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

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.

Download Full-text

Effect of Intraoral Drainage after Impacted Mandibular Third Molar Extraction on Non-Infectious Postoperative Complications

Journal of Clinical Medicine ◽

10.3390/jcm10204705 ◽

2021 ◽

Vol 10 (20) ◽

pp. 4705

Author(s):

Grzegorz Trybek ◽

Joanna Jarzęcka ◽

Olga Preuss ◽

Aleksandra Jaroń

Keyword(s):

Postoperative Complications ◽

Sodium Alginate ◽

Third Molar ◽

Surgical Removal ◽

Third Molars ◽

Third Molar Extraction ◽

Mandibular Third Molar ◽

Wisdom Teeth ◽

Group B ◽

Mandibular Third Molars

Surgical removal of mandibular third molars is associated with non-infectious postoperative complications, including pain, swelling, trismus. Intraoral drains are noteworthy because of their ease of application, availability, and effectiveness. This study aimed to evaluate the use of latex and calcium–sodium alginate mouth flat drains on the severity of postoperative complications such as pain, trismus, and edema after surgical removal of mandibular third molars. Ninety patients who underwent surgical removal of wisdom teeth were studied. The patients were divided into three groups. Group A—with a latex flat drain, group B—with a sodium–calcium alginate (Kaltostat) flat drain, and group C—with a wound closed with knotted sutures. Patients were assessed for pain on a VAS scale every day from surgery to postoperative day 7. Before the procedure and on postoperative days 1, 2, and 7, the pain level, edema, and trismus were measured, respectively. Intraoral drainage with a flat drain after mandibular third molar removal does not significantly reduce pain, as measured by the VAS scale, or postoperative swelling, as measured by lines between craniometric points. Intraoral drainage with a latex drain after mandibular third molar removal does not significantly reduce trismus, while intraoral drainage with a calcium–sodium alginate drainage bag significantly increases trismus.

Download Full-text

Correlation between mandibular third molar and mandibular incisor crowding: A retrospective CBCT-based study

Journal of Dental Research Dental Clinics Dental Prospects ◽

10.34172/joddd.2021.040 ◽

2021 ◽

Vol 15 (4) ◽

pp. 247-250

Author(s):

Seerab Husain ◽

Sri Rengalakshmi

Keyword(s):

Third Molar ◽

Third Molars ◽

Mandibular Incisor ◽

Positive Correlation ◽

Irregularity Index ◽

Mandibular Third Molar ◽

Group A ◽

The Mean ◽

Group B ◽

Mandibular Third Molars

Background. Late mandibular incisor crowding is a fairly common phenomenon experienced by growing adults. The etiology of late mandibular incisor crowding, however, is controversial and inconclusive. Hence, this study aimed to investigate the correlation between mandibular third molar and mandibular incisor crowding using Cone-beam computed tomography (CBCT) data. Methods. The study consisted of 40 samples of CBCT images divided into two groups (n=20). Group A comprised CBCT images without third molars, and group B included CBCT images with third molars. The images were observed in the axial view and manually marked to calculate the amount of crowding using Little’s irregularity index. The obtained values were statistically analyzed using Pearson’s correlation test. SPSS 23 was used for statistical analysis. Results. The results showed a positive correlation between the mandibular third molars and mandibular incisor crowding, which was significant (P=0.033). The mean Little’s irregularity index score for groups A and B were 4.26 and 6.799, respectively (P=0.033). Conclusion. The positive correlation between the two groups suggests an association between the mandibular third molars and mandibular incisor crowding.

Download Full-text

The use of piezosurgery for mandibular third molar extraction

Stomatoloski glasnik Srbije ◽

10.2298/sgs1404203t ◽

2014 ◽

Vol 61 (4) ◽

pp. 203-209 ◽

Cited By ~ 2

Author(s):

Nenad Tanaskovic ◽

Miroslav Lucic

Keyword(s):

Postoperative Complications ◽

Surgical Techniques ◽

Inferior Alveolar Nerve ◽

Third Molar ◽

Mouth Opening ◽

Standard Group ◽

Third Molars ◽

Wisdom Teeth ◽

Impacted Mandibular Third Molars ◽

Mandibular Third Molars

Introduction. Extraction of impacted mandibular third molars is often accompanied by intraoperative and postoperative complications such as damage of the inferior alveolar nerve, prolonged difficulty in mouth opening, alveolitis, pain and swelling in the region of surgery. The aim of this study was to compare two surgical techniques (standard and piezo) in the extraction of mandibular third molars and to assess their postoperative complications. Material and Methods. Study included 16 patients (8 male and 8 female) age 17 to 32 years treated in the period from 2012 to 2014. All patients had both mandibular molars impacted. One third molar was extracted using classical technique while the other one using a piezo device. Preoperative preparation was the same for all patients and included radiological analysis and verification of teeth by ortopan tomography (OPG) and CT. Patients were assessed one, seven and 14 days after the procedure. Results. After the extraction, all patients were followed for postoperative symptoms: pain, swelling and paresthesia of the inferior alveolar nerve. The results confirmed advantages of piezosurgery in the removal of impacted mandibular third molars. Average duration of the intervention was 18 minutes with standard technique while the duration with piezo technique was 23 minutes. According to the visual-analog scale (VAS) the average pain in the standard group was 9 whereas in the piezo group it was 6. Postoperative swelling was 10 mm (pronounced) the first day after the procedure in the standard group while in the piezo group it was 6 mm (moderate). Conclusion. The use of piezo technology for the extraction of impacted wisdom teeth is reliable method which reduces the risk of the most common postoperative complications following mandibular wisdom teeth removal.

Download Full-text

Use of Collagen Membrane in the Treatment of Periodontal Defects Distal to Mandibular Second Molars Following Surgical Removal of Impacted Mandibular Third Molars: A Comparative Clinical Study

Biology ◽

10.3390/biology10121348 ◽

2021 ◽

Vol 10 (12) ◽

pp. 1348

Author(s):

C. Burnice Nalina Kumari ◽

Thiagarajan Ramakrishnan ◽

Pradeep Devadoss ◽

Rajaram Vijayalakshmi ◽

Khalid J. Alzahrani ◽

...

Keyword(s):

Alveolar Bone ◽

Third Molar ◽

Collagen Membrane ◽

Surgical Removal ◽

Third Molars ◽

Membrane Barrier ◽

Group A ◽

Impacted Mandibular Third Molars ◽

Group B ◽

Mandibular Third Molars

The study aims to assess the efficacy of using collagen membrane in the treatment of distal periodontal defects of mandibular second molars following the removal of mesioangularly or horizontally impacted mandibular third molars surgically. Forty sites in twenty patients with bilaterally impacted mandibular third molars (mesioangular or horizontal) were considered for the study. In 20 test sites (Group A), after surgical removal of the mandibular third molar, a resorbable collagen membrane barrier was placed on the distal aspect of the mandibular second molar to cover the post-surgical bone defect. In the other control 20 sites (Group B), the same surgical procedure was repeated without placing any membrane barrier. The clinical parameters recorded were Oral Hygiene Index Simplified (OHI-S), Probing pocket depth (PPD), Clinical attachment level (CAL), and radiographic assessment of alveolar bone level (ABL). OHI-S score of most of the patients was observed to be satisfactory. Group A was observed to achieve a statistically significant reduction in PPD, CAL, and ABL gain compared to Group B. The improvements indicated that the use of collagen membrane facilitates early wound stabilization and promotes primary closure of the defect. This recovery is achieved through its unique property to assist fibrinogenesis over osteoconduction. Further longitudinal studies are needed to confirm the present findings.

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

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

Journal of Oral Medicine Oral Surgery Oral Pathology and Oral Radiology ◽

10.18231/j.jooo.2021.051 ◽

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.

Download Full-text

Correlation Between the Maturation Stages of Mandibular Third Molars and Chronological Age in Patients Visiting Sardar Begum Dental College, Peshawar

Journal of Gandhara Medical and Dental Science ◽

10.37762/jgmds.5-2.79 ◽

2019 ◽

Vol 5 (2) ◽

pp. 3-7

Author(s):

Muhammad Ilyas ◽

Asma Khan ◽

Syed Murad Ali Shah ◽

Salman Khan ◽

Junaid Nadeem Malik

Keyword(s):

Pearson Correlation ◽

Third Molar ◽

Cross Sectional Study ◽

Chronological Age ◽

P Value ◽

Third Molars ◽

Cross Sectional ◽

Mandibular Third Molar ◽

Maturation Stages ◽

Mandibular Third Molars

OBJECTIVES: The objective of this study was to determine the correlation of chronological age with the maturation stages of mandibular third molar. METHODOLOGY: This descriptive, cross-sectional study was conducted at Sardar Begum Dental College, Gandhara University Peshawar on 384 patients from January 2018 to June 2018 and included patients having age 11-26 years with good quality Orthopantomogram showing mandibular third molar tooth germs bilaterally. Data were analyzed using SPSS version 22. p ≤ 0.05 was considered as statistically significant. RESULTS: Females 286 (74.5%) were predominant than males 98 (25.5%) with mean age presentation of 18.12±3.03 years. The most frequent stage of Demirjian’s stages of mandibular third molar was stage F (24.7%). Pearson correlation showed that maturation stages of mandibular third molars were significantly related to the chronological age ( r=0.446, p value=0.00). CONCLUSION: A correlation between maturation stages of mandibular third molars and chronological age existed.

Download Full-text

Flap design: Comparison of ward’s flap versus modified ward’s flap in surgical extraction of impacted mandibular third molar.

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.08.3877 ◽

2019 ◽

Vol 26 (08) ◽

pp. 1323-1327

Author(s):

Ashook Kumar ◽

Anny Memon ◽

Suneel Kumar Panjabi ◽

Salman Shams

Keyword(s):

Postoperative Pain ◽

Third Molar ◽

P Value ◽

Full Thickness ◽

Mandibular Third Molar ◽

Surgical Extraction ◽

Flap Design ◽

Mucoperiosteal Flap ◽

Group A ◽

Group B

To compare the Ward’s Flap Versus Modified Ward’s flap in relation to access, healing & postoperative complications in surgical extraction of mandibular third molar impaction. Study Design: Comparative Cross Sectional. Setting: Department of Oral & Maxillofacial Surgery LUMHS Jamshoro/Hyderabad: Period: March 2017 to November 2017. Materials and Methods: The history, clinical examination and radiographs (OPG and periapical) had done by team of researchers and recorded on proforma. After selection of patient into either group (Group A=Wards Flap, Group B Modified Wards), the surgical extraction was carried out under local anesthesia. For group A, a standard full thickness mucoperiosteal flap (ward’s flap) was raised. The incision was given mesial to the impacted lower third molar. For group B, a standard full thickness mucoperiosteal flap (Modified ward’s flap) was given mesial to second molar. At the end of the surgery, the flap design used for the extraction of impacted lower third molar tooth and the duration of each operation (from the first extraction maneuver to the completion of the last suture), Pain, Swelling and Trismus13 were recorded on the proforma. Every patient was called for follow up on the 3rd day and 7th day. Results: Mean age was found 27.93 years, with range of minimum 20 years and maximum 35 years. Male were found in the majority 72.3%. Majority of the cases 51.5% were found with class B, in class A 37.5% and 10.9% were found with class C. According to the impaction position 50% cases were in class I, and 50% cases were in class II. Preoperative pain measurement was done according VAS, 71.9% patients were found with mild pain, 9.4% were with moderate pain while 18.8% patients were without pain. Modified Wards flap showed good efficacy regarding duration of third molar extraction as compare to Ward’s flap P-value 0.018. Modified ward’s flap had showed less postoperative pain as compare to ward’s flap p-value 0.022. No significant difference was found between both groups on 3rd and 7th postoperative day in Mouth opening. Conclusion: This study concluded that both ward’s flap and modified ward’s flaps showed good efficacy, while duration of surgery and postoperative pain were significantly less in the modified ward’s flaps as compare to ward’s flap. More large sample size studies are required to evaluate more accurate findings.

Download Full-text

Prevalence of mandibular third molar impaction pattern in a private dental clinic of Sultanpur Lodhi

International Journal of Health ◽

10.14419/ijh.v3i2.5173 ◽

2015 ◽

Vol 3 (2) ◽

pp. 47

Author(s):

Pushappreet Kaur

Keyword(s):

Third Molar ◽

Third Molars ◽

Radiographic Assessment ◽

Dental Clinic ◽

Impacted Tooth ◽

Mandibular Third Molar ◽

Class 1 ◽

Impacted Mandibular Third Molars ◽

Tooth Number ◽

Mandibular Third Molars

Background: Mandibular third molar is the most commonly impacted tooth, and its removal is a frequently performed dentoalveolar procedure. It is important to know the prevalence rate in a particular community.Objective: This article aims at evaluation of angulation, ramus relationship and depth of impacted mandibular third molars among patients visiting a private dental clinic in Sultanpur Lodhi.Methodology: 150 patients presenting with 228 cases of lower third molar impaction were included within this study. IOPAR and where necessary, OPG was used for radiographic assessment. Age, sex and tooth number were recorded in each patient on a specially designed performa. Angulation was determined using winter’s method whereas assessment of ramus relationship and depth was done using Pell and Gregory's method.Results and Conclusion: The age of patients ranged from 21-43 years with mean age of 26.6 years. Males showed preponderance to mandibular M3 impaction (54%) in our study, and right side was found more frequently involved (53%). Radiographic assessment revealed that mesioangular impaction (45.2%) was the most prevalent angular pattern followed by vertical, distoangular and horizontal types, and Class 2 Position A (29.4%) most common and Class 1 Position C the least common type of impaction depth and ramus relationship.

Download Full-text