scholarly journals Evaluating the Presence of Paresthesia in Patients with Juxta-apical Radiolucency after Third Molar Surgery: A Case-control Study

2021 ◽  
Author(s):  
Mahvash Hasani ◽  
Nasim Razavi ◽  
Abdolaziz Haghnegahdar ◽  
Motahhareh Zarifi
Keyword(s):  
Significant Relationship ◽  
Third Molar ◽  
Mandibular Canal ◽  
Cortical Plate ◽  
Third Molar Surgery ◽  
Surgical Removal ◽  
Third Molars ◽  
Chi Square ◽  
Exact Test ◽  
Increased Risk

Abstract Background: Juxta-apical radiolucency (JAR) has been presented as a radiographic sign, suggestive of the IAN injury through third molar surgery. This study aimed to evaluate the relation of JAR with paresthesia in cone-beam computed tomography (CBCT) images and to determine whether the presence of JAR is related to tooth angulation, proximity to the mandibular canal, position to the IAN and thinning of the cortical plates.Methods: Of an initial sample of 545 mandibular third molars, a total of 75 JAR and 75 control teeth were evaluated by CBCT. The association of JAR with the IAN, position to IAN, lingual cortical plate thinning, and tooth angulation was investigated in this study. Temporary and permanent paresthesia were also examined in the subjects. Descriptive statistics, Chi-square test, and Fisher’s exact test were performed for statistical analysis.Results: A significant relationship was found between JAR and temporary paresthesia (P=0.034). However, there was no case of permanent paresthesia. JAR showed no significant relationship with the tooth angulation, cortical plate thinning, position to IAN and proximity to the mandibular canal. The lingual position of JAR relative to the mandibular canal was related to the presence of paresthesia in the JAR group. Also, most cases of paresthesia showed some degree of lingual cortical plate thinning (P=0.012). Conclusion: JAR is generally in contact with the mandibular canal, and some degree of cortical thinning can be found in most cases. In this study, JAR was significantly related to temporary paresthesia. The present findings may indicate the increased risk of nerve injury during the surgical removal of third molars.

scholarly journals Evaluating the presence of IAN injury in patients with juxta-apical radiolucency after third molar surgery: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mahvash Hasani ◽  
Nasim Razavi ◽  
Abdolaziz Haghnegahdar ◽  
Motahhareh Zarifi
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Significant Relationship ◽  
Third Molar ◽  
Mandibular Canal ◽  
Cone Beam ◽  
Cortical Plate ◽  
Third Molar Surgery ◽  
Surgical Removal ◽  
Third Molars

Abstract Background Juxta-apical radiolucency (JAR) has been presented as a radiographic sign, suggestive of the IAN injury through third molar surgery. This study aimed to evaluate the relation of JAR with IAN injury in cone-beam computed tomography (CBCT) images and to determine whether the presence of JAR is related to tooth angulation, proximity to the mandibular canal, position to the IAN, and thinning of the cortical plates. Methods Of an initial sample of 545 mandibular third molars, a total of 75 JAR+ and 75 JAR− teeth were evaluated by CBCT. We assessed the relationship between the presence of JAR in cone-beam computed tomography (CBCT) images and the presence of IAN injury after mandibular third molar surgeries. Moreover, we investigated whether the presence of IAN injury is related to tooth angulation, proximity to the mandibular canal, position to the IAN, and thinning of the cortical plates. Descriptive statistics, Chi-square test, and Fisher’s exact test were performed for statistical analysis. Results A significant relationship was found between JAR and temporary IAN injury (P = 0.036). However, there was no case of permanent IAN injury. IAN injury showed no significant relationship with the tooth angulation, position to IAN and proximity to the mandibular canal, lingual cortical plate thinning, sex, and age. Conclusions JAR is generally in contact with the mandibular canal, and some degree of cortical thinning can be found in most cases. In this study, JAR was significantly related to temporary IAN injury. JAR may increase the risk of nerve injury during the surgical removal of third molars.

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

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.

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 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 Retrospective Analysis on Inferior Third Molar Position by Means of Orthopantomography or CBCT: Periapical Band-Like Radiolucent Sign

2021 ◽  
Vol 11 (14) ◽  
pp. 6389
Author(s):  
Young-Sam Kim ◽  
Young-Min Park ◽  
Saverio Cosola ◽  
Abanob Riad ◽  
Enrica Giammarinaro ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Third Molar ◽  
Cortical Plate ◽  
Third Molar Surgery ◽  
Chi Square ◽  
Dental Clinics ◽  
Tooth Roots ◽  
Root Position ◽  
Chi Square Test ◽  
The Mean

Background: Orthopantomography (OPG) is usually used as a primary diagnostic radiological exam in the planning of third molar surgery because it is deeply available in dental clinics and has lower radiation doses compared to Cone-beam computed tomography (CBCT). The OPG provides a bi-dimensional image, but several radiological signs have been proposed to study the position of the lower third molar and to predict surgical risks. Methods: Patients were divided into two groups, the OPG with a radiolucent area (D-group) and the OPG without any sign (C-group) in correspondence of inferior wisdom tooth roots. Results: The mean distance between the inferior third molar root and the lingual cortical mandibular bone was −1.09 ± 1.5 mm. The nearness of the root that is less than 1 mm was more frequent in the D-group (84.85%) compared to the C-group (14.58%) with statistical significance (Odd ratio: 32.8) using the Chi-square test. Conclusions: When the root of the impacted inferior third molar is impacted into the lingual cortical plate, a periapical band-like radiolucent sign may appear in the OPG image. It could be useful for the prediction of root position and surgical risks.

scholarly journals Impact of electro-neuro-feedback on postoperative outcome of impacted lower third molar surgery

2018 ◽  
Vol 12 (01) ◽  
pp. 077-088
Author(s):  
Giacomo Oteri ◽  
Antonia Marcianò ◽  
Gabriele Cervino ◽  
Matteo Peditto
Keyword(s):  
Clinical Outcome ◽  
Biochemical Parameters ◽  
Oral Surgery ◽  
Third Molar ◽  
Postoperative Outcome ◽  
Third Molar Surgery ◽  
Surgical Removal ◽  
Third Molars ◽  
School Of Dentistry ◽  
The Impact

ABSTRACT Objective: The purpose of this study was to evaluate the impact of a treatment with electro-neuro-feedback (ENF), a portable transcutaneous electrical nerve stimulation (TENS) device, on the clinical outcome and inflammatory biochemical parameters related to the impacted lower third molar surgery. Materials and Methods: A randomized, split-mouth, and single-blind study was conducted on 32 patients requiring lower third molars extractions and referred to the Oral Surgery Unit of the School of Dentistry of the University of Messina. Every patient underwent surgical removal of both lower third molars. The first extraction included a placebo (electrodes placement with turned-off device) treatment following the surgery, while the second had the ENF used next to the avulsion and the following days. Clinical parameters were collected 4 days before, immediately after, 2, 4, and 7 days after the surgical procedure. Biochemical parameters were obtained 1 day before the surgical removal and 7 days after. Data were processed using Wilcoxon–Mann–Whitney test, with significance being set at P < 0.05. Results: Clinical outcome parameters showed a significant improvement after the ENF treatment, while considered inflammatory markers expressed different patterns. Conclusions: ENF, a reliable portable TENS device, has demonstrated to be a useful tool in the managing of the postsurgical phases, reducing edema, pain, and consequent pain-killers consumption.

scholarly journals External root resorption of second molars caused by impacted third molars: an observational study in panoramic radiographs

2018 ◽  
Vol 47 (1) ◽  
pp. 25-30
Author(s):  
Jhonatan Thiago LACERDA-SANTOS ◽  
Gélica Lima GRANJA ◽  
Jalber Almeida dos SANTOS ◽  
Julliana Cariry PALHANO-DIAS ◽  
José Cadmo Wanderley Peregrino de ARAÚJO-FILHO ◽  
...  
Keyword(s):  
Root Resorption ◽  
Young Patients ◽  
Third Molar ◽  
Third Molars ◽  
Chi Square ◽  
Cross Sectional ◽  
Exact Test ◽  
Panoramic Radiographs ◽  
Second Molar ◽  
External Root Resorption

Abstract Objective This research investigate the presence of external root resorption (ERR) in second molars caused by impacted third molars in panoramic radiographs, relating to the position of third molars according to classification of Winter, Pell and Gregory. Material and method A cross-sectional, retrospective study using panoramic radiographs obtained from January 2014 to December 2015. The inclusion criterion was the presence of a second molar adjacent to an impacted third molar. Data were analyzed using descriptive and inferential statistics. Pearson's Chi-Square Test and Fisher's Exact Test (p≤0.05) were performed. Result The sample consisted of 584 panoramic radiographs, 356 (60.95%) of women, and 228 (39.05%) of men, the mean age was 25.31 years. The prevalence of ERR was 12.5%, and the group of 14-24 year olds was the most affected (p = 0.46). The presence of ERR was statistically higher in the mandible (42.1%) with p=0.01. The ERR located in the cervical (57.1%) and medium (58.8%) thirds was proportionally higher in the teeth with B2 (p=0.02) and mesio-angular positions (p=0.26). Conclusion The prevalence of ERR in second molars, caused by impacted third molars, was shown to be similar to results found in the literature, with no gender preference, this affects young patients, occurring frequently in mandible teeth, and presents greater severity in the cervical and middle thirds. The B2 and mesio-angular positions were more prone to ERR.

scholarly journals Association between Demographic Factors and BMI with Osteoporosis: A Cross-Sectional Study in Kurdistan Province, West of Iran

2019 ◽  
pp. 1-7
Author(s):  
Nasrin Moghimi ◽  
Khaled Rahmani ◽  
Mohsen Rajabnia
Keyword(s):  
Significant Relationship ◽  
Demographic Factors ◽  
Cross Sectional Study ◽  
P Value ◽  
Fisher Exact Test ◽  
Chi Square ◽  
Cross Sectional ◽  
Exact Test ◽  
Increased Risk ◽  
Prevalence Of Osteoporosis

Background: Regarding the association of osteoporosis with various fractures and its disabilities, high cost of treatment and rehabilitation, asymptomatic majority of patients and revealing after serious disability and preventable disability and its complications, this study was conducted to determine the prevalence of osteoporosis and its association with demographic factors and body mass index (BMI) in patients referred to Sanandaj densitometry center. Methods: This cross- sectional descriptive- analytic study was carried out on 250 patients referring to Sanandaj densitometry center from September 2017 to September 2018. For the subjects, BMD was determined by dual-energy X-ray absorptiometry method at two bone segments, ie the hip and spine. Data were analyzed using independent t-test, fisher exact test, chi- square test and logistic regression test using SPSS V.23 software. Results: In 250 studied subjects, there were found 68 cases (27.2%) osteoporosis in spine region and 38 cases (15.2%) in hip region. There was a significant correlation between age and incidence of osteoporosis in the spine and hip (P-value < 0.001), with the increase in age, the prevalence of osteoporosis increased. Despite the prevalence of osteoporosis in females, there was no significant relationship between sex and osteoporosis in spine and hip (P-value > 0.05). Despite the higher prevalence of osteoporosis in the study population living in the city, there was no significant relationship between residence and osteoporosis in spine and hip (P- value > 0.05). There was a significant relationship between education level and osteoporosis in spine and hip (P- value < 0.001), so that with the increase in education, the prevalence of osteoporosis decreases. There was a significant correlation between BMI and osteoporosis in spine and hip (P- value < 0.05), with an increase in BMI, the prevalence of osteoporosis decreases. Conclusion: This study revealed a high prevalence of osteoporosis. Therefore, considering the increased risk of fracture, the morbidity and mortality due to osteoporosis and their costs, increasing awareness of people about complications, how to reduce the risk factors and timely treatment, it seems necessary.

scholarly journals A Comparison of Pre-emptive Analgesic Efficacy of Aceclofenac and Piroxicam for Post-Operative Pain Management after third Molar Surgery: A Prospective, Randomized, Double-blind Study

2020 ◽  
Vol 11 (4) ◽  
pp. 6188-6195
Author(s):  
Jones Jayabalan ◽  
Muthusekhar M R ◽  
Senthil Murugan P
Keyword(s):  
Pain Intensity ◽  
Third Molar ◽  
Analgesic Efficacy ◽  
Third Molar Surgery ◽  
Surgical Removal ◽  
Double Blind Study ◽  
Third Molars ◽  
Double Blind ◽  
Post Operative Pain ◽  
Significant Difference

The study aimed to compare the analgesic efficacy of 100 mg and 20 mg as a analgesic for preventing post-operative pain after third molar surgery. Fifty patients with impacted mandibular third molars who required surgical removal were included in the study. These patients were divided into two groups randomly. One group consisted of patients receiving 100 mg as a analgesic, and the other group consisted of patients receiving 20 mg as a analgesic 1 hour before the procedure. The study findings show both the drugs were equally effective in managing post-operative pain following third molar surgery. On statistical analysis, there was no significant difference in pain experience among both groups A and B in post-operative period who underwent surgery. However, the study observes a highly significant difference in both the groups in terms of pain intensity scores at different times. Results show that there was a significant difference before, 3rd day and 5th day; Further study shows that the effectiveness of the drug was not confirmed in 24 hours to 3 days. It was observed both the groups shows a significant difference in on the 5thand 3rd day. This comparative research of pain intensity shows after analgesia with and in of third molars, a pronounced effect in the group treated with 20mg was seen. Still, there was no statistically significant difference noted in VAS before and 5th day of both groups.

Third Molar Surgery: Risk Factors and Complications after Removal of Third Molars

2021 ◽  
Vol 15 (11) ◽  
pp. 3520-3522
Author(s):  
Syed Zuhair Mehdi ◽  
Faizan Munir Khan ◽  
Nighat Shafiq ◽  
Sarah Salim ◽  
Muhammad Amer Khan ◽  
...  
Keyword(s):  
Common Factor ◽  
Third Molar ◽  
Personal Data ◽  
Third Molar Surgery ◽  
Third Molars ◽  
The Third ◽  
Bone Removal ◽  
Increased Risk ◽  
Tooth Impaction ◽  
Transversal Study

Objective: There is a need for this research because it aims to identify characteristics that increase the likelihood of negative outcomes following the removal of third molars. Study Design: Observational/transversal study Place and Duration: Dental College HITEC-IMS Taxilla/ Gulraiz Dental Clinic Quaid Avenue Main Road, Gulraiz 3, Rawalpindi. Nov 2020-June 2021 Methods: A total of 180 male and female participants were included in this study. The patients ranged in age from 20 to 50. Pericoronitis and tooth impaction were among the complaints of the patients included in the study. The oral and maxillofacial department operated on all of the patients who requested the removal of their third molars. All patients provided written consent before having their personal data collected, including their age, gender, BMI, kind of impaction, and location of their third molar. Various operative variables were employed. In our research, we looked at post-operative complications and risk variables. The whole data was analyzed with SPSS 23.0. Results: 110 (61.1%) patients were males and 70 (38.9%) cases were females. 28.17±9.47 years were the mean age with mean BMI 24.11±3.65 kg/m2. Most of the teeth impacted in left side found in 102 (56.7%) patients. Most common type of impaction was mesioangular among 90 (50%) cases followed by distoangular 45 (23.7%) cases. Majority of the third molars were fully impacted 120 (66.7%), 38 (21.1%) were partially impacted and frequency of erupted tooth was 22 (12.2%). All the third molars were removed by buccal guttering technique under local anesthesia. Post-operative infection was the most common complication found in 80 (44.4%) cases followed by gingival defect in 27 (15%) radicular fractures in 24 (13.3%) cases. Location of the third molar and bone removal was the most common factor found. Conclusion: There was an increased risk of problems with tooth sectioning, bone removal, and/or tooth localization in patients above the age of 22. Both the evaluation of the indications for the removal of third molars and the process of informed consent should reflect this information. Keywords: Third Molars, Surgery, Anesthesia, Complications, Impactions

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