International journal of oral surgery最新文献

The vertical ramus osteotomy is performed in many clinics throughout the world. Some hazards concerning the intraoral vertical ramus osteotomy and how to avoid them are discussed.

A total of 185 permanent teeth were extracted in 43 hemophiliacs. The patient material is divided into 3 groups with respect to antifibrinolytic therapy. Patients in group 1 were given antifibrinolytics systemically. In group 2, antifibrinolytics were applied locally, and in group 3 they were used both locally and systemically. The results of the treatment were evaluated using the number of units per kilogram of F VIII administered per patient and the Coagulum Index (Col). It is shown that local use of antifibrinolytics can reduce the amount of F VIII required for the control of bleeding, but regarding the high values of the Col, the therapeutic effects are unsatisfactory. Approximately 20 U/kg of F VIII per patient, given in single infusion prior to intervention, were required in group 1 as well as in group 3. However, with respect to the Col, a statistically significant difference is found between groups 3 and 1. On this basis, it is concluded that antifibrinolytics, used both locally and systemically, appear to show distinct advantages in the treatment of hemophiliacs undergoing dental extractions and also receiving F VIII therapy.

A clinical study of patients, suffering from an extraoral sinus was undertaken. The various aspects of incidence of an extraoral sinus and its management, have been reviewed and discussed.

In a controlled trial, before having a lower wisdom tooth surgically removed, 190 patients were blindly randomized to 2 parallel groups. One group received 100 mg Voltaren® (diclofenac-sodium) before surgery and then 50 mg 3 times a day for 5 days; the other group in Sweden widely used fixed combination tablets (acetylsalicylic acid 500 mg, caffeine 50 mg, aprobarbital 20 mg, codeine phosphate 10 mg) in the highest recommended dose, 2 tablets when needed at most 3 times a day. Twice a day the patients recorded pain and swelling on 100 mm visual analogue scales. Patients treated with Voltaren had significantly less pain and swelling (p < 0.001). Furthermore, they had significantly, fewer days away from work (p < 0.01). The study indicates that visual analogue scales may also be useful in assessment of swelling and that Voltaren in a fixed dosage offers a promising alternative against postoperative pain and swelling.

A case of oral squamous cell carcinoma with pemphigus vulgaris is reported and the literature is reviewed. Association between the above entities has essentially been founded upon the specificity of cancer-associated antigen. To date, such an antigen has not been adequately defined, and, therefore, any causal relationship between the 2 processes on the grounds of antigenic-specificity or cancer cells remains unjustified. Hence, pemphigus and malignancy may occur as a coexisting phenomenon.

140 patients suffering from trigeminal neuralgia are evaluated. 22 patients were treated by sympatholytic and parasympatholytic drugs and the remaining 118 were operated on by peripheral neurectomy and nerve avulsion. In case of involvement of the inferior alveolar nerve, Thoma's, Poppen's and Ginwalla's method were tried. All cases were critically evaluated and followed for a period of 6 months to 5 years. The objective was to assess the different techniques and to find out the most ideal method of management. Our study showed that an injection of atropine was quite promising in the third division involvement while peripheral neurectomy in second division involvement (Ginwalla's technique of nerve avulsion) was found to be more satisfactory than Thoma's or Poppen's method.

The effect of cryopreservation in liquid nitrogen at −196°C for 1 week was studied by histometric analysis of 60 mature teeth replanted in 10 green Vervet monkeys. The effect of preincubation in enriched tissue culture medium was also investigated. 2 different freezing rates were compared, and the effect of stepwise equilibration of DMSO was studied as well as the effect of root canal treatment. The histometric analysis carried out 8 weeks after replantation revealed that if the cryoprotectant was equilibrated stepwise at room temperature, 10% DMSO had an even better cryoprotecting effect than previously shown by 5% DMSO equilibrated at 0°C. When this procedure was combined with a slow freezing rate of 0.3°C/min from −4°C to −35°C followed by plunging in liquid nitrogen, and supplemented by endodontic treatment before replantation, the amount of normal periodontal healing was almost similar to unfrozen and immediately replanted control teeth. Furthermore, this cryoprofile induced replacement resorption equal to the replanted control teeth. Preincubation in enriched medium for 24 h did not reduce resorption activity of the periodontal ligament. Endodontic treatment reduced the inflammatory resorption, demasking, however, hereby limited amount of ankylosis, that could be reduced by the above-mentioned cryoprofile.

An optimal cryoprofile for mature teeth seemed to be (i) slow equilibration at room temperature to a final concentration of 10% DMSO, (ii) slow freezing rates (0.3°C/mm) and plunging in liquid nitrogen at −35°C combined with fast thawing after storage at −196°C, and followed by (iii) endodontic treatment after thawing.

Histologic and histochemical changes in experimental SCCs following cryosurgery were reported. Effects of cryosurgery on SCCs of hamster cheek pouch were classified into 3 zones; the superficial zone was the cryodestructive layer on which the cryoprobe had been attached directly to the SCC; the zone beneath this layer was the indirect cryodestructive layer; the 3rd zone was unaffected tissue in which the critical low temperature was never reached. In the superficial cryodestructive layer, tumor cells were destroyed completely and bleeding was found in the stroma. In the zone beneath it, neoplastic cells also showed morphologic and enzymatic changes indicating incomplete cellular destruction; dilatation of capillary vessels was also found. LDH isozyme pattern displayed a high level of LDH 5 in the non-treated SCC, and following cryosurgery, the high level of LDH 5 decreased and revealed an approximately normal LDH 5 pattern.