Project description:Subcutaneous emphysema occurs when air is forced under the tissue, causing swelling, crepitus on palpation, and the possibility of spreading along the fascial planes. Although subcutaneous emphysema secondary to dental procedures is rare, it can be a potentially fatal complication if not diagnosed and treated promptly and correctly. Dentists need to be able to differentiate subcutaneous emphysemas from more common disease processes that have similar clinical presentations. We report a 22-year-old male who underwent mandibular wisdom tooth extraction and subsequently developed extensive subcutaneous emphysema. The patient was quickly taken care of, in partnership with the maxillofacial department. The purpose of this report is to bring attention to the fact that obtaining an accurate diagnosis for this condition is very important and management on time can prevent serious complications.
Project description:Necrotizing soft tissue infections with mediastinal extension are exceedingly rare. This submission provides dynamic and static visual stimuli (CT images) and a case report describing the history of present illness, initial ED presentation and inpatient course of a 33-year-old man who developed facial necrotizing fasciitis complicated by mediastinitis secondary to odontogenic infection following wisdom tooth extraction. Discussion of the key features of this rare presentation, the diagnostic and therapeutic approaches to making the diagnosis (including CT), and the role of the Emergency Physician, are highlighted.TopicsNecrotizing fasciitis, necrotizing mediastinitis, odontogenic infection, CT scan.
Project description:IntroductionLabyrinthine infarction is a cause of acute audiovestibulopathy, but can be diagnosed only in association with other infarctions involving the brainstem or cerebellar areas supplied by the anterior inferior cerebellar artery (AICA) since current imaging techniques cannot visualize an infarction confined to the labyrinth. This case series aimed to establish embolic labyrinthine infarction as a mechanism of isolated acute audiovestibulopathy.MethodsWe analyzed clinical features, imaging findings, and mechanisms of embolism in 10 patients (8 men, age range: 38-76) who had developed acute audiovestibulopathy in association with an obvious source of embolism and concurrent acute embolic infarctions in the non-anterior inferior cerebellar artery territories. The presence of audiovestibulopathy was defined when bedside or laboratory evaluation documented unilateral vestibular (head-impulse tests or caloric tests) or auditory loss (audiometry).ResultsSix patients showed combined audiovestibulopathy while three had isolated vestibulopathy. One patient presented isolated hearing loss. Audiovestibular findings were the only abnormalities observed in nine patients. In all patients, MRIs documented single or multiple infarctions in the cerebellum (n = 5) or cerebral hemispheres (n = 5). Especially three patients showed single or scattered foci of tiny acute infarctions only in the cerebral hemispheres. Cardiac sources of embolism were found in eight, and artery-to-artery embolism was presumed in two patients.ConclusionSelective embolism to the labyrinth may be considered in patients with acute unilateral audiovestibulopathy and concurrent acute infarctions in the non-AICA territories.
Project description:The stromal cell-derived factor 1 (SDF-1)/chemokine receptor type 4 (CXCR4) axis plays a key role in alveolar bone metabolism during orthodontic tooth movement (OTM). Herein, the effects of the SDF-1/CXCR4 axis on the regional acceleratory phenomenon (RAP) in OTM velocity and on changes in the surrounding periodontium after adjacent tooth extraction in rats were investigated. Six-week-old male Wistar/ST rats underwent left maxillary first molar (M1) extraction and mesial OTM of the left maxillary second molar (M2) with a 10-g force closed-coil spring. Phosphate-buffered saline, immunoglobulin G (IgG) isotype control antibody, or anti-SDF-1 neutralizing monoclonal antibody were injected at the M1 and M2 interproximal areas (10 μg/0.1 mL) for the first three days. Analyses were performed after 1, 3, and 7 days (n = 7). The results demonstrated a significant increase in SDF-1 expression from day 1, which was effectively blocked via anti-SDF-1 neutralizing monoclonal antibody injection. On day 3, the M2 OTM distance and the number of positively stained osteoclasts significantly reduced alongside a reduction in inflammatory markers in the experimental group. Our results demonstrated that serial local injection of the anti-SDF-1 neutralizing monoclonal antibody reduces M2 OTM, osteoclast accumulation, and localized inflammatory responses in an OTM model with tooth extraction-induced RAP.
Project description:ObjectiveThe objective of this systematic review was to evaluate the impact of mandibular wisdom tooth extraction on a patient's quality of life "QoL".MethodsAn electronic search was conducted through September 2021 on MEDLINE database, ELSEVIER- ScienceDirect, Ebsco, Scopus and Google Scholar to collect sufficient articles relevant to our subject. Data were extracted and analyzed from selected studies including study type, sample size and characteristics, duration of the observation after removal wisdom teeth, the questionnaire used for evaluation of this QoL and, the result.ResultsOf 107 studies, fourteen representing 4990 cases met the inclusion criteria. The quality of life has deteriorated but different factors contributed to his improvement. Thus, different instruments have been used in these studies: 24 the OHIP-14, 10 the OHQoLUK, 8 the HRQOL, 2 the EQ-5D-3L QOL, and 1 used UW-QOL.ConclusionThe extraction of mandibular wisdom teeth has a negative effect on the quality of life during the first postoperative days but improved progressively by following the medical instructions given by the dental surgeon.