Extraction Of Molar Teeth Research Articles

Evaluation of the effect of green tea extract on postoperative pain management following surgical removal of impacted mandibular third molar.

Pain following surgical removal of impacted molars has remained a principal concern among practitioners. Since green tea has anti-inflammatory and anti-bacterial properties, the current study aimed to evaluate the efficacy of green tea extract local application in controlling postoperative pain following surgical extraction of the impacted mandibular third molar teeth. In a double-blinded randomized controlled trial study with a split-mouth design, 32 patients underwent bilateral removal of impacted third molars in a 2-month time interval; afterward, the sterile gauzes impregnated with green tea extract and saline were applied randomly to the surgical sites. Postoperative pain was evaluated 6, 12, 24, and 48 h after surgery using a questionnaire based on the Visual Analog Scale (VAS) and the number of analgesics used after surgery. Data were subjected to exact and Chi-square tests with the significance level set at 0.05. There was a decrease in the mean scores of the VAS and the mean number of analgesic consumptions in the first 2 days after surgery. Chi-square test results showed a significant reduction in the VAS scores after applying the green tea extract only 6 and 12 h after surgery (P < 0.05). Moreover, the number of analgesic consumptions was significantly lower in the green tea group compared to the control group. Green tea extract may be an appropriate and safe choice for postoperative pain control after surgical extraction of the impacted mandibular third molar teeth.

Successful Management of an Acute Case of Orbital Cellulitis of Odontogenic Origin.

Sir, Dental infections left untreated can progress through tissue planes into the orbital space through sinuses and result in orbital abscess which is an ophthalmic emergency. We describe the case of a 47-year-old female, a known diabetic who presented with complaints of severe swelling and pain in periorbital region, associated with fever, vomiting, and prostration for 20 days’ duration. She gave a history of repeated episodes of dental pain arising out of her impacted upper third molar tooth for the past 2 months. Ocular examination of the right eye showed significant proptosis of 24 mm, restriction of extraocular movements in all directions, normal pupillary reaction with best-corrected visual acuity of 6/24, and intraocular pressure of 21 mm of Hg [Figure 1a]. Magnetic resonance imaging (MRI) showed heterogeneous multifocal lesions in the right orbit with T1 hypointensity, T2 hyperintensities with internal septation in the intra-conal and extraconal compartments producing compression over the globe [Figure 1b]. Dental X-ray was suggestive of impacted right maxillary third molar tooth [Figure 1c]. On the second day of her hospital stay, she developed multiple upper and lower eyelid pre-septal and post-septal abscesses which were drained, and the pus was sent for culture and sensitivity. Systemic antibiotics were started in the form of intravenous piperacillin/tazobactam (4.0/0.5 g) 8 hourly, metronidazole (500 mg/100 ml) 8 hourly, and oral linezolid (600 mg) 12 hourly. Blood sugars were monitored and insulin was administered as per her requirement. She was referred to dental surgeon for extraction of the impacted molar tooth. She recovered completely with best-corrected visual acuity of 6/9 and intraocular pressure of 16 mm of Hg. She showed remarkable improvement at 2 weeks after tooth extraction [Figure 1d].Figure 1: (a) Clinical photograph at presentation showing severe proptosis, complete ptosis, erythema, restricted extraocular movements, and pus pointing over lower eyelid skin. (b) MRI sagittal section T1 image showing multiloculated abscesses in intraconal and extraconal compartment of right orbit causing compression of eyeball. (c) Right maxillary posterior intraoral periapical radiograph showing impacted upper third molar tooth. (d) Clinical photograph of the same patient after two weeks with complete resolution of edema, proptosis, and extraocular movements. MRI: Magnetic resonance imagingOrbital cellulitis secondary to dental infection is rare accounting for 2%-5% of all cases of orbital infections.[1] To add to its rarity, orbital abscess constitutes less than 1.3% of abscesses seen in maxillofacial region.[2] Surgical drainage of the abscess and pus sample collection is a recommended modality of treatment as reported by many authors.[3,4] Empirical antibiotics and proper intravenous fluid hydration are mainstay of treatment. Systemic corticosteroids fasten the resolution of inflammation and duration of hospital stay.[5] A multidisciplinary approach with dentists, diabetologists, and ophthalmologists is required to prevent serious complications of venous sinus thrombosis. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form the patient has given her consent for her images and other clinical information to be reported in the journal. The patient understands that her name and initials will not be published and due efforts will be made to conceal her identity, but anonymity cannot be guaranteed. Research quality and ethics statement The authors followed applicable EQUATOR Network (http://www.equator-network.org/) guidelines, notably the CARE guideline, during the conduct of this report. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Evaluation of efficacy of simvastatin in bone regeneration following local application in third molar extraction socket: A randomized control trial.

The aim of this study is to study the efficacy of simvastatin in bone regeneration following the local application in third molar extraction sockets. This is a randomized controlled trial done on 50 patients involving 100 third molar teeth extraction sockets. The patients were randomly divided based on the placement of simvastatin. Extraction sockets which were treated with simvastatin were considered study sockets and without simvastatin were considered control sockets. The study socket was assigned for the placement of simvastatin (10 mg) powder along with gelfoam as carrier moistened with normal saline solution and control socket was assigned for the placement of gelfoam moistened with saline. Intraoral periapical radiographs were taken on the 1st, 4th, 8th, and 12th weeks, and mean gray scale values indicating bone density were evaluated for both the groups. Cone-beam computed tomography (CBCT) was taken by the end of the 12th week to further evaluate the osseous regeneration. Patients were compared and evaluated for bone density, pain, and swelling. Pain and swelling were evaluated on postoperative days 1 and 7. The mean gray-level histogram values (bone density) were statistically highly significant in the study group compared to the control group in the 1st, 4th, 8th, and 12th weeks, and CBCT also showed statistically significant difference between the control and study group by the end of the 12th week. The present data suggest that the local application of simvastatin promotes and enhances bone formation in the extraction sockets, which provides a very cost-effective way for faster bone regeneration.

Evaluation of YouTube™ Platform, which can be used as a source of information about the Impacted Mandibular Third Molar Tooth Extraction Procedure

Evaluation of YouTube™ Platform, which can be used as a source of information about the Impacted Mandibular Third Molar Tooth Extraction Procedure

Gömülü Üçüncü Molar Diş Çekimlerinde Cinsiyetin Etkisi: Retrospektif Kesitsel Bir Çalışma

Objective: Removing the impacted third molar is the most common surgical procedure in oral and maxillofacial surgery. The removal times and complications can be affected by many factors, and this study evaluated the removal time and complications of the impacted third molar between genders&#x0D; Methods: This study included 40 patients, 20 female and 20 male patients. In the extraction of impacted third molar teeth with the same operative difficulty score (score 4), operation times and complications were evaluated in terms of gender.&#x0D; Results: With the descriptive statistical analysis, the average age of the patients was 26.85 ±8.37, the removal time of the female patients was 19.65 ± 10.63 minutes, and the average duration of the male patients was 14.30 ± 5.55 minutes. Postoperatively, 4 (10%) of the patients had alveolitis. Dehiscence was not seen. In the extraction of an impacted third molar with the same operative difficulty score, there was a statistically significant difference between genders in terms of operation time (p

A Comparative Evaluation of Anesthetic Effectiveness of 4% Articaine vs 0.5% Bupivacaine for Lower Molar Tooth Extraction.

Safe and efficient pain control is essential for today's dental practice. This randomized controlled study was conducted to evaluate the effectiveness of 0.5% bupivacaine with 4% articaine in lower molar tooth extraction. One hundred subjects were classified into two groups, with 50 samples for each. Group A participants were managed with 0.5% bupivacaine with 1:200,000 epinephrine and group B participants with 4% articaine with 1:100,000 epinephrine for mandibular first and second molar extraction. Criteria such as onset and duration of anesthesia, pain throughout the procedure, pain during injection, and pain after the procedure were evaluated. Systolic and diastolic blood pressure (mmHg)and heart rate (per minute)were evaluated for all participants. There was a faster onset (53.2 vs 83.1 s) and lesser duration of action (216.6 vs 298.4 min) with articaine (group B) compared to bupivacaine (group A). Thirty-eight (76.0%) participants in group A and 44 (88.0%) participants in group B did not require re-anesthesia, whereas 12 (24%) participants in group A and six (12%) participants in group B required one-time re-anesthesia and it was insignificant. Articaine has a faster onset but a relatively lower duration of action and requires statistically insignificant but lower re-anesthesia. As a result, articaine anesthesia can be efficiently recommended in oral surgical techniques.

La suplementación lingual opcional después de la anestesia por infiltración bucal con articaína para la extracción de molares inferiores: un estudio clínico comparativo

Purpose: To investigate the anesthetic effectiveness of buccal infiltration (BI) versus buccal plus lingual infiltration (BI+LI) of 4% articaine for intra-alveolar extraction of erupted mandibular molar teeth Material and Methods: Eighty patients were included in this prospective clinical study. They were randomly divided into 1 of 2 equal groups: the 1st group received BI of 4% articaine 1.8 ml and LI of 0.5 ml, while the 2nd group received 4% articaine 1.8 ml BI plus 0.5 ml LI of normal saline. Another 1.8 ml articaine BI was given if initial anesthesia was inadequate. Outcome variables included pain, which was rated by patients at 3 intervals using visual analogue scale, and lingual anesthesia and patients' satisfaction which were measured using 5-score verbal rating scale. Data analyses used were descriptive statistics, t test, χ2 test, and Pearson's correlation coefficient. P-value value less than 0.05 was considered significant Results: There were 46 females and 34 males and the mean age was 35.3 years. All outcome variables were comparable between the two study groups (p˃0.05). Anesthesia was successful in 78% and 88% of cases in the (BI) and (BI+LI) groups respectively with no significant difference (p=0.2392). The mean articaine volume used was 2.5 ml and 2.87 ml respectively without significant difference (p=0.090). Conclusion: The anesthetic efficacy of (BI) alone and (BI+LI) of 4% articaine was comparable. When given in an adequate dose, articaine (BI) alone could be justified as an anesthetic option for the intra-alveolar extraction of mandibular molar teeth.

Hypertrophic Scars in Molar Tooth Extraction Socket: A Case Report

Among the various problems that can occur in the extraction socket, hypertrophic scars are rare. A hypertrophic scar with a pattern similar to that of a keloid should be treated by accurately identifying its clinical characteristics. This report describes the clinical differential diagnosis and treatment of hypertrophic scars after extraction of the maxillary left first and second molars. The treatment of hypertrophic scars with excisional biopsy was successful, and there was uneventful healing in the subsequent sinus floor elevation and implant placement. In addition, there were no recurrences or other problems during a follow-up period of approximately 16 months after completion of the prosthesis. Under a clear diagnosis, hypertrophic scars can be treated through excision, and primary wound closure after excision is important for successful results.

A Life-Saving Early Diagnosis of Burkitt Lymphoma Involving both Jaws, Misdiagnosed as Pericoronitis

Purpose: Burkitt lymphoma (BL) is a highly aggressive and rare B-cell non-Hodgkin’s lymphoma. In this paper, a rare case of BL, involving both jaws, was presented. &#x0D; &#x0D; Case Report: A 24-year-old male patient was referred to our clinic with the complaint of mandibular and maxillary swelling for two months. He was previously misdiagnosed with pericoronitis and had a history of right mandibular third molar tooth extraction, one-month prior. Intraoral examination showed swelling, ulceration, and spontaneous bleeding in both jaws. Radiographically, extensive osteolytic lesions, irregular periodontal space widening, loss of lamina dura, and peri-radicular radiolucencies were detected. Incisional biopsy was performed from both jaws and the final diagnosis was made as BL. &#x0D; &#x0D; Conclusion: It is crucial to be aware of the clinical and radiological features of this disease by dentists and to consult the attending physician without delay.

Lingual Mucosal Ulceration with Bony Sequestration

This case report describes a rare condition of lingual mucosal ulceration associated with bony sequestration following non-surgical lower molar tooth extraction of a healthy 58-year-old female patient. Clinically, she presented with a painful ulcer on the lingual aspect of the posterior mandible and noticed a sharp bone which caused irritation to the side of the tongue. The exposed bone was removed surgically, and the ulcer was completely healed. Thus, emphasizing the understanding of the causative factors of oral ulcers can help in giving a proper treatment plan.

Lingual Mucosal Ulceration with Bony Sequestration

This case report describes a rare condition of lingual mucosal ulceration associated with bony sequestration following non-surgical lower molar tooth extraction of a healthy 58-year-old female patient. Clinically, she presented with a painful ulcer on the lingual aspect of the posterior mandible and noticed a sharp bone which caused irritation to the side of the tongue. The exposed bone was removed surgically, and the ulcer was completely healed. Thus, emphasizing the understanding of the causative factors of oral ulcers can help in giving a proper treatment plan.

Diş Çekim Endikasyonu ve Sosyodemografik Özelliklerine Göre Üçüncü Molar Diş Prevalansı

Amaç: Bu çalışma; toplumda üçüncü molarların çekim endikasyonlarını, gömüklük oranlarını, çekim tekniklerini ve cinsiyet-yaş dağılımlarını bulmayı amaçlamaktır.&#x0D; Gereç ve Yöntem: Bu çalışmada; 2018 – 2021 yılları arasında Karabük Üniversitesi ve İstanbul Üniversitesi Diş Hekimliği Fakültelerinde üçüncü molar dişleri çekilen 1718 hasta incelendi. Çekim endikasyonları, çekim teknikleri ve gömüklük oranlarının yaş ve cinsiyete göre dağılımları tespit edildi. Çekim endikasyonlarını değerlendirmek için; çürük, ortodontik amaçlı, perikoronitis varlığı, kist-tümör oluşumu, profilaktik, komşu diş hasarı, periodontal harabiyet, atipik ağrı, planlanan implant kriterlerinden yararlanıldı. &#x0D; Bulgular: Hastaların %53.73’ünün erkek, %46.27’ sinin kadın olduğu görüldü. En fazla üçüncü molar dişi çekilen yaş grubunun 18-29 (%49.94) yaş aralığı olduğu tespit edildi. En çok çürük (%45,11) sebebiyle üçüncü molarlara çekim endikasyonu verildiği ve bunu perikoronitisin (%22.41) takip ettiği görüldü. Erkeklerde komşu diş hasarı (%6.93) ve çürük (%50,27) endikasyonuyla yapılan çekimlerin kadınlardan daha fazla olduğu görüldü. Kadınlarda ise atipik ağrı ve perikoronitis endikasyonuyla yapılan üçüncü molar çekimi daha fazlaydı. Alt üçüncü molarların daha sık cerrahi yaklaşımla (%87.58) çekildiği ve üst üçüncü molarlara göre daha fazla kemik (%85.32) ya da mukoza (%71,65) retansiyonunda pozisyonlandığı belirlendi.&#x0D; Sonuç: Üçüncü molar dişleri çok farklı endikasyonlarla çekilmektedir ve bunlar arasında çürük ve perikoronitis ön plandadır. Farklı yaş gruplarında ve cinsiyetler arasında çekim endikasyonlarında belirgin farklar mevcuttur. Alt ve üst üçüncü molarların gömüklük farklılıklarının göz önünde bulundurulması ve uygulanacak çekim yaklaşımının tedavi öncesi değerlendirilmesi hem hekim hem de hastaya kolaylık sağlayacaktır.

Predictors of Preventable Tooth Loss due to Extraction- A Cross-Sectional Study

Introduction: Dental extraction is an irreversible treatment and knowledge about patient’s perspective to submit an extraction request is essential to help develop guidelines that support oral surgeons in describing the ethical and legal issues, guiding them in decision-making, and responding to extraction requests. This study was planned to investigate the potential correlations between the predictors and extraction of permanent tooth that could be saved, in our area of practice.&#x0D; Methods: The patients were divided into two categories; Group 1: teeth can be saved and Group 2: teeth cannot be saved. Habits of the patients, their socio-demographic variables, medical history, reasons for a dental visit, reason for teeth extraction, and anatomical location of teeth were analyzed as a risk factor for preventable teeth loss using student t-test or chi-square test where appropriate.&#x0D; Results: Preventable tooth loss occurred more commonly at the age of 41 to 50 years of life. Low educational level and anatomic location of the tooth (anterior/posterior positioning) were more significantly associated with the loss of tooth that can be saved at the time of the visit. Extraction of the mandibular right first molar tooth was significantly more on patient request compared to other teeth. Social disbelief was a major factor in opting for patients to choose extraction over teeth preservation.&#x0D; Conclusions: Additional care and counseling are required whenever risk factors such as: age group (41 to 50 years), low educational level, attrition and abrasion, endodontic failures, and treatment of first molars are present.

Effects of Kinesio tape on pain and edema following surgical extraction of the third molar: A meta-analysis and systematic review.

Kinesio tape (KT) has been in extensive use for the rehabilitation of injuries related to sports, however, only a handful of studies have focused on the efficacy of KT following extraction of a third molar tooth. The study aims to assess whether pain and edema following surgical extraction of the third molar can be reduced by KT. This research was carried out following the principles of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Web of Science, Embase, PubMed, The Cochrane Library, CNKI, VIP, and WanFang Data databases were searched for trials published from their inception to eighth October 2021. They included published randomized controlled trials in Chinese or English languages. The methodological quality of the included studies was assessed using the Physiotherapy Evidence Database scale. Mean differences (MDs) with 95% confidence intervals (CIs) were used for the analysis of continuous data. The heterogeneity was measured using the I2 statistics. Then, Revman 5.4 software was employed for performing the meta-analysis. Eight studies comprising 453 participants in total were included. In comparison to the no kinesio tape group, KT did not furnish improved results on mouth opening ([MD = 0.36, 95% CI (-0.67, 1.40), p= 0.49]), and swelling ([MD =-1.24, 95% CI (-3.43, 0.95), p= 0.79]). However, KT manifested a reduction in operation time ([MD =-1.00, 95% CI (-1.93, -0.07), P= 0.04]), edema ([MD =-0.53, 95% CI (-0.88, -0.19), P= 0.003]), and pain intensity ([MD =-1.29, 95% CI (-1.86, -0.73), P< 0.00001]), favouring the kinesio tape group. Overall, the size of the effect was found in the small to moderate range. Despite the fact that KT can reduce pain and has been shown to have positive effects in several studies, there is no convincing evidence that it can reduce the swelling after surgical extraction of the third molar.

Comparison of Surgery-Related Knowledge Levels Between Patient Groups with and without Experience of Impacted Tooth Extraction

Purpose: Comparison of the knowledge levels of patients in different demographic groups with and without impacted third molar experience. The authors' expectation was that experienced patients would have a higher level of knowledge. Materials and Methods: Sixty-five patients (34 experienced, 31 inexperienced) with impacted third molar extraction indication were included in the study. A questionnaire with 23 questions concerning different operative phases and where the patients could write down their own questions were administered before surgeries. Demographic data (gender, age group and educational status) were also noted. Results: Questionnaire success did not show a significant difference in different demographic groups and between patients with and without experience of third molar tooth extraction (p&amp;gt;0.05). Conclusion: Dental surgeons should do their best to provide written and verbal information before surgical procedures, each patient should be evaluated as a first-time patient, regardless of demographic data and past experiences. It should not be neglected to provide a detailed information process.

Frequency and causes of extraction of first permanent molar tooth in patients presented to a teaching hospital, Multan.

Objective: To know the frequency and causes of extraction of first permanent molar tooth in patients presented to a teaching hospital, Multan. Study Design: Retrospective Cross Sectional Descriptive study. Setting: Dental Outdoor Department of Ibn-e-siena Hospital. Period: July 2019 to September 2021. Material &amp; Methods: Patients between the age of 5 years to 15 years, Age, gender, fate of the first permanent molar and the cause of decay of first permanent molar were recorded. Results: Out of 4200 patients 490 patients have decayed first permanent molar. Majority of the children were below 10 years with mean age was 8.6±05. Caries was the most frequent cause of decay. Conclusion: It can be concluded from the study that rate of extraction of first permanent molar is quite high and it is mostly due to caries and periodontal disease. It is mostly in children below ten years of age and has almost equal gender distribution.

Comparison of efficacy and post injection parasthesia between articaine and lidocaine in local anesthesia for inferior alveolar nerve block

Puepose: Considering the high failure rate of using lidocaine in the lower jawbone block and the recommendation of some researchers regarding the use of articaine, and considering the contradictions and the lack of adequate and reliable evidence for comparing these two drugs, we found a study on comparing the effects and side effects of these two anesthesia. Methods: In a double-blind, randomized controlled trial, the effect and side effects of articaine 4% and lidocaine 2% with epinephrine 1 in 100000 units were compared in lower Jaw nerve block. 110 patients with molar tooth extraction were entered our study and divided into two groups of 55 subjects. Patients in case group received 4% articaine anesthesia in lower jaw block and Patients in control group received 2% lidocaine anesthesia in lower jaw block. The onset of the effect of anesthetics, the success rate of inducing complete anesthesia+, duration of anesthesia, patient's pain during surgery, and anesthetic stability (paresthesia) after 24 hours and one week were investigated in these two groups.

Performance Analysis of Supervised Machine Learning Algorithms for Automatized Radiographical Classification of Maxillary Third Molar Impaction

Background: Oro-antral communication (OAC) is a common complication following the extraction of upper molar teeth. The Archer and the Root Sinus (RS) systems can be used to classify impacted teeth in panoramic radiographs. The Archer classes B-D and the Root Sinus classes III, IV have been associated with an increased risk of OAC following tooth extraction in the upper molar region. In our previous study, we found that panoramic radiographs are not reliable for predicting OAC. This study aimed to (1) determine the feasibility of automating the classification (Archer/RS classes) of impacted teeth from panoramic radiographs, (2) determine the distribution of OAC stratified by classification system classes for the purposes of decision tree construction, and (3) determine the feasibility of automating the prediction of OAC utilizing the mentioned classification systems. Methods: We utilized multiple supervised pre-trained machine learning models (VGG16, ResNet50, Inceptionv3, EfficientNet, MobileNetV2), one custom-made convolutional neural network (CNN) model, and a Bag of Visual Words (BoVW) technique to evaluate the performance to predict the clinical classification systems RS and Archer from panoramic radiographs (Aim 1). We then used Chi-square Automatic Interaction Detectors (CHAID) to determine the distribution of OAC stratified by the Archer/RS classes to introduce a decision tree for simple use in clinics (Aim 2). Lastly, we tested the ability of a multilayer perceptron artificial neural network (MLP) and a radial basis function neural network (RBNN) to predict OAC based on the high-risk classes RS III, IV, and Archer B-D (Aim 3). Results: We achieved accuracies of up to 0.771 for EfficientNet and MobileNetV2 when examining the Archer classification. For the AUC, we obtained values of up to 0.902 for our custom-made CNN. In comparison, the detection of the RS classification achieved accuracies of up to 0.792 for the BoVW and an AUC of up to 0.716 for our custom-made CNN. Overall, the Archer classification was detected more reliably than the RS classification when considering all algorithms. CHAID predicted 77.4% correctness for the Archer classification and 81.4% for the RS classification. MLP (AUC: 0.590) and RBNN (AUC: 0.590) for the Archer classification as well as MLP 0.638) and RBNN (0.630) for the RS classification did not show sufficient predictive capability for OAC. Conclusions: The results reveal that impacted teeth can be classified using panoramic radiographs (best AUC: 0.902), and the classification systems can be stratified according to their relationship to OAC (81.4% correct for RS classification). However, the Archer and RS classes did not achieve satisfactory AUCs for predicting OAC (best AUC: 0.638). Additional research is needed to validate the results externally and to develop a reliable risk stratification tool based on the present findings.

Maxillary Tuberosity Fractures Following Third Molar Extraction, Prevalence, and Risk Factors.

The aim of this study was to evaluate the prevalence of maxillary tuberosity fractures in an adult population and to examine the different risk factors associated with these fractures. This is a retrospective study; data was collected from medical records of patients who underwent a non-surgical extraction of a maxillary third molar tooth between January 2017 and March 2019. All extractions were performed by 2 maxillofacial specialists. A total of 403 extracted maxillary third molar teeth were included in the study. Out of them 73 cases of tuberosity fractures were recorded (18.1%). No significant difference in the number of recorded fractures was found between the 2 surgeons. The mean age of patients was 32.8 ± 11.5. In the age group of 30 years and under a fractures rate of 12.1% was recorded compared to 25.0% in the age group of over 30 (P = 0.001). Divergent or extremely curved root morphology were associated with a higher risk for fractures (30.7%) compared to convergent root morphology (13.1%) ( P < 0.001). Borderline significance ( P = 0.069) was observed for extractions of teeth with caries lesions (21.9%) compared to teeth with no caries lesions (14.6%). The risk of developing a tuberosity fracture during an extraction of an upper wisdom tooth increases with age by 3.1% per year. Teeth with a caries lesion or teeth with divergent or extremely curved root morphology are associated with a higher risk for tuberosity fractures. Although, distoangular teeth had reduced risk of developing a tuberosity fractures. Data collected in this study may help to evaluate the risk factors associated with tuberosity fractures, and can assist in minimizing complications during extractions.

Evaluation of Pentoxifylline efficacy in Socket healing in Type-2 Diabetic adult males

Introduction: because of lack of proper documented literature, many oral health professionals in diabetic patients citing reasons like delayed wound healing, dry socket and pain defer minor oral surgical treatments including extractions. All of those factors can have significant implications and negative impacts on the standard of lifetime of the individuals. The present study aimed to evaluate the effect of Pentoxifylline (PTX) on socket healing after mandibular molar tooth extraction in diabetic males in Syria. Various parameters like post-extraction pain (PeP) and the number of leukocytes and epithelial cells, which are initial parameters for healing socket. Methods: 22 older than 40 years male participants were divided into 3 group. Group 1(Control) was 8 participants, group 2 (Case) was 8 participants and group 3 (Case+Treated) was 6 participants got 400 mg sustained release tablet of PTX once a day for a week before of mandibular molar tooth extraction. For three days after the extraction, non-parametric pain values were as assessed by the participant and dry socket was diagnosed. Non-stimulated mixed saliva samples were collected by draining method to count leukocytes and epithelial cells. The sample was stained with Giemsa’s stain and examined microscopically. The statistical analyses were done using one-way analysis of variance (ANOVA), followed by Sidak's multiple comparison test for the parameter data and also the Kruskal-Wallis test followed by Dunn's multiple comparison test for non-parametric data. Results: on comparing PeP in group 1 against group 2 or group 2 against group 3 was no statistical significance altogether studied days. On comparing dry socket, presence in group 1 against group 2 or group 2 against group 3 was no statistical significance all told studied days. On comparing epithelial cells count in group 1 against group 2 was a statistically significant difference (P value =0.0011) but in group 2 against group 3 was no statistical significance. On comparing leukocytes count in group 1 against group or group 2 against group 3 was a statistically significant difference (P value =0.0140) (P value =0.0458). Conclusion: PTX increased leukocytes number 1 h after extraction, which is critical for socket healing as acute response during a heamostasis and inflammatory phase, but it did not improve of pain or prevent dry socket incidence. The sample of study was small and limited, so larger samples of other research studies are needed to substantiate our findings.