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Article
Salivary Alpha-Amylase and Calcium levels Evaluation as a Biomarker in Stress Patients Undergoing Surgical Wisdom Tooth Extraction
قياس إنزيم الالفا- اميليز وايون الكالسيوم في اللعاب كدالة حيوية عند الشد العصبي للمرضى الخاضعين لقلع ضرس العقل جراحيا

Author: Ali Jabbar Hussain Al_Sheakh علي جبار حسين الشيخ
Journal: Al-Rafidain University College For Sciences مجلة كلية الرافدين الجامعة للعلوم ISSN: 16816870 Year: 2013 Issue: 31 Pages: 137-151
Publisher: Rafidain University College كلية الرافدين الجامعة

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Abstract

The salivary enzyme alpha-amylase has been proposed as a biomarker for stress-induced activity of the sympathetic nervous system. In the growing field of amylase research, recent studies have underscored the usefulness of salivary alpha-amylase in this regard. Calcium is the major component of bones and teeth, and it is not surprising that disturbances in calcium metabolism have been implicated in most of the major chronic diseases, including renal disease, osteoporosis; and periodontal tissues.Twenty healthy Iraqi male undergo wisdom tooth extraction from undergraduates dental students were considered in this study with age mean of 22 years old, 2 ml samples of stimulated saliva were collected prior ten mints of surgical wisdom tooth removal, and recollected after one week fromsurgery from these students, the samples were analyzed to assess changes in ∝-amylase and calcium ion concentration under controlled conditions. The collected data predicted elevation of amylase level from ((7652.965 ±34.0410) to (7674.710 ± 68.8958) IU/L) with a significant change. And also increase in the calcium ion concentration level from (0.1465 ± 0.048) to reach level (0.1975± 0.100) mmol/L. Positive correlation were recorded between alpha amylase and calcium concentration when plotted the correlations values of stress and no stress individual's. In a conclusion. Acute stresscaused by wisdom tooth removal will elevate level of amylase in saliva significantly, howeverSignificant increasing in calcium concentration was observed in the stimulated saliva in comparison with the non-stimulated saliva with significant mean changes. However, our result predicted elevated levels of calcium concentration of the stimulated saliva than the non-stimulated (after extraction).

استخدم إنزيما الامليز اللعابي كمؤشر بيولوجي لفعالية الجهاز العصبي التلقائي ومحفز للشد العصبي. ويتطلب الوصول للفعالية القصوى للإنزيم وجود ايون الكالسيوم. يعد الكالسيوم من العناصر المتوفرة في العظام والأسنان وهو في حركة متواصلة بين النسيج وسوائل الجسم المختلفة. يتأثر تركيز الكالسيوم بالعديد من الإمراض مثل ترقق العظام, الكلية وأمراض اللثة وغيرها. تم شمول عشرون طالب من الذكور بمعدل عمر يبلغ اثنان وعشرون سنة. تم جمع 2 مل من اللعاب قبل عشرة دقائق من قلع سن العقل جراحيا ومرة أخرى بعد اسبوع من إجراء عملية إزالة سن العقل. وتم إجراء حساب مستوى الامليز الكالسيوم لبيان تأثير الشد العصبي .النتائج التي تم الحصول عليها تبين ارتفاع مستوى الامليز اللعابي من (7652. 965 ±34.0410) إلى(7674.710 ± 68.8958) IU/L . كذلك تبين ارتفاع مستوى الكالسيوم من (0.1465 ± 0.048) إلى (0.1975± 0.100) ملي مول / لتر وبترابط إحصائي موجب. من خلال النتائج تبين تأثير الشد العصب على رفع مستوى إنزيم الامليز مقرون بارتفاع ايون الكالسيوم مقارنة بنفس الأشخاص ولكن في غياب تأثير الشد النفسي.


Article
Evaluation of the Effectiveness of Two Methods Using Methylprednisolone on Post Operative Sequelae Following Lower Third Molar Surgery

Author: *Ibrahim S. Gataa, BDS , FICMS
Journal: KUFA MEDICAL JOURNAL مجلة الكوفة الطبية ISSN: 1993517X Year: 2009 Volume: 12 Issue: 2 Pages: 257-266
Publisher: University of Kufa جامعة الكوفة

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Abstract

The surgical extraction of lower wisdom tooth like any surgical procedure is usually associated with postoperative sequelae (pain, swelling and trismus).Different drugs and surgical techniques were used to decrease these inflammatory responses. Steroids have been used commonly for this purposes particularly methylprednisolone (MP). The aim of this study was evaluating the efficacy of preoperative systemic and local administration of MP (10 mg) on the post operative sequelae following surgical removal of lower third molar. Patients included in the study were (60) divided into 3 groups each group consist from (20) persons. The first group was the control one while the second group received (10mg) of MP orally and the third group injected with (10mg) of MP locally around the site of surgery one hour preoperatively. The postoperative sequelae were assessed on the 2nd,5th, and 7th days following the operation. The result showed significant reduction in pain and oedema with the use of systemic MP and there was no effect on trismus. The local injection of (10mg) of MP was significantly affecting the oedema formation on the 5th, and 7th days. The administration of oral methylprednisolone (10mg) played a good role in reducing pain and oedema following lower third molar surgery. The method used was simple, applicable and easily accepted by the patients.


Article
Anti–Nociceptive Efficacy of Tramadol Following Surgical Removal of Impacted Mandibular Third Molar

Author: Tahani A Al-Sandook
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2013 Volume: 13 Issue: 1 Pages: 88-94
Publisher: Mosul University جامعة الموصل

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Abstract

Aims of the Study: To evaluate the efficacy of analgesia mediated by preoperative 100 mg IM Tra-madol to the post operative Tramadol and placebo after the surgical removal of mandibular wisdom tooth. Materials and Methods: Surgical removal of mandibular third molar was performed in three groups of individuals, total of thirty patients were anticipated in this study. All medically fit, average of age 24 + 2.2; each group consisted of ten patients. Group 1: Preoperative 100 mg Tramadol IM injec-tion 30 minutes prior surgical operation; Group 2: Post operative 100 mg Tramadol IM injection; Group 3: Placebo or control group where distilled water IM injection was applied. All patients received post operatively Augmentin capsules 675 mg tid, and supplementary Paracetamol 500 mg tablet as required. Analgesia was assessed by Visual Analog Scale (VAS) and Verbal Pain Scale (VPS), patient satisfaction (PS), duration of post operative analgesia and total number of analgesic tablet were record-ed between groups. Results: Analgesia mediated by Tramadol was superior in its efficacy compared to control group in both pre and post operative Tramadol groups, according to VAS and VPS assessment (p= 0.001). There was no significant difference between the preoperative and post operative analgesia according to VAS and VPS; whereas there was a significant difference in PS, and duration of analgesia mediated by the preoperative injection in comparison to the post operative and control groups. Conclu-sion: Preoperative Tramadol analgesia was superior to post operative analgesia in PS and prolonged duration of analgesia that explain its anti–nociceptive effect in controlling post surgical pain.


Article
The Impact of General and Local Fac-tors as Criterions of Assessment for the Difficult Lower Wisdom Tooth. A Ret-rospective Study

Authors: Wael Sh Shallawi --- Ziad H Delemi
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2014 Volume: 14 Issue: 1 Pages: 115-122
Publisher: Mosul University جامعة الموصل

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Abstract

The aim of the study is to evaluate the relationship of the general and local factors which have an impact on the difficulty during the removal of impacted lower wisdom teeth. Several factors such as age , gender, mouth opening , chief complain, bone surrounding and radiographic appearance and sur-geon experience, will be included as factors which affect the difficulty during the removal of impacted lower wisdom teeth. Materials and methods: One hundred twenty medically fit patients were selected with an age range between 17–47 years of both sexes had impacted lower third molars and indicated for surgical extraction. Surgical removal performed by senior surgeon and junior, operation was per-formed under local anesthesia, all cases done between November 2008- June 2010, in oral and maxillo-facial surgery departmentdentistry college university of Mosul the collected data were analyzed statis-tically by using SPSS program. Results: the sample comprised of 62.5% female and 37.5% male with mean age 24.5 years, the mean of the mouth opening was 39mm, the chief complain distributed as fol-low( pain 65%, dental check up 25.8%, orthodontic reasons 6.7% and others 2.5%), according to Pell and Gregory classification the percentage were class І 44.2%, class ІІ 44.1%, class ІІІ 11.7%, while the angulations were horizontally 15.8%, mesioangular 44.2%, vertical 24.2%,distoangular 15.8%, levels position A 40%, position B 36%, position C 17%. The mean time for the experienced surgeon was 23.33 minutes while for the non experienced 53.11 minutes. There was statistically significant differ-ence between the time of the operation and the experience of the surgeon at P value =0.003. The rela-tion between the time of the operation and class, level and angulations of impaction was statistically not significant. To successfully evaluate the difficulty of lower third molar extraction prior to surgery, clinical, radiologic findings, local and general factors must be taken into account and there are special indexes used in the assessment of difficulty in lower wisdom tooth surgery with no one of them consid-ered the most reliable one because of the difference in the studies samples and in the local and general factors that had been used in the assessment of difficulty like age, gender, mouth opening , chief com-plain in addition to the clinical and radio graphical features. Conclusions: in regardless of type of diffi-culty index used in addition to local and general factors as a criteria for the assessment of lower molar


Article
Impact of Age, Procedural Duration and Impaction Type on Pain and Trismus After Surgery of Mandibular Wisdom Tooth

Author: Ahmed Salah Hameed Al-Noaman
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2017 Volume: 14 Issue: 2 Pages: 353 -360
Publisher: Babylon University جامعة بابل

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Abstract

This study assessed the impact of patient's age, duration of surgical procedure and type of impaction on pain and trismus after surgery of impacted mandibular wisdom tooth.Successive patients with impacted mandibular wisdom tooth were recruited. Winter's classification was used to classify impacted teeth. Surgical removal of impacted teeth was done using local anesthesia. The effect of age, duration of surgical operation and pattern of impaction on post-operative pain and trismus was studied after 3 and 7 days. Visual analogue score (VAS) was used to assess pain, trismus was measured as the inter-incisal distance using manual caliper and duration of surgical procedure was defined as the period between incision and finishing of suturing. Seventy nine patients with age ranged 15 to 41 years were recruited. The highest percentage were male gender (57%). The highest pain VAS score was recorded in the age group (30-41) after 3 days and the lowest mouth opening was seen in the same population after 3 and 7 days. The mean of operation time was 38.5 and its effect after < 20 minutes recorded the least pain score and trismus after 3 and 7 days. Highest pain score and more trismus were related to horizontal impaction on day 3 (p=0.04, p=0.000); whereas lowest pain value and better mouth opening were related to vertical impaction.Postoperative pain and trismus increased with advancing age, operation time and horizontally impacted tooth and trismus did not resolve within short time and may last for more than 10 days..

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