Online ISSN: 2515-8260

Keywords : Extraction


DRY SOCKET ETIOPATHOGENESIS, MANAGEMENT and PREVENTION: A BRIEF SYSTEMATIC REVIEW of LITERATURE

Nithin Kumar

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 9, Pages 24-29

Dry socket is an unavoidable complication of dental extraction facing the dental practitioners on a regular basis. We performed a brief systemic review of the etiopathogenesis, prevention and management of dry socket. The inclusion criteria for including articles were that all the studies discussed the dry socket etiopathogenesis, prevention and management and the exclusion criteria were all the studies that included other complications of tooth extraction. The method used for this systemic review was to search in the PubMed database using MeSH terms “dry socket”, “alveolar ostitis” for etiopathogenesis, prevention and management and published in the English language, 86 articles were identified by abstract for relevance to etiopathogenesis, prevention and management of dry socket and a total of 24 publications were included in the final systematic review according to the specific keywords and materials mentioned above. The audit of the literature showed that the prevention methods include avoiding smoking after surgery, atraumatic extraction, the use of antibiotics and other preventive measures such as use of chlorhexidine rinse or gel to reduce the incidence of dry socket. For management of dry socket, wide range of treatment options are being suggested including using chlorhexidine or saline solution irrigation, placement of non- absorbable obtundent dressing(zinc oxide eugenol dressing) or absorbable dressing(alveogyl dressing) and instruction of home rinsing with chlorhexidine mouthwash. There are also new agents in the field being tried that accelerates the healing of the socket such as PRF and GECB as well as combination of PRF with chlorhexidine gel. This paper is a brief review of the literature on etiopathogenesis, prevention and management of dry socket, in order to best guide clinical practice based on current available evidence

EFFICACY OF HEMOCOAGULASE AS A TOPICAL HEMOSTATIC AGENT AFTER EXTRACTIONS: A REVIEW

Dr. Balakrishnan Ramalingam; Dr. Vijay Ebenezer

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 3, Pages 1933-1936

Extractions are the most common surgical procedures carried out and postextraction bleeding is most commonly seen complication. The aim of this review was to determine the effectiveness of topical hemocoagulase as a hemostatic agent and its role in reducing postextraction bleeding and its comparison to routine saline pressure pack after tooth extraction. Various differences was present between the hemostatic agent and saline pressure pack in relation to pain, swelling, wound healing, bleeding time, and other complications. Topical hemocoagulase is effective in reducing bleeding, pain, and swelling after extraction when compared to saline pressure packs. It also act as a promoter of wound healing.

CBCT IMAGING IN ASSESSING IMPACTED THIRD MOLARS COVERING LETTER

Abhinaya LM; Muthukrishnan Arvind; Deepika Rajendran

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 1776-1785

Impaction denotes a tooth failing to attain its normal position to reach the occlusal table with third molars impaction being common in the mandible. The conventional radiographic views such as peri-apical, panoramic radiograph are two dimensional representations of three dimensional structure. Absence of information on relation of vital anatomical structures to impacted teeth, bone quality is a drawback for the operating surgeon which could lead to pre or post operative complications. CBCT imaging fills the lacunae of two dimensional imaging and holds a key role in impaction assessment.A retrospective analysis of 45 patients who underwent CBCT imaging prior to extraction of impacted third molars were included in the study and the data was analysed using SPSS.Among the 45 patients, 20 were males (44.4%) and 25 were females (55.5%) and the age group commonly affected with impaction was between 25-30 years (35.5%).The frequency of impacted third molars was more in mandible (80.0%) compared to maxilla (20%).There was significant correlation between nerve involvement and angulation of impacted third molars.CBCT imaging modality provides a three dimensional view to help in better treatment planning, anticipating possible complications post surgery. CBCT must be recommended as the only imaging modality in impaction assessment.

AGE AS A RISK FACTOR IN PATIENTS WITH DRY SOCKETS : A RETROSPECTIVE STUDY

Kethiswar Raj; Balakrishna R N

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 1159-1165

Alveolar osteitis which is also known as dry socket, is an inflammation of the alveolar bone. Usually, this occurs after a postoperative complication of tooth extraction.Alveolar osteitis can occur where the blood clot fails to form or is lost from the socket and this leaves the empty socket where bone is exposed to the oral cavity, causing a localized alveolar osteitis limited to the lamina dura . This most specific type is known as dry socket and is associated with increased pain and delayed healing time.The aim of the study is to compare the prevalence of dry socket and age as a risk factor in patients who visited Saveetha Dental College.The objective was to find the base in Saveetha Dental college by the data collected for the theoretical framework for research proposal.In materials and methods , there are certain requirements that were necessary such as case control study for a better understanding , patients details who visited saveetha dental college for a background check , data obtained from the outpatient record was to ensure that the data can be supported , followed by analytics of dry socket patients to know the total number of patients involved ,the sample size obtained and the tabulation of data was done in excel sheet and finally a satisfied analysis is done with the proper data.The majority of patients that are with dry socket were around the age range from 28 years to 47 years and is more common in females than in males and majority of them are non-smokers.Even in the gender prevalence , the total number of females are more than males by numbers and it is obtained with the confirmed data.The mean age group from the age range of 28 years to 47 years is the age group 50 years and the positive statistically significant correlation between the age and dry sockets.The type of test used in this study is this chi square test and the P value of the test is <0.05 which is significant.We can observe the graph showing distributions such as age where the age group from 28 years to 47 years has a total value of (9 with 53.1%) and we also can conclude that the age group from 55 years to 74 years have a total value of 46.9%.In gender we can tell from the graph that the male group has a total value of (8 with 47.1%) and that the female group has a total value of (52.9%).From smoking we can conclude that a total of (76.5%) of the obtained patients are non-smokers and a total of (23.5%) of the obtained patients are smokers

EVALUATION OF SITE PREDILECTION FOR SOCKET PRESERVATION

Nur Liyana Hannah Binti Izham Akmal; Revathi Duraisamy M.D.S

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 1887-1894

Changes in alveolar ridge in terms of volume, height and morphological features tend to be clinically significant and may result in difficulty for the placement of a conventional bridge or an implant-supported crown. Bone deformities or resorption from tooth removal can be prevented by a procedure called socket preservation. Studies have discussed the rationale of performing socket preservation as a therapeutic procedure following tooth extraction which includes the procedure done during or after the removal of tooth in order to reduce the risk of external ridge resorption and increase the formation of bone with the socket. This study aims to evaluate the site predilection for socket preservation in maxillary and mandibular anterior teeth following extraction. It is a retrospective study conducted by reviewing 86,000 patient case records of the Saveetha Dental College and Hospital, Chennai, India. A total of 25 consecutive case records of patients for a period of October 2019 to March 2020 with signed informed consent were selected from the Departments of Prosthodontics and Implantology based on the inclusion criteria of patients who have undergone socket preservation procedure indicated for implant placement. Information such as patient’s name, patient’s identification number (PID), age, gender and area of socket preservation were retrieved from the patients’ case records. Datas were entered in Excel and analyzed using SPSS software version 23.0. Descriptive analysis was done for the assessment of age, gender and area of socket preservation. Chi-square test was used to evaluate the association of socket preservation with age and gender. Significant level test was set at less than or equal to 0.05 (p≤0.05). In this study, higher prevalence of socket preservation was seen in the upper anterior region (60%) than the other sites. Most cases of socket preservation were seen in males (80%) as compared to females (20%). Socket preservation was done mainly in individuals within the 21-30 years age group.Within the limits of the study, socket preservation is done mainly in individuals within the 21-30 years age group with higher predilection in males compared to females. Most of the socket preservation procedures are done in the upper anterior region, followed by upper posterior, both upper anterior and posterior and lower posterior. However, there is no significant association between the area of socket preservation with age and gender.

REASONS FOR EXTRACTION OF PERMANENT FIRST MOLARS IN CHILDREN BETWEEN 6-17 YEARS OF AGE - A RETROSPECTIVE STUDY

Karthikeson. P.S; Vignesh Ravindran; Kiran Kumar Pandurangan

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 3282-3294

Introduction:
The permanent first molar teeth are the most caries prone teeth in mixed dentition. Reasons for permanent molar teeth loss include poor prognosis, caries,orthodontic and periodontal reasons. This study was done with the aim to assess the common reasons for extraction of first permanent molars in children between 6-17 years of age.
Materials and methods:
A total of 89000 case sheets were reviewed and cross verified from June 2019 to March 2020. Data related to permanent molar extractions were retrieved by searching with Patient ID, age, gender ,tooth number and treatment relevant to the study. Data was tabulated in the excel sheet. Statistical analysis was done using Statistical Package for the Social Sciences software(version 9.0.3). Results were statistically analysed using association analysis.
Results:
Higher number of males (64.47%) had first permanent molar extractions when compared to females (35.53%). In males, dental caries with pulpitis (22.37%) was the most common reason for extraction of permanent molars. In females, root stumps(13.16%) was the most common reason for extraction of permanent molars. In both 8-12 years age group and 13-17 years age group, dental caries with pulpitis (34.21%) was the most common reason for extraction of permanent molars.
Conclusion:
Within the limitations of the current study, first permanent molars were commonly extracted among males and dental caries with pulpitis was the most common reason for extraction of first permanent molars.

KNOWLEDGE AND AWARENESS OF DENTAL STUDENTS IN MANAGING HYPERGLYCEMIC PATIENTS INDICATED FOR EXTRACTION

Prabhav Kumar Iyer; Dr. Deepika Rajendaran; Dr. Sarvana Dinesh S.P

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 660-676

Hyperglycemia is a condition in which there is an increase in the blood glucose level of the person. It is one of the most common systemic conditions in middle aged Indians. It is important for a dentist and dental students to be aware of the condition especially while performing invasive procedures as delayed wound healing, coma and hypoglycemic shock are some of the most common complications encountered in some patients. Hence, it is important to know about this condition to prevent any kind of medical emergency on a dental chair. The aim of the study was to assess the knowledge and attitude of dental students while managing hyperglycemic patients indicated for extraction. This study was carried out in a self administered questionnaire format among the students of a dental university. The questionnaire was created on an online platform called “Survey Planet” and was filled by 100 students. The questionnaire consisted of the major aspects of knowledge on hyperglycemia and how students will manage the patient before performing the extraction procedure on them. Based on the tabulated results, it was seen that dental students have greater knowledge towards dealing with hyperglycemic patients indicated for extraction. 64% said that they can perform extraction on a hyperglycemic patient. 93% said that they would test an elderly patient to check their blood glucose level before the procedure. 72% were aware of the management of hyperglycemia. 45% of the participants said that they would do the treatment only after the patient consulted a physician. 11% said that they would deny the treatment. 82% of the participants said that they would keep the appointment for the extraction in the morning. Thus we can conclude that dental students have good knowledge and attitude toward managing hyperglycemic patients indicated for extraction

EVALUATION OF ASSOCIATION BETWEEN IMPACTED TEETH AND TEMPOROMANDIBULAR JOINT DISORDERS

Trishala A; M.P.Santhosh Kumar; Arthi B

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 1987-1995

Impaction of the third molars has been established as a factor with the potential to damage temporomandibular joints. Furthermore, the trauma resulting from the surgery of third molars has been reported to be a predisposing factor in the progression of temporomandibular joint disorders (TMD) symptoms. The high frequency of third molar surgery can result in an increased number of patients who suffer from chronic oral and facial pains. Thus, it is important to identify those patients who have pre‐existing pain or any signs of dysfunction in their temporomandibular joints and masticatory structures, prior to third molar surgery. The aim of this study was to evaluate the association between impacted teeth and temporomandibular joint disorders. A retrospective study was conducted by reviewing the case records of patients who underwent treatment in Saveetha Dental College and Hospital from June 2019 - March 2020. The study population included 96 patients diagnosed with temporomandibular joint disorders and 98 patients without TMD. Thus the sample size included a total of 194 patients who were evaluated for the presence of impacted teeth. Data was collected and statistical analysis was performed. Microsoft Excel 2016 (Microsoft office 10) data spreadsheet was used to collect data and later exported to SPSS IBM (version 23.0). Descriptive statistics and chi square test were employed with a level of significance set at p<0.05. The most prevalent age group among the patients was 21 - 30 years (34.39%), followed by 31 - 40 years (29.29%). 60.8% were male patients and 39.2% were females. TMD was predominantly present (29.38%) in patients with impacted teeth than in patients without impacted teeth (20.1%) and the results were statistically significant (p=0.003). Within the limits of this study, there is a significant association between the presence of impacted teeth and temporomandibular joint disorders. Therefore, it is important to include an assessment of the temporomandibular apparatus in the pre‐operative evaluation of patients with impacted third molars.

EVALUATION OF PRIMARY TEETH WITH CARIES REQUIRING PULPECTOMY AND EXTRACTION IN CHILDREN BETWEEN 5-7 YEARS OLD VISITING A UNIVERSITY DENTAL HOSPITAL

Anupama Deepak; EMG Subramaniam; Ganesh Jeevanandan; M. Jeevitha

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 1302-1312

Dental caries in the form of early childhood caries is more prevalent in children. Severe form of caries extending throughout the coronal structure in the root can result in tooth pain. These kinds of teeth with caries extending to the pulp may require pulpectomy or extraction. Pulpectomy is a restorative treatment done in primary teeth which is used to extirpate the coronal and radicular pulp and seal the entire root canal using an obturating material. The obturating material is of different types. The commonly used material is the Metapex, which helps in the natural resorption of the roots, exfoliation and does not irritate the periapical region. Extraction in children can be due to trauma or grossly decayed teeth in children due to caries extending subgingivally or presence root stumps. Children presenting with class 2 caries have been exposed to caries involving the pulp. Early childhood caries is one of the most infectious diseases of childhood having a chronic progression rate resulting in the destruction of tooth structure. They are of different types and patterns being rampant caries, nursing bottle caries. This is generally associated with unusual dietary patterns and improper feeding patterns in children with prolonged use of baby bottles for milk feeding. Caries in children are mainly caused by the bacteria Streptococcus mutans. The aim of this study is to evaluate the primary teeth with caries requiring pulpectomy and extraction in children between 5-7 years old. A retrospective study was carried out using digital records of 903 subjects. These data were collected from DIAS and coded in MS Excel sheets. The collected data was analysed by computer software SPSS version 21 using Chi square test and graphical illustration was done. From the above study, it was found that extraction and pulpectomy was common in males, with prevalence of extraction in the maxillary arch among children of 7 years and pulpectomy in children of 5 years , and seen in the mandibular posterior region.

Stem Cells Harvested From Exfoliated Deciduous Teeth - A Review

KiranSrinivas B; Gifrina Jayaraj; YuvarajBabu K

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 2888-2899

Stem cells harvested from exfoliated deciduous teeth are a type of mesenchymal cells, serving its main purpose for regenerative treatment. They have lots of clinical applications. They are studied for their distinct proliferative properties. It helps in regeneration of tissues in the site of an injury and also helps in reducing the healing time of an injury. It also serves as the research interest for many because of its easy source of availability, extensive regenerative capacity and multiple lineage properties. This article is in the narrative format of previous research articles on stem cells exfoliated from deciduous teeth, which discusses various complex procedures associated with SHED - like extraction, isolation, post extraction and banking of it mentioned from other articles as well. SHED has a lot of branches to be studied and understood deeply. So that they can be implemented for many human uses. It is used for future as well as diagnosis.