Antibacterial prophylaxis of surgical site infections in oral surgery: not only and not always systemic antibiotics

Antibacterial prophylaxis is a set of treatment measures, including antibiotic prophylaxis, under surgeon’s responsibility. If local measures are always to be applied, antibiotic prophylaxis administration needs a careful case selection in order to avoid indiscriminate prescription. Local measures include the following: use of sterile instrumentation and special devices to prevent surgical site contamination; good surgical treatment; pre-surgical treatment of acute local infections; pre-surgical calculus removal and perioperative plaque control; post-surgical follow-up. Antibiotic prophylaxis should follow the following five basic principles: only procedures that have high risk of infection need antibiotic prophylaxis; an adequate antibiotic should be chosen; a high dose of antibiotic should be used; the time of administration should be correct; antibiotic activity should be as short as possible

Fibrolipoma of the oral cavity: treatment choice in a case with an unusual location

Fibro-lipoma has been infrequently found in the oral cavity. Clinical and histological features of an unusual case located alongside the lingual cortical of the mandible are reported. A particular surgical approach was used with an intrasulcular incision, since it allowed best access to the pathological tissue, optimal flap repositioning and a lower risk of post-surgical wound dehiscence

The window approach for extraction of tooth root fragments: a different soft tissue management

Different techniques have been proposed for the removal of the apical portion of fractured teeth. The window approach was proposed in the past to remove a tooth root fragment through a buccal bone opening at the level of fragment. In the classical approach, a marginal triangular flap is elevated, only the bone overlying the fractured apex is removed and then the apex is pushed out by an elevator toward the alveolar crest. In this technique, the bone removal is minimal, and it does not involve the marginal bone so that patient’s post-surgical discomfort is reduced, and bone resorption is less. A different kind of soft tissue management for bone exposure is proposed here with a simple linear incision at the level of the root apex without any vertical incision. This kind of incision is simple and versatile, leads to a lesser discomfort to the patient and avoids un-aesthetic scar

Minor salivary gland sialolithiasis: a clinical diagnostic challenge

Sialolithiasis is a non-neoplastic salivary gland disease that rarely affects the minor salivary glands. There are no guidelines in the literature which can suggest which is the best surgical approach to treat Minor Salivary Glands Sialolithiasis (MSGL). The present case was of a 48-year-old male patient complaining of painful swelling localized in the left back-commissural zone which was 0.5 mm in diameter, for which surgical enucleation approach was done and in that some small calcific masses ranging from 0.2 to 4 mm in diameter were found. They were surrounded by granulation tissue and associated with small pus oozing. Histopathological examination was carried out leading to a final diagnosis of MSGL

The central odontogenic fibroma: how difficult can be making a preliminary diagnosis

Central odontogenic fibroma (COF) is a rare benign odontogenic tumor derived from the dental ectomesenchymal tissues. A 16-year-old Caucasian female patient was referred by her dentist for a radiolucent asymptomatic area associated with the crown of the impacted lower right third molar. A preliminary diagnosis of a follicular cyst was supposed. The lesion was surgically removed under general anesthesia together with the impacted tooth. The microscopic diagnosis of the excised tissue revealed an odontogenic fibroma. No clinical or radiographic signs of recurrence were found five years after surgical excision. Despite the various differential diagnoses of homogeneous unilocular and well delimited radiolucencies of the jaws, enucleation with peripheral curettage, without any other pre-operative imaging exams or biopsies, can be considered as the treatment of choice

Oral health literacy: how much Italian people know about the dental hygienist

People with poor OHL have the highest level of oral diseases and the worst oral treatment results. The main aim of the present study was to investigate the degree of knowledge of the role of the dental hygienist in patients who go to a public dental facility for the first time. A semi-structured questionnaire was administered to the patients with the “face-to-face” mode during a 12-month period. The principal component analysis, the general linear model and the chi-square test were used for the statistical analysis. A total number of 900 questionnaires were completed. Sixty-seven per cent of patients know that a specific degree is needed to practice dentistry and 93.1% of them know that a specific educational qualification is required to practice the dental hygienist profession. Sixty-three per cent of the subjects were aware of dental hygienist’s activities. There is no patient preference of gender as far as both dentist (84.11%) and dental hygienist (85.11%) are concerned. Seventy-five per cent of patients claimed to know what “dental hygiene” means and 65% of them believed that a good level of oral hygiene was important for oral disease prevention. Both qualification and marital status of patients are significantly associated with the patient’s level of knowledge of the dental hygienist profession. Patients with “High” scholastic qualifications showed significantly higher scores than those with “Low” qualifications. Married patients have less knowledge than widows/widowers, while divorced patients have greater knowledge than widows/widowers. Patients’ educational qualification itself only partially justifies the apparent high level of knowledge of patients about the dental hygienist’s role

A Case of Inferior Alveolar Nerve Entrapment in the Roots of a Partially Erupted Mandibular Third Molar

[No abstract available