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PubMed1971

Tooth extraction.

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Orthodontics, Corrective↗
PubMed2000

Computed tomography of emphysema following tooth extraction.

Subcutaneous and tissue space emphysema following surgical extraction of mandibular third molars is a rare and serious complication of dental surgery. Recognition of mediastinal emphysema following surgical extraction is difficult because there are no absolute clinical symptoms and signs. We present two cases of emphysema following extraction of a lower third molar and discuss the contribution of CT to the early recognition of the presence and spatial migration of air and to clinical management.

Adult↗
PubMed2003

Terrible accidents during tooth extraction in the earlier days of dentistry.

In the earlier days of dentistry, patients suffered terrible tortures and accidents at the hands of untrained individuals who attempted to extract the sufferer's teeth. Even as dental knowledge and skill advanced, there were still numerous untoward occurrences during extractions, some of them resulting in the death of the patient. The article ends with the recounting of a near-fatal case that was in no way the dentist's fault and could not have been prevented.

History, 16th Century↗
PubMed2003

Dynamics of bone tissue formation in tooth extraction sites. An experimental study in dogs.

OBJECTIVES: The aim of the present experiment was to study events involved in the healing of marginal, central and apical compartments of an extraction socket, from the formation of a blood clot, to bone tissue formation and remodeling of the newly formed hard tissue. MATERIAL AND METHODS: Nine mongrel dogs were used for the experiment. The fourth mandibular premolars were selected for study and were divided into one mesial and one distal portion. The distal root was removed and the socket with surrounding soft and mineralized tissue was denoted "experimental unit". The dogs were killed 1, 3, 7, 14, 30, 60, 90, 120 and 180 days after the root extractions. Biopsies including the experimental units were demineralized in EDTA, dehydrated in ethanol and embedded in paraffin. Serial sections 7 microm thick were cut in a mesio-distal plane. From each biopsy, three sections representing the central part of the socket were selected for histological examination. Morphometric measurements were performed to determine the volume occupied by different types of tissues in the marginal, central and apical compartments of the extraction socket at different intervals. RESULTS: During the first 3 days of healing, a blood clot was found to occupy most of the extraction site. After seven days this clot was in part replaced with a provisional matrix (PCT). On day 14, the tissue of the socket was comprised of PM and woven bone. On day 30, mineralized bone occupied 88% of the socket volume. This tissue had decreased to 15% on day 180. The portion occupied by bone marrow (BM) in the day 60 specimens was about 75%, but had increased to 85% on day 180. CONCLUSION: The healing of an extraction socket involved a series of events including the formation of a coagulum that was replaced by (i) a provisional connective tissue matrix, (ii) woven bone, and (iii) lamellar bone and BM. During the healing process a hard tissue bridge--cortical bone--formed, which "closed" the socket.

Animals↗
PubMed1999

Inflammatory dentigerous cysts of children treated by tooth extraction and decompression--report of four cases.

Inflammatory dentigerous cysts are only found in the mixed dentition. The four cases presented here illustrate the uncomplicated behavior of these cysts when properly treated. By extracting the infected primary teeth, opening the cyst and ensuring continuous drainage, it is possible to achieve spontaneous eruption of the involved permanent teeth into the dental arch even if they are badly dislocated. Simultaneous with the eruption of the permanent teeth, ossification of the bony defect can take place. The reparatory process is completed in one to two years.

Bicuspid↗
PubMed1990

Helium-neon laser therapy in the prevention of postoperative swelling and pain after wisdom tooth extraction.

Seventeen patients with symmetrically embedded lower wisdom teeth were selected for this study, intended to evaluate the local effect of soft laser therapy on postoperative pain. Both lower third molars were removed in the same operation. The test side, chosen by lot, was treated using a helium-neon laser (632,8 nm, 8 mW, 50 Hz) for 2 minutes. The other side served as the untreated control side. Facial swelling was measured using a modification of the face-bow technique. Postoperative pain was estimated using a visual analogue scale (VAS). When it became apparent that conventional statistical analysis was revealing no difference in postoperative swelling and pain between the test and the control groups, the study was discontinued for ethical reasons.

Adult↗
PubMed1995

Stability of occlusion after orthodontic treatment with tooth extraction in adult cases.

The purpose of this study was to evaluate stability of occlusion in adult cases at least 4 years after orthodontic treatment and to clarify parameters influencing this stability. The subjects were 25 cases (mean age: 19 y 8 m) who had been treated with Edgewise technique involving first-premolar extraction. During orthodontic treatment, decreases in the maxillary and mandibular incisors' irregularity index (Max.I.I. and Mand.I.I.), posterior movement of the upper and lower incisors, increases in upper incisal height, decreases in lower incisal height, and increases in upper and lower canine width were noted. In the posttreatment period, increases in Max.I.I. and Mand.I.I., anterior movement of incisors, increases in incisal height, and decreases in canine width were observed. The amounts of overjet and overbite decreased during the treatment period and increased during the post-treatment period. Multiple regression analysis was useful to deduce which parameters influenced stability of occlusion after orthodontic treatment.

Adult↗
PubMed2004

Observations on healing of human tooth extraction sockets implanted with bioabsorbable polylactic-polyglycolic acids (PLGA) copolymer root replicas: a clinical, radiographic, and histologic follow-up report of 8 cases.

OBJECTIVE: The objective was to conduct a clinical, radiographic, and histologic follow-up of alveolar socket healing in 8 human cases in which the extraction sockets of the involved teeth were treated with biodegradable root replicas before metallic implants were placed. STUDY DESIGN: Chair side prepared solid and porous forms of root replicas made out of polylactic-polyglycolic acids (PLGA) copolymer were utilized. Five patients were treated with the solid form and 3 with the porous form of the replicas. The cases were followed up at regular intervals postoperatively, and standardized photographs and radiographs were taken. The cylindrical core of biopsies that were removed with trephine for placement of titanium implants were processed and examined by light and transmission-electron microscopy. RESULTS: Both forms of the root replicas were well tolerated and biodegraded by the body. There were no histologically observable pathological tissue reactions at the time of implant application. However, the solid form seemed to cause an initial decalcification of the bone surrounding the extraction sockets that was subsequently repaired along with the bone healing of the extraction sockets. Such initial decalcification of the alveolar process was not observed in the cases that were treated with the porous form of root replicas. There was wide variation in the osseous component of the trephine-harvested biopsies in both treatment groups that suggests inconsistency in bone healing of the alveolar sockets. CONCLUSION: The 2 forms of root replicas under investigation were found to be biocompatible and biodegradable. But the compact solid form may cause an initial temporary lactic acid induced decalcification of the alveolar process, which makes it unsuitable for regular clinical application as compared to the granular porous form. The observed inconsistent and unpredictable bone regeneration calls for further research to develop more optimal replica materials.

Absorbable Implants↗
PubMed2006

Bioabsorbable root analogue for closure of oroantral communications after tooth extraction: a prospective case-cohort study.

OBJECTIVE: To assess the clinical capacity of a bioabsorbable root analog to close oroantral perforations after extraction. STUDY DESIGN: In this prospective case-cohort study, 20 consecutive patients with oroantral communications greater than 2 mm were treated with a bioabsorbable root analog (RootReplica). Patients were followed up clinically and radiographically for 3 months to monitor the healing process. RESULTS: Root replicas could be placed in 14 patients, whereas 6 patients required the socket to be covered with a buccal sliding flap. In the latter cases, fragmentary roots or overly large defects prohibited replica fabrication or accurate fitting of the analog, respectively. Healing was uneventful in all patients, and epistaxis, swelling, or pain was observed only in patients treated with flaps. CONCLUSIONS: The method described is a valuable alternative method with which to close oroantral communications but cannot be performed in all patients because of technical limitations.

Absorbable Implants↗
PubMed1980

Histologic study of the effects of occlusal hypofunction following antagonist tooth extraction in the rat.

A histologic study was done to observe the influence of occlusal hypofunction on periodontal tissues and the physiologic drift process, and to elucidate the origin of periodontal ligament narrowing. Twenty-four Wistar rats were used. Hypofunction was induced by extracting the right maxillary molars. Histologic observations were reported on the right lower jaws which were fixed, decalcified, sectioned and stained according to classical histologic methods. Two groups of five animals each were used for a complementary study study using sequential fluorescent labeling in order to evaluate the bone formation rate. After 15 days of hypofunction, the periodontal ligament was obviously narrowed and its structure was disorganized. Woven-bone formation was noted at the top of the interradicular septa, at the bottom of the sockets and along their modeling sides. At 30 days and at intervals up to 3 months, the periodontal ligament remained disorganized and narrowed. The newly-formed bone was engaged in a maturation process. Nevertheless, osteoporosis was also observed at the inferior part of the interradicular septa. Fluorescent labeling confirmed the histologic findings and showed that the induced bone formation is related to periodontal ligament narrowing and the supra-eruption process.

Alveolar Process↗
PubMed2001

Histologic evaluation of immediate versus delayed placement of implants after tooth extraction.

OBJECTIVE: Full osseointegration is necessary to achieve long-term success of dental implants. We aimed to find out the relative merits of immediate and delayed insertion of implants after dental extraction. STUDY DESIGN: We completed a histologic and histomorphometric examination of the tissue adjacent to delayed and immediate implants in 8 beagle dogs. In 4 dogs, implants were inserted immediately after the extraction of second premolars; in the remaining 4, the implants were inserted 6 months after the extraction. Fluorochrome bone markers were injected on 2 occasions before the dogs were killed 8 months after the implants had been inserted. Each implant and its surrounding tissue was examined macroscopically and microscopically. Both histologic dynamic and histologic static histomorphometry were used in this analysis. Statistical significance was tested by using the Student t test for paired and unpaired observations, the Dunnett t test, and Fisher's least significant difference method for multiple comparisons. RESULTS: The implants placed immediately had 76% of their surface covered with bone, whereas the implants placed after bony healing had 81% of their surface covered with bone. The fibrous tissue at the cervical end of the implant was more dense; the delayed implants also had a greater number of adhesive epithelial elements (hemidesmosomes). Use of dynamic and static histomorphometry revealed no significant differences between the 2 groups. CONCLUSION: We found new soft and hard tissue around dental implants 8 months after their insertion in both groups. Pseudoankylotic healing was seen in the osseous part. The lower level of osseointegration in the immediately placed implants was attributable to the early resorption of bone in the crestal part, resulting in a larger part of the implant being surrounded by soft tissue.

Animals↗
PubMed2004

Immediate or early placement of implants following tooth extraction: review of biologic basis, clinical procedures, and outcomes.

PURPOSE: The aim of this article was to review the current literature with regard to survival and success rates, along with the clinical procedures and outcomes associated with immediate and delayed implant placement. MATERIALS AND METHODS: A MEDLINE search was conducted of studies published between 1990 and June 2003. Randomized and nonrandomized clinical trials, cohort studies, case-control studies, and case reports with a minimum of 10 cases were included. Studies reporting on success and survival rates were required to have follow-up periods of at least 12 months. RESULTS: Thirty-one articles were identified. Most were short-term reports and were not randomized with respect to timing of placement and augmentation methods used. All studies reported implant survival data; there were no reports on clinical success. Peri-implant defects had a high potential for healing by regeneration of bone, irrespective of healing protocol and bone augmentation method. Sites with horizontal defects (HD) of 2 mm or less healed by spontaneous bone fill when implants with rough surfaces were used. In the presence of HDs larger than 2 mm, or when socket walls were damaged, concomitant augmentation procedures with barrier membranes and bone grafts were required. Delayed implant placement allowed for resolution of local infection and an increase in the area and volume of soft tissue for flap adaptation. However, these advantages were diminished by simultaneous buccolingual ridge resorption and increased requirements for tissue augmentation. DISCUSSION: Immediate and delayed immediate implants appear to be predictable treatment modalities, with survival rates comparable to implants in healed ridges. Relatively few long-term studies were found. Successful clinical outcomes in terms of bone fill of the peri-implant defect were well established. However, there was a paucity of data on long-term success as measured by peri-implant tissue health, prosthesis stability, and esthetic outcomes. CONCLUSIONS: Short-term survival rates and clinical outcomes of immediate and delayed implants were similar and were comparable to those of implants placed in healed alveolar ridges.

Alveolar Ridge Augmentation↗