Third Molar Surgery: Risk Factors and Complications after Removal of Third Molars

2021 ◽  
Vol 15 (11) ◽  
pp. 3520-3522
Author(s):  
Syed Zuhair Mehdi ◽  
Faizan Munir Khan ◽  
Nighat Shafiq ◽  
Sarah Salim ◽  
Muhammad Amer Khan ◽  
...  

Objective: There is a need for this research because it aims to identify characteristics that increase the likelihood of negative outcomes following the removal of third molars. Study Design: Observational/transversal study Place and Duration: Dental College HITEC-IMS Taxilla/ Gulraiz Dental Clinic Quaid Avenue Main Road, Gulraiz 3, Rawalpindi. Nov 2020-June 2021 Methods: A total of 180 male and female participants were included in this study. The patients ranged in age from 20 to 50. Pericoronitis and tooth impaction were among the complaints of the patients included in the study. The oral and maxillofacial department operated on all of the patients who requested the removal of their third molars. All patients provided written consent before having their personal data collected, including their age, gender, BMI, kind of impaction, and location of their third molar. Various operative variables were employed. In our research, we looked at post-operative complications and risk variables. The whole data was analyzed with SPSS 23.0. Results: 110 (61.1%) patients were males and 70 (38.9%) cases were females. 28.17±9.47 years were the mean age with mean BMI 24.11±3.65 kg/m2. Most of the teeth impacted in left side found in 102 (56.7%) patients. Most common type of impaction was mesioangular among 90 (50%) cases followed by distoangular 45 (23.7%) cases. Majority of the third molars were fully impacted 120 (66.7%), 38 (21.1%) were partially impacted and frequency of erupted tooth was 22 (12.2%). All the third molars were removed by buccal guttering technique under local anesthesia. Post-operative infection was the most common complication found in 80 (44.4%) cases followed by gingival defect in 27 (15%) radicular fractures in 24 (13.3%) cases. Location of the third molar and bone removal was the most common factor found. Conclusion: There was an increased risk of problems with tooth sectioning, bone removal, and/or tooth localization in patients above the age of 22. Both the evaluation of the indications for the removal of third molars and the process of informed consent should reflect this information. Keywords: Third Molars, Surgery, Anesthesia, Complications, Impactions

2021 ◽  
Author(s):  
Mahvash Hasani ◽  
Nasim Razavi ◽  
Abdolaziz Haghnegahdar ◽  
Motahhareh Zarifi

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.


2017 ◽  
Vol 6 (1) ◽  
pp. 1430
Author(s):  
Tsvetan Borisov Tsvetanov ◽  
Nicola Stamenov

The aim of this case report was to review two cases of patients with impacted maxillary third molars. Both were symptomatic and presence of pathology clinically and radiographically. Surgical extraction of these third molars with accessible positions requires a bone removal. Moreover, it contains a high risk of displacement of the third molars into the maxillary sinus. The postoperative period for both cases was without complications.


Author(s):  
Josefine Cederhag ◽  
Nina Lundegren ◽  
Per Alstergren ◽  
Xie-Qi Shi ◽  
Kristina Hellén-Halme

Abstract Objectives The aim was to evaluate the characteristics of the mandibular third molars, especially in relation to the inferior alveolar nerve. Further aims were to investigate incidental findings in panoramic radiographs in an adult population, and to investigate image quality related to patient positioning. Materials and Methods From a previous study with 451 randomly selected adult participants who lived in Sweden, 442 panoramic radiographs from four dental public health clinics were used. The third molars’ characteristics and relation to inferior alveolar nerve were evaluated. Incidental findings and patient positioning were recorded. Statistical Analysis Frequency analysis was used to investigate the occurrence of all findings and their possible interconnections. Whether the patients’ age or gender had an impact or not was also analyzed. Results The third molars were erupted in vertical position among 73% regardless of age. When retained or semi-retained, they were most commonly in mesioangular positions. The inferior alveolar nerve was located inferior to the roots in 52%, whereas an overlapped position was most common if the third molar was retained (90%), semi-retained (83%) or the age was less than 30 years (66%). Common incidental findings were apical radiolucencies, idiopathic osteosclerosis, and tooth fragments. Suboptimal patient positioning was found in one-third of the radiographs. Conclusions Panoramic radiography is a useful method to evaluate third molar prior to surgical removal and may be the only image required. Most incidental findings on panoramic radiographs does not seem to require any further odontological management.


2017 ◽  
Vol 65 (1) ◽  
pp. 13-19 ◽  
Author(s):  
Tiago Nascimento MILETO ◽  
Fabiano Goulart AZAMBUJA

ABSTRACT The search for means that enable a better quality of life for postoperative patients should be incessant. The surgical extraction of third molars can result in potential complications such as pain, swelling and trismus, along with discomfort in the recovery phase. Therefore, this narrative review was to analyze, from systematic reviews and randomized clinical trials, the use of low level laser therapy as influencer the clinical state after third molar surgery. Scientific articles were searched through PubMed and Science Direct database. In spite of the evaluated studies have cited the effectiveness of laser therapy such as tissue repair, anti-inflammatory and analgesic, variety of analysis models and diversity of dosimetry leaves a gap on their true efficacy. Based on the research conducted, we suggest the adjuvant use of diode laser GaAlAs with 810 nm (λ), 100 mW constant power and 4 J/cm2 of energy, intra and extra oral form at least three sections to minimize possible occurrences of third molar surgery.


Author(s):  
А. . Atyakshev ◽  
N. . Tekoutieva

Extraction of the third molars from the upper jaw can cause somatic dysfunctions and changes in cerebral hemodynamics in patients. Rehabilitation measures aimed to correct somatic dysfunctions and restore cerebral hemodynamics are necessary for these patients.


Author(s):  
Katherine Luzuriaga ◽  
Santiago López Jurado

Third molars have an unusual eruption pattern. Studies suggest that, due to the position and angulation of these, various pathologies could occur in the adjacent molars, such as periodontal problems and the appearance of distal caries. The objective of this work is to describe the periodontal status of mandibular second molars adjacent to mandibular third molars. For this, a descriptive transversal study was carried out. We worked with a sample of 277 patients that went to the Dental UCSG Clinic to have their third molars extracted in the period A-2018. An intraoral clinical examination was performed, and the following variables were observed: probing depth, gingival state, and presence of caries in mandibular second molars. In addition, panoramic x-rays of the patients were reviewed to determine the position of the third mandibular molar and the level of the distal bone crest of the second molars. The results showed that the depth of distal probing of the mandibular second molars were normal (from 1 to 3mm) in 31% of the cases, while in 69% depths greater than 3mm were found. Regarding the presence of bone loss, in 43% of the cases there was no loss, in 35% of the cases there was a slight loss, 22% presented moderate loss and only 1% had severe loss. The presence of mandibular third molars significantly affects the periodontal status of the adjacent second molar, which can lead to periodontal pockets, bone los sand caries in their distal area.


2016 ◽  
Vol 10 (04) ◽  
pp. 454-458 ◽  
Author(s):  
Roberto Pippi ◽  
Marcello Santoro ◽  
Ferdinando D'Ambrosio

ABSTRACT Objective: Cone-beam computed tomography (CBCT) has been proposed in surgical planning of lower third molar extraction. The aim of the present study was to assess the reliability of CBCT in defining third molar root morphology and its spatial relationships with the inferior alveolar nerve (IAN). Materials and Methods: Intraoperative and radiographic variables of 74 lower third molars were retrospectively analyzed. Intraoperative variables included IAN exposure, number of roots, root morphology of extracted third molars, and presence/absence of IAN impression on the root surface. Radiographic variables included presence/absence of the cortex separating IAN from the third molar roots on CBCT examination, number of roots and root morphology on both orthopantomography (OPG) and CBCT. The statistical association between variables was evaluated using the Fisher's exact test. Results: In all cases of intraoperative IAN exposure, the cortex appeared discontinuous on CBCT images. All cases, in which the cortical bone was continuous on CBCT images, showed no association with nerve exposure. In all cases in which nerve impression was identified on the root surface, the IAN cortex showed interruptions on CBCT images. No nerve impression was identified in any of the cases, in which the cortex appeared continuous on CBCT images. CBCT also highlighted accessory roots and apical anomalies/curvatures, not visible on the OPG. Conclusions: CBCT seems to provide reliable and accurate information about the third molar root morphology and its relationship with the IAN.


1974 ◽  
Vol 1 (4) ◽  
pp. 139-142
Author(s):  
C. P. Adams

The Oblique Lateral Jaw Radiograph has been used as a routine diagnostic x-ray view for many years as an aid to orthodontic diagnosis and for the assessment of the positions of unerupted third molar teeth. Many methods for obtaining clear undistorted views of the teeth have been suggested from a freehand setting up of film, patient and x-ray tube, to the use of simple orientated devices. The present article describes a method of standardizing the relationship of film and x-ray tube to one another so that it is only necessary for the radiographer thereafter to place the patient on the film area in a manner depending on whether a view. is required of the third molars only or of the complete upper and lower buccal segments.


Author(s):  
Mario F. Muñoz-Guerra ◽  
Raúl González-García ◽  
Ana L. Capote ◽  
Verónica Escorial ◽  
Luis Naval Gías

2016 ◽  
Vol 4 (1) ◽  
pp. 11-16
Author(s):  
Winnie Zhang

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.


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