentieth Century, regulations pertaining to mine and quarry safety were typically deficient, entirely absent, or not followed. Extractive activities of non-energy mineral resources from quarries and mines were and continue to be widespread in Italy, which currently ranks fifth among what are now countries of the European Union (EU). Mining sites are present in all regions of Italy, particularly in the northern part of the country and along coasts, often in areas of geohydrogeological risk. Consequences of anthropogenic pressures that alter the natural environment, such as the physical size of aquifer drawdowns, are linked to issues for a number of extractive sites across the country. This report analyzes historical and technical documents, conducts a geomorphological analysis of hilly slopes surrounding these communities, and examines urban planning and geophysical surveys to determine the impact of subsurface quarrying activities on the overlying ground surface. The study highlights significant problems that are applicable to other localities globally. This research demonstrates: (a) the importance of geological considerations to development and abandonment of mining activity in inhabited areas; (b) the importance of establishing and following safety protocols; and (c) the manner in which economic interests can take precedence over the well-being and lives of those employed to extract resources.

522 A Snapshot Audit of Incisional Hernia Rates Following Colorectal Cancer Resection

Abstract Aim Incisional hernia is a common complication of colorectal surgery. Recent European Hernia Society guidelines recommend strategies such as small bites closure and off-midline incisions to reduce incisional hernia rates. We aimed to evaluate our centres incisional hernia rate and performance against these categories Method All patients undergoing surgery for colorectal cancer in 2020 were included. Operative details including incision location and closure method were collected. Post-operative CT scans were assessed and correlated with clinic letters to determine presence of incisional hernia. Patients were excluded if they underwent re-operation through the midline within 12 months, or if had no imaging after 12 months. Results 118 patients were included. The incisional hernia rate was 31.4% at a mean follow-up of 24.9 months. Large bites closure (Hughes or loop PDS, n=80) had a higher incisional hernia rate compared to small bite closure ( n=38) (35.0% vs 23.6%). Incisional hernia rates were 44.1% in laparotomy incisions, 37.2% in midline extraction sites, 8% in Pfannensteil extraction sites and 0% in transverse extraction sites. Overall, IH rates in midline incisions were 40.7%, compared to 6.3% in off-midline incisions. Conclusions Incisional Hernia rates remain high following colorectal cancer surgery in our institution. Small bites closure and off-midline incisions appear to reduce this risk, but use of these techniques remains low. Work is ongoing to identify and implement strategies to improve uptake of small bites and off-midline incisions.

Rebellion, Resistance, and Resilience: Three Black British Artists and Eco-Feminism

This paper critically discusses the work of three women artists of colour who, in different ways, engaged with environmental catastrophe and called for climate justice during the late 1980s and early 1990s. Leslie Hakim-Dowek, Gurminder Sikand, and Nina Edge each engaged in particular types of thoughtful, practice-led decolonial feminism that addressed the consequences of rampant corporate neo-colonialism and the ways that the global North has treated the global South as a site for material extraction and exploitation. Echoing the non-violent systems of protest of the women-led Chipko environmental movement in northern India, Sikand's delicate and gentle paintings may nonetheless be understood as searing eco-feminist statements; Edge's work from 1991 combines image and poetry to address the on-going consequences of the devastating industrial disaster at Bhopal, India, in 1984; while Hakim-Dowek's 1991 series of paintings titled Endangered Species (1991) presents a memorial to what has already been lost. This paper will argue that despite the curatorial and critical neglect experienced by these artists, their work nonetheless offers entryways into current, globally important, conversations about the ongoing struggle of women in the global South against white neo-colonial capitalism, and the fight for climate justice.

Analysis of predicted and achieved root angulation changes in teeth adjacent to maxillary premolar extraction sites in patients treated with the Invisalign appliance

This study aimed to investigate the expression of root angulation in canine, premolar, and first molar teeth adjacent to first and second premolar extraction sites in the maxilla after treatment with an initial series of Invisalign aligners (Align Technology, Santa Clara, Calif). Adult patients (aged≥18 years) with at least 1 first and/or second premolar extraction in the maxilla and satisfying strict selection criteria were evaluated. Digital models representing pretreatment, predicted, and posttreatment were obtained from Align Technology's digital interface, ClinCheck. The Geomagic Control X (version 2017.0.3; 3D systems, Rock Hill, NC) software facility was used to determine and compare the root angulation of adjacent canine, premolar, and first molar teeth at different time points. The predicted angulation of teeth was significantly different (P<0.02) than that achieved in most patients. When adjacent teeth roots were planned to tip away from the extraction site, there was an overexpression of the movement. When teeth roots were planned to tip into the extraction site, underexpression occurred, and movement was in the opposite direction in some instances. There was no difference in root angulation outcomes according to the prescribed number of aligners, 1- or 2-week wear protocols, and sex (P>0.05). Attachments were influential in controlling angulation in first-premolar extractions (P= 0.05), but optimized attachments were not any more effective than conventional attachments (P>0.05). The achieved root angulation in teeth adjacent to premolar extraction sites in the maxilla after treatment with an initial series of Invisalign aligners differed significantly from that predicted. Attachments play a minor role in the predictability of root angulation outcomes.

Spatial and angular alterations in the dental arch after premature loss of primary molars: Immediate and 9-month computed tomography evaluation.

Contemporary imaging methods and quickly advancing technologies have increased the number of diagnostic tools available in medicine and orthodontics. The current study aimed to determine three-dimensional (3D) space changes that occurred after the extraction of either the maxillary or mandibular primary molars during the mixed dentition period. The present study was a longitudinal split-mouth study with a study group and a control group. The sample consisted of 20 children aged between 6 and 9 years. Clinical examination, radiological analysis, and 3D digital images of the plaster casts were used sequentially to gather all the data. The dental cast measurements recorded were arch width, arch length, hemi-perimeter, dental space at the extraction site, and angulation of the first permanent molar. The children were recalled for follow-up after 9 months, and all dental cast measurements were repeated using nondestructive 3D computed tomography software. For repeated measurements, the test applied was a paired t-test, and for independent samples, the test was a Student's t-test. A significant decrease in arch width (P = 0.001), arch length (P < 0.001), hemi-perimeter (P < 0.001), D-space (P < 0.001), and E-space (P = 0.001) was observed following extraction. A significant increase in angulation measurements was observed (P = 0.001). The study revealed a comparative reduction in mandibular arch width, a reduction in arch length in both the maxilla and the mandible, a reduced hemi-perimeter of dental arches, loss of dental extraction space, and a change in angulation of the erupted first permanent molars following premature loss of the primary molar.

The Efficacy of Ketorolac Buccal Infiltration Following Surgical Removal of The Impacted Mandibular Third Molar on Postoperative Pain and Trismus

Surgical extraction of the mandibular third molars are widely carried out in dental practice. The procedure is associated with postoperative complications such as pain and trismus. Objective: The study aimed to assess ketorolac's analgesic and anti-inflammatory efficacy after surgical extraction of the mandibular third molar. Methods: The study was designed as a double-blinded, randomized prospective clinical study in which 44 patients who required surgical removal of an impacted mandibular third molar were included. They were randomly distributed into two groups (the study and the control/placebo groups), with 22 patients in each group. Immediately after the last stitch, the study group received 30mg/1 ml of ketorolac, while the control group received 1 ml of normal saline at the buccal mucosa near the extraction site of both groups. The mouth openings of the patients were recorded preoperatively, and on the 2nd and 7th postoperative days, a comparison between the two groups was made. The pain level was assessed postoperatively using the numeric rating scale. Results: The comparison between the two groups by pain score showed that there was a statistically significant difference (P = 0.001) in postoperative pain between the study and control groups at all times after the operation. Regarding the trismus, there was no significant difference (p&gt;0.05) between both groups on the 2nd and 7th postoperative days. Conclusion: Ketorolac buccal infiltration is effective for postoperative pain following third molar surgery but has no significant effect on trismus.

Making Space for Feminist Decolonial Geographies of Peace with the Shuar in the Ecuadorian Amazon: A Case for ‘Cuerpo Territorio’

ABSTRACT This article follows urgent calls from peace and conflict studies and geographies of peace to be decolonised. Our study shows that for the Shuar communities in the Ecuadorian Amazon, the concept of peace is quite different from that of the Ecuadorian state. This study demonstrates how ‘Western’ centric definitions of the term are rooted in colonial logic and power structures. In this article, we explore what it could mean to decolonise theories and spaces for peace. Through encounters with Indigenous Shuar understandings of peace in a community-based participatory research project, we highlight the plurality of possibilities for the term. Using a decolonial lens we conclude with a call to action for scholars in those disciplines to engage with the Feminist Indigenous Latin American and Caribbean methodology and epistemology ‘cuerpo territorio’ (body-territory) to understand territory from the perspective of Abya Yala, that sees women’s bodies as the ‘first territory’. We argue that ‘cuerpo territorio’ is well suited to do decolonial work and help us step outside a Westernized understanding of peace and make strides towards the pluriverse. While typically this Indigenous concept has been used to better understand violence surrounding extraction sites, we propose that engaging with the methodology will prove useful for theoretical findings in spatial understandings of peace and its praxis.