1/3. Clinical significance of the structural integrity of the superior aspect of the mandibular canal.BACKGROUND: Sparse data can be found regarding the structural integrity of the superior aspect of the mandibular canal. In many cases, the mandibular canal must be carefully evaluated prior to defining patient treatment. methods: In this case report, a 54-year-old patient presented with a periapical infection involving the mesial root of the mandibular right second molar (#31). Radiographic evaluation revealed that the periapical lesion extended from the apex of the tooth to the superior aspect of the mandibular canal. Upon surgical removal of the tooth, an apical communication between the extraction socket and mandibular nerve was located. A guided bone regeneration procedure was performed to protect the nerve from subsequent damage and to prepare the site for future implant placement. Implants were placed in the area approximately 5 months following the regenerative procedure. RESULTS: After implant placement, the patient experienced normal function and no mandibular symptomatology. Implants have been in function for the past 4 years. CONCLUSIONS: Many factors, both pathologic and developmental, can lead to a discontinuity of the superior aspect of the mandibular canal. Normally, a thin cortical plate of bone protects the nerve. When a lack of structural integrity of the canal roof is discovered, enucleation of a periapical infection or subsequent implant placement can lead to potential disruption of the nerve. Limited information is available regarding the integrity of this protective cover. This case report underscores the importance of proper clinical diagnosis before implant placement in the posterior mandible.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
2/3. Bisphosphonates: case report of nonsurgical periodontal therapy and osteochemonecrosis.The risk of developing osteochemonecrosis is increased in patients who are taking bisphosphonate drugs and must undergo extractions or other dental surgery. Because of the difficulty in predicting and preventing osteochemonecrosis and in managing patients after it has occurred, avoidance of surgery has been advised. This paper reports on the development of this complication in a patient who received nonsurgical periodontal treatment. Although it is believed that the risk of developing this severely debilitating complication is low when treating patients nonsurgically, practitioners must be able to recognize and understand the presentation and difficulties in managing osteochemonecrosis, even when only nonsurgical therapy is performed.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
3/3. Consequences of serious oral injury associated with the congenital analgia syndrome.Three sisters at the ages of seven months, twelve years, and thirteen years presented with the initial damages to the oral tissues and the distinctive long-term effects in conjunction with the congenital analgia syndrome. The severity of this syndrome justifies the consideration of a prophylactic extraction of the primary dentition. A controlled mastication will be more likely with increasing age and eruption of the permanent teeth.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |