In the presence of acute pericoronitis of mandilbular third molar, antibiotic therapy and early incision and drainage are the method of choice, followed by definitive surgical extraction of the tooth as soon as it becomes subacute. If excision of the overlying tissues is decided on, it should be done adequately. All overlying tissues must be throughly excised, and the crown portion of the unerupted tooth should be completely exposed. After excision has been completed, the wound should be managed with a surgical dressing. This should be allowed to remain approximately 7 days. And then, surgical extraction of the impacted mandibular third molar can be done usually. In this operation, there are many complications, such as, postoperative bleeding, infection, trismus, dysphasia and paresthesia. The surgeon are discredited and medicolegal problem may be occurred in the presence of many distressed complications. Therefore, the relatively nonsurgical treatment is the method of choice. So, authors selected the conservative treatment methods of incision and drainage, primary endodontic drainage, operculectomy without surgical extraction of the mandibular third molars. The results were more favorable without the postoperative complication in Wonju old offender prison.
Aphasia ; Bandages ; Criminals ; Crowns ; Drainage ; Hemorrhage ; Humans ; Infection Control ; Molar, Third ; Paresthesia ; Pericoronitis ; Postoperative Complications ; Prisoners ; Prisons ; Tooth ; Tooth, Unerupted ; Trismus

The management of teeth in the line of a mandibular fracture is controversial despite the general agreement that most of these teeth can be preserved. Teeth should be retained if bony attachments are adequate for survival, the tooth is sound and important in maintaining fixation of the fractured segment of bone. Teeth should be removed if they are loose and interfere with the reduction of fragments, are devitalized and potentially a source of wound infection, are damaged beyond their usefulness or may become devital and interfere with healing by becoming infected. However, tooth removal will increase the level of trauma, extend the severity of the wound and require expensive prosthetic treatment. Therefore, it is very important to conserve infected teeth in the line of a mandibular fracture through early primary endodontic treatment (pulp extirpation, canal enlargement and canal opening drainage) and splinting. The basic principles underlying the treatment of pulpless teeth are those underlying general surgery. Therefore, debridement of the infected wound (pulp extirpation and canal enlargement), drainage (canal opening) and gentle treatment of the tissues (occlusal reduction and teeth splinting) are the principles of surgery. This is a representative case report of conservative care by the early endodontic drainage of infected teeth in the line of a mandibular fracture.
Debridement ; Drainage ; Mandibular Fractures ; Tooth ; Tooth, Nonvital ; Wound Infection

Excessive oral and maxillofacial bleeding causes upper airway obstruction, bronchotracheal and gastric aspiration and hypovolemic shock. Therefore, the rapid and correct bleeding control is very important for saving lives in the emergency room. Despite the conventional bleeding control methods of wiring (jaw fracture, wound suture and direct pressure), continuous bleeding can occur due to the presence of various bleeding disorders. There are five main causes for excessive bleeding disorders in the clinical phase; (1) vascular wall alteration (infection, scurvy etc.), (2) disorders of platelet function (3) thrombocytopenic purpura (4) inherited disorders of coagulation, and (5) acquired disorders of coagulation (liver disease, anticoagulant drug etc.). In particular, infections can alter the structure and function of the vascular wall to a point at which the patient may have a clinical bleeding problem due to vessel engorgement and erosion. Wound infection is a frequent cause of postoperative active bleeding. To prevent postoperative bleeding, early infection control using a wound suture with proper drainage establishment is very important, particularly in the active bleeding sites in a contaminated emergency room. This is a case report of a rational bleeding control method by rapid wiring, wound suture with drainage of a rubber strip & iodoform gauze and wet gauze packing, in a 26-year-old male cerebral palsy patient with active oral and maxillofacial bleeding injuries caused by a traffic accident.
Adult ; Airway Obstruction ; Blood Platelets ; Cerebral Palsy ; Drainage ; Emergencies ; Glycosaminoglycans ; Hemorrhage ; Humans ; Hydrocarbons, Iodinated ; Infection Control ; Male ; Mentally Disabled Persons ; Purpura, Thrombocytopenic ; Rubber ; Scurvy ; Shock ; Sutures ; Wound Infection

Airway Obstruction ; Brain ; Cavernous Sinus ; Craniocerebral Trauma ; Emergencies ; Hemorrhage ; Humans ; Male ; Shock ; Skull ; Skull Fractures ; Sutures ; Wound Infection

Drainage ; Fractures, Open ; Hematoma ; Hemorrhage ; Humans ; Jaw ; Lacerations ; Malnutrition ; Mandibular Fractures ; Oral Hygiene ; Paresthesia ; Rubber ; Seroma ; Tooth ; Traction ; Trismus ; Wound Infection

Anesthesia, Local ; Dentistry ; Drainage ; Hematoma ; Hemorrhage ; Hydrocarbons, Iodinated ; Oral Hygiene ; Rubber ; Seroma ; Splints ; Stress, Psychological ; Tooth ; Wound Infection

Carcinoma, Hepatocellular ; Crowns ; Drainage ; Electrocoagulation ; Gingiva ; Glycosaminoglycans ; Hemorrhage ; Humans ; Inflammation ; Leukemia ; Liver ; Liver Cirrhosis ; Molar ; Mouth Mucosa ; Periodontitis ; Sutures ; Toothache

There are five principal causes for excessive bleeding in the immediate postextraction phase ; (1) Vascular wall alteration (wound infection, scurvy, chemicals, allergy) (2) Disorders of platelet function (genetic defect, drug-aspirin, autoimmune disease) (3) Thrombocytopenic purpuras (radiation, leukemia), (4) Inherited disorders of coagulation (hemophilia, Christmas disease, vitamin deficiency, anticoagulation drug-heparin, coumarin). If the hemorrhage from postextraction wound is unusually aggressive, and then dehydration and airway problem are occurred, the socket must be packed with gelatine sponge(Gelfoam) that was moistened with thrombin and wound closure & pressure dressing are applied. The thrombin clots fibrinogen to produce rapid hemostasis. Gelatine sponges moistened with thrombin provide effective coagulation of hemorrhage from small veins and capillaries. But, in dental alveoli, gelatine sponges may absorb oral microorganisms and cause alveolar osteitis (infection). This is a case report of bleeding control by continuous rubber strip & iodoform gauze drainage (without gelfoam packing) of active bleeding infection sites of three teeth extraction wounds in a 46-years-old female patient with advanced liver cirrhosis.
Avitaminosis ; Bandages ; Blood Platelets ; Capillaries ; Dehydration ; Drainage ; Dry Socket ; Female ; Fibrinogen ; Gelatin ; Gelatin Sponge, Absorbable ; Hemophilia B ; Hemorrhage ; Hemostasis ; Humans ; Hydrocarbons, Iodinated ; Liver ; Liver Cirrhosis ; Porifera ; Purpura, Thrombocytopenic ; Rubber ; Scurvy ; Thrombin ; Tooth ; Veins

BACKGROUND: The vascularity of the peri-implant tissue is a very important parameter in establishment and maintenance of a healthy tissue after dental implant insertion. OBJECTIVE: The purpose of this study was to compare the vascularity of the peri-implant mucosa between flap and flapless implant surgeries by using a canine mandible model. STUDY DESIGN: In six mongrel dogs, bilateral, edentulated, flat alveolar ridges were created in the mandible. After 3 months of healing, two implants were placed in each side by either the flap or flapless procedures. After another healing period of 3 months, biopsies were obtained, prepared for light microscopy and exposed to morphometric measurements. RESULTS: The supracrestal connective tissue lateral to the implant was found to be more richly vascularized in the flapless group than in the flap group. CONCLUSION: These results suggest that the flapless procedure may have an effect on increasing the vascularity of the peri-implant mucosa.
Animals ; Biopsy ; Blood Vessels ; Connective Tissue ; Dental Implants ; Dogs ; Light ; Mandible ; Microscopy ; Mucous Membrane

Wegener's granulomatosis is a rare disease that pathologically causes necrotizing granulomatous vasculitis in the arterioles and venules and it can invade the whole body. In addition, it is difficult to distinguish between a nontuberculous mycobacteria infection that shows manifestations of granuloma and Wegener's granulomatosis. There has been no reported on a patient who had the 2 abovementioned two diseases at the same time. A 69 year old male patient had Wegener's granulomatosis that had invaded the prostate. He also had a scrotal swelling and back pain. He had manifestations of granulomatous infection on the scrotum and spine biopsies. However, there was no clinical evidence of Wegener's granulomatosis. As a result, we examined him for other diseases that can cause a granuloma. Consequently, he was also diagnosed as suffering with a nontuberculous mycobacteria infection. We report here on this case and we review the relevant medical literature.
Arterioles ; Back Pain ; Biopsy ; Granuloma ; Humans ; Male ; Nontuberculous Mycobacteria ; Prostate ; Rare Diseases ; Scrotum ; Spine ; Stress, Psychological ; Vasculitis ; Venules ; Wegener Granulomatosis