Assessment of factors associated with surgical difficulty during removal of impacted maxillary third molars

PURPOSE

Estimating the difficulty of removing third molars is a common dilemma. However, the estimation of the difficulty associated with maxillary third molar surgery has not yet been defined. The aim of the present study was to determine the degree of difficulty and identify predictor variables associated with the occurrence of difficulty in the removal of impacted maxillary third molars.

MATERIALS AND METHODS

A prospective cohort study was carried out involving patients who underwent at least 1 surgical removal of an impacted maxillary third molar at the Oral and Maxillofacial Surgery Unit, University of Pernambuco (Pernambuco, Brazil). Predictor variables indicative of surgical difficulty were classified by their demographic, clinical, and radiographic aspects. Degree of surgical difficulty was categorized as low, moderate, or high based on the surgical technique used. Descriptive and bivariate statistics were computed.

RESULTS

In total, 106 patients fulfilled the eligibility criteria and 204 surgeries were performed. Patients' mean age was 22.8 ± 2.2 years and the proportion of women to men was 3:1. Approximately 20% of patients were overweight. Surgical difficulty was generally low and 5 variables were significantly associated with the occurrence of a high degree of surgical difficulty.

CONCLUSION

Surgical difficulty during the removal of impacted maxillary third molars is generally low. However, for cases with a high degree of difficulty, identification of predictor variables may be useful for students and inexperienced clinicians to consider the decision not to execute the procedure, thus avoiding complications that often require complex management.

Retrograde migration of a ventriculoperitoneal shunt to the neck after dental treatment

The ventriculo-peritoneal shunt (VPS) is the technique most often employed for the treatment of hydrocephaly, but may present complications after placement. Retrograde migration of the peritoneal catheter to the cervical region is rarely reported. This manuscript to describes a case of migration of the distal portion of the VPS system to the neck after dental treatment in a child and discusses the possible causes for this complication.

Prevalence and predictive factors of dental anxiety in Brazilian adolescents

PURPOSE

The purpose of this study was to determine the prevalence and predicitve factors of dental anxiety among Brazilian adolescents.

METHODS

This was a cross-sectional study of a random sample of 340 Brazilian adolescents, done between 2005 and 2010. Corah's Dental Anxiety Scale and an objective questionnaire were used to determine the degree of dental anxiety.

RESULTS

The prevalence of moderate to severe dental anxiety was approximately 18%. Dental anxiety was correlated with the following factors: gender (P<.05), age group (P<.001), degree of schooling (P<.001), access to newspapers and/or the Internet (P<02), oral hygiene frequency (P=.005), visits to the dentist (P<.02), reason for last visit to the dentist (P<.001), and experience with dental pain (P=.002).

CONCLUSIONS

Dental fear and anxiety in Brazilian adolescents are associated with lack of economic resources, negligence of oral health, low educational level, female gender, and younger age.

Ansiedade frente ao tratamento odontológico: prevalência e fatores predictores em brasileiros

Diante do impacto negativo que a ansiedade exerce sobre o atendimento odontológico, buscou-se conhecer sua prevalência e seus fatores predictores frente esse tratamento em brasileiros. Foi realizado um estudo de corte transversal, utilizando-se a escala de ansiedade de Corah para avaliar 3000 pacientes. Os resultados demonstram que 2 em cada 8 brasileiros avaliados apresentaram moderada ou severa ansiedade frente ao atendimento odontológico, verificando-se que a probabilidade de um paciente da população da qual a amostra foi extraída apresentar ansiedade é mais elevada se: for mulher (p = 0,007), da faixa etária superior a 20 anos (p = 0,006), se não possuir acesso a internet e/ou jornais (p = 0,016), se tiver baixa frequência de higiene oral (p = 0,001), se a visita dental for motivada por busca de tratamento curativo, por dor ou outro problema, ao invés de um check-up (p = 0,047), e experiência de odontalgia (p<0,001). O medo e a ansiedade a fatores odontológicos existem de fato na população brasileira e as conclusões do estudo sugerem que, além da falta de recursos econômicos, o descaso com a saúde bucal, o gênero e a idade podem aumentar o grau de ansiedade.

Clinical study of hemodynamic changes comparing 4% articaine hydrochloride with 1:100,000 and 1:200,000 epinephrine

OBJECTIVE

To evaluate hemodynamic changes with the use of 4% articaine and 2 different concentrations of epinephrine (1:100,000 and 1:200,000) in the surgical removal of symmetrically positioned lower third molars.

STUDY DESIGN

A prospective, randomized, double-blind clinical trial was carried out involving 42 patients each undergoing 2 surgeries on separate occasions under local anesthesia with 4% articaine and either epinephrine 1:100,000 or 1:200,000. The following parameters were assessed at 4 different moments: systolic, diastolic, and mean blood pressure; heart rate; oxygen saturation; rate pressure product (RPP); and pressure rate quotient (PRQ).

RESULTS

The concentration of epinephrine did not affect diastolic blood pressure or oxygen saturation during the surgeries. Significant differences between were detected for heart rate, RPP, and PRQ (P < .05).

CONCLUSIONS

The epinephrine concentration (1:100,000 or 1:200,000) in a 4% articaine solution influences hemodynamic parameters without perceptible clinical changes in healthy patients undergoing lower third molar removal.

Ameloblastic fibro-odontoma in children: report of 2 cases

Ameloblastic fibro-odontoma is a rare, mixed, benign, odontogenic tumor of significant prevalence in the mandible, with epithelial and mesenchymal components. It usually affects pediatric patients and is associated with teeth, causing a delay in eruption chronology or an alteration in the dental eruption pathway. It is occasionally diagnosed during radiographic evaluations of these patients. The literature is unclear whether it is a distinct pathological entity or a stage of odontoma. As it is benign and has a low recurrence rate, conservative treatment is recommended. The purpose of this paper was to present 2 cases of ameloblastic fibro-odontoma in the mandibles of children.

Tooth embedded in tongue following firearm trauma: report of two cases

Injuries caused by projectiles from firearms involve diverse patterns of dentoalveolar trauma due to the different types of wound and extent of tissue damage. This article reports two cases in which tooth fragments were embedded in the tongue following aggression from a firearm projectile in the facial region. Radiographs confirmed the presence of foreign bodies, which were surgically removed under local anesthesia. When dentoalveolar trauma occurs in facial injuries, both hard and soft tissues must be carefully examined to avoid overlooking embedded tooth fragments not located immediately in the soft tissue.

[Psychosocial aspects of teenager in Aracaju, Sergipe State, related to oral health perception]

The objective of this article is to investigate the autoperception of teenagers, age range of 12 to 19 years old in Aracaju, Sergipe State, about their health and relate it with psychosocial aspects. The present work is a quali-quantitative study of transversal cut, carried through with 247 adolescents registered institutions of education, private or public, of the urban zone of the city of Aracaju. Most of the adolescents (85%) consider themselves healthful, while 9% have shame of the oral conditions. Seventy-one percent of the students referred to pain, however it wasn't the main cause to search dentistry services. The subjective pointers of this research may be used to guide programs directed toward education in health.

Estudo da prevalência de fluorose dentária em Aracaju

Com o objetivo de determinar a prevalência de fluorose dentária em Aracaju (SE), 196 escolares foram submetidos a exame clínico bucal, utilizando o índice de Dean. Pôde ser concluído que a prevalência de fluorose dentária em escolares de cinco a quinze anos do município de Aracaju (SE) foi de 8,16%, não implicando risco à saúde pública. Porém, estudos semelhantes devem ser realizados com periodicidade regular, além de orientação aos órgãos responsáveis pela fluoretação da água, para que os níveis considerados ótimos para essa região sejam respeitados, prevenindo assim o surgimento de tal ocorrência.

Hereditary gingival fibromatosis: a report of four cases in the same family

Hereditary gingival fibromatosis is characterized by a slow, progressive increase in the gingival tissue that develops as either an isolated disorder or as part of the clinical characteristics of diverse syndromes. The present case report describes a Brazilian family with individuals from three generations affected. The proposed treatment was maxillary and mandibular gingivectomy with 12 months of monitoring.