scholarly journals Pterygoid process fracture during dental extraction – an unusual complication

2018 ◽  
Vol 32 (3) ◽  
pp. 160
Author(s):  
Gustavo Almeida Souza ◽  
Zarina Tatia Santos ◽  
Alexander Tadeu Sverzut ◽  
Luciana Asprino ◽  
Márcio De Moraes
Keyword(s):  
Maxillofacial Surgery ◽  
Third Molar ◽  
Invasive Technique ◽  
Oral And Maxillofacial Surgery ◽  
Unusual Complication ◽  
Common Procedure ◽  
Pterygoid Process ◽  
Oroantral Fistula ◽  
Facial Swelling ◽  
Upper Third

INTRODUCTION: The extraction of the upper third molar is a simple and common procedure in Oral and Maxillofacial Surgery daily practice. Infection, facial swelling, trismus, wound dehiscence, root fracture, oroantral fistula, iatrogenic displacement, fracture of the maxillary tuberosity are some of the complications that can occur during third molar extraction.CASE DESCRIPTION: In this article, an unusual fracture of the pterygoid process during upper third molar extraction and a minimally invasive technique for treatment are described.CONCLUSION: It is important to recognize the fracture and not remove the fragment before a complementary image exam, it will guide the type of treatment that should be use.

scholarly journals Automated Prediction of Extraction Difficulty and Inferior Alveolar Nerve Injury for Mandibular Third Molar Using a Deep Neural Network

2022 ◽  
Vol 12 (1) ◽  
pp. 475
Author(s):  
Junseok Lee ◽  
Jumi Park ◽  
Seong Yong Moon ◽  
Kyoobin Lee
Keyword(s):  
Maxillofacial Surgery ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Oral And Maxillofacial Surgery ◽  
Third Molars ◽  
Radiographic Image ◽  
Common Procedure ◽  
Radiographic Images ◽  
Mandibular Third Molar ◽  
Mandibular Third Molars

Extraction of mandibular third molars is a common procedure in oral and maxillofacial surgery. There are studies that simultaneously predict the extraction difficulty of mandibular third molar and the complications that may occur. Thus, we propose a method of automatically detecting mandibular third molars in the panoramic radiographic images and predicting the extraction difficulty and likelihood of inferior alveolar nerve (IAN) injury. Our dataset consists of 4903 panoramic radiographic images acquired from various dental hospitals. Seven dentists annotated detection and classification labels. The detection model determines the mandibular third molar in the panoramic radiographic image. The region of interest (ROI) includes the detected mandibular third molar, adjacent teeth, and IAN, which is cropped in the panoramic radiographic image. The classification models use ROI as input to predict the extraction difficulty and likelihood of IAN injury. The achieved detection performance was 99.0% mAP over the intersection of union (IOU) 0.5. In addition, we achieved an 83.5% accuracy for the prediction of extraction difficulty and an 81.1% accuracy for the prediction of the likelihood of IAN injury. We demonstrated that a deep learning method can support the diagnosis for extracting the mandibular third molar.

scholarly journals Submucosal administration of dexamethasone versus methyl prednisolone in management of postoperative sequelae after mandibular third molar impaction - A systematic review

2020 ◽  
Vol 11 (3) ◽  
pp. 4479-4486
Author(s):  
Janani Kandamani ◽  
Divya Sanjeevi Ramakrishnan ◽  
Sudarssan Subramaniam Gouthaman ◽  
Santhosh Kumar M P
Keyword(s):  
Sodium Succinate ◽  
Maxillofacial Surgery ◽  
Third Molar ◽  
Cochrane Library ◽  
Oral And Maxillofacial Surgery ◽  
Third Molar Extraction ◽  
Methylprednisolone Sodium Succinate ◽  
Methyl Prednisolone ◽  
Mandibular Third Molar

Third molar extraction is one of the most commonly performed minor surgical procedure in any dental practice worldwide, often accompanied by various postoperative sequelae such as swelling pain and trismus which intern affects the quality of life of a patient. Over the past few decades, different methods have been proposed in the literature and were clinically evaluated to reduce the postoperative discomfort after mandibular third molar impaction and out of which corticosteroids, have shown promising results. Dexamethasone (administered either orally, submucosally, IV or IM), methylprednisolone acetate and methylprednisolone sodium succinate (IV or IM or submucosal) are most commonly preferred corticosteroids in oral and maxillofacial surgery. The main objective is to systematically review the comparison of the effectiveness of submucosal administration of dexamethasone with methylprednisolone following mandibular third molar impaction in reducing the postoperative sequelae, and its discomfort and searches were performed in the PubMed, Medline, Scopus, and Cochrane Library databases. Two articles were most relevant, and the results of the comparison of the selected articles were analysed. From this deliberate audit, it is very well may be inferred that submucosal injection of dexamethasone plays a promising role in reducing the postoperative sequelae which includes swelling, pain and trismus and its discomfort following mandibular third molar impaction when compared with that of methylprednisolone.

scholarly journals Evaluation of demographic and radiological risk factors for assessment of difficulty in surgical removal of impacted mandibular third molar – A prospective study.

2019 ◽  
Vol 6 (1) ◽  
pp. 10-13
Author(s):  
Manu R. Goel ◽  
Milind D. Shringarpure ◽  
Vasant V. Shewale ◽  
Tejasvini Dehankar ◽  
Ajit Joshi
Keyword(s):  
Risk Factors ◽  
Scientific Evidence ◽  
Maxillofacial Surgery ◽  
Third Molar ◽  
Oral And Maxillofacial Surgery ◽  
Surgical Removal ◽  
Third Molars ◽  
Surgical Time ◽  
Impacted Tooth ◽  
Surgical Difficulty

The extraction of impacted third molars is among the most common surgical procedures carried out in the field of Oral and Maxillofacial Surgery. Both the patient and dentist must therefore have scientific evidence-based information concerning the estimated level of surgical difficulty of every case to consider in referring cases of impacted third molars for specialists’ handling. We have undertaken a study in which demographic and radiological variables were considered together to evaluate the risk factors for surgical difficulty in a cohort of 100 impacted mandibular third molars. There were 13 variables evaluated for surgical difficulty. Total surgical time intervention was noted at the end of each surgery. Each variable was analysed with total surgical time intervention with univariate and multiple linear regression. Out of 13 variables, 9 were found statistically significant. The most significant predictors for surgical difficulty were Body Mass Index, Depth of impacted tooth and Retromolar space. No postoperative complications were reported.

scholarly journals Efficacy of platelet rich plasma (PRP) on mouth opening and pain after surgical extraction of mandibular third molars

2020 ◽  
Vol 27 (1) ◽  
pp. 9
Author(s):  
Maidah Hanif ◽  
Muhammad Azhar Sheikh
Keyword(s):  
Platelet Rich Plasma ◽  
Maxillofacial Surgery ◽  
Third Molar ◽  
Mouth Opening ◽  
Third Molar Surgery ◽  
Oral And Maxillofacial Surgery ◽  
Surgical Removal ◽  
Mandibular Third Molar ◽  
Surgical Extraction ◽  
Molar Teeth

Introduction: Surgery of mandibular third molar teeth for removal is one of the most common procedures undertaken in oral and maxillofacial surgery departments. The complications created by the post extraction wound healing and physiological consecution of third molar surgery can affect patients' quality of life. Platelet rich plasma (PRP) is an autologous concentrate of platelets suspended in the Plasma that accelerates healing by concentration of growth factors which lessen the inflammation and as a result pain and trismus. Materials and methods: A Study was conducted on 130 patients at the department of Oral and Maxillofacial Surgery, FUCD Islamabad, for a period of 6 months after ethical approval. The patients with impacted mandibular wisdom teeth were selected and divided equally into two equal groups. The pain score was measured using the visual analogue scale (VAS) and trismus was measured using Vernier caliper before the surgery, immediately after surgery, on 3rd and 7th follow up visits. Results: The mean postoperative pain on 7th day was significantly lower in the PRP group with statistically significant P-value <0.0001. Trismus was also less reported in the PRP group with P-value <0.00065. Conclusion: Platelet Rich Plasma is effective to lessen trismus and pain after surgical removal of mandibular third molar teeth.

scholarly journals IMPACTED MANDIBULAR THIRD MOLAR SURGERY;

2014 ◽  
Vol 21 (06) ◽  
pp. 1272-1278
Author(s):  
Muhammad Ilyas Shaikh ◽  
Safia Khatoon ◽  
Fozia Rajput, ◽  
Syed Yousif Ali Shah
Keyword(s):  
Social Life ◽  
Maxillofacial Surgery ◽  
Third Molar ◽  
Mouth Opening ◽  
Third Molar Surgery ◽  
Control Group ◽  
Random Allocation ◽  
Significant Difference ◽  
Facial Swelling ◽  
And Gender

Objective: The objective of this study was to evaluate the therapeutic effect of dexamethasone in post-operative edema and trismus after impacted third molar surgery. Materials & Methods: It was a prospective randomized control study carried in Department of Oral & Maxillofacial surgery, BADC, Larkana from March 2012 to Feb 2013. Patients age between 20-45 years of either gender; unilateral mandibular impacted third molars (right or left) were included. Patients divided in two groups by using random allocation number. Patients in Group-A were given intramuscular 8 mg dexamethasone 1 hour before surgery and four tablets (2mg) dexamethasone orally immediate postoperatively and 24 hours after surgery. The facial swelling was checked before surgery, after 24 hours (1st day), after 48 hours (2nd day), after 72 hours (3rd day) and on 7th postoperative day Inter-incisor distance was checked on every follow up. Data was analyzed by SPSS version 17. Mean and standard deviation was calculated for age and gender. Mean and SD of facial swelling and mouth opening was calculated before extraction, on 1st, 2nd, 3rd and on 7th post-operative day in both groups. Results: The dexamethasone group showed significant reduction in swellingcompared with control group at all intervals. Dexamethasone resulted in significantly less trismus than controls on day 2 postoperatively, but there was no significant difference among the groups at 7thday. Conclusions: Dexamethasone is effective in minimizing swelling and trismus after removal of impacted lower third molar and improves the social life of individual.

Artificial Intelligence in Positioning Between Tooth and Nerve on Panoramic Radiography

2021 ◽  
Author(s):  
Eunhye Choi ◽  
Soohong Lee ◽  
Eunjae Jeong ◽  
Seokwon Shin ◽  
Sekyoung Youm ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Panoramic Radiography ◽  
Maxillofacial Surgery ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Model Performance ◽  
Oral And Maxillofacial Surgery ◽  
Position Determination ◽  
Contact Position ◽  
True Contact

Abstract Determining the exact positional relationship between mandibular third molar (M3) and inferior alveolar nerve (IAN) is important for surgical extractions. Panoramic radiography is the most common dental imaging test. The purposes of this study were to develop an artificial intelligence (AI) model to determine two positional relationships (true contact and bucco-lingual position) between M3 and IAN when they were overlapped in panoramic radiographs and compare its performance with that of oral and maxillofacial surgery (OMFS) specialists. A total of 571 panoramic images of M3 from 394 patients was used for this study. Among the images, 202 were classified as true contact, 246 as intimate, 61 as IAN buccal position, and 62 as IAN lingual position. A deep convolutional neural network model with ResNet-50 architecture was trained for each task. We randomly split the dataset into 75% for training and validation and 25% for testing. Model performance was superior in bucco-lingual position determination (accuracy 0.76, precision 0.83, recall 0.67, and F1 score 0.73) to true contact position determination (accuracy 0.63, precision 0.62, recall 0.63, and F1 score 0.61). AI exhibited much higher accuracy in both position determinations compared to OMFS specialists. In determining true contact position, OMFS specialists demonstrated an accuracy of 52.68% to 69.64%, while the AI showed an accuracy of 72.32%. In determining bucco-lingual position, OMFS specialists showed an accuracy of 32.26% to 48.39%, and the AI showed an accuracy of 80.65%. Moreover, Cohen’s kappa exhibited a substantial level of agreement for the AI (0.61) and poor agreements for OMFS specialists in bucco-lingual position determination. Determining the position relationship between M3 and IAN is possible using AI, especially in bucco-lingual positioning. The model could be used to support clinicians in the decision-making process for M3 treatment.

Effects of different polyvinylpyrrolidone iodine concentrations on trismus and swelling following third molar surgery

2020 ◽  
pp. 1-16
Author(s):  
Esra Yüce ◽  
Omur Dereci ◽  
Nazli Altin ◽  
Cansugul Efeoglu Koca ◽  
Murude Yazan
Keyword(s):  
Povidone Iodine ◽  
Maxillofacial Surgery ◽  
Third Molar ◽  
Group Iv ◽  
Controlled Study ◽  
Third Molar Surgery ◽  
Group Iii ◽  
Group I ◽  
Facial Swelling ◽  
Group Ii

Abstract Objective: To compare the clinical efficacy of different povidone iodine concentrations for the management of postoperative pain and swelling following mandibular third molar surgery. Methods: The randomised, prospective, double-blind and controlled study was conducted from October 2016 to January 2018 at the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Biruni University, Istanbul, Turkey, and comprised individuals aged 18-30 years who underwent surgical removal of pathology-free completely unerrupted mandibular lower third molars. The participants were randomly assigned to four groups: Group I had saline-only controls, Group II was given 0.5% concentration of povidone iodine, Group III had 1% concentration of povidone iodine, and Group IV had 3% concentration of povidone iodine. Facial swelling and trismus were assessed on the 2nd and 7th postoperative days. Data was analysed using SPSS 22. Results: Of the 80 patients, 34(42.5%) were males and 46(57.5%) were females with an overall mean age of 24.6±3.68 years. Each group had 20(25%) subjects. All three concentrations of povidone iodine provided significant reduction in postoperative trismus compared to the controls. Trismus was less in Group III and Group IV compared to Group II up to 7 days after surgery. Conclusion: Irrigation with 3% povidone iodine concentration was found to be more effective in reducing the level of facial swelling after impacted third molar surgery. (Clinical Trials.gov Identifier: NCT03894722) Key Words: Maxillofacial surgery, Third molar, Povidone-Iodine, Swelling, Tismus

scholarly journals Anxiety Measurements among Dental Students undergoing Third Molar Removal

2011 ◽  
Vol 3 (1) ◽  
pp. 21-27
Author(s):  
Channaveer Pattanshetti ◽  
Rajendra Desai
Keyword(s):  
Dental Anxiety ◽  
Maxillofacial Surgery ◽  
Third Molar ◽  
Dental Students ◽  
Oral And Maxillofacial Surgery ◽  
Female Patients ◽  
Third Molar Extraction ◽  
Anxiety Levels ◽  
The Difference ◽  
Dental Offices

Abstract Background and objective This study was conducted to quantify the anxiety associated with third molar extraction in dental students. And to compare the anxiety levels between males and females, among impacted and non-impacted groups. Methods The study included 100 dental students who reported to Department of Oral and Maxillofacial Surgery, College of Dental Sciences, requiring mandibular third molar removal. Only those patients who met the inclusion and exclusion criteria were selected. The anxiety levels were evaluated based on the scores of the Corah's Dental Anxiety Scale. Results Results showed scores among female patients was higher than males; however the difference between male and female patients was statistically not significant. Among impacted and non-impacted groups score was higher among the impacted group, but the difference between impacted and non-impacted groups was statistically not significant too. Conclusion To conclude, maxillofacial surgeons should consider patients who visit dental offices for third molar impaction surgery as most prone to anxiety which could either result from conditioning or learned responses from their peers. Noteworthy, prior awareness of the patient's psychologic makeup and susceptibility to anxiety may be of value, thus enabling appropriate therapy and improved recovery postoperatively.

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