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Article
The Effect of Flap Design on Wound Healing after Periapical Surgery: A Comparative Study.

Author: Mohammad S. Suleiman
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2008 Volume: 8 Issue: 1 Pages: 120-127
Publisher: Mosul University جامعة الموصل

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Abstract

Aims: To assess the clinical effect of different flap design that used in periapical surgery and their
relation to untoward postoperative sequel. Materials and methods: Forty five patients were included
in the present study, they were divided randomly into three groups, each comprised of (15) patients. In
the first group, apicectomy was done using intrasulcular triangular (2–sided) flap. Whereas, in the
second group, a submarginal (Luebke–Ochsenbein) scalloped 2–sided flap was used. While in the third
group, a new experimental (straight mucogingival) 2–sided flap was tested. Postoperative healing was
evaluated clinically in regard to oedema, alteration of soft tissue colour, recession of marginal gingiva,
extent of scarring, and closure of the wound site. Assessment was done at 2, 7, 15 and 30 days
postoperative intervals. Results: Comparison among the three study groups was performed. Statistical
analysis revealed significant differences in the results of experimental flap over the other two types in
regard to oedema, colour and wound closure with the superiority of the former on the latter flaps. Both
experimental and Luebke–Ochsenbein flaps showed significant differences from intrasulcular incision
in their effect on gingival recession. In contrast, scarring was less evident in intrasulcular flap followed
by experimental flap while in Luebke–Ochsenbein incision, this complication was significant.
Conclusion: This study; however, revealed that the experimental flap allows for rapid and recession
free healing following periapical surgery. In addition, inflammatory changes persist for longer time in
the intrasulcular and submarginal (Luebke–Ochsenbein) incision than in experemintal incision. So it
was concluded that the new flap design could provide an alternative.


Article
A mucosal Flap for Periapical Surgery

Author: Dr. Lukman Fawzi Omar . B.D.S, M.S.C د.لقمان فوزي
Journal: MUSTANSIRIA DENTAL JOURNAL مجلة المستنصرية لطب الاسنان ISSN: 18138500 Year: 2009 Volume: 6 Issue: 3 Pages: 256-261
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

The function of flap is to raise the soft tissue overlying the surgical site to give the best possible view to the operator and sufficient exposure of the area to be operated on with minimal postoperative complications.The objective of this study is to evaluate a new flap design for exposure of periapical lesion, also to compare it with other common flaps used in periapical surgery.The study include 107 young patients apicectomized for one, two, or three anterior teeth from January2007 to June 2008, age ranged between 18-30 years old, using special case sheet.The flap has given good access to one, two or three apices apicectomized with less postoperative complications including pain, swelling, parasthesia of lip and wound healing.The flap described is an alternative approach to reach the periapical area that may be used to overcome the disadvantages of other flap designs used in periapical surgery.


Article
A clinical evaluation on the alkalization of local anesthetic solution in periapical surgery

Authors: Fa’iz A Al–Sultan --- Wafaa Kh Fathie --- Rayan S Hamid
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2006 Volume: 6 Issue: 1 Pages: 71-77
Publisher: Mosul University جامعة الموصل

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Abstract

Aims: To assess the effect of alkalization of local anesthetic solution for the purpose of enhancing itsefficiency in periapical surgery. Materials and Methods: A total sample of 80 patients, all needingperiapical surgery on one or more of their upper anterior tooth (teeth) was subjected to this trial. For thepurpose of comparison, the sample was randomly divided into two groups based on the local anestheticsolution that they were to receive before surgery. The first group(control) included those patients whoreceived the commercially available local anesthetic solution with a standard pH of 3.5.The secondgroup (trial group) included those patients who received a pH adjusted local anesthetic solution at 7.2(using sodium bicarbonate).Prior to, and at the completion of intended surgery, the following datawere recorded: Pain during injection, onset of achievement of surgical anesthesia, pain duringoperation and the duration of operation itself. Results: A significant difference in regard to onset ofachievement of surgical anesthesia between both groups was noticed with a faster onset in group two where the patients received a pH adjusted local anesthetic solution when compared to control group where the patients received the commercially available local anesthetic solution. Also, less pain on deposition of solution was noticed in the second group as well as less pain score levels were recorded during operation in regard to the same group. Conclusion: The pH adjusted local anesthetic solutionsmay provide certain advantages when compared to the commercially available local anesthetic solutions regarding enhancement of anesthetic efficiency, reduced pain on injection as well as during surgery.


Article
Prospective Clinical Study Evaluating The V Flap for Surgical Endodontic Treatment of Periapical Lesions

Authors: Yahya A.Ali يحيى علي --- Riad G.altaee رعد الطائي --- Haitham.Y.Mohammad هيثم ياسين محمد
Journal: Tikrit Journal for Dental Sciences مجلة تكريت لعلوم طب الاسنان ISSN: 20731213 Year: 2015 Volume: 3 Issue: 1 Pages: 83-88
Publisher: Tikrit University جامعة تكريت

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Abstract

The aim of this study was to evaluate the V shaped flap for surgical endodontic treatment of periapical lesions. The study included 62 patients in good general health, referred to the Department of oral surgery in the specialized center of Dentistry in Basra between March 2009 and June 2010, for surgical endodontic treatment. V shaped flap was used in all cases. Our intraoperative and postoperative clinical findings regarding the implentation of the vestibular V flap in surgical treatment of periapical diseases, have confirmed its individualy. It was perform the procedure which enabled a traumatic retraction with abundant blood supply and repositioning with a few stitches. the following day 62.9% of the patients experienced no pain, and mild swelling of the surgical site was evident in 79 % of the cases. The healing was complete, without any signs of tissue retraction and dehiscence.


Article
The effect of certain materials as haemostatic agents in periapical surgery

Authors: Wafaa KH FATHIE --- Wa,el T AL WATTAR --- Rayan S HAMID
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2002 Volume: 2 Issue: 2 Pages: 226-230
Publisher: Mosul University جامعة الموصل

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Abstract

Four different materials were used to assess their activities to control blood oozing. A surprising result showed that chlorhexidine(2%) has good haemostatic activity beside gel foam. Local anesthesia showed haemostatic activity for short time, while no effect of normal saline on blood oozing during operation. Further studies on this approach are recommended for further evaluation of haemostatic activity of chlorhexidine.


Article
A clinical comparative evaluation between upper and lower first molar apicectomy procedures (A retrospective trial).

Authors: Wafaa K Fathi --- Wael T Al Wattar
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2011 Volume: 11 Issue: 2 Pages: 381-389
Publisher: Mosul University جامعة الموصل

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Abstract

Aims: The aim of this retrospective clinical trial was to evaluate and compare the upper and lower first molar apicectomy procedures in terms based on certain clinical criteria selected. Materials and Meth-ods: This clinical trial was conducted at the Department of Oral and Maxillofacial Surgery / College of Dentistry / University of Mosul. The sample recruited was composed of forty healthy subjects who required apicectomy procedures on either an upper or lower fist molar. The sample was subdivided into two groups of twenty subjects each. The first group comprised those patients where root end resection ( apicectomy ) on an upper first molar tooth was required. The second group included those patients who required an apicectomy procedure on one of their lower first molar tooth . Criteria that were eval-uated and compared included pain, swelling and trismus which were evaluated on the first operative day, second, third and seventh postoperative day. Results: A significant difference was observed be-tween recall visits in regard to the pain level of mandibular procedures and was also observed in maxil-lary procedures. In regard to pain level assessment between mandibular and maxillary procedures, a significant difference was observed with pain levels higher in mandibular procedures for the second and third day when compared to maxillary procedures. A significant difference was observed between recall visits in regard to swelling of soft tissue of mandibular and maxillary procedures. Concerning grade of swelling assessment between mandibular and maxillary procedures, a significant difference was observed with swelling of soft tissue higher in mandibular procedures on the second and third day when compared to maxillary procedures. A significant difference was observed for limitation of mouth opening in mandibular procedures between recall visits specifically on the first and second day but was not observed in maxillary procedures. When comparing between upper and lower surgical procedures, a significant difference was observed in trismus specially on the second and third post-operative day and which was more pronounced in mandibular procedures. Conclusions: It seems that complications following root end resection on lower first molar teeth are more evident when compared to the upper first molar region, but only in the first few days following surgery. However, such complications were tolerable to the patient and can be overcome by medications and exercise. Such complications should not hinder the oral surgeon from performing endodontic surgery on posterior teeth when indicated

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