Wisdom tooth

The reconstruction of the periodontal tissue with chitosan was a prelude to the discovery of the osteoinductive properties of chitosan [331]. Surgical wounds from wisdom tooth avulsions were treated with freeze-dried methylpyrrolidinone chitosan that promoted bone regeneration. Methyl-pyrrolidinone chitosan was useful in apicoectomy as well. None of the patients reported adverse effects over three years of observation [332]. 

Pericoronitis- It is the inflammation of soft tissues surrounding the crown of a partially erupted tooth and most commonly, a wisdom tooth. It generally occurs when bacterial plaque and food debris accumulate beneath the flap of gum covering the partially erupted tooth. It is characterized by inflammation, often complicated by trauma from the opposing tooth, leads to swelling of the flap, tenderness, pain and a bad taste due to pus oozing from beneath the flap. 

A teenage boy is seen at the office of a dental surgeon for extraction of an impacted wisdom tooth. He is so nervous that the dentist decides to administer a sedative to calm the boy. After intravenous administration of the sedative (promethazine), the boy relaxes and the extraction is accomplished with no complications. However, when the boy stands up from the dental chair, he turns very pale and faints. Lying on the floor, he rapidly regains consciousness, but has a rapid heart rate of 120 bpm and a blood pressure of only 110/70 mm Hg. When he sits up, his heart rate increases to 140 bpm, his pressure drops to 80/40 mm Hg, and he complains of faintness. He is helped to a couch in the reception area, where he rests for 30 minutes. At the end of this time the boy is able to sit up without symptoms and, after an additional 15 minutes, is able to stand without difficulty. What autonomic effects might promethazine have that would explain the patient s signs and symptoms Why did his heart rate increase when his blood pressure dropped ... 

Barbiturates are referred to as sedative-hypnotics. These drugs will induce sleep which can lead to even deeper sedation (hypnosis) and can cause a fatal depression of the RAS affecting the respiratory system. The sleep which is encountered does not have the normal cycles of slow wave and rapid eye movement activity, so it is not always restful. However, these agents prove to be useful in anesthesia for both short and longer durations of time. Many of you may have been given thiopental prior to wisdom tooth extraction. Thiopental "wears off quickly and so the actual anesthetic for the time of the extraction is usually nitrous oxide. 

Horace Wells, a dentist, attended Colton s nitrous-oxide exhibition in Hartford, Connecticut, and noticed that when one of the audience members who had sniffed nitrous oxide tripped and cut his leg, he was astounded to feel no pain. Wells experimented the very next day by having a fellow dentist pull out one of his own teeth after Wells inhaled nitrous oxide. After awakening and feeling the empty hole where his troublesome wisdom tooth had been. Wells exclaimed, It is the greatest discovery ever made. I didn t feel so much as a prick of a pin ... 

Fig.13.18. Patient A, mandibular canal passes the wisdom tooth on the lingual side. Patient B, nerve canal passes straight between the roots. Patient C, nerve canal meanders between the roots from lingual side between the roots to the buccal side...

CT is helpful when extraction of an unerupted wisdom tooth is planned and where the mandibular canal crosses the roots of the wisdom teeth, i.e., the roots reach deeper than the mandibular canal. In these cases, it is helpful for the surgeon to know whether the canal runs along the roots on the Ungual or the buccal side, or whether the canal meanders through the roots. These cases are Uked least by the surgeons. With the knowledge of the path of the nerve, the extraction can be planned with less risk of paresis of the inferior alveolar nerve. 

Beginning distally from the wisdom tooth, the mandibular canal is identified and then followed through the sUces along the wisdom tooth. The determination of the pathway is, in most cases, relatively easy. The deformation of the channel on the lingual or buccal side of the roots is sometimes considerable, and sometimes the channel runs only slit-like within the cortex (Fig.l3.18A,B,C). 

RIQS, emptiness, vacuum ShKL, wisdom, understanding, prudence, cunning ShN, prong, point, edge, tooth, the name of the letter of FIRE. SPIR also means beam or ray of light from the sun), then Sol will give thee a sign."... 

Standard addition graph. Tooth enamel consists mainly of the mineral calcium hydroxyapatite, Caio(P04)6(OH)2. Trace elements in teeth of archeological specimens provide anthropologists with clues about diet and diseases of ancient people. Students at Hamline University measured the trace element strontium in enamel from extracted wisdom teeth by atomic absorption spectroscopy. Solutions were prepared with a constant total volume of 10.0 mL containing 0.750 mg dissolved tooth enamel plus variable concentrations of added Sr. 

The compound form has recognizable parts of the teeth with dentine or enamel and displays high differentiation. Most compound odontomas are in the vicinity of an impacted tooth. The most common location is the anterior portion of the maxilla. Complex odontomas have amorphous calcifications, either in the region of the lower wisdom teeth or near the posterior region of the maxiUa (Fig. 13.9). 

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