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Oral Surgery (oral + surgery)

Distribution by Scientific Domains
Medical Sciences100%
Distribution within Medical Sciences
Anesthesia & Pain Management15%

Terms modified by Oral Surgery

  • oral surgery procedure
    		•

    Selected Abstracts

    World dental research production: an ISI database approach (1999,2003)

    EUROPEAN JOURNAL OF ORAL SCIENCES, Issue 2 2006
    Jose Antonio Gil-Montoya
    The objective of this study was to obtain a geographic world map of scientific production in dentistry by analysing published papers. Articles and reviews in the Dentistry, Oral Surgery & Medicine category published from 1999 to 2003 were accessed through the ISI database. The data were analyzed quantitatively (number of documents, number of researchers, productivity, interannual variation rate and relative specialization index), qualitatively (weighted impact factor, relative impact factor, citation rate per document and top 5 publications) and socioeconomically (number of documents per inhabitant and per dentist and in relation to the country's GDP). The USA, UK, Japan and Scandinavian countries were found to be the most productive countries (number of publications). Publications from Scandinavian countries were also of high quality as measured by Impact Factor and Citation Rate, while the UK had one of the highest productivity rates (number of documents per researcher). [source]

    Pre-audit survey of documentation of invasive procedures in paediatric anaesthesia

    PEDIATRIC ANESTHESIA, Issue 9 2002
    A. Patil
    Introduction Consent of patients for any medical procedure is an essential part of good practice (1). Verbal consent is increasingly sought for invasive anaesthetic procedures and documentation of this is an important feature of risk management. Paediatric consent is a complex issue and although it is common practice to explain things to the child, written consent is generally still sought from the parent (2). Recent guidelines from the Royal College (3) are quite specific about having a ,child centred approach'. They clearly state that ,where special techniques (e.g. epidurals, other regional blocks including caudal, and invasive monitoring or blood transfusion) are used there should generally be written evidence that these have been discussed with the child (when appropriate) and the parents'. Our aim was to discover the current amount of documentation on invasive procedures in our paediatric anaesthetic notes and to subsequently agree on a local standard. Method We looked retrospectively at anaesthetic records of children aged 10, 11 and 12 years undergoing general anaesthesia for elective surgery over a 2-month period. We specifically looked for documentation of who was present at the pre-operative discussion and where an invasive anaesthetic technique was planned. written evidence that it had been discussed. Results 73 anaesthetic records were examined. The case mix was as follows: 37% ENT, 28% Plastic Surgery, 24% General Surgery, 11 % Orthopaedic and Oral Surgery. A Consultant was present for 98% of the anaesthetics and was accompanied by a trainee in half of those cases. In 82% (60 patients) there was no documentation of who was present at the pre-operative discussion. In 2 cases (3%) the child was seen alone, in 8 cases (11 %) both a parent and child were documented to have been involved in the discussion and in 3 cases (4%) only the parents appeared to have been involved. Of the 73 anaesthetic records, 11 did not have invasive procedures planned or performed and the following data is from the remaining 62 anaesthetic records ,,83.5% of invasive procedures were documented pre-operatively ,,12 patients (19%) had more than one procedure. ,,Only 7 notes (11 %) had a record of the procedure being specifically discussed with the child. ,,2 out of the 4 caudal (50%) were done without documentatior, of discussion about the procedure ,,7 out of 48 suppositories (14%) were given without record of verbal consent ,,5 out of 16 (31 %) of the local anaesthetic techniques were performed without documentation of discussion. Discussion This pre-audit survey demonstrates that in 82% of cases there was no record of exactly who was present at the preoperative discussion and that some invasive procedures were carried out without any record of a discussion having taken place. We feel that this level of documentation is insufficient. We looked at the age range 10,12 years as this might be regarded as approximately the age at which agreement should be sought for relatively simple procedures such as those chosen in this survey. This is not to imply that children below this age should not be involved in a plan of management or that all children of this age will be fully competent to participate in decisions. We deliberately chose to look at elective surgery, as there should be better documentation in these cases. One reason for such poor results may be that most anaesthetists do not realise the importance of documentation. Our current chart provides no means of prompting the anaesthetist to record who was present at pre-operative discussions. There is also a lack of a clear standard as to an age when invasive procedures should generally be discussed. We feel that this is probably a common problem and hope this surveys increases awareness on this important topic. Conclusions The results of this survey are to be brought to the attention of the local department. Having identified the problem we hope to agree on a local standard and audit against these standards. [source]

    Effects of sinus lifting on voice quality

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 6 2003
    A prospective study, risk assessment
    Abstract: A variety of potential complications associated with sinus lift surgery have been reported in the literature. However, potential alterations of voice quality following sinus elevation have so far not been mentioned or evaluated scientifically. For the majority of patients, slight changes of the voice pattern are of no importance. However, for voice professionals, whose voices have become part of their distinctive profession or trademark, minimal changes may have dramatic consequences. This specific group of patients, such as speakers, actors and singers, depend on the particular quality and timbre of their voice for their livelihood. Consequently, the purpose of this study was to assess the effects of sinus lifting on voice quality in the above patient group. In a collaborative interdisciplinary effort, the Departments of Oral Surgery and Otorhinolaryngology, Section of Phoniatrics and Logopedics, thoroughly evaluated a series of voice parameters of four patients undergoing sinus lifting pre- and postoperatively. The parameters analyzed included pitch, dynamic range, sound pressure level, percent jitter, percent shimmer and noise-to-harmonics ratio with special emphasis on formant analysis. No changes were detected in any of the commonly evaluated parameters. These were rated subjectively by patients and their friends or relatives and objectively with instrumental tools under isolated phoniatric lab conditions. In conclusion, sinus lift surgery appears to be a safe, predictable evidence-based method for regenerating the highly atrophic posterior maxilla, which does not jeopardize the individual characteristic voice pattern of high-profile patients critically dependent on their voices for their livelihood. Résumé Quelques complications potentielles associées à la chirurgie d'épaississement du plancher sinusal ont été rapportées dans la littérature. Les altérations potentielles de la qualité de la voix suivant l'épaississement du plancher sinusal n'ont pas encore été mentionnées et évaluées scientifiquement. Pour la majorité des patients, des petites variations dans le timbre de la voix ne sont pas importantes. Cependant, pour les professionnels de la phonation pour lesquels la voix est devenue une partie importante de leur profession, des variations même faibles peuvent entraîner des conséquences dramatiques. Ce groupe spécifique de patients, tels que les orateurs, les acteurs et les chanteurs dépendent essentiellement de la qualité et du timbre particulier de leur voix dans leur vie professionnelle. Par conséquent, le but de cette étude a été d'estimer les effets d'un épaississement du sinus sur la qualité de la voix dans ce groupe de patients. Dans un effort interdisciplinaire collaboratif, les départements de chirurgie buccale et d'otorhino-laringologie, la section de phonétique et de logopédie ont évalué de manière très précise une série de paramètres de la voix avant et après l'opération chez quatre patients ayant subi un épaississement du sinus maxillare. Les paramètres analysés contenaient la hauteur, l'étalement, le niveau de pression du son, le pourcentage de trac, le pourcentage de chatoiements et la proportion bruit-harmonie avec une insistance spéciale sur l'analyse du formant. Aucun changement n'a été détecté dans aucun des paramètres évalués couramment. Ces derniers étaient estimés subjectivement par les patients et par leurs amis ou parents, et objectivement à l'aide des instruments sous des conditions de laboratoire de phonétique isolé. En conclusion, la chirugie d'épaississement du plancher sinusal semble une méthode sûre, avec un pronostic basé sur l'évidence, permettant de regénérer les maxillaires très atrophiés qui n'empêche pas la caractéristique individuelle de la voix chez des patients avec des profils où la voix est essentielle à leur vie active. Zusammenfassung Der Einfluss einer Sinusbodenelevation auf die Stimmqualität, eine Langzeitstudie und Risikoanalyse. In der Literatur werden eine ganze Reihe von möglichen Komplikationen beschrieben, die bei dem chirurgischen Eingriff der Sinusbodenelevation auftreten können. Veränderungen der Stimme, die als Folge einer Sinusbodenelevation vorkommen können, wurden aber bis heute weder beschrieben, noch wissenschaftlich ausgewertet. Für den Grossteil der Patienten haben leichte Veränderungen der Stimme keine Bedeutung. Für Personen aber, deren Stimme bei der Ausübung ihres Berufes wichtig ist, eventuell ein Teil ihres Berufes oder gar Markenzeichen geworden ist, können kleine Veränderungen dramatische Folgen haben. Diese ausgewählte Gruppe von Patienten, wie zum Beispiel Nachrichtensprecher, Schauspieler oder Sänger, sind im täglichen Leben auf die spezifische Art und den Klang ihrer Stimme angewiesen. Daher war das Ziel dieser Studie, Einflüsse einer Sinusbodenelevation auf die Stimmqualität bei den oben erwähnten Patienten zu untersuchen. In einer interdisziplinären Zusammenarbeit untersuchten die Klinik für Oralchirurgie und Otorhinolaryngologie und die Abteilung für Phonetik und Logopädie an 4 Patienten vor und nach der Sinusbodenelevation sehr eingehend verschiedene Parameter der Stimme. Die untersuchten Parameter waren Tonhöhe, Tonvolumen, den durch den Ton erzeugten Luftdruck, Schwingungen, Vibrationen und das Verhältnis zwischen Nebengeräuschen und harmonischem Klang mit speziellem Augenmerk auf formative Analysen. Man erkannte bei keinem der oben untersuchten Parametern eine Veränderung. Sie wurden sowohl subjektiv durch die Patienten und ihre Freunde oder Verwandten, sowie objektiv mit Messinstrumenten unter absolut schallisolierten Laborbedingungen gemessen. Über die Sinusbodenelevation kann man zusammenfassend sagen, dass es sich um eine sichere, voraussagbare und auf wissenschaftlichen Grundlagen basierende Operationsmethode zum Wiederaufbau einer massiv athrophischen Maxilla im Seitenzahnbereich handelt. Sie gefährdet die individuellen Stimmcharakteristika von kritischen und sehr anspruchsvollen Patienten, die in ihrem täglichen Leben auf ihre charakteristische Stimme angwiesen sind, nicht. Resumen Se han descrito en la literatura una variedad de complicaciones asociadas con la cirugía de la elevación del seno. Pero hasta el momento no se han mencionado ni evaluado científicamente alteraciones potenciales de la calidad de voz tras la elevación del seno. Para la mayoría de los pacientes, pequeños cambios en el patrón de voz no tienen importancia. De todos modos, en los profesionales de la voz, cuyas voces se han convertido en parte distintiva de su profesión o marca, pequeños cambios pueden tener consecuencias dramáticas. Este grupo específico de pacientes, tales como locutores, actores y cantantes, dependen de la calidad particular y timbre de su voz para su sustento. Consecuentemente, el propósito de este estudio fue valorar los efectos de la elevación del seno en la calidad de voz en el anterior grupo de pacientes. En un esfuerzo de colaboración interdisciplinaria, los departamentos de Cirugía Oral y Otorrinolaringología, Sección de Foniatría y Logopedia, evaluaron e profundidad una serie de parámetros de voz de 4 pacientes que se someterían a elevación del seno pre y postoperatoriamente. Los parámetros analizados incluyeron tono, rango dinámico, nivel de presión sonoro, porcentaje de reverberación, porcentaje de tremulación y relación ruido a harmónicos con especial énfasis en el análisis formante. No se detectaron cambios en ninguno de los parámetros evaluados comúnmente. Estos se valoraron subjetivamente por los pacientes y sus amigos o parientes y objetivamente por herramientas instrumentales bajo condiciones de laboratorio de aislamiento foniátrico. En definitiva, la cirugía de elevación del seno parece ser un método seguro, predecible basado en la evidencia para regenerar el maxilar posterior altamente atrófico, que no pone en peligro las características del patrón de voz de los pacientes de características especiales dependientes de manera crítica de sus voces para su sustento. [source]

    Oral surgery in patients on oral anticoagulant therapy: a randomized comparison of different INR targets

    JOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 3 2006
    R. SACCO
    [source]

    Management of third molar removal with a single dose of recombinant Factor IX (BeneFIX) and local measures in severe haemophilia B

    AUSTRALIAN DENTAL JOURNAL, Issue 3 2010
    ID Hewson
    Abstract Background:, Patients with inherited bleeding disorders have historically had factor cover for oral surgery. Factor support is expensive, time consuming and places the patient at a potential risk of blood-borne diseases. This case describes the use of a significant reduction in factor support for a severe haemophilia B patient having third molars surgically removed. Methods:, Local measures were used after a single preoperative dose of Factor IX to obtain good postoperative haemostasis. Results:, Excellent haemostasis was achieved using local measures of 5% tranexamic acid solution, Surgicel® and Monocryl® sutures after a single preoperative dose of Factor IX. Conclusions:, Oral surgery may be performed on patients with inherited bleeding disorders using minimal factors and local haemostatic measures. A study of this patient population has commenced at The Alfred Hospital. [source]

    Altered expression of mRNA for HIF-1, and its target genes RTP801and VEGF in patients with oral lichen planus

    ORAL DISEASES, Issue 3 2010
    M Ding
    Oral Diseases (2010) 16, 299,304 Objective:, To explore a potential causal contribution of the transcription factor HIF-1, and its target gene, RTP801 and VEGF, to the development of oral lichen planus (OLP). Design relevant:, Twenty-two adult OLP patients were enrolled in this study. All OLP diagnoses were verified by histopathological characteristics. Normal mucous specimens were collected from 12 controls after various oral surgeries. Material and method:, RNA was isolated from OLP and control specimens. Microarray was performed using BiostarH-40s gene chip. Expression of HIF-1,, VEGF and RTP801 was evaluated using quantitative real-time polymerase chain reaction (qPCR). Unpaired t -test and one-way ANOVA was used for statistical analysis. Results:, Microarray results showed that RTP801 expression was lower in OLP than in controls (779 vs 3090). qPCR further confirmed that expression of RTP801 was similarly lower in OLP than in controls (0.363 vs 1.473, P < 0.001); expression of VEGF was also lower in OLP (0.448 vs 1.74, P = 0.012). In contrast, expression of HIF-1, was higher in OLP than in controls (11.12 vs 1.628, P < 0.001). Conclusion:, The oral mucosa of OLP is hypoxic. Genes that are activated by hypoxia, such as RTP801 and VEGF, and their signal cascades may be novel potential therapeutic targets for OLP. [source]

    Teaching oral surgery to undergraduate students: a pilot study using a Web-based practical course

    EUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 3 2003
    Luciana Corrêa
    The Internet has been used in oral surgery teaching mainly to deliver learning material across the World Wide Web and to make use of online interactivity resources in everyday surgical practice, such as by e-mails, discussion groups, and chats. The aim of this paper is to describe and evaluate a Web-based practical course on oral surgery principles, which was applied to undergraduate students. This course was investigated as a distance learning simulation in which the student would be performing surgical activities at home, and the teacher and the school environment would be absent. A Web site was created containing the course material. For this study, the students participated in the Web-based course in a multimedia lab equipped with computers and Internet, internal sound system and TV circuits. In the event of significant mistakes by students, the TV circuit could be used to show the correct procedure for all the participants at the same time. Microcameras were used to monitor the student's actions during the Internet use. Students' impressions were determined by a questionnaire. Computer manipulation with ease and antiergonomic postures were observed. We concluded that distance learning courses with practical modules must be considered as a special type of educational modality, with reference to the relationship between the student and the computer. [source]

    Perspective: Assessing the Clinical Utility of Serum CTX in Postmenopausal Osteoporosis and Its Use in Predicting Risk of Osteonecrosis of the Jaw,

    JOURNAL OF BONE AND MINERAL RESEARCH, Issue 4 2009
    Sanford Baim
    Abstract Bone turnover markers (BTMs) have become increasingly important in the management of postmenopausal osteoporosis (PMO). In bisphosphonate-treated women with PMO, BTMs can provide early indications of treatment efficacy, are predictors of BMD response and fracture risk reduction, and are potentially useful for monitoring patient compliance. The bone resorption marker serum C-telopeptide cross-link of type 1 collagen (sCTX) has shown high sensitivity and specificity for the detection of increased bone resorption. Recently, sCTX has been singled out as a potential indicator of risk of osteonecrosis of the jaw (ONJ) in patients receiving oral bisphosphonates who require oral surgery. However, whether BTMs are capable of predicting ONJ risk and whether sCTX is usable for this purpose are controversial questions. This article presents an overview of the current literature regarding critical issues affecting the clinical utility of BTMs (including variability and reference ranges) and the current applications of BTMs in PMO management, with a focus on sCTX. Last, the appropriateness of using sCTX to predict ONJ risk in women receiving oral bisphosphonates for PMO is evaluated. [source]

    US4 Pharmacotherapy complicating dental surgery

    ORAL DISEASES, Issue 2006
    Boras
    Planning dental treatments for patients taking antithrombotic can be difficult for the general dental practitioner, particularly when surgical interventions are needed. The drugs employed in the long-term treatment of such patients include platelet aggregation inhibitors and oral anticoagulants. Platelet aggregation inhibitors do not represent a contraindication to oral surgery. The activity of oral anticoagulants can be affected by many substances, for this reason it is necessary to monitor by INR the patients taking those drugs. When INR is within therapeutic limits for the more common conditions, most of the oral surgery interventions do not need any special precaution. Evidence indicates that suspending antithrombotic drugs is not indicate, as complications following a thrombotic accident are more frequent and serious than bleedings following oral surgery. It is well known that systemic corticosteroid therapy due to the effect on adrenal suppression can interfere with dental surgical procedures. However, that is largely dependent on the type and dose of corticosteroid that patient is currently taking, or has been taking in the last 12 months and on the type and extent of surgical procedure which is to be performed. Surgical management of dental patients with history of systemic corticosteroid therapy is proposed from the existing literature. [source]

    Reviewing the efficacy of changing prophylactic measures for the prevention of bisphosphonate related osteonecrosis of the jaws (BRONJ) in the management of oral surgery patients

    ORAL SURGERY, Issue 3 2010
    C.J. Hanson
    Abstract Aims:, Many papers postulate treatments for established bisphosphonate related osteonecrosis of the jaws (BRONJ) or advise on ideal long-term strategies to avoid BRONJ. This article demonstrates prophylactic regimes and compares their outcomes when patients' acute symptoms demand active treatments involving bone. It assesses the efficacy of the protocols developed at Dundee Dental Hospital for prophylaxis of BRONJ in the management of patients undergoing oral surgery. Materials and methods:, This prospective study tracked the progress of patients who were treated in the exodontia clinics and had taken, or were taking bisphosphonates. Their consequent recovery was documented over 1, 4, 12 and 24 weeks. The prophylactic protocol followed was recorded. These data were then reviewed for healing, operator, jaw predilection and co-morbidity influences. Results:, In total, 25 patients were treated over the 1 year period of the study 2008,09. This amounted to 33 oral surgery treatments involving 64 extractions. Several protocols had been followed however these were grouped into: antimicrobial or chlorhexidine based protocols. In all cases, complete healing was achieved. Concomitant steroid use and increasing age were the only associated co-morbidities that increased the length of healing time. There were no direct associations of any of the other variables with healing. No prophylactic protocol was superior to another with chlorhexidine rinses proving as efficacious as any of the antibiotic regimes. Conclusion:, For patients taking oral bisphosphonates, simple extractions carried out with minimal trauma by graduate and supervised undergraduate operators with prophylactic chlorhexidine rinses, heal as satisfactorily as those with antibiotic based protocols for prophylaxis. [source]

    Bisphosphonates and oral surgery

    ORAL SURGERY, Issue 2 2009
    R. Oliver
    Abstract Osteonecrosis of the jaws, or the threat of it, because of the use of bisphosphonates, is an increasing problem facing all dentists and oral surgeons. The link is somewhat circumstantial but compelling and there are emerging risk factors that increase a patient's susceptibility to developing osteonecrosis including the use of intravenous bisphosphonates, length of time taking the drug, smoking and possibly a genetic predisposition. There is a lack of randomised trial evidence regarding the best strategies for prevention and treatment of the condition. This article discusses current evidence, largely from observational studies on the development, prevention and management of bisphosphonate-related osteonecrosis. [source]

    The Parker Flex-TipÔ tube for nasotracheal intubation: the influence on nasal mucosal trauma

    ANAESTHESIA, Issue 1 2010
    T. Sanuki
    Summary We tested our hypothesis that use of the Parker Flex-TipÔ tracheal tube could reduce the incidence of nasal mucosal trauma during nasotracheal intubation when compared with a conventional tip tracheal tube. One hundred and two patients, who were scheduled for elective oral surgery in which nasotracheal intubation was indicated to optimise the surgical approach, were recruited into this study. Either a Flex-Tip tracheal tube or a conventional tip tracheal tube was chosen randomly for each nasotracheal intubation. The incidence of epistaxis using the Flex-Tip tracheal tube (6 (11.8%)) was significantly lower than that with the conventional tip tracheal tube (18 (35.3%); p = 0.009). Nasal pain due to intubation, rated on a 100-mm visual analogue scale, was less intense with the Flex-Tip tracheal tube (median, (10th,90th percentile) 19 (12,28) mm compared with the conventional tip tracheal tube (30 (22,35) mm; p < 0.001). The Flex-Tip tracheal tube thus appeared to reduce the incidence of nasal mucosal trauma during nasotracheal intubation and the incidence of post-intubation nasal pain, compared with the conventional tip tracheal tube. [source]

    A comparison of a flexometallic tracheal tube with the intubating laryngeal mask tracheal tube for nasotracheal fibreoptic intubation using the two-scope technique,

    ANAESTHESIA, Issue 12 2009
    M. R. Rai
    Summary We compared the incidence and site of impingement of a flexometallic tracheal tube with those of the re-usable intubating laryngeal mask (ILMA) tube in 60 anaesthetised patients undergoing nasotracheal fibreoptic intubation for oral surgery. A two-scope technique was used, observing the site of impingement with one scope whilst intubating with the other. The tubes were 6.0-mm in females and 6.5-mm in males. Impingement occurred with 10 (33%) flexometallic and 2 (7%) ILMA tubes (p < 0.032). In all but one case, the impingement was posterior to the right arytenoid cartilage. When impingement was observed, a single disempaction with a 90° anticlockwise rotational manoeuvre overcame impingement in every case except one, allowing successful intubation. We conclude that the incidence of impingement of the tracheal tube, and therefore of potential laryngeal trauma from nasotracheal fibreoptic intubation, is significantly greater with the flexometallic tube than with the ILMA tube. [source]

    World War I: the genesis of craniomaxillofacial surgery?

    ANZ JOURNAL OF SURGERY, Issue 1-2 2004
    Donald A. Simpson
    Herbert Moran enlisted in the Royal Army Medical Corps early in World War I. His autobiography captures the impact of contemporary experience of wartime gunshot wounds, seen in vast numbers and with little understanding of the requirements of wartime surgery. Wounds of the face and brain were numerous, especially in trench fighting. In France, Germany, Britain and elsewhere, surgeons and dentists collaborated to repair mutilated faces and special centres were set up to facilitate this. The innovative New Zealand surgeon Harold Gillies developed his famous reconstructive techniques in the Queen's Hospital at Sidcup, with the help of dental surgeons, anaesthetists and medical artists. The treatment of brain wounds was controversial. Many surgeons, especially on the German side, advocated minimal primary operative surgery and delayed closure. Others advocated early exploration and immediate closure; among the first to do so was the Austro-Hungarian otologist Robert Bárány. In 1918, the pioneer American neurosurgeon Harvey Cushing published well-documented proof of the desirability of definitive operative management done as soon as possible. Few World War I surgeons developed their knowledge of plastic surgery, neurosurgery and oral surgery in post-war practice. An exception was Henry Newland, who went on to pioneer the development of these specialties in Australasia. After World War II, the French plastic surgeon Paul Tessier created the multidisciplinary subspecialty of craniomaxillofacial surgery, with the help of his neurosurgical colleague Gérard Guiot, and applied this approach to the correction of facial deformities. It has become evident that the new subspecialty requires appropriate training programs. [source]

    Management of third molar removal with a single dose of recombinant Factor IX (BeneFIX) and local measures in severe haemophilia B

    AUSTRALIAN DENTAL JOURNAL, Issue 3 2010
    ID Hewson
    Abstract Background:, Patients with inherited bleeding disorders have historically had factor cover for oral surgery. Factor support is expensive, time consuming and places the patient at a potential risk of blood-borne diseases. This case describes the use of a significant reduction in factor support for a severe haemophilia B patient having third molars surgically removed. Methods:, Local measures were used after a single preoperative dose of Factor IX to obtain good postoperative haemostasis. Results:, Excellent haemostasis was achieved using local measures of 5% tranexamic acid solution, Surgicel® and Monocryl® sutures after a single preoperative dose of Factor IX. Conclusions:, Oral surgery may be performed on patients with inherited bleeding disorders using minimal factors and local haemostatic measures. A study of this patient population has commenced at The Alfred Hospital. [source]

    Public dental service utilization among adults in South Australia

    AUSTRALIAN DENTAL JOURNAL, Issue 2 2009
    L Luzzi
    Abstract Background:, Longitudinal patterns of public dental service use may reflect access issues to public dental care services. Therefore, patterns of dental service use among South Australian adult public dental patients over a 3½-year period were examined. Methods:, Public dental patients (n = 898) initially receiving a course of emergency dental care (EDC) or general dental care (GDC) at baseline were followed for up to 3½ years. Patient clinical records were accessed electronically to obtain information on dental visits and treatment received at those visits. Results:, Some 70.7 per cent of EDC and 51.3 per cent of GDC patients returned for dental treatment post-baseline. EDC patients returned within a significantly shorter time period post-baseline, received significantly more courses of care and were visiting more frequently than GDC patients. A greater proportion of EDC patients received oral surgery, restorative, endodontic and prosthodontic services, but fewer received periodontic services. EDC patients received significantly more oral surgery and fewer preventive services per follow-up year, on average, than GDC patients. Large proportions of EDC (52.4 per cent) and GDC (63.8 per cent) patients who returned sought emergency care post-baseline. Conclusions:, Patients appeared to be cycling through emergency dental care because of lack of access to general care services, highlighting access problems to public dental care. [source]

    What influence do anticoagulants have on oral implant therapy?

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 2009
    A systematic review
    Abstract Objectives: This systematic review aims to assess the risks (both thromboembolic and bleeding) of an oral anticoagulation therapy (OAT) patient undergoing implant therapy and to provide a management protocol to patients under OAT undergoing implant therapy. Material and methods: Medline, Cochrane Data Base of Systematic Reviews, the Cochrane Central Register of Controlled Trials and EMBASE (from 1980 to December 2008) were searched for English-language articles published between 1966 and 2008. This search was completed by a hand research accessing the references cited in all identified publications. Results: Nineteen studies were identified reporting outcomes after oral surgery procedures (mostly dental extractions in patients on OAT following different management protocols and haemostatic therapies). Five studies were randomized-controlled trials (RCTs), 11 were controlled clinical trials (CCTs) and three were prospective case series. The OAT management strategies as well as the protocols during and after surgery were different. This heterogeneity prevented any possible data aggregation and synthesis. The results from these studies are very homogeneous, reporting minor bleeding in very few patients, without a significant difference between the OAT patients who continue with the vitamin K antagonists vs. the patients who stopped this medication before surgery. These post-operative bleeding events were controlled only with local haemostatic measures: tranexamic acid mouthwashes, gelatine sponges and cellulose gauzes's application were effective. Post-operative bleeding did not correlate with the international normalised ratio (INR) status. In none of the studies was a thromboembolic event reported. Conclusions: OAT patients (INR 2,4) who do not discontinue the AC medication do not have a significantly higher risk of post-operative bleeding than non-OAT patients and they also do not have a higher risk of post-operative bleeding than OAT patients who discontinue the medication. In patients with OAT (INR 2,4) without discontinuation, topical haemostatic agents were effective in preventing post-operative bleeding. OAT discontinuation is not recommended for minor oral surgery, such as single tooth extraction or implant placement, provided that this does not involve autogenous bone grafts, extensive flaps or osteotomy preparations extending outside the bony envelope. Evidence does not support that dental implant placement in patients on OAT is contraindicated. [source]

    Bone healing and graft resorption of autograft, anorganic bovine bone and ,-tricalcium phosphate.

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 3 2006
    A histologic, histomorphometric study in the mandibles of minipigs
    Abstract Objective: The purpose was to qualitatively and quantitatively compare the bone formation and graft resorption of two different bone substitutes used in both orthopedic and oral surgery, with autogenous bone as a positive control. Materials and methods: Three standardized bone defects were prepared in both mandibular angles of 12 adult minipigs. The defects were grafted with either autograft, anorganic bovine bone (ABB), or synthetic ,-tricalcium phosphate (,-TCP). Sacrifice was performed after 1, 2, 4, and 8 weeks for histologic and histomorphometric analysis. Results: At 2 weeks, more new bone formation was seen in defects filled with autograft than with ABB (P,0.0005) and ,-TCP (P,0.002). After 4 weeks, there was no significant difference between ,-TCP and the two other materials. Defects grafted with ABB still exhibited less bone formation as compared with autograft (P,0.004). At 8 weeks, more bone formation was observed in defects grafted with autograft (P,0.003) and ,-TCP (P,0.00004) than with ABB. No difference could be demonstrated between ,-TCP and autograft. ,-TCP resorbed almost completely over 8 weeks, whereas ABB remained stable. Conclusion: Both bone substitutes seemed to decelerate bone regeneration in the early healing phase as compared with autograft. All defects ultimately regenerated with newly formed bone and a developing bone marrow. The grafting materials showed complete osseous integration. Both bone substitutes may have a place in reconstructive surgery where different clinical indications require differences in biodegradability. [source]

    Representative marketing-oriented study on implants in the Austrian population.

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 5 2003

    Abstract: Oral implantology is an established subspecialty of restorative dental and oral surgery. While an extensive body of evidence on the fundamentals of osseointegration and associated factors has been published, marketing-oriented analyses based on representative public opinion polls of implant acceptance, patient-perceived cost and patient satisfaction are scarce. In this study, an attempt was made to address these points by questioning a representative sample of 1000 adults in the household setting. The interviewees were presented with 14 questions. Of those familiar with implants as one of the treatment alternatives, 61% reported they would accept implants if the need arose. Implant acceptance was highest among males and interviewees below the age of 30 years. The interest in implants increased with increasing family incomes. Four percent of those questioned already had implants. Twenty-five percent knew someone who had undergone implant treatment. All those questioned found implant-supported rehabilitation to be very expensive. Many of them blamed the dentists for the high cost. One detail was particularly evident: satisfaction among implanted patients was clearly higher than satisfaction rates perceived by them from what they were told about implants by others. First-hand experiences with implants proved to be less biased than reported second-hand information. Résumé L'implantologie buccale est une technique appliquée dans certaines spécialités de médecine dentaire. Tandis que la proportion d'évidences s'accroît en ce qui concerne la recherche sur l'ostéoïntégration et les facteurs associés, les analyses orientées sur le marketing et l'opinion du public sur l'acceptation de l'implant, le prix et la satisfaction se font rares. Cette étude a été réalisée pour analyser ces différents points via un échantillon de 1 000 adultes. Les interviewés ont répondu à quatorze questions. De ceux qui étaient familiers à l'idée que les implants pouvaient être une alternative au traitement, 61 % ont répondu qu'ils pourraient si nécessaire y recourir. L'acceptation de l'implant était plus importante chez les hommes et les personnes âgées de moins de trente ans. L'intérêt à propos des implants augmentait parallèlement aux revenus de la famille. Quatre pour cent des personnes étaient déjà porteurs d'implants. Vingt-cinq pour cent connaîssaient une personne ayant subi un traitement d'implant buccal. Parmi toutes les personnes interrogées, la réhabilitation sur implants semblait trop chère. Beaucoup d'entre-eux rejetaient la responsabilité des prix trop élevés sur les dentistes. Un détail était particulièrement évident : la satisfaction parmi les patients possèdant des implants était clairement plus importante que le taux de satisfaction perçu par ceux n'en portant pas mais ayant reçu l'information par d'autres personnes. L'expérience personnelle était moins déformée que celle obtenue de manière indirecte. Zusammenfassung Die orale Implantologie ist eine etablierte Subspezialität der restaurativen Zahnmedizin und der Oralchirurgie. Während extensive Evidenz über die Grundlagen der Osseointegration und der assoziierten Faktoren publiziert worden ist, sind marketing-orientierte Analysen basierend auf repräsentativen Meinungsumfragen über die Akzeptanz von Implantaten, über die von Patienten empfundenen Kosten und über die Patientenzufriedenheit rar. In dieser Studie wird der Versuch unternommen, diese Punkte mit Hilfe einer Befragung einer repräsentativen Gruppe von 1000 Erwachsenen anzusprechen. Den Befragten wurden 14 Fragen gestellt. Von denen, welche über Implantate als Behandlungsalternative Bescheid wussten, gaben 61% an, sie würden Implantate bei sich akzeptieren, falls die Notwendigkeit dafür besteht. Die Akzeptanz von Implantaten war bei Männern und Befragten unter 30 Jahren am grössten. Das Interesse an Implantaten nahm mit zunehmendem Familieneinkommen zu. Vier Prozent der Befragten hatten bereits Implantate. Fünfundzwanzig Prozent kannten jemanden, der sich einer Implantation unterzogen hat. Alle Befragten empfanden Implantatversorgungen zu kostspielig. Viele davon fanden, der Zahnarzt sei schuld an den hohen Kosten. Ein Detail war von besonderem Interesse: Die Zufriedenheit bei mit Implantaten versorgten Patienten war deutlich grösser als die von anderen Leuten empfundene Zufriedenheit, welche über Implantatversorgung von anderen gehört haben. Erfahrungen mit Implantaten aus erster Hand waren mit weniger Vorurteilen behaftet als Informationen aus zweiter Hand, über die berichtet wurde. Resumen La implantología oral es una subespecialidad establecida de restauración dental y cirugía oral. Mientras que se ha publicado una gran cantidad de evidencias sobre los fundamentos de la osteointegración y factores asociados, los análisis orientados al marketing basados en encuestas representativas de la opinión pública sobre aceptación de los implantes, costo percibido por el paciente y satisfacción del paciente son escasos. En este estudio se hizo un intento de dirigir estos puntos encuestando una muestra representativa de 1000 adultos en su hogar. A los entrevistados se les presentaron 14 preguntas. De aquellos familiarizados con los implantes como una de las alternativas de tratamiento, el 61% respondió que aceptarían los implantes llegada la necesidad. La aceptación de los implantes fue mayor en varones y entrevistados menores de 30 años. El interés en los implantes creció con ingresos familiares crecientes. El 4% de los encuestados ya tenían implantes. El 25% conocía a alguien que se había sometido a tratamiento de implantes. Todos los encuestados encontraron la rehabilitación con implantes demasiado cara. Muchos de ellos culparon a los dentistas del alto costo. Un detalle fue particularmente evidente: La satisfacción entre los pacientes implantados fue claramente mas alta que los índices de satisfacción percibidos por ellos de lo que se les dijo sobre los implantes por otros. Las experiencias de primera mano con implantes demostraron ser menos viciadas que las informaciones reportadas de segunda mano. [source]