scholarly journals Retrospective analysis of malpositioned mandibular third molars in elderly patients

2019 ◽  
Vol 41 (2) ◽  
pp. 1-7
Author(s):  
Charles E. Anyanechi ◽  
Birch D Saheeb

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.

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.


Author(s):  
V. Usha ◽  
G. Rajabackiyam ◽  
K. Prabhu Sankar ◽  
Varun Muthuraman ◽  
Aravind Christo ◽  
...  

Surgical removal of impacted mandibular third molars are the most commonly performed minor surgical procedures by maxillofacial surgeon. If not treated can lead to few complications like pericoronitis, root resorption of second molar, caries of second molar, cyst and tumours can arise from them. The common complications include swelling, hematoma, trismus and lingual nerve injuries. In this article 1000 cases of various types impactions were surgically operated and assessment of lingual nerve injury was done.


2019 ◽  
Vol 6 (2) ◽  
pp. 41-43
Author(s):  
Manu Goel ◽  
Milind Shringarpure ◽  
Vasant Shewale ◽  
Chandrashekhar Bande ◽  
Ajit Joshi ◽  
...  

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.


2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Hani Arakji ◽  
Mohamed Shokry ◽  
Nayer Aboelsaad

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.


2020 ◽  
Vol 3 (2) ◽  
pp. 352-355
Author(s):  
Mabel Okiemute Etetafia ◽  
Ese Anibor ◽  
Martins Obaroefe

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.


2021 ◽  
Vol 7 ◽  
pp. 18-22
Author(s):  
Sushmitha Mohan ◽  
Annamalai Thangavelu ◽  
Aravindraj

Objectives: The objective of the study is to revisit the forgotten art of Lingual split bone technique during the COVID pandemic as a Standard Operating Procedure (SOP) for the surgical removal of impacted mandibular third molars. It was originally introduced in early 90’s by Sir William Kelsey Fry and also we have compared its advantages over the bone guttering technique. Materials and Methods: Twenty seven cases were operated during COVID pandemic in our institution using Davi’s modified lingual split technique under strict COVID protocol. Results: All impacted mandibular third molars were successfully removed. With regards to post-operative complication; 3 patients had nerve injury (11%), 2 patients had lingual paraesthesia (7.6%), 1 patient had alveolar osteitis (3.8%), 2 patients had postoperative infection (7.6%), 3 patients had trismus (19%). The overall success rate was 100%. Also the results of a comparison between bone guttering and chisel-mallet technique were stated. Conclusion: The use of lingual split bone technique deserves consideration during this COVID time as an alternate for bone guttering in surgical removal of third molar as it ensures minimal cross infectivity rate among both dentists and patients. Thus, patient care can be delivered with confidence even during pandemic.


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.


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