Background: Vasovagal syncope (VVS) is a neurogenic reflex-mediated fainting episode characterized by sudden, transient, and self-limiting symptoms. While VVS accounts for a significant portion (around 60%) of emergen...Background: Vasovagal syncope (VVS) is a neurogenic reflex-mediated fainting episode characterized by sudden, transient, and self-limiting symptoms. While VVS accounts for a significant portion (around 60%) of emergent medical events in dental practice, it remains an underrecognized condition among dental professionals, often misdiagnosed as hypoglycemia, conversion disorder, or epilepsy. This case report describes a VVS episode induced by tooth extraction, aiming to improve dental clinicians’ awareness and diagnostic approach to VVS. Case Presentation: A 35-year-old female visited the dental department in April 2022 with a two-year history of food impaction in the upper right molar. Examination revealed an elongated, discolored, and tender tooth 18, lacking proper occlusion with the opposing tooth. After confirming no contraindications, the tooth was extracted using a minimally invasive technique. Following the procedure, the patient experienced dizziness upon standing;her blood pressure was 69/47 mmHg, and her heart rate was 65 bpm. The nursing staff assisted her to sit as she showed limb weakness, closed eyes, and briefly lost consciousness. Oxygen was administered, and her blood glucose was 6.5. Blood pressure later improved to 124/78 mmHg, with a pulse of 62 bpm. Oral glucose was given, which she vomited, and emergency services were called. Upon arrival, the patient was alert and cooperative. Neurology consultation and imaging (MRI, MRA, and DWI) ruled out cerebral infarction, initially diagnosing a conversion disorder. A subsequent tilt-table test, including sublingual nitroglycerin, induced a marked blood pressure drop and symptoms confirming a diagnosis of vasovagal syncope (VVS). Conclusions: This case shows that preoperative anxiety, fear, and prolonged waiting can trigger vasovagal reflex during tooth extraction, especially in patients with anxiety or cardiac arrhythmias. For such patients, preoperative precautions and intraoperative cardiac monitoring are advised. In cases of VVS, quick actions like monitoring blood pressure, placing the patient in a supine position, providing oxygen, and administering IV fluids or medications like atropine, if necessary, can help stabilize the patient.展开更多
Aim To determine the effect of local simvastatin application on the mRNA expression level of transforming growth factor-β1 （TGF-β1）, bone morphogenetic protein-2 （BMP-2） and vascular endothelial growth factor （...Aim To determine the effect of local simvastatin application on the mRNA expression level of transforming growth factor-β1 （TGF-β1）, bone morphogenetic protein-2 （BMP-2） and vascular endothelial growth factor （VEGF） in the tooth sockets of rat. Methodology Forty-eight male Wistar rats were randomly divided into experimental and control groups （n=24）. Polylactic acid/polyglycolic acid copolymer carriers, with or without simvastatin, were implanted into extraction sockets of right mandibular incisors. The expression of TGF-β1, BMP-2 and VEGF mRNA was determined by in situ hybridization in the tooth extraction socket at five days, one week, two weeks and four weeks after implantation. Results The fusiform stroma cells in the tooth extraction socket began to express TGF-β1, BMP-2 and VEGF mRNA in both experimental and control groups from one week after tooth extraction until the end of experiment. The expression of TGF-131 and BMP-2 mRNA in the experimental group was significantly up-regulated after one, two and four weeks, and expression of VEGF mRNA was significantly increased after one and two weeks compared with that in the control group. Conclusion The findings indicate that local administration of simvastatin can influence alveolar bone remodeling by regulating the expression of a school of growth factors which are crucial to osteogenesis in the tooth extraction socket.展开更多
A 60 year-old man presented with acute on set of left eye proptosis and ptosis. It was associated with poor vision, eye pain and restriction of eye movement of the same eye after 5 hours post left upper molar tooth ex...A 60 year-old man presented with acute on set of left eye proptosis and ptosis. It was associated with poor vision, eye pain and restriction of eye movement of the same eye after 5 hours post left upper molar tooth extraction. The visual acuity in the left eye was hand movement. There was severe ptosis and proptosis of the left eye. The conjunctiva was chemotic with quite anterior chamber. The pupil was mid dilated and sluggished to light. The ocular movement was restricted in all directions. Fundoscopy of the left eye revealed features of central retinal artery occlusion with hyperaemic disc and subretinal exudates at posterior pole. The right eye appeared normal. Urgent MRI brain and orbit revealed severe left paranasal sinusitis with anterior displacement of the left globe and presence orbital abscess. Patient was managed with Otorhinolaryngology and Neurosurgery teams. He underwent emergency transnasal drainage of abscess. Histopathological examination of unhealthy sinus mucosa showed evidence of fungal infection. However, the culture and sensitivity result was inconclusive. Patient was treated with amphotericin B, ceftriaxone, amoxicillin clavulanate and metronidazole. Patient was detected to have high blood sugar level and was managed accordingly. The proptosis improved with treatment. However, his vision, ptosis and ophthalmoplegia remained static. Assessing the immunocompromised status is important for the management of patient presented as acute orbital apex syndrome to avoid fatal outcome.展开更多
Preservation of teeth until old ages indicates oral health status. Improving life expectancy in developing countries makes teeth care an important topic. This study assessed reasons of tooth extraction (TE), oral heal...Preservation of teeth until old ages indicates oral health status. Improving life expectancy in developing countries makes teeth care an important topic. This study assessed reasons of tooth extraction (TE), oral health determinants and demographic factors of permanent TE in Iranian adults. Adult people who referred to dental clinic of Mashhad Medical University in 2012 for dental extraction and lived in Mashhad city, participated in this study by convenient sampling method after obtaining informed consent. Demographic characteristics, oral health status, health habit and reasons of TE of participants were assessed. Data were analyzed by SPSS11.5 by Chi-Square, T-Test, ANOVA, Mann-Whitney and Kruskall-Wallis tests. Totally 254 people participated (383 extracted teeth) that 55% were female. Mean age of participants was 39.3 years;females were 6.1 years younger than males. The main reason of TE was dental caries (55.1%), following by impaction. There was significant difference between average times of tooth brushing in both sexes, but difference was not shown in sugar intake. Except in people with college degrees that dental caries is the main cause of TE. With increase in life expectancy to more than 70 years old in Iranian, the age of TE especially in women is younger than expected. The most common cause of TE is dental caries that seem in spite of improving health indexes in Iran, poor oral hygiene remains as a problem. There is no significant difference between frequency of sugar intake and level of education that indicates unhealthy dietary habits related to tooth decay.展开更多
Background: Arteriovenous malformations (AVM) in mandible and neck are potentially life-threatening conditions because of possible massive hemorrhage. They are often first diagnosed by dentists as bleeding. In this ca...Background: Arteriovenous malformations (AVM) in mandible and neck are potentially life-threatening conditions because of possible massive hemorrhage. They are often first diagnosed by dentists as bleeding. In this case, we report how a tooth extraction turned to a catastrophic condition in a patient with multiple AVMs in the mandibular, submandibular and hyoid region. Case: A 19-year-old male patient diagnosed with AVMs in the mandibular and submandibular regions was admitted to our hospital with the complaint of leaky hemorrhage around the lower left 3rd molar tooth. Tooth extraction was planned after embolization procedure. The patient was intubated uneventfully using video laryngoscope. However, an acute bleeding of more than 1600 ml occurred in one minute just after the mouth opener was inserted. The patient was transferred to the Interventional Radiology and other branches of the high-flow AVM were embolized. The patient was taken back to the operating room and the tooth was extracted uneventfully. Conclusion: In AVM cases, trauma should be minimized during induction of general anesthesia and intubation should be performed gently with fiberoptic bronchoscopy or video laryngoscopy. We conclude that a multidisciplinary approach as applied to our patient would be valuable in such cases.展开更多
Objective: to summarize the method and effect of minimally invasive tooth extraction technology in the extraction of impacted teeth. Methods: 92 patients who underwent extraction of impacted teeth in our hospital from...Objective: to summarize the method and effect of minimally invasive tooth extraction technology in the extraction of impacted teeth. Methods: 92 patients who underwent extraction of impacted teeth in our hospital from June 2020 to June 2021 were selected and divided into two groups by different surgical methods. The conventional group and the experimental group were treated with traditional tooth extraction and minimally invasive tooth extraction respectively. The comparison was made between the two groups based on the extraction time, pain, integrity and the incidence of complications. Results: the extraction time, integrity and pain score of the experimental group were significantly better than those of the conventional group (P < 0.05). The incidence of complications in the experimental group was significantly lower than that in the conventional group (P < 0.05). Conclusion: minimally invasive tooth extraction technology has obvious technical advantages for the extraction of impacted teeth. It not only has less pain, but also has higher alveolar integrity. It has obvious technical advantages and is worth popularizing.展开更多
Delayed tooth extraction socket(TES)healing can cause failure of subsequent oral implantation and increase socioeconomic burden on patients.Excessive amounts of M1 macrophages,apoptotic neutrophils(ANs),and neutrophil...Delayed tooth extraction socket(TES)healing can cause failure of subsequent oral implantation and increase socioeconomic burden on patients.Excessive amounts of M1 macrophages,apoptotic neutrophils(ANs),and neutrophil extracellular traps(NETs)impair alveolar bone regeneration during TES healing.In the present study,we first discovered that conditioned medium(CM)collected from berberine-treated human bone marrow mesenchymal stem cells(BBR-HB-CM)accelerated TES healing.BBR-HB-CM contained bioactive materials that promoted the polarization of macrophages from M1 to M2,impeded the formation of ANs and NETs,and modulated M2 macrophage efferocytosis in vivo and in vitro.Mechanistically,BBR-HB-CM promoted bone formation by inhibiting macrophage-myofibroblast transition and reprogrammed macrophage polarization through p85/AKT/mTOR pathway-dependent autophagy.The 3-methyladenine abolished the therapeutic effects of BBR-HB-CM.Further studies revealed that BBR-HB-CM accelerated TES healing in rats with type 2 diabetes mellitus.Overall,our results demonstrated that BBR-HB-CM had high potential to promote rapid TES healing.展开更多
Objective:To explore the clinical effect of improved incision in the extraction of impacted mandibular wisdom teeth.Methods:160 patients who were treated in our hospital from October,2024 to April,2025 and had their m...Objective:To explore the clinical effect of improved incision in the extraction of impacted mandibular wisdom teeth.Methods:160 patients who were treated in our hospital from October,2024 to April,2025 and had their mandibular impacted wisdom teeth removed according to the doctor’s advice were randomly divided into observation group and control group.The observation group used modified incision,while the control group used traditional triangular incision.The operation time,intraoperative visual analogue scale(VAS)pain score,pain VAS score on the 1st,2nd and 3rd day after operation,facial swelling on the 2nd day after operation,mouth opening limitation on the 2nd day after operation and the incidence of dry socket after operation were recorded and compared between the two groups.Results:There was no significant difference in operation time between the two groups(p>0.05).The VAS score of pain in the observation group was significantly lower than that in the control group at each time point during and after operation(p<0.05).On the second day after operation,the facial swelling and mouth opening limitation in the observation group were significantly lighter than those in the control group(p<0.05).The incidence of dry socket in the observation group was 1.25%(1/80),which was significantly lower than that in the control group(8.75%,7/80),and the difference was statistically significant(p<0.05).Conclusion:The application of modified triangular incision in the extraction of impacted mandibular wisdom teeth can effectively relieve the pain during and after operation,reduce postoperative facial swelling and mouth opening limitation,and reduce the incidence of dry socket.展开更多
Objective To evaluate the success rates of immediate and delayed placement of implants with respect to the causes of tooth extraction and implant positions.Methods A total of 310 dental implants (immediate implants...Objective To evaluate the success rates of immediate and delayed placement of implants with respect to the causes of tooth extraction and implant positions.Methods A total of 310 dental implants (immediate implants∶delayed implants=76∶234) were inserted into 80 patients. The types,sizes and positions of the implants and the causes of tooth extraction were recorded. We then investigated the relationship of implant loss with the causes of tooth extraction and placement methods. Results A higher failure rate was found for the implants in the posterior region of the maxilla,and when periodontitis was cited as a reason for tooth extraction. The overall success rates were 93.4% and 95.7% in the immediate and delayed implant placement groups,respectively,after a 2-year follow-up. No obvious relationship of success rate was observed with the implant placement method,cause of tooth extaction,and implants’ position. Conclusion The immediate placement of implants into fresh extraction sockets could offer advantages over the delayed implant placement. It seems to be a safe and predictable method for patients.展开更多
Objective:The application effect of xenograft materials in patients with implant restoration after minimally invasive tooth extraction is explored.Methods:From February 2016 to December 2019,80 patients with minimally...Objective:The application effect of xenograft materials in patients with implant restoration after minimally invasive tooth extraction is explored.Methods:From February 2016 to December 2019,80 patients with minimally invasive dental implants were treated in our hospital and selected as the research object.They were divided into the observation group and the control group based on to the random number table methods,and 40 patients in each group.The patients in the control group were sutured directly after minimally invasive tooth extraction.After the minimally invasive tooth extraction in the observation group,Bio-Oss Collagen was implanted into the alveolar fossa,which was covered with Bio-Gide absorbable biofilm.Changes in the height of the mastoid,the width and height of the crest crest,and the width of the lip between the two groups of patients immediately and 6 months after the tooth extraction were compared.Results:Changes of the alveolar ridge height and width in the observation group were less than those in the control group,and the difference was statistically significant(t=5.816,3.997,and P=0.000);the width of lip and tongue and the height of the interdental mastoid in the observation group.The amount of change was less than that in the control group,and the difference was statistically significant(t=7.384,10.686,and P=0.000).Conclusion:Bio-Oss Collagen and Bio-Gide absorbable biofilms have significant clinical effects on patients with minimally invasive tooth extraction and implant restoration,helping to maintain the stability of the alveolar ridge height and width,which is conducive to the creation of later dental implants in good conditions.展开更多
BACKGROUND The numbers of mandibular first premolar roots and root canals vary,and the incidence of three roots and three canals is 0.09%.CASE SUMMARY In this article,we review the root and root canal conditions for t...BACKGROUND The numbers of mandibular first premolar roots and root canals vary,and the incidence of three roots and three canals is 0.09%.CASE SUMMARY In this article,we review the root and root canal conditions for the mandibular first premolar and report the case of a mandibular left first premolar with three roots and three canals in a male patient,with suggestions for clinical diagnosis and treatment.The patient was referred by an orthodontist for the extraction of the tooth.Preoperative cone-beam computed tomography examination revealed that it had three roots.Under local anesthesia,the extraction socket was carefully expanded,and the tooth was successfully removed intact using forceps.The procedure was uneventful,with no root fractures,postoperative bleeding,or sensory abnormality observed.CONCLUSION The mandibular first premolar is characterized by multiple roots and canal variations that can increase the difficulty of treatment.展开更多
A series of changes occur in the remaining alveolar process after whole tooth extraction.The basic question is,why do the bony walls(especially the labial/buccal)get resorbed immediately after the tooth is removed?Thi...A series of changes occur in the remaining alveolar process after whole tooth extraction.The basic question is,why do the bony walls(especially the labial/buccal)get resorbed immediately after the tooth is removed?This could be because,with cementum of the concerned tooth and its periodontal ligament,the supporting bundle bone is dependent on the presence of the tooth.This loss can be compensated using numerous techniques,such as socket grafting using various biomaterials to preserve the alveolar bone and buccal grafting with guided tissue regeneration to increase the thickness of buccal bone or placement of implant immediately.However,none of these techniques prevent the modelling of the alveolar bone post-extraction.Few studies have demonstrated that preservation of the roots in the alveolar process maintains the bone volume and facilitates vertical bone growth.A histological study in animals and humans has shown that the retained root shell does not pose any interference in the osseointegration of the implant(if placed simultaneously).Although various names have been proposed to describe the concept of retaining full or part of the root to prevent the resorption of the ridge,socket-shield and pontic-shield are the two most commonly used terms worldwide.The extraction of the whole tooth might be the choice of therapy when socket-shield or pontic-shield is not possible due to anatomical variations,infections,or lack of clinical expertise.Irrespective of the size,when a whole root or a root fragment(is left in situ),it is the dentist’s ethical duty to advise/inform the patient and ensure repeated clinical and radiographic follow-up.The present study aimed to highlight the current status of these techniques,their benefits,and possible complications and address whether the paradigm of the teeth extraction methods should be altered.展开更多
This study aims to develop various types of collagen devices for use in oral surgery. The targets are the sheet-shaped sponges to cover mucosal defect wounds (product-1) and gingival defect wounds (product-2) and the ...This study aims to develop various types of collagen devices for use in oral surgery. The targets are the sheet-shaped sponges to cover mucosal defect wounds (product-1) and gingival defect wounds (product-2) and the cylindrical sponge to fill tooth extraction sockets (product-3). The sheet-shaped sponges were manufactured by freeze-vacuum drying the aqueous solution of collagen (Col) and heat-denatured collagen (Col’) at a composition ratio of 2/1, 1/1 or 1/2. Both surfaces of the sheet-shaped sponge were treated by ultraviolet (UV) irradiation for 5, 10 or 15 minutes to introduce intermolecular crosslinks between collagen molecules. The elution behavior of each collagen sponge was investigated by immersing the sponge in water for a predetermined time and then by measuring the weight change. The collagen sponge composed of Col and Col’ with a composition ratio of 2/1 that was treated by UV irradiation for 15 minutes showed very slow elution properties. This sheet-shaped sponge is the top candidate for product-1. The collagen sponge composed of Col and Col’ with a composition ratio of 2/1 that was treated by UV irradiation for 5 minutes showed slightly fast elution properties. This sheet-shaped sponge is the top candidate for product-2. Next, the cylindrical sponge was manufactured by freeze-vacuum drying the aqueous solution of Col and Col’ at a composition ratio of 2/1. Both sides of the cylindrical sponge were treated by UV irradiation for 15 minutes. This sponge showed initially fast elution properties and subsequent very slow elution properties. This cylindrical sponge is a good candidate for product-3. As a basic design, the sheet-shaped sponge and the cylindrical sponge should be biodegraded and absorbed by the time new tissue formation is completed.展开更多
The loss of the post-extraction alveolar ridge vertical and horizontal volume constitutes an irreversible process and presents a considerable impact on the prosthetic rehabilitation,particularly when implantsupported....The loss of the post-extraction alveolar ridge vertical and horizontal volume constitutes an irreversible process and presents a considerable impact on the prosthetic rehabilitation,particularly when implantsupported.Therefore,alveolar ridge resorption has become a challenge in contemporary clinical dentistry and alveolar ridge preservation and augmentation are an interesting therapeutic approach.The employment of biomaterials,as a therapeutic alternative to preserve bone in height and volume,has been frequently studied over the years,due to its conceptual attractiveness and its simple technique.The purpose of this paper is to review and discuss current methods to optimize the alveolar bone repair while maintaining its horizontal and vertical dimensions.This paper is based on scientific studies published in English including systematic reviews and also animal and human studies that were searched using the keywords"alveolar ridge preservation,""bone substitute","biomaterials","bone graft"and"grafting".Either autogenous bone as xenogenic and alloplastic materials,platelet rich plasma and use of membrane are alternatives.It becomes fundamental to understand that alveolar bone loss is still a clinical challenge and alveolar ridge preservation techniques can minimize,but not completely,eliminate the resorption process.The goal of alveolar ridge preservation and augmentation is to use a combination of bone or biomaterials to create bone which is sufficient for dental implant placement.Freeze-dried bone is generally recognized as giving more predictable treatment outcomes than synthetic materials or platelet rich plasma,and membranes must always be used to separate hard and soft tissues to promote optimal tissue healing.展开更多
文摘Background: Vasovagal syncope (VVS) is a neurogenic reflex-mediated fainting episode characterized by sudden, transient, and self-limiting symptoms. While VVS accounts for a significant portion (around 60%) of emergent medical events in dental practice, it remains an underrecognized condition among dental professionals, often misdiagnosed as hypoglycemia, conversion disorder, or epilepsy. This case report describes a VVS episode induced by tooth extraction, aiming to improve dental clinicians’ awareness and diagnostic approach to VVS. Case Presentation: A 35-year-old female visited the dental department in April 2022 with a two-year history of food impaction in the upper right molar. Examination revealed an elongated, discolored, and tender tooth 18, lacking proper occlusion with the opposing tooth. After confirming no contraindications, the tooth was extracted using a minimally invasive technique. Following the procedure, the patient experienced dizziness upon standing;her blood pressure was 69/47 mmHg, and her heart rate was 65 bpm. The nursing staff assisted her to sit as she showed limb weakness, closed eyes, and briefly lost consciousness. Oxygen was administered, and her blood glucose was 6.5. Blood pressure later improved to 124/78 mmHg, with a pulse of 62 bpm. Oral glucose was given, which she vomited, and emergency services were called. Upon arrival, the patient was alert and cooperative. Neurology consultation and imaging (MRI, MRA, and DWI) ruled out cerebral infarction, initially diagnosing a conversion disorder. A subsequent tilt-table test, including sublingual nitroglycerin, induced a marked blood pressure drop and symptoms confirming a diagnosis of vasovagal syncope (VVS). Conclusions: This case shows that preoperative anxiety, fear, and prolonged waiting can trigger vasovagal reflex during tooth extraction, especially in patients with anxiety or cardiac arrhythmias. For such patients, preoperative precautions and intraoperative cardiac monitoring are advised. In cases of VVS, quick actions like monitoring blood pressure, placing the patient in a supine position, providing oxygen, and administering IV fluids or medications like atropine, if necessary, can help stabilize the patient.
基金supported by grants from the National Nature Science foundation of China(Grant Nos.30872912 and 30830108)
文摘Aim To determine the effect of local simvastatin application on the mRNA expression level of transforming growth factor-β1 （TGF-β1）, bone morphogenetic protein-2 （BMP-2） and vascular endothelial growth factor （VEGF） in the tooth sockets of rat. Methodology Forty-eight male Wistar rats were randomly divided into experimental and control groups （n=24）. Polylactic acid/polyglycolic acid copolymer carriers, with or without simvastatin, were implanted into extraction sockets of right mandibular incisors. The expression of TGF-β1, BMP-2 and VEGF mRNA was determined by in situ hybridization in the tooth extraction socket at five days, one week, two weeks and four weeks after implantation. Results The fusiform stroma cells in the tooth extraction socket began to express TGF-β1, BMP-2 and VEGF mRNA in both experimental and control groups from one week after tooth extraction until the end of experiment. The expression of TGF-131 and BMP-2 mRNA in the experimental group was significantly up-regulated after one, two and four weeks, and expression of VEGF mRNA was significantly increased after one and two weeks compared with that in the control group. Conclusion The findings indicate that local administration of simvastatin can influence alveolar bone remodeling by regulating the expression of a school of growth factors which are crucial to osteogenesis in the tooth extraction socket.
文摘A 60 year-old man presented with acute on set of left eye proptosis and ptosis. It was associated with poor vision, eye pain and restriction of eye movement of the same eye after 5 hours post left upper molar tooth extraction. The visual acuity in the left eye was hand movement. There was severe ptosis and proptosis of the left eye. The conjunctiva was chemotic with quite anterior chamber. The pupil was mid dilated and sluggished to light. The ocular movement was restricted in all directions. Fundoscopy of the left eye revealed features of central retinal artery occlusion with hyperaemic disc and subretinal exudates at posterior pole. The right eye appeared normal. Urgent MRI brain and orbit revealed severe left paranasal sinusitis with anterior displacement of the left globe and presence orbital abscess. Patient was managed with Otorhinolaryngology and Neurosurgery teams. He underwent emergency transnasal drainage of abscess. Histopathological examination of unhealthy sinus mucosa showed evidence of fungal infection. However, the culture and sensitivity result was inconclusive. Patient was treated with amphotericin B, ceftriaxone, amoxicillin clavulanate and metronidazole. Patient was detected to have high blood sugar level and was managed accordingly. The proptosis improved with treatment. However, his vision, ptosis and ophthalmoplegia remained static. Assessing the immunocompromised status is important for the management of patient presented as acute orbital apex syndrome to avoid fatal outcome.
文摘Preservation of teeth until old ages indicates oral health status. Improving life expectancy in developing countries makes teeth care an important topic. This study assessed reasons of tooth extraction (TE), oral health determinants and demographic factors of permanent TE in Iranian adults. Adult people who referred to dental clinic of Mashhad Medical University in 2012 for dental extraction and lived in Mashhad city, participated in this study by convenient sampling method after obtaining informed consent. Demographic characteristics, oral health status, health habit and reasons of TE of participants were assessed. Data were analyzed by SPSS11.5 by Chi-Square, T-Test, ANOVA, Mann-Whitney and Kruskall-Wallis tests. Totally 254 people participated (383 extracted teeth) that 55% were female. Mean age of participants was 39.3 years;females were 6.1 years younger than males. The main reason of TE was dental caries (55.1%), following by impaction. There was significant difference between average times of tooth brushing in both sexes, but difference was not shown in sugar intake. Except in people with college degrees that dental caries is the main cause of TE. With increase in life expectancy to more than 70 years old in Iranian, the age of TE especially in women is younger than expected. The most common cause of TE is dental caries that seem in spite of improving health indexes in Iran, poor oral hygiene remains as a problem. There is no significant difference between frequency of sugar intake and level of education that indicates unhealthy dietary habits related to tooth decay.
文摘Background: Arteriovenous malformations (AVM) in mandible and neck are potentially life-threatening conditions because of possible massive hemorrhage. They are often first diagnosed by dentists as bleeding. In this case, we report how a tooth extraction turned to a catastrophic condition in a patient with multiple AVMs in the mandibular, submandibular and hyoid region. Case: A 19-year-old male patient diagnosed with AVMs in the mandibular and submandibular regions was admitted to our hospital with the complaint of leaky hemorrhage around the lower left 3rd molar tooth. Tooth extraction was planned after embolization procedure. The patient was intubated uneventfully using video laryngoscope. However, an acute bleeding of more than 1600 ml occurred in one minute just after the mouth opener was inserted. The patient was transferred to the Interventional Radiology and other branches of the high-flow AVM were embolized. The patient was taken back to the operating room and the tooth was extracted uneventfully. Conclusion: In AVM cases, trauma should be minimized during induction of general anesthesia and intubation should be performed gently with fiberoptic bronchoscopy or video laryngoscopy. We conclude that a multidisciplinary approach as applied to our patient would be valuable in such cases.
文摘Objective: to summarize the method and effect of minimally invasive tooth extraction technology in the extraction of impacted teeth. Methods: 92 patients who underwent extraction of impacted teeth in our hospital from June 2020 to June 2021 were selected and divided into two groups by different surgical methods. The conventional group and the experimental group were treated with traditional tooth extraction and minimally invasive tooth extraction respectively. The comparison was made between the two groups based on the extraction time, pain, integrity and the incidence of complications. Results: the extraction time, integrity and pain score of the experimental group were significantly better than those of the conventional group (P < 0.05). The incidence of complications in the experimental group was significantly lower than that in the conventional group (P < 0.05). Conclusion: minimally invasive tooth extraction technology has obvious technical advantages for the extraction of impacted teeth. It not only has less pain, but also has higher alveolar integrity. It has obvious technical advantages and is worth popularizing.
基金supported by grants from the Jiangsu Province Capability Improvement Project through Science,Technology and Education-Jiangsu Provincial Research Hospital Cultivation Unit(YJXYYJSDW4)Jiangsu Provincial Medical Innovation Center(CXZX202227)。
文摘Delayed tooth extraction socket(TES)healing can cause failure of subsequent oral implantation and increase socioeconomic burden on patients.Excessive amounts of M1 macrophages,apoptotic neutrophils(ANs),and neutrophil extracellular traps(NETs)impair alveolar bone regeneration during TES healing.In the present study,we first discovered that conditioned medium(CM)collected from berberine-treated human bone marrow mesenchymal stem cells(BBR-HB-CM)accelerated TES healing.BBR-HB-CM contained bioactive materials that promoted the polarization of macrophages from M1 to M2,impeded the formation of ANs and NETs,and modulated M2 macrophage efferocytosis in vivo and in vitro.Mechanistically,BBR-HB-CM promoted bone formation by inhibiting macrophage-myofibroblast transition and reprogrammed macrophage polarization through p85/AKT/mTOR pathway-dependent autophagy.The 3-methyladenine abolished the therapeutic effects of BBR-HB-CM.Further studies revealed that BBR-HB-CM accelerated TES healing in rats with type 2 diabetes mellitus.Overall,our results demonstrated that BBR-HB-CM had high potential to promote rapid TES healing.
文摘Objective:To explore the clinical effect of improved incision in the extraction of impacted mandibular wisdom teeth.Methods:160 patients who were treated in our hospital from October,2024 to April,2025 and had their mandibular impacted wisdom teeth removed according to the doctor’s advice were randomly divided into observation group and control group.The observation group used modified incision,while the control group used traditional triangular incision.The operation time,intraoperative visual analogue scale(VAS)pain score,pain VAS score on the 1st,2nd and 3rd day after operation,facial swelling on the 2nd day after operation,mouth opening limitation on the 2nd day after operation and the incidence of dry socket after operation were recorded and compared between the two groups.Results:There was no significant difference in operation time between the two groups(p>0.05).The VAS score of pain in the observation group was significantly lower than that in the control group at each time point during and after operation(p<0.05).On the second day after operation,the facial swelling and mouth opening limitation in the observation group were significantly lighter than those in the control group(p<0.05).The incidence of dry socket in the observation group was 1.25%(1/80),which was significantly lower than that in the control group(8.75%,7/80),and the difference was statistically significant(p<0.05).Conclusion:The application of modified triangular incision in the extraction of impacted mandibular wisdom teeth can effectively relieve the pain during and after operation,reduce postoperative facial swelling and mouth opening limitation,and reduce the incidence of dry socket.
文摘Objective To evaluate the success rates of immediate and delayed placement of implants with respect to the causes of tooth extraction and implant positions.Methods A total of 310 dental implants (immediate implants∶delayed implants=76∶234) were inserted into 80 patients. The types,sizes and positions of the implants and the causes of tooth extraction were recorded. We then investigated the relationship of implant loss with the causes of tooth extraction and placement methods. Results A higher failure rate was found for the implants in the posterior region of the maxilla,and when periodontitis was cited as a reason for tooth extraction. The overall success rates were 93.4% and 95.7% in the immediate and delayed implant placement groups,respectively,after a 2-year follow-up. No obvious relationship of success rate was observed with the implant placement method,cause of tooth extaction,and implants’ position. Conclusion The immediate placement of implants into fresh extraction sockets could offer advantages over the delayed implant placement. It seems to be a safe and predictable method for patients.
文摘Objective:The application effect of xenograft materials in patients with implant restoration after minimally invasive tooth extraction is explored.Methods:From February 2016 to December 2019,80 patients with minimally invasive dental implants were treated in our hospital and selected as the research object.They were divided into the observation group and the control group based on to the random number table methods,and 40 patients in each group.The patients in the control group were sutured directly after minimally invasive tooth extraction.After the minimally invasive tooth extraction in the observation group,Bio-Oss Collagen was implanted into the alveolar fossa,which was covered with Bio-Gide absorbable biofilm.Changes in the height of the mastoid,the width and height of the crest crest,and the width of the lip between the two groups of patients immediately and 6 months after the tooth extraction were compared.Results:Changes of the alveolar ridge height and width in the observation group were less than those in the control group,and the difference was statistically significant(t=5.816,3.997,and P=0.000);the width of lip and tongue and the height of the interdental mastoid in the observation group.The amount of change was less than that in the control group,and the difference was statistically significant(t=7.384,10.686,and P=0.000).Conclusion:Bio-Oss Collagen and Bio-Gide absorbable biofilms have significant clinical effects on patients with minimally invasive tooth extraction and implant restoration,helping to maintain the stability of the alveolar ridge height and width,which is conducive to the creation of later dental implants in good conditions.
文摘BACKGROUND The numbers of mandibular first premolar roots and root canals vary,and the incidence of three roots and three canals is 0.09%.CASE SUMMARY In this article,we review the root and root canal conditions for the mandibular first premolar and report the case of a mandibular left first premolar with three roots and three canals in a male patient,with suggestions for clinical diagnosis and treatment.The patient was referred by an orthodontist for the extraction of the tooth.Preoperative cone-beam computed tomography examination revealed that it had three roots.Under local anesthesia,the extraction socket was carefully expanded,and the tooth was successfully removed intact using forceps.The procedure was uneventful,with no root fractures,postoperative bleeding,or sensory abnormality observed.CONCLUSION The mandibular first premolar is characterized by multiple roots and canal variations that can increase the difficulty of treatment.
文摘A series of changes occur in the remaining alveolar process after whole tooth extraction.The basic question is,why do the bony walls(especially the labial/buccal)get resorbed immediately after the tooth is removed?This could be because,with cementum of the concerned tooth and its periodontal ligament,the supporting bundle bone is dependent on the presence of the tooth.This loss can be compensated using numerous techniques,such as socket grafting using various biomaterials to preserve the alveolar bone and buccal grafting with guided tissue regeneration to increase the thickness of buccal bone or placement of implant immediately.However,none of these techniques prevent the modelling of the alveolar bone post-extraction.Few studies have demonstrated that preservation of the roots in the alveolar process maintains the bone volume and facilitates vertical bone growth.A histological study in animals and humans has shown that the retained root shell does not pose any interference in the osseointegration of the implant(if placed simultaneously).Although various names have been proposed to describe the concept of retaining full or part of the root to prevent the resorption of the ridge,socket-shield and pontic-shield are the two most commonly used terms worldwide.The extraction of the whole tooth might be the choice of therapy when socket-shield or pontic-shield is not possible due to anatomical variations,infections,or lack of clinical expertise.Irrespective of the size,when a whole root or a root fragment(is left in situ),it is the dentist’s ethical duty to advise/inform the patient and ensure repeated clinical and radiographic follow-up.The present study aimed to highlight the current status of these techniques,their benefits,and possible complications and address whether the paradigm of the teeth extraction methods should be altered.
文摘This study aims to develop various types of collagen devices for use in oral surgery. The targets are the sheet-shaped sponges to cover mucosal defect wounds (product-1) and gingival defect wounds (product-2) and the cylindrical sponge to fill tooth extraction sockets (product-3). The sheet-shaped sponges were manufactured by freeze-vacuum drying the aqueous solution of collagen (Col) and heat-denatured collagen (Col’) at a composition ratio of 2/1, 1/1 or 1/2. Both surfaces of the sheet-shaped sponge were treated by ultraviolet (UV) irradiation for 5, 10 or 15 minutes to introduce intermolecular crosslinks between collagen molecules. The elution behavior of each collagen sponge was investigated by immersing the sponge in water for a predetermined time and then by measuring the weight change. The collagen sponge composed of Col and Col’ with a composition ratio of 2/1 that was treated by UV irradiation for 15 minutes showed very slow elution properties. This sheet-shaped sponge is the top candidate for product-1. The collagen sponge composed of Col and Col’ with a composition ratio of 2/1 that was treated by UV irradiation for 5 minutes showed slightly fast elution properties. This sheet-shaped sponge is the top candidate for product-2. Next, the cylindrical sponge was manufactured by freeze-vacuum drying the aqueous solution of Col and Col’ at a composition ratio of 2/1. Both sides of the cylindrical sponge were treated by UV irradiation for 15 minutes. This sponge showed initially fast elution properties and subsequent very slow elution properties. This cylindrical sponge is a good candidate for product-3. As a basic design, the sheet-shaped sponge and the cylindrical sponge should be biodegraded and absorbed by the time new tissue formation is completed.
文摘The loss of the post-extraction alveolar ridge vertical and horizontal volume constitutes an irreversible process and presents a considerable impact on the prosthetic rehabilitation,particularly when implantsupported.Therefore,alveolar ridge resorption has become a challenge in contemporary clinical dentistry and alveolar ridge preservation and augmentation are an interesting therapeutic approach.The employment of biomaterials,as a therapeutic alternative to preserve bone in height and volume,has been frequently studied over the years,due to its conceptual attractiveness and its simple technique.The purpose of this paper is to review and discuss current methods to optimize the alveolar bone repair while maintaining its horizontal and vertical dimensions.This paper is based on scientific studies published in English including systematic reviews and also animal and human studies that were searched using the keywords"alveolar ridge preservation,""bone substitute","biomaterials","bone graft"and"grafting".Either autogenous bone as xenogenic and alloplastic materials,platelet rich plasma and use of membrane are alternatives.It becomes fundamental to understand that alveolar bone loss is still a clinical challenge and alveolar ridge preservation techniques can minimize,but not completely,eliminate the resorption process.The goal of alveolar ridge preservation and augmentation is to use a combination of bone or biomaterials to create bone which is sufficient for dental implant placement.Freeze-dried bone is generally recognized as giving more predictable treatment outcomes than synthetic materials or platelet rich plasma,and membranes must always be used to separate hard and soft tissues to promote optimal tissue healing.
