Purpose: The main objective of the current study is to determine whether it is possible to correlate the longevity of the hospitalization period (LOS) to efficacy of surgical treatment regime and severity scoring. Mat...Purpose: The main objective of the current study is to determine whether it is possible to correlate the longevity of the hospitalization period (LOS) to efficacy of surgical treatment regime and severity scoring. Materials and Methods: A total of 100 patients met our inclusion criteria. All patient records, including results of hematologic and biochemical parameters, were recorded. The patients were later subcategorized further according to a severity score (“Low, Moderate, Severe”) of their main facial space involvement. The main analysis of the study is a regression analysis model;all the variables (sex, age, CRP, white blood cell count, fever, space, and etiology) were stratified according to the overall hospital stay. A crosstab comparison was performed next;the variables were categorized and combined with hospital stay, and then entered in Spearman’s rank correlation coefficient or Spearman’s rho (ρ), 2-tailed (t) Test, and regression equation. The significance level was set at p Results: The most prevalent anatomical space infection was vestibular space abscess or cellulitis 33%, followed by an infraorbital space abscess or cellulitis 17%. Most commonly involved teeth are lower molars with 43% of the total, upper central sixth with 20% and upper molars with 10%;mandibular origin was found to be the cause in 54%. The regression equation showed no linear relation between CRP with the overall hospital stay (p > 0.05). No systemic temperature values were found to be correlated to any space involved or LOS. Log-rank chi-square effect tests indicated only a significant effect of severity, p =0.00016. The “Moderate & Severe” group compared to the “Low” group had a longer median LOS, 4.5 (2 to 8) vs 3 (1 to 8) respectively. Conclusion: The findings of this study have shown severity scoring to be statistically significant parameter in LOS prediction.展开更多
Background: The surgical removal of impacted mandibular molars represents one of the most prevalent procedures carried out by the oral and maxillofacial surgeon. Despite its prevalence, unusual impaction location of m...Background: The surgical removal of impacted mandibular molars represents one of the most prevalent procedures carried out by the oral and maxillofacial surgeon. Despite its prevalence, unusual impaction location of mandibular molars necessitates alternative extraction approaches. One of the methods described for extraction of deeply impacted molars is the bony lid approach which was first presented for surgical endodontic treatment of mandibular molars. The aim of this study was to evaluate the outcome of the bony lid approach in extracting mandibular molars. In addition, critical clinical key points, new aspects while performing this procedure, indications and contraindications are discussed. Materials and Methods: 9 patients were treated with the bony lid technique. A retrospective analysis of medical charts was conducted to evaluate the results of surgery. Results: The operative technique described in the article was successfully carried out in 12 cases of impacted mandibular molars. No incidence of permanent sensory deficit was recorded. In one patient, an infection mandated the removal of the bony lids. In all other cases the healing process was uneventful. Conclusion: The bony lid technique has many advantages over alternative extraction methods and should be considered as a treatment option in cases of critical proximity between an impacted tooth and the inferior alveolar nerve.展开更多
文摘Purpose: The main objective of the current study is to determine whether it is possible to correlate the longevity of the hospitalization period (LOS) to efficacy of surgical treatment regime and severity scoring. Materials and Methods: A total of 100 patients met our inclusion criteria. All patient records, including results of hematologic and biochemical parameters, were recorded. The patients were later subcategorized further according to a severity score (“Low, Moderate, Severe”) of their main facial space involvement. The main analysis of the study is a regression analysis model;all the variables (sex, age, CRP, white blood cell count, fever, space, and etiology) were stratified according to the overall hospital stay. A crosstab comparison was performed next;the variables were categorized and combined with hospital stay, and then entered in Spearman’s rank correlation coefficient or Spearman’s rho (ρ), 2-tailed (t) Test, and regression equation. The significance level was set at p Results: The most prevalent anatomical space infection was vestibular space abscess or cellulitis 33%, followed by an infraorbital space abscess or cellulitis 17%. Most commonly involved teeth are lower molars with 43% of the total, upper central sixth with 20% and upper molars with 10%;mandibular origin was found to be the cause in 54%. The regression equation showed no linear relation between CRP with the overall hospital stay (p > 0.05). No systemic temperature values were found to be correlated to any space involved or LOS. Log-rank chi-square effect tests indicated only a significant effect of severity, p =0.00016. The “Moderate & Severe” group compared to the “Low” group had a longer median LOS, 4.5 (2 to 8) vs 3 (1 to 8) respectively. Conclusion: The findings of this study have shown severity scoring to be statistically significant parameter in LOS prediction.
文摘Background: The surgical removal of impacted mandibular molars represents one of the most prevalent procedures carried out by the oral and maxillofacial surgeon. Despite its prevalence, unusual impaction location of mandibular molars necessitates alternative extraction approaches. One of the methods described for extraction of deeply impacted molars is the bony lid approach which was first presented for surgical endodontic treatment of mandibular molars. The aim of this study was to evaluate the outcome of the bony lid approach in extracting mandibular molars. In addition, critical clinical key points, new aspects while performing this procedure, indications and contraindications are discussed. Materials and Methods: 9 patients were treated with the bony lid technique. A retrospective analysis of medical charts was conducted to evaluate the results of surgery. Results: The operative technique described in the article was successfully carried out in 12 cases of impacted mandibular molars. No incidence of permanent sensory deficit was recorded. In one patient, an infection mandated the removal of the bony lids. In all other cases the healing process was uneventful. Conclusion: The bony lid technique has many advantages over alternative extraction methods and should be considered as a treatment option in cases of critical proximity between an impacted tooth and the inferior alveolar nerve.
