Although rare, hypodermic needle fractures can occur in the maxillofacial region. In cases of fracture, urgent intervention is required to prevent further complications. We present the case of a 37-year-old female patient with a fractured needle in the left sublingual fossa during a lingual nerve block 6 months before referral. The fragment of a 30-gauge needle was located using cone-beam computed tomography and retrieved under local anesthesia with blunt dissection. The patient recovered uneventfully, except for predictable postoperative inflammatory complications, which resolved within 2 weeks. Precautions should be implemented to prevent needle fractures, which are usually preventable. However, if the retrieval is unsuccessful, the patient should be referred to a well-equipped surgical unit without delay.

BACKGROUND: In dentistry, pain is a factor that negatively affects treatments and drug use. The aim of this study was to evaluate the correlations of the postoperative analgesic use with pain catastrophizing and anxiety in patients who underwent removal of an impacted mandibular third molar.METHODS: We recruited 92 patients who underwent the extraction of impacted mandibular third molar. In this study, the Pederson index was used to preoperatively determine the difficulty of surgical extraction. Patients were asked to note the number of analgesics used for 7 postoperative days. Patients were divided into two groups based on the Pain Catastrophizing Scale: low and high score groups. State-Trait Anxiety Inventory-trait and State-Trait Anxiety Inventory-state questionnaires were used to determine the anxiety levels of the patients. The obtained data were examined to evaluate the correlations of pain catastrophizing and anxiety with the postoperative analgesic use.RESULTS: In this study, 92 patients, including 60 women and 32 men, were recruited. The analgesic use was higher in women than in men but with no significant difference (P > 0.05). Pain Catastrophizing Scale scores were higher in women than in men but with no significant difference (P > 0.05). The analgesic use was higher in patients with high pain catastrophizing than in those with low pain catastrophizing but with no significant difference (P > 0.05). State-Trait Anxiety Inventory-trait scores were higher in women than in men but with no significant difference. However, state-Trait Anxiety Inventory-state scores were significantly higher in women than in men (P < 0.05).CONCLUSION: The postoperative analgesic use may be higher in patients who catastrophize pain than in others. Knowing the patient's catastrophic characteristics preoperatively would contribute to successful pain management and appropriate drug selection.
Analgesics ; Anxiety ; Catastrophization ; Dental Anxiety ; Dentistry ; Female ; Humans ; Male ; Molar, Third ; Pain Management ; Tooth, Impacted

Objective: To evaluate the effect of free and liposome form of gallic acid on bone regeneration in critical defects in Wistar rats. Methods: Thirty-two female Wistar rats were divided into four study groups: group 1, negative control; group 2, positive control; group 3, gallic acid powder; group 4, gallic acid liposome. A critical-sized defect was created in all rats. Groups 2 to 4 had xenograft, autograft and membrane placement while negative control rats did not receive any treatment. The defect area was sutured and rats were kept alive for 30 d. At the end of the study, a bone specimen including the defect area was removed from calvaría. All specimens were evaluated under the stereomicroscope, then underwent histological analysis. Inflammatory cell counts, osteoblast, osteoclast counts, receptor activator of nuclear factor κ-B (RANKL), osteoprotegerin (OPG), runt-related transcription factor 2 (Runx2), bone morphogenetic protein-2 (BMP-2), and alkaline phosphatase were determined. Results: The biggest unhealed defect area was observed in the negative control group and the smallest was observed in the gallic acid liposome group. There were no differences between the positive control group vs. the gallic acid powder group and the gallic acid powder group vs. the gallic acid liposome group. The severity of inflammation was the highest in the negative control group and the lowest in the gallic acid liposome group with significant differences between the groups. All groups had similar osteoblast counts while osteoclast counts were the highest in the positive control group. Gallic acid groups had a lower number of osteoclasts compared with the positive control group. Runx2 and alkaline phosphatase levels were similar in the groups while OPG and BMP-2 levels exhibited a significant increase compared with the negative control group and the positive control group. RANKL was similar in the negative control group, the positive control group, and the gallic acid powder groups but decreased in the gallic acid liposome group. Conclusions: Gallic acid powder and liposome significantly improve bone regeneration in Wistar rats with calvarial defects. The improvement in healing is evident with decreased inflammation and RANKL expressions and increased OPG and BMP-2 expressions. Altan Ahmet 1 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gaziosmanpaşa University, Tokat Yuce Hatice 2 Department of Periodontology, Faculty of Dentistry, Gaziosmanpaşa University, Tokat Karataş Őzkan 3 Department of Periodontology, Faculty of Dentistry, Gaziosmanpaşa University, Tokat Taşkan Mehmet 4 Department of Periodontology, Faculty of Dentistry, Gaziosmanpaşa University, Tokat Gevrek Fikret 5 Department of Histology and Embryology, Faculty of Medicine, Gaziosmanpaşa University, Tokat Çolak Sefa 6 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gaziosmanpaşa University, Tokat Akbulut Nihat 7 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gaziosmanpaşa University, Tokat Al Anouti F, Taha Z, Shamim S, Khalaf K, Al Kaabi L, Alsafar H. An insight into the paradigms of osteoporosis: From genetics to biomechanics. Bone Rep 2019; 11:100216. Doi: 10.1016/j.bonr.2019.100216. Croes M, van der Wal BC, Vogely HC. 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