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

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.

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Pattern of Angulations and Common Indications for Extraction of Impacted Mandibular Third Molar at KMU-Institute of Dental Sciences, Kohat

Journal of Islamabad Medical & Dental College ◽

10.35787/jimdc.v8i2.360 ◽

2019 ◽

Vol 8 (2) ◽

pp. 79-83

Author(s):

Tariq Sardar ◽

Gulrukh Sheikh ◽

Saddique Aslam ◽

Numan Muhammad Khan ◽

Javed Akhtar Rana

Keyword(s):

Maxillofacial Surgery ◽

Third Molar ◽

Age Group ◽

Third Molars ◽

Impacted Tooth ◽

Female Ratio ◽

Impacted Mandibular Third Molar ◽

Mandibular Third Molar ◽

Impacted Mandibular Third Molars ◽

Mandibular Third Molars

Background: The extraction of an impacted mandibular third molar (MTM), with associated pathologies or clinical manifestations is an important and one of the most frequent decisions in dentistry. The angle formed by the longitudinal axis of second and third molar is used to determine angulation of impacted MTM. The aim of this study was to identify the pattern of angulations of impacted mandibular third molar and common indications for extraction associated with these angulations.Material and Methods: This descriptive cross-sectional study was carried out at Department of Oral & Maxillofacial Surgery, Khyber Medical University Institute of Dental Sciences, Kohat, Khyber Pakhtunkhwa (KP) from November 2017 to July 2018. A total of 349 patients presenting with impacted mandibular third molars were included in this study. Name, age, gender, address, the angulation of the impacted tooth and the indication for extraction of the impacted tooth were recorded. Data comprising of qualitative and quantitative variables were analyzed using SPSS version 17.Results: Out of 349 patients, 206 were male and 143 females, with the male to female ratio of 1.4:1. The age range of the patients was from 18 years to 60 years with a mean age of 26 ± 6 years. The most common age group with impacted third molar was ≤ 25 years followed by 26 to 30 years’ age group. The most common angulation was mesioangular followed by vertical, horizontal and distoangular impacted mandibular third molar. Pericoronitis was the most common indication for extraction in all angulations except horizontal impaction where root resorption of the second molar was more common.Conclusion: Mesioangular is the most common angulation in impacted mandibular third molars. Pericoronitis is the main indication for all angulations of impacted mandibular third molars except horizontal angulation, occurring mostly in the third decade of life.

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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.

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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.

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Pattern of Impacted Mandibular Third Molar Teeth in Rangpur Region, Bangladesh: A Radiological Evaluation

KYAMC Journal ◽

10.3329/kyamcj.v12i1.53360 ◽

2021 ◽

Vol 12 (1) ◽

pp. 8-13

Author(s):

Md Rubayet Alam Prodhan ◽

Md Shahidul Islam ◽

Rifat Rezwana ◽

Md Moynul Hasan

Keyword(s):

Third Molar ◽

Third Molars ◽

Radiographic Assessment ◽

Impacted Tooth ◽

Panoramic Radiographs ◽

Impacted Mandibular Third Molar ◽

Mandibular Third Molar ◽

Molar Teeth ◽

Impacted Mandibular Third Molars ◽

Mandibular Third Molars

Background: Third molar is the most commonly impacted tooth in the oral cavity and accounts for large of all impactions. The most common complication in the extraction of the third mandibular molars is nerve and vessels damage. Therefore, thorough radiographic assessment is a necessary to avoid these surgical complications. Objective: The purpose of this study was to evaluate the frequency, angulation, depth of the impacted mandibular third molars and its relationship with ramus on radiographs. Materials and Methods: This study comprised 800 orthopantomograms (OPGs) of patients attending different dental clinics and hospitals in Rangpur region, Bangladesh between June 2014 to May 2015. Panoromic Radiographic assessment was carried out to evaluate the pattern of third molar impaction in terms of age, gender, angulation of impaction, level of eruption and available retromolar space using panoramic radiographs and Pell & Gregory classification. Results: A total of 314 radiographic third molar areas were found in this study, out of them 137 belong to male patients and 177 belong to the female patients. The mesio angular types of angulation was most prevalent (46%) whereas distoangular was rare (5%) in our study. In relation to anterior border of the ramus of mandible Level B 52% and Class II 59% were the most common pattern of impaction. The female tends to be dominant as compared to male & the maximum number (35%) of impacted third molars are found in an age group of 38 years and above. Conclusion: Panoramic radiographs can be used as reliable investigation for evaluation of impacted mandibular third molar. KYAMC Journal.2021;12(01): 08-13

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Influence of Lidocaine including Buprenorphine for Postoperative Analgesia after the Extraction of Mandibular Third Molars: A Randomized Controlled, Double-Blind, Split-Mouth Study

The Scientific World JOURNAL ◽

10.1155/2021/7097948 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Nimrat K. Jawanda ◽

Anand Shukla ◽

Anupam Singh ◽

Kalyana C. Pentapati ◽

Srikanth Gadicherla

Keyword(s):

Opioid Receptors ◽

Postoperative Analgesia ◽

Third Molar ◽

Control Group ◽

Third Molars ◽

Surgical Extraction ◽

Significant Difference ◽

Impacted Mandibular Third Molars ◽

Mandibular Third Molars ◽

And Control

Background. The presence of opioid receptors around the peripheral nerves offers the possibility of providing postoperative analgesia, thereby encouraging the study of the effect of opioids in combination with local anesthesia (LA). Studies have also reported the efficacy of peripherally administered opioids in achieving adequate analgesia in regions with inflammation. Applying the concept of peripheral opioid receptors, our study aimed to evaluate the effectiveness of opioid analgesia in managing postoperative pain. The split-mouth study was carried out to evaluate the efficacy of buprenorphine added to lidocaine 2% in providing postoperative analgesia after the surgical extraction of the impacted mandibular third molar. Materials and Methods. We conducted a randomized, double-blinded, split-mouth trial among 21 patients with impacted mandibular third molars bilaterally. In all patients, bilateral impacted mandibular third molars were extracted at different periods. The primary outcomes assessed were postoperative analgesia by the VAS score and the number of rescue analgesics consumed by patients at 24, 48, and 72 hours of interval via a questionnaire. Results. There was a statistical significant difference in postoperative analgesia duration at 24 (P = 0.012) and 48 hours (P = 0.024), respectively, between the test and control group. Even though the mean number of rescue analgesics consumed by the test group was less than that of the control group, no significant difference was seen. Conclusion. Buprenorphine added to lidocaine 2% showed a minimal decrease in the pain score and duration of postoperative analgesia with no difference in the frequency of rescue analgesics consumed between the test and control.

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Comparing the Effect of Facial Compression Bandage to That of Systemic Dexamethasone on Postsurgical Sequels after Extraction of Impacted Mandibular Third Molars: A Split-mouth Randomized Clinical Trial

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.6659 ◽

2021 ◽

Vol 9 (D) ◽

pp. 160-165

Author(s):

Ibraheem Hamadi ◽

Nuraldeen Maher Al-Khanati ◽

Zafin Kara Beit

Keyword(s):

Third Molar ◽

Study Groups ◽

Third Molars ◽

Dexamethasone Group ◽

Surgical Extraction ◽

Significant Difference ◽

Impacted Mandibular Third Molars ◽

The Mean ◽

Mandibular Third Molars ◽

Present Trial

AIM: The present study aimed to compare the clinical efficiency of facial pressure bandage, to that of intramuscular injection of dexamethasone (8 mg) on postsurgical sequels (swelling, pain, and trismus) of extraction of impacted mandibular third molar. METHODS: The study implemented a randomized split-mouth design. Patients with symmetrical bilateral impacted molars were eligible for the present trial. Sides were randomly assigned to two groups: pressure bandage group and dexamethasone group. The evaluated postsurgical sequels were extraoral swelling, trismus, and pain after 48 h and 7 days. RESULTS: The study included 42 impacted third molars (n = 42) in 21 patients with a mean age of 23.4 years. Most participants were females (66.7%). The mean postoperative swelling rates after 48 h and 7 days in pressure bandage group were found to be comparable to those of dexamethasone group. No significant difference was found in the mean rates of postoperative trismus between study groups after 48 h and 7 days. Differences in mean pain level scores between the pressure bandage group and dexamethasone group were statistically insignificant after 48 h and 7 days. CONCLUSION: The study findings showed that the effect of the pressure bandage was comparable to dexamethasone effect on the postsurgical sequels after surgical extraction of impacted mandibular third molars.

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

Journal of The Pakistan Dental Association ◽

10.25301/jpda.301.50 ◽

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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Retrospective analysis of malpositioned mandibular third molars in elderly patients

Iraqi Dental Journal ◽

10.46466/idj.v41i2.193 ◽

2019 ◽

Vol 41 (2) ◽

pp. 1-7

Author(s):

Charles E. Anyanechi ◽

Birch D Saheeb

Keyword(s):

Elderly Patients ◽

Third Molar ◽

Third Molars ◽

Hospital Records ◽

Mandibular Third Molar ◽

Surgical Extraction ◽

Alveolar Osteitis ◽

Impacted Mandibular Third Molars ◽

The Common ◽

Mandibular Third Molars

Objective: To determine the frequency of symptomatic malpositioned mandibular third molars in elderly patients. Method: An analytic study of hospital records of elderly patients with symptomatic impacted mandibular third molars over 17 years was undertaken. Information on demographics, types of impaction, reasons for surgical extraction, and complications after treatment were obtained. Those who were asymptomatic would be excluded from analysis. Results: Altogether, 6214 impacted mandibular third molars were isolated in 5, 431 patients. However, 436 (7.0%) symptomatic impacted teeth were recorded in 436 (8.0%) patients and these were extracted, while the rest, 5778 (93.0%) were asymptomatic. Males were greater than females in the ratio of 1.1:1. The frequency of occurrence of mesio-angular and vertical impactions were significant (P= 0.001) compared with disto-angular and horizontal. Periodontal disease was 211 (48.4%) of the case in addition to dental caries and its clinical sequelae 203 (46.6%) were significant reasons for extractions (P=0.000). The common postoperative complications were alveolar osteitis and hypersensitivity of the adjacent molar 22(68.7%) which related to surgical extraction of disto-angular impactions (P= 0.001). Conclusions: This study showed the older the patient the less likely malpositioned mandibular third molar suggesting that majority of such impactions do not cause pathology after many years of their presence in the oral cavity. Prophylactic extraction of malpositioned mandibular third molars in all patients should be discouraged, but each case should be treated on merit or when symptomatic.

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Surgical Extraction of Mesio-Angularly Impacted Mandibular Third Molars:An Alternative Instrument for the Osteotomy Procedure

International Journal of Medical and Dental Sciences ◽

10.18311/ijmds/2017/18845 ◽

2017 ◽

Vol 6 (2) ◽

pp. 1529

Author(s):

Charles E. Anyanechi

Keyword(s):

Maxillofacial Surgery ◽

Oral And Maxillofacial Surgery ◽

Prospective Clinical Study ◽

Third Molars ◽

Duration Of Treatment ◽

Impacted Tooth ◽

Surgical Extraction ◽

Impacted Mandibular Third Molars ◽

Mandibular Third Molars ◽

Contemporary Practice

Background: Osteotomy of the bone surrounding mesio-angularly impacted tooth is part of the surgical procedure required for their extraction and has evolved in contemporary practice from the use of mallet/chisel to dental drill.Objective: To describe the extractions of mesio-angularly impacted mandibular third molars using Crane pick dental elevator for the osteotomy procedure.Materials and Methods: This was a prospective clinical study of patients done at the Oral and Maxillofacial Surgery Clinic of our institution, over three years period. With gentle, controlled, downward force, bone was removed with Crane pick elevator to expose the mesio-angularly impacted tooth cervical line, creating buccal and distal troughs that were linked and made in cancellous bone. The clinical variables evaluated were age, gender, and reason(s) for extraction, duration of treatment/osteotomy, degree of postoperative trismus and swelling, and complaints during follow-Up.Results: The ages of the 74 patients studied ranged from 18-63 years with mean age of 32.6± 2.8 years. Majority (83.8%) were in the age category of 16-45 years (P=0.001). The duration of the surgery from incision to placement of the last suture ranged from 12.8 to 17.1 minutes with mean 14.3±1.4 minutes. The duration of the osteotomy including the delivery of the tooth from their sockets ranged from 3.2 to 7.4 minutes with mean 5.3±0.7 minutes. The younger the patient's age, the shorter the osteotomy procedure (P=0.001).Conclusion: This study showed that certain mesio-angularly impacted mandibular third molars can be extracted using only Crane pick elevator.

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Assessment of intraoperative risk factors for surgical difficulty in surgical extraction of impacted mandibular third molar – A prospective study.

International Journal of Medical and Surgical Sciences ◽

10.32457/ijmss.2019.014 ◽

2019 ◽

Vol 6 (2) ◽

pp. 41-43

Author(s):

Manu Goel ◽

Milind Shringarpure ◽

Vasant Shewale ◽

Chandrashekhar Bande ◽

Ajit Joshi ◽

...

Keyword(s):

Risk Factors ◽

Third Molar ◽

Third Molars ◽

Surgical Time ◽

Impacted Mandibular Third Molar ◽

Mandibular Third Molar ◽

Surgical Extraction ◽

Impacted Mandibular Third Molars ◽

Surgical Difficulty ◽

Mandibular Third Molars

The extraction of impacted third molars is among the most common surgical procedures carried out in the field of Oral and Maxillofacial Surgery. For proper planning of surgical extraction, especially for impacted mandibular third molars the estimated level of surgical difficulty of the case is important. This study was conducted to evaluate the intraoperative risk factors contributing to surgical difficulty in extraction of impacted mandibular third molars and consequently the post-operative outcome. Here, we have undertaken a study in which the intraoperative variables were considered, to evaluate their contribution for surgical difficulty and postoperative complications in surgical removal of 100 impacted mandibular third molars. Three variables were found significant associated with total surgical time intervention, i.e., surgeon’s experience (p=0.006), Inter-incisal opening (p=0.032), and cheek flexibility (p=0.004). Total surgical time intervention for ‘right side’ was higher with 49.20 ± 17.94 minutes (p=0.691). Total surgical time intervention for ‘gagging reflex present’ was 50.21 ± 17.812 (p=0.674). Multiple linear regression shows that surgeon’s experience was the only predictor (p<0.001). The surgical difficulty of impacted mandibular third molar are likely to depend on the intraoperative factors like Surgeon’s time, surgeon’s experience, check flexibility, and inter incisal mouth opening.

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