scholarly journals Comparison of Piezosurgery and Conventional Rotary Instruments for Removal of Impacted Mandibular Third Molars: A Randomized Controlled Clinical and Radiographic Trial

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Hani Arakji ◽  
Mohamed Shokry ◽  
Nayer Aboelsaad
Keyword(s):  
Statistical Significance ◽  
Third Molar ◽  
Test Site ◽  
Surgical Removal ◽  
Third Molars ◽  
Randomized Controlled ◽  
Surgical Extraction ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars ◽  
Bone Quantity

The purpose of this study was to test the effect of the surgical removal of impacted mandibular third molars using piezosurgery versus the conventional surgical technique on postoperative sequelae and bone healing.Material and Methods.This study was carried out as a randomized controlled clinical trial: split mouth design. Twenty patients with bilateral mandibular third molar mesioangular impaction class II position B indicated for surgical extraction were treated randomly using either the piezosurgery or the conventional bur technique on each site. Duration of the procedure, postoperative edema, trismus, pain, healing, and bone density and quantity were evaluated up to 6 months postoperatively.Results.Test and control sites were compared using pairedt-test. There was statistical significance in reduction of pain and swelling in test sites, where the time of the procedure was statistically increased in test site. For bone quantity and quality, statistical difference was found where test site showed better results.Conclusion.Piezosurgery technique improves quality of patient’s life in form of decrease of postoperative pain, trismus, and swelling. Furthermore, it enhances bone quality within the extraction socket and bone quantity along the distal aspect of the mandibular second molar.

scholarly journals Factors affecting the Duration of Surgical Extraction of Impacted Mandibular Third Molars

2018 ◽  
Vol 9 (1) ◽  
pp. 8-12 ◽  
Author(s):  
Salwan Y Bede
Keyword(s):  
Statistical Significance ◽  
Demographic Data ◽  
Surgical Removal ◽  
Third Molars ◽  
Factors Affecting ◽  
Surgical Extraction ◽  
Duration Of Surgery ◽  
Impacted Mandibular Third Molars ◽  
Unerupted Teeth ◽  
Mandibular Third Molars

ABSTRACT Aim The aim of this study is to evaluate the effect of demographic, clinical, and radiographic factors on the duration of surgical extraction of impacted lower third molars. Materials and methods This retrospective study included patients who underwent surgical removal of impacted lower third molars, and the investigated factors were demographic data including age and gender, radiographic data including the impacted tooth angulation and depth of impaction and ramus relation, and clinical data including the state of eruption of the impacted teeth. These factors were evaluated for association with the duration of surgery. Descriptive statistical analysis included percentages and mean ± standard deviation (SD). Student's t-test was used to compare means between two groups, while for comparing the means among three or more groups for statistical significance, analysis of variance (ANOVA) test was used. Results Forty patients were included: 20 (50%) males and 20 (50%) females. The age range was from 17 to 37 years with a mean ± SD of 23.4 ± 5.016 years. The duration of surgery (± SD) in all the patients ranged from 10 to 40 minutes with a mean of 25.8 ± 8.56 minutes. Clinically unerupted teeth and deep ramus relationship were associated with statistically significant increase in duration of surgical extraction. Conclusion This study identifies state of eruption and ramus relation to be significant predictive factors, whereas other investigated factors, namely, age of patient, sex, angulation of teeth, and depth of impaction, were found to be not significant in determining the duration of surgery and hence, the difficulty of extraction. Clinical significance Duration of surgical extraction of impacted mandibular third molars can be considered as an indicator for difficulty of surgical extraction. Difficult surgical extraction of impacted mandibular third molars can be anticipated in clinically unerupted teeth and those with deep ramus relationship. How to cite this article Bede SY. Factors affecting the Duration of Surgical Extraction of Impacted Mandibular Third Molars. World J Dent 2018;9(1):8-12.

scholarly journals Clinical assessment of impacted lower third molars at Ekpan, Delta State in Nigeria

2020 ◽  
Vol 3 (2) ◽  
pp. 352-355
Author(s):  
Mabel Okiemute Etetafia ◽  
Ese Anibor ◽  
Martins Obaroefe
Keyword(s):  
Third Molar ◽  
Third Molars ◽  
Impacted Tooth ◽  
Female Ratio ◽  
Impacted Teeth ◽  
Pull Out ◽  
Carious Lesions ◽  
Surgical Extraction ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars

Introduction: Diagnosis and management of impacted mandibular third molars call for a cogent appraisal and treatment choice both for the sick person and the dental practitioner. This academic work scrutinized the pattern as well as treatment of impacted mandibular third molars at the Teem Clinic and Dental Centre, Ekpan, Delta State, in Nigeria.Materials and Methods: This cross-sectional survey involved 131 cases who reported impacted mandibular third molars. The age, gender, impacted tooth, type of impaction, pathological conditions, and treatment proffered were recorded.Results: The male to female ratio was 0.8:1, with an age range of 10 to 40 years. Of the lower third molar impactions 58 (42.0%) were mesioangular, 5 (3.6%) horizontal, 18 (13.0%) vertical and 57 (41.3%) were distoangular. A total of 47 (34.1%) quested for dental attention following varying degrees of pain induced by pericoronitis. Teeth removal was accomplished for 76 (55.0%) owing to carious lesions on the impacted teeth, proximate tooth, or both. Surgical extraction was the option taken in 69 (50.0 %) with caries on the impacted teeth while 3 (2.2%) had to pull out of their teeth done owing to carious lesions on the bordering second molars. In 3 (2.2%) both the impacted third molar and the proximate second molar were decayed. Conclusions: The prevailing indication for pulling out impacted mandibular third molars was acute pericoronitis. Mesioangular sort of impaction was most recurrent and ought to be considered for theplausibility of frequentness of complications.

scholarly journals Lingual split bone technique – Revisited as a standard operating procedure for surgical removal of third molar during COVID pandemic

2021 ◽  
Vol 7 ◽  
pp. 18-22
Author(s):  
Sushmitha Mohan ◽  
Annamalai Thangavelu ◽  
Aravindraj
Keyword(s):  
Operating Procedure ◽  
Third Molar ◽  
Standard Operating Procedure ◽  
Surgical Removal ◽  
Third Molars ◽  
Standard Operating ◽  
Infectivity Rate ◽  
Alveolar Osteitis ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars

Objectives: The objective of the study is to revisit the forgotten art of Lingual split bone technique during the COVID pandemic as a Standard Operating Procedure (SOP) for the surgical removal of impacted mandibular third molars. It was originally introduced in early 90’s by Sir William Kelsey Fry and also we have compared its advantages over the bone guttering technique. Materials and Methods: Twenty seven cases were operated during COVID pandemic in our institution using Davi’s modified lingual split technique under strict COVID protocol. Results: All impacted mandibular third molars were successfully removed. With regards to post-operative complication; 3 patients had nerve injury (11%), 2 patients had lingual paraesthesia (7.6%), 1 patient had alveolar osteitis (3.8%), 2 patients had postoperative infection (7.6%), 3 patients had trismus (19%). The overall success rate was 100%. Also the results of a comparison between bone guttering and chisel-mallet technique were stated. Conclusion: The use of lingual split bone technique deserves consideration during this COVID time as an alternate for bone guttering in surgical removal of third molar as it ensures minimal cross infectivity rate among both dentists and patients. Thus, patient care can be delivered with confidence even during pandemic.

scholarly journals TO COMPARE THE EFFECT OF PRE-EMPTIVE DEXAMETHASONE AND METHYLPREDNISOLONE EITHER BY INTRAMUSCULAR OR BY SUBMUCOSAL ROUTE FOR THE POSTOPERATIVE CONTROL OF PAIN, SWELLING, AND LIMITED MOUTH OPENING FOLLOWING THE EXTRACTION OF IMPACTED THIRD MOLARS

2020 ◽  
pp. 1-7
Author(s):  
Kiran Shubha ◽  
Ravi Narula ◽  
Navneet Kaur
Keyword(s):  
Intramuscular Injection ◽  
Third Molar ◽  
Mouth Opening ◽  
Surgical Removal ◽  
Third Molars ◽  
Limited Mouth Opening ◽  
Submucosal Injection ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars ◽  
Better Than

Introduction: The surgical removal of impacted mandibular third molars is an invasive procedure that involves extensive tissue trauma and a considerable postoperative inflammatory response. Although the inflammatory process is necessary for healing when exacerbated it may cause pain, swelling and limited mouth opening. Corticosteroids are among the most widely employed pre-operative medication administered for the control of such complications. Objective: To compare the effects of single dose of pre-operative Injection Dexamethasone versus Injection Methylprednisolone via Intramuscular or Submucosal route for controlling the post-operative pain, swelling and limited mouth opening in the removal of impacted mandibular third molars. Material and Method:. The present study was conducted on 40 healthy adult patients with bilaterally symmetrical impacted mandibular third molar, reporting to the Department of oral and Maxillofacial Surgery of Guru Nanak Dev Dental College and Research Institute, Sunam. Clinically, pain, swelling, mouth-opening were evaluated pre-operatively as baseline and post-operatively on 1st, 3rd and 7th post-operative days. Results: The results of our study are summarized below: In Group A: Submucosal injection of dexamethasone gave better results in controlling pain, swelling and trismus in comparison to Intramuscular injection of dexamethasone. In Group B: Submucosal injection of methylprednisolone showed better results in terms of pain, swelling and trismus when compared with Intramuscular injection of methylprednisolone. In Group C: Intramuscular injection of dexamethasone gave better results in terms of pain and mouth opening but, swelling was reduced with Intramuscular methylprednisolone. In Group D: Submucosal injection of dexamethasone showed better results in terms of pain, but swelling and mouth opening was reduced when methylprednisolone was used submucosal. Conclusion: The results of our study concluded that Dexamethasone is better than Methylprednisolone in controlling post-operative sequelae after third molar surgery. This can attributed to the higher potency and longer half-life and less sodium retaining capacity of dexamethasone than methylprednisolone. The results of our study also concluded that submucosal route of administration of drug is better than Intramuscular route because of the repository effect of the submucosal route, also this route is beneficial to the patient as well to the surgeon because needle penetration is done in the pre-anesthetized area, also it is an easy technique to be mastered by the surgeon.

scholarly journals Comparative evaluation of effectiveness of 2% lignocaine hydrochloride with 1.5% potassium chloride versus 2% lignocaine hydrochloride with adrenaline bitartrate versus 2% lignocaine hydrochloride as local anaesthetic for adult patients undergoing surgical extraction of impacted mandibular third molars: a randomized controlled clinical study

2021 ◽  
Vol 27 (4) ◽  
pp. 55
Author(s):  
Rinku Kalra ◽  
Shreyas Gupte ◽  
Thomson D'Cruz ◽  
Nidhi Pandey ◽  
Drishti Shah ◽  
...  
Keyword(s):  
Potassium Chloride ◽  
Controlled Study ◽  
Depth Of Anesthesia ◽  
Third Molars ◽  
Randomized Controlled ◽  
Surgical Extraction ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars

Background and objective: Administration of some additives with local anesthetics can prolong pain free period post-operatively, thereby reducing need for post-operative analgesics and improving patient comfort. Potassium chloride was found to increase duration and quality of anesthesia in various studies on brachial plexus blockade. This study was designed to evaluate and compare the effect of 2% lignocaine with 1.5% potassium chloride, 2% lignocaine with adrenaline and 2% lignocaine (plain) in pterygomandibular nerve blocks. Materials and methods: A triple blind randomized controlled study was conducted on 120 adults, aged 18–45 years in ASA-I category, requiring surgical extraction of impacted mandibular third molars. The subjects were divided equally into 3 groups randomly by computer generated sequence; Group 1: 2% lignocaine plus 1.5% solution of potassium chloride, group 2: 2% lignocaine with 1:80,000 adrenaline and group 3: 2% plain lignocaine. Onset, duration, depth (pain) of anesthesia, patient satisfaction, systolic and diastolic blood pressures, heart rate and oxygen saturation, were evaluated and compared. Results: Onset was shortest for group1 and longest for grp3, statistically highly significant difference between the 3 groups (p < 0.01). Statistically significant difference (p < 0.05) was found in duration of surgery, duration of analgesia and VAS scores between groups 1 & 3. Duration and depth of anesthesia were comparable for groups 1 & 2. There was no statistically significant difference seen for total amount of dose used, SBP, DBP, HR and SpO2 between the 3 groups (p > 0.05). Conclusion: Potassium chloride, a physiological salt is inert and causes no local/systemic adverse effects when injected with lignocaine in physiologically permissible amounts. The combination achieves satisfactory onset, duration, depth of anesthesia without altering hemodynamic variables. Hence, it may be considered as a safe and effective additive.

scholarly journals Influence of Lidocaine including Buprenorphine for Postoperative Analgesia after the Extraction of Mandibular Third Molars: A Randomized Controlled, Double-Blind, Split-Mouth Study

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Nimrat K. Jawanda ◽  
Anand Shukla ◽  
Anupam Singh ◽  
Kalyana C. Pentapati ◽  
Srikanth Gadicherla
Keyword(s):  
Opioid Receptors ◽  
Postoperative Analgesia ◽  
Third Molar ◽  
Control Group ◽  
Third Molars ◽  
Surgical Extraction ◽  
Significant Difference ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars ◽  
And Control

Background. The presence of opioid receptors around the peripheral nerves offers the possibility of providing postoperative analgesia, thereby encouraging the study of the effect of opioids in combination with local anesthesia (LA). Studies have also reported the efficacy of peripherally administered opioids in achieving adequate analgesia in regions with inflammation. Applying the concept of peripheral opioid receptors, our study aimed to evaluate the effectiveness of opioid analgesia in managing postoperative pain. The split-mouth study was carried out to evaluate the efficacy of buprenorphine added to lidocaine 2% in providing postoperative analgesia after the surgical extraction of the impacted mandibular third molar. Materials and Methods. We conducted a randomized, double-blinded, split-mouth trial among 21 patients with impacted mandibular third molars bilaterally. In all patients, bilateral impacted mandibular third molars were extracted at different periods. The primary outcomes assessed were postoperative analgesia by the VAS score and the number of rescue analgesics consumed by patients at 24, 48, and 72 hours of interval via a questionnaire. Results. There was a statistical significant difference in postoperative analgesia duration at 24 (P = 0.012) and 48 hours (P = 0.024), respectively, between the test and control group. Even though the mean number of rescue analgesics consumed by the test group was less than that of the control group, no significant difference was seen. Conclusion. Buprenorphine added to lidocaine 2% showed a minimal decrease in the pain score and duration of postoperative analgesia with no difference in the frequency of rescue analgesics consumed between the test and control.

scholarly journals Comparing the Effect of Facial Compression Bandage to That of Systemic Dexamethasone on Postsurgical Sequels after Extraction of Impacted Mandibular Third Molars: A Split-mouth Randomized Clinical Trial

2021 ◽  
Vol 9 (D) ◽  
pp. 160-165
Author(s):  
Ibraheem Hamadi ◽  
Nuraldeen Maher Al-Khanati ◽  
Zafin Kara Beit
Keyword(s):  
Third Molar ◽  
Study Groups ◽  
Third Molars ◽  
Dexamethasone Group ◽  
Surgical Extraction ◽  
Significant Difference ◽  
Impacted Mandibular Third Molars ◽  
The Mean ◽  
Mandibular Third Molars ◽  
Present Trial

AIM: The present study aimed to compare the clinical efficiency of facial pressure bandage, to that of intramuscular injection of dexamethasone (8 mg) on postsurgical sequels (swelling, pain, and trismus) of extraction of impacted mandibular third molar. METHODS: The study implemented a randomized split-mouth design. Patients with symmetrical bilateral impacted molars were eligible for the present trial. Sides were randomly assigned to two groups: pressure bandage group and dexamethasone group. The evaluated postsurgical sequels were extraoral swelling, trismus, and pain after 48 h and 7 days. RESULTS: The study included 42 impacted third molars (n = 42) in 21 patients with a mean age of 23.4 years. Most participants were females (66.7%). The mean postoperative swelling rates after 48 h and 7 days in pressure bandage group were found to be comparable to those of dexamethasone group. No significant difference was found in the mean rates of postoperative trismus between study groups after 48 h and 7 days. Differences in mean pain level scores between the pressure bandage group and dexamethasone group were statistically insignificant after 48 h and 7 days. CONCLUSION: The study findings showed that the effect of the pressure bandage was comparable to dexamethasone effect on the postsurgical sequels after surgical extraction of impacted mandibular third molars.

scholarly journals Incidence of neurosensory deficits following surgical removal of mandibular third molars: a prospective clinical study

2019 ◽  
Vol 7 (5) ◽  
pp. 1546
Author(s):  
Thaufiq Ahamed M. I. ◽  
Naveen Jayakumar ◽  
Neelakandan R. S.
Keyword(s):  
Tamil Nadu ◽  
Statistical Significance ◽  
Maxillofacial Surgery ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Lingual Nerve ◽  
Surgical Removal ◽  
Third Molars ◽  
Post Surgery ◽  
Mandibular Third Molars

Background: The aim of this prospective study was to determine the incidences of inferior alveolar nerve and lingual nerve deficit following surgical removal of impacted mandibular third molars and to evaluate the risk factors responsible for these postoperative neurosensory deficits.Methods: A total of 80 patients who reported to department of oral and maxillofacial surgery, Meenakshi Ammal Dental College, Chennai, Tamil Nadu, India requiring surgical removal of impacted mandibular third molar were included in this cross-sectional study. Standard surgical procedure was performed. All patients were reassessed one week post-surgery. Subjectively reported altered sensations were recorded and objective assessments were performed with light touch test, two-point discrimination threshold and pin-pick pain threshold. The collected data was analyzed using the chi square test to find out any clinical relevance.Results: There was no inferior alveolar nerve related neurosensory deficits and 6 (7.5%) resulted in lingual nerve related neurosensory deficits. The incidence of LN deficit for mesioangular, horizontal, distoangular was 1.3%, 3.8% and 2.5% respectively. Type of impaction assumed a mild statistical significance (p = 0.050).Conclusions: This study highlights the importance of careful preoperative clinical and radiographic assessment of patients where third molar surgery is planned. The surgical technique of third molar removal is also likely to have great impact on the outcome.

scholarly journals The Growth Factors in Advanced Platelet-Rich Fibrin (A-PRF) Reduce Postoperative Complications after Mandibular Third Molar Odontectomy

2021 ◽  
Vol 18 (24) ◽  
pp. 13343
Author(s):  
Anna Starzyńska ◽  
Magdalena Kaczoruk-Wieremczuk ◽  
Michele Antonio Lopez ◽  
Pier Carmine Passarelli ◽  
Paulina Adamska
Keyword(s):  
Growth Factors ◽  
Postoperative Complications ◽  
Clinical Features ◽  
Oral Surgery ◽  
Third Molar ◽  
Surgical Removal ◽  
Third Molars ◽  
Platelet Rich Fibrin ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars

Surgical removal of impacted mandibular third molars constitutes one of the most frequently performed procedures within oral surgery. This surgery procedure is associated with many post-operative complications. Advanced platelet-rich fibrin (A-PRF) belongs to the second generation of platelet concentrates and is rich in numerous growth factors. The aim of this study was to assess the influence of A-PRF on selected clinical features following the surgical removal of impacted mandibular third molars. The research was conducted on 100 generally healthy patients, who underwent a lower third molar odontectomy in Department of Oral Surgery, Medical University of Gdańsk, Poland, between 2018 and 2019. The research group consisted of 50 patients (immediate A-PRF socket filling) and control group (50 patients without A-PRF socket filling). During the study, the following clinical features were assessed: pain (visual analog scale), analgesics intake, the presence of trismus, edema, hematomas within the surrounding tissues (e.g., cheek), prevalence of pyrexia, dry socket, secondary bleeding, presence of hematomas, skin warmth in the post-operative area, and bleeding time observed by the patient were analyzed on the 3rd, 7th, and 14th day after the procedure. There was a significant association between A-PRF socket filling and pain intensity, the analgesics intake, trismus, and edema on the 3rd and the 7th day (p < 0.05). The presence of hematomas and skin warmth on the 3rd day after the surgery (p < 0.05) were also statistically associated with A-PRF use. The study showed that in reducing the incidence of postoperative complications, A-PRF was more important than the position of the tooth or the duration of the procedure. The growth factors in A-PRF reduce postoperative complications, such as pain, trismus, edema, analgesics intake, presence of hematomas, and skin warmth, after mandibular wisdom teeth odontectomy.

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