scholarly journals Influence of Surgical Flap Design (Envelope and Szmyd) for Removal of Impacted Mandibular Third Molars on Clinical Periodontal Parameters: A Clinical Trial

2021 ◽  
Vol 18 (9) ◽  
pp. 4465
Author(s):  
Muhtada Ahmad ◽  
Zafar Ali Khan ◽  
Tahir Ullah Khan ◽  
Montaser N. Alqutub ◽  
Sameer A. Mokeem ◽  
...  
Keyword(s):  
Third Molar ◽  
Periodontal Pocket ◽  
Third Molars ◽  
Chi Square ◽  
Pocket Depth ◽  
Clinical Attachment Loss ◽  
Exact Test ◽  
Second Molar ◽  
Third Molar Extraction ◽  
Flap Design

The aim of the study was to assess the influence of flap designs (Envelope flap (EF) and Szmyd flap (SF)) for impacted mandibular third molar extraction, on periodontal pocket depth (PPD), clinical attachment loss (CAL) and bone levels (BL) of second molar. Sixty patients indicated for third molar extractions with healthy second molars were allocated into two groups: EF and SF (n = 30). Third molars were assessed for angulation, root patterns, depth of impactions and relation with ramus (Pell and Gregory classification). Extraction of third molars was performed and PPD, CAL and BL around second molars at 0, 3 and 6 month (mon) follow-ups (FU) were assessed clinically and radiographically. ANOVA, Chi-square and Fisher’s exact test were employed to compare periodontal factors between EF and SF groups, considering p ≤ 0.05 as significant. Sixty participants with a mean age of 23.22 ± 3.17 were included in the study. Based on angulation, the most common impaction in the EF and SF groups was mesio-angular (EF, 50%; SF, 36.7%). Buccal and distal PPD showed a significant increase (p < 0.001) in both EF and SF patients from baseline to 6 mon. EF patients showed significantly higher distal and buccal CAL (6.67 ± 0.18 mm; 6.91 ± 0.17 mm) and BL (7.64 ± 0.16 mm; 7.90 ± 0.15 mm) as compared to SF patients (CAL, 6.76 ± 0.26 mm; 6.91 ± 0.17 mm-BL, 7.42 ± 0.38 mm; 7.34 ± 0.34 mm) at 6 mon FU. SF showed better soft tissue attachment (PPD and CAL) and bone stability (less bone loss) around second molars compared to EF after third molar extractions regardless of the patient, tooth and operator factors.

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

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.

scholarly journals External root resorption of second molars caused by impacted third molars: an observational study in panoramic radiographs

2018 ◽  
Vol 47 (1) ◽  
pp. 25-30
Author(s):  
Jhonatan Thiago LACERDA-SANTOS ◽  
Gélica Lima GRANJA ◽  
Jalber Almeida dos SANTOS ◽  
Julliana Cariry PALHANO-DIAS ◽  
José Cadmo Wanderley Peregrino de ARAÚJO-FILHO ◽  
...  
Keyword(s):  
Root Resorption ◽  
Young Patients ◽  
Third Molar ◽  
Third Molars ◽  
Chi Square ◽  
Cross Sectional ◽  
Exact Test ◽  
Panoramic Radiographs ◽  
Second Molar ◽  
External Root Resorption

Abstract Objective This research investigate the presence of external root resorption (ERR) in second molars caused by impacted third molars in panoramic radiographs, relating to the position of third molars according to classification of Winter, Pell and Gregory. Material and method A cross-sectional, retrospective study using panoramic radiographs obtained from January 2014 to December 2015. The inclusion criterion was the presence of a second molar adjacent to an impacted third molar. Data were analyzed using descriptive and inferential statistics. Pearson's Chi-Square Test and Fisher's Exact Test (p≤0.05) were performed. Result The sample consisted of 584 panoramic radiographs, 356 (60.95%) of women, and 228 (39.05%) of men, the mean age was 25.31 years. The prevalence of ERR was 12.5%, and the group of 14-24 year olds was the most affected (p = 0.46). The presence of ERR was statistically higher in the mandible (42.1%) with p=0.01. The ERR located in the cervical (57.1%) and medium (58.8%) thirds was proportionally higher in the teeth with B2 (p=0.02) and mesio-angular positions (p=0.26). Conclusion The prevalence of ERR in second molars, caused by impacted third molars, was shown to be similar to results found in the literature, with no gender preference, this affects young patients, occurring frequently in mandible teeth, and presents greater severity in the cervical and middle thirds. The B2 and mesio-angular positions were more prone to ERR.

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

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.

scholarly journals Evaluating the Presence of Paresthesia in Patients with Juxta-apical Radiolucency after Third Molar Surgery: A Case-control Study

2021 ◽  
Author(s):  
Mahvash Hasani ◽  
Nasim Razavi ◽  
Abdolaziz Haghnegahdar ◽  
Motahhareh Zarifi
Keyword(s):  
Significant Relationship ◽  
Third Molar ◽  
Mandibular Canal ◽  
Cortical Plate ◽  
Third Molar Surgery ◽  
Surgical Removal ◽  
Third Molars ◽  
Chi Square ◽  
Exact Test ◽  
Increased Risk

Abstract Background: Juxta-apical radiolucency (JAR) has been presented as a radiographic sign, suggestive of the IAN injury through third molar surgery. This study aimed to evaluate the relation of JAR with paresthesia in cone-beam computed tomography (CBCT) images and to determine whether the presence of JAR is related to tooth angulation, proximity to the mandibular canal, position to the IAN and thinning of the cortical plates.Methods: Of an initial sample of 545 mandibular third molars, a total of 75 JAR and 75 control teeth were evaluated by CBCT. The association of JAR with the IAN, position to IAN, lingual cortical plate thinning, and tooth angulation was investigated in this study. Temporary and permanent paresthesia were also examined in the subjects. Descriptive statistics, Chi-square test, and Fisher’s exact test were performed for statistical analysis.Results: A significant relationship was found between JAR and temporary paresthesia (P=0.034). However, there was no case of permanent paresthesia. JAR showed no significant relationship with the tooth angulation, cortical plate thinning, position to IAN and proximity to the mandibular canal. The lingual position of JAR relative to the mandibular canal was related to the presence of paresthesia in the JAR group. Also, most cases of paresthesia showed some degree of lingual cortical plate thinning (P=0.012). Conclusion: JAR is generally in contact with the mandibular canal, and some degree of cortical thinning can be found in most cases. In this study, JAR was significantly related to temporary paresthesia. The present findings may indicate the increased risk of nerve injury during the surgical removal of third molars.

scholarly journals Knowledge and Awareness on the Usage of Preemptive Analgesics in Third Molar Extraction among Dental Students: A Survey

2020 ◽  
pp. 75-87
Author(s):  
Keerthana Balaji ◽  
M. Dinesh Prabu
Keyword(s):  
Postoperative Pain ◽  
Descriptive Analysis ◽  
Healing Process ◽  
Third Molar ◽  
Dental Students ◽  
P Value ◽  
Third Molars ◽  
Chi Square ◽  
Third Molar Extraction ◽  
Pain Symptoms

Postoperative pain control after extraction of third molars is important for patients because of the effect of pain symptoms on the healing process and quality of life. The aim of this study was to assess the knowledge and awareness of dental students towards the use of preemptive analgesics in third molar extractions. A questionnaire based survey was conducted among 100 dental students. Questionnaire was distributed through a survey link. Results were collected and analysed using IBM SPSS Statistical Analyzer (23.0 version). Frequency distribution and descriptive analysis were carried out. The variables were analysed using Pearson Chi square test. P Value less than or equal to 0.05 was considered to be statistically significant. The results of the study showed that the knowledge and awareness of dental students about the usage of preemptive analgesics in day to day practice varied according to their year of study. Interns were observed to have more knowledge and awareness regarding preemptive analgesics in comparison to third years and final years. Preemptive analgesics play a significant role in the elimination of postoperative pain in patients after removal of third molars. Therefore, it is of utmost importance for dental students to gain sufficient knowledge regarding the usage and importance of preemptive analgesics in dentistry.

scholarly journals Validity of the Community Periodontal Index of Treatment Needs' (CPITN) for population periodontitis screening

2006 ◽  
Vol 22 (2) ◽  
pp. 277-283 ◽  
Author(s):  
Diego Garcia Bassani ◽  
Carina Maciel da Silva ◽  
Rui Vicente Oppermann
Keyword(s):  
Gold Standard ◽  
Roc Curves ◽  
Periodontal Pocket ◽  
Treatment Needs ◽  
Chi Square ◽  
Pocket Depth ◽  
Clinical Attachment Loss ◽  
Predictive Values ◽  
Periodontal Index ◽  
Global Agreement

The aim of the present study was to validate two versions of CPITN for periodontitis diagnosis. A sample of 400 individuals underwent full mouth periodontal examination including Clinical Attachment Loss, Periodontal Pocket Depth, and Sub-gingival Calculus. Full and partial CPITN versions were derived from this exam (gold standard). Contingency tables were constructed and operational characteristics obtained, as well as ROC curves. The results show 58% sensitivity for full CPITN and 80.6% specificity. Positive and negative predictive values were 87% and 46.3%, respectively. According to the test, estimated periodontitis prevalence was 46%, while the figure obtained with the gold standard was 69%. The partial version of the CPITN showed 50% sensitivity and 87.1% specificity. Positive and negative predictive values were 89.6% and 43.9%, respectively. Estimated periodontitis prevalence, through partial CPITN, was 30.5%. Adjusted global agreement (kappa) for partial and full CPITN was 0.32 and 0.29, respectively. Both CPITN versions disagreed significantly with gold standard results (chi-square p < 0.001). As a conclusion, both total and partial CPITN failed to reflect the real periodontal status of the sample.

scholarly journals Effects Of Impacted Lower Third Molar Removal On Alveolar Bone Height And Periodontal Parameters Of Adjacent Second Molar

2017 ◽  
Vol 16 (2) ◽  
Author(s):  
Wan Nur Alwani bt Wan Abdul Aziz ◽  
Azlan b Jaafar ◽  
Ahmad Dzulfikar b Samsudin
Keyword(s):  
Alveolar Bone ◽  
Third Molar ◽  
Surgical Removal ◽  
Third Molars ◽  
Pocket Depth ◽  
Bleeding On Probing ◽  
Second Molar ◽  
Probing Pocket Depth ◽  
Post Surgery ◽  
Bone Height

Introduction: The effect of surgical removal of impacted third molars on the periodontal parameters of adjacent second molar revealed inconsistent results. Some authors suggested improvement of periodontal parameters distal to second molar, whilst others demonstrated loss of attachment and reduction of alveolar bone height. This study was conducted to evaluate the alveolar bone height (ABH) and periodontal status of second molar after the surgery. Materials and Methods: Out of 42 subjects selected, 33 subjects completed the study. Only subject who had mesio-angular or horizontal impaction of third molar with available previous records of digital orthopantomogram (OPG) were recruited into the study. ABH of adjacent second molar on the previous OPG were compared with the current OPG using technique described by Krausz et al., (2005). Other paramaters such as probing pocket depth (PPD), bleeding on probing (BOP), recession (REC) were also recorded. Results:  There was significant reduction (p<0.001) in mean ABH at distal of second molar between pre-surgery (4.30±1.09mm) and post-surgery (2.80±2.05mm). No significant different was found in ABH between 47 and 37 at baseline; (4.09±1.09mm vs 4.30±2.55mm) and post-surgery (3.00±2.20mm vs 2.70±2.35mm) where p<0.423. Distal sites of second molars consistently showed significantly higher mean PPD (3.76±1.32mm) when compared with mesial, mid buccal and mid lingual sites (p<0.001). Higher frequency of BOP (90.9%) were also recorded for distal sites. Conclusion(s):  Within the limitation of this study, surgical removal of impacted third molars demonstrated significant reduction in ABH of second molar post surgically. Significantly deeper PPD were also recorded at distal sites as compared to other sites. 

scholarly journals Evaluasi Ekstraksi Molar Ketiga Rahang Bawah Berdasarkan Angulasi Mesial pada Radiografi Panoramik

e-GIGI ◽  
2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Rosalina I. Saputri ◽  
Rizky M. Boedi
Keyword(s):  
Predictive Factor ◽  
Third Molar ◽  
Third Molars ◽  
Panoramic Radiographs ◽  
Second Molar ◽  
Stomatognathic System ◽  
Third Molar Extraction ◽  
Irregular Pattern ◽  
Mandibular Third Molar ◽  
Mandibular Third Molars

Abstract: Third molar development is a concern in dental care because of its influence on stomatognathic system. Due to third molar irregular pattern of eruption, different clinical and radiographic considerations on how to decide an extraction were studied. This study was aimed to evaluate the effect of mandibular third molar mesial angulation (MA) towards the extractions on panoramic radiographs. This was a retrospective study. A longitudinal study of mandibular third molars (n=192) of 102 individuals (50 Female and 52 Male) was conducted. Development of the mandibular third molar was staged according to modified Köhler et al. staging technique. Mesial angulation was measured from the intersection between axes of third molar and adjacent second molar of the most developed stage for extraction cases or before root completion for non-extraction cases. Of 102 subjects, 107 mandibular third molars were extracted. The increase of 1° of MA would increase the odds ratio (OR) of extraction by 1.113 (95% CI 1.070-1.158, p<0.01). The ROC curve showed the MA of 18.5o as the threshold of extraction with 76% of sensitivity and 68% of specificity. In conclusion, MA has the possibility as a predictive factor of mandibular third molar extraction. Future studies using bigger sample sizes and variations of third molar development are suggestedKeywords: third molar, angulation, extraction, predictive factor, panoramic radiographs Abstrak: Pertumbuhan molar ketiga menjadi perhatian pada perawatan dental karena pengaruh-nya pada sistem stomatognasi. Terdapat banyak penelitian tentang berbagai pertimbangan klinis dan radiografis untuk melakukan ekstraksi molar ketiga karena pola erupsinya yang tidak menentu. Penelitian ini bertujuan untuk mengevaluasi efek angulasi mesial (AM) dari molar ketiga rahang bawah terhadap tindakan ekstraksi pada radiografi panoramik. Jenis penelitian ialah retrospektif. Pengamatan molar ketiga rahang bawah (n=192) secara longitudinal dilakukan pada 102 individu (50 perempuan dan 52 laki-laki). Pertumbuhan molar ketiga diukur berdasarkan tahap pertumbuhan dari teknik modifikasi Köhler et al. AM diukur dari pertemuan aksis molar ketiga dan molar kedua di sebelahnya, pada tahap pertumbuhan paling akhir pada kasus ekstraksi, atau sebelum akar gigi terbentuk sempurna pada kasus non-ekstraksi. Pada sampel penelitian, ekstraksi dilakukan pada 104 molar ketiga rahang bawah. Peningkatan 1o dari AM akan meningkatkan rasio peluang dari ekstraksi sebesar 1,113 (95% CI 1,070-1,158, p<0,01). Pada kurva ROC, AM sebesar 18,5o menunjukan 76% sensitivitas dan 68% spesifisitas. Simpulan penelitian ini ialah AM dapat digunakan sebagai faktor prediksi terhadap ekstraksi molar ketiga rahang bawah. Perkembangan penelitian selajutnya dapat dilakukan dengan jumlah sampel yang lebih besar dan dengan memperhatikan pertimbahan klinis serta parameter radiografik lainnya.Kata kunci: molar ketiga, angulasi, ekstraksi, faktor prediksi, radiografi panoramik

Sign in / Sign up

Export Citation Format

Share Document