scholarly journals Third Molar Displacement into Submandibular Space

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Mirlany Mendes Maciel Oliveira ◽  
Rodrigo da Franca Acioly ◽  
Dennis Dinelly de Souza ◽  
Bruno Araújo da Silva ◽  
Daniel Do Carmo Carvalho
Keyword(s):  
Surgical Procedure ◽  
Clinical Characteristics ◽  
Clinical Case ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Molar Tooth ◽  
Surgical Removal ◽  
Submandibular Space ◽  
Adjacent Structures

There are various accidents and complications that may occur during extraction of dental elements. The displacement of dental elements to other facial spaces is one kind of the possible complications, and there may be significant physical and psychological results for the patient. The treatment for this kind of occurrence may vary from a conservative technique to surgical procedure, what will depend on clinical characteristics, symptoms, the location of the dental element, and its relation to adjacent structures. The objective of this article is to report a clinical case of the displacement of a lower third molar tooth into the submandibular space during its extraction, followed by surgical removal through extraoral approach, with proservation for the next two years when patient evolved to paresthesia of the inferior alveolar nerve.

scholarly journals Evaluation of Panoramic Radiographs in Relation to the Mandibular Third Molar and to Incidental Findings in an Adult Population

2020 ◽  
Author(s):  
Josefine Cederhag ◽  
Nina Lundegren ◽  
Per Alstergren ◽  
Xie-Qi Shi ◽  
Kristina Hellén-Halme
Keyword(s):  
Incidental Findings ◽  
Adult Population ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Patient Positioning ◽  
Vertical Position ◽  
Surgical Removal ◽  
Third Molars ◽  
Panoramic Radiographs ◽  
The Third

Abstract Objectives The aim was to evaluate the characteristics of the mandibular third molars, especially in relation to the inferior alveolar nerve. Further aims were to investigate incidental findings in panoramic radiographs in an adult population, and to investigate image quality related to patient positioning. Materials and Methods From a previous study with 451 randomly selected adult participants who lived in Sweden, 442 panoramic radiographs from four dental public health clinics were used. The third molars’ characteristics and relation to inferior alveolar nerve were evaluated. Incidental findings and patient positioning were recorded. Statistical Analysis Frequency analysis was used to investigate the occurrence of all findings and their possible interconnections. Whether the patients’ age or gender had an impact or not was also analyzed. Results The third molars were erupted in vertical position among 73% regardless of age. When retained or semi-retained, they were most commonly in mesioangular positions. The inferior alveolar nerve was located inferior to the roots in 52%, whereas an overlapped position was most common if the third molar was retained (90%), semi-retained (83%) or the age was less than 30 years (66%). Common incidental findings were apical radiolucencies, idiopathic osteosclerosis, and tooth fragments. Suboptimal patient positioning was found in one-third of the radiographs. Conclusions Panoramic radiography is a useful method to evaluate third molar prior to surgical removal and may be the only image required. Most incidental findings on panoramic radiographs does not seem to require any further odontological management.

scholarly journals Does a Preoperative Cone Beam Ct Reduce Complication Rates in the Surgical Removal of Complex Lower Third Molars? A Retrospective Study Including 486 Cases

2020 ◽  
Author(s):  
Jan Klatt ◽  
Tony Sorowka ◽  
Lan Kluwe ◽  
Ralf Smeets ◽  
Martin Gosau ◽  
...  
Keyword(s):  
Neurological Disorders ◽  
Three Dimensional ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Cone Beam ◽  
Surgical Removal ◽  
Radiographic Imaging ◽  
Third Molars ◽  
Nerve Bundle ◽  
Neurological Damage

Abstract BackroundThis study was designed to analyse the value of preoperative Cone Beam CTs prior to the surgical removal of complex lower third molars. Furthermore, the aim was to assess injuries to the inferior alveolar nerve bundle and postoperative neurological disorders depending on the position of the lower third molar and theinferior alveolar nerve bundle.MethodsPreoperative Cone Beam CTs and Orthopantomographs of 324 patients were analysed concerning the location of the lower third molars in relation to the mandible and the inferior alveolar nerve bundle. Surgery protocols of all patients who underwent the surgical removal of at least one complex lower third molar were analysed concerning patient data, length of surgery, intraoperative haemorrhage, intraoperative exposure of the inferior alveolar nerve bundle, postoperative swelling and postoperative neurological disorders. The data was then compared to data from international studies.ResultsIn all 324 patients a permanent neurological damage was not found. Temporary neurological damage was recorded in 13 cases (2.6%). A caudal nerve position with no measurable distance to the root of the lower third molar was associated with the highest risk of a temporal neurological damage. A vestibular touching nerve route also correlated with postoperative sensitivity impairment.ConclusionsThree-dimensional radiographic imaging,in our patient group, does not significantly affect the risk for complications during the surgical removal of complex lower third molars,but allows the surgeon to choose the best surgical approch for a fast and most atraumatic operation. Therefore, it should only be utilized for risk assessment, especially in cases of symptom-free lower third molars. A preoperative orthopantomogram still can be accepted as standard for radiographic imaging. The interpretation of the orthopantomogram may lead to the indication for three-dimensional imaging, if signs of increased surgery risk are present.

scholarly journals Does a preoperative cone beam CT reduce complication rates in the surgical removal of complex lower third molars? A retrospective study including 486 cases

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Jan C. Klatt ◽  
Tony Sorowka ◽  
Lan Kluwe ◽  
Ralf Smeets ◽  
Martin Gosau ◽  
...  
Keyword(s):  
Neurological Disorders ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Cone Beam ◽  
Surgical Removal ◽  
Complication Rates ◽  
Radiographic Imaging ◽  
Third Molars ◽  
Nerve Bundle ◽  
Neurological Damage

Abstract Backround This study was designed to analyse the value of preoperative Cone Beam CTs (CBCT) prior to the surgical removal of complex lower third molars. Furthermore, the aim was to assess injuries to the inferior alveolar nerve (IAN) bundle and postoperative neurological disorders depending on the position of the lower third molar and the inferior alveolar nerve bundle. Methods In this retrospective examination preoperative Cone Beam CTs and Orthopantomographs (OPT) of 324 patients were analysed concerning the location of the lower third molars in relation to the mandible and the inferior alveolar nerve bundle. Surgery protocols of all patients who underwent the surgical removal of at least one complex lower third molar were analysed concerning patient data, length of surgery, intraoperative haemorrhage, intraoperative exposure of the inferior alveolar nerve bundle, postoperative swelling and postoperative neurological disorders. The data was then compared to data from international studies. Results In all 324 patients a permanent neurological damage was not found. Temporary neurological damage was recorded in 13 cases (2.6%). A caudal nerve position with no measurable distance to the root of the lower third molar was associated with the highest risk of a temporal neurological damage. A vestibular touching nerve route also correlated with postoperative sensitivity impairment. If a mesioangulation (Winter) or a Pell and Gregory Type IIIC appears in the OPT, risk of neurological damage is at its highest. Conclusions Three-dimensional radiographic imaging, in our patient group, does not significantly affect the risk for complications during the surgical removal of complex lower third molars. Therefore, it should only be utilized for risk assessment, especially in cases of symptom-free lower third molars. A preoperative orthopantomogram still can be accepted as standard for radiographic imaging. An intraoperative exposure of the IAN bundle does not necessarily predict simultaneous neurological damage. Exposure of the IAN bundle is no indication for a discontinuation of the surgery.

scholarly journals Multiple unilateral accessory mandibular foramina-a case report

2012 ◽  
Vol 01 (04) ◽  
pp. 190-192
Author(s):  
Anupama Mahajan ◽  
Keyword(s):  
Case Report ◽  
Surgical Procedures ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Mandibular Canal ◽  
Molar Tooth ◽  
Posterior Border ◽  
Mandibular Foramen ◽  
Inner Surface ◽  
Accessory Foramina

AbstractAccessory foramina in the mandible are known to transmit branches of nerves supplying the roots of the teeth. The mandibular foramen is present on the inner surface of the ramus of the mandible which transmits the inferior alveolar nerve. An adult human mandible of unknown sex was found to have multiple mandibular foramina on the medial surface of right ramus. A large accessory mandibular foramen was present anterosuperior to the main mandibular foramen. The dimensions were 6 mm antero posteriorly and 11mm vertically. The dimensions of the mandibular foramen were 9 mm antero posteriorly and 12mm vertically. The distance between two foramina was 20 mm and between the accessory mandibular foramen and apex of lingula was 7 mm. The distance between the posterior border of the accessory mandibular foramen and posterior border of ramus were 15 mm. The accessory mandibular foramen led into a canal which was directed obliquely and joined the mandibular canal at the level of third molar tooth. Two more small mandibular foramina were present one just below the accessory mandibular foramen discussed above and second near the main mandibular foramen. Both of them were of too small size to measure. The accessory mandibular foramen is a rare variation and awareness of its incidence and its position is necessary. The structures passing through it can be compromised during surgical procedures of this area.

scholarly journals Inferior alveolar nerve injury assessment after surgical removal of mandibular third molar.

2020 ◽  
Vol 27 (03) ◽  
pp. 530-534
Author(s):  
Abdul Wahid Bhangwar ◽  
Muhammad Irfan Khan ◽  
Hira Fatima ◽  
Salman Shams
Keyword(s):  
Nerve Injury ◽  
Local Anesthesia ◽  
Maxillofacial Surgery ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Surgical Removal ◽  
Third Molars ◽  
Mandibular Third Molar ◽  
Mandibular Third Molars ◽  
Inferior Alveolar Nerve Injury

To assess the nerve injury (inferior alveolar nerve) after surgical removal of mandibular third molars under local anesthesia. Study Design: Observational study. Setting: Oral & Maxillofacial Surgery Department LUMHS Jamshoro/Hyderabad. Period: From 11th November 2015 to 10th May 2016. Material & Methods: This study consisted of one hundred patients. Inclusion criteria’s were patients with impacted mandibular third molar, patient’s age from 18 to 45years and irrespective of gender. Exclusion criteria were patients younger than 18yrs of age of above 45 years, patients having neurological disorders, medically compromised patients, patients receiving radiotherapy or chemotherapy, patients with known allergy to local anesthesia, patients having pathology due to mandibular third molars, patients radiographicaly root is very near to inferior dental canal. Results: Out of 100 patients incorporated in this research 66 were male (66%) and 34 female (34%). The mean age was 29+3.20 years. Common indication of extraction were recurrent pericoronitis  52(52%) cases followed by deep caries/ pulpitis in 28(28%)  cases, orthodontic reason in 11(11%) cases and caries to adjacent tooth in 9(9%) cases. Third molar impaction according to winter’s classification were Mesioangular in 54(54%) cases followed by Horizontal in 26(26%) cases and Vertical in 11(11%). Radiographic showed Narrowing of root in 21% cases and narrowing of inferior dental (ID) canal 20% cases, followed by diversion of ID canal in 16 % cases, deflection of root 14 % cases and darkening of root in 11% cases. After surgical removal of mandibular third molar, the inferior alveolar nerve injury was observed in 6(6%) cases. Conclusion: We conclude that inferior alveolar nerve paresthesia occurs in 6% after surgical removal of mandibular third molars.

scholarly journals Coronectomy of the wisdom teeth: the dental extraction alternative

2021 ◽  
Vol 3 (59) ◽  
pp. 12-17
Author(s):  
Sergiu Beliniuc ◽  
◽  
Gabriela Motelica ◽  
Keyword(s):  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Mandibular Canal ◽  
Surgical Removal ◽  
Third Molars ◽  
Close Proximity ◽  
Wisdom Teeth ◽  
Low Incidence ◽  
Upper Third ◽  
Surgical Separation

Background. Coronectomy of the wisdom teeth is an alternative surgical procedure to tooth extraction, which aims to preserve the roots of the wisdom teeth in the dental socket after surgical separation of the crown, in order to avoid the injury of the inferior alveolar vascular-nervous bundle. Purpose. Minimizing the damage to the inferior alveolar nerve when extracting lower third molars caused by the intimate relationship between the nerve and the roots of the teeth, by using the technique of coronectomy, or intentional root retention. Material and Methods. Patients who reported to University Dental clinic during the period 2020–2021 for surgical removal of impacted L3M were screened for nerve–root relationship with OPG or CBCT. 15 patients underwent coronectomy as a procedure to remove the crown and upper third of the roots of a lower third molar to reduce the risk of damage to the inferior alveolar nerve. Results. 15 patients were enrolled in this study, with a total of 17 lower third molars. Sixteen sites healed primarily, but in 1 case the sockets on both sides opened and failed to close secondarily. In this case, the root fragments were later removed and found to be mobile. Conclusion. Coronectomies are safer to perform than complete extractions in situations in which the third molar is in close proximity to the mandibular canal. The technique appears to be associated with a low incidence of complications and the removal of remaining roots is required in around 6-7% of cases due to the mesial migration of the fragment and not any symptoms or reinfection.

scholarly journals Removal of dental surgical bur from maxillary sinus: a case report

2018 ◽  
Vol 17 ◽  
pp. e18224
Author(s):  
Yeon Jung Kim ◽  
Ana Maria Barg da Silva ◽  
Mirko Dennys Ayala Perez ◽  
Heloisa F. Marão ◽  
Debora Pallos
Keyword(s):  
Maxillary Sinus ◽  
Clinical Case ◽  
Treatment Plan ◽  
Correct Diagnosis ◽  
Maxillofacial Surgery ◽  
Third Molar ◽  
Oral And Maxillofacial Surgery ◽  
Surgical Removal ◽  
Third Molars ◽  
Third Molar Extraction

The most commonly performed surgical procedure in Oral and Maxillofacial Surgery practices are the removal of impacted third molars. Extensive training, skill and experience allow this procedure to be performed in an atraumatic approach. The aim of this study was to drawing attention to the importance of the correct management of the complications cases of foreign body inside maxillary sinus after surgical removal of maxillary third molars. This is an unusual clinical case of a dental surgical bur accidentally displacement into the maxillary sinus during an upper third molar extraction surgery. After removal, the clinical case showed a satisfactory repair emphasizing the importance of a meticulous clinical examination to achieve a correct diagnosis and an appropriate treatment plan, which is essential for a favorable prognosis.

scholarly journals Comparative evaluation of anti inflammatory effect of bromelain-trypsin combination versus diclofenac sodium after surgical removal of mandibular third molar teeth

2020 ◽  
Vol 10 (1) ◽  
pp. 16-20
Author(s):  
ASM Ariful Islam ◽  
Mohammad Asifur Rahman ◽  
Shakhawat Hossain ◽  
Quazi Billur Rahman
Keyword(s):  
Diclofenac Sodium ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Anesthetic Technique ◽  
P Value ◽  
Surgical Removal ◽  
Posterior Teeth ◽  
Dental Surgery ◽  
Mandibular Molars ◽  
Group 2

Aim: The focus of the education was to assess the success between localanesthetic infiltration injection and inferior alveolar nerve block anesthesia in extraction of Chronic periodontitis mandibular posterior teeth. Methods: 100 patients aged between 13 and 73 years who attended the Department of Dental surgery, BIRDEM General Hospital for extraction of advance periodontitis of mandibular molars were included in this study. For the infiltration anesthetic technique, patient’s approval was taken. The patients were equally divided into two groups. Group (1) received 0.6 ml out of 1.8 ml of 2% lidocaine with 1:80000 adrenaline injection bucally and the same amount infiltration lingually opposite the intended tooth. Group (2) received 1.5 ml out of 1.8 ml of 2% lidocaine with 1:80000 and the remaining 0.3 ml was injected for long buccal nerve anesthesia. Results: In this Study we found 88% patients were pain free and Group-2 94% patients were pain free During extraction of Advance periodontitis of mandibular molars. P-value was 0.138 and it was not < 0.05. So it was not significant. On the other side 103 patients out of 113 were pain free in male and 79 patients out of 87 were pain free in female and 6 patients out of 87 were feeling pain during tooth extraction of advance periodontitis of mandibular molars. P-value was 0.138 and it was not < 0.05. So it was not significant. Conclusion: Infiltration anesthesia for non-vital mandibular molars is effective as a substitute for inferior alveolar block technique. Update Dent. Coll. j: 2020; 10 (1): 16-20

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