Comparing the efficacy of sinus irrigation with traditional Caldwell–Luc procedure following odontogenic cyst surgery involving the maxillary sinus

AbstractA large maxillary odontogenic cyst could intrude into the maxillary sinus. The traditional approach following surgery for such a cyst is the Caldwell–Luc procedure. However, the traditional CDL procedure is associated with more complications and damage of the sinus mucosa. The purpose of this study was to assess a new method with easier operation, which not only prevented postoperative infection but also caused less damage to the maxillary sinus mucosa. A large odontogenic cyst in the maxillary sinus of 40 patients was diagnosed through radiographic imaging and postoperative histopathology. Twenty patients were treated with maxillary sinus saline irrigation after surgery, while 20 patients underwent the traditional Caldwell–Luc procedure. The therapeutic efficacy was evaluated by clinical examination and radiographic imaging; the longest follow-up was 36 months. The postoperative reaction was evaluated. There was a statistically significant difference in facial swelling, visual analog scale (VAS) and temperature elevation between the 2 groups. Sinus irrigation following large odontogenic cyst surgery involving the maxillary sinus can serve as an alternative to standard CDL and has the advantages of fewer complications, reduced trauma, restoration of the mucosa and more satisfactory results.

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Comparing the Efficacy of Sinus Irrigation with Traditional Caldwell-Luc Procedure Following Odontogenic Cyst Surgery Involving The Maxillary Sinus

10.21203/rs.3.rs-624924/v1 ◽

2021 ◽

Author(s):

Niu Gang ◽

Chen JiaMin ◽

Wu Ye ◽

Xie FuPing ◽

Liu HuangHuang ◽

...

Keyword(s):

Maxillary Sinus ◽

Severe Pain ◽

Traditional Approach ◽

Postoperative Recovery ◽

Odontogenic Cyst ◽

Radiographic Imaging ◽

Moderate Pain ◽

Saline Irrigation ◽

Mild Pain ◽

Sinus Mucosa

Abstract Objective: A large maxillary odontogenic cyst could intrude into the maxillary sinus. The traditional approach following surgery for such a cyst is the Caldwell-Luc procedure However the traditional CDL procedure is associated with more complications and damage of the sinus mucosa. The purpose of this study was to assess a new method with easier operation, which not only prevented postoperative infection but also caused less damage to the maxillary sinus mucosa.Methods: A large odontogenic cyst in the maxillary sinus of 40 patients was diagnosed through radiographic imaging and postoperative histopathology. Twenty patients were treated with maxillary sinus saline irrigation after cyst resection surgery, while 20 patients underwent the traditional Caldwell-Luc procedure. The therapeutic efficacy was evaluated by clinical examination and radiographic imaging; the longest follow-up was 36 months.Results: The postoperative recovery of the 20 patients treated with sinus irrigation. Six patients had mild swelling (30%), 12 had moderate swelling (60%), and 2 had severe swelling (10%); 16 had mild pain (80%), 4 had moderate pain (20%), and 0 had severe pain (0%). Among the 20 patients treated by the Caldwell-Luc approach. Immediately postoperatively, 2 patients had mild swelling (10%), 12 had moderate swelling (60%), and 6 had severe swelling (30%); 10 had mild pain (50%); 6 had moderate pain (30%), and 4 had severe pain (20%). On the second day after surgery, a mild temperature elevation (38.0°C-39.0°C) was noted in 8 patients (40%) treated with the Caldwell-Luc procedure and 1 patient (5%) treated with saline irrigation.Conclusion: Sinus irrigation following large odontogenic cyst surgery involving the maxillary sinus can serve as an alternative to standard CDL and has the advantages of fewer complications, reduced trauma, restoration of the mucosa and more satisfactory results.

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Hypersensitivity relief of MIH-affected molars using two sealing techniques: a 12-week follow-up

Clinical Oral Investigations ◽

10.1007/s00784-021-04163-5 ◽

2021 ◽

Author(s):

Katrin Bekes ◽

Stefanie Amend ◽

Julia Priller ◽

Claudia Zamek ◽

Tanja Stamm ◽

...

Keyword(s):

Visual Analog Scale ◽

Clinical Relevance ◽

Retention Rates ◽

Glass Ionomer ◽

Analog Scale ◽

Time Points ◽

Clinical Pain ◽

Molar Incisor Hypomineralization ◽

Significant Difference

Abstract Objectives The aim of this study was to compare the efficacy in reducing hypersensitivity in molar incisor hypomineralization (MIH)-affected molars immediately and over 12 weeks after sealing using two different materials (composite and glass ionomer). Furthermore, the retention rates of both materials were analyzed. Methods Thirty-nine children with two MIH-affected molars showing hypersensitivity and non-occlusal breakdowns were included. Hypersensitivity was assessed with an evaporative (air) stimulus. Both teeth were sealed by two calibrated operators using a split-mouth design with either Clinpro Sealant in combination with Scotchbond Universal (C) or Ketac Universal (K), respectively. Clinical pain assessments (Schiff Score Air Sensitivity Scale [SCASS], Visual Analog Scale [VAS]) were made at baseline (“pre”), immediately after treatment (“post”), and after 1, 4, 8, and 12 weeks. Paired t tests were calculated in each group between baseline and all other time points. Results Thirty-eight children with 76 molars completed all stages of the study. Regardless of the material used, the application of the sealant decreased hypersensitivity significantly immediately as well as throughout the 12-week recalls (all p values < 0.001). We found no statistically significant difference among both materials chosen in any of the time points evaluated. Furthermore, retention of both materials was comparable in both groups. Conclusions Both sealant materials were able to reduce hypersensitivity successfully immediately and throughout the 12-week follow-up. Furthermore, their performance was similar in terms of retention. Clinical relevance Hypersensitivity can be a major complaint in patients with MIH. This is the first study evaluating hypersensitivity relief of MIH-affected molars using two sealing techniques.

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Association between Cone-Beam Computed Tomography and Histological and Immunohistochemical Features in Periapical Lesions Correlated with Thickened Maxillary Sinus Mucosa

Medicina ◽

10.3390/medicina57080840 ◽

2021 ◽

Vol 57 (8) ◽

pp. 840

Author(s):

Alexandra Dumitrescu ◽

Maria-Alexandra Martu ◽

Alexandru Nemtoi ◽

Ana Sirghe ◽

Liliana Chelaru ◽

...

Keyword(s):

Computed Tomography ◽

Maxillary Sinus ◽

B Lymphocytes ◽

Cone Beam Computed Tomography ◽

Maxillary Sinusitis ◽

Cone Beam ◽

Periapical Lesions ◽

Significant Difference ◽

The Mean ◽

Sinus Mucosa

Background and Objectives: Odontogenic sinusitis is a frequently underestimated pathology with fewer symptoms in patients with periapical lesions, periodontal disease, or iatrogenic foreign bodies in the maxillary sinus. The aim of our study was to determine the correlation between maxillary sinusitis and periapical lesions using cone-beam computed tomography (CBCT) imaging and histological and immunohistochemical investigations. Materials and Methods: A total of 1450 initial patients diagnosed with maxillary sinusitis in the Ear-Nose-Throat (ENT) Department, University of Medicine and Pharmacy “Grigore T. Popa” Iasi, Romania, were treated with anti-inflammatory drugs. Of these, 629 still had unresolved symptomatology and were later referred to the Dental Medicine departments for further investigations. Only 50 subjects with periapical lesions in the premolar/molar maxillary area were included in the present study. All the periapical lesions were observed on CBCT and classified using the Periapical Status Index (PSI) and the mean maxillary sinus mucosa thicknesses (MSMT). The enrolled patients underwent surgical procedures with the excision of periapical lesions. The excised samples were submitted to the histological and immunohistochemical investigations. Results: The 50 patients presented periapical lesions of their maxillary teeth in 328 dental units. There was a higher prevalence of periapical lesions in men than in women (chi-square test). We observed a significant difference between the mean MSMT of individuals with periapical lesions compared to those without (p < 0.01). Mean MSMT was 1.23 mm for teeth without periapical lesions and 3.95 mm for teeth with periapical lesions. The histopathological study identified 50% cases with periapical granulomas, 10% cases with periapical granulomas with cystic potential, and 40% cases as periapical cysts. Immunohistochemical stainings showed that CD4+ helper and CD8+ cytotoxic T lymphocytes, along with CD20+ B lymphocytes and CD68+ macrophages, were diffusely distributed in all periapical cysts and in some periapical granulomas, but CD79α+ plasma cells characterized especially periapical granulomas. Conclusions: The current study observed a significant correlation between CBCT maxillary mucosa thickness and type of periapical lesion. Chronic inflammatory lympho-histiocytic infiltrate predominates in periapical lesions, supporting the idea that lesion progression is determined by a humoral-type (CD20+ and CD79α+ B lymphocytes) but also by a cellular-type (CD4+ and CD8+ T lymphocyte population) immune mechanism.

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EFFECTIVENESS OF SPIRULINA MOUTHWASH ON REDUCTION OF DENTAL PLAQUE AND GINGIVITIS: A CLINICAL STUDY

International Journal of Pharmacy and Pharmaceutical Sciences ◽

10.22159/ijpps.2017v9i7.18415 ◽

2017 ◽

Vol 9 (7) ◽

pp. 136

Author(s):

Radhika Maniyar ◽

Umashankar G. K.

Keyword(s):

Visual Analog Scale ◽

Dental Plaque ◽

Rank Test ◽

Analog Scale ◽

Mean Values ◽

Significant Difference ◽

Intervention Protocol ◽

The Mean ◽

The Individual

Objective: The present study evaluated the effectiveness of Spirulina mouthwash on the reduction of dental plaque and gingivitis.Methods: A single-blind clinical trial was conducted among thirty patient’s aged 18-40 y visiting dental college and hospital in Bangalore city. Mouthwash was prepared using 0.5% Spirulina. Intervention protocol consisted of instructing the patients to rinse with 10 ml of mouthwash for 1 minute twice daily for 7 d. Plaque index and Gingival index were used to assess the variables at the baseline and after the intervention. The perception of the individual subjects with regard to the use of mouthwash was assessed using 10 cm long visual analog scale (VAS). Statistical analysis was carried out using Wilcoxon signed rank test for mean pre and post plaque and gingival scores respectively. Descriptive statistics was performed for VAS questionnaireResults: The results showed a highly significant difference (p<0.001) between the mean plaque scores at the baseline (2.16±0.34) and at the follow up (1.27±0.46). The mean gingival scores at the baseline (1.86±0.38) and at the follow-up (1.05±0.43) also showed a highly significant difference (p<0.001). Regarding the Visual Analog Scale, the mean values of 5 or greater than suggested the responses to be favourable as the values were reflectedConclusion: The study showed that Spirulina mouthwash resulted in significant reduction in dental plaque and gingivitis. Also, the mouthwash was convenient to use without any adverse effects. Hence, the use of herbal mouth rinses such as Spirulina should be supported.

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Randomized Trial Comparing Self-Gripping Mesh with Polypropylene Mesh in Female Lichtenstein Hernioplasty

The American Surgeon ◽

10.1177/000313482008600229 ◽

2020 ◽

Vol 86 (2) ◽

pp. 110-115

Author(s):

Dianchen Wang ◽

Hui Zhang ◽

Ting Lei ◽

Jianmin Chen ◽

Yake Chen ◽

...

Keyword(s):

Foreign Body ◽

Visual Analog Scale ◽

Short Form ◽

Operation Time ◽

Analog Scale ◽

Lichtenstein Hernioplasty ◽

Operative Outcomes ◽

Significant Difference ◽

One Year

Several randomized trials comparing self-gripping mesh with polypropylene (PL) mesh in Lichtenstein hernioplasty revealed that the self-gripping mesh significantly reduced the operation time. In these studies, some enrolled only male patients, and in others, the proportion of women was extremely low. The aim of this research was to compare outcomes after self-gripping mesh repair with PL mesh secured with sutures in female Lichtenstein hernioplasty. Female patients with primary unilateral inguinal hernia were assigned randomly to undergo Lichtenstein hernioplasty with a self-gripping ProGrip (PG) mesh or a sutured PL mesh, followed-up at one week, one month, three months, one year, and two years. Demographics, hernia characteristics, and operative outcomes data were analyzed. Pain was assessed with a visual analog scale (0–10), and quality of life (QOL) was estimated by a 36-item short-form general survey (0–26). Forty eight patients in the PG group and 51 participants in the PL group completed the follow-up. The operation time of the PG (54.1 ± 12 minutes) group was significantly shorter than that of the PL (60.9 ± 11.3 minutes) group ( P = 0.045). At the one-month follow-up, the incidence of foreign body feeling in the PG group was significantly higher than that in the PL group ( P = 0.031), whereas no significant difference was observed in visual analog scale ≥3 and QOL. In a follow-up of three months, one year, and two years, there was no significant difference in foreign body feeling, chronic pain, QOL, and recurrence between two groups. The surgical outcomes of self-gripping mesh are comparable to those of the ordinary PL mesh with a reduced operation time in female Lichtenstein hernioplasty. Registration number: ChiCTR1800017360 ( http://www.chictr.org.cn ).

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Endoscopic Surgical Approach for Antrochoanal Polyps

American Journal of Rhinology ◽

10.2500/105065891781874866 ◽

1991 ◽

Vol 5 (6) ◽

pp. 211-214 ◽

Cited By ~ 1

Author(s):

Sujana S. Chandrasekhar ◽

Joseph B. Jacobs

Keyword(s):

Surgical Technique ◽

Maxillary Sinus ◽

Surgical Approach ◽

Antrochoanal Polyp ◽

Minimal Morbidity ◽

Sinus Mucosa

The endoscopic surgical technique for the removal of antrochoanal polyps is a safe and effective method with minimal morbidity. We present our results in 14 patients treated with this approach. The follow-up time ranged from 3 months to 3 years with an average of 2 years. All patients are symptom free with normal appearing maxillary sinus mucosa on office endoscopy. Only two patients required a Caldwell-Luc procedure. There were no complications in our series. We recommended the endoscopic surgical technique for the management of the antrochoanal polyp.

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Giant antrochoanal polyp: Case report and literature review

Medicinski pregled ◽

10.2298/mpns1412410c ◽

2014 ◽

Vol 67 (11-12) ◽

pp. 410-412 ◽

Cited By ~ 1

Author(s):

Karol Canji ◽

Slobodan Mitrovic

Keyword(s):

Case Report ◽

Maxillary Sinus ◽

Common Symptom ◽

Antrochoanal Polyp ◽

Nasal Pyramid ◽

The Right ◽

Sinus Ostium ◽

Sinus Mucosa ◽

Endotracheal Anesthesia

Introduction. Antrochoanal polyp is a benign tumor of the maxillary sinus mucosa passing through the sinus ostium into the nasal cavity. Nasal obstruction is the most common symptom in all patients. Case Report. The authors present a case of a 28-year old female who was admitted to hospital with breathing difficulty, unilateral nasal secretion, headache and deformity of the nasal pyramid. Computerized tomography examination of the nose and paranasal sinuses indicated a possibility of giant antrochoanal polyp. The antrochoanal polyp was extirpated completely using forceps, under general endotracheal anesthesia. The length of the giant polyp was 16 cm. A follow-up examination of the nose and the right maxillary sinus was performed using a rigid endoscope, but no remains of the polyp were found. Conclusion. The authors believe that this is probably the first or a very rare published case of complete extirpation of a giant antrochoanal polyp of this size.

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Comparison of Sertraline with Rifampin in the treatment of Cholestatic Pruritus: A Randomized Clinical Trial

Reviews on Recent Clinical Trials ◽

10.2174/1574887114666190328130720 ◽

2019 ◽

Vol 14 (3) ◽

pp. 217-223

Author(s):

Sara Ataei ◽

Leila Kord ◽

Amir Larki ◽

Fatemeh Yasrebifar ◽

Maryam Mehrpooya ◽

...

Keyword(s):

Clinical Trial ◽

Randomized Clinical Trial ◽

Total Bilirubin ◽

Total Bilirubin Level ◽

Intervention Strategies ◽

Primary Biliary Cholangitis ◽

Efficacy And Safety ◽

Analog Scale ◽

Significant Difference

Background: Pruritus is one of the most common and disabling symptoms of liver disease such as Primary Sclerosing Cholangitis and Primary Biliary Cholangitis. Cholestyramine, rifampin, opioid antagonists, antihistaminic agents and SSRIs are used for the management of pruritus. Due to rifampin drug interactions as well as its serious side effects such as hepatotoxicity, clinicians are endeavoruing to find a safer and a more effective substitution. Objective: The purpose of this study was to compare the efficacy and safety of sertraline with rifampin in the management of cholestatic pruritus. Methods: In a single-blinded randomized clinical trial a total of 36 patients of PSC and PBC were divided into two equal groups, one group received 100 mg/day sertraline and the other group received rifampin 300 mg/day for 4 weeks. Visual analog scale was used to record pruritus severity at baseline and 4 weeks after drug intervention, also, ALT, AST, ALP and total bilirubin of all patients were measured at three different time points. Results: Over the follow-up period, pruritus had relieved in both groups, but there was no significant differences between sertraline and rifampin in pruritus management (pvalue=0.740), also there was no significant difference between the two intervention strategies (A versus B) in total bilirubin level (pvalue=0.106). Moreover, the ALT, AST and ALP levels were found to be significantly different between the two groups (Pvalue˂0.01). Conclusion: There is no difference between sertraline and rifampin in pruritus improvement, but sertraline has less adverse effects on hepatobiliary enzyme levels, so it seems to be safer than rifampin.

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Arnica and Bromelain for Blepharoplasty-Associated Ecchymosis

The American Journal of Cosmetic Surgery ◽

10.1177/0748806817743904 ◽

2017 ◽

Vol 35 (3) ◽

pp. 130-134

Author(s):

David Seamont ◽

Ivan Vrcek ◽

Tanuj Nakra ◽

Ronald Mancini

Keyword(s):

Adverse Reactions ◽

Skin Flap ◽

Treatment Protocol ◽

Analog Scale ◽

Upper Eyelid ◽

Postoperative Course ◽

Significant Difference ◽

Lost To Follow Up ◽

The Impact

Homeopathic and naturopathic supplementation has gained increasing popularity as complementary and alternative medicine (CAM) modalities. Arnica and Bromelain are 2 commonly used supplements thought to be effective in reducing ecchymosis. This study was designed to explore the impact of combination therapy with Arnica and Bromelain on postoperative ecchymosis in patients undergoing blepharoplasty. In total, 130 patients undergoing upper eyelid blepharoplasty were enrolled. Patients with bleeding diatheses or inability to comply with cessation of anticoagulants were excluded. Aspirin and all naturopathic and homeopathic treatments were discontinued 2 weeks prior to surgery. In all, 64 patients received oral Arnica and Bromelain treatment starting 7 days prior to surgery and extending 7 days postoperatively. Sixty-six patients received no supplementation. Upper eyelid blepharoplasty was performed with skin flap excision, hemostasis with electrocautery, and closure with running 6-0 fast absorbing plain gut. Postoperative photos were taken 7 days following surgery. Photos were analyzed by 2 blinded reviewers, who graded the severity of ecchymosis using a visual analog scale. All 130 patients were seen during the postoperative course. There were no patients lost to follow-up, and there were no adverse reactions to the treatment protocol that necessitated discontinuation of Arnica and Bromelain. Average ecchymosis in the treatment arm was 5.00 compared with 4.43 in the control arm ( P = .67). At the conclusion of this study, the investigators find insufficient evidence that the combination of Arnica and Bromelain is effective at producing a statistically significant difference in ecchymosis following upper eyelid blepharoplasty.

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Relationship between Thyroglobulin and Tumor Detectabilily with Thallium-201 in Differentiated Thyroid Cancer

Nuklearmedizin ◽

10.1055/s-0038-1632238 ◽

2000 ◽

Vol 39 (01) ◽

pp. 10-15 ◽

Cited By ~ 1

Author(s):

S. P. Müller ◽

Ch. Reiners ◽

A. Bockisch ◽

Katja Brandt-Mainz

Keyword(s):

Thyroid Cancer ◽

Differentiated Thyroid Cancer ◽

Roc Analysis ◽

Tsh Suppression ◽

Significant Difference ◽

Test Specificity ◽

The Relationship ◽

Tumor Scintigraphy ◽

Tsh Stimulation

Summary Aim: Tumor scintigraphy with 201-TICI is an established diagnostic method in the follow-up of differentiated thyroid cancer. We investigated the relationship between thyroglobulin (Tg) level and tumor detectability. Subject and methods: We analyzed the scans of 122 patients (66 patients with proven tumor). The patient population was divided into groups with Tg above (N = 33) and below (N = 33) 5 ng/ml under TSH suppression or above (N = 33) and below (N = 33) 50 ng/ml under TSH stimulation. Tumor detectability was compared by ROC-analysis (True-Positive-Fraction test, specificity 90%). Results: There was no significant difference (sensitivity 75% versus 64%; p = 0.55) for patients above and below 5 ng/ml under TSH suppression and a just significant difference (sensitivity 80% versus 58%; p = 0.04) for patients above and below 50 ng/ml under TSH stimulation. In 18 patients from our sample with tumor, Tg under TSH suppression was negative, but 201-TICI-scan was able to detect tumor in 12 patients. Conclusion: Our results demonstrate only a moderate dependence of tumor detectability on Tg level, probably without significant clinical relevance. Even in patients with slight Tg elevation 201-TICI scintigraphy is justified.

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