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Specific Diseases and Procedures
Published in Michele Barletta, Jane Quandt, Rachel Reed, Equine Anesthesia and Pain Management, 2023
General anesthesia may be necessary for repair of fractures of maxilla or mandible or extraction of molar teeth. Include regional anesthesia block in the anesthetic protocol.Perform endotracheal intubation and inflate the cuff to an airtight seal to avoid pulmonary aspiration of blood. Risk of aspiration is present even for repair of a fracture close behind the incisors because the surgeon may elevate the nose to assess the repair and alignment, allowing blood to flow from that site into the pharynx. Consider nasotracheal intubation or intubation through a tracheotomy for bilateral mandibular fracture repair, which will require complete closure of the mandible during anesthesia to achieve an accurate alignment. Both procedures for intubation can be performed after the horse is anesthetized but before the start of surgery.A mouth gag will be needed to hold the jaws apart. Various gag designs are available (Figure 11.11). To provide best exposure for the procedure, choice of gag design and position will depend on where in the mouth the procedure is to be performed.
Plastic Restorations for Primary Teeth
Published in M S Duggal, M E J Curzon, S A Fayle, K J Toumba, A J Robertson, Restorative Techniques in Paediatric Dentistry, 2021
M S Duggal, M E J Curzon, S A Fayle, K J Toumba, A J Robertson
The types of restorations required in primary molar teeth will vary from tiny ‘preventive resin restorations’ (PRR), buccal pits, large occlusal restorations, Class V fillings, through to multisurface fillings (MO, DO, MOD etc). When caries involves more than two surfaces of the primary molar, a stainless steel crown should be used. Large cavities in primary molars inevitably involve undermined enamel and weak margins, and may already have developed pulp inflammation. Again, if pulpal treatment is required, a stainless steel crown is desirable because of the weakening of the remaining tooth structure. The failure rate for multisurface plastic fillings is very high (Papathanasiou et al, 1994). Therefore, the use of plastic restorations should be restricted to minimal one- or two-surface cavities. Hence, the restoration of large mesio-occlusal, disto-occlusal and mesio-occlusal-distal cavities will not be discussed further.
Degenerative Diseases of the Nervous System
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
James A. Mastrianni, Elizabeth A. Harris
Congenital cerebellar hypoplasia/aplasia can occur as a component of a heterogeneous group of brain malformations.9 A typical molar tooth sign is not usually seen, and these disorders are usually sporadic.
Evaluating tooth extraction as a stand-alone treatment for odontogenic sinusitis
Published in Acta Oto-Laryngologica, 2023
Emi Tsuchiya, Momoko Takeda, Eri Mori, Ikuko Takakura, Ryoto Mitsuyoshi, Nobuyoshi Otori, Katsuhiko Hayashi
Additionally, our results demonstrated that younger patients were less likely to be cured of OS with tooth extraction alone. The maxillary sinus begins to rapidly expand around the age of 6 years, when the first molar erupts, achieves its maximum volume between the late teens and mid-20s, and subsequently decreases with advancing age [10]. Tian et al. reported that individuals aged <40 years were more likely to have the maxillary root positioned above or inside the maxillary sinus floor [11]. Therefore, the distance between the maxillary sinus floor and the root apex of the maxillary molar is shorter in a larger maxillary sinus, leading to OS pathogenesis and intractable conditions. Moreover, it is suspected that molar tooth roots extending into the maxillary sinus are more likely to cause an inflammatory reaction in the sinus membrane because of periodontitis, which may become exacerbated with dental treatment. Leaving untreated dental lesions and improper dental treatment for the maxillary molars in young patients may lead to OS or make extant OS refractory, depending on the proximity of the roots to the maxillary sinus.
Provider-directed analgesia for dental pain
Published in Expert Review of Clinical Pharmacology, 2023
Pain is a common complication following extraction of impacted third molar teeth. The pathophysiology of pain following surgical incisions is complex, involving both peripheral and central sensitization, which often necessitates multi-modal therapies for optimal resolution. The mainstay analgesics used by dentists include acetaminophen, NSAIDs, and opioids. Opioid combinations have traditionally been used to manage postoperative dental pain, but the epidemic rise of opioid-related misuse, abuse, and fatalities in society has limited the scope of opioid prescribing. However, there are certain clinical scenarios in which opioid prescription may be justified. When prescribing an opioid, dentists commonly select a codeine-acetaminophen product. However, systematic reviews do not support the routine use of codeine or codeine-acetaminophen combinations for acute postoperative dental pain, and there are no systematic reviews and meta-analyses of the comparative efficacy of hydrocodone, the opioid found in combination with acetaminophen in various pharmaceutical products. Furthermore, both codeine and hydrocodone are prodrugs, and ~ 10% of the population have impaired ability to bioactivate these drugs after ingestion, thus, in essence, any pain relief for these patients is largely due to the acetaminophen content. This may be insufficient to treat severe pain cases unless there is a therapeutic switch or an adjuvant analgesic is administered. Taken together, this information, combined with findings from systematic reviews, supports the recommendation of oxycodone for acute dental pain when opioid therapy is warranted.
Effects of radiotherapeutic X-ray irradiation on cervical enamel
Published in International Journal of Radiation Biology, 2021
Yeşim Deniz, Çağatay Aktaş, Tuğba Misilli, Burak Çarıkçıoğlu
‘Radiation caries’ is a clinically common chronic side effect of RT applied on head and neck cancers, causing destructive decays on teeth in a rapid course (Kielbassa et al. 2000). This study aimed to investigate that high-dose irradiation adversely affects the cervical inner enamel tissue. Regarding to the presented investigation, the SEM analyses demonstrated that alterations observed in micro-morphology of the cervical enamel especially in the interprismatic enamel by an account of the increasing therapeutic in vitro radiation doses. Nevertheless, there were no traces of alterations in crystallinity, elemental analysis, and stoichiometric Ca/P, Ca/N, P/N ratios, except the atomic percentage of the Mg. This study used impacted mandibular third molars of the patient between 18 and 25 years. The selection for working with impacted third molar teeth is related for the protection of these teeth from all diet influences and external factors such as drug and oral health behavior. In addition to that, the teeth included in this investigation were selected from patients living in the same geographic area to reduce some differences caused by genetic, epigenetic, and geographic features (Lane and Peach 1997).