scholarly journals DIFFERENTIATED APPROACH TO THE SURGICAL EXTRACTION OF WISDOM TEETH

2019 ◽  
pp. 24-28
Author(s):  
A.I. Pankevych ◽  
I.A. Kolisnyk ◽  
A.M. Hohol
Keyword(s):  
Classical Method ◽  
Third Molar ◽  
Mandibular Canal ◽  
Tooth Crown ◽  
Wisdom Tooth ◽  
Patients Âgés ◽  
Advantages And Disadvantages ◽  
The Third ◽  
Surgical Extraction ◽  
Wisdom Teeth

Impaction and malposition of wisdom teeth and associated inflammatory and tumor-like complications occur in 35-50% of the able-bodied population. The operation of surgical extraction of the third molar of the mandible is indicated for these patients and this operation is one of the most common in surgical dentistry today.Alsoasignificant indication for wisdom teeth removaliscrowding of teeth. The classic operation of surgical wisdom tooth removal, even with careful planning, can be accompanied by different intraoperative and postoperative complications. Planning of removal of the third lower molar requires an individual approachwith mandatory consideration not only of the tooth position but also the topography of the causative tooth relative to the adjacent tooth and mandibular canal. Among the surgical procedures which are used to remove wisdom teeth, in addition to the classic surgery extraction, coronectomy and germectomy should be noted. The purpose of our study was to analyze the advantages and disadvantages of different techniques used for surgical extraction of impacted and malposition wisdom teeth. 208 operations regarding the removal of the third lower molars have been performedduring 2016-2019, of which surgical wisdom teeth removal were 213, coronectomies – 23 and germectomies – 29.Patients' ages ranged from 13 to 26 years. A germectomy was performed in 13-16 years old patient, usually at the stage of a fully formed tooth crown or at the beginning of root formation. The choice of surgery in patients with fully formed roots was dependent on the ratio of the root of the tooth and mandibular canal, which was evaluated after a preliminary computer examination, taking into account the complexity of the surgery and the prognosis of complications. Acoronectomy operation was performed with the close location of the roots of the wisdom tooth with the mandibular canal, taking into account the risk of the damage of lower alveolar nerve. Germectomy and surgery of wisdom teeth removal were performed according to the classical method with cutting of mucoperiostal flaps, preparation of bone, if necessary – separation of crown and roots with subsequent removal of the germ or tooth. The crown of wisdom tooth was separated with a coronectomy, (and cut in height with insufficient access) and the tooth crown was removed, leaving the roots in the jaw. Patients were observed on the next day after surgery, a week later, and as needed. The course of the postoperative period was evaluated: the presence of pain, swelling, complications. The duration of follow-up was up to 2 years. Conclusions: To the choice of surgery in patients with impaction and malposition of wisdom teeth should be approached in a differentiated manner, taking into account topographic and anatomical features, including the ratio of the roots of the teeth to the mandibular canal and assessing the risks of possible complications. Germectomy and coronectomy surgery can be recommended as surgery of choice for orthodontic indications in the treatment of patients with crowded teeth.

scholarly journals SURGICAL EXTRACTION OF THIRD LOWER MOLARS IN COMPLEX TREATMENT OF CROWDED TEETH

2020 ◽  
Vol 20 (3) ◽  
pp. 81-86
Author(s):  
P.I. Tkachenko ◽  
A.I. Pankevych ◽  
I.A. Kolisnyk ◽  
A.M. Hohol ◽  
K.Yu. Rezvina
Keyword(s):  
Computed Tomography ◽  
Orthodontic Treatment ◽  
Surgical Techniques ◽  
Integrated Approach ◽  
Mandibular Canal ◽  
Wisdom Tooth ◽  
Surgical Interventions ◽  
The Third ◽  
Surgical Extraction ◽  
Wisdom Teeth

The success of orthodontic treatment quite often depends on cooperation between the orthodontist and the dental surgeon. An integrated approach, including orthodontic treatment of dento-maxillary anomalies in combination with using the latest surgical techniques can provide quick defect correction of the maxillofacial region and ensure better stability of the results achieved; in most cases of teeth crowding, there is no alternative to the removal of the third lower molars. The purpose of this study was to analyze the surgical interventions performed on for surgical extraction of wisdom teeth for orthodontic reasons and the approach to their choice. Materials and methods. During 2016-2020 years, 158 patients were subjected to 241 surgical interventions for surgical extraction of the third lower molars for orthodontic reasons. We performed on 160 (66.4%) standard operations of atypical tooth extraction, 43 (17.8%) germectomies and 38 (15.8%) coronectomies. The patients' age ranged from 12 to 26 years. All patients were examined by applying the standard technique including orthopantomogram. In cases then it was impossible to clearly assess the ratio between the roots of the wisdom tooth and the mandibular canal as a result of the superposition of their projections on the obtained pantomograms, we used computed tomography. Based on the data obtained from the examination of the patient, the optimal safest surgical intervention was chosen for removal: the surgical extraction of the wisdom tooth, germectomy, or coronectomy. Conclusions: 1. Operations on surgical extraction of the lower wisdom teeth require mandatory planning and an individual approach to each patient based on a thorough preliminary examination. 2. In cases when it is impossible to clearly assess the ratio between the roots of the wisdom tooth and the mandibular canal as a result of overlapping their projections on the pantomograms, patients are recommended to undergo computed tomography, and then based on the assessment of CT findings to determine the topographic and anatomical relationship of the mandibular canal and roots. 3. The operation of surgical extraction of the lower wisdom tooth can be performed as a standard operation, germectomy can be recommended for patients with underdeveloped roots, coronectomy is a good option when the roots of the wisdom tooth are very close to the mandibular canal.

scholarly journals The Impact of Using Kinesio Tape on Non-Infectious Complications after Impacted Mandibular Third Molar Surgery

2021 ◽  
Vol 18 (2) ◽  
pp. 399
Author(s):  
Aleksandra Jaroń ◽  
Olga Preuss ◽  
Elżbieta Grzywacz ◽  
Grzegorz Trybek
Keyword(s):  
Third Molar ◽  
Infectious Complications ◽  
Wisdom Tooth ◽  
Kinesio Tape ◽  
The Third ◽  
Kinesio Taping ◽  
Impacted Mandibular Third Molar ◽  
Mandibular Third Molar ◽  
Surgical Extraction ◽  
The Impact

Non-infectious complications such as post-extraction pain, trismus, and swelling are extremely common after impacted wisdom tooth removal. The aim of the study was to assess the impact of using kinesio tape on the level of the postoperative swelling of soft tissues, trismus, and pain in patients undergoing the surgical extraction of an impacted mandibular third molar. One hundred patients undergoing the surgical extraction of a lower wisdom tooth were randomly divided into two groups: a study group with kinesio taping (KT) (n = 50) and a control group without kinesio taping (NKT) (n = 50). The surgical procedure was performed according to the same repeatable scheme. Kinesio tape was applied immediately after surgery in the KT group. In both groups, measurements of swelling, trismus, and pain were performed before the surgery and on the third and seventh postprocedural days. Kinesio tape had a significant effect on the decrease in facial swelling on the third day after surgery and a decrease in trismus and pain severity levels on the third and seventh days after surgery. The kinesio tape method is non-invasive, continuously active throughout the entire application period, and requires no additional patient appointments. KT application is an effective method for reducing postoperative edema, pain, and trismus after impacted mandibular wisdom teeth surgery.

Dental Inclusion of Canine and Wisdom Tooth in Orthodontics Chemical Necroses

2018 ◽  
Vol 69 (8) ◽  
pp. 2191-2196
Author(s):  
Cristian Constantin Budacu ◽  
Nicoleta Ioanid ◽  
Cristian Romanec ◽  
Mihail Balan ◽  
Liliana Lacramioara Pavel ◽  
...  
Keyword(s):  
Third Molar ◽  
Point Of View ◽  
Separate Entity ◽  
Wisdom Tooth ◽  
Facial Aesthetics ◽  
The Third ◽  
Edentulous Mandible ◽  
Canine Guidance ◽  
Upper Jaw ◽  
Functional Point

Canine plays an important role in the dento-maxillary system. From a functional point of view, it provides the canine guidance, by positioning it in the frontal area, has a role in facial aesthetics. It plays an important prosthetic role by having the longest root and one of the longest arcade teeth. Three molars represent the last teeth that erupt in the arches both in the jaw and in the mandible, which is why they remain the most frequently included.Canine incidence is quite common following the wisdom tooth. It can be unilateral or bilateral and is more common in the upper jaw. The canine may remain included at the vestibular, palatal or between the two bones. A separate entity is the incision of the canine in the edentulous mandible or jaw. The study included 213 cases with dento-alveolar pathology, of which 128 patients were selected with dental inclusion. Our study reports that the first three molars are frequent, followed by the canine as opposed to other studies conducted by Guzduz K in 2011 and Fardi A of the same year bringing the canines first (Fardi, Guzduz). Some studies attribute the first place to the superior canine in terms of frequency, but they are abstracted from the molar three inclusion that they consider as most frequently (Compoy). The most common tooth in inclusion is the third molar (lower and upper) followed by the upper canine; the most commonly affected are women for both canine and molar.

scholarly journals Assessment of the Retromolar Canal in Taiwan Subpopulation: A Cross-Sectional Cone-Beam Computed Tomography Study in a Medical Center

Tomography ◽  
2021 ◽  
Vol 7 (2) ◽  
pp. 219-227
Author(s):  
Yen-Wen Shen ◽  
Wan-Chun Chang ◽  
Heng-Li Huang ◽  
Ming-Tzu Tsai ◽  
Lih-Jyh Fuh ◽  
...  
Keyword(s):  
Medical Center ◽  
Third Molar ◽  
Mandibular Canal ◽  
Cone Beam ◽  
Horizontal Distance ◽  
Taiwanese Population ◽  
Mandibular Bone ◽  
Second Molar ◽  
The Third ◽  
Retromolar Canal

The retromolar canal is an anatomical variation that occurs in the mandibular bone. The retromolar canal typically originates in the mandibular canal on the distal side of the third molar and extends forward and upward to the retromolar foramen (RMF), which contains the neurovascular bundle. Accidentally damaging the neurovascular bundle in the retromolar canal during the extraction of the third molar, dental implant surgery, or maxillofacial orthognathic surgery may lead to subsequent complications such as incomplete local anesthesia, paresthesia, and bleeding during operation. The objective of this study was to investigate the prevalence of the RMF in the Taiwanese population in a medical center by using dental cone-beam computed tomography (CBCT) and to identify the position of the RMF in the mandibular bone. The dental CBCT images for the mandibular bone of 68 hemi-mandible were uploaded to the medical imaging software Mimics 15.1 to determine the prevalence of the RMF in the Taiwanese population and the three positional parameters of the RMF in the mandibular bone: (1) The diameter of the RMF, (2) the horizontal distance from the midpoint of the RMF to the distal cementoenamel junction of the second molar, and (3) the vertical distance from the midpoint of the RMF to the upper border of the mandibular canal. Seven RMFs were observed in the 68 hemi-mandibles. Thus, the RMF prevalence was 10.3%. In addition, the diameter of the RMF was 1.41 ± 0.30 mm (mean ± standard deviation), the horizontal distance from the midpoint of the RMF to the distal cementoenamel junction of the the second molar was 12.93 ± 2.87 mm, and the vertical distance from the midpoint of the RMF to the upper border of the mandibular canal below second molar was 13.62 ± 1.3487 mm. This study determined the prevalence of the RMF in the Taiwanese population in a medical center and its relative position in the mandibular bone. This information can provide clinicians with a reference for posterior mandible anesthesia and surgery to ensure medical safety.

A longitudinal study on timing and velocity of rat molar eruption: Timing of rat molar eruption

2018 ◽  
Vol 52 (4) ◽  
pp. 394-401 ◽  
Author(s):  
Balazs J Denes ◽  
Aikaterini Lagou ◽  
Domna Dorotheou ◽  
Stavros Kiliaridis
Keyword(s):  
Mixed Model ◽  
Third Molar ◽  
Mandibular Canal ◽  
Reference Points ◽  
Micro Computed Tomography ◽  
Eruption Rate ◽  
Second Molar ◽  
Mixed Model Analysis ◽  
The Third ◽  
Rat Molar

Rat molar eruption and occlusion data were compiled from several studies but several inconsistencies were found, rendering the planning of eruptional studies difficult and imprecise. Our aim was to measure eruption and occlusion days, as well as eruption velocity, in the upper and lower three molars from infancy to end of adolescence in the rat. A total of 19 male and female Wistar rats were scanned daily by micro-computed tomography (CT) from day 15 to 70. We measured the eruption of all maxillary and mandibular molars with reference points at the hard palate and mandibular canal at three stages: pre-emergent, pre-occlusal, and functional. Statistical analysis was performed with a mixed-model analysis of variance (ANOVA) and a Sidak post hoc test. The first molar erupts on average on day 17, the second molar on day 20, and the third molar on day 33. The eruption velocity of the first molar was the highest at 90.9 microns/day (standard error (se) = 12.80), followed by the second molar at 65.9 microns/day (se = 5.80), and the lowest was the third at 47.0 microns/day (se = 3.28), ( p < 0.001). On average, the pre-occlusal phase had the highest velocity at 97.2 microns/day (se = 1.72), the pre-emergent was lower at 84.9 (se = 2.29), and the functional was the lowest at 21.7 (se = 0.45), ( p < 0.001). The eruption rate decreased from the first to third molar and was also different between phases: the pre-occlusal phase had the highest rate, closely followed by the pre-emergent phase while the functional eruption rate was significantly lower than the other phases.

scholarly journals Association between imaging and clinical findings in mandibular third molar surgeries

2018 ◽  
Vol 23 (1) ◽  
Author(s):  
Marcelo Bonifácio da Silva Sampieri ◽  
Danilo Da Silva Correa ◽  
Francisca Lívia Parente Viana ◽  
Thaís Sumie Nozu Imada ◽  
Josfran Da Silva Ferreira Filho ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Statistical Significance ◽  
Third Molar ◽  
Panoramic Radiograph ◽  
Mandibular Canal ◽  
Clinical Findings ◽  
Cone Beam ◽  
The Third ◽  
Close Relationship

Objective: it is important to evaluate the position andestablish the third molar relationship with the mandibularcanal to minimize the risk of nerve injury and assistin planning the extraction of this tooth. The panoramicradiograph is the standard diagnostic tool for this purpose.However, if it indicates a close relationship betweenthe third molar and the mandibular canal, furtherinvestigation using cone beam computed tomography(CBCT) may be recommended to check the three-dimensionalrelationship between the tooth and the mandibularcanal. Thus, this study aimed to correlate the clinicalfindings (observed in third molar surgeries) to imagingfindings (observed in panoramic radiographs andCBCT). Subjects and method: after the extraction of 20mandibular third molars, the panoramic radiograph andthe cone beam computed tomography were analyzed.Then, the surgical findings were correlated to the imagefindings. Results: It was observed that the radiographicfinding type 2 (darkening of roots) observed in the panoramicradiograph presented a greater relation to theabsence of cortical bone between the mandibular canaland the third molar (CBCT finding), with statistical significance(p

scholarly journals Prevention of Periodontal Pocket Formation after Mandibular Third Molar Extraction Using Dentin Autologous Graft: A Split Mouth Case Report

2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Alberto De Biase ◽  
Giulia Mazzucchi ◽  
Dario Di Nardo ◽  
Marco Lollobrigida ◽  
Giorgio Serafini ◽  
...  
Keyword(s):  
Case Report ◽  
Third Molar ◽  
Periodontal Pocket ◽  
Pocket Depth ◽  
Second Molar ◽  
The Third ◽  
Third Molar Extraction ◽  
Probing Pocket Depth ◽  
Surgical Extraction ◽  
A Minor

Surgical extraction of the third molar can often result in the development of a periodontal pocket distal to the second molar that could delay the healing, and the socket could be colonized by bacteria and lead to secondary abscesses, or it may cause mobility or hypersensitivity. The aim of this case report is to assess the efficacy of a dentin autograft in the prevention of periodontal dehiscences after the surgical extraction of the third molar, obtained by the immediate grinding of the extracted tooth. A healthy 18-year-old male patient underwent surgery of both impacted mandibular molars: right postextractive socket was filled with grinded dentin; then, the left one was filled with fibrin sponge. The patient was followed up for six months, and clinical and radiographic assessment were performed: measurements of plaque index (PI), bleeding on probing (BOP), gingival index (GI), clinical attachment level (CAL), and probing pocket depth (PPD) were done before surgery and repeated at 90 and 180 days after the extractions. Measurements made at six months after the surgery revealed that the grafted site was characterized by a minor depth of the pocket if compared with the nongrafted site, with no clinical/radiographic signs of complications.

scholarly journals Third Molar Eruption Mechanisms and Patterns

2016 ◽  
Vol 4 (1) ◽  
pp. 11-16
Author(s):  
Winnie Zhang
Keyword(s):  
Molecular Mechanisms ◽  
Third Molar ◽  
Radiographic Examination ◽  
Third Molars ◽  
The Third ◽  
Occlusal Surfaces ◽  
Surgical Extraction ◽  
Incipient Caries ◽  
The Moment ◽  
Third Molar Eruption

Third molars are highly variable in their presence and form. This report focuses on a horizontally impacted third molar and analyzes the potential etiology of this situation. Upon a clinical and radiographic examination, it was noted that the patient had four third molars present. The patient’s third molars began erupting around the age of 19. Currently, they are asymptomatic with incipient caries on the occlusal surfaces. While three of the third molars erupted in a normal orientation, one of the third molars (mandibular left) erupted in an orientation that would be classified as horizontal and/or mesio-angular. No treatment has been undertaken at the moment, however surgical extraction can be recommended with the prognosis being very good. For the clinician that has to treat dental complications that arise from abnormal tooth eruption, as seen in numerous genetic and acquired disorders, knowledge about the basic molecular mechanisms involved may become extremely important.

scholarly journals Frequency and risk factors for injury of the inferior alveolar nerve during surgical extraction of the impacted lower third molars

2019 ◽  
Vol 76 (12) ◽  
pp. 1240-1244
Author(s):  
Dejan Dubovina ◽  
Stevo Matijevic ◽  
Filip Djordjevic ◽  
Jelena Stanisic ◽  
Branko Mihailovic ◽  
...  
Keyword(s):  
Nerve Injury ◽  
Statistical Significance ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Mandibular Canal ◽  
Sensory Disturbance ◽  
Third Molars ◽  
Root Tips ◽  
Surgical Extraction ◽  
Inferior Alveolar Nerve Injury

Background/Aim. The injury of inferior alveolar nerve during a surgical extraction of impacted lower third molars, followed by sensory disturbance, is, for the patient, an extremely unpleasant complication. The aim of this study was to determine the frequency of this complication after the third molar surgery and its frequency depending on a tooth position and tooth relation to the mandibular canal. Methods. In this study, 800 surgical extractions of the impacted lower third molar were performed. The position of the impacted tooth was recorded according to the Winter classification, as well as the ratio of their root tips to the mandibular canal using the Tanaka et al. and Rood and Shebab classifications. Results. The frequency of the recorded post extraction sensory disturbance was 2.25%, most frequently when teeth were in the mesioangular position. Concerning Tanaka and al. classification, the incidence of injuries was inversely proportional to the increase of distance between roots and mandibular canal with the statistical significance in cases where mandibular canal overlaps more than a half of the root of the tooth (p = 0.001). Considering the radiological signs recommended by Rood and Shehab, a higher frequency of the inferior alveolar nerve injury was recorded when illumination in the area of the root tips was present and when the loss of linear overshadowing characterized by the ?roof? and the ?bottom? of the mandibular canal were observed, or diversion of the canal and root deflection, but without a statistical significance. Conclusion. The superposition of the mandibular canal with the lower third molar roots at the panoramic radiographies may increase a possibility of the inferior alveolar nerve injury. The angulations of the impacted lower third molar as well as the vicinity of the tips of its roots to the content of the mandibular canal, do not significantly affect the frequency of the nerve injury.

scholarly journals COMPARISON BETWEEN DEXAMETHASONE AND COOL JAW WRAP ON POSTOPERATIVE PAIN AFTER SURGICAL REMOVAL OF LOWER WISDOM TEETH

2017 ◽  
Vol 9 (4) ◽  
pp. 33
Author(s):  
Nasma M. Al-fahad ◽  
Wael Sheet Shallawe
Keyword(s):  
Quality Of Life ◽  
Postoperative Pain ◽  
Third Molar ◽  
Control Group ◽  
Surgical Removal ◽  
Life Questionnaire ◽  
Quality Of Life Questionnaire ◽  
Surgical Extraction ◽  
Wisdom Teeth

Objective: The aim is to compare between the effect of cool jaw wraps and dexamethasone injection on postoperative pain and evaluate the quality of life after surgical removal of lower wisdom tooth.Methods: Extraction of impacted lower third molar will surgically operate (by the same difficulty of surgical extraction and same operator) on 30 patients, which divide into three groups, each group have 10 patients.We will instruct the patients in cool jaw wrap group to put cool jaw wrap after the operation. While the second group give dexamethasone injection after the operation. The last group which is the control group will left them with the usual instruction postoperatively.This study evaluates the facial pain, swelling, and trismus on days 1,2 and 7 postoperatively. Objective measurements of swelling, pain, and trismus were undertaken at days 1, 2 and 7. The quality of life questionnaire was estimated at day 7 postoperatively.Results: Cool jaw wrap showed no significant differences on the postoperative pain when it used after surgical removal of the lower third molar BUT have significant differences on the Quality of life of patients.Conclusion: Cool jaw face wrap can be recommended as a safe method that participates in some degree to reduce postoperative pain, it easy to handle, comfort, avoiding damage by freezing due to the barrier between cool jaw and skin and the patient can avoid the side effect of dexamethasone and the phobia from the injection.

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