scholarly journals Preoperative visualization of the lingual nerve by 3D double-echo steady-state MRI in surgical third molar extraction treatment

2021 ◽  
Author(s):  
Adib Al-Haj Husain ◽  
Silvio Valdec ◽  
Bernd Stadlinger ◽  
Martin Rücker ◽  
Marco Piccirelli ◽  
...  
Keyword(s):  
Steady State ◽  
Intraclass Correlation ◽  
Third Molar ◽  
Lingual Nerve ◽  
Point Scale ◽  
Surgical Interventions ◽  
Second Molar ◽  
Third Molar Extraction ◽  
Clinical Scenarios ◽  
Extraction Treatment

Abstract Objectives To assess the lingual nerve (LN) visualization using a 3D double-echo steady-state MRI sequence (3D-DESS). Materials and methods Three readers prospectively evaluated the LN for its continuous visibility in 3D-DESS MRI in 19 patients with an indication for removal of mandibular impacted third molars, using a 5-point scale (4 = excellent to 0 = none). Six LN anatomical intermediate points (IP) were selected and checked for their detectability by a 4-point scale (4 = yes to1 = no). Inter- and intra-rater agreement was evaluated using intraclass correlation coefficient and percentage of agreement. Results The average nerve continuity score was 3.3 ± 0.46. In 35% of the cases, the entire course was continuously visible. In 10%, the proximal and 60%, the distal part of the nerve was not continuously visible. Inter- and intra-reader agreement was good (ICC = 0.76, ICC = 0.75). The average detectability score of all IP was 3.7 ± 0.41. From IP1 to IP5, the detectability was excellent; meanwhile, IP6 had lower visibility. The inter- and intra-reader percentage of agreement was 77% and 87%. Conclusions The 3D-DESS sequence allowed accurate and continuous visualization of the LN with high reproducibility in more than one-third of the patients. This could improve the preoperative clarification of the LN position and thereby reduce complications during dentoalveolar surgical interventions. Clinical relevance 3D-DESS MRI might be beneficial in clinical scenarios where the second molar is elongated or presents a difficult rotational position while simultaneously having a close positional relationship to the third molar. Thereby, osteotomy performed more lingually, indicating extended lingual flap detachment may increase the risk of LN damage.

scholarly journals Influence of Surgical Flap Design (Envelope and Szmyd) for Removal of Impacted Mandibular Third Molars on Clinical Periodontal Parameters: A Clinical Trial

2021 ◽  
Vol 18 (9) ◽  
pp. 4465
Author(s):  
Muhtada Ahmad ◽  
Zafar Ali Khan ◽  
Tahir Ullah Khan ◽  
Montaser N. Alqutub ◽  
Sameer A. Mokeem ◽  
...  
Keyword(s):  
Third Molar ◽  
Periodontal Pocket ◽  
Third Molars ◽  
Chi Square ◽  
Pocket Depth ◽  
Clinical Attachment Loss ◽  
Exact Test ◽  
Second Molar ◽  
Third Molar Extraction ◽  
Flap Design

The aim of the study was to assess the influence of flap designs (Envelope flap (EF) and Szmyd flap (SF)) for impacted mandibular third molar extraction, on periodontal pocket depth (PPD), clinical attachment loss (CAL) and bone levels (BL) of second molar. Sixty patients indicated for third molar extractions with healthy second molars were allocated into two groups: EF and SF (n = 30). Third molars were assessed for angulation, root patterns, depth of impactions and relation with ramus (Pell and Gregory classification). Extraction of third molars was performed and PPD, CAL and BL around second molars at 0, 3 and 6 month (mon) follow-ups (FU) were assessed clinically and radiographically. ANOVA, Chi-square and Fisher’s exact test were employed to compare periodontal factors between EF and SF groups, considering p ≤ 0.05 as significant. Sixty participants with a mean age of 23.22 ± 3.17 were included in the study. Based on angulation, the most common impaction in the EF and SF groups was mesio-angular (EF, 50%; SF, 36.7%). Buccal and distal PPD showed a significant increase (p < 0.001) in both EF and SF patients from baseline to 6 mon. EF patients showed significantly higher distal and buccal CAL (6.67 ± 0.18 mm; 6.91 ± 0.17 mm) and BL (7.64 ± 0.16 mm; 7.90 ± 0.15 mm) as compared to SF patients (CAL, 6.76 ± 0.26 mm; 6.91 ± 0.17 mm-BL, 7.42 ± 0.38 mm; 7.34 ± 0.34 mm) at 6 mon FU. SF showed better soft tissue attachment (PPD and CAL) and bone stability (less bone loss) around second molars compared to EF after third molar extractions regardless of the patient, tooth and operator factors.

scholarly journals Influence of unilateral maxillary first molar extraction treatment on second and third molar inclination in Class II subdivision patients

2015 ◽  
Vol 86 (1) ◽  
pp. 94-100 ◽  
Author(s):  
Christos Livas ◽  
Nikolaos Pandis ◽  
Johan Willem Booij ◽  
Demetrios J. Halazonetis ◽  
Christos Katsaros ◽  
...  
Keyword(s):  
Private Practice ◽  
Orthodontic Treatment ◽  
Statistical Significance ◽  
Third Molar ◽  
Class Ii ◽  
Second Molar ◽  
Inclination Angles ◽  
And Gender ◽  
Extraction Treatment ◽  
Over Time

ABSTRACT Objective:  To assess the maxillary second molar (M2) and third molar (M3) inclination following orthodontic treatment of Class II subdivision malocclusion with unilateral maxillary first molar (M1) extraction. Materials and Methods:  Panoramic radiographs of 21 Class II subdivision adolescents (eight boys, 13 girls; mean age, 12.8 years; standard deviation, 1.7 years) before treatment, after treatment with extraction of one maxillary first molar and Begg appliances and after at least 1.8 years in retention were retrospectively collected from a private practice. M2 and M3 inclination angles (M2/ITP, M2/IOP, M3/ITP, M3/IOP), constructed by intertuberosity (ITP) and interorbital planes (IOP), were calculated for the extracted and nonextracted segments. Random effects regression analysis was performed to evaluate the effect on the molar angulation of extraction, time, and gender after adjusting for baseline measurements. Results:  Time and extraction status were significant predictors for M2 angulation. M2/ITP and M2/IOP decreased by 4.04 (95% confidence interval [CI]: −6.93, 1.16; P  =  .001) and 3.67 (95% CI: −6.76, −0.58; P  =  .020) in the extraction group compared to the nonextraction group after adjusting for time and gender. The adjusted analysis showed that extraction was the only predictor for M3 angulation that reached statistical significance. M3 mesial inclination increased by 7.38° (95% CI: −11.2, −3.54; P &lt; .001) and 7.33° (95% CI: −11.48, −3.19; P  =  .001). Conclusions:  M2 and M3 uprighting significantly improved in the extraction side after orthodontic treatment with unilateral maxillary M1 extraction. There was a significant increase in mesial tipping of maxillary second molar crowns over time.

scholarly journals Effects of Impacted Lower Third Molar Extraction on Periodontal Tissue of the Adjacent Second Molar

2021 ◽  
Vol Volume 17 ◽  
pp. 235-247
Author(s):  
Yuan Zhang ◽  
Xiaohang Chen ◽  
Zilan Zhou ◽  
Yujia Hao ◽  
Huifei Li ◽  
...  
Keyword(s):  
Third Molar ◽  
Periodontal Tissue ◽  
Second Molar ◽  
Third Molar Extraction ◽  
Molar Extraction

scholarly journals Prevention of Periodontal Pocket Formation after Mandibular Third Molar Extraction Using Dentin Autologous Graft: A Split Mouth Case Report

2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Alberto De Biase ◽  
Giulia Mazzucchi ◽  
Dario Di Nardo ◽  
Marco Lollobrigida ◽  
Giorgio Serafini ◽  
...  
Keyword(s):  
Case Report ◽  
Third Molar ◽  
Periodontal Pocket ◽  
Pocket Depth ◽  
Second Molar ◽  
The Third ◽  
Third Molar Extraction ◽  
Probing Pocket Depth ◽  
Surgical Extraction ◽  
A Minor

Surgical extraction of the third molar can often result in the development of a periodontal pocket distal to the second molar that could delay the healing, and the socket could be colonized by bacteria and lead to secondary abscesses, or it may cause mobility or hypersensitivity. The aim of this case report is to assess the efficacy of a dentin autograft in the prevention of periodontal dehiscences after the surgical extraction of the third molar, obtained by the immediate grinding of the extracted tooth. A healthy 18-year-old male patient underwent surgery of both impacted mandibular molars: right postextractive socket was filled with grinded dentin; then, the left one was filled with fibrin sponge. The patient was followed up for six months, and clinical and radiographic assessment were performed: measurements of plaque index (PI), bleeding on probing (BOP), gingival index (GI), clinical attachment level (CAL), and probing pocket depth (PPD) were done before surgery and repeated at 90 and 180 days after the extractions. Measurements made at six months after the surgery revealed that the grafted site was characterized by a minor depth of the pocket if compared with the nongrafted site, with no clinical/radiographic signs of complications.

scholarly journals A Four-Year Monocentric Study of the Complications of Third Molars Extractions under General Anesthesia: About 2112 Patients

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
A. Guerrouani ◽  
T. Zeinoun ◽  
C. Vervaet ◽  
W. Legrand
Keyword(s):  
General Anesthesia ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Lingual Nerve ◽  
Third Molars ◽  
Nerve Injuries ◽  
Third Molar Extraction ◽  
Discharge From Hospital ◽  
Clear Information ◽  
Tooth Section

Introduction. The aim of this study was to assess the complications resulting from third molar extraction under general anesthesia.Material and Methods. The retrospective study included all patients who underwent impacted third molars extraction from January 2008 until December 2011. 7659 third molars were extracted for 2112 patients. Postoperative complications were retrieved from medical files.Results. No complications were related to general anesthesia. The most frequent postoperative complication was infection (7.15%). Lingual nerve injuries affected 1.8% of the patients. All of them were transient and were not related to tooth section. Inferior alveolar nerve injuries were reported in 0.4% of the cases. 95.8% of these patients were admitted for one-day ambulatory care, and only two patients were readmitted after discharge from hospital.Discussion. This surgical technique offers comfort for both surgeons and patients. Risks are only linked to the surgical procedure as we observed no complication resulting from general anesthesia. One-day hospitalization offers a good balance between comfort, security, and cost. The incidence of complications is in agreement with the literature data, especially regarding pain, edema, and infectious and nervous complications. It is of utmost importance to discuss indications with patients, and to provide them with clear information.

Mandibular Second Molar Periodontal Status After Third Molar Extraction

2001 ◽  
Vol 72 (12) ◽  
pp. 1647-1651 ◽  
Author(s):  
Kuang-Yao Peng ◽  
Yuen-Chin Tseng ◽  
E-Chin Shen ◽  
Shian-Chung Chiu ◽  
Earl Fu ◽  
...  
Keyword(s):  
Third Molar ◽  
Periodontal Status ◽  
Second Molar ◽  
Third Molar Extraction ◽  
Mandibular Second Molar ◽  
Molar Extraction

scholarly journals A case report of a long-term abandoned torn lingual nerve injury repaired by collagen nerve graft induced by lower third molar extraction

2019 ◽  
Vol 41 (1) ◽  
Author(s):  
Shigeyuki Fujita ◽  
Naoki Mizobata ◽  
Takashi Nakanishi ◽  
Itaru Tojyo
Keyword(s):  
Peripheral Nerves ◽  
Third Molar ◽  
Lingual Nerve ◽  
Case Presentation ◽  
Nerve Grafts ◽  
Third Molar Extraction ◽  
The Usa ◽  
Direct Anastomosis ◽  
Molar Extraction

Abstract Background The lingual nerve plays an important role in multiple functions, including gustatory sensation and contact sensitivity and thermosensitivity. Misdiagnosed conservative treatments for serious lingual nerve (LN) injuries can induce the patient to serious mental disability. After continuous observation and critical diagnosis of the injury, in cases involving significant disruption of lingual nerve function, microneurosurgical reconstruction of the nerve is recommended. Direct anastomosis of the torn nerve ends without tension is the recommended approach. However, in cases that present significant gaps between the injured nerve ends, nerve grafts or conduits (tubes of various materials) are employed. Recently, various reconstruction materials for peripheral nerves were commercially offered especially in the USA, but the best method and material is still unclear in the world. There currently exists no conventional protocol for managing LN neurosensory deficiency in regard to optimal methods and the timing for surgical repair. In Japan, the allograft collagen nerve for peripheral nerves reconstruction was permitted in 2017, and we tried to use this allograft nerve and got a recommendable result. Case presentation This report is a long-term abandoned torn LN reconstructed with allograft nerve induced by the lower third molar extraction. Conclusions In early sick period, with the exact diagnosis, the LN disturbance should be managed. In a serious condition, the reconstruction with allograft nerve is one of the recommendable methods.

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