Frequency of Lingual Nerve Damage during Surgical Removal of Impacted 3rd Molar

2021 ◽  
Vol 15 (9) ◽  
pp. 2441-2443
Author(s):  
Wajiha Abbas ◽  
Umer Hussain ◽  
Ali Shahid ◽  
Mustafa Qadeer ◽  
Muhammad Anwaar Alam ◽  
...  

Introduction: Professional skills, training and experience is mandatory for removing impacted 3rd molars with aid of local/general anesthesia, sedation. As for symptomatic 3rd molars decision for removing is not difficult usually, but for removing asymptomatic 3rd molars decision is less clear & requiring good clinical experience. Objective: The objective this study was to determine frequency of lingual nerve damage during surgical removal of impacted 3rd molar Design: Descriptive cases series Study Setting: This study was conducted at Department of Oral and Maxillofacial Surgery, Sandeman Provincial Hospital Quetta over 6 months (April 10, 2018 till Oct 10, 2018). Materials and Methods: All 149 cases after approval of hospital ethical committee fulfilling the inclusion criteria were included in this study. After clinical and radiographic diagnosis of affected tooth like depth, position or any other difficulty, the surgical procedure was selected. An impacted tooth was labeled when it was failed to explode into the dental arch within the expected developmental window. After operation surgical sites of all patients were reviewed by the same consultant after 7 days. It was instructed to all patients that report any problem in lingual sensation; by clinical examination sensory deficits were recognized bilaterally. Results: The mean age of all cases was 29.82 ± 6.81 years with minimum and maximum age of 18 and 40 years. There were 83(55.7%) male and 66(44.3%) were females. According to types of impaction 22(14.8%) cases had Mesioangular, 10(6.7%) had Horizontal, 12(8.1%) had Vertical, 17(11.4%) had Distoangular, 14(9.4%) had Class I, 15(10.1%) had Class II, 11(7.4%) had Class III, 14(9.4%) had Class A, 16(10.7%) had Class B and 18(12.1%) cases had Class C. A total of 16(10.7%) cases had inguinal injury in this study. Conclusion: This study concludes that 10.7% cases had inguinal injury in this study. So, this procedure of impacted mandibular third molar is associated with minor but expected complications like the lingual nerve damage. Hence, preoperative and intraoperative consideration must be taken up to reduce this preventable complication. Keywords: Impacted teat, 3rd molar, surgery, complications, lingual nerve damage

2019 ◽  
Vol 6 (1) ◽  
pp. 10-13
Author(s):  
Manu R. Goel ◽  
Milind D. Shringarpure ◽  
Vasant V. Shewale ◽  
Tejasvini Dehankar ◽  
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. Both the patient and dentist must therefore have scientific evidence-based information concerning the estimated level of surgical difficulty of every case to consider in referring cases of impacted third molars for specialists’ handling. We have undertaken a study in which demographic and radiological variables were considered together to evaluate the risk factors for surgical difficulty in a cohort of 100 impacted mandibular third molars. There were 13 variables evaluated for surgical difficulty. Total surgical time intervention was noted at the end of each surgery. Each variable was analysed with total surgical time intervention with univariate and multiple linear regression. Out of 13 variables, 9 were found statistically significant. The most significant predictors for surgical difficulty were Body Mass Index, Depth of impacted tooth and Retromolar space. No postoperative complications were reported.


2020 ◽  
Vol 27 (1) ◽  
pp. 9
Author(s):  
Maidah Hanif ◽  
Muhammad Azhar Sheikh

Introduction: Surgery of mandibular third molar teeth for removal is one of the most common procedures undertaken in oral and maxillofacial surgery departments. The complications created by the post extraction wound healing and physiological consecution of third molar surgery can affect patients' quality of life. Platelet rich plasma (PRP) is an autologous concentrate of platelets suspended in the Plasma that accelerates healing by concentration of growth factors which lessen the inflammation and as a result pain and trismus. Materials and methods: A Study was conducted on 130 patients at the department of Oral and Maxillofacial Surgery, FUCD Islamabad, for a period of 6 months after ethical approval. The patients with impacted mandibular wisdom teeth were selected and divided equally into two equal groups. The pain score was measured using the visual analogue scale (VAS) and trismus was measured using Vernier caliper before the surgery, immediately after surgery, on 3rd and 7th follow up visits. Results: The mean postoperative pain on 7th day was significantly lower in the PRP group with statistically significant P-value <0.0001. Trismus was also less reported in the PRP group with P-value <0.00065. Conclusion: Platelet Rich Plasma is effective to lessen trismus and pain after surgical removal of mandibular third molar teeth.


RSBO ◽  
2016 ◽  
Vol 12 (1) ◽  
pp. 98
Author(s):  
Radamés Bezerra Melo ◽  
Yuri Edward de Souza Damasceno ◽  
Celio Armando Couto da Cunha Junior ◽  
Igor Vasconcelos Pontes

Introduction: The dentigerous cyst, also called a follicular cyst is an odontogenic cyst that develops in association with crown of an impacted tooth, predominantly in mandibular third molars of young patients. The Odontoma is a ectomesenquimal tumor of unknown origin that are more considered developmental malformations (harmatomas) than benign neoplasms. Occasionally, the dentigerous cyst is associated with odontoma. Objective: The article aims to report a case of surgical treatment of dentigerous cyst associated with compound odontoma and unerupted tooth in anterior region of the mandible. Case report: A male patient, 17 years of age, without systemic changes, was sent to the Center for Dental Specialties of Horizonte, Ceará, Brazil, specialty of Oral and Maxillofacial Surgery, for diagnosis and treatment of oral lesions visualized after periapical radiographic examination to determine failed eruption of element 42. Observing the periapical radiograph it was possible to visualize radiopaque lesion suggestive of a compound odontoma and a cystic capsule in association with the element 42. A panoramic radiographwas requested and it was planned a surgical removal of odontoma with curettage of bone cavity and removing the cystic capsule and element 42. There were no significant postoperative complications, the suture removal was performed 7 days after surgery where it was possible to observe a good healing, no swelling and no paresthesia. Conclusion: The treatment of choice is surgical excision of the lesions with the tooth associated to the cyst, it should be performed with proper planning, avoiding injury to vital structures and should not be delayed in order to avoid possible occlusion sequelae.


2012 ◽  
Vol 65 (5-6) ◽  
pp. 233-237
Author(s):  
Sinisa Mirkovic ◽  
Ivan Sarcev ◽  
Branislav Bajkin ◽  
Ana Tadic ◽  
Tatjana Djurdjevic-Mirkovic

Introduction. Therapy of impacted teeth is undoubtedly one of the most intriguing issues for the experts in the field of dentistry. General dental practitioners, as well as specialists in the field of pediatric dentistry, periodontology, orthodontics and particularly oral and maxillofacial surgery have been facing this challenge throughout past several years. Each of these experts can contribute to solving this problem; however, each of them alone can solve only a limited number of cases. Discussion and Conclusion. Since recently, the fate of impacted tooth has been determined mainly by the competence, experience and skill of the orthodontist to apply light traction in an appropriate direction once the tooth has been made surgically exposed. Oral surgeon and orthodontist should share the responsibility for a patient with impaction as they together have the necessary skill and competence required for an effective therapy. In addition, dental age of the child is to be taken into consideration, as well as his/her overall health status and potential interference with other anomalies of dental arch.


2018 ◽  
Vol 17 ◽  
pp. e18224
Author(s):  
Yeon Jung Kim ◽  
Ana Maria Barg da Silva ◽  
Mirko Dennys Ayala Perez ◽  
Heloisa F. Marão ◽  
Debora Pallos

The most commonly performed surgical procedure in Oral and Maxillofacial Surgery practices are the removal of impacted third molars. Extensive training, skill and experience allow this procedure to be performed in an atraumatic approach. The aim of this study was to drawing attention to the importance of the correct management of the complications cases of foreign body inside maxillary sinus after surgical removal of maxillary third molars. This is an unusual clinical case of a dental surgical bur accidentally displacement into the maxillary sinus during an upper third molar extraction surgery. After removal, the clinical case showed a satisfactory repair emphasizing the importance of a meticulous clinical examination to achieve a correct diagnosis and an appropriate treatment plan, which is essential for a favorable prognosis.


2019 ◽  
Vol 28 (3) ◽  
pp. 231-235 ◽  
Author(s):  
Yukari Shintani ◽  
Takashi Nakanishi ◽  
Masamichi Ueda ◽  
Naoki Mizobata ◽  
Itaru Tojyo ◽  
...  

Objective: Mandibular third molar extractions are important in oral maxillofacial surgery. Damage to the lingual nerves, although rare, is a possible complication. There are reports of postoperative recovery after lingual nerve repair, but few reports have compared subjective and objective assessments of neurosensory function. Therefore, this study aims to compare subjective and objective assessments of neurosensory function after lingual nerve repair. Subjects and Methods: This retrospective cohort study comprised 52 patients with lingual nerve anesthesia after third molar extraction at the Department of Oral and Maxillofacial Surgery, Wakayama Medical University Hospital, Wakayama, Japan, between December 2008 and December 2015. We recorded pre- and postoperative (6 months and 12 months) neurosensory examinations. Results: Patient’s subjective assessments of neurosensory function suggested improvement between the preoperative period and 12 months postoperation, although this difference was not significant. Objective assessment based on examination and testing, on the other hand, showed a significant difference in improvement (p < 0.05). Conclusions: There was no evidence that improvement of subjective preoperative and postoperative assessments was significantly associated with improvement of objective neurosensory assessments after lingual nerve repair. Overall physical condition and background were thought to affect subjective evaluation. Subjective assessment is important in conjunction with objective evaluation because it may reveal dysesthesia that would otherwise be missed. In the future, we will examine those cases in whom subjective assessments showed no improvement although objective assessments showed improvement.


Author(s):  
Khaled Ramzi Shora ◽  
Kashif Ali Channar ◽  
Irfan Ahmed Shaikh ◽  
Abdul Bari Memon ◽  
Abdul Hayee Shaikh ◽  
...  

Aim: The aim of this study was to evaluate the clinical presentation of mandibular impacted teeth and associated pathologies in Unaizah, Al Qaseem; Saudi Arabia. Study Design: Descriptive cross sectional study. Place and Duration of Study: Department of Oral and Maxillofacial Surgery (OMFS), King Saud Hospital Unaizah Saudi Arabia from March 2019 and December 2020. Methodology: The record of patients attending dental section was reviewed from hospital record. Demographic data of patients were recorded through medical record Number by Medicapluse software. Orthopantamograms (OPGs) xrays were reviewed by maxillofacial surgeons on Dell LCD using software IMPEX 6.3.1.2794 enterprise unlimited Agfa. The variables like presence of impacted tooth, type of angulations, reason for extraction, caries on distal surface of 2nd molar tooth, and occlusal or mesial surface of 3rd molar were examined on OPGs. Data was analyzed using SPSS version-21. Results: Males and females were 49% and 51% respectively. The most common type of impaction was vertical 45%, followed by horizontal 27% and mesio angular 22%. The impacted tooth on right side was observed as 51% and on left side as 49%. The relationship of gender with type of impaction was statistically insignificant (p value-0.157). The relationship was reasons and type of impaction was statistically insignificant (p value-0.317) Conclusion: the both genders were almost equally affected. Vertical Impactions were more frequent and the pericoronitis was common reason for extraction of mandibular third molar. The relationship of gender and type of impaction was not significantly associated with type of impaction.


Author(s):  
Thaufiq Ahamed M. I. ◽  
Naveen Jayakumar ◽  
Neelakandan R. S.

Background: The aim of this prospective study was to determine the incidences of inferior alveolar nerve and lingual nerve deficit following surgical removal of impacted mandibular third molars and to evaluate the risk factors responsible for these postoperative neurosensory deficits.Methods: A total of 80 patients who reported to department of oral and maxillofacial surgery, Meenakshi Ammal Dental College, Chennai, Tamil Nadu, India requiring surgical removal of impacted mandibular third molar were included in this cross-sectional study. Standard surgical procedure was performed. All patients were reassessed one week post-surgery. Subjectively reported altered sensations were recorded and objective assessments were performed with light touch test, two-point discrimination threshold and pin-pick pain threshold. The collected data was analyzed using the chi square test to find out any clinical relevance.Results: There was no inferior alveolar nerve related neurosensory deficits and 6 (7.5%) resulted in lingual nerve related neurosensory deficits. The incidence of LN deficit for mesioangular, horizontal, distoangular was 1.3%, 3.8% and 2.5% respectively. Type of impaction assumed a mild statistical significance (p = 0.050).Conclusions: This study highlights the importance of careful preoperative clinical and radiographic assessment of patients where third molar surgery is planned. The surgical technique of third molar removal is also likely to have great impact on the outcome.


2021 ◽  
Vol 24 (4) ◽  
Author(s):  
Dena Ali

Objective: The aim of this study was to determine the complications that were associated with the surgical removal of third molars (M3s), and to assess the association of patient, anatomic, and surgical risk factors with the postoperative complications of surgically removed impacted M3s. Material and Methods: This study was a cohort prospective study conducted on patients, aged 17 and older, admitted to the oral and maxillofacial surgery clinic. All patients who needed 1 or more extractions were included and totalled 268 patients with 314 extracted teeth. Risk factors were divided into patient factors, anatomic factors and surgical factors. The postoperative complication variables mainly included: pain, alveolar osteitis, infection, bleeding, swelling, trismus. Statistical analysis used: Chi-square test was used for the bivariate analyses while Pearson correlation coefficient (1- tailed) test was used for the purpose of determining the association between the study variables. The significance of associations was considered statistically significant at P < 0.05. Results: Patients aged of 25 years and above experienced more complications, 39 (88.6%). With respect to gender, females experienced more complications, 29 (65.9%). Mandibular M3s had more complications than maxillary M3s, 34 (8.0%), followed by distoangular inclined M3s, 23 (52.3%), and last was full bony impaction, 13 (29.5%). Pain was the most frequent complication, 18 (40.9%), followed by alveolar osteitis 12 (27.3%). Conclusion: The results indicated that the most frequently complications were pain, infection, alveolar osteitis. These complications were associated with common risk factors such as age, gender, medical history, M3 angulation, impaction level, bone removal, tooth sectioning, and number of M3 removed per session. Keywords  Complications; Surgical extraction; Third molar.


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