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Death Along the Tracks: The Role of Forensic Anthropology and Social Media in a Homicide Investigation
Published in Heather M. Garvin, Natalie R. Langley, Case Studies in Forensic Anthropology, 2019
Prior to processing the remains to remove the mummified skin, identifying features were assessed visually. The examination revealed the presence of a tattoo consisting of two parallel black lines running transversely along the upper right thigh (see Figure 1.1). Because no other identifying soft tissue features were noted, the remaining skin was removed, and the processing was completed using a dermestid beetle colony. No evidence of antemortem trauma was noted on the skeleton. However, evidence of remodeling of the tooth sockets of the third molars suggests that these teeth were recently extracted prior to death. Occlusal surface restorations were noted on ten teeth, and buccal restorations were noted on five teeth. In addition, the left central mandibular incisor was represented by a partial deciduous tooth with evidence of an antemortem fracture of the occlusal surface (see Figure 1.2).
Anatomy and Embryology of the Mouth and Dentition
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
The first deciduous teeth to erupt into the mouth appear at approximately 6 months after birth and, by around the age of 3 years, all the deciduous teeth have erupted. By 6 years of age, the first permanent teeth appear (lower incisors and first molars) and thence the deciduous teeth are exfoliated one by one as they are replaced by their permanent successors. A complete permanent dentition is present when the third molars erupt at around the age of 18–21 years. Information on the sequence of development and eruption of teeth into the oral cavity may be important in forensic medicine and archaeology in helping to age individuals. The data provided in Tables 41.3 and 41.4 concerning the chronology of tooth development are largely based on European-derived populations and there is evidence of ethnic variation. When a permanent tooth erupts, approximately two-thirds of the root is formed and it takes approximately another 3 years for the root to be completed. For deciduous teeth, root completion is more rapid. The developmental stages of initial calcification and crown completion are less affected by environmental influences than eruption, the timing of which may be modified by several factors such as early tooth loss and severe malnutrition.
The Crucial Role of Craniofacial Growth on Airway, Sleep, and the Temporomandibular Joint
Published in Aruna Bakhru, Nutrition and Integrative Medicine, 2018
Periodontitis is generally not a chronically painful disorder. Typically, patients may notice gingival sensitivity and tenderness, or gingival enlargement caused by inflammation and bleeding with brushing or probing examination. There is loss of gingival attachment around the necks of and soft tissue pocketing around the roots of the tooth with loss of bone support, which may result in tooth sensitivity, tenderness, and mobility. Pain secondary to periodontal disease is typically dull, generalized to a larger area, and more constant. In the presence of an acute infection in the periodontal tissues, tenderness to the touch, erythema, and bleeding may be evident. An acute periodontal abscess may cause swelling and purulence. When inflammation or infection occurs in the soft tissue or bone around an erupting or partially erupted tooth (particularly third molars), similar signs and symptoms may be seen with pain as a primary complaint.
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.
Is the third molar erupting at a younger age than before?
Published in Acta Odontologica Scandinavica, 2022
Eveliina Tuovinen, Marja Ekholm, Irja Ventä
It is clear, that mean and median ages of eruption depend on the age range of the sample. In many studies, the age intervals are wide, often including 10 to 16 separate age groups [4,5,9,10], while we analysed nine of them. To explore the difference between our study and the earlier Finnish study [1], we analysed the same age interval, namely 18–23 years, instead of our 15–23 years. Subsequent calculations (not reported in the results) revealed that our median ages for gingival emergence ranged from 20.3 (Standard error, SE 0.23) to 21.5 (SE 0.25) years (depending on the sex and the jaw) and were still lower than in the earlier study, where they varied between 21.7 (SE 0.17) and 23.3 (SE 0.41) years. This comparison implies that third molars erupt nowadays at a younger age than previously reported for our country.
Planned and unplanned follow-up visits after mandibular third molar surgery in the Public Dental Service in Örebro
Published in Acta Odontologica Scandinavica, 2021
Third molar surgery is the most common surgical procedure in dentistry in Sweden [1]. Surgical removal of third molars is performed by both specialized surgeons and general dentists in the Public Dental Service. A Norwegian study from 1994 found that about 75,000 third molars were removed every year [2]. Of these, approximately 55,000 were removed by general dentists and the rest by specialized surgeons [2]. There are multiple reasons why a third molar may need to be surgically removed, including caries in the third or second molars, pericoronitis, periodontal defects posterior to the second molars, pathological bone degradation, occurrence of cysts, unopposed/hyper/nonfunctional third molars, neurogenic and myofascial pain, and orthodontic indications [3,4]. When mandibular third molar surgery is performed, it is reportedly associated with less frequent postoperative complications in patients under the age of 25 years [5,6]. Surgical removal of third molars is associated with several common and generally accepted postoperative complications, so adequate preoperative information is important. The most common postoperative complications described in the literature include pain, swelling, trismus and alveolitis [7–10]; more unusual and severe complications include bleeding, loss of sensation, infections, jaw fractures, leftover parts of instruments, and root fragments [11,12]. Patients undergoing third molar surgery may need to stay home from school, work and other social activities due to complications after surgery [13].