Inferior alveolar nerve canal position: a clinical and radiographic study.

Purpose: To document a clinically relevant position of the inferior alveolar nerve (IAN) in dentate patients and identify patient factors associated with IAN position.

Materials And Methods: The investigators used a cross-sectional study design and a study sample of subjects who had a radiographically identifiable IAN canal and at least 1 mandibular first molar was enrolled. Predictor variables were age, gender, and race.

Does prophylactic administration of systemic antibiotics prevent postoperative inflammatory complications after third molar surgery?

Purpose: To estimate and compare the frequencies of inflammatory complications after third molar (M3) surgery in subjects receiving intravenous prophylactic antibiotics or saline placebo.

Materials And Methods: Using a placebo-controlled, double-blind, randomized clinical trial, the investigators enrolled a sample composed of subjects who required extraction of at least 1 impacted M3 and requested intravenous sedation or general anesthesia. The predictor variable was treatment group classified as active treatment (penicillin or clindamycin for penicillin-allergic subjects) or placebo (0.

Preoperative computed tomography imaging in the management of impacted mandibular third molars.

Purpose: The purpose of this study was to examine the role of preoperative computed tomography (CT) imaging of the inferior alveolar nerve (IAN) for patients at increased risk for nerve injury during mandibular third molar (M3) extraction.

Materials And Methods: To address the research purpose, the investigators enrolled a sample composed of subjects who presented for mandibular M3 extraction and had panoramic radiographic signs interpreted as being associated with an increased risk for inferior alveolar nerve injury. All subjects had preoperative CT imaging studies done to ascertain the position of the IAN with respect to M3.

Functional sensory recovery after trigeminal nerve repair.

Purpose: The aim of this study was to estimate the proportion of subjects who achieved functional sensory recovery (FSR) 1 year after inferior alveolar or lingual nerve repair and to identify risk factors associated with failure to achieve FSR.

Methods: Using a retrospective cohort study design, we developed a sample composed of subjects who underwent lingual or inferior alveolar nerve repair. Eligible subjects had at least 1 postoperative visit.

Comparison of wound management methods after removal of maxillofacial osseous lesions.

Purpose: To evaluate outcomes associated with choice of wound management, ie, primary closure or healing by secondary intention, of osseous defects after excision of maxillofacial bone lesions as a guide to clinical practice.

Patients And Methods: Using a retrospective cohort study design, we enrolled a sample composed of subjects treated for jaw lesions between 1995 and 2003. The primary predictor variable was the wound management choice of the residual jaw defect, classified as primary closure or healing by secondary intention.

Maxillary sinus augmentation as a risk factor for implant failure.

Purpose: The investigators sought to determine whether maxillary sinus augmentation (MSA) was an independent risk factor for implant failure.

Materials And Methods: Using a retrospective cohort study design, the investigators enrolled a sample composed of subjects having 1 or more implants placed in the posterior maxilla. The primary predictor variable was MSA status at the time of implant placement (MSA present or absent).

A predictive model to identify women with injuries related to intimate partner violence.

Purpose: The diagnosis of intimate partner violence (IPV) is challenging. The authors conducted a cross-sectional study to develop a predictive model to identify IPV-related injuries and validate the model with an independent sample.

Materials And Methods: The authors enrolled women older than 18 years seeking treatment for injuries.

A protocol to diagnose intimate partner violence in the emergency department.

Background: To better identify women at risk for intimate partner violence (IPV), we developed a diagnostic protocol composed of injury location and response to a verbal questionnaire to identify women at high risk for reporting an IPV-related injury etiology. The purpose of this study was to test the external validity of the protocol when applied at two institutions that differ considerably in terms of geography and socioeconomic measures.

Methods: A cross-sectional design was used at two demographically and geographically different hospitals, designated H1 and H2.

Changes in crestal bone levels for immediately loaded implants.

Purpose: The authors' objective was to measure crestal bone level change in subjects with immediately loaded implants and to identify risk factors associated with changes in bone level.

Materials And Methods: A retrospective cohort study design was used. The sample comprised subjects who had had endosseous implants placed and immediately loaded between July 2001 and July 2003.

Predictors of dental implant survival.

Purpose: To summarize dental implant survival rates under a variety of clinical conditions and identify prognostic variables associated with implant survival.

Materials/methods: The articles reviewed in this paper were designed as retrospective cohort studies and composed of three subject cohorts having implants placed between 1992 and 2003. The prognostic variables were categorized as demographic/health status, anatomic, implant-specific, prosthetic, and perioperative/operative.

Role of computerized tomography in management of impacted mandibular third molars.

Nerve injury following mandibular third molar (M3) removal is a rare but serious complication. The purpose of this article is to review the role of currently available imaging technologies to facilitate clinical decision-making in the setting of M3 surgery. Given findings suggestive of high risk for inferior alveolar nerve (IAN) injury, the clinician should consider additional imaging to assess better the anatomic relationship of the IAN and M3.

Survival estimates and risk factors for failure with 6 x 5.7-mm implants.

Purpose: Short dental implants facilitate prosthetic restoration in the setting of limited alveolar bone height. The study objectives were to (1) estimate the 1-year survival of Bicon 6 x 5.7-mm implants, (2) compare the 1-year survival of 6 x 5.

Secondary conversion of the Gore Excluder to operative abdominal aortic aneurysm repair.

Objective: Reports continue to document the occurrence of major adverse events after endovascular aortic aneurysm repair. Although many of these problems can be successfully managed through endovascular salvage, operative conversion with explantation of the endoprosthesis remains necessary in some patients. We report herein a review of all patients initially enrolled in multicenter US clinical trials of the Excluder endograft who underwent secondary conversion to open surgical repair.

Injury location and screening questionnaires as markers for intimate partner violence.

Purpose: We sought to evaluate the performance of 2 different screening questionnaires for intimate partner violence (IPV), in conjunction with injury location, as markers for IPV-related injuries.

Methods: We implemented a cross-sectional study and enrolled a sample of women presenting to the emergency department for evaluation and management of nonverifiable injuries. Study subjects were randomly assigned to receive 1 of 2 IPV screening questionnaires: the Partner Violence Screen (PVS) or the short-Woman Abuse Screening Tool (short-WAST).

A comparison of patient satisfaction and objective assessment of neurosensory function after trigeminal nerve repair.

Purpose: The purpose of this study was to compare objective and subjective assessments of neurosensory function after trigeminal nerve repair.

Methods: This was a retrospective cohort study using a sample of patients who underwent surgical repair of trigeminal nerve injuries. The primary study variables were categorized as objective or subjective.

Risk of periodontal defects after third molar surgery: An exercise in evidence-based clinical decision-making.

Objective: The object of this study was to apply evidence-based principles to answer the question, What is the risk of having periodontal defects on the distal aspect of the mandibular second molar (M2) following third molar (M3) removal?

Study Design: To identify relevant articles for review, we completed a computerized literature search of Medline. The inclusion criteria for articles included prospective cohort studies or randomized clinical trials with follow-up periods of 6 months or more, and preoperative and postoperative measurements of periodontal probing depths (PDs) or attachment levels (ALs).

Results: Eight articles met the inclusion criteria.

Is there a role for reconstructive techniques to prevent periodontal defects after third molar surgery?

Purpose: Among patients at high risk for second molar (M2) periodontal defects after third molar (M3) removal, does active treatment at the time of extraction, when compared with no treatment, alter the risk of postextraction M2 periodontal defects?

Materials And Methods: We used a prospective cohort study design and a sample composed of subjects at high risk for developing M2 periodontal defects after M3 extraction, that is, age > or = 26 years, pre-existing periodontal defects (attachment level [AL] > or = 3 mm), and mesioangular or horizontal M3 impaction. The predictor variable was treatment status of the M3 extraction site. The M3 extraction sites were reconstructed with demineralized bone powder (DBP), bioresorbable guided tissue regeneration (GTR) therapy, or no treatment.

Estimating third molar extraction difficulty: a comparison of subjective and objective factors.

Purpose: The purpose of this study was to compare and contrast subjective and objective assessments of variables associated with third molar (M3) extraction difficulty.

Materials And Methods: To address the research purpose we implemented a prospective cohort study and enrolled a sample of surgeons removing M3s in an ambulatory care setting. Predictor variables were categorized as demographic, anatomic, or operative.

Why do residents leave general surgery? The hidden problem in today's programs.

Objective: Much has been written and discussed about the reasons for reduced interest in surgery, but few institutions have chosen to examine the loss or attrition of general surgery residents from their own programs. In preparation for an upcoming Residency Review Committee analysis of our program, we took the opportunity to examine the reasons for attrition in our own institution.

Design, Setting, And Participants: During the years 1990 to 2003, 120 categorical residents were admitted into our general surgery residency program.