Hard Tissue Preservation in Minimally Invasive Mandibular Third Molar Surgery Using In Situ Hardening TCP Bone Filler

Background. Maintenance of hard tissue in the case of impacted third molars (M3M) with close relationship to the mandibular canal is still a surgical challenge which may be overcome using the inward fragmentation technique. Methods. A consecutive case series of 12 patients required the extraction of 13 impacted M3M with a close relationship to the inferior alveolar nerve (IAN). Via occlusal miniflaps, M3M were exposed occlusal under endoscopic vision and removed by inward fragmentation. All patients received socket preservation with resorbable in situ hardening TCP particles to reduce the risk of pocket formation at the second molar. Results. All 13 sites healed uneventfully. Bone height was assessed using CBCT cross-sectional reformats pre- and 3 months postoperatively. The bone height was reduced by 1.54 mm lingual (SD 0.88), 2.91 mm central (SD 0.93), and 2.08 mm buccal (SD 1.09). Differences were significant at a 0.05% level. No tissue invagination at the extraction sites was observed. Conclusions. Major bone defects can be avoided safely using inward fragmentation surgery. The self-hardening bone filler appears to enhance the mineralization of the intrabony defect.

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The correlation between Rood and Shehab’s radiographic features and the incidence of inferior alveolar nerve paraesthesia following odontectomy of lower third molars

Dental Journal (Majalah Kedokteran Gigi) ◽

10.20473/j.djmkg.v49.i2.p59-62 ◽

2017 ◽

Vol 49 (2) ◽

pp. 59

Author(s):

David Buntoro Kamadjaja ◽

Djodi Asmara ◽

Gita Khairana

Keyword(s):

Inferior Alveolar Nerve ◽

Third Molar ◽

Mandibular Canal ◽

Cross Sectional Study ◽

Third Molar Surgery ◽

Third Molars ◽

Chi Square ◽

Cross Sectional ◽

Radiographic Features ◽

Close Relationship

Background: Odontectomy of lower third molar has a potential risk for inferior alveolar nerve impairment. Paresthesia of inferior alveolar nerve has often been associated with close relationship between the apex of lower third molar and mandibular canal. Rood and Shehab’s category has been commonly used for radiological prediction of inferior alveolar nerve injury following third molar surgery. Purpose: This study aimed to determine whether there was correlation between Rood and Shehab’s radiographic features and the incidence of inferior alveolar nerve paraesthesia following odontectomy of lower third molar. Method: This was a retrospective cross-sectional study, using data obtained from the dental record of patients who had undergone odontectomy of lower third molars in Dental hospital of Universitas Airlangga during 2 years period. Samples were cases that, from presurgical radiograph, showed close relationship between lower third molar roots and mandibular canal. The case and non-case groups were assigned based on the presence of paraesthesia and non-paraesthesia of inferior alveolar nerves, respectively. Based on Rood and Shehab’s category, the samples collected were then classified into two groups which were those whose relationship matched and did not match with the category, respectively. Data were analyzed using Chi-square correlation test. Result: Of 975 odontectomy cases included in this study, 80 cases were taken as study samples consisting of 15 and 65 cases assigned, respectively, as case and non-case. The 32 cases matched with the criteria of Rood and Shehab's category while the remainder of 48 cases did not. Of 32 cases which met the criteria of Rood and Shehab’s relationship, only 5 cases showed paraesthesia, whereas out of 48 cases which did not met the criteria 10 cases showed paraesthesia. Statistical analysis showed significance value of 0.770 (p>0.05) indicating that there was no significant correlation between relations of third molar root and mandibular canal, based on Rood and Shehab’s category, and the incidence of inferior alveolar nerve paraesthesia. Conclusion: There was no correlation between Rood and Shehab’s radiographic features and the incidence of paraesthesia of inferior alveolar nerve following odontectomy of lower third molars.

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Outcomes after mandibular third molar coronectomy

RGO - Revista Gaúcha de Odontologia ◽

10.1590/1981-86372020000063688 ◽

2020 ◽

Vol 68 ◽

Author(s):

Lucas Borin MOURA ◽

Bibiana Dalsasso VELASQUES ◽

Bhárbara Marinho BARCELLOS ◽

Melissa Feres DAMIAN ◽

Cristina Braga XAVIER

Keyword(s):

Nerve Injury ◽

Inferior Alveolar Nerve ◽

Third Molar ◽

Case Series ◽

Postoperative Outcomes ◽

Alternative Technique ◽

Safe Method ◽

Mandibular Third Molar ◽

Close Relationship ◽

Inferior Alveolar Nerve Injury

ABSTRACT Coronectomy is an alternative technique to mandibular third molar removal to avoid inferior alveolar nerve impairment. It is indicated in cases where the dental roots are in close relationship with the nerve which results in a higher risk of damage and paresthesia. The coronectomy technique is considered a safe method to prevent inferior alveolar nerve injury, however it shows particular postoperative outcomes as migration and exposure of the retained roots, and possibility of additional intervention. The aim of this case series is to describe four different outcomes from coronectomy, in patients treated by the same protocol. The outcomes ranged from asymptomatic to migration, infection and root removal. Although the variety of outcomes, none of the patients showed inferior alveolar nerve impairment. Therefore, the main objective of coronectomy was reached.

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4% lidocaine versus 4% articaine for inferior alveolar nerve block in impacted lower third molar surgery

Journal of Dental Anesthesia and Pain Medicine ◽

10.17245/jdapm.2017.17.1.29 ◽

2017 ◽

Vol 17 (1) ◽

pp. 29 ◽

Cited By ~ 12

Author(s):

Kiatanant Boonsiriseth ◽

Sittipong Chaimanakarn ◽

Prued Chewpreecha ◽

Natee Nonpassopon ◽

Manop Khanijou ◽

...

Keyword(s):

Nerve Block ◽

Inferior Alveolar Nerve ◽

Third Molar ◽

Third Molar Surgery ◽

Inferior Alveolar Nerve Block

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Panoramic versus CBCT used to reduce inferior alveolar nerve paresthesia after third molar extractions: a systematic review and meta-analysis

Dentomaxillofacial Radiology ◽

10.1259/dmfr.20190265 ◽

2020 ◽

Vol 49 (4) ◽

pp. 20190265

Author(s):

Nathalia Calzavara Del Lhano ◽

Rosangela Almeida Ribeiro ◽

Carolina Castro Martins ◽

Neuza Maria Souza Picorelli Assis ◽

Karina Lopes Devito

Keyword(s):

Systematic Review ◽

Panoramic Radiography ◽

Meta Analysis ◽

Inferior Alveolar Nerve ◽

Third Molar ◽

Risk Of Bias ◽

Third Molar Surgery ◽

Reference List ◽

Significant Heterogeneity ◽

Eligibility Criteria

Objectives: The aim of this systematic review was to verify whether CBCT in comparison with panoramic radiography reduced the cases of temporary paresthesias of the inferior alveolar nerve (IAN) associated with third molar extractions. Methods: The literature search included five databases (PubMed, Scopus, Web of Science, Cochrane, SciELO), in addition to gray literature and hand search of reference list of included studies. Two reviewers independently screened titles/abstracts, and full texts according to eligibility criteria, extracted data and evaluated risk of bias through Revised Cochrane Risk of Bias Tool for Randomized Trials (RoB 2.0). Data were meta-analyzed by comparing CBCT versus panoramic radiographs for number of events (temporary paresthesia after third molar surgery). Fixed effect model was used for non-significant heterogeneity; relative risk (RR) and 95% CI were calculated. The certainty of evidence was evaluated by Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Results: Four randomized controlled trials (RCTs) were included in meta-analysis, and for the majority of domains they presented low risk of bias. RR was 1.23 (95% IC: 0.75–2.02; I2: 0%; p = 0.43) favouring panoramic radiography, but without significant effect, and with moderate certainty of evidence. Conclusions: We concluded that both interventions had a similar ability to reduce temporary paresthesia of the IAN after third molar surgery with moderate certainty of evidence.

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Comparison of Articaine and Lidocaine for Buccal Infiltration After Inferior Alveolar Nerve Block For Intraoperative Pain Control During Impacted Mandibular Third Molar Surgery

Anesthesia Progress ◽

10.2344/anpr-64-02-06 ◽

2017 ◽

Vol 64 (2) ◽

pp. 80-84 ◽

Cited By ~ 8

Author(s):

Geraldo Prisco da Silva-Junior ◽

Liane Maciel de Almeida Souza ◽

Francisco Carlos Groppo

Keyword(s):

Nerve Block ◽

Inferior Alveolar Nerve ◽

Third Molar ◽

Third Molar Surgery ◽

Inferior Alveolar Nerve Block ◽

Mandibular Third Molar ◽

Intraoperative Pain ◽

Group 2 ◽

Mandibular Third Molar Surgery ◽

Buccal Infiltration

In order to compare the efficacy of lidocaine and articaine for pain control during third molar surgery, 160 patients presenting bilateral asymptomatic impacted mandibular third molars were selected. They received 1.8 mL of 2% lidocaine with epinephrine 1:100,000 during inferior alveolar nerve block. In group 1 (n = 80), an infiltrative injection of 0.9 mL of 2% lidocaine with epinephrine 1:100,000 was performed in buccal-distal mucosa of the third molar. Group 2 (n = 80) received 0.9 mL of 4% articaine with epinephrine 1:100,000 in the contralateral side. All procedures were performed at the same visit, by a single operator, in a double-blind and parallel design. The duration of each surgery and the moment when the patient expressed pain were noted. Data were analyzed by nonpaired t test and chi-square test (alpha = 5%). Duration of surgery did not differ (p = .83) between Groups 1 (19.8 ± 2.3 minutes) and 2 (19.7 ± 3.0 minutes). Pain was expressed more in group 1 (26.3%) than in group 2 (10%) (odds ratio = 3.2, p = .0138). In both groups, tooth sectioning was the most painful event (p < .0001). No influence of gender (p = .85) or age (p = .96) was observed in pain response. Buccal infiltration of 4% articaine with epinephrine 1:100,000 showed more efficacy than 2% lidocaine with epinephrine 1:100,000 when used in combination with inferior alveolar nerve block in controlling intraoperative pain related to impacted mandibular third molar surgery.

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