"1: J Oral Maxillofac Surg. 2008 Dec;66(12):2482-7."

Impact of symptomatic pericoronitis on health-related quality of life.

McNutt M, Partrick M, Shugars DA, Phillips C, White RP Jr.

Department of Oral and Maxillofacial Surgery, School of Dentistry, University of 
North Carolina, Chapel Hill, NC 27599-7450, USA.

PURPOSE: To assess the impact of symptomatic pericoronitis on health-related
quality of life (HRQOL). PATIENTS AND METHODS: Healthy subjects with symptomatic 
pericoronitis were enrolled in an institutional review board-approved study. Each
was given a third molar condition-specific HRQOL instrument to assess the impact 
of pericoronitis in the preceding week. Lifestyle and oral-function outcomes were
"assessed using a 5-point Likert-type scale, with anchors of ""no trouble"" (1) and "
lots of trouble (5). Pain outcomes were assessed using a 7-point scale anchored
"by ""no pain"" (1) and ""worst pain imaginable"" (7). Verbal descriptors for sensory "
perception and unpleasantness of pain were recorded on Gracely scales. The impact
of symptomatic pericoronitis on overall health and well-being in the previous 3
months was recorded using the Oral Health Impact Profile (OHIP-14). RESULTS: The 
median age of 57 subjects was 23.1 years (interquartile range [IQR], 21.2 to 25.8
years). Forty-nine percent were female, 56% were Caucasian, 21% were Asian, and
16% were African American. Ninety-one percent had at least some college
experience. Twenty-eight percent of subjects described their worst pain in the
week before enrollment as severe (5-7/7), 40% as moderate (3-4/7), and 32% as
none/little (1-2/7). Average pain in the previous week was described as severe
(5-7/7) for 4% of subjects, as moderate (3-4/7) for 40%, and as none/little
(1-2/7) for 56%. On the Gracely scales, 9% of subjects reported the sensory
"intensity of pain in the past week as ""intense,"" ""very intense,"" or ""extremely"
"intense."" Subjects reported ""quite a bit/lots"" of difficulty (4-5/5) with oral"
"function (23% with eating, 19% with chewing, and 6% with opening) and ""quite a"
"bit/lots"" of difficulty (4-5/5) with lifestyle (sleeping, social life, and"
sports/hobby, all at 2%). The median OHIP-14 Severity score was 11/56 (IQR,
5-17). The most frequently reported OHIP-14 items in the 3 months before
enrollment were in the pain dimensions. The median Severity score for pain items 
was 4/8 (IQR, 2-6). CONCLUSION: Symptomatic pericoronitis can have adverse
outcomes, compromising the quality of life and inflicting pain.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 19022127 [PubMed - indexed for MEDLINE]

"2: Anesth Analg. 2008 Dec;107(6):2048-55."

Single dose analgesic efficacy of tapentadol in postsurgical dental pain: the
results of a randomized, double-blind, placebo-controlled study.

Kleinert R, Lange C, Steup A, Black P, Goldberg J, Desjardins P.

Grunenthal GmbH, Zieglerstr. 6 52078, Aachen, Germany.

BACKGROUND: Tapentadol is a novel, centrally acting analgesic with two modes of
action, combining mu-opioid agonism and norepinephrine reuptake inhibition in a
single molecule. We compared the efficacy and tolerability of tapentadol and a
standard dose of morphine with placebo in a model of moderate-to-severe
postoperative dental pain. METHODS: Patients undergoing mandibular third molar
extraction and experiencing moderate-to-severe pain postsurgery were randomized
to receive single, oral doses of tapentadol HCl (25, 50, 75, 100, or 200 mg),
"morphine sulfate (60 mg), ibuprofen (400 mg; used to establish model"
sensitivity), or placebo. Mean total pain relief over 8 h (TOTPAR-8) was the
primary end point. Secondary end points included mean total pain relief over 4 h 
(TOTPAR-4) and onset of analgesia. Pairwise comparisons of study drug to placebo 
were assessed using the Fisher least significant difference test. Adverse events 
were recorded. RESULTS: Four hundred patients were randomized to treatment and
completed the study. Compared with placebo, mean TOTPAR-8 was significantly
greater for tapentadol HCl 50 mg (P = 0.041), 75 mg (P = 0.001), 100 mg (P <
"0.001), and 200 mg (P < 0.001); morphine sulfate 60 mg (P < 0.001); and ibuprofen"
400 mg (P < 0.001) in a nonparametric analysis of the primary end point. The
significantly higher TOTPAR-8 score for ibuprofen compared with placebo
established the sensitivity of the model. Mean TOTPAR-4 was higher and onset of
action appeared more rapid for tapentadol HCl 200 mg than morphine sulfate 60 mg.
Pain relief scores with morphine sulfate 60 mg were between those of tapentadol
HCl 100 and 200 mg. The incidence of nausea and vomiting appeared to be lower
with all doses of tapentadol HCl compared with morphine sulfate 60 mg, but was
not statistically significant. CONCLUSION: Single oral doses of tapentadol 75 mg 
or higher effectively reduced moderate-to-severe postoperative dental pain in a
dose-related fashion and were well-tolerated relative to morphine. These data
suggest that tapentadol is a highly effective, centrally acting analgesic with a 
favorable side effect profile and rapid onset of action.

Publication Types: 
    Clinical Trial, Phase II
    Randomized Controlled Trial

PMID: 19020157 [PubMed - indexed for MEDLINE]

"3: Anesth Analg. 2008 Dec;107(6):2018-24."

The analgesic efficacy and safety of a novel intranasal morphine formulation
(morphine plus chitosan), immediate release oral morphine, intravenous morphine, 
and placebo in a postsurgical dental pain model.

Christensen KS, Cohen AE, Mermelstein FH, Hamilton DA, McNicol E, Babul N, Carr
DB.

Jean Brown Associates, Salt Lake City, Utah, USA.

BACKGROUND: Opioids are standard treatment for postoperative pain. In this study,
we compared the safety and efficacy of intranasal (i.n.) morphine to i.v. and
oral morphine and placebo. METHODS: Two-hundred-twenty-five patients with
moderate-to-severe pain after third molar extraction were randomized to receive a
single dose of i.n. morphine 7.5 mg or 15 mg, i.v. morphine 7.5 mg, oral morphine
60 mg or placebo. Pain intensity was assessed using visual analog and categorical
scales, and pain relief using a categorical scale. Outcomes included total pain
relief, pain intensity difference, summed pain intensity difference, time to
analgesic onset, time to requesting rescue medication, and patients' global
evaluation of their treatment. Safety assessments included adverse event
recording and nasal examinations. RESULTS: Across the various efficacy outcomes, 
both i.n. morphine doses were statistically similar to the positive comparators
(i.v. and oral morphine), and all four morphine treatments were statistically
superior to placebo. Overall, i.n. morphine 15 mg presented an efficacy profile
"similar to i.v. morphine 7.5 mg; both treatments demonstrated rapid onset of"
efficacy, generally persistent throughout the 6-h assessment period. The lower
dose of i.n. morphine, 7.5 mg, was statistically similar to the other active
treatments at 2 h and 6 h and similar to placebo at 4 h. Study medications were
generally well tolerated, with no withdrawals due to adverse events or other
safety concerns, and no serious adverse events reported. The most frequently
reported adverse events were typical systemic opioid effects. CONCLUSIONS: I.n.
morphine offers a noninvasive alternative to i.v. morphine for postoperative
analgesia.

Publication Types: 
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 19020153 [PubMed - indexed for MEDLINE]

"4: J Oral Maxillofac Surg. 2008 Mar;66(3):453-61."

Hemodynamic changes during the surgical removal of lower third molars.

Alemany-Martínez A, Valmaseda-Castellón E, Berini-Aytés L, Gay-Escoda C.

School of Dentistry, University of Barcelona, Barcelona, Spain.

PURPOSE: This study was conducted to determine the hemodynamic changes in healthy
patients during the surgical removal of lower third molars, and to evaluate
whether these variations are attributable to patient anxiety and pain experienced
during the surgical procedure. PATIENTS AND METHODS: A prospective study was made
of 80 normotensive individuals (40 females and 40 males, mean age, 27 years
[range, 18 to 67 years]) seen in the Service of Oral Surgery in the context of
the Master's Degree Program in Oral Surgery and Implantology, School of
Dentistry, University of Barcelona, for surgical extraction of the lower third
molars. Local anesthesia comprised 4% articaine with vasoconstrictor (adrenalin
1:100.000). The following parameters were monitored in each of the surgical
interventions: systolic blood pressure (SBP), diastolic blood pressure (DBP),
heart rate (HR), and oxygen saturation (SaO(2)). Finally, tests of patient
anxiety (Corah's Dental Anxiety Scale and Kleinknecht's Dental Fear Scale) were
carried out, and the degree of pain experienced during the surgical procedure was
assessed by means of a visual analog scale. RESULTS: The females showed higher
levels of anxiety. The most anxious patients had the lowest BP values and the
highest HR, although the differences did not reach statistical significance. The 
variations in BP and HR during surgical extraction of the molars were within
"normal limits. In the case of BP, no significant changes were recorded; the"
highest mean SBP and DBP values were observed at the time of ostectomy and/or
tooth sectioning. The lowest HR values were recorded at baseline, before the
start of the surgical procedure, whereas the highest values were obtained during 
incision and flap raising. The SaO(2) values showed no significant changes and
were lower at the start of the surgical procedure. CONCLUSIONS: Most of the
cardiovascular changes induced by the surgical extraction of molars were within
normal ranges, considering the anxiety and stress induced by surgery. We consider
it essential to avoid pain and minimize patient anxiety to ensure safe clinical
practice.

PMID: 18280377 [PubMed - indexed for MEDLINE]

"5: Rev Stomatol Chir Maxillofac. 2008 Apr;109(2):91-5; discussion 95-7. Epub 2008"
Jan 16.

[Third molar surgery under general anesthesia: a review of 180 patients]

[Article in French]

Trost O, Kadlub N, Robe N, Lépine J, Rombi H, Noirot-Letourneau MT, Trouilloud P,
Malka G.

Service de chirurgie maxillofaciale et stomatologie, CHU de Dijon, 3, rue du
Faubourg-Raines, B.P. 1519, 21033 Dijon, France. otrost@caramail.com

BACKGROUND: Third molar surgery is an important part of the activity in a
maxillofacial surgery department. This common activity is often under-evaluated
by patients who forget its surgical aspect. The aim of this study was to evaluate
our practice, and especially complications, with special consideration given to
medicolegal aspects. MATERIALS AND METHODS: All the patients operated between
September 2004 and July 2006 were enrolled in a retrospective study. This
population is described, with the indications, follow-up, and complications.
RESULTS: One hundred and eighty patients were reviewed (sex-ratio 1, mean age 27 
years). The most frequent indications were impaction and pain. The mean duration 
of hospitalization was 1.7 days and temporary disability, one week. Local
"infection occurred in 8%; there was neurological complication in 2% for the"
inferior alveolar nerve, and 1% for the lingual nerve. These were all transient
cases. DISCUSSION: Third molar surgery is an important and profitable part of the
activity in a maxillofacial surgery department. Standardized information is
necessary even if the rate of complications remains low.

Publication Types: 
    English Abstract

PMID: 18201737 [PubMed - indexed for MEDLINE]

"6: J Oral Maxillofac Surg. 2008 Jan;66(1):167-9."

Malposed teeth in the pterygomandibular space: report of 2 cases.

Kupferman SB, Schwartz HC.

Section of Oral and Maxillofacial Surgery, University of California, Los Angeles,
CA 90095, USA. stevenkupferman@post.harvard.edu
<stevenkupferman@post.harvard.edu>

Publication Types: 
    Case Reports

PMID: 18083435 [PubMed - indexed for MEDLINE]

"7: J Oral Maxillofac Surg. 2007 Dec;65(12):2568-74."

Jaw cysts with sebaceous differentiation: report of 5 cases and a review of the
literature.

Chi AC, Neville BW, McDonald TA, Trayham RT, Byram J, Peacock EH Jr.

Division of Oral Pathology, Medical University of South Carolina, Charleston, SC,
USA.

Publication Types: 
    Case Reports
    Review

PMID: 18022486 [PubMed - indexed for MEDLINE]

"8: J Oral Maxillofac Surg. 2007 Dec;65(12):2559-62."

Squamous cell carcinoma radiographically resembling a dentigerous cyst: report of
a case.

Elo JA, Slater LJ, Herford AS, Tanaka WK, King BJ, Moretta CM.

Department of Oral and Maxillofacial Surgery, Loma Linda University Medical
Center, Loma Linda, CA, USA.

Publication Types: 
    Case Reports

PMID: 18022484 [PubMed - indexed for MEDLINE]

"9: Int J Oral Maxillofac Surg. 2007 Dec;36(12):1177-82. Epub 2007 Nov 19."

A blinded randomized controlled trial comparing lignocaine and placebo
administration to the palate for removal of maxillary third molars.

Badcock ME, Gordon I, McCullough MJ.

School of Dental Science, University of Melbourne, 720 Swanston Street,
"Parkville, Vic. 3010, Australia; Private Practice, Melbourne, Australia."
markbadcock@oralsurgery.net.au <markbadcock@oralsurgery.net.au>

Routine use of a palatal injection for the removal of maxillary third molars has 
never been validated. The purpose of this blinded, randomized, controlled trial
was to assess the requirement of a separate palatal injection for the extraction 
of maxillary third molars. Fifty-one patients requiring the removal of bilateral 
maxillary third molars were enrolled. Each patient acting as their own control
received buccal infiltrations of lignocaine bilaterally, then 0.2 mL of
lignocaine without vasoconstrictor was administered to one side of the palate and
the same amount of normal saline administered to the other side. Sides were
randomized as to the active ingredient and both the patient and operator were
blinded. All extractions were performed by a single operator using a consistent
technique and no additional sedative or anaesthetic agents were utilized. Data
relating to the pain of the extractions and of the palatal injection were
obtained on a Visual Analogue Scale (VAS). Verbal Response Scale (VRS) data were 
obtained additionally for a subset of 21 patients. Statistical analysis confirmed
clinical equivalence between saline and lignocaine to the palate (95% CI -1.7 to 
6.2mm, equivalence range -6.75 to 6.75 mm). No patients requested additional
lignocaine to the palate in order to ensure comfortable extraction. This study
provides evidence that the poorly tolerated palatal injection of local
anaesthetic for the removal of maxillary third molars may not be required.

Publication Types: 
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 18022350 [PubMed - indexed for MEDLINE]

"10: Quintessence Int. 2007 Sep;38(8):e497-505."

Unerupted mandibular third molars: symptoms, associated pathologies, and
indications for removal in a Turkish population.

Doğan N, Orhan K, Günaydin Y, Köymen R, Okçu K, Uçok O.

Department of Oral and Maxillofacial Surgery, Gülhane Military Medical Academy,
Ankara, Turkey.

OBJECTIVES: To analyze the occurrence of symptoms of unerupted mandibular third
molars, to investigate associated pathologies, and to determine indications for
removal of unerupted mandibular third molars in a Turkish population. METHOD AND 
MATERIALS: A retrospective study was performed by reviewing 832 patients referred
to Gulhane Military Medical Academy Dentistry Center for evaluation of their
mandibular third molars. The patients were clinically examined, and unerupted and
partially erupted mandibular third molars were determined from radiographs. The
symptoms and pathologies associated with these teeth were analyzed. The
indications for removal were classified into 10 groups. RESULTS: Two-thirds of
the patients were between 20 and 29 years of age. Of the 832 unerupted mandibular
third molars found, 557 (66.9%) teeth were partially erupted and 275 (33.1%) were
completely unerupted. A total of 521 (62.6%) of all unerupted third molars had no
symptoms, while 311 (37.4%) were associated with symptoms. The most frequent
complaints of the patients were pain and swelling. Pericoronitis was observed as 
the most frequent pathology, in 142 patients. Of 832 unerupted mandibular third
molars, 582 (69.9%) had complete root formation, 177 (21.2%) had two-thirds root 
formation, and 73 (8.9%) had one-third root formation. CONCLUSION: Patients
between 20 and 29 years of age had the highest prevalence of unerupted mandibular
third molars (69.3%). However, this figure decreased with increasing age.
Partially erupted teeth (n = 228) caused the occurrence of symptoms more than
completely erupted teeth (n = 83) in a Turkish population.

PMID: 17823674 [PubMed - indexed for MEDLINE]

"11: J Oral Maxillofac Surg. 2007 Mar;65(3):560-1."

A case report: toothache caused by epidermoid cyst manifested in cerebellopontine
angle.

Uehara M, Tobita T, Inokuchi T.

Division of Oral and Maxillofacial Surgical Reconstruction and Functional
Restoration, Department of Developmental and Reconstructive Medicine, Graduate
School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
uehara@net.nagasaki-u.ac.jp

Publication Types: 
    Case Reports

PMID: 17307609 [PubMed - indexed for MEDLINE]

"12: Int Endod J. 2006 Sep;39(9):724-9."

Referred pain: a confusing case of differential diagnosis between two teeth
presenting with endo-perio problems.

Koyess E, Fares M.

Department of Endodontics, Dental School at the Lebanese University, Beirut,
Lebanon. bestendo@msn.com

AIM: A case of a patient with a confusing referred pain is reported that
emphasizes the importance of providing a differential diagnosis in order to avoid
inappropriate treatment. SUMMARY: This article describes the management of a
patient presenting with a combined endo-perio problem that was apparently treated
adequately. After a short period of time, the reappearance of mild pain was
misdiagnosed. The situation was more complicated when multiple diagnostic
procedures were attempted and inadequate therapies were tried consecutively. When
the true differential diagnosis was established and appropriate treatment
provided, the symptoms disappeared and normal function returned. Diagnosis of
teeth with necrotic pulps may be difficult to establish with possible reasons
including inconclusive and poorly localized symptoms and signs. The situation can
be further complicated if other teeth developing endodontic or combined
endo-perio problems occur simultaneously as this may lead to misdiagnosis and
treatment of the wrong tooth.

Publication Types: 
    Case Reports

PMID: 16916362 [PubMed - indexed for MEDLINE]

"13: J Am Dent Assoc. 2006 Apr;137(4):480-7."

The use of COX-2 inhibitors for acute dental pain: A second look.

Huber MA, Terezhalmy GT.

Division of Oral Medicine, Department of Dental Diagnostic Science, The
University of Texas Health Science Center at San Antonio Dental School, San
Antonio, Texas 78229-3900, USA. Huberm@uthscsa.edu

BACKGROUND: On the basis of their perceived better safety profile compared with
other analgesic agents, cyclo-oxygenase-2 (COX-2) inhibitors have been prescribed
frequently as first-line agents to treat acute dental pain. However, recently
identified cardiovascular adverse reactions associated with these drugs mandate a
reappraisal of their use in dental practice. TYPES OF STUDIES REVIEWED. The
authors reviewed 18 clinical studies that evaluated the efficacy of a COX-2
inhibitor for the treatment of acute dental pain. All of the studies used the
widely established third-molar surgical extraction model to induce postsurgical
inflammatory based pain, and all were randomized, double-blinded and
placebo-controlled. However, numerous vagaries in overall study design made
direct comparisons difficult. RESULTS: None of the studies established any of the
COX-2 inhibitors as clearly better than ibuprofen, the current gold standard for 
the treatment of surgically induced dental pain. However, in single-dosing
scenarios, the COX-2 inhibitor often demonstrated a longer duration of action
compared with ibuprofen. CLINCAL IMPLICATIONS: The evidence to date fails to
demonstrate any therapeutic advantage to using a COX-2 inhibitor to treat acute
dental pain compared with ibuprofen. In the rare event that a COX-2 inhibitor may
be appropriate, the clinician must inform the patient of the potential risks, and
the drug should be used for the shortest possible time.

Publication Types: 
    Review

PMID: 16637477 [PubMed - indexed for MEDLINE]

"14: Community Dent Oral Epidemiol. 2006 Feb;34(1):53-62."

Assessing oral health-related quality of life in general dental practice in
Scotland: validation of the OHIP-14.

Fernandes MJ, Ruta DA, Ogden GR, Pitts NB, Ogston SA.

Section of Public Health, Health Informatics Centre, University of Dundee, UK.
m.j.fernandes@dundee.ac.uk

OBJECTIVES: To validate the Oral Health Impact Profile (OHIP)-14 in a sample of
patients attending general dental practice. METHODS: Patients with pathology-free
impacted wisdom teeth were recruited from six general dental practices in
Tayside, Scotland, and followed for a year to assess the development of problems 
related to impaction. The OHIP-14 was completed at baseline and at 1-year
follow-up, and analysed using three different scoring methods: a summary score, a
weighted and standardized score and the total number of problems reported.
Instrument reliability was measured by assessing internal consistency and
test-retest reliability. Construct validity was assessed using a number of
variables. Linear regression was then used to model the relationship between
OHIP-14 and all significantly correlated variables. Responsiveness was measured
using the standardized response mean (SRM). Adjusted R(2)s and SRMs were
calculated for each of the three scoring methods. Estimates for the differences
between adjusted R(2)s and the differences between SRMs were obtained with 95%
confidence intervals. RESULTS: A total of 278 and 169 patients completed the
questionnaire at baseline and follow-up, respectively. Reliability - Cronbach's
alpha coefficients ranged from 0.30 to 0.75. Alpha coefficients for all 14 items 
were 0.88 and 0.87 for baseline and follow-up, respectively. Test-retest
coefficients ranged from 0.72 to 0.78. Validity - OHIP-14 scores were
significantly correlated with number of teeth, education, main activity, the use 
of mouthwash, frequency of seeing a dentist, the reason for the last dental
appointment, smoking, alcohol intake, pain and symptoms. Adjusted R(2)s ranged
from 0.123 to 0.202 and there were no statistically significant differences
between those for the three different scoring methods. Responsiveness - The SRMs 
ranged from 0.37 to 0.56 and there was a statistically significant difference
between the summary scores method and the total number of problems method for
symptomatic patients. CONCLUSIONS: The OHIP-14 is a valid and reliable measure of
oral health-related quality of life in general dental practice and is responsive 
to third molar clinical change. The summary score method demonstrated performance
as good as, or better than, the other methods studied.

Publication Types: 
    Multicenter Study
    Research Support, Non-U.S. Gov't

PMID: 16423032 [PubMed - indexed for MEDLINE]

"15: J Oral Maxillofac Surg. 2004 Sep;62(9):1118-24."

Comment in:
"    J Evid Based Dent Pract. 2005 Sep;5(3):158-9."

The impact of third molar symptoms, pain, and swelling on oral health-related
quality of life.

Slade GD, Foy SP, Shugars DA, Phillips C, White RP Jr.

Australian Research Centre for Population Oral Health, Dental School, University 
of Adelaide, Australia.

"PURPOSE: This study was designed to assess the impact of ""pain and swelling"""
associated with third molars on patients' quality of life before surgery.
PATIENTS AND METHODS: The data for these analyses were obtained from a larger
ongoing study designed to examine the surgical and medical management of problems
associated with third molars. Data from 480 patients with 4 third molars
scheduled for removal were used in the analysis. Questionnaires administered
presurgery assessed patients' medical and dental history, their reasons for
seeking third molar removal, and sociodemographic characteristics. Adverse
impacts on oral health-related quality of life were measured using the 14-item
Oral Health Impact Profile (OHIP) questionnaire. The primary outcome variable was
the percentage of people reporting 1 or more of the 12 non-pain-specific OHIP
"items ""fairly often"" or ""very often"" during the 3 months before enrollment."
RESULTS: One third (178 of 480) of patients said they were seeking third molar
surgery because of current or previous symptoms of pain/swelling, and 17%
reported 1 or more of the 12 non-pain-specific OHIP items. In the multivariate
logistic regression model, the odds of one or more impacts was greater for people
"who presented because of symptoms (odds ratio [OR], 2.9; 95% confidence interval "
"[CI], 1.7 to 4.8), who were aged 25 years or more (OR, 1.9; 95% CI, 1.1-3.3), and"
who had a self-reported history of tooth loss due to pathology or trauma (OR,
"2.9; 95% CI, 1.9 to 5.5). CONCLUSIONS: Adverse impacts on quality of life"
occurred for 1 in 8 patients seeking third molar surgery, and the odds increased 
3-fold for patients who had experienced pain/swelling compared with those who
were asymptomatic.

Publication Types: 
    Clinical Trial
    Research Support, Non-U.S. Gov't

PMID: 15346364 [PubMed - indexed for MEDLINE]

"16: Shanghai Kou Qiang Yi Xue. 2004 Apr;13(2):147-9."

[Comparison of the effects of three analgesic therapies on odontalgia caused by
pulpitis in molars]

[Article in Chinese]

Wang XP, Wang ZG, Wang XT, Ye R.

Department of Emergency, School of Stomatology, Peking University, Beijing
100081, China. jamesluofeng@yahoo.com

PURPOSE: To compare the effects of analgesic therapies on odontalgia caused by
pulpitis in molars by three different methods. METHODS: 173 molars were diagnosed
as irreversible pulpitis, and randomized block designed in three groups. Under
block or local anesthesia: 46 cases of the first group, leaving teeth on open
drainage, after 1 day, sealing devitalized material (arsenic), arranged next
appointment 2 weeks later. 52 molars of the second group, enlarging exposure
site, drainage several minutes only, sealed devitalized material, re-examined 2
weeks later. 75 cases of the third group, removing roof of pulp chamber,
undergoing pulpectomy directly, re-examined 1 week later. Adopting VAS(vital
analogue scale) to analyze the pulp receptivity of three different methods and to
evaluate the analgesic effects by complete analgesia, effective analgesia, and no
response. The data was analysed using chi-square test. RESULTS: The rate of
complete analgesia was 50.0%, 63.46% and 76.0%, respectively. There was a
significant difference in complete analgesia among the three methods. The
analgesic effect of the third group (pulpectomy) was significantly higher than
that of the first group (P<0.01).Pulpectomy group had impossibility of adverse
effects caused by using devitalizing material (arsenic). CONCLUSIONS: It is
worthy to adopt pulpectomy extensively to relieve the pain of molars caused by
pulpitis clinically. The course of treatment of the third group was significantly
shorter than other groups, and the simultaneous symptoms occurred rarely.

Publication Types: 
    Clinical Trial
    Comparative Study
    English Abstract
    Randomized Controlled Trial

PMID: 15133565 [PubMed - indexed for MEDLINE]

"17: Dent Today. 2001 Apr;20(4):144-7."

Why patients really visit the dentist.

Kushner R.

PMID: 12528217 [PubMed - indexed for MEDLINE]

"18: Clin Pharmacol Ther. 2001 Jul;70(1):66-73."

Analgesic effects of peripherally administered opioids in clinical models of
acute and chronic inflammation.

Dionne RA, Lepinski AM, Gordon SM, Jaber L, Brahim JS, Hargreaves KM.

National Institute of Dental and Craniofacial Research, National Institutes of
Health, Bethesda, MD, USA. rdionne@dir.nidcr.nih.gov

A series of double-blind, placebo-controlled clinical trials demonstrated that
low doses of morphine (0.4, 1.2, and 3.6 mg) administered into the
intraligamentary space of a chronically inflamed hyperalgesic tooth produced a
dose-related naloxone-reversible analgesia. This analgesic effect is mediated by 
a local mechanism in the inflamed tissue, because subcutaneous administration of 
a 1.2 mg dose of morphine failed to elicit an analgesic response. In contrast,
submucosal administration of 1.2 mg morphine or 50 microg fentanyl to the site of
extraction of an impacted third molar after the onset of acute pain failed to
elicit an analgesic response despite demonstration of a sensitive bioassay. These
data indicate that peripheral opioid analgesia can be evoked in a model of
chronic, but not acute, inflammatory pain, suggesting a temporal dependent
mechanism needed for the expression of peripheral opiate analgesia during
inflammation in humans.

Publication Types: 
    Clinical Trial
    Multicenter Study
    Randomized Controlled Trial

PMID: 11452246 [PubMed - indexed for MEDLINE]

"19: Int J Oral Maxillofac Surg. 2001 Feb;30(1):54-7."

Radiographic follow-up of impacted third molars from age 20 to 32 years.

Ventä I, Turtola L, Ylipaavalniemi P.

Department of Oral Medicine, University of Helsinki, Finland.
irja.venta@helsinki.fi

Nineteen patients (13 male, six female) with 34 impacted third molars, 21 in the 
mandible and 13 in the maxilla were radiographically followed from age 20 to 32. 
All were examined clinically and panoramic radiographs were taken at baseline and
at the end of the study. Radiographic analysis included resorption of teeth,
enlargement of the follicle, development of the root, change in inclination of
the third molar, state of impaction, relative depth of the third molar in bone
and relation to the ramus of the mandible and to the second molar tooth. In the
mandible, the mean change in inclination was 19 degrees and the percentage of
teeth with changed angulation was 76%. In the maxilla, only 23% of the teeth
changed their inclination. The state of impaction (soft tissue, partially in
bone, completely in bone) had changed for 44% of the teeth. According to the
questionnaire, no pain or symptoms in the region of the third molars were
reported by 74% of the students during the 12-year period. It is concluded that
considerable radiographic changes, without notable symptoms, may occur involving 
inclination of the tooth and state of impaction in impacted third molars after
the usual age of eruption.

PMID: 11289622 [PubMed - indexed for MEDLINE]

"20: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000 Sep;90(3):310-6."

Familial hypophosphatemic vitamin D-resistant rickets: dental findings and
histologic study of teeth.

Murayama T, Iwatsubo R, Akiyama S, Amano A, Morisaki I.

Division of Oral and Maxillofacial Surgery, Kyoto First Red Cross Hospital,
Osaka, Japan. morisaki@dent.osaka-u.ac.jp

A case of familial hypophosphatemic vitamin D-resistant rickets or X-linked
hypophosphatemia (XLH) accompanied by specific systemic and dental findings is
reported. A 15-year-old boy with XLH visited our facility complaining of a
toothache in the left lower canine region. Two other family members of the
patient, his younger sister and their mother, also had XLH, whereas the other 2
members, his younger brother and father, are healthy. Those with XLH show
systemic signs of the disease, such as growth retardation, limb deformity, and
"spinal curvature disorders; however, these symptoms are more severe in the"
patient than in the others. The patient had multiple periodontal abscesses, but
no evidence of dental caries, trauma, or periodontal disease on the corresponding
teeth at the time of his oral examination. A radiographic examination showed root
dysplasia and enlarged pulp chambers.A histologic examination of an extracted
third molar showed marked globular dentin and an increased predentin width. The
abscess was thought to be caused by pulpal infection, which came from bacterial
invasion through enamel cracks and dentinal microcleavage of the teeth. The
treatments provided in this case are discussed.

Publication Types: 
    Case Reports

PMID: 10982952 [PubMed - indexed for MEDLINE]

"21: Br Dent J. 1999 Apr 24;186(8):369."

Microwave molars.

Budden P.

Publication Types: 
    Letter

PMID: 10365456 [PubMed - indexed for MEDLINE]

"22: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999 Mar;87(3):305-10."

Symptoms of unerupted mandibular third molars.

Punwutikorn J, Waikakul A, Ochareon P.

Department of Surgery, Faculty of Dentistry, Mahidol University, Bangkok,
Thailand.

OBJECTIVE: The purpose of this study was to analyze the occurrence of symptoms in
patients with unerupted mandibular third molars and to investigate the associated
pathoses. STUDY DESIGN: Through a review of clinical records and periapical
radiographs of completely unerupted and partially erupted mandibular third
molars, a retrospective study was carried out. For each axial inclination,
symptoms and pathoses associated with these teeth were analyzed. Statistical
differences were tested by chi square analysis. RESULTS: Most of the patients
were between 16 and 30 years of age. In 83% of cases, the mandibular third molars
"were partially erupted; in the other 17% of cases, the mandibular third molars"
were completely unerupted. Pain was the most frequent symptom in both groups.
Pericoronitis was found mostly in third molar teeth with vertical and distal
inclinations (P< .05), whereas caries was found mainly in mesially tipped third
molars (P < .05). CONCLUSIONS: Most of the patients were in the third decade of
life. Partially erupted mandibular third molars had more symptoms than completely
unerupted teeth. Pain and pericoronitis were the most common problems in patients
with unerupted third molars.

PMID: 10102590 [PubMed - indexed for MEDLINE]

"23: Aust Dent J. 1998 Oct;43(5):328-30."

Comment in:
"    Aust Dent J. 1998 Dec;43(6):436."

Dens evaginatus on a wisdom tooth: a diagnostic dilemma. Case report.

Ngeow WC, Chai WL.

Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of
Malaya, Kuala Lumpur, Malaysia.

Pericoronitis is the most common odontogenic problem associated with the wisdom
tooth in young men and women. Patients may present with problems associated with 
infection, swelling and pain. However, other associated pathology such as caries,
periodontal disease and referred pain from the temporomandibular joint must be
investigated when treating pain from the wisdom tooth. The authors wish to
present a case in which the pain from a wisdom tooth was due to a fractured dens 
evaginatus. The importance of this dental anomaly should not be overlooked.

Publication Types: 
    Case Reports

PMID: 9848984 [PubMed - indexed for MEDLINE]

"24: Lakartidningen. 1998 May 13;95(20):2320-5."

[Neurologist, otolaryngologist...? Which specialist should treat facial pain?]

[Article in Swedish]

Köling A.

Oron-, näs-och halskliniken, Akademiska sjukhuset, Uppsalsa.

Pain is a major public health problem. The management of orofacial pain may be a 
difficult challenge to the medical and dental professions. Ideally, severe cases 
of this type of pain should be treated by a team drawn from several disciplines
such as neurology, otolaryngology, dentistry and psychiatry. Trigeminal neuralgia
patients develop brief, very severe unilateral pain, usually radiating from the
upper or lower jaw toward the ear, and confined to the distribution of the
trigeminal nerve. The pain may be triggered by chewing, shaving or exposure to
cold wind. Most patients respond to carbamazepine, with phenytoin or baclofen as 
an alternative. Intractable pain may require surgical treatment. Horton's
syndrome (cluster headache) is always unilateral and is often associated with
unilateral lacrimation and rhinorrhoea. The pain is extreme, and its typical
localisation the eye, forehead, temple, jaws, or teeth. Treatment with ergotamine
and sumatriptan has been used with some success, calcium blockers (e.g.,
verapamil) being used as prophylaxis. Atypical facial pain is a continuous ache
with intermittent episodes, localised to non-muscular, non-joint facial areas.
The pain may be unilateral or bilateral, and may persist for many years.
Typically, these patients consult a variety of specialists, such as dentists and 
otolaryngologists. Surgical procedures such as tooth extraction or sinus surgery,
even if skillfully executed, exacerbate the condition, are are thus
contraindicated. If the patient does not respond to reassurance, antidepressants 
may be tried. In sinusitis, the pain location is dependent upon which paranasal
sinus is affected. Routine diagnostic nasal endoscopy and coronal plane computed 
tomography enable subtle pathological changes that are related to chronic pain to
be identified. If medical treatment fails to afford relief, surgery should be
considered. Pain, limited range of jaw motion, and joint noises are the common
characteristics of temporomandibular disorders. Treatment usually consists of
non-surgical means such as splints, occlusal equilibration, and non-steroidal
anti-inflammatory drugs. Surgical treatment is indicated in a few carefully
selected cases. Most dental pain is attributable to caries or periodontal
disease. When pus is present, drainage affords excellent pain relief. Acute
pericoronitis involving mandibular third molars responds to irrigation, removal
of maxillary third molar trauma, and--in cases of serious
infection--antimicrobial therapy. Early recognition of a case of chronic pain
improves the chances of successful management, and avoids frustration and
disillusion both to patient and doctor.

Publication Types: 
    English Abstract
    Review

PMID: 9630798 [PubMed - indexed for MEDLINE]

"25: Aust Dent J. 1997 Jun;42(3):153-5."

Incidence of inflammation in completely impacted lower third molars.

Yamaoka M, Tambo A, Furusawa K.

Oral and Maxillofacial Surgery Department II, Matsumoto Dental College, Japan.

The influence of ageing and the contact of the adjacent tooth on purulent
inflammation associated with the completely impacted lower third molar was
assessed in 26 patients with clinical symptoms of infection out of 800 patients
who had roentgenographically-confirmed completely impacted lower third molars.
These 26 patients were 23 years of age or older. The 9 with pain alone ranged
from 25 to 44 years of age, whereas the 17 patients with inflammation ranged from
29 to 67 years of age, and non-contact to adjacent tooth was associated with
purulent inflammation in older patients, indicating completely impacted lower
"third molars may cause pain only until 45 years of age; but purulent inflammation"
occurs even in the group of non-contact to adjacent tooth after 45 years of age. 
The authors recommend that a completely impacted lower third molar should be
removed if the risk factors of advanced age and contact with the adjacent tooth
are present.

PMID: 9241923 [PubMed - indexed for MEDLINE]

"26: Community Dent Oral Epidemiol. 1996 Oct;24(5):336-40."

Survey of reasons for extraction of permanent teeth in Italy.

Angelillo IF, Nobile CG, Pavia M.

Chair of Hyglene, Medical School, University of Reggio Calabria, Catanzaro,
Italy.

The purpose of the study is to collect information on the reasons given by
dentists, randomly selected from the Italian Dental and Maxillo-Facial
Association's, for extracting permanent teeth in Italy. From the 164 dentists
responding, 1056 teeth in 839 patients were extracted during two weeks of working
activity. More than two-thirds of the teeth were extracted for dental caries
(34.4%) and periodontal disease (33.1%). The mean number of teeth extracted per
patient showed a significant increasing trend with increasing age, being 1.09 in 
those from 16 to 39 yr, 1.25 in the 40-59-yr-old group, to 1.54 in those over 59 
"yr of age (F = 21.44; P < 0.0001). The third molar was the most frequently"
extracted tooth and 41.3% were removed due to impaction reasons, in particular
from the mandible. The first and second molars and the premolars were extracted
"most often because of caries; more than half of the incisors and the canines were"
"extracted for periodontal reasons; the majority of the teeth removed for"
"prosthetic reasons, 57.1%, were incisors and canines, especially in the mandible;"
of the teeth extracted for orthodontic reasons, 47.4% were first and second
premolars. The prevalence of subjects with at least one tooth extracted for
dental caries and for orthodontic reasons were respectively significantly higher 
"in the irregular than the regular attenders (chi-square = 46.55; P < 0.0001), and"
"in the regular than the irregular dental attenders (chi-square = 63.12; P <"
0.0001). Dental practitioners should promote targeted initiatives for prevention 
and treatment of diseases in order to reduce in particular the incidence of tooth
extraction because of caries and periodontal disease.

PMID: 8954220 [PubMed - indexed for MEDLINE]

"27: N M Dent J. 1994 Winter;45(1):11-4."

A brief review of the newer nonsteroidal anti-inflammatory analgesics.

Cage TW.

Department of Oral and Maxillofacial Surgery and Pharmacology, Baylor College of 
Dentistry, Dallas, Texas, USA.

The intent of this article is to present information about selected analgesic
products marketed within the past five years and their potential for use in
dental practice. As a rule, most new drugs are not specifically produced for
dental therapy as economics and medical needs drive research and development.
However, for this group of drugs, the dental pain model involving third molar
extractions has provided some of the clinical data. Because the information
presented is brief, the practitioner is cautioned to consult complete prescribing
information, such as the drug package insert, prior to using of any medication
which might be appropriate to employ in the usual course of dental therapeutics.

Publication Types: 
    Review

PMID: 9543824 [PubMed - indexed for MEDLINE]

"28: Oral Surg Oral Med Oral Pathol. 1993 Aug;76(2):135-40."

Third molars as an acute problem in Finnish university students.

Ventä I, Turtola L, Murtomaa H, Ylipaavalniemi P.

Department of Oral and Maxillofacial Surgery, University of Helsinki, Finland.

The study was carried out to determine the risk of acute disease of third molars 
in young adult patients. The subjects in this case-control study were 100
consecutive university students who complained of third molar problems when
making an appointment. The third molars were mostly mandibular, partly erupted,
and distoangularly oriented. Severity of discomfort and interference with daily
activities were graded by the patients on average as 5.0 (SD +/- 2.7) and 3.6 (SD
+/- 2.9), on a scale from 0 through 10. Distoangular lower third molars caused
the most discomfort and interfered most with activities of patients. The risk of 
acute disease in patients with distoangularly oriented third molars was 3.6 times
that in other patients. Bivariate analysis showed that if the follicle of a
distoangular third molar were enlarged, the risk of acquiring acute disease was
44 times that in other patients. It was concluded that early removal of partially
erupted and distoangularly oriented lower third molars is recommended, especially
when they are associated with an enlarged follicle.

PMID: 8361720 [PubMed - indexed for MEDLINE]

"29: Acta Odontol Scand. 1993 Apr;51(2):115-21."

Symptoms and lesions associated with retained or partially erupted third molars. 
Some variables of third-molar surgery in Norwegian general practice.

Berge TI, Bøe OE.

Institute of Oral Surgery and Oral Medicine, University of Bergen, Norway.

A questionnaire on third-molar problems was mailed to a systematic random sample 
of 200 Norwegian general dental practitioners in November 1991. A 88% return rate
was obtained. The following conclusions were drawn: on an average, 3.8 patients
with lesions or complaints from retained or partially erupted third molars were
seen in general practice in 1 month, and most of these consultations were
associated with partially erupted third molars. A mean of 1.3 surgical removals
of third molars was performed in general practice in 1 month. The mean one-way
travel time for patients to specialists in oral surgery was 1.3 h, and variations
were not related to surgical activity in practice. Fourteen per cent of the
general practitioners refer surgical cases to non-specialists.

PMID: 8498161 [PubMed - indexed for MEDLINE]

"30: Oral Surg Oral Med Oral Pathol. 1991 Feb;71(2):223-7."

Referred pain of muscular origin resembling endodontic involvement. Case report.

Reeh ES, elDeeb ME.

Department of Endodontics, University of Minnesota School of
Dentistry,Minneapolis.

Referred pain is common in the orofacial region and can cause considerable
difficulties in diagnosis. Referred pain is defined as pain that is referred to a
part of the body other than the site of origin, and as a result, severe pain may 
arise without an associated causative lesion. A muscular trigger point that
resembled a tooth with endodontic involvement is discussed.

Publication Types: 
    Case Reports

PMID: 2003017 [PubMed - indexed for MEDLINE]

"31: J Endod. 1991 Jan;17(1):38-40."

Thermally induced pulpalgia in endodontically treated teeth.

Keir DM, Walker WA 3rd, Schindler WG, Dazey SE.

Wilford Hall USAF Medical Center, Lackland AFB, TX.

Two cases of thermally induced pulpalgia in teeth previously endodontically
treated are presented. Reproduction of the patient's chief complaint was the key 
to identifying the teeth involved. In both cases, the pulpalgia was stimulated by
heat. After locating and treating an unfilled canal, the teeth have remained
asymptomatic. Possible explanations for this occurrence are discussed.

Publication Types: 
    Case Reports

PMID: 1895039 [PubMed - indexed for MEDLINE]

"32: Clin J Pain. 1991;7 Suppl 1:S72-6."

Clinical experience in the treatment of dental pain.

Marcucci M, Panelli G, Cambini S.

Odontoiatric Clinic, Pisa University, Italy.

Good dental analgesia requires drugs that are endowed with strong and fast
activity and that are well tolerated. In addition, optimal analgesia should
essentially be of the peripheral type, thereby eliminating the risk of sedation
that may cause unpleasant effects on the patient's daily life. Meclofenamic acid 
is among those substances whose analgesic effect is more evident than that of
anti-inflammatory action. The mechanism of action of meclofenamic acid makes it
distinctly different from other nonsteroidal anti-inflammatory drugs (NSAIDs) in 
that it inhibits the metabolic pathways of arachidonic acid and, at the same
time, antagonizes the effects of prostaglandins at the peripheral receptor level.
A number of controlled clinical trials showed that meclofenamic acid is an
excellent analgesic, offering good tolerability when used in oral surgery,
dysodontiasis, avulsion of the third impacted molar, and periodontitis. The
following report is a presentation of results obtained in a controlled clinical
trial in which the speed of pain relief was assessed in 20 patients suffering
from acute periodontitis. The patients were treated orally with a single dose of 
meclofenamate sodium (100 mg) or with piroxicam-beta-cyclodextrin (20 mg). The
intensity of the drug's analgesic effect was measured at 0.5, 1, 2, 4, and 6 h
after administration. After initial testing, meclofenamate sodium was found to be
significantly more effective than piroxicam-beta-cyclodextrin. Both the physician
and patient found this drug to be considerably better. Pain relief after
treatment with meclofenamate sodium was clinically and statistically faster than 
piroxicam-beta-cyclodextrin, and both drugs were found to be well
tolerated.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial

PMID: 1810525 [PubMed - indexed for MEDLINE]

"33: Community Dent Oral Epidemiol. 1990 Oct;18(5):260-3."

Patients' retrospective preference for extraction of asymptomatic third molars.

Cohen ME, Arthur JS, Rodden JW.

Clinical Investigations Department, Naval Dental Research Institute, Great Lakes,
IL 60088-5259.

The purpose of this study was to determine the personal utility of asymptomatic
third molar removal in military patients. From 1 to 30 days (mean = 7.4) after
the extraction of one or more third molars, 100 returning patients (all male,
mean age = 20.1) were asked to respond to hypothetical questions concerning the
extraction of asymptomatic third molars. If the likelihood of third molars ever
having to be removed was given as 10%, 50%, and 100%, then 45%, 61%, and 88% of
responses, respectively, showed preference for immediate extraction. When
respondents chose to delay treatment until there was a problem, no likelihood
group would tolerate more than 2.77 additional days of post-extraction pain
before changing their preference to immediate extraction. 87% of respondents
preferred extractions prior to a deployment which would make treatment delivery
difficult, and 89% prior to becoming a civilian at which time treatment might no 
longer be free. The results indicate general acceptance of the strategy of
prophylactic third molar removal among a sample of military patients who have
undergone pre-treatment counseling and the surgical procedure. A question remains
as to the personal utility that might be measured prior to surgery.

Publication Types: 
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 2249410 [PubMed - indexed for MEDLINE]

"34: Singapore Dent J. 1988 Dec;13(1):27-30."

Dental survey on soldiers of an infantry battalion of Singapore Armed Forces
(SAF) at the time of completion of national service.

Cheong YH, Chong LL.

A three-part survey on 20-year-old national servicemen was conducted just before 
they left the army to determine their dental history and residual dental disease 
after two years of military service. The findings highlighted caries as a major
cause of dental discomfort for which treatment was obtained. The impacted lower
third molar was also a common cause of pain. The pattern of tooth loss showed
that the lower first molar and the upper incisors were the teeth most frequently 
lost through caries. The findings reinforce the perception of the dental patient 
as being not the best person to appreciate his own dental needs and to do
something positive about them.

PMID: 3155000 [PubMed - indexed for MEDLINE]

"35: Oral Surg Oral Med Oral Pathol. 1988 Aug;66(2):243-8."

Undiagnosed benign cementoblastoma in a patient with a 6-year pain condition.
Report of a case.

Forsslund HG, Bodin I, Julin P.

Department of Oral Surgery, Danderyd Hospital, Stockholm, Sweden.

Symptoms in the lower first molar developed in a 15-year-old girl. The problems
started with tenderness during occlusion. The first radiographic examination
revealed a radiopacity at the distal root, which was considered in the
radiographic report to be a cementoma. Therapy commenced with occlusal
adjustment, but this was followed 20 months later by endodontic therapy, which
was undertaken because of the suspicion of partial pulpal necrosis with
condensing osteitis. A painful condition developed and led first to apicoectomy
and then to extraction 2 1/2 years after the start of the endodontic therapy.
Light microscopic examination of adjacent hard tissue revealed signs of chronic
inflammation on both occasions, and a diagnosis of diffuse sclerosing
osteomyelitis was made. The pain was not relieved but remained at a tolerable
level for 18 months. Then a reexamination of the first radiographs led to a
strong suspicion of a benign cementoblastoma. A thorough third operation revealed
a small piece of hard tissue in a lacuna of the lingual part of the mandible
covered buccally by granulation tissue and inflammatory affected bone. The final 
histopathologic diagnosis was benign cementoblastoma combined with chronic
inflammation.

Publication Types: 
    Case Reports

PMID: 3174059 [PubMed - indexed for MEDLINE]

"36: Gen Dent. 1987 Nov-Dec;35(6):464-5."

Herpes zoster.

Hager TS, Connor JP.

Publication Types: 
    Case Reports

PMID: 3481730 [PubMed - indexed for MEDLINE]

"37: Int J Oral Surg. 1981;10(Suppl 1):187-90."

Facial pain - toothache or tumour?

Aiken A.

Three cases are presented which illustrate the diagnostic problem of vague facial
pain. One patient complained of toothache and was finally proved to have an
intraventricular meningioma. The second had been diagnosed as trigeminal
neuralgia but was finally found to have a meningioma. The third presented with
facial pain, underwent 2 weeks of intensive neurological investigations and the
pain was finally related to pulpitis in an upper molar. These three cases serve
to stimulate a discussion on the problems of diagnosis of facial pain and the
role of computerised axial tomography in this field.

Publication Types: 
    Case Reports

PMID: 6807876 [PubMed - indexed for MEDLINE]

"38: Stomatol Vjesn. 1978;7(1-2):53-6."

[Most frequent symptoms of unerupted lower wisdom teeth and their dependence on
tooth position]

[Article in Croatian]

Jojić B, Milosević Z.

Publication Types: 
    English Abstract

PMID: 293966 [PubMed - indexed for MEDLINE]