Computed tomography as a diagnostic modality for mandibular third molars in vicinity to the nerve

Dento alveolar surgery molar on a purposive sampling who fulfill certain inclusion and exclusion criteria. The paper discusses the procurement and preparation of platelet rich plasma (PRP), its benefits/efficacy and evaluation of bone formation and bone density in extracted third molar socket filled with platelet rich plasma (PRP). Comparison of both clinical and radiographic assessment done with control on contra-lateral third molar socket not filled with platelet rich plasma (PRP) and in the study overall results are discussed. doi:10.1016/j.ijom.2007.08.178

O6.13 Dry socket: a prospective study of risk factors in a Nigerian population F.O. Oginni Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, College of Health Sciences, Obafemi Awolowo University, Osun State, Nigeria This prospective study was undertaken to determine the risk factors in patients presenting with dry socket at the oral surgery clinic of the OAUTH, a Nigerian tertiary care facility. Relevant demographic and clinical information were obtained. The procedures were classified as traumatic or atraumatic. The status of clinician, form(s) of post-operative instructions given, onset of symptoms, period and mode of presentation, compliance with post-operative instructions, antibiotic use and management were documented. Fifty nine extraction sockets in 56 patients (male:female 17:39) with mean age 32.73 (13.31) years were included. They were mostly mandibular teeth (40/59), previously infected teeth (56/59), usually with poor/fair oral hygiene (35/56). Smoking was admitted in 1.8%, alcoholism in 10.7%, presence of systemic disease in 19.6%, use of contraceptives in 18% of females and previous dry socket in 8.9% while 66.1% of the procedures were traumatic. Clinicians were usually House officers/Students (21/56) and Registrars (25/56). Majority (71.4%) had both written and verbal post-operative instructions. Pain was the commonest presenting symptom (52/56) and onset was usually on day 1-3 (48/55), poor compliance with post-operative instructions was evident in 27/56 cases. The female gender, presence of pre-operative infection, posterior tooth/difficult extraction and fair to poor oral hygiene are the prominent risk factors in this group. doi:10.1016/j.ijom.2007.08.179

O6.14 Gender differences in pain and side effects using the third molar model of acute pain M.F. Stavropoulos*, B.A. Hastie Division of Oral & Maxillofacial Surgery, University of Florida College of Dentistry, 1600 SW Archer Road, D7-6 Gainesville, FL 32610, United States Objective: It is reported that women experience more clinical pain and increased sensitivity to experimentallyinduced pain than men. The objective of this study was to explore gender differences in pre-operative pain sensitivity with post-operative pain and side effects using the third molar model. Methods: Thirty-three healthy individuals, 67% females, ranging in age from 18–32 were recruited from the University of Florida Oral Surgery clinic. Inclusion criteria were four third molars with at least one impaction. Subjects underwent pre-operative experimental pain procedures using four modalities, thermal, temporal summation, pressure, and cold pressor as well as completing psychological measures. The surgeries were performed by one attending surgeon. Post-operative assessments were completed by each subject. Results: For baseline pain sensitivity, men reported higher pressure pain, warmth thresholds and lower temporal summation (p’s < .05) but no differences were found on heat or cold pain measures. Pre-operative pain sensitivity ratings were not correlated with post-operative pain ratings. Women reported higher post-operative pain. Men experienced more frequent and severe somatic side effects than women. Conclusions: Variations exist between men and women in clinical pain and side effects and future research is required. doi:10.1016/j.ijom.2007.08.180

O6.15 Anaesthetic efficacy of infiltration followed by papillary injection in mandibular primary molar treatment R. Roza-Haghgoo Dental School, Shahed University, N 71 Italy street between Ghods and Vesal street, Keshavarz Avenue, Tehran, Iran Aim: Inferior alveolar nerve block is the selective technique for treatment of mandibular primary molar. This technique has some disadvantages, especially the lengthy duration of the anaesthesia allows

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for a greater possibility of postoperative trauma, such as lip or tongue biting. Infiltration technique is an easy way that offers a shorter anaesthesia duration. The purpose of this study was to evaluate the efficacy of mandibular infiltration for the treatment of primary molar. Methods and materials: 80 mandibular primary molar in children 3–9 years old that should be treated by restorative procedure, pulpotomy and extraction were selected. These teeth received infiltration and then papillary injection and procedures were performed. Sign of discomfort included hand and body tension, eye movement indicating pain, verbal complaints and tear were evaluated by a single rater who was not the operator. Results: Success rate was 98/5  1/37. Conclusion: This study showed infiltration accompanied with papillary injection can be used for anaesthesia of mandibular primary molars. doi:10.1016/j.ijom.2007.08.181

O6.16 Computed tomography as a diagnostic modality for mandibular third molars in vicinity to the nerve A. Jhamb*, R.S. Dolas, P.K. Pandilwar Oral & Maxillofacial Surgery, Maulana Azad Institute of Dental sciences, New Delhi 110002, India Purpose: To assess the relationship of the Inferior Alveolar Neurovascular Bundle (IANB) and the impacted mandibular third molar on spiral computed tomography (SCT) and determine the validity of this assessment and compare it with that for Orthopantomogram (OPG). Materials and methods: The study was conducted in the Department of Maxillofacial Surgery, Govt. Dental College & Hospital, Nagpur, India. Clinical findings of operated patients were compared with the SCT findings. Sensitivity, specificity and area under the Receiver Operating Characteristic (ROC) curve were determined as part of ROC analysis. The values were then compared using Chi square test. Results: The number of positive clinical findings was observed significantly more in patients with no distance measurable between the tooth and the canal (P < 0.001; Fisher Exact Test), lack of cortication of the canal and lingual or intra-radicular course of the IANB (p = 0.009; Fisher Exact test). ROC analyses of both these diagnostic modalities have shown that the SCT performed better

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than OPG, although the difference is not statistically significant (p = 0.9871; Chi square test). Conclusions: The spiral CT images definitely enhance the visualization of the relation of the tooth to the IANB which might provide a higher level of intra surgical safety and safeguard the interests of both the surgeon and the patient. doi:10.1016/j.ijom.2007.08.182

O6.17 Comparative evaluation of computed tomography and orthopentomogram in diagnosis and treatment planning of impacted maxillary canines D.A. Agrawal*, P.K. Pandilwar Sri Aurobindo College Of Dentistry, Indore, India Failure of eruption due to impaction or malposition of maxillary canine is a common finding in surgical practice. In planning the surgical orthodontic repositioning or removal of malpositioned maxillary canines, correct diagnosis require not only their precise spatial location but also a thorough and accurate assessment of the intimate relationship with not only adjacent anatomical structures, but also in particular the roots of adjacent teeth. Conventional radiography has often failed to depict because of its two dimensional

structure and superimposition. So, this prospective study of 23 patients with 33 impacted canines was carried with the aim of finding evidence for justifying the use of computed tomography and orthopentomogram as a diagnostic modality prior to surgical intervention of impacted maxillary canine. Result and conclusion: The perceptibility of root resorption was observed much more easily and in much detail with the use of CT than Conventional X-rays, a fact that has therapeutic consequence. Also, the spiral CT depicts closeness of impacted canine to adjacent anatomical structures accurately which aids in establishing good surgical plan and predicting post-op complication, which is of utmost importance in the era of medicolegal consumerism. doi:10.1016/j.ijom.2007.08.183

O6.18 Pattern of bacteraemia after nonsurgical extraction of tooth S. Ahmed*, S.M. Haider Abbasi Shaheed Hospital, Karachi Medical and Dental College, Karachi, Pakistan Introduction: Dental extractions have been used to treat a variety of illnesses. Oral disease has been a problem for humans from the beginning of history. Dental manipulation has been proven to

cause transient bacteraemia. This condition is usually not serious. A variety of organisms are found in the microenvironment of the oral cavity. Increasing evidence indicates that oral microbes participate in various systemic diseases, especially in patients at risk. Objectives: The objectives of this study were to assess the: (1) types of organisms causing bacteraemia after non-surgical extraction of teeth; (2) sensitivity pattern of bacterial isolates after non-surgical extraction of tooth or teeth. Results: A total of fifty patients were included in our study, 34 (68%) patients were male and 16 (32%) were female. Mean age of patients was 32.14 years SD/SE. The commonest reason for tooth extraction was presence of dental caries (60%), followed by increased tooth mobility (22%), impact. The preextraction intravenous blood culture was negative in all 50 patients. While the local gingival culture yields 11 different organisms, mostly Gram-positive cocci, including both aerobes and anaerobes, these organisms include Streptococcus species, Peptostreptococcus and Streptococcus viridians. The post-extraction intravenous culture in 1 min was negative in 30 (60%) patients, Streptococcus viridians in 12, Eubacterium species in seven and six cultures were positive for Klebsiella and Nisseria sicca species. doi:10.1016/j.ijom.2007.08.184