The Criteria for Lower Second Molar Extraction

1987 ◽  
Vol 14 (1) ◽  
pp. 1-9 ◽  
Author(s):  
J. T. Dacre

The benefits of lower second molar extraction are substantially reduced if the third molar fails to erupt into a satisfactory position. The selection criteria offered by the literature have been tested in a sample of 51 patients. Prediction is uncertain and cases should be followed until such time as a satisfactory third molar position has been achieved. Failure may be unilateral and more often on the right side. The need for follow-up treatment is subjective but may be as many as one in the patients.

2021 ◽  
Author(s):  
Solmaz Valizadeh ◽  
Seyedeh Mahshid Ahmadi ◽  
Mitra Ghazizadeh Ahsaie ◽  
Zahra Vasegh ◽  
Navid Jamalzadeh

Abstract IntroductionDetection of exact location of greater palatine foramen and its anatomical variations are vital prior to posterior maxillary surgeries and gingival grafts. The aim of this study is to determine the anatomical position and size of the greater palatine canal (GPC) and foramen (GPF) using cone beam computed tomography (CBCT) scans.Materials and methodsIn this descriptive-analytic study, CBCT images of 148 patients were assessed. To determine the anatomical foramen position, the posterior maxilla area was divided into five regions on the axial view (A: from the mesial surface of the second molar to the center of the second molar, B: from the center of the second molar to its distal, C: from the mesial surface of the third molar to the center of the third molar, D: from the center of the third molar to the distal of the third molar, E: distal to the third molar.). The length of the canal was investigated on both coronal and sagittal views. Independent and paired T-test were used to analyze the data.ResultsAmong 80 females -68 males, the anatomical position of the GPF was mainly located in region E on the left (55%) and the right (50%), and then, respectively, in region D and region C. The mean diameter of GPF was 4/48 mm on the left and 4/63 mm on the right side (P-value = 0/01). The average length of the canal on the coronal view was 29.46 mm on the left side and 29.75 mm on the right (P-Value = 0/005). The average length of the canal on the sagittal view was 29.62 mm on the left and 30.02 mm on the right (P-value = 0/001).ConclusionThe anatomical position of the GPF was primarily located distal to the third maxillary molar. CBCT is a valuable diagnostic tool for evaluation of vital anatomic landmarks in the maxillofacial region prior to surgeries and interventions.


2009 ◽  
Vol 79 (3) ◽  
pp. 422-427 ◽  
Author(s):  
Cathrine Magnusson ◽  
Heidrun Kjellberg

Abstract Objective: To evaluate treatment outcome in patients with second molar impaction and retention. Materials and Methods: A total of 135 second molars, 65 in the maxilla and 70 in the mandible were collected from 87 patients (45 girls and 42 boys) with a mean age of 15 years (range: 11– 19 years). Available patient records, x-rays, study casts, and photos were studied. The mean follow-up period was 22 months (range: 4–106 months). Results: A total of 166 second molars were diagnosed as impacted, 24 as primary and 5 as secondarily retained; 80% of the second molars were orthodontically or surgically treated. In more than half of the treated patients the second molars failed to erupt into a proper position. Surgical exposure of the retained or impacted second molar was the treatment found most successful (71%). The least successful treatment (11%) used the third molar to replace the second molar after the second molar was extracted. No clear difference in treatment outcome could be detected between the impacted and the primary or secondary retained teeth. However, a clear difference was found between the impacted and the primary retained second molars regarding treatment strategy: 9% of the impacted and 67% of the primary retained teeth were left untreated. Dental crowding was found in 70% of the patients. Conclusion: In more than half of the treated patients the second molars failed to erupt into a proper position. The most common treatment given (extraction of the second molar) was the least successful.


Tomography ◽  
2021 ◽  
Vol 7 (2) ◽  
pp. 219-227
Author(s):  
Yen-Wen Shen ◽  
Wan-Chun Chang ◽  
Heng-Li Huang ◽  
Ming-Tzu Tsai ◽  
Lih-Jyh Fuh ◽  
...  

The retromolar canal is an anatomical variation that occurs in the mandibular bone. The retromolar canal typically originates in the mandibular canal on the distal side of the third molar and extends forward and upward to the retromolar foramen (RMF), which contains the neurovascular bundle. Accidentally damaging the neurovascular bundle in the retromolar canal during the extraction of the third molar, dental implant surgery, or maxillofacial orthognathic surgery may lead to subsequent complications such as incomplete local anesthesia, paresthesia, and bleeding during operation. The objective of this study was to investigate the prevalence of the RMF in the Taiwanese population in a medical center by using dental cone-beam computed tomography (CBCT) and to identify the position of the RMF in the mandibular bone. The dental CBCT images for the mandibular bone of 68 hemi-mandible were uploaded to the medical imaging software Mimics 15.1 to determine the prevalence of the RMF in the Taiwanese population and the three positional parameters of the RMF in the mandibular bone: (1) The diameter of the RMF, (2) the horizontal distance from the midpoint of the RMF to the distal cementoenamel junction of the second molar, and (3) the vertical distance from the midpoint of the RMF to the upper border of the mandibular canal. Seven RMFs were observed in the 68 hemi-mandibles. Thus, the RMF prevalence was 10.3%. In addition, the diameter of the RMF was 1.41 ± 0.30 mm (mean ± standard deviation), the horizontal distance from the midpoint of the RMF to the distal cementoenamel junction of the the second molar was 12.93 ± 2.87 mm, and the vertical distance from the midpoint of the RMF to the upper border of the mandibular canal below second molar was 13.62 ± 1.3487 mm. This study determined the prevalence of the RMF in the Taiwanese population in a medical center and its relative position in the mandibular bone. This information can provide clinicians with a reference for posterior mandible anesthesia and surgery to ensure medical safety.


2020 ◽  
pp. 1-3
Author(s):  
Anoop. A. S ◽  
Anupama. A. S ◽  
Kannan Sagar

Stroke or cerbreovascular accidents are the leading cause of morbidity and mortality across the world.Infact the third leading cause after heart diseases and cancer.Strokes can be classied broadly as ischemic and hemorrhagic which accounts for 80% and 20% of the total cases.The prognosis of CVA depends on the type and its fast and appropriate management.A 50 year old male patient who is k/c/o type 2 diabetes mellitus,hypertension and hypercholistremia was admitted to the inpatient department of Sri Jayendra Saraswathi Ayurveda College and Hospital,Chennai on 20.01.2020 with the conrmed diagnosis of stroke(CVA) having both infarct and hemorrhage.The chief complaints were difculty in walking without support,reduced strength, stiffness and heaviness in the right hand and leg, difculty in speech, pain in right shoulder joint and knee joint since 4 months.This condition can be understood as Pakshaghata in Ayurveda.After proper evaluation of the avastha of the patient,Avarana chikitsa along with the Pakshaghata chikitsa was adopted in this case,Signicant improvements were observed on various subjective and objective parameters.The patient was discharged after 10 days of treatment with oral medications and advised for a follow up after 1 month.


2021 ◽  
Vol Volume 17 ◽  
pp. 235-247
Author(s):  
Yuan Zhang ◽  
Xiaohang Chen ◽  
Zilan Zhou ◽  
Yujia Hao ◽  
Huifei Li ◽  
...  

2017 ◽  
Vol 63 (2) ◽  
pp. 83-86
Author(s):  
Misato TADA ◽  
Shigehiro ONO ◽  
Kouji OHTA ◽  
Hideo SHIGEISHI ◽  
Kazuki SASAKI ◽  
...  

2018 ◽  
Vol 52 (4) ◽  
pp. 394-401 ◽  
Author(s):  
Balazs J Denes ◽  
Aikaterini Lagou ◽  
Domna Dorotheou ◽  
Stavros Kiliaridis

Rat molar eruption and occlusion data were compiled from several studies but several inconsistencies were found, rendering the planning of eruptional studies difficult and imprecise. Our aim was to measure eruption and occlusion days, as well as eruption velocity, in the upper and lower three molars from infancy to end of adolescence in the rat. A total of 19 male and female Wistar rats were scanned daily by micro-computed tomography (CT) from day 15 to 70. We measured the eruption of all maxillary and mandibular molars with reference points at the hard palate and mandibular canal at three stages: pre-emergent, pre-occlusal, and functional. Statistical analysis was performed with a mixed-model analysis of variance (ANOVA) and a Sidak post hoc test. The first molar erupts on average on day 17, the second molar on day 20, and the third molar on day 33. The eruption velocity of the first molar was the highest at 90.9 microns/day (standard error (se) = 12.80), followed by the second molar at 65.9 microns/day (se = 5.80), and the lowest was the third at 47.0 microns/day (se = 3.28), ( p < 0.001). On average, the pre-occlusal phase had the highest velocity at 97.2 microns/day (se = 1.72), the pre-emergent was lower at 84.9 (se = 2.29), and the functional was the lowest at 21.7 (se = 0.45), ( p < 0.001). The eruption rate decreased from the first to third molar and was also different between phases: the pre-occlusal phase had the highest rate, closely followed by the pre-emergent phase while the functional eruption rate was significantly lower than the other phases.


2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Alberto De Biase ◽  
Giulia Mazzucchi ◽  
Dario Di Nardo ◽  
Marco Lollobrigida ◽  
Giorgio Serafini ◽  
...  

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.


2012 ◽  
Vol 69 (12) ◽  
pp. 1101-1105 ◽  
Author(s):  
Stevo Matijevic ◽  
Zoran Damjanovic ◽  
Zoran Lazic ◽  
Milka Gardasevic ◽  
Dobrila Radenovic-Djuric

Introduction. Odontogenic keratocyst (OKC) is a rare developmental, epithelial and benign cyst of the jaws of odontogenic origin with high recurrence rates. The third molar region, especially the angle of the mandible and the ascending ramus are involved far more frequently than the maxilla. The choice of treatment approach was based on the size of the cyst, recurrence status, and radiographic evidence of cortical perforation. Different surgical treatment options like marsupialization, decompression, enucleation, enucleation with Carnoy?s solution, peripheral ostectomy with or without Carnoy?s solution, and jaw resection have been discussed in the literature with variable rates of recurrence. Case report. We presented a 52-yearold male with orthokeratinized odontogenic keratocyst. Elliptical unilocular radiolucency located in the third molar region and the ascending ramus of the mandible, 40 ? 25 mm in diameter with radiographic evidence of cortical perforation at the anterior ramus border of the mandible 20 mm in diameter, was registrated on orthopantomographic radiography. Surgical treatment included enucleation of the cyst and peripheral ostectomy with the use of Carnoy?s solution and excision of the overlying attached mucosa. Postoperatively, no paresthesia in the inervation area of the inferior alveolaris nerve was registrated. Recurrences were not registrated within 5 years post-intervention. Coclusion. Treatment of odontogenic keratocyst with enucleation and peripheral ostectomy with the use of Carnoy?s solution and excision of the overlying attached mucosa had a very low rate of recurrence. Radical and more aggressive surgical treatments as jaw resection should be reserved for multiple recurrent cysts and when OKC is associated with nevoid basal cell carcinoma syndrome (NBCCS). Following the treatment protocol in the management of OKC and systematic and long-term postsurgical follow-up are considered key elements for successful results.


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