scholarly journals The Evaluation of Further Complications after the Extraction of the Third Molar Germ: A Pilot Study in Paediatric Dentistry

Healthcare ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 121
Author(s):  
Giacomo D’Angeli ◽  
Francesca Zara ◽  
Iole Vozza ◽  
Francesco Maria D’Angeli ◽  
Gian Luca Sfasciotti
Keyword(s):  
Oral Surgery ◽  
Third Molar ◽  
Development Stage ◽  
Anterior Crowding ◽  
The Third ◽  
Delayed Onset ◽  
First Case ◽  
Operative Complications ◽  
Mandibular Third Molars ◽  
Post Operative Complications

Some authors suggest germectomy to prevent the impaction of mandibular third molars, which can cause anterior crowding. The aim of the study, conducted with 2 years of follow-up, was to clarify when the extraction of the germ of the third molar is optimal, together with possible post-operative complications. A new surgical approach was performed through the application of a combined suture, which can provide better wound healing. The study was performed on 25 patients with a mean age of 15.44 ± 2.06. Based on orthodontic and surgical indications, 46 germectomies were performed. Follow-ups were conducted after 1 week, 2 weeks, 4 weeks, 1 year and 2 years. All procedures were carried out by the same operator and were standardized. Data analysis was conducted using R-Software. Statistical evaluation used the chi-squared test and the Monte Carlo test. The level of significance was set as 0.05. Results showed that out of 46 germectomies, the prevalence of complications was 4.2% for two patients (8%). Both complications were observed in male patients. In the first case, the patient (at Nolla stage 7) showed delayed onset infections after four weeks; in the second case, the patient (at Nolla stage 6) showed bleeding immediately after surgery and suture. With reference to delayed onset infections, no statistically significant association was found among gender (χ2 = 0.719; p = 0.396), germ development stage (χ2 = 2.595; p = 0.658) or Winter’s classifications (χ2 = 0.046; p = 0.829); similarly, no significant associations were found among bleeding, gender (χ2 = 0.719; p = 0.396), germ development stage (χ2 = 2.595; p = 0.658) or Winter’s classification (χ2 = 0.046; p = 0.829). From our results, it is also possible to state that post-operative complications following germectomy of the mandibular third molar germ in adolescence occur in a significantly reduced percentage of patients, so this oral surgery treatment becomes a reliable surgical technique in adolescence.

Comparison of the Effects of Dexamethasone Administration on Postoperative Sequelae Before and After “Third Molar" Extraction Surgeries

2020 ◽  
Vol 20 (3) ◽  
pp. 356-364 ◽  
Author(s):  
Ehsan Shoohanizad ◽  
Milad Parvin
Keyword(s):  
Oral Surgery ◽  
Controlled Trial ◽  
Maxillofacial Surgery ◽  
Third Molar ◽  
Cochrane Library ◽  
Third Molar Surgery ◽  
Third Molars ◽  
Operative Complications ◽  
The Impact ◽  
Post Operative Complications

Introduction: Impacted third molars (ITMs) surgery, is one of the most common methods in the field of oral and maxillofacial surgical operations. Administration of corticosteroid such as dexamethasone diminishes the postoperative sequelae. The study aimed to compare the impact of dexamethasone administration on pre-operative and post-operative complications in third molar surgery. Methods: We collected all randomized controlled trial data on the influences of pre-operative and postoperative dexamethasone administration between 2006-2019 on third molar surgery sequelae by searching the keywords: dexamethasone, third molar surgery, wisdom teeth, corticosteroids, oral surgery, maxillofacial surgery, preoperative, postoperative, pain, swelling, and trismus in international databases such as: Web of Science (ISI), PubMed, Scopus, Embase and Cochrane Library. Results: Twenty-three articles were included in this narrative review. Among them, 22 studies used dexamethasone in particular and 1 study used dexamethasone with amoxicillin. Twenty studies evaluated the prescription of dexamethasone in pre-operative and post-operative routes on pain, trismus and edema following third molars operation. Five studies administered dexamethasone postoperatively and 15 studies administered the drug preoperatively. Two studies evaluated the preoperative and postoperative administration method. Fourteen studies used a 4 mg dexamethasone dose and drug administration was variable. The treatment period in postoperative studies varied between 1 to 7 days. Conclusion: Dexamethasone appears to be a promising agent in in reduction of post-operative complications following third molar surgery. As a potent anti-inflammatory agent, it has an effective role in pain, trismus and edema reduction distinguished from the routes of administration, dosage and timing, pre or postoperative prescription.

Can diagnostic changes caused by cone beam computed tomography alter the clinical decision in impacted lower third molar treatment plan?

2020 ◽  
pp. 20200412
Author(s):  
Lucas Moreira Mendonça ◽  
Hugo Gaêta-Araujo ◽  
Pedro Bastos Cruvinel ◽  
Ingrid Wenzel Tosin ◽  
Marcelo Rodrigues Azenha ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Logistic Regression ◽  
Cone Beam Computed Tomography ◽  
Treatment Plan ◽  
Third Molar ◽  
Clinical Decision ◽  
Cone Beam ◽  
Diagnostic Features ◽  
Operative Complications ◽  
Post Operative Complications

Objectives: This study observed whether changes in diagnosis caused by analysis of three-dimensional images can lead to alterations in the treatment plans of impacted lower third molars (ILTMs). Methods: Sets of panoramic (PAN) – cone beam computed tomography (CBCT) of 218 patients were assessed for ILTM classification, contact with mandibular canal, contact and resorption of the lower second molar (LSM), intraoperative planning and post-operative expectations. Results: Percentage agreement and McNemar test compared PAN vs CBCT assessments. Logistic regression analyzed the dependency of change in surgical planning considering the changes in diagnostic features; descriptive statistics was used to observe the expectation of post-operative complications and paresthesia. Differences were found between PAN vs CBCT for classification of impaction and positioning, LSM relationship, choice for crown and root sectioning and expectation of post-operative complications (all with p < 0.001). Logistic regression indicated that the change in diagnosis caused by CBCT examination did not change the clinical decision to extract ILTM but altered the planning of intraoperative steps such as osteotomy, crown sectioning and relaxing incision. The expectation of post-operative complications decreased when professionals planned the ILTM removal using tri-dimensional images. Conclusions: We concluded that changes in the diagnosis after CBCT examination can lead to alterations in the treatment plan of impacted lower third molar.

scholarly journals A Comparative Study on Efficacy of Amoxicillin and Azithromycin in Prevention of Postoperative Sequelae Following Third Molar Surgery

2019 ◽  
Vol 21 (3) ◽  
pp. 224-229
Author(s):  
Rashmi Shakya Gurung ◽  
K. Bimb ◽  
D. Shrestha
Keyword(s):  
Maxillofacial Surgery ◽  
Third Molar ◽  
Controlled Study ◽  
Third Molar Surgery ◽  
Mandibular Third Molar ◽  
Surgical Extraction ◽  
Operative Complications ◽  
Alternative Drug ◽  
Group B ◽  
Post Operative Complications

Amoxicillin is the commonly prescribed antimicrobial for prevention of post-operative complications following surgical extraction of mandibular third molar. However recently, the use of macrolideantibiotics had been encouraged in dentistry. The aim of this study was to compare the efficacy of Amoxicillin and Azithromycin in preventing post-operative sequelae following third molar surgery. An open- labeled randomized controlled study was carried out in Department of Oraland Maxillofacial surgery, college of Dental Sciences and Hospital, Nepal Medical College (CODSHNMC), Attarkhel, Kathmandu, Nepal from May 2018 to June 2019. One hundred and twenty patients undergoing surgical extraction of impacted mandibular third molar were randomized by lottery method into two groups: Group A received Amoxicillin and Group B received Azithromycin. Both the groups were assessed postoperatively on 1st, 3rd and 7th days for post-operative complications- pain, swelling, trismus and pus discharge. The present study revealed no significant differences between the efficacy of Amoxicillin and Azithromycin in preventing postoperative sequelae following surgical extraction of impacted third molar. Amoxicillin and Azithromycin were therefore found to be equally effective. Thus, Azithromycin can be used as an alternative drug to Amoxicillin in case of resistance and intolerance to Amoxicillin.

scholarly journals Presence and Maturation Dynamics of Mandibular Third Molars and Their Influence on Late Mandibular Incisor Crowding: Longitudinal Study

2021 ◽  
Author(s):  
Martina Žigante ◽  
Andrej Pavlic ◽  
Luka Morelato ◽  
Vaska Vandevska-Radunovic ◽  
Stjepan Spalj
Keyword(s):  
Third Molar ◽  
Third Molars ◽  
Mandibular Incisor ◽  
Dental Maturation ◽  
The Third ◽  
Irregularity Index ◽  
Mandibular Third Molar ◽  
Mandibular Third Molars ◽  
Dental Plaster ◽  
The Relationship

Abstract OBJECTIVE: To investigate the relationship between the presence and dynamics of mandibular third molar development and the occurrence and amount of late mandibular incisor crowding. MATERIALS AND METHODS: Dental plaster casts and panoramic radiographs of 72 orthodontically untreated subjects from the Nittedal growth study, Norway were analysed. The subjects were recalled for check-up at 12, 15, 18 and 21 years of age. Mandibular incisor crowding was assessed using the Little’s irregularity index and dental maturation of the third molars by the Cameriere’s index.RESULTS: The majority of the subjects (64%) had ≥1mm increase in irregularity; 22% experienced increase of 0.1-0.9mm and 14% had unchanged or decreased irregularity. Incisor irregularity increased with age, regardless of absence or presence of third molars. The amount of change in incisor irregularity from 12 to 21 years did not differ significantly between subjects with hypodontia of third molars, extraction and those with third molars present. No differences were observed between erupted, unerupted or impacted third molars. No correlation was found between the amount of change in irregularity and maturation of the third molars.CONCLUSIONS: Occurrence and amount of mandibular late incisor crowding is not significantly influenced by presence or development dynamics of mandibular third molars.

scholarly journals Indications for removal of impacted mandibular third molars and associated pathologies

2020 ◽  
Vol 13 (2) ◽  
pp. 134-139
Author(s):  
Sushil Subedi ◽  
Ujjwal Koirala ◽  
Bijayata Shrestha
Keyword(s):  
Oral Surgery ◽  
Age Groups ◽  
Angular Position ◽  
Third Molar ◽  
Common Finding ◽  
Radiographic Examination ◽  
Third Molars ◽  
Cross Sectional ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars

Introduction: The purpose of this study was to assess the various indications of impacted mandibular third molar removal and pathologies associated with it. Methods: A retrospective cross-sectional study was conducted in the Department of Oral Surgery, Gandaki Medical College. The clinical case records from September 2016 to August 2019 were retrieved, reviewed, and analyzed. Surgically removed impacted mandibular third molars for which orthopantomogram were available and the lesions verified histologically were included in the study. Orthopantomograms were studied to determine the angular position of the impacted mandibular third molars and associated pathology. The data was entered in SPSS 20 and descriptive statistics was applied. Results: A total of 1344 impacted mandibular third molars (Male-709, 52.8%; Female - 635, 47.2%) were surgically extracted during the three-year period. The majority of patients (36.5%) were in the age groups of 25 - 34 years with a higher incidence of mesioangular impaction (33%). Recurrent pericoronitis (62.9%) was the most common indication followed by caries (11.7%). The radiographically detectable lesion was seen in 471 (35%) cases out of which 304 (64.5%) were symptomatic at the time of extraction. Among137 histopathologically diagnosed cases, chronic inflammatory lesion (76, 55.9%) was the most common finding. Conclusion: Awareness of the indications for removal of impacted mandibular third molars helps in proper management and prevention of future complications associated with retention and delayed extraction of such teeth. So, regular and periodic clinical and radiographic examination is required for patients with impacted mandibular third molars.

scholarly journals Factors associated with spontaneous mesialization of impacted mandibular third molars after second molar protraction

2019 ◽  
Vol 90 (2) ◽  
pp. 181-186
Author(s):  
Un-Bong Baik ◽  
Jin Hye Kang ◽  
Ui-Lyong Lee ◽  
Nikhilesh R Vaid ◽  
Yoon-Ji Kim ◽  
...  
Keyword(s):  
Third Molar ◽  
Regression Analyses ◽  
Third Molars ◽  
Second Molar ◽  
Factors Associated ◽  
The Third ◽  
Mandibular Second Molar ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars ◽  
Mandibular First Molar

ABSTRACT Objectives: To investigate factors associated with spontaneous mesialization of impacted third molars after second molar protraction to close the space caused by a missing mandibular first molar (L-6) or retained deciduous mandibular second molars with a missing succedaneous premolar (L-E). Materials and Methods: Panoramic radiographs of patients treated with mandibular second molar protraction to close the space due to missing L-6 or L-E (14 males, 36 females, mean age = 18.6 ± 4.4 years) were analyzed before treatment (T1) and after second molar protraction (T2). Factors associated with the amount of third molar mesialization were investigated using regression analyses. Results: Mandibular second molars were protracted by 5.1 ± 2.1 mm and 5.8 ± 2.7 mm, measured at the crown and root furcation, respectively. After second molar protraction, third molars showed spontaneous mesialization by 4.3 ± 1.6 mm and 3.8 ± 2.6 mm, measured at the crown and root furcation, respectively. Nolla's stage of the third molar at T1 (B = 0.20, P = .026) and second molar protraction time (B = 0.04, P = .042) were significantly associated with the amount of third molar mesialization. Conclusions: Greater third molar mesialization was observed when Nolla's stage of the third molar was higher before treatment and when the second molar protraction time was longer.

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