Orthognathic Treatment with Autotransplantation of Impacted Maxillary Third Molar

Abstract This article presents orthognathic treatment in successful collaboration with autotransplantation of the maxillary third molar. The case report describes a 24-year-old man with severe mandibular protrusion and severe crowding in both dentitions. Overbite was 0 mm, overjet, −15 mm. Maxillary second molars and mandibular third molars were extracted, and presurgical multibracket treatment was begun. Maxillary third molars were impacted completely at 18 months in terms of presurgical tooth alignment. Autotransplantation of the teeth was achieved to substitute for extracted maxillary second molars. At 6 months after autotransplantation, the maxilla was advanced 4 mm on both sides through a Le Fort I procedure; left and right sides of the mandible were set back 15 and 18 mm, respectively, via sagittal split ramus osteotomy to improve mandibular protrusion. The total treatment period lasted 37 months. Autotransplantation treatment is an effective modality for tooth replacement when a donor tooth is available. Fully impacted maxillary third molars are potentially reliable candidates for autotransplantation.

Download Full-text

Mesial Migration Effect on Root Morphology of Mandibular Third Molars

The Angle Orthodontist ◽

10.2319/021006-53r.1 ◽

2007 ◽

Vol 77 (1) ◽

pp. 73-76 ◽

Cited By ~ 2

Author(s):

A. Altuğ Bıçakçı ◽

Oral Sökücü ◽

Hasan Babacan ◽

H. Hüseyin Köşger

Keyword(s):

Third Molar ◽

Root Apex ◽

Central Line ◽

Occlusal Plane ◽

Third Molars ◽

Migration Effect ◽

Mandibular Third Molar ◽

Root Curvature ◽

History Of ◽

Mandibular Third Molars

Abstract Objective: To test the hypothesis that there is a relationship between forward mandibular third molar migration and root curvature of the mandibular third molars. Materials and Methods: The study is comprised of 64 patients who had a history of unilateral mandibular first molar extraction before 16 years of age with no other missing teeth or prosthetic restorations in the mandible. The extraction space was fully or partly closed. The mean remaining space was 1.1 ± 0.41 mm. The root angles for the mesial and distal roots of the mandibular third molars were measured on the panoramic radiographs by calculating the differences between the angle formed by the long axis drawn perpendicular to the occlusal plane of the crown of mandibular third molar and the central line of the lower one ninth of the root through the root apex. The differences between the extracted and nonextracted sides for mesial and distal roots were analyzed using a paired sample t-test. Results: Both mesial and distal roots were approximately 8° more vertical on the extraction sides than on the nonextraction sides. The differences were statistically significant. Conclusion: Mesial tooth migration of mandibular third molars reduces the amount of root curvature developing on this tooth.

Download Full-text

Comparison of Piezosurgery and Conventional Rotary Instruments for Removal of Impacted Mandibular Third Molars: A Randomized Controlled Clinical and Radiographic Trial

International Journal of Dentistry ◽

10.1155/2016/8169356 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 10

Author(s):

Hani Arakji ◽

Mohamed Shokry ◽

Nayer Aboelsaad

Keyword(s):

Statistical Significance ◽

Third Molar ◽

Test Site ◽

Surgical Removal ◽

Third Molars ◽

Randomized Controlled ◽

Surgical Extraction ◽

Impacted Mandibular Third Molars ◽

Mandibular Third Molars ◽

Bone Quantity

The purpose of this study was to test the effect of the surgical removal of impacted mandibular third molars using piezosurgery versus the conventional surgical technique on postoperative sequelae and bone healing.Material and Methods.This study was carried out as a randomized controlled clinical trial: split mouth design. Twenty patients with bilateral mandibular third molar mesioangular impaction class II position B indicated for surgical extraction were treated randomly using either the piezosurgery or the conventional bur technique on each site. Duration of the procedure, postoperative edema, trismus, pain, healing, and bone density and quantity were evaluated up to 6 months postoperatively.Results.Test and control sites were compared using pairedt-test. There was statistical significance in reduction of pain and swelling in test sites, where the time of the procedure was statistically increased in test site. For bone quantity and quality, statistical difference was found where test site showed better results.Conclusion.Piezosurgery technique improves quality of patient’s life in form of decrease of postoperative pain, trismus, and swelling. Furthermore, it enhances bone quality within the extraction socket and bone quantity along the distal aspect of the mandibular second molar.

Download Full-text

Clinical assessment of impacted lower third molars at Ekpan, Delta State in Nigeria

Nepalese Medical Journal ◽

10.3126/nmj.v3i2.29486 ◽

2020 ◽

Vol 3 (2) ◽

pp. 352-355

Author(s):

Mabel Okiemute Etetafia ◽

Ese Anibor ◽

Martins Obaroefe

Keyword(s):

Third Molar ◽

Third Molars ◽

Impacted Tooth ◽

Female Ratio ◽

Impacted Teeth ◽

Pull Out ◽

Carious Lesions ◽

Surgical Extraction ◽

Impacted Mandibular Third Molars ◽

Mandibular Third Molars

Introduction: Diagnosis and management of impacted mandibular third molars call for a cogent appraisal and treatment choice both for the sick person and the dental practitioner. This academic work scrutinized the pattern as well as treatment of impacted mandibular third molars at the Teem Clinic and Dental Centre, Ekpan, Delta State, in Nigeria.Materials and Methods: This cross-sectional survey involved 131 cases who reported impacted mandibular third molars. The age, gender, impacted tooth, type of impaction, pathological conditions, and treatment proffered were recorded.Results: The male to female ratio was 0.8:1, with an age range of 10 to 40 years. Of the lower third molar impactions 58 (42.0%) were mesioangular, 5 (3.6%) horizontal, 18 (13.0%) vertical and 57 (41.3%) were distoangular. A total of 47 (34.1%) quested for dental attention following varying degrees of pain induced by pericoronitis. Teeth removal was accomplished for 76 (55.0%) owing to carious lesions on the impacted teeth, proximate tooth, or both. Surgical extraction was the option taken in 69 (50.0 %) with caries on the impacted teeth while 3 (2.2%) had to pull out of their teeth done owing to carious lesions on the bordering second molars. In 3 (2.2%) both the impacted third molar and the proximate second molar were decayed. Conclusions: The prevailing indication for pulling out impacted mandibular third molars was acute pericoronitis. Mesioangular sort of impaction was most recurrent and ought to be considered for theplausibility of frequentness of complications.

Download Full-text

The Frequency of Mandibular Third Molar Impaction in Different Types of Vertical Skeletal Faces

Journal of The Pakistan Dental Association ◽

10.25301/jpda.302.118 ◽

2021 ◽

Vol 30 (02) ◽

pp. 118-123

Author(s):

Sana Viqar ◽

◽

Sadia Rizwan ◽

Syed Shah Faisal ◽

Syed Sheeraz Hussain

Keyword(s):

Third Molar ◽

Third Molars ◽

Skeletal Malocclusion ◽

Mandibular Third Molar ◽

Lateral Cephalograms ◽

Significant Difference ◽

Pre Treatment ◽

Mandibular Third Molars ◽

Facial Types ◽

Third Molar Eruption

OBJECTIVE: To determine the frequency of mandibular third molar impaction in different vertical skeletal facial types. METHODOLOGY: Data was collected using pre-treatment records including orthodontic files, pre-treatment lateral cephalograms and OPGs of 90 orthodontic patients. Patients from both genders were included. The age group of selected patients was 18-30 years. Vertical skeletal malocclusion was measured using facial angle and mandibular plane angle on cephalogram to group the subjects into Mesiofacial, Brachyfacial and Dolichofacial patients. Third molar eruption status was assessed using OPG. RESULTS: Results showed that erupted third molars were mostly found in brachyfacial patients. Among 32 erupted mandibular third molars, 16 belong to brachyfacial, 11 belonged to mesiofacial and 5 belonged to dolichofacial group. Complete impaction of mandibular third molar was most common among dolichofacial patients. Among 29 completely impacted mandibular third molars, 14 belong to dolichofacial, 9 belonged to mesiofacial and 6 belonged to brachyfacial group. No significant difference was found for partially impacted third molars among the three groups of facial types. There was higher prevalence of mandibular third molar impaction in females as compared to males. CONCLUSION: Frequency of third molar impaction was found to be highest in dolichofacial patients and lowest in brachyfacial patients due to forward direction of mandibular growth contributing to greater resorption of the anterior border of ramus and the additional space required for third molar eruption.

Download Full-text

Coronectomy - A viable alternative to prevent inferior alveolar nerve injury

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v11i3.14055 ◽

2015 ◽

Vol 11 (3) ◽

pp. 1-5

Author(s):

Alok Sagtani ◽

Reshu Agrawal Sagtani ◽

Mehul Jaisani ◽

Leeza Pradhan

Keyword(s):

Nerve Injury ◽

Inferior Alveolar Nerve ◽

Third Molar ◽

Viable Alternative ◽

Third Molars ◽

Dry Socket ◽

Root Exposure ◽

Mandibular Third Molars ◽

Inferior Alveolar Nerve Injury

Background and Objectives: Coronectomy is a relatively new method to prevent the risk of Inferior Alveolar Nerve (IAN) injury during removal of lower third molars with limited scientific literature among Nepalese patients. Thus, a study was designed to evaluate coronectomy regarding its use, outcomes and complications.Materials and Methods: A descriptive study was conducted from December 2012 to December 2013 among patients attending Department of Oral and Maxillofacial Surgery, College of Dental Sciences, BP Koirala Institute of Health Sciences, Dharan, Nepal for removal of mandibular third molars. After reviewing the radiograph for proximity of third molar to the IAN, coronectomy was advised. A written informed consent was obtained from the patients and coronectomy was performed. Patients were recalled after one week. The outcome measures in the follow-up visit were primary healing, pain, infection, dry socket, root exposure and IAN injury. The prevalence of IAN proximity of lower third molars and incidence of complications were calculated.Results: A total 300 mandibular third molars were extracted in 278 patients during the study period. Out of 300 impacted mandibular third molar, 41 (13.7%) showed close proximity to inferior alveolar nerve . The incidence of complications and failed procedure was 7.4% among the patients who underwent coronectomy. During the follow up visit, persistent pain and root exposure was reported while other complications like inferior alveolar nerve injury, dry socket and infection was not experienced by the study patients.Conclusion: With a success rate of 92.6% among the 41 patients, coronectomy is a viable alternative to conventional total extraction for mandibular third molars who have a higher risk for damage to the inferior alveolar nerve.JCMS Nepal. 2015;11(3):1-5.

Download Full-text

Retained Third Molars Removal in a Severely Resorbed Edentulous Mandible. A Case Report

Brazilian Dental Journal ◽

10.1590/0103-6440201302018 ◽

2013 ◽

Vol 24 (5) ◽

pp. 532-536 ◽

Cited By ~ 2

Author(s):

Cassio Edvard Sverzut ◽

Alexandre Elias Trivellato ◽

Alexander Tadeu Sverzut ◽

Marcelo Rodrigues Azenha ◽

Marco Aurélio Kenichi Yamaji ◽

...

Keyword(s):

Potential Problem ◽

Preventive Measures ◽

Treatment Plan ◽

Third Molar ◽

Surgical Removal ◽

Third Molars ◽

Edentulous Mandible ◽

Mandibular Body ◽

Mandibular Third Molars ◽

Tooth Removal

The presence of asymptomatic third molars can represent a potential problem in the mandible when these teeth are retained and the patient has lost all normally erupted teeth. Once the mandibular first and second molars are removed, the mandibular body becomes weaker with time, increasing the complexity, morbidity and incidence of complication in the surgical procedure to remove the retained third molar. This paper reports a case where the mandibular third molars retained in a severely resorbed mandible were removed in a 54-year-old female patient. The treatment plan was based on the safe surgical removal of the teeth and prosthetic rehabilitation with an implant-supported milled bar overdenture and a bone-mucous-supported complete denture in the mandibular and maxillary arch, respectively. If the removal of a retained third molar is indicated in a severely resorbed edentulous mandible, the treatment plan must involve not only preventive measures in order to avoid mandible fracture during or after tooth removal, but also alternatives that allow an adequate mandibular rehabilitation.

Download Full-text

Calcifying cystic odontogenic tumor in radiologically normal dental follicular space of mandibular third molars: report of two cases

Clinics and Practice ◽

10.4081/cp.2017.933 ◽

2017 ◽

Vol 7 (1) ◽

Cited By ~ 3

Author(s):

Gargi S. Sarode ◽

Sachin C. Sarode ◽

Ghevaram Prajapati ◽

Mahesh Maralingannavar ◽

Shankargouda Patil

Keyword(s):

Cell Transformation ◽

Histopathological Examination ◽

Third Molar ◽

Odontogenic Tumor ◽

Third Molars ◽

Radiographic Evidence ◽

Odontogenic Epithelium ◽

Mandibular Third Molar ◽

One Year ◽

Mandibular Third Molars

Two cases of calcifying cystic odontogenic tumor (CCOT) of the dental follicle in an impacted third molar without clinical and radiological evidence are reported during routine histopathological examination. In both the cases left mandibular third molar was mesioangularly impacted with pericoronal radiolucency of less than 2.5 mm, which was not indicative of any pathology. As a routine protocol (which is not practiced widely) of our institution, dental follicles associated with extracted molars were sent for histopathological examination. Histopathological features were consistent with CCOT with pathognomonic ghost cell transformation of odontogenic epithelium. The patients were followed for one year with no recurrence. This paper emphasizes the importance of routine histopathological examination of dental follicles associated with asymptomatic impacted teeth without any clinical or radiographic evidence of follicular lesion.

Download Full-text

Lingual split bone technique – Revisited as a standard operating procedure for surgical removal of third molar during COVID pandemic

Journal of Academy of Dental Education ◽

10.25259/jade_3_2021 ◽

2021 ◽

Vol 7 ◽

pp. 18-22

Author(s):

Sushmitha Mohan ◽

Annamalai Thangavelu ◽

Aravindraj

Keyword(s):

Operating Procedure ◽

Third Molar ◽

Standard Operating Procedure ◽

Surgical Removal ◽

Third Molars ◽

Standard Operating ◽

Infectivity Rate ◽

Alveolar Osteitis ◽

Impacted Mandibular Third Molars ◽

Mandibular Third Molars

Objectives: The objective of the study is to revisit the forgotten art of Lingual split bone technique during the COVID pandemic as a Standard Operating Procedure (SOP) for the surgical removal of impacted mandibular third molars. It was originally introduced in early 90’s by Sir William Kelsey Fry and also we have compared its advantages over the bone guttering technique. Materials and Methods: Twenty seven cases were operated during COVID pandemic in our institution using Davi’s modified lingual split technique under strict COVID protocol. Results: All impacted mandibular third molars were successfully removed. With regards to post-operative complication; 3 patients had nerve injury (11%), 2 patients had lingual paraesthesia (7.6%), 1 patient had alveolar osteitis (3.8%), 2 patients had postoperative infection (7.6%), 3 patients had trismus (19%). The overall success rate was 100%. Also the results of a comparison between bone guttering and chisel-mallet technique were stated. Conclusion: The use of lingual split bone technique deserves consideration during this COVID time as an alternate for bone guttering in surgical removal of third molar as it ensures minimal cross infectivity rate among both dentists and patients. Thus, patient care can be delivered with confidence even during pandemic.

Download Full-text

Is prophylactic extraction of mandibular third molar indicated? A retrospective study.

10.21203/rs.3.rs-32327/v1 ◽

2020 ◽

Author(s):

Zhouxi Ye ◽

Wenhao Qian ◽

Yubo Wu ◽

Bing Sun ◽

Zhiyao Li ◽

...

Keyword(s):

Soft Tissue ◽

Older Patients ◽

Third Molar ◽

P Value ◽

Third Molars ◽

Impacted Teeth ◽

Second Molar ◽

Mandibular Third Molar ◽

Mandibular Second Molar ◽

Mandibular Third Molars

Abstract Background To evaluate the associations of impaction patterns of mandibular third molars (M3Ms) with pathologies caused by them. Methods In this study, 262 patients with 432 impacted M3Ms were included. The pathologies include pericoronitis, mandibular second molar (M2M) caries, and M2M distal periodontal pathology. The impaction patterns of M3Ms and the pathologies were examined, and the M2Ms outcomes after the surgeries were evaluated. χ2 test was used to analyze the data and a P value of <0.05 was considered statistically significant. Results Pericoronitis was the major symptom in all patients, whereas the propensities of M2M distal caries and periodontal pathologies increased in older patients. Soft tissue impacted and vertically angulated teeth were more associated with the pericoronitis (p <0.05); Mesio-angular impacted teeth in less deep positions had greater risks of M2Ms distal caries (p <0.05); Mesio-angular and horizontal impacted teeth in relative deep positions were more likely to cause M2Ms distal periodontal pathologies (p <0.05). Conclusions Extractions of soft tissue impacted teeth in vertical angulations should be considered. While removals of mesially and horizontally angulated or bony impacted teeth could be delayed.

Download Full-text

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

10.36106/ijsr/1824575 ◽

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.

Download Full-text