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PubMed1971

Tooth extraction.

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Tooth Extraction↗
PubMed2005

[Topical application of local anesthetics and opioids after elective tooth extraction].

The aim of this study was to provide evidence for the peripheral effect of opioids in oromaxillary procedures and to investigate whether postoperative morphine sulfate plus lidocaine administered as a local spray achieve better analgesic efficacy than lidocaine applied alone. The double-blind randomized study included 60 patients. The patients exhibited neither preoperative pain nor inflammation (tooth extractions) and when pain occurred received as alternative medication diclofenac retard 50 mg or tramadol. Side effects were documented. No differences between the two groups were observed in the demographic data, visual and numeric analog scale in the first 24 h, or in the consumption of analgesics. Since the patients presented in a pain-free state at the time of surgery, apparently no activation of the peripheral opioid receptors occurs. Thus, a peripheral effect of opioids could not be demonstrated in this model.

Administration, Topical↗
PubMed2000

[The nonhealing of the buccal mucosa after tooth extraction. Apropos a case of histiocytosis X].

We report a case of eosinophilic granuloma falsely diagnosed as a radicular cyst in a 28-year-old patient. Between August 1996 and June 1997, successful extraction [correction of avulsion] of teeth 36 and 37 was followed by non-healing of the mucosa in the corresponding sockets. Three bone biopsies were needed to establish the diagnosis of histiocytosis X. In case of non-healing of the intraoral mucosa after tooth extraction [correction of avulsion], the first step is to rule out a malignant tumor. A clinical and radiographic work-up as well as biopsy are needed. Less common conditions such as tuberculosis or histiocytosis X requiring specific treatment can be diagnosed by pathology.

Adult↗
PubMed2000

Intra-alveolar granulocytic sarcoma developing after tooth extraction.

Granulocytic sarcoma (GS) is a malignant tumour composed of poorly differentiated myeloid cells forming in an extramedullary site. It is generally associated with acute leukaemia, particularly the myelocytic type. Its appearance in patients with chronic myeloid leukaemia is exceptional. GS can appear in multiple locations with the oral cavity being rarely involved. A mandibular GS detected in a patient with chronic myeloid leukaemia 10 days after a tooth extraction is reported. The pathogenesis (by metastatic cells or migration through the Haversian canals) of the tumour is discussed.

Diagnosis, Differential↗
PubMed2005

Central giant cell reparative granuloma of the mandible caused by a molar tooth extraction: special reference to the maneuver of drilling the surgical field.

Central giant cell reparative granuloma (CGCRG) is an uncommon benign, reactive osseous lesion usually located in the mandible and maxilla. Although it is histologically benign, it may be locally destructive. There is still controversy on its development and growth pattern. Surgery is the treatment traditionally recommended. In this article, we presented a 12 year-old girl CGCRG of the mandible caused by a molar tooth extraction and discussed its histopathological, clinical, radiological and therapeutic features in the light of the current literature. Also we described our additional surgical maneuver 'drilling the surgical field' after the removal of the lesion.

Child↗
PubMed2006

[Tooth extraction under medication with acetylsalicylic acid].

PURPOSE: The purpose of this prospective study was to show and analyze the bleeding complications after teeth extraction under therapy with 100 mg acetylsalicylic acid (ASA) and to compare them to bleeding complications after teeth extraction in patients with a healthy blood profile. PATIENTS AND METHODS: In 65 patients under medication with 100 mg ASA and in 252 healthy patients, 151/ 543 teeth were extracted and the bleeding complications monitored. RESULTS: The postoperative bleeding frequency was 1.54% in the ASA 100 group and 1.59% in the healthy control group without any medication. No serious or uncontrollable postoperative bleedings arose in either group. All bleedings could be easily handled. No obvious difference concerning the bleeding frequency between the two groups was observed. The small number of bleeding events and the complexity of affecting parameters did not permit statistical tests. CONCLUSION: It is not necessary to interrupt the medication of 100 mg acetylsalicylic acid given to prevent thromboembolism before tooth extractions.

Administration, Oral↗
PubMed1974

Bacteremia after tooth extractions studied with the aid of prereduced anaerobically sterilized culture media.

Both prereduced molten agar and broth and aerobic molten agar and broth were inoculated with blood samples collected from patients with periodontitis, but in otherwise good health, both before and after extraction of two or more teeth. Postoperative blood samples from 23 of 25 patients sampled yielded anaerobic and facultative species. Colony counts from nine samples yielded from less than 1 to over 100 colonies per ml of blood. Organisms detected were species belonging to the genera Bacteroides, Fusobacterium, Peptostreptococcus, Leptotrichia, Propionibacterium, Peptococcus, Veillonella, plus Streptococcus mitis, S. salivarius, vibrio forms, and strains resembling S. mutans. The data indicate that prereduced anaerobically sterilized culture medium with polyanethol sulfonate is effective for detecting anaerobic species in bacteremia and that anaerobic species can be prevalent in bacteremias immediately after tooth extraction in patients with periodontitis.

Aerobiosis↗
PubMed1990

Studies on the enhanced effect of acupuncture analgesia and acupuncture anesthesia by D-phenylalanine (2nd report)--schedule of administration and clinical effects in low back pain and tooth extraction.

D-phenylalanine (DPA) is known to block the activity of carboxypeptidase, an enzyme which degrades enkephalins, endogenous morphine-like substances. Therefore, it is considered that DPA administered as an inhibiting drug of this degrading enzyme might prolong analgesia induced by acupuncture. 1) Thirty patients suffering from chronic low back pain were treated with acupuncture 30 minutes after the oral administration of 4.0 grams of DPA. The results were: excellent in 7 cases, good in 11, fair in 6 and poor in 6. Cases graded excellent and good were then compared with a placebo group. The effect was increased 26% in the DPA-acupuncture group, which shows no statistically significant difference (P less than 0.1). 2) In 56 patients, tooth extraction was performed under acupuncture anesthesia: 18 had received 4.0 gram of DPA (P.O.) 30 minutes earlier. The results were excellent in 8, good in 6, fair in 3, and poor in 1. The excellent and good cases were compared with 38 placebo group cases. The effect in the DPA-acupuncture anesthesia group was significantly increased by 35% (P less than 0.01). 3) In order to determine the optimum time for the administration of DPA, two schedules of administration were compared. [1] DPA was given on the previous day in three 0.5 gram doses (26 cases). [2] A single 4 gram dose was administered 30 minutes before treatment (30 cases). The results from the "excellent", "good" and "fair" cases showed a 16% increase in effectiveness when DPA was administered the day before, not a statistically significant difference (P less than 0.1), but a clear tendency to increase was observed. The above findings show that DPA has an enhancing effect on acupuncture analgesia and anesthesia in clinical practice.

Acupuncture Analgesia↗
PubMed2001

Tooth extraction, bleeding and pain control.

Local anaesthesia is used routinely in dental surgery; it is effective in both pain control and--through the vasoconstrictors often contained within it--the reduction of bleeding. The extraction of deciduous teeth under general anaesthesia is often carried out without these local effects. There are no previous studies to investigate the combined effect of local anaesthesia with general anaesthesia on blood loss and pain control. A randomised, controlled clinical trial was carried out with one hundred children aged 3-5 years. Ethical approval and informed consent were obtained. Surface anaesthetic cream (EMLA) was placed on the hand into which the intravenous access was to be placed. One to two ml of blood was taken at the time of induction as a baseline of the patient's level of haematin pigment. Children in the experimental group were given one quarter of a cartridge (0.5 ml) of local anaesthetic containing epinephrine (1:80,000) in each quadrant before tooth extraction; all blood in swabs, suction equipment and disposables was collected and digested with NaOH. The children were observed for 11 minutes post-operatively for any signs of distress. Total blood loss was calculated by comparison of the baseline sample and the shed blood digests. This study showed that using local anaesthesia for dental extractions under general anaesthesia was associated with decreased blood loss (p = 0.001). The second finding--which has not been reported before--was that this use of local anaesthesia was shown to cause distress to this age group of children upon recovery from the general anaesthetic (p <0.0001). The use of local anaesthetic in this situation provided a useful reduction in post-operative bleeding. However, its use was associated with greater post-operative distress.

Analgesics↗
PubMed2001

[A clinical investigation of oro-maxillary sinus-perforation due to tooth extraction].

Oro-maxillary sinus perforation occurs occasionally at the extraction of a maxillary tooth, and it may be a cause of maxillary sinusitis or antro-oral fistula. Our purpose was to investigate the most frequent site of perforation, and to understand the clinical course of patients after perforation. We examined 2,038 maxillary teeth extracted from 1,337 patients (473 males and 864 females) at the First Department of Oral and Maxillofacial Surgery, Tokyo Medical and Dental University, from January 1991 to December 1993. Perforation occurred in 77 of all 2,038 teeth (3.8%). Of these, 38 teeth were from males (38/733; 5.2%), and 39 were from females (39/1,305; 3.0%). The perforation rate was significantly higher in males. Perforation occurred most often with extraction of an upper first molar, and in the third decade of life. The perforation rate gradually decreased with higher age. We classified 38 cases into 3 categories according to panorama X-P: 1) The tip of the root crossed over the bottom line of the maxillary sinus (29 cases), 2) Not crossed over distinctly (4 cases), 3) Just lie on, or whether the tip of the root crossed over the bottom line of the maxillary sinus was not distinct (5 cases). As to treatment, 30 perforations (39.0%) closed spontaneously in the course of observation, irrigation with physiological saline was used in 43 cases (55.8%), radical sinusotomy accompanied by closure of the perforation was performed in 4 cases, and only flap closure was used in 7 cases. There were no cases of relapse.

Adult↗
PubMed1990

[Study of structural changes in canine maxillary trabecular bone after tooth extraction].

All teeth on the right side of the upper and lower jaws were extracted from canine specimens; and changes in maxillary trabecular-bone structure caused by the resultant reduction in functional pressure were studied by means of image analysis of trabecular-bone density, width, specific length (which indicates bone length to unit area), and trabecular-bone orientations. Results 1. Trabecular-bone density Over the 13-month period, in comparison with the normal side, trabecular-bone density on the experimental side dropped to 69.4% in the incisor region, 82.2% in the premolar region, and from 60.0 to 68.0% in the molar region. The greatest reduction occurred in the molar region. 2. Trabecular-bone width Over the 13-month period, in comparison with the normal side, trabecular-bone width on the experimental side dropped to 86.9% in the incisor region, 86.1% in the premolar region, and from 66.4 to 71.4% in the molar region. The greatest reduction occurred in the molar region. 3. Specific length Over the 13-month period, in comparison with the normal side, specific length on the experimental side dropped to 81.9% in the incisor region, 82.9% in the premolar region, and from 65.6 to 70.5% in the molar region. The greatest reduction occurred in the molar region. 4. Orientation No regular trabecular-bone orientation was observed in the tooth-extraction sockets. In the incisor region, trabecular bone was often distributed at from 100 degrees to 120 degrees in relation to the dental roots. As time passed after extraction, the amount of bone with this orientation gradually decreased. At 13 months, amounts with bone orientation of from 40 degrees to 60 degrees had increased. In the premolar region, a great deal of trabecular bone was oriented at from 140 degrees to 150 degrees in relation to the dental roots. As time passed after extraction, the amount of bone with this orientation gradually decreased. At 13 months, amounts with bone orientation of from 110 degrees to 130 degrees had increased. In the molar buccal region, trabecular bone was often distributed at from 20 degrees to 40 degrees, and 90 degrees in relation to the dental roots. In the molar palatal region, trabecular bone was often distributed at from 120 degrees to 140 degrees in relation to the dental roots. At 13 months, the amount of trabecular bone oriented at about 90 degrees had increased.

Alveolar Bone Loss↗