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Ulnar-sided wrist pain remains a commonly encountered diagnostic challenge, and its successful management requires a comprehensive understanding of the multiple conditions that can present with this symptom. Midcarpal impaction syndromes in the form of Hamato-lunate and Triquetro-hamate impingement have both previously been reported as rare potential causes of ulnar-sided wrist pain. Despite this, they remain poorly recognized and incompletely understood. This article reviews existing literature that describes the diagnosis and management of these clinical entities. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the efficacy of aqua titan patch in postoperative sequelae after mandibular third molar surgery. Material and Methods: A total of 20 patients were selected and divided into two groups, Group A was evaluated by using Aqua titan patch with oral antibiotics and anti-inflammatory analgesics while Group B was only provided with antibiotics and anti-inflammatory analgesics. Results: There were total 20 subjects, with 4 males and 16 females. Pain was evaluated after surgical removal, where significant reduction was observed on 5 and 7th postoperative day in study group with p value 0.004 and 0.013, respectively. Reduction in swelling was observed to be statistically highly significant (p values = 0.000) in study group on 5 and 7th postoperative days. Beneficial results were obtained in study group where mouth opening was statistically significant with p value 0.002 on 5th and 0.049 on 7th postoperative day. For postoperative neurosensory deficit, mean values were constant and difference was found to be statistically insignificant with p value 0.13. Conclusion: Postoperative local application of aqua titan patch in study group provided beneficial effects in terms of reduction in pain, swelling and maximum mouth opening as compared to the control group. [ABSTRACT FROM AUTHOR]

Stone size and location are key factors in predicting spontaneous stone passage (SSP), but little attention has been paid to the influence of radiological signs of stone impaction (RSSI). This research aims to determine whether RSSI, alongside stone size, can predict SSP and to evaluate the consistency of ureteral wall thickness (UWT) measurements among observers. In this retrospective study, 160 patients with a single upper or middle ureteral stone on acute non-enhanced computed tomography (NCCT) were analysed. Patient data were collected from medical records. Measurements of RSSI, including UWT, ureteral diameters, and average attenuation above and below the stone, were taken on NCCT by four independent readers blind to the outcomes. The cohort consisted of 70% males with an average age of 51 ± 15. SSP occurred in 61% of patients over 20 weeks. The median stone length was 5.7 mm (IQR: 4.5–7.3) and was significantly shorter in patients who passed their stones at short- (4.6 vs. 7.1, p < 0.001) and long-term (4.8 vs. 7.1, p < 0.001) follow-up. For stone length, the area under the receiver operating characteristic curve (AUC) for predicting SSP was 0.90 (CI 0.84–0.96) and only increased to 0.91 (CI 0.85–0.95) when adding ureteral diameters and UWT. Ureteral attenuation did not predict SSP (AUC < 0.5). Interobserver variability for UWT was moderate, with ± 2.0 mm multi-reader limits of agreement (LOA). The results suggest that RSSI do not enhance the predictive value of stone size for SSP. UWT measurements exhibit moderate reliability with significant interobserver variability. [ABSTRACT FROM AUTHOR]

Tooth impaction is an abnormality that occurs when a tooth does not emerge into its place in the dental arch. Impacted permanent molar is an unusual condition that is usually detected during a routine examination. This impaction type is mostly problematic and can cause serious issues, especially when early detection and appropriate treatment are not achieved. This article highlights a case with a complaint of an ill-fitting denture, accompanied by an impacted molar that was identified during routine radiographic examination. The available treatment options include periodic follow-up, surgical exposure and orthodontic repositioning, and more invasively, surgical extraction and prosthetic replacement. The case was treated by a nonsurgical prosthodontics approach, in addition to regular follow-up, avoiding surgical interventions. This approach successfully restored both the patient’s function and esthetics. The case demonstrated the potential of prosthodontics therapy for managing impacted teeth and offering a minimally invasive and short treatment alternative to surgical and orthodontic interventions.

Retention (delayed eruption) of the third molar is one of the most common pathologies in the outpatient practice of a dentist-surgeon. Such a pathology can very often be complicated by inflammatory diseases, such as pericoronitis, periostitis and other more serious diseases. Therefore, early warning and most gentle removal of the causative tooth determines the professionalism of the dental surgeon. A large number of indexes of difficulty of removal of the third molar have been proposed by different authors, but none of them is considered universal and optimal for different clinical cases. The level of complexity is most clearly characterized by a scale that takes into account not only radiological but also clinical and demographic indicators. Such scales exist in modification or in more recent literary sources. Having chosen the most clear and correct scale, it is possible for the surgeon to clearly assess the entire level of complexity and responsibility for surgical intervention on removing the third molar, thereby obtaining the most effective result, minimizing complications both during the operation and after a while. The purpose of the study: justification of the selection of the difficulty rating scale for the removal of the third molar of the lower jaw, depending on its position. The study analyzed and compared 18 basic scales of complexity that are most often used by surgeons before removing the impacted third molar of the lower jaw. Data sources that were used for the search were taken from Medline, PubMed, Google Scholar, Minerva library databases. Each of the difficulty scales was presented and translated into Ukrainian for convenient use in the practice of a dental surgeon. A general table was provided where a comparative analysis of the difficulty scales was made according to thirty parameters. It is shown that the Cosme Gay-Escoda C. scale has the most indicators for preoperative assessment of complexity. There are many difficulty scales for preoperative assessment for the removal of impacted third molars of the lower jaw. Some of them have radiological evaluation criteria, some have clinical criteria, and only the Pernumbuco index (2017), Zhang X. (2019), and Cosme Gay-Escoda C. (2022) scales also have demographic indicators. However, the latter has the largest number of criteria, according to which the difficulty of removing the third molar of the lower jaw is calculated.

The most common kind of developing odontogenic cysts are dentigerous cysts. They frequently push impacted teeth into ectopic locations by encircling the crown of the tooth. The mandibular third molar, maxillary canine, mandibular premolar, and maxillary third molar are the teeth that are most commonly afflicted, in decreasing order. Although these cysts are more prevalent in men, they can also occur in children and teenagers, especially in the second and third decades of life. Dentigerous cyst-related teeth in the maxilla frequently cause root dilatation in the mandibular area, permanent tooth bud displacement close to the sinus, and cortical bone enlargement, sometimes, even up to the level of the orbit or floor of the nose. Clinically, these cysts do not cause any symptoms and are frequently found by chance during radiographs done to look into cases of primary teeth that are retained, teeth that are missing, teeth that erupt slowly, or orthodontic issues. Cone-beam computed tomography’s advent has just made it possible to shed fresh, extensively documented light on diagnostic and treatment approaches. Protocol for management: Surgery is typically used to treat dentigerous cysts. In this instance, the affected tooth underwent endodontic therapy, after which the cyst was curettaged, a further apicoectomy was performed, and canine impaction was completed. In the end, a bone graft and platelet-rich fibrin were implanted for rehabilitation.

This report presents the successful orthodontic management of a case of odontoma associated with impaction of the mandibular right permanent canine and Molar-incisor-hypomineralization (MIH). Although case studies have reported the management of odontomas and MIH as separate entities, there is a lack of evidence regarding the comprehensive management of patients presenting with a combination of odontoma, dental impaction, and MIH. A 15-year, 7-month-old female patient complained of the appearance of her smile and the delayed eruption of her mandibular right permanent canine. She was diagnosed with Angle’s Class I molar relationship and Class II canine relationship with the maxillary permanent right lateral incisor in a lingual crossbite. Furthermore, she had mandibular right permanent canine impaction, retained mandibular right primary canine, and MIH in the permanent anterior teeth and first molars. The management involved the removal of the odontoma to allow for orthodontic traction of the lower permanent right canine. After that, the esthetic appearance of the teeth was improved through restorative treatment.

The aim of this review is to consolidate the current literature on the diagnosis, trends, and management of faecal impaction in the elderly population. Constipation is a commonly occurring issue in clinical practise. Faecal impaction is a more severe and debilitating complication. Whilst constipation is well researched, there is limited discussion on faecal impaction which is often labelled as a complication of chronic constipation. Faecal impaction is of relevance to the elderly population due to their susceptibility to complications and morbidity. A systematic search of PubMed and EMBASE databases was conducted, and 14 articles were included in the final review. Multiple associated factors were identified including low fibre diet, reduced fluid intake, medications, neurological disorders, and lack of physical activity. This review further explores management options and potential complications of faecal impaction. Finally, this review highlights the importance of preventative measures including close monitoring of patients and early initiation of bowel regimes. This review concludes that further research is needed in this area and an improved methodology for collecting data on faecal impaction in the elderly and institutionalised patients. [ABSTRACT FROM AUTHOR]

Background: Surgical removal of the mandibular third molar requires reflection of the mucoperiosteal flap. Several studies have suggested different varieties and innovative designs for flap reflection. We have designed a randomized controlled trial (RCT) to check the feasibility of two flap designs: lingual-based triangular flap (LBTF) and buccal-based triangular flap (BBTF) by calculating the duration of surgery and evaluating postoperative complications such as pain, swelling, and trismus. Materials and Method: It was a non-inferiority parallel-group RCT. The trial was registered in the Control Trial Register of India (CTRI/2021/10/037182) and was performed according to Consolidated Standards of Registered Trial (CONSORT) guidelines. Intraoperative surgery time and postoperative pain, swelling, and trismus were measured and analyzed by a two-sample t test. The Chi-square test was used to measure gender distribution in the study. Result: Of the total of 88 required subjects, gender distribution and performed surgical time were statistically insignificant with a p-value of 0.76 and 0.48, respectively. The pain was significantly higher in the LBTF group in the 5th and 7th postoperative days with a p-value of 0.02 and 0.028. The swelling was statistically higher during all the follow-ups except for the 28th day in the LBTF group with values of 0.006, 0.002 and 0.003, respectively. There was no significant difference in inter-incisional distance (IID) between the groups during postoperative check-ups. Conclusion: LBTF shows no edge over BBTF during mandibular third molar disimpaction. [ABSTRACT FROM AUTHOR]

Complete failure of eruption leads to impaction. Impacted teeth are more common in maxilla as compare to mandible. The impaction of permanent dentition is not uncommon but out of them, few permanent teeth are rarely impacted such as maxillary first molars. Etiology behind this can be multifactorial. Here, we report two rare cases of impacted maxillary first molars which require very technique sensitive surgical removal so as to minimize risks of injury to adjacent teeth and other adjacent structures. Follow-up was made first day, third day, seventh day, and 1 month with no complication. [ABSTRACT FROM AUTHOR]

Mandibular crowding is the most common type of dental crowding among adolescents. To investigate the relationship between the angulation pattern of impacted mandibular third molars and the severity of mandibular anterior crowding. A total of 69 participants with impacted mandibular third molars were included in the study, and their records were analysed. There was no significant association between impacted mandibular third molars' angulation pattern and mandibular anterior crowding severity, as well as no correlation between gender and either impacted mandibular third molars' angulation pattern or mandibular anterior crowding severity. Our findings suggest that the angulation pattern of impacted mandibular third molars is not a significant contributing factor to the severity of mandibular anterior crowding. However, further studies with larger sample sizes are necessary to validate these results. [ABSTRACT FROM AUTHOR]

Tooth impaction is an abnormality that occurs when a tooth does not emerge into its place in the dental arch. Impacted permanent molar is an unusual condition that is usually detected during a routine examination. This impaction type is mostly problematic and can cause serious issues, especially when early detection and appropriate treatment are not achieved. This article highlights a case with a complaint of an ill-fitting denture, accompanied by an impacted molar that was identified during routine radiographic examination. The available treatment options include periodic follow-up, surgical exposure and orthodontic repositioning, and more invasively, surgical extraction and prosthetic replacement. The case was treated by a nonsurgical prosthodontics approach, in addition to regular follow-up, avoiding surgical interventions. This approach successfully restored both the patient’s function and esthetics. The case demonstrated the potential of prosthodontics therapy for managing impacted teeth and offering a minimally invasive and short treatment alternative to surgical and orthodontic interventions. [ABSTRACT FROM AUTHOR]

In this study, a brass or glass spherical impactor vertically penetrating into a granular bed composed of mono-sized spherical or elongated particles was simulated with three-dimensional (3D) discrete element method (DEM). Good agreement of the particle masses in the cup before and after penetration can be found in the simulations and experiments. The effects of particle length (Lp), friction coefficient, and particle configuration on the penetration depth of the impactor, ejecta mass, and solid volume fraction describing the response of the granular bed are discussed. The penetration depth is negatively correlated with Lp as the corresponding solid volume fraction of the granular bed decreases. A smaller friction coefficient leads to a larger penetration depth of the impactor and more ejection of particles. When the impactor is penetrating the Lp = 10 mm elongated particles, the penetration depth is negatively correlated to the order parameter and solid volume fraction.

Purpose: Cerumen impaction is a public problem of great concern due to associated hearing impairment. Despite cerumen impaction being one of the commonest causes of hearing loss among primary school children, there is no any published study to date from northern Tanzania focused on this topic. This study aimed to address this gap. Methods: A cross-sectional study design was used where 307 primary school pupils were recruited using a multistage cluster sampling technique and it was conducted from January to July 2023. Data was collected using Swahili translated semi-structured questionnaires. Results: The prevalence of cerumen impaction was 10.7% with the right ear being mostly affected (57.6%). A statistically significant association was found between prevalence of cerumen impaction and mother's education level though no association was found between sex, residence, father's education level and mother's occupation status. Predisposing factors like history or presence of ear infection, habit of cleaning ears and using hearing aids or earphones showed a statistically significant association The commonest clinical presentation was otalgia (36.4%) and washing ears with water (71.5%) was the commonly applied method of cleaning the ears apart from hospital based interventions. The commonest method of wax removal for those who visited health facilities was ear syringing (42.9%). Conclusion: Lesser prevalence of cerumen impaction was found in this study though majority had previous history of impacted wax. Cotton bud was the commonest predisposing factor for cerumen impaction. The commonest clinical presentation among those with impacted cerumen was otalgia though some pupils reported asymptomatic cerumen impaction. [ABSTRACT FROM AUTHOR]

Retention (delayed eruption) of the third molar is one of the most common pathologies in the outpatient practice of a dentist-surgeon. Such a pathology can very often be complicated by inflammatory diseases, such as pericoronitis, periostitis and other more serious diseases. Therefore, early warning and most gentle removal of the causative tooth determines the professionalism of the dental surgeon. A large number of indexes of difficulty of removal of the third molar have been proposed by different authors, but none of them is considered universal and optimal for different clinical cases. The level of complexity is most clearly characterized by a scale that takes into account not only radiological but also clinical and demographic indicators. Such scales exist in modification or in more recent literary sources. Having chosen the most clear and correct scale, it is possible for the surgeon to clearly assess the entire level of complexity and responsibility for surgical intervention on removing the third molar, thereby obtaining the most effective result, minimizing complications both during the operation and after a while. The purpose of the study: justification of the selection of the difficulty rating scale for the removal of the third molar of the lower jaw, depending on its position. The study analyzed and compared 18 basic scales of complexity that are most often used by surgeons before removing the impacted third molar of the lower jaw. Data sources that were used for the search were taken from Medline, PubMed, Google Scholar, Minerva library databases. Each of the difficulty scales was presented and translated into Ukrainian for convenient use in the practice of a dental surgeon. A general table was provided where a comparative analysis of the difficulty scales was made according to thirty parameters. It is shown that the Cosme Gay-Escoda C. scale has the most indicators for preoperative assessment of complexity. There are many difficulty scales for preoperative assessment for the removal of impacted third molars of the lower jaw. Some of them have radiological evaluation criteria, some have clinical criteria, and only the Pernumbuco index (2017), Zhang X. (2019), and Cosme Gay-Escoda C. (2022) scales also have demographic indicators. However, the latter has the largest number of criteria, according to which the difficulty of removing the third molar of the lower jaw is calculated. [ABSTRACT FROM AUTHOR]

The third molar or wisdom teeth are generally the last and posteriorly in position, which is permanent to erupt, usually between the ages of 16 years to 25 years during adolescence and adult age. The usual presentation of wisdom teeth is pain, swelling, tender gums, unpleasant taste, and difficulty in opening the mouth. The objective of this study was to determine the prevalence of impacted third molars, angulations, and levels of eruption in the Qassim region of Saudi Arabia. This investigation was carried out on patients who obtained an orthopantomogram for the complaint of pain or discomfort in the third molar from the Department of Oral Radiology between the years of 2019 to 2022 as part of a retrospective study (OPG), a total of 1,516 OPG taken from patients aged 25 to 46 years. Data was analyzed by using SPSS 21.0 version (IBM Corp., Armonk, NY), and simple proportions and chi-square tests were applied. The pattern of third molar impaction in the present sample is characterized by a relatively high prevalence (33.50 %) and mostly bilateral impaction with male sex predilection. The most common level of impaction was the A level. There was a significant difference between the percentage of males with impacted third molars (72.63 percent) and females with impacted third molars (27.36 percent) (P = 0.001) in the study sample. Five hundred-eight of the OPG appears to show one impacted the third molar. A total of 345 patients had impacted third molars on both sides of their mouths, while 163 patients only had one side of their mouth affected. Level I was significantly more prevalent than Level II, and Level III in both the maxilla and mandible. Based on the results, nearly one-third of the patients have bilateral impaction. The vertical angulation of the mandible and maxilla was by far the most common of all the possible angles. Maxillary both right and left third molars show an almost similar angular pattern of impaction, whereas mandibular right and left third molar shows a significantly different angular pattern of impaction. It will be necessary for future research to analyze the pattern of third molar impaction in other parts of Saudi Arabia. [ABSTRACT FROM AUTHOR]

The most common kind of developing odontogenic cysts are dentigerous cysts. They frequently push impacted teeth into ectopic locations by encircling the crown of the tooth. The mandibular third molar, maxillary canine, mandibular premolar, and maxillary third molar are the teeth that are most commonly afflicted, in decreasing order. Although these cysts are more prevalent in men, they can also occur in children and teenagers, especially in the second and third decades of life. Dentigerous cyst-related teeth in the maxilla frequently cause root dilatation in the mandibular area, permanent tooth bud displacement close to the sinus, and cortical bone enlargement, sometimes, even up to the level of the orbit or floor of the nose. Clinically, these cysts do not cause any symptoms and are frequently found by chance during radiographs done to look into cases of primary teeth that are retained, teeth that are missing, teeth that erupt slowly, or orthodontic issues. Cone-beam computed tomography's advent has just made it possible to shed fresh, extensively documented light on diagnostic and treatment approaches. Protocol for management: Surgery is typically used to treat dentigerous cysts. In this instance, the affected tooth underwent endodontic therapy, after which the cyst was curettaged, a further apicoectomy was performed, and canine impaction was completed. In the end, a bone graft and platelet-rich fibrin were implanted for rehabilitation. [ABSTRACT FROM AUTHOR]

Purpose: This study was designed to investigate the changes in nasal soft tissue following maxillary Lefort I advancement with and without impaction in subjects presenting a skeletal class III malocclusion, using a 3D photogrammetry scanner. Materials and methods: Patients with class III malocclusion undergoing Lefort I advancement with and without impaction and bilateral sagittal split osteotomy with the standard technique were included in this study. Patients were divided into two groups: maxillary Lefort I advancement alone (group 1) and combined with impaction (group 2). Facial soft tissue landmarks of the nose including nasal height (NH), nasal length (NL), nasal tip projection (NTP), alar width (AW), alar base width (ABW), subalar width (Sbal), nasolabial angle (NLA), nasofrontal angle (NFA), and columella inclination (CI) before and at least 4 months after surgery were obtained by a 3D scanner. Results: Twenty-one patients were included in this study (Group 1: 11 and Group 2: 10). NH, NTP, and NL decreased significantly in both groups following surgery. In addition, Sbal decreased only in group 2. On the other hand, NLA and CI increased significantly in group 2. The inter-group comparison revealed a statistically significant difference in the alterations in NH, NL, and CI between the two groups. Conclusion: Changes in the nose soft tissue occurred after both surgeries, but their type and extent were different. Actions taken to reduce unwanted changes need to be further investigated. To evaluate the changes, 3D photogrammetry scan is a feasible imaging technique that can be used, providing numerous benefits. [ABSTRACT FROM AUTHOR]

Introduction: Single tooth anesthesia via intra-ligamentary injections has long been used to provide localized pain control with minimal discomfort while avoiding undesirable effects like lip numbness, mainly in pediatric population with definite success. In this study, we aimed to assess the efficacy of single tooth anesthesia (STA) via intra-ligamentary injections using WAND® STA in the surgical removal of impacted third molar. Methodology: Sixty patients were randomly divided into two groups of 30 each where Group I (study group) received local anesthesia via STA system with 4% articaine and Group II (control group) received conventional injection, that is, inferior alveolar nerve block, (IANB) with 4% articaine. Assessment of the effectiveness of the anesthesia was made by noting the onset of action, failure of anesthesia, intra-operative pain and necessity for additional injection. Additional effects such as lip numbness were also noted. Patients were evaluated for pain and discomfort after 24 h. Results: The difference between the mean time for onset of action for STA injections and conventional block and the mean difference in the onset of action between both groups was 2.2 (± 0.25) minutes which was statistically significant (p < 0.05). Statistically significant difference in VAS score was noted only during tooth elevation with Group I reporting higher VAS score than Group II. Additional blocks were indicated in 6.7% for lingual block and 50% for long buccal nerve block in Group I and repetition of long buccal nerve block was indicated in 23.3% patients in group II. Postoperative pain and trismus was found to be higher in Group II. Conclusion: In spite of some limits in the extent of anesthesia achieved, WAND® STA was seen to be able to achieve adequate anesthesia for surgical removal of impacted third molar and is a viable alternative, particularly in patients where blocks are contraindicated due to systemic conditions. [ABSTRACT FROM AUTHOR]

Recent fresh produce outbreaks potentially associated with bioaerosol contamination from animal operations in adjacent land highlighted the need for further study to better understand the associated risk. The purpose of this research was to evaluate three sampling methods for quantifying target bacterial bioaerosols from animal operations. A dairy cattle and poultry farm located in Georgia, U.S. were visited six times each. Air was collected for 10 min using: 2-stage Andersen impactor with and without mineral oil overlay and impingement samplers. Sampling devices were run concurrently at 0.1, 1, and 2 m heights (n = 36). Andersen samplers were loaded with CHROMagar™ Salmonella, CHROMagar™ STEC, or Brilliance™ coliforms/E. coli. The impingement sampler contained buffered peptone water (20 mL) which was vacuum filtered through a 0.45 µm filter and placed onto the respective media. Plates were incubated at 37 ℃ for 48 h. PCR confirmation followed targeting ttr for Salmonella and stx1, stx2, and eae genes for STEC. No significant differences were found among methods to quantify coliforms and E. coli. Salmonella and STEC bioaerosols were not detected by any of the methods (Limit of detection: 0.55 log CFU/m3). E. coli bioaerosols were significantly greater in the poultry (2.76–5.00 log CFU/m3) than in the cattle farm (0.55–2.82 log CFU/m3) (p 7 μm; stage 2: 0.65–7 μm particle size). Sampling day did not have a significant effect on the recovery of coliforms/E. coli bioaerosols in the poultry farm when samples were taken at the broiler house exhaust fan (p > 0.05). A greater and constant emission of coliforms and E. coli bioaerosols from the poultry farm warrants further investigation. These data will help inform bioaerosol sampling techniques which can be used for the quantification of bacterial foodborne pathogens and indicator organisms for future research.

Objective: This study aims to describe the clinicodemographic profile of patients with foreign bodies in the upper aerodigestive tract and their treatment outcomes. Methods: Design: Retrospective review of records Setting: Tertiary Government Training Hospital Participants: Records of 304 patients diagnosed with aerodigestive foreign bodies Results: Three hundred-four (304) patients were included. The median age was 5.26 years in the pediatric age group and 42.53 years in the adult age group, with a male-to female ratio = 1.97:1. Foreign bodies were ingested in 291 (96%) patients while aspiration occurred in 13 (4%). Overall, 211 (69%) of cases involved the pediatric population (

Introduction: Surgical extraction of impacted third molars is an increasingly common procedure but is associated with postoperative sequelae such as pain, swelling, and trismus. This study aims to compare the effects of preemptive piroxicam and oral dexamethasone on pain, swelling and trismus following third molar surgery. Materials and Methods: A prospective randomized study consisting of 31 patients requiring lower third molar surgery were selected. They were randomly allocated to two treatment groups, oral dexamethasone (8 mg) and oral piroxicam (20 mg). The overall analgesic efficacy and anti-inflammatory effect of the two drugs were assessed postoperatively after 24, 48, 72 h, and on day 7 for pain, swelling, and trismus. Results: The difference in the mean scores of piroxicam group and dexamethasone group was statistically significant with the dexamethasone group showing better analgesia at the end of 24 h, 48 h, and 72 h done using Mann–Whitney U test. The swelling was compared between the two groups using an independent t-test. These results were statistically significant and dexamethasone was more effective at return to normal preoperative measurements 1-week postsurgery. When the mouth opening at day 7 was compared with the preoperative values, subjects in the piroxicam group showed a decrease of 0.18 ± 0.13, and those in the dexamethasone group showed a decrease of 0.05 ± 0.13 showing that dexamethasone group was significantly closer to returning to normal mouth opening at the end of 1 week post-surgery using independent t-test. Conclusion: We can conclude that the use of 8 mg oral dexamethasone 1 h preoperatively leads to a more comfortable and pain-free period for patients who undergo wisdom teeth removal, within its limitations.

Abstract Background The occurrence of mandibular canine impaction and/ or transmigration is a rare clinical entity but diagnosis and treatment planning is of clinical significance. The associated etiological factors and the clinical guidelines for the management are still not clear. The aim of this systematic review was to summarize the available data to report the prevalence and identify the etiological factors, clinical features, and various treatment outcomes in patients with mandibular canine impaction and/or transmigration. Methods The review protocol was registered in PROSPERO (CRD42021222566) and was conducted and reported according to the PRISMA and Cochrane Handbook / Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. A computerized search of studies published up to April 30, 2023, was conducted using the following databases: Medline, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, and Latin American and Caribbean Health Sciences Literature. A manual search of the reference and citation lists of eligible articles and existing systematic reviews for any additions were also conducted. The Newcastle–Ottawa Scale quality assessment tool was used to assess the studies' quality. Results After removing 6 duplicates, 3700 articles were identified. For the final analysis, 19 studies published between 1985 and 2023 met all the eligibility criteria and were included. A total of 7 studies presented as good and 12 studies presented as satisfactory. Patients were screened in ten studies and diagnostic records from archives were retrieved in nine studies. The total number of diagnostic records screened was 138.394, and the total number of patients from the included studies was 43.127. Conclusions Based on the findings from this systematic review, the prevalence of mandibular canine impaction ranged from 0.008% to 1.29% while canine transmigration from 0.12% to 0.98%. Crowding of the mandibular arch, the presence of a retained deciduous canine, and odontoma or cyst are the etiological factors more commonly associated with mandibular canine impaction and or transmigration. Surgical extraction and surgical exposure followed by orthodontic traction are the two most frequently carried out treatment modalities in the management of mandibular canine impaction and or transmigration.

Background and purpose: This study aimed to localize impacted maxillary canines and root resorption of neighboring incisors using cone beam computed tomography (CBCT) in 12-20-year-old patients referred to two private oral and maxillofacial radiology centers in Sari. Materials and methods: In this descriptive-analytical study, 89 CBCT images were included. Of which, 31 images related to unilateral buccal impaction of the maxillary canine and 58 images related to unilateral palatal impaction of the maxillary canine were analyzed in order to measure the parameters of central and lateral resorption and the amount of resorption of these teeth. Data were analyzed in SPSS software (version 21) at a significance level of 0.05. Results: Findings revealed no statistically significant relationship between gender and the side of indentation (buccal and palatal). Moreover, the highest position was related to the palatal site in both genders. Based on the chi-square test, there was no significant relationship between gender and latent canine position. Nonetheless, there was a significant relationship between age and latent position, as well as the occurrence of decayed lateral and the position of the impacted canine, which is the opposite of the lateral tooth in the central tooth. Conclusion: This investigation revealed that the incidence of lateral tooth resorption was associated with the latent canine position, while the incidence of central tooth resorption did not demonstrate a significant correlation

INTRODUCTION: The aim of this study was to compare the effectiveness of glucagon vs placebo in resolving esophageal foreign body impaction (EFBI), as well as the length of the procedure and adverse events. METHODS: This was a multicenter, randomized, double-blind trial involving consecutive patients diagnosed with alimentary EFBI. Participants were randomized to receive either 1 mg of intravenous glucagon or placebo. All patients underwent upper endoscopy, and adverse events were assessed through a protocolized telephonic interview 7 days later. RESULTS: The study included 72 subjects in the glucagon group and 68 in the placebo group. The foreign body was not identified in 23.6% of subjects in the glucagon group and 20.6% of subjects in the placebo group (difference 3%, 95% confidence interval -10.7% to 16.8%, P = 0.67). The median time required to remove the foreign body was similar in both groups 4 minutes (range 2-10) in the glucagon group and 3.5 minutes (range 2-7) in the placebo group (difference 0.5 minutes, 95% confidence interval -1.3 to 2.3; P = 0.59). The most common adverse event reported in both groups was mild pharyngeal pain. DISCUSSION: Glucagon is no more effective than placebo in resolving EFBI or shortening the time required to remove the foreign body (EUDRA-CT number 2019-004920-40). [ABSTRACT FROM AUTHOR]

Due to dental diseases, anatomical restrictions, and mixed dentition, the reduction in the number of teeth and the displacement of tooth germs pose challenges in orthodontic treatment, limiting anchorage options. The presented case demonstrates an advanced treatment solution using digital CAD/CAM-technologies and medical imaging for the creation of a mini-implant template. A 12-year-old male patient experiencing delayed tooth eruption, multiple impacted germs, and maxillary constriction underwent intraoral scanning and CBCT. Utilizing coDiagnostiXTM Version 10.2 software, the acquired data were merged to determine the mini-implant placement and to design the template. The template was then manufactured through stereolithography using surgical-guide material. Mini-implants were inserted using the produced appliance, enabling safe insertion by avoiding vital structures. Surgically exposed displaced teeth were aligned using a Hyrax screw appliance anchored on the mini-implants for rapid palatal expansion (RPE) and subsequently used as fixed orthodontics to align impacted teeth. The screw was activated daily for 10 weeks, resulting in a 7 mm posterior and 5 mm anterior maxillary transversal increase. Skeletal anchorage facilitated simultaneous RPE and tooth alignment, ensuring accuracy, patient safety, and appliance stability. The presented case shows a scenario in which computer-aided navigation for mini-implant positioning can enhance precision and versatility in challenging anatomical cases. [ABSTRACT FROM AUTHOR]

Introduction: Surgical extraction of impacted third molars is an increasingly common procedure but is associated with postoperative sequelae such as pain, swelling, and trismus. This study aims to compare the effects of preemptive piroxicam and oral dexamethasone on pain, swelling and trismus following third molar surgery. Materials and Methods: A prospective randomized study consisting of 31 patients requiring lower third molar surgery were selected. They were randomly allocated to two treatment groups, oral dexamethasone (8 mg) and oral piroxicam (20 mg). The overall analgesic efficacy and anti-inflammatory effect of the two drugs were assessed postoperatively after 24, 48, 72 h, and on day 7 for pain, swelling, and trismus. Results: The difference in the mean scores of piroxicam group and dexamethasone group was statistically significant with the dexamethasone group showing better analgesia at the end of 24 h, 48 h, and 72 h done using Mann–Whitney U test. The swelling was compared between the two groups using an independent t-test. These results were statistically significant and dexamethasone was more effective at return to normal preoperative measurements 1-week postsurgery. When the mouth opening at day 7 was compared with the preoperative values, subjects in the piroxicam group showed a decrease of 0.18 ± 0.13, and those in the dexamethasone group showed a decrease of 0.05 ± 0.13 showing that dexamethasone group was significantly closer to returning to normal mouth opening at the end of 1 week post-surgery using independent t-test. Conclusion: We can conclude that the use of 8 mg oral dexamethasone 1 h preoperatively leads to a more comfortable and pain-free period for patients who undergo wisdom teeth removal, within its limitations. [ABSTRACT FROM AUTHOR]

Third mandibular molars mainly appear to be in an inappropriate position in dental arch, so become the teeth which barely erupt or stay impacted in jaws. The aim of this study is to analyze the correlation between the preoperative pathologies with the position of the impacted third mandibular molar, sex and age of the patients. The sample of the study consisted of a total of 80 patients, of both sexes, diagnosed with fully or partially impacted third mandibular molars, who were followed up after the surgery for a three-month period. All the patients were clinically examined and for each of them was registered a panoramic radiography, to analyze the factors causing the pathology, which leads to the surgical extraction of the teeth. The most manifested preoperative pathologies correlating to the position of impacted mandibular third molars were: resorption of distal root of mandibular second adjacent molar, caries of second adjacent molar, pericoronitis, periodontal disease, frontal incisal mandibular crowding. All the pathologies were associated with the tooth position, some differed by age and gender. We conclude that preoperative complaints related to the position of the impacted third mandibular molar are in positive proportion to the age of the patients, i.e. subjective complaints increase with age: pain, limited opening of the mouth, local inflammation of the gingiva and paresthesia. The position of the impacted third mandibular molar affects the occurrence of preoperative pathologies: pericoronitis was most prevalent in impacted third mandibular molars with vertical position, class II, A position and partial impaction; periodontal diseases of second adjacent mandibular molar are most prevalent in impacted third mandibular molar with mesioangular position, class III, B position and partial impaction. [ABSTRACT FROM AUTHOR]

Aim: To determine the prevalence of different types of dental anomalies using cone-beam computed tomography (CBCT) images among the Al-Hasa population in Saudi Arabia and compare these variables between genders and nationalities. Materials and Methods: A retrospective study involving 509 CBCT images, in which patients were grouped based on their gender and nationality. The presence of dental anomalies was determined through the evaluation of CBCT images. Version 28 of the Statistical Package for the Social Sciences (IBM Corp., Armonk, NY, USA) was utilized to analyze the data, chi-square tests and multivariate analysis of variance were used, and P value was fixed at =0.05. Results: Out of the 509 CBCT images reviewed, a total of 135 patients (26.5%) exhibited one or more dental anomalies. Impacted canines had the highest prevalence among all types of impacted teeth, with a rate of 9.2%. Impacted premolars and molars (excluding third molars) had a lower prevalence of 2.6% and 1.2%, respectively. Impacted incisors had the lowest prevalence of 0.8%. Among dental anomalies affecting the number, position, and shape of teeth, the prevalence rates are as follows: congenitally missing teeth (6.7%), supernumerary teeth (2.2%), dilaceration (8.1%), microdontia (3.1%), ectopic eruption (2.6%), rotation (1.8%), and transposition (0.2%). Conclusions: The prevalence of dental anomalies is relatively high, with impacted canines being the most prevalent impacted teeth excluding third molars, whereas dilaceration was the most common anomaly affecting the shape of teeth. The prevalence of anomalies did not differ significantly between genders, except for rotation. Additionally, there was no significant difference reported in nationalities. [ABSTRACT FROM AUTHOR]

Background: The occurrence of mandibular canine impaction and/ or transmigration is a rare clinical entity but diagnosis and treatment planning is of clinical significance. The associated etiological factors and the clinical guidelines for the management are still not clear. The aim of this systematic review was to summarize the available data to report the prevalence and identify the etiological factors, clinical features, and various treatment outcomes in patients with mandibular canine impaction and/or transmigration. Methods: The review protocol was registered in PROSPERO (CRD42021222566) and was conducted and reported according to the PRISMA and Cochrane Handbook / Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. A computerized search of studies published up to April 30, 2023, was conducted using the following databases: Medline, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, and Latin American and Caribbean Health Sciences Literature. A manual search of the reference and citation lists of eligible articles and existing systematic reviews for any additions were also conducted. The Newcastle–Ottawa Scale quality assessment tool was used to assess the studies' quality. Results: After removing 6 duplicates, 3700 articles were identified. For the final analysis, 19 studies published between 1985 and 2023 met all the eligibility criteria and were included. A total of 7 studies presented as good and 12 studies presented as satisfactory. Patients were screened in ten studies and diagnostic records from archives were retrieved in nine studies. The total number of diagnostic records screened was 138.394, and the total number of patients from the included studies was 43.127. Conclusions: Based on the findings from this systematic review, the prevalence of mandibular canine impaction ranged from 0.008% to 1.29% while canine transmigration from 0.12% to 0.98%. Crowding of the mandibular arch, the presence of a retained deciduous canine, and odontoma or cyst are the etiological factors more commonly associated with mandibular canine impaction and or transmigration. Surgical extraction and surgical exposure followed by orthodontic traction are the two most frequently carried out treatment modalities in the management of mandibular canine impaction and or transmigration. [ABSTRACT FROM AUTHOR]

Objective: To assess the value medial deviation of the ureter at site of ureteric stone as a sign of ureteric stone impaction. Patients and methods: All cases with medial deviation of the ureter at site of ureteric stones in our department over 4 years were enrolled in this pilot study. All cases were diagnosed with KUB and non-contrast CT (NCCT). Radiological and ureteroscopic findings were recorded. Results: A total of 32 patients with a single impacted stone in the proximal and middle third of the ureter were included in the study. Medial deviation of the ureter at the site of the stone was detected in the upper third of the ureter in 24 (75%) cases and in the middle third in 8 (25%) cases. There were mucosal polyps and mucosal erythema (inflammatory changes) seen by ureteroscopy in all cases (100%). Ureteroscopy was successfully completed with stone fragmentation in 23 (71.8%) patients: 8 of them needed ureteric catheter and 15 required JJ stent insertion. Failure of ureteroscopy with insertion of JJ stent was done in 5 (15.6%) patients. Removal of the stent and ureteroscopy was done after 4 weeks. Conclusion: We conclude from this study that medial deviation of the ureter is a new reliable radiological sign of ureteric stone impaction. [ABSTRACT FROM AUTHOR]

Objective To discuss the effectiveness and mechanism for movement of maxillary buccally transposed canines by using a door-shaped individualized dental archwire mechanic and to provide a reference for clinicians. Methods Eight patients with unilateral maxillary transposed canines were enrolled. All patients were treated with door-shaped individualized archwires. Before treatment (T1) and after the crowns of the transposed canines were moved to the right buccal positions in the dental arch during the treatment (T2), orthopantomograms were taken both at T1 and T2 to compare the linear changes (distance changes of the crown and root apex) and angular changes to study the mechanisms of tooth movement. The probing depth and buccal crown height were measured using a periodontal probe to compare periodontal changes before treatment (T1) and after treatment (T3) between the transposed canines and contralateral canines. Results All eight transposed canines were successfully brought back to their normal dental arch position but were made more buccal by using the door-shaped individualized dental archwire, with a mean of (11.5 ± 2.7) months. The average overall duration was (28.3 ± 4.7) months. The crown distance changes of the canines from T1 to T2 (8.1 mm) were greater than those of the root apexes (1.5 mm) (P0.05). Conclusion The buccal movement of maxillary transposed canines under a door-shaped individualized dental archwire was effective and feasible. The movement pattern under this mechanism was controlled tipping.

The glenohumeral joint is one of the most commonly dislocated joints. When dislocated, the humeral head typically moves anteriorly and medially within the soft tissues adjacent to the glenoid. We present a case of a 64-year-old female who presented with a locked anterior shoulder dislocation with impaction of the humeral head onto the coracoid. To our knowledge, this is the first reported instance of humeral head impaction onto the coracoid causing the shoulder dislocation to be irreducible by closed means. Complications of this dislocation can include humeral head deformity, pseudoparalysis, brachial plexus injury, and significant pain. Level of evidence V.

Purpose: Endoscopes are increasing the surgical spectrum for Oral and Maxillofacial Surgery. Naaj et al. quote that for third molars below the inferior dentoalveolar nerve (IDN), extra-oral removal is the best technique. The authors demonstrate that with endoscopic assistance, deeply impacted third molars can be removed intra-orally instead, without any complications. Endoscopes have demonstrated their usefulness in Oral and Maxillofacial surgery by aiding intra-oral repair of condylar fractures and submandibular gland removal; surgeries that are traditionally carried out with extra-oral access. The authors demonstrate how endoscopes have a place in minor oral surgery, particularly reducing the amount of bone removal needed to gain access to the surgical site. Methods: The article reports on two case studies of lingually placed third molars lying below the IDN. They were removed with endoscope assisted lingual access. Surgical planning was done using CT/CBCT scanning. The authors also detail how neurosensory disturbance was avoided when raising a lingual flap. Results: Wisdom teeth were successfully removed in all instances, whole, via lingual access. Patients had uneventful recovery and there were no cases of reported neurosensory disturbance. Conclusion: The authors demonstrate that the use of an endoscope, CT/CBCT guided surgical planning and careful lingual retraction provides a safe alternative to extra-oral removal of deeply impacted third molars. The advantages are avoidance of post-operative scarring and the potential to operate in ambulatory care.

Background context: Lumbar spine disc pathologies often necessitate removal of the intervertebral disc and implantation of a lumbar interbody fusion (LIF) device. Herein, the objective was to measure use condition forces while simulating intra-operative loading conditions of transforaminal lumbar interbody fusion (TLIF) procedures. Methods: In this work, we developed a transferable method to measure impact forces in a cadaveric intra-operative setting and designed a drop weight benchtop device equipped with force and displacement sensors to replicate cadaveric impact conditions, including number of strikes required for interbody device insertion, peak force, initial slope of the impact waveform, impact duration, and area under the force-time curve (impulse). Following cadaveric testing, a benchtop biomechanical study varying interbody device height, drop height, and drop weight was performed to evaluate the utility of the benchtop device to replicate impact loading conditions which occurred in the cadaveric model. Results: Several benchtop test groups replicated the cadaver group in number of strikes required for device insertion. The average cadaveric peak force, 13.03 kN, was replicated by three benchtop groups: 12 mm device height, 60 cm drop height, 0.75 lb drop weight; 12 mm device height, 60 cm drop height, 1.0 lb drop weight; and 14 mm device height, 60 cm drop height, 0.50 lb drop weight. The initial slope of the impact waveform was replicated best by 12 mm devices. Both the impact duration and impulse were lower in all benchtop groups than in cadaver testing. Conclusions: This work validated the outfitting of an impact force sensor onto an interbody device insertion instrument as a reproducible, quantifiable method for collecting impact loading data in a cadaveric model. This benchtop device and methodology will aid in testing interbody devices relative to anticipated use conditions, enhance interbody device designs, and accelerate surgical technique refinement.

This article discusses a case study of a 65-year-old female patient who experienced pain and swelling in the front part of her upper jaw. Clinical examinations and radiographic imaging revealed an impacted dilacerated maxillary central incisor. The article emphasizes the importance of radiographic examination in diagnosing and planning treatment for edentulous patients. Surgical removal of the impacted tooth was performed, and postoperative healing was satisfactory. The article also highlights the need for judicious use of panoramic radiography in edentulous patients to minimize radiation exposure and financial burden. [Extracted from the article]

The holotype of Hapalodectes dux Lopatin, 2001 from the Upper Paleocene of Mongolia (Tsagan-Khushu locality, Naran Bulak Formation, Zhigden Member) is a lower jaw with complete dentition, showing healed alveoli in place of the right P3. Examination of the holotype using X-ray microtomography revealed a rare dental anomaly previously unknown in fossil mammals, namely the presence of the inverted (positioned upside down and rotated lingual side labially) impacted premolar inside the dentary. The cause of this anomaly may be an aberration of a tooth bud location or an injury. [ABSTRACT FROM AUTHOR]

Background: Dilaceration is a rare dental condition that can occur during tooth development, resulting in distortion of the normal axial relationship between the crown and root. Although it can affect any tooth, it most commonly occurs in permanent incisors, often as a result of trauma to the primary predecessor. The impact of even a slight displacement of a primary incisor can be significant, disrupting the normal development of the follicles of new permanent teeth. Despite its rarity, dilaceration can pose significant challenges for dental professionals in terms of diagnosis and treatment. Case Description: A case report of a 27-year-old female patient is presented, who attended with a missing maxillary left permanent central incisor and a hard palpable bulge in the maxillary vestibular area. Radiography revealed an impacted maxillary left central incisor, which was found to be dilacerated with a 120⁰ angle. Consequently, surgical extraction of the impacted tooth was planned as orthodontic extrusion is not a viable option in such cases. The extracted tooth was found to have no signs of resorption, and healing was progressing satisfactorily. Conclusion: Radiography is the most reliable method of detecting the condition. The report emphasizes the importance of detecting dilaceration early and adhering to basic principles for its diagnosis and management. Clinical Significance: The report provides valuable insights for dental professionals on the surgical management of severely dilacerated teeth and the need for a multidisciplinary approach due to the high risk of root fractures. Received: 04 March 2023Accepted: 09 April 2023Published: 20 April 2023

Context Postoperative, critically ill, and elderly patients often have fecal loading or impaction. In a few such patients, disimpaction of fecalomas and colon cleansing are difficult. Bowel obstruction, megacolon, lower gastrointestinal bleeding, and gut perforation are complications that may ensue. Oral laxatives or enemas may only be partially effective. Surgical intervention may be needed for salvage or to treat complications. Series and Design Fourteen hospitalized cases with defecation disorder due to fecal loading of the colon were enrolled for retrospective analysis. Colonoscopic instillation of mannitol and/or lactulose was undertaken as an intervention when the use of oral laxatives was either ineffective or unfeasible, and enema had yielded poor results. Results Ten patients had satisfactory outcomes for fecal clearance, whereas four patients with poor or incomplete responses underwent repeat interventions or surgery. No significant complications were encountered due to this therapy. Conclusion Colonoscopic instillation of mannitol or lactulose in fecal-loaded critically ill patients results in a safe and satisfactory fecal clearance.

Introduction: An impacted tooth is one that remains unerupted and/or is partly erupted due to mechanical obstructions. These teeth can give rise to a magnitude ranging from dental caries, tumors, periodontal diseases to even jaw fractures. Materials and Methods: The study aimed to identify and analyze the impaction of maxillary and mandibular canines, premolars, and molars among children and adolescents aged 13 to =21 years of Indian origin belonging to both sexes who reported orthodontic treatment having good quality radiographs and medical/dental case sheets. The Pearson's Chi-square test analyzed the data obtained. Level of with a significance was set at P < 0.05. Results: Of 1001 individuals (551 M, 450 F), we could detect 709 individuals with impaction. The prevalence of impaction of third molar, canine, and premolar was found to be 29.1%, 31.4%, and 10.3%, respectively. Molar and canine impactions were more common in males, while premolar impactions were observed more in females. Conclusion: The prevalence of third molar impaction, canine impaction, and premolar impaction was found to be 29.1%, 31.4%, and 10.3%, respectively. Molar and canine impactions were more common in males, while premolar impactions were observed more in females among the patients reported for orthodontic treatment. [ABSTRACT FROM AUTHOR]