The aetiology of dry socket continues to be the subject of intense research. Local disturbances of fibrinolytic activity appear to be the most satisfactory explanation for the pathogenesis of this disorder. The factors that are responsible for local changes in fibrinolytic activity are reviewed and evaluated. In the management of this disorder attention should be directed towards the prevention of local changes in fibrinolytic activity.
Oroantral fistula is an uncommon complication in oral surgery. Although smaller fistulas of less than 5 mm in diameter may close spontaneously, larger fistulas always require surgical closures. The literature review revealed various procedures for the closure of oroantral fistulas. These procedures may be subdivided into local flap, distant flap and grafting. Procedures involving local flaps are usually adequate to close minor to moderate size defects. Those procedures utilizing the buccal mucoperiosteal flap as the tissue closure include straight-advancement, rotated, sliding and transversal flap procedures; while those involving the palatal mucoperiosteum are straight advancement, rotational-advancement, hinged and island flap procedures. The combinations of various local flaps to strengthen the tissue closure are also being advocated. The advantages and the limitations of these procedures are discussed. Distant flaps and bone grafts are usually indicated in the closure of larger defects in view of their greater tissue bulks. Tongue flaps have superseded extra-oral flaps from extremities and forehead for aesthetic reasons and also in view of their similar tissue replacement. Various tongue flap procedures are described. At present, various alloplastic materials such as gold, tantalum and polymethylmethacrylate are infrequently reported in the closure of oroantral fistulas. However, in the light of successful reports over the use of biological materials, collagen and fibrin, in the closure of oroantral fistulas, there seems to be another simple alternative technique for treating oroantral fistulas.
Areca catechu (betel) nut is widely used as a chewing agent. The nut alkaloids have been implicated in the pathogenesis of oral precancerous lesions. Quantitative analysis of the chloroform extracts by gas-liquid chromatography of ten commercial nut samples from Bombay have shown a wide variations In their arecoline contents (0% - 1.4%; mean: 0.7%). Nut samples of Identical processing method also vary in their arecoline levels. These variations were suggested to be due to the difference In the raw materials and processing methods. Comparisons were made between the arecoline contents and the Incidence of oral precancerous lesions from the present studies and also from those of Kerala and Mysore. It was concluded that the difference in nut arecoline contents not only reflect their appeal, potency but also influence upon the incidence of these diseases.
A case of unicystic ameloblastoma which recurred after 15 years showing unusual histological features is reported. The prominent pseudo-glandular features present are described. This case highlights the importance of extensive histological examination for more characteristic features of ameloblastoma to reach a correct diagnosis.
The results of the present investigation have shown the usefulness of suprofen in the control of pain following surgical removal of impacted wisdom tooth. The regime of 200 mg. q.d.s. orally, was shown to be satisfactory in the control of postoperative pain. Pain was rapidly controlled by the 1st hour after ingestion and subsequently maintained at a low profile until is was completely abolished by the 8th hour of the postoperative period.