EXTRATION OF MANDIBULAR THIRD MOLARS, A CORRELATION BETWEEN THE SURGICAL TECHNIQUE AND WINTER’S

2018 ◽  
Vol 28 (2) ◽  
pp. 407-413
Author(s):  
Zaklina Menceva ◽  
Biljana Evrosimovska ◽  
Aneta Terzievska ◽  
Daniela Veleska Stevkovska ◽  
Bogdan Ilievski

Total and partial impaction of the teeth is considered to be a developmental anomaly, that can affect any tooth in both deciduous and permanent dentition, but according to a large number of dental authors it is mostly associated with the mandibular third molars. Its multifactorial etiology, diagnostics, oral surgical approach and techniques can increase the difficulties of this problem which is encountered in the everyday oral surgical practice.The selection of the appropriate oral surgical technique mostly depends on the various positions in which the total or partial impacted mandibular third molar may appear and his correlation with the adjacent anatomical structures, thus leading to different diagnostic and therapeutic problems.This study includes 80 patients, divided in two groups of 40 patients, where one group is diagnosed with a total impaction and the other group with a partial impaction of the mandibular third molars.After a statistical analysis of the obtained data was performed with the help of appropriate world renowned classifications concerning the position of the impacted mandibular third molars, we came to the following results: according to Winter’s classification, the impacted molars where dominantly in a vertical position; Axhausen’s flap design was dominantly a method of choice; buccodistal osteotomy is the most frequently used technique; the impacted molars presented a convergent anatomical configuration of the roots in most of the cases.

Author(s):  
Neeraj ◽  
Banshilal Beniwal ◽  
Padmanidhi Agarwal ◽  
Vikas Berwal ◽  
Richa Malik

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.


2015 ◽  
Vol 3 (2) ◽  
pp. 47
Author(s):  
Pushappreet Kaur

<p><strong>Background:</strong> 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.</p><p><strong>Objective:</strong> 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.</p><p><strong>Methodology:</strong> 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.</p><p><strong>Results and Conclusion: </strong>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.</p>


KYAMC Journal ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 8-13
Author(s):  
Md Rubayet Alam Prodhan ◽  
Md Shahidul Islam ◽  
Rifat Rezwana ◽  
Md Moynul Hasan

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


2019 ◽  
Vol 8 (2) ◽  
pp. 79-83
Author(s):  
Tariq Sardar ◽  
Gulrukh Sheikh ◽  
Saddique Aslam ◽  
Numan Muhammad Khan ◽  
Javed Akhtar Rana

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.


2011 ◽  
Vol 10 (2) ◽  
pp. 93
Author(s):  
Rahardjo ` Rahardjo

Odontoma is a mixed odontogenic neoplasm composed of epithelial and mesenchymal tissues. There are: compoundodontoma and complex odontoma. Compound odontoma appears to be a radiopaque mass composed of in-groupsmall teeth. Compound odontoma is generally found in the anterior maxilla, and is double in number than complexodontoma. Complex Odontoma appears to be an irregularly-shaped mass and an amorphous radiopaque image,which is often found in the posterior maxilla. Impacted mandibular third molars occur due to either insufficientspace for teeth to grow or improper dental position. Two cases of complex odontoma-generated impactedmandibular third molar were reported. Extirpation and extraction were performed on the impacted teeth.


2013 ◽  
Vol 25 (1) ◽  
Author(s):  
Sanjit Singh Munjit Singh ◽  
Suhardjo Sitam ◽  
Belly Sam

Introduction: The third molar is undoubtedly the most variable tooth in the human dentition, and also the most common tooth to become impacted due to it being the last tooth to erupt into the dental arch The aim of research is to obtain the prevalence of the mandibular third molar (M3) impaction among the patients attending the Radiology Clinic. Methods: The type of research conducted was a descriptive research. The sampling was purposive, drawn from a population of 1451 digital panoramic radiographs taken from January – December in the year 2010, of which 392 samples were included in the survey, with patient ages ranging between 18 – 59 years at time of exposure. The position of the M3’s was assessed using the Pell and Gregory and, Winter’s impaction classification. Results: The prevalence of impacted mandibular M3’s in this study is 76.8% overall. Of the impacted mandibular M3’s present, 76.1% were bilateral impactions and of these bilateral impactions 50.7% are similar in impaction classification. Of the mandibular M3’s examined, 40.1% are in a vertical angulation, 33.3% mesioangular, 23.5% horizontal and 3.1% distoangular. The three most common types of impaction according to the Pell and Gregory classification are IIB at 38.5%, IA at 36.8% and IIA at 18.8%. Conclusion: Prevalence of  mandibular third molar of the patients attending the Radiology Clinic is 76.8%.


2014 ◽  
Vol 15 (1) ◽  
pp. 34-36 ◽  
Author(s):  
Nishi Singh ◽  
Amiya Agrawal ◽  
Arvind Yadav ◽  
Siddhartha Chandel ◽  
Ankita Singhal

ABSTRACT The purpose of this study is to analyze the incidence of complications in a group of 171 patients in whom extractions of impacted mandibular third molar have been performed by two oral surgeons between the period April 2010 and March 2012. This retrospective study comprises evaluation of 270 impacted mandibular third molars which were classified into two groups A and B on the basis of procedure of osteotomy only and osteotomy and odontotomy both respectively. Total no of complications reported were 40 (14.81%). Maximum no of cases reported alveolar osteitis (AO) (11.11%) while other complications reported root tip fractures (2.22%), lingual nerve parasthesia and TMJ problems (each 0.74%) in descending frequency. Conclusion drawn is that the risk of complications in extractions of impacted mandibular third molars always exists, and extractions associated with both osteotomy and odontotomy are associated with higher risk of complications. How to cite this article Agrawal A, Yadav A, Chandel S, Singh N, Singhal A. Wisdom Tooth—Complications in Extraction. J Contemp Dent Pract 2014;15(1):34-36.


Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2282
Author(s):  
Rakhi Issrani ◽  
Namdeo Prabhu ◽  
Mohammed Sghaireen ◽  
Hasna Rasheed Alshubrmi ◽  
Amal Mohamed Alanazi ◽  
...  

Background: Pre-operative radiographic assessment of the anatomical relationship between the roots of the mandibular third molar and the inferior alveolar nerve (IAN) is a must to minimize the risk of IAN injury during surgery. Objectives: To compare the radiographic signs of digital orthopantomogram (OPG) and cone-beam computed tomography (CBCT). An additional objective was to assess the cortex status between the mandibular canal and third molar on CBCT images in relation to the demographic characteristics, region (right or left side), and angulation of mandibular molar. Methodology: In this retrospective study, a total of 350 impacted mandibular third molars with a close relationship between the inferior alveolar canal (IAC) and impacted mandibular third molars on digital OPG were further referred for CBCT imaging for assessment of the position of the mandibular canal. The study was conducted between August 2018 and February 2020. Digital OPGs were evaluated for radiographic signs like interruption of the mandibular canal wall, darkening of the roots, diversion of the mandibular canal, and narrowing of the mandibular canal. The age and sex of patients, site of impacted third molar, Winter’s classification of mandibular third molar, position of IAC relative to impacted molar, and the radiographic markers of OPG were assessed for cortical integrity using CBCT. Chi square testing was applied to study the values of difference and binomial logistic regression was done to assess the factors associated with cortication. Statistical significance was set at p ≤ 0.05. Results: Among 350 patients, 207 (59.1%) were male and 143 (40.9%) were female with a mean age of 36.8 years. The most common OPG sign was interruption of white line, seen in 179 (51.1%) cases. In total, 246 cases (70.3%) showed an absence of canal cortication between the mandibular canal and the impacted third molar on CBCT images. Cortication was observed in all cases with a combination of panoramic signs which was statistically significant (p = 0.047). Cortication was observed in 85 (50.6%) cases where IAC was positioned on the buccal side, 11 (16.9%) in cases of inferiorly positioned IAC, and just 8 (7.6%) for cases of lingually positioned IAC which was statistically significant (p = 0.003). Statistically insignificant (p > 0.05) results were noted for cortex status in CBCT images with regards to the age, sex, site, and angulation of impacted third molars. Conclusion: CBCT imaging is highly recommended for those cases where diversion of the mandibular canal is observed on OPG and when the roots are present between canals.


2020 ◽  
Vol 27 (07) ◽  
pp. 1408-1413
Author(s):  
Wajid Ali Rajper ◽  
Kashif Ali Channar ◽  
Munawar Din Larik ◽  
Sajid Ali Majeedano ◽  
Aftab Ahmed Soomro ◽  
...  

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.


2012 ◽  
Vol 83 (3) ◽  
pp. 376-380 ◽  
Author(s):  
Bradly Russell ◽  
Mark Skvara ◽  
Eric Draper ◽  
William R. Proffit ◽  
Ceib Philips ◽  
...  

ABSTRACT Objective: To assess changes in mandibular third molar angulation during orthodontic treatment in subjects having either first or second premolars or neither removed. Materials and Methods: In a retrospective study approved by the institutional review board, right and left mandibular third molar angulations were compared to the vertical axis of adjacent second molars before and at the end of orthodontic treatment. The sample included 25 subjects with first premolars removed, 25 subjects with second premolars removed, and 24 subjects with no premolars removed. A decrease in angulation over time of at least 5°, so that the third molar became more vertical, was considered clinically favorable. Data were assessed by a linear mixed effect model and a proportional odds model with significance set at P &lt; .05. Results: Prior to treatment, the average mandibular third molar angulation did not differ significantly among the three study groups (P  =  .97). The average change during treatment was not significantly affected by group (P  =  .59), but a higher proportion of mandibular third molars were more vertical by at least 5° in the second premolar extraction group compared to the other two groups at the completion of treatment. Conclusion: Although creating space for third molars to erupt and function has intuitive appeal, clinicians should not assume that third molars will move upright to a vertical position even if premolar removal is performed as part of an orthodontic treatment plan.


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