scholarly journals Modified and Grafted Coronectomy: A New Technique and a Case Report with Two-Year Followup

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Michael Leizerovitz ◽  
Olga Leizerovitz
Keyword(s):  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Panoramic Radiograph ◽  
Good Alternative ◽  
New Technique ◽  
Graft Material ◽  
Second Molar ◽  
Mandibular Third Molar ◽  
A New Technique

Purpose. A standard coronectomy (intentional partial odontectomy) is recommended for mandibular third molar (MTM) extraction cases with a high risk of inferior alveolar nerve injury (IANI). However, complications such as inadvertent intraoperative root removal, post-op root migration, second molar (MSM) periodontal defects and others do exist. This report presents a new technique, the Modified and Grafted Coronectomy (MGC), describes the measures to prevent or minimize the known drawbacks of the standard coronectomy, and reviews the literature for comparison with three other IANI-prevention techniques.Materials and Methods. MGC was performed on two MTMs with nerve involvement and severe periodontal pockets on the distal of MSM. Modifications were: stabilizing the root stump to prevent intraoperative movement, creation of a large intrabony space for bone graft material, and grafting for periodontal healing while minimizing the possibility of post-op root migration.Results. Excellent overall periodontal improvement, with probing depths reduced to 3-4 mm. Panoramic radiograph displayed remarkable bone regeneration. No residual root migration was evident at the two year follow up.Conclusion. MGC may be a good alternative, especially in cases with periodontal defects on the distal of MSM. It may also help to minimize inadvertent intraoperative root removal and postoperative root migration.

scholarly journals Modified coronectomy procedure for mandibular third molar: association of platelet-rich fibrin

2021 ◽  
Vol 69 ◽  
Author(s):  
Ronaldo Célio MARIANO ◽  
Alexandre Augusto Ferreira da SILVA ◽  
Guilherme Menali GOMES ◽  
Luis Henrique Theodoro ALVES ◽  
Marina Reis OLIVEIRA
Keyword(s):  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Panoramic Radiograph ◽  
Mandibular Canal ◽  
Modified Technique ◽  
Present Case Report ◽  
Platelet Rich Fibrin ◽  
Good Healing ◽  
Mandibular Third Molar

ABSTRACT The present case report describes a modified technique of coronectomy for mandibular third molar with association of Platelet-Rich Fibrin Graft (PRF). The panoramic radiograph showed proximity of the roots of the vertical positioned 48 tooth with the superior wall of the mandibular canal, since the erasure of the superior cortical of the mandibular canal was observed. Due to the risk of injury to the inferior alveolar nerve, the technique of coronectomy was chosen. After the realized the coronectomy, in order to promote the regeneration of soft and hard tissues and also to prevent pulp changes that could lead to pain, pulp necrosis and infection, the PRF graft was used to fill the surgical defect formed by removal of the crown. Good healing evolution was observed and after 12 months of clinical and radiographic follow-up there was complete bone formation in the area where the crown was removed and no complications were observed.

scholarly journals Autotransplantation of a Mandibular Third Molar: A Case Report with 5 Years of Follow-up

2013 ◽  
Vol 24 (3) ◽  
pp. 289-294 ◽  
Author(s):  
Mauro Henrique Chagas e Silva ◽  
Mariane Floriano Lopes Santos Lacerda ◽  
Maria das Gracas Afonso Miranda Chaves ◽  
Celso Neiva Campos
Keyword(s):  
Autologous Transplantation ◽  
Third Molar ◽  
Treatment Alternative ◽  
Missing Teeth ◽  
Second Molar ◽  
Root Canals ◽  
Mandibular Third Molar ◽  
Feasible Option ◽  
Viable Treatment

This paper describes the autologous transplantation of a mandibular right third molar to replace the residual roots of the second molar in the same quadrant, preserving function and aesthetics. A 5-year clinical and radiographic follow-up was undertaken. After transplantation, the donor tooth received endodontic treatment and placement of calcium hydroxide, which was periodically replaced every 3 months until the filling of the root canals, totalizing a period of 1-year, when apical closure was confirmed. The tooth was in perfect functional and aesthetic conditions 5 years after beginning of treatment. Autotransplantation is a feasible option for replacing missing teeth when a donor tooth is available. The autotransplantation of a right mandibular third molar with compromised function and aesthetics to replace the residual roots resulting from coronal destruction due to extensive carious lesion of the second molar in the same quadrant was a viable treatment alternative.

scholarly journals Primary epithelioid angiosarcoma originating from the mandibular gingiva: a case report of an extremely rare oral lesion

2020 ◽  
Author(s):  
Yuko Komatsu ◽  
Ikuya Miyamoto ◽  
Yu Ohashi ◽  
Katsunori Katagiri ◽  
Daisuke Saito ◽  
...  
Keyword(s):  
Dentigerous Cyst ◽  
Third Molar ◽  
Panoramic Radiograph ◽  
Oral Lesion ◽  
Epithelioid Angiosarcoma ◽  
Case Presentation ◽  
Mandibular Third Molar ◽  
Old Japanese ◽  
Molar Region

Abstract Background Angiosarcoma occurs very rarely in the oral cavity, and the epithelioid type is even rarer. Here, we report a rare case involving an elderly man with a primary epithelioid angiosarcoma that originated from the mandibular gingiva and resembled a dentigerous cyst on radiographs. Case presentation A 66-year-old Japanese man visited our hospital with a chief complaint of gingival swelling in right mandibular third molar region. A panoramic radiograph showed bone resorption around the crown of right mandibular third molar, which was impacted. Incisional biopsy confirmed a diagnosis of epithelioid angiosarcoma. The lesion exhibited aggressive proliferation after biopsy resulting in uncontrolled bleeding and difficulty in closing the mouth. Mandibular segmental resection including the tumor was performed without reconstruction. Because of the aggressive preoperative course of the tumor, the patient received adjuvant chemotherapy. There were no signs of recurrence during a 2-year follow-up period. ConclusionsA review of the literature yielded only four reported cases of epithelioid angiosarcoma in the jaw region, with the lesions occurring in the maxilla in three cases. To our knowledge, this is the second case of primary epithelioid angiosarcoma in the mandible.

scholarly journals Primary epithelioid angiosarcoma originating from the mandibular gingiva: a case report of an extremely rare oral lesion

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Yuko Komatsu ◽  
Ikuya Miyamoto ◽  
Yu Ohashi ◽  
Katsunori Katagiri ◽  
Daisuke Saito ◽  
...  
Keyword(s):  
Dentigerous Cyst ◽  
Third Molar ◽  
Panoramic Radiograph ◽  
Oral Lesion ◽  
Epithelioid Angiosarcoma ◽  
Case Presentation ◽  
Mandibular Third Molar ◽  
Old Japanese ◽  
Molar Region

Abstract Background Angiosarcoma occurs very rarely in the oral cavity, and the epithelioid type is even rarer. Here, we report a rare case involving an elderly man with a primary epithelioid angiosarcoma that originated from the mandibular gingiva and resembled a dentigerous cyst on radiographs. Case presentation A 66-year-old Japanese man visited our hospital with a chief complaint of gingival swelling in right mandibular third molar region. A panoramic radiograph showed bone resorption around the crown of right mandibular third molar, which was impacted. Incisional biopsy confirmed a diagnosis of epithelioid angiosarcoma. The lesion exhibited aggressive proliferation after biopsy resulting in uncontrolled bleeding and difficulty in closing the mouth. Mandibular segmental resection including the tumor was performed without reconstruction. Because of the aggressive preoperative course of the tumor, the patient received adjuvant chemotherapy. There were no signs of recurrence during a 2-year follow-up period. Conclusions A review of the literature yielded only four reported cases of epithelioid angiosarcoma in the jaw region, with the lesions occurring in the maxilla in three cases. To our knowledge, this is the second case of primary epithelioid angiosarcoma in the mandible.

scholarly journals Primary epithelioid angiosarcoma originating from the mandibular gingiva: a case report of an extremely rare oral lesion

2020 ◽  
Author(s):  
Yuko Komatsu ◽  
Ikuya Miyamoto ◽  
Yu Ohashi ◽  
Katsunori Katagiri ◽  
Daisuke Saito ◽  
...  
Keyword(s):  
Dentigerous Cyst ◽  
Third Molar ◽  
Panoramic Radiograph ◽  
Oral Lesion ◽  
Epithelioid Angiosarcoma ◽  
Case Presentation ◽  
First Case ◽  
Mandibular Third Molar ◽  
Old Japanese

Abstract BackgroundAngiosarcoma occurs very rarely in the oral cavity, and the epithelioid type is even rarer. Here we report a rare case involving an elderly man with a primary epithelioid angiosarcoma that originated from the mandibular gingiva and resembled a dentigerous cyst on radiographs.Case presentationA 66-year-old Japanese man visited our hospital with a chief complaint of gingival swelling in right mandibular third molar region. A panoramic radiograph showed bone resorption around the crown of right mandibular third molar, which was impacted. Incisional biopsy confirmed a diagnosis of epithelioid angiosarcoma. The lesion exhibited aggressive proliferation after biopsy resulting in uncontrolled bleeding and difficulty in closing the mouth. Mandibular segmental resection including the tumor was performed without reconstruction. Because of the aggressive preoperative course of the tumor, the patient received adjuvant chemotherapy. There were no signs of recurrence during a 1-year follow-up period.ConclusionsA review of the literature yielded only three reported cases of epithelioid angiosarcoma in the jaw region, with the lesions occurring in the maxilla in all three cases. To our knowledge, this is the first case of primary epithelioid angiosarcoma in the mandible.

scholarly journals The ability of orthodontists and maxillofacial surgeons in predicting spontaneous eruption of mandibular third molar using panoramic serial radiographs

2020 ◽  
Vol 25 (4) ◽  
pp. 68-74
Author(s):  
Mylena Ranieri Libdy ◽  
Nicole Melres Rabello ◽  
Leandro Silva Marques ◽  
David Normando
Keyword(s):  
Orthodontic Treatment ◽  
Third Molar ◽  
Panoramic Radiograph ◽  
Third Molars ◽  
The Third ◽  
Mandibular Third Molar ◽  
Panoramic Analysis ◽  
Orthodontic Patients ◽  
Mandibular Third Molars

ABSTRACT Objective: To evaluate the skill of orthodontists and oral/maxillofacial surgeons (OMFS) in providing a prognosis of mandibular third molars spontaneously erupted, through follow-up panoramic analysis. Methods: 22 orthodontic patients treated without extraction, presenting spontaneously erupted mandibular third molars (n = 44) were analyzed through panoramic serial radiographs. The first panoramic radiograph was obtained just after orthodontic treatment (PR1), in patients aging from 13 to 19 years. A second panoramic radiograph (PR2), was obtained in average two years later. The radiographs were randomly analyzed by 54 specialists, 27 orthodontists and 27 OMFS, to obtain the opinion about the approach to be adopted to these teeth in PR1. Then, another opinion was collected by adding a serial radiograph (PR1+2). Results: The concordance of the answers was moderate for OMFS (Kappa 0.44; p< 0.0001) and significant for orthodontists (Kappa 0.39; p< 0.0001). In the analysis of the first radiograph (PR1) of the spontaneously erupted molars, OMFS indicated extraction in 44.5% of cases, while orthodontists indicated in 42%, with no difference between groups (p= 0.22). In PR1+2 analysis, orthodontists maintained the same level of extraction indication (45.6%, p= 0.08), while surgeons indicated more extractions (63.2%, p< 0.0001). Conclusions: Orthodontists and OMFS were not able to predict the eruption of the third molars that have erupted spontaneously. Both indicated extractions around half of the third molars. A follow-up analysis, including one more radiograph, did not improve the accuracy of prognosis among orthodontists and worsened for OMFS.

scholarly journals Mandibular Third Molar Surgery: Intraosseous Localization of the Inferior Alveolar Nerve Using 3D Double-Echo Steady-State MRI (3D-DESS)

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1245
Author(s):  
Adib Al-Haj Husain ◽  
Bernd Stadlinger ◽  
Sebastian Winklhofer ◽  
Marcel Müller ◽  
Marco Piccirelli ◽  
...  
Keyword(s):  
Steady State ◽  
Nervous Tissue ◽  
Imaging Modality ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Maximum Diameter ◽  
Third Molar Surgery ◽  
Second Molar ◽  
The Third ◽  
Mandibular Third Molar

The aim of this study was to evaluate the inferior alveolar nerve’s (IAN) intraosseous position within the inferior alveolar canal (IAC) using a 3D double-echo steady-state MRI sequence (3D-DESS). The IAN position was prospectively evaluated in 19 patients undergoing mandibular third molar (MTM) surgery. In the coronal reference layer, the IAC was divided into six segments. These segments were checked for the presence of hyperintense tubular MRI signals representing the IAN’s nervous tissue and assessed as visible/non-visible. Furthermore, the IAN in MRI and the IAC in MRI and CBCT were segmented at the third and second molar, determining the maximum diameter in all planes and a conversion factor between the imaging modalities. Regardless of the positional relationship at the third and second molar, the IAN showed the highest localization probability in the central segments (segment 2: 97.4% vs. 94.4%, segment 5: 100% vs. 91.6%). The conversion factors from IAC in CBCT and MRI to IAN in MRI, respectively, were the following: axial (2.04 ± 1.95, 2.37 ± 2.41), sagittal (1.86 ± 0.96, 1.76 ± 0.74), and coronal (1.26 ± 0.39, 1.37 ± 0.25). This radiation-free imaging modality, demonstrating good feasibility of accurate visualization of nervous tissue within the nerve canal’s osseous boundaries, may benefit preoperative assessment before complex surgical procedures are performed near the IAC.

In-block lateralization as a new technique for mobilization of the inferior alveolar nerve: a technique case series

2020 ◽  
Author(s):  
Marcos Augusto Tomazi ◽  
Alexandre da Silveira Gerzson ◽  
Angelo Menuci Neto ◽  
André Luciano Pasinato da Costa
Keyword(s):  
Treatment Options ◽  
Inferior Alveolar Nerve ◽  
Case Series ◽  
New Technique ◽  
Autogenous Bone ◽  
Minimal Risk ◽  
Short Implants ◽  
Bone Atrophy ◽  
A New Technique ◽  
Number Of Treatment

The edentulous atrophic posterior mandible is often a great challenge for implant rehabilitation. Although a number of treatment options have been proposed, including the use of short implants and surgical grafting techniques, in cases of severe bone atrophy, techniques for mobilization of the inferior alveolar nerve (IAN) have been shown to be efficient, with good results. Four female patients underwent IAN lateralization for prosthetic rehabilitation of the posterior mandible from 2013 to 2019, with 1 year to 5 years and 4 months of follow-up. This case series describes a new technique for mobilization of the IAN, named in-block lateralization, to facilitate access to the IAN and to reduce nerve manipulation. The implant is immediately installed (allowing nerve lateralization in unitary spaces) and the original mandibular anatomy is restored with autogenous bone from the original bed during the same surgical procedure. When well indicated and well performed, this new approach provides better and easier visualization of the IAN as well as safer manipulation aiming to achieve good results for implant stability and minimal risk of neurosensory disturbances, allowing rehabilitation even in unitary spaces.

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