Flap vs flapless technique for impacted third molar removal: A split mouth prospective randomized control study

2021 ◽  
Vol 7 (3) ◽  
pp. 167-171
Author(s):  
Neeraj ◽  
Banshilal Beniwal ◽  
Padmanidhi Agarwal ◽  
Vikas Berwal ◽  
Richa Malik
Keyword(s):  
Healing Process ◽  
Third Molar ◽  
Mouth Opening ◽  
Third Molars ◽  
Pocket Depth ◽  
Second Molar ◽  
Group I ◽  
Flap Design ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars

The aim of this study was to compare the post-operative sequelae of removal of impacted third molars in participants treated with conventional flap elevation technique or with a minimally invasive flapless technique. Participants with bilaterally impacted mandibular third molars were included. They were divided into two sites constituting 2 groups. One group was operated by using conventional flap design and elevation and other with flapless technique. Objective clinical parameters were recorded and compared in the post-operative period like mouth opening, swelling, surgical time, and pocket depth. Subjective parameters including pain were also assessed and statistically analyzed. The sites operated in Group II (Flapless technique) had better results (p≤0.05) in terms of pain, swelling, trismus, and pocket depth distal to second molar when compared to Group I (Flap). The flapless technique gives better surgical results and improved healing process after third molar removal and so should be recommended in routine clinical practice.

scholarly journals Flap vs flapless technique for impacted third molar removal: A split mouth prospective randomized control study

2021 ◽  
Vol 7 (3) ◽  
pp. 167-171
Author(s):  
Neeraj ◽  
Banshilal Beniwal ◽  
Padmanidhi Agarwal ◽  
Vikas Berwal ◽  
Richa Malik
Keyword(s):  
Healing Process ◽  
Third Molar ◽  
Mouth Opening ◽  
Third Molars ◽  
Pocket Depth ◽  
Second Molar ◽  
Group I ◽  
Flap Design ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars

The aim of this study was to compare the post-operative sequelae of removal of impacted third molars in participants treated with conventional flap elevation technique or with a minimally invasive flapless technique. Participants with bilaterally impacted mandibular third molars were included. They were divided into two sites constituting 2 groups. One group was operated by using conventional flap design and elevation and other with flapless technique. Objective clinical parameters were recorded and compared in the post-operative period like mouth opening, swelling, surgical time, and pocket depth. Subjective parameters including pain were also assessed and statistically analyzed. The sites operated in Group II (Flapless technique) had better results (p≤0.05) in terms of pain, swelling, trismus, and pocket depth distal to second molar when compared to Group I (Flap). The flapless technique gives better surgical results and improved healing process after third molar removal and so should be recommended in routine clinical practice.

scholarly journals Influence of Surgical Flap Design (Envelope and Szmyd) for Removal of Impacted Mandibular Third Molars on Clinical Periodontal Parameters: A Clinical Trial

2021 ◽  
Vol 18 (9) ◽  
pp. 4465
Author(s):  
Muhtada Ahmad ◽  
Zafar Ali Khan ◽  
Tahir Ullah Khan ◽  
Montaser N. Alqutub ◽  
Sameer A. Mokeem ◽  
...  
Keyword(s):  
Third Molar ◽  
Periodontal Pocket ◽  
Third Molars ◽  
Chi Square ◽  
Pocket Depth ◽  
Clinical Attachment Loss ◽  
Exact Test ◽  
Second Molar ◽  
Third Molar Extraction ◽  
Flap Design

The aim of the study was to assess the influence of flap designs (Envelope flap (EF) and Szmyd flap (SF)) for impacted mandibular third molar extraction, on periodontal pocket depth (PPD), clinical attachment loss (CAL) and bone levels (BL) of second molar. Sixty patients indicated for third molar extractions with healthy second molars were allocated into two groups: EF and SF (n = 30). Third molars were assessed for angulation, root patterns, depth of impactions and relation with ramus (Pell and Gregory classification). Extraction of third molars was performed and PPD, CAL and BL around second molars at 0, 3 and 6 month (mon) follow-ups (FU) were assessed clinically and radiographically. ANOVA, Chi-square and Fisher’s exact test were employed to compare periodontal factors between EF and SF groups, considering p ≤ 0.05 as significant. Sixty participants with a mean age of 23.22 ± 3.17 were included in the study. Based on angulation, the most common impaction in the EF and SF groups was mesio-angular (EF, 50%; SF, 36.7%). Buccal and distal PPD showed a significant increase (p < 0.001) in both EF and SF patients from baseline to 6 mon. EF patients showed significantly higher distal and buccal CAL (6.67 ± 0.18 mm; 6.91 ± 0.17 mm) and BL (7.64 ± 0.16 mm; 7.90 ± 0.15 mm) as compared to SF patients (CAL, 6.76 ± 0.26 mm; 6.91 ± 0.17 mm-BL, 7.42 ± 0.38 mm; 7.34 ± 0.34 mm) at 6 mon FU. SF showed better soft tissue attachment (PPD and CAL) and bone stability (less bone loss) around second molars compared to EF after third molar extractions regardless of the patient, tooth and operator factors.

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 Factors associated with spontaneous mesialization of impacted mandibular third molars after second molar protraction

2019 ◽  
Vol 90 (2) ◽  
pp. 181-186
Author(s):  
Un-Bong Baik ◽  
Jin Hye Kang ◽  
Ui-Lyong Lee ◽  
Nikhilesh R Vaid ◽  
Yoon-Ji Kim ◽  
...  
Keyword(s):  
Third Molar ◽  
Regression Analyses ◽  
Third Molars ◽  
Second Molar ◽  
Factors Associated ◽  
The Third ◽  
Mandibular Second Molar ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars ◽  
Mandibular First Molar

ABSTRACT Objectives: To investigate factors associated with spontaneous mesialization of impacted third molars after second molar protraction to close the space caused by a missing mandibular first molar (L-6) or retained deciduous mandibular second molars with a missing succedaneous premolar (L-E). Materials and Methods: Panoramic radiographs of patients treated with mandibular second molar protraction to close the space due to missing L-6 or L-E (14 males, 36 females, mean age = 18.6 ± 4.4 years) were analyzed before treatment (T1) and after second molar protraction (T2). Factors associated with the amount of third molar mesialization were investigated using regression analyses. Results: Mandibular second molars were protracted by 5.1 ± 2.1 mm and 5.8 ± 2.7 mm, measured at the crown and root furcation, respectively. After second molar protraction, third molars showed spontaneous mesialization by 4.3 ± 1.6 mm and 3.8 ± 2.6 mm, measured at the crown and root furcation, respectively. Nolla's stage of the third molar at T1 (B = 0.20, P = .026) and second molar protraction time (B = 0.04, P = .042) were significantly associated with the amount of third molar mesialization. Conclusions: Greater third molar mesialization was observed when Nolla's stage of the third molar was higher before treatment and when the second molar protraction time was longer.

scholarly journals Vertical eruption patterns of impacted mandibular third molars after the mesialization of second molars using miniscrews

2014 ◽  
Vol 86 (4) ◽  
pp. 565-570 ◽  
Author(s):  
Un-Bong Baik ◽  
Yoon-Ah Kook ◽  
Mohamed Bayome ◽  
Je-Uk Park ◽  
Jae Hyun Park
Keyword(s):  
Third Molar ◽  
Control Group ◽  
Third Molars ◽  
Panoramic Radiographs ◽  
Second Molar ◽  
Space Closure ◽  
Impacted Mandibular Third Molars ◽  
Group 2 ◽  
Mandibular Third Molars ◽  
Group 1

ABSTRACT Objective:  To investigate (1) whether vertical eruption of impacted third molars improves after mesialization of second molars and (2) what factors affect the vertical eruption of impacted third molars when space caused by missing molars is successfully closed by mesialization of the second molar using miniscrews. Materials and Methods:  The treatment group (Group 1) included 52 patients who had (1) missing mandibular first molars (ML-6) or missing deciduous mandibular second molars (ML-E), (2) initially impacted mandibular third molars, and (3) successful space closure of the edentulous area with orthodontics. Panoramic radiographs at start of treatment (T1) and at time of space closure (T2) were collected. The control group (Group 2) included 46 nonedentulous patients with impacted mandibular third molars without molar protraction treatment. Panoramic radiographs with similar T1/T2 treatment times were selected. Nine measurements were obtained regarding horizontal available space, vertical eruption, and third molar angulation. Results:  Third molars erupted vertically an average of 2.54 mm in Group 1 compared with 0.41 mm in Group 2. Age, gender, Nolla stage, and angle of the third molars did not show significant correlations with the vertical change of the impacted third molars, whereas the depth of third molar impaction and available space showed significant correlations. Conclusions:  Impacted mandibular third molars vertically erupt as a result of uprighting with mesialization of the second molar, and vertical eruption is affected by the initial vertical location of impacted third molars and available space.

Prevalence of Distal Cervical Caries in Mandibular Second Molar caused by impacted third molar

2021 ◽  
Vol 15 (12) ◽  
pp. 3253-3256
Author(s):  
M Arshman Khan ◽  
Talib Hussain ◽  
Bilal Z. Babar ◽  
Sikandar J. Bajwa ◽  
S. Ghani ◽  
...  
Keyword(s):  
Tooth Loss ◽  
Early Recognition ◽  
Demographic Data ◽  
Third Molar ◽  
Third Molars ◽  
Second Molar ◽  
Impacted Third Molar ◽  
Mandibular Second Molar ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars

Aim: To analyse early recognition of the distal cervical caries of mandibular second molar caused by impacted mandibular third molar, to correlate oral health and caries status and to find out the average age groups and gender affected by impacted third molar Methods: A cross-sectional survey of 300 participants was conducted over a 15-month period at Rehmat Memorial Hospital, Abbottabad. 300 participants having impacted third molar having distal cervical caries in mandibular second molar were analyzed clinically and radiographically. Data was analyzed using SPSS version 23.0 Results: the demographic data of 300 patients with impacted mandibular third molars were analyzed. 64% were male and 36% female that have extractions due to impaction. Caries caused in more than half of participants by mesioangular impaction, which was 52%, 3% due to distoangular, 26% due to distal, and 18% due to horizontal impaction. In 63.25% of cases, teeth were lost due to caries, periodontitis caused 20.25% of tooth loss, pericoronitis 7.75%, orthodontics 3.75%, prosthodontics 1.2%, trauma 1%, and other factors were 2.5%. study reveals that 30.5 % of the extractions were done from 21 and 30 years and 23 %of extractions were performed. 40% of those who took part in the study did not brush their teeth. Socioeconomic status also has a great impact on tooth extractions. Conclusion: After conducting this study, it was concluded that there was a relationship between the prevalence of distal cervical caries in mandibular second molars and the placement of neighbouring impacted mandibular third molars. As a result, the extraction of mandibular third molars should be done to avoid cavities and premature tooth loss in the neighboring molar. Key words: Third molar impaction, distoangular, distal cervical caries, extraction, 2nd molar caries

scholarly journals Comparison of postoperative complications after impacted mandibular third molar extraction with conventional suturing versus tube drainage.

2020 ◽  
Vol 27 (07) ◽  
pp. 1408-1413
Author(s):  
Wajid Ali Rajper ◽  
Kashif Ali Channar ◽  
Munawar Din Larik ◽  
Sajid Ali Majeedano ◽  
Aftab Ahmed Soomro ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Third Molar ◽  
Mouth Opening ◽  
P Value ◽  
Third Molars ◽  
Mandibular Third Molar ◽  
Group A ◽  
Impacted Mandibular Third Molars ◽  
Group B ◽  
Mandibular Third Molars

Objectives: To determine the effectiveness of tube drain compared with conventional suturing on postoperative complications after extraction of impacted mandibular third molars. Study Design: Cross Sectional study (Comparative). Setting: Department of Oral & Maxillofacial Surgery, Institute of Dentistry, LUMHS Jamshoro/Hyderabad. Period: Six months duration from 12-11-2015 to 13-05-2016. Material & Methods: All the patient age from 18 to 45 years irrespective of gender, having mesioangular impacted mandibular third molar were included in the study. Patients were divided into two groups, Group-A and group-B. The severity of pain was recorded by using Visual Analog Scale from 0 no pain to 10 worst pain, degree of swelling was measured by facial size through Amin and Laskin criteria and mouth opening was measured by interincisal distance through ruler. All data was recorded on the 3rd and 7th day by the clinician. Results: Mean age of group A was 31.22+7.21 years, and mean age of group B was 28.34+5.33 years. Male were found slightly more as compared to female. On 3rd day the post-operative pain assessment was almost equal in both groups p-value 0.06 and assessment of post-operative swelling on 3rd day was found with insignificant difference p-value 0.22. Assessment of pain on 7th post-operative day was that the severe pain was found significantly reduced in group B as compared to group A p-value 0.01, swelling was significantly reduced in group B p-value 0.04. While mouth opening was also found significantly more in group B as compared to group A p-value 0.022. Conclusion: After removal of impacted mandibular third molars, incorporating tube drain is very effective as compared to conventional suturing in reducing the facial swelling, trismus and postoperative pain.

EXTRATION OF MANDIBULAR THIRD MOLARS, A CORRELATION BETWEEN THE SURGICAL TECHNIQUE AND WINTER’S

2018 ◽  
Vol 28 (2) ◽  
pp. 407-413
Author(s):  
Zaklina Menceva ◽  
Biljana Evrosimovska ◽  
Aneta Terzievska ◽  
Daniela Veleska Stevkovska ◽  
Bogdan Ilievski
Keyword(s):  
Surgical Technique ◽  
Third Molar ◽  
Vertical Position ◽  
Third Molars ◽  
Anatomical Structures ◽  
Mandibular Third Molar ◽  
Flap Design ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars ◽  
Selection Of

Total and partial impaction of the teeth is considered to be a developmental anomaly, that can affect any tooth in both deciduous and permanent dentition, but according to a large number of dental authors it is mostly associated with the mandibular third molars. Its multifactorial etiology, diagnostics, oral surgical approach and techniques can increase the difficulties of this problem which is encountered in the everyday oral surgical practice.The selection of the appropriate oral surgical technique mostly depends on the various positions in which the total or partial impacted mandibular third molar may appear and his correlation with the adjacent anatomical structures, thus leading to different diagnostic and therapeutic problems.This study includes 80 patients, divided in two groups of 40 patients, where one group is diagnosed with a total impaction and the other group with a partial impaction of the mandibular third molars.After a statistical analysis of the obtained data was performed with the help of appropriate world renowned classifications concerning the position of the impacted mandibular third molars, we came to the following results: according to Winter’s classification, the impacted molars where dominantly in a vertical position; Axhausen’s flap design was dominantly a method of choice; buccodistal osteotomy is the most frequently used technique; the impacted molars presented a convergent anatomical configuration of the roots in most of the cases.

scholarly journals Assessment of Lingual Nerve Paresthesia after Removal of Mandibular Third Molar

2021 ◽  
pp. 253-259
Author(s):  
V. Usha ◽  
G. Rajabackiyam ◽  
K. Prabhu Sankar ◽  
Varun Muthuraman ◽  
Aravind Christo ◽  
...  
Keyword(s):  
Root Resorption ◽  
Third Molar ◽  
Lingual Nerve ◽  
Surgical Removal ◽  
Third Molars ◽  
Second Molar ◽  
Mandibular Third Molar ◽  
Impacted Mandibular Third Molars ◽  
The Common ◽  
Mandibular Third Molars

Surgical removal of impacted mandibular third molars are the most commonly performed minor surgical procedures by maxillofacial surgeon. If not treated can lead to few complications like pericoronitis, root resorption of second molar, caries of second molar, cyst and tumours can arise from them. The common complications include swelling, hematoma, trismus and lingual nerve injuries. In this article 1000 cases of various types impactions were surgically operated and assessment of lingual nerve injury was done.

scholarly journals Prevalence of Distal Carious Lesions in Mandibular Second Molars Due to Mesio-Angular Impacted Third Molars

2021 ◽  
Vol 30 (1) ◽  
pp. 50-55
Author(s):  
Talha Ashar ◽  
◽  
Asma Shakoor ◽  
Sadia Ghazal ◽  
Naghma Parveen ◽  
...  
Keyword(s):  
Third Molar ◽  
Data Entry ◽  
Target Population ◽  
Dental Arch ◽  
Third Molars ◽  
Cross Sectional ◽  
Second Molar ◽  
Carious Lesions ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars

OBJECTIVE: This study was conducted to observe the relationship of mesio-angular impacted third molars to the development of distal caries in adjacent second molars. METHODOLOGY: This cross-sectional study was conducted at Nishtar Institute of Dentistry, Multan. Nine hundred and eighty nine periapical, bitewing and Panoramic radiographs were recorded and examined for distally carious second molars and impacted mandibular third molars. SPSS version 23.0 was used for data entry and analysis. RESULTS: Almost 40.8% of the target population reported with distal caries due to third molar impactions. A total of 53.30% of these impactions were of the mesio-angular variety. No distal caries was detected in transverse type of impactions. CONCLUSION: The current study concluded that the prevalence of distal caries in mandibular second molars and the positioning of adjacent impacted mandibular third molars in the dental arch were interlinked. Consequently, extraction of mandibular third molars should be considered to prevent caries and premature loss of second molar teeth. KEYWORDS: Distal caries, Impacted third molar, Infections, Risk Factor HOW TO CITE: Ashar T, Shakoor A, Ghazal S, Parveen N, Saleem MN, Raja HZ. Prevalence of distal carious lesions in mandibular second molars due to mesio-angular impacted third molars. J Pak Dent Assoc 2021;30(1):50-55.

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