scholarly journals Management of Unilateral Multiple Impacted Molars- An Interdisciplinary Approach of a Rare Clinical Case

2021 ◽  
Author(s):  
S Gopalakrishnan ◽  
. Kamal ◽  
. Karthikeyan ◽  
V Keerthi Narayan ◽  
D Gomathy
Keyword(s):  
Third Molar ◽  
Mouth Opening ◽  
Interdisciplinary Approach ◽  
Surgical Removal ◽  
Graft Material ◽  
Therapeutic Approaches ◽  
Optimal Outcomes ◽  
Ceramic Crowns ◽  
One Year ◽  
Fixed Orthodontic Appliance

Impaction of first, second and third molars at once comprise a rare clinical scenario with diverse therapeutic approaches and possess a great challenge for the dentist. Early detection of the eruption disturbances helps to manage and produce optimal outcomes. Here, the authors reported a case of 17-year-old male patient who reported with the chief complaint of pain in his lower left back tooth region with difficulty in mouth opening and chewing that revealed impacted mandibular left first, second and third molar on radiographic investigation. A proper decision making is required to satisfy the patient and also get an effective result. As the patient had severe pain in the left side of the jaw near the angle of the mandible, surgical removal of the impacted molars was planned and performed using extra oral submandibular approach. Following the removal of the teeth, implants were placed in the extracted site supported by bone graft material and fixed orthodontic appliance therapy was carried out to correct the supra- erupted upper molars on the left side and arch expansion screw with upper Hawley’s appliance was given to expand the maxillary arch to aid in appropriate occlusion. Restoration of the implant was done after one year of orthodontic treatment using ceramic crowns. The combined surgical, orthodontic and periodontal interdisciplinary approach helped the patient to gain proper occlusion and satisfactory masticatory function.

scholarly journals TO COMPARE THE EFFECT OF PRE-EMPTIVE DEXAMETHASONE AND METHYLPREDNISOLONE EITHER BY INTRAMUSCULAR OR BY SUBMUCOSAL ROUTE FOR THE POSTOPERATIVE CONTROL OF PAIN, SWELLING, AND LIMITED MOUTH OPENING FOLLOWING THE EXTRACTION OF IMPACTED THIRD MOLARS

2020 ◽  
pp. 1-7
Author(s):  
Kiran Shubha ◽  
Ravi Narula ◽  
Navneet Kaur
Keyword(s):  
Intramuscular Injection ◽  
Third Molar ◽  
Mouth Opening ◽  
Surgical Removal ◽  
Third Molars ◽  
Limited Mouth Opening ◽  
Submucosal Injection ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars ◽  
Better Than

Introduction: The surgical removal of impacted mandibular third molars is an invasive procedure that involves extensive tissue trauma and a considerable postoperative inflammatory response. Although the inflammatory process is necessary for healing when exacerbated it may cause pain, swelling and limited mouth opening. Corticosteroids are among the most widely employed pre-operative medication administered for the control of such complications. Objective: To compare the effects of single dose of pre-operative Injection Dexamethasone versus Injection Methylprednisolone via Intramuscular or Submucosal route for controlling the post-operative pain, swelling and limited mouth opening in the removal of impacted mandibular third molars. Material and Method:. The present study was conducted on 40 healthy adult patients with bilaterally symmetrical impacted mandibular third molar, reporting to the Department of oral and Maxillofacial Surgery of Guru Nanak Dev Dental College and Research Institute, Sunam. Clinically, pain, swelling, mouth-opening were evaluated pre-operatively as baseline and post-operatively on 1st, 3rd and 7th post-operative days. Results: The results of our study are summarized below: In Group A: Submucosal injection of dexamethasone gave better results in controlling pain, swelling and trismus in comparison to Intramuscular injection of dexamethasone. In Group B: Submucosal injection of methylprednisolone showed better results in terms of pain, swelling and trismus when compared with Intramuscular injection of methylprednisolone. In Group C: Intramuscular injection of dexamethasone gave better results in terms of pain and mouth opening but, swelling was reduced with Intramuscular methylprednisolone. In Group D: Submucosal injection of dexamethasone showed better results in terms of pain, but swelling and mouth opening was reduced when methylprednisolone was used submucosal. Conclusion: The results of our study concluded that Dexamethasone is better than Methylprednisolone in controlling post-operative sequelae after third molar surgery. This can attributed to the higher potency and longer half-life and less sodium retaining capacity of dexamethasone than methylprednisolone. The results of our study also concluded that submucosal route of administration of drug is better than Intramuscular route because of the repository effect of the submucosal route, also this route is beneficial to the patient as well to the surgeon because needle penetration is done in the pre-anesthetized area, also it is an easy technique to be mastered by the surgeon.

scholarly journals Efficacy of platelet rich plasma (PRP) on mouth opening and pain after surgical extraction of mandibular third molars

2020 ◽  
Vol 27 (1) ◽  
pp. 9
Author(s):  
Maidah Hanif ◽  
Muhammad Azhar Sheikh
Keyword(s):  
Platelet Rich Plasma ◽  
Maxillofacial Surgery ◽  
Third Molar ◽  
Mouth Opening ◽  
Third Molar Surgery ◽  
Oral And Maxillofacial Surgery ◽  
Surgical Removal ◽  
Mandibular Third Molar ◽  
Surgical Extraction ◽  
Molar Teeth

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.

Comparative Effectiveness of the Homeopathic Preparation Traumeel S in Third Molar Extraction Surgery: A Preliminary Triple-Blind Clinical Trial

Homeopathy ◽  
2021 ◽  
Author(s):  
Glaciele Maria de Souza ◽  
Ighor Andrade Fernandes ◽  
Marcos Luciano Pimenta Pinheiro ◽  
Saulo Gabriel Moreira Falci
Keyword(s):  
Clinical Trial ◽  
Null Hypothesis ◽  
Third Molar ◽  
Mouth Opening ◽  
Surgical Removal ◽  
Linear Measurements ◽  
Significance Level ◽  
Third Molar Extraction ◽  
Homeopathic Preparation ◽  
Molar Extraction

Abstract Background and Aim This preliminary study aimed to evaluate whether a homeopathic preparation (Traumeel S) might be a good option to control post-operative outcomes (pain, edema and trismus) associated with surgical removal of mandibular third molar teeth. The null hypothesis was that Traumeel S is not different from dexamethasone (gold standard) in controlling these post-operative inflammatory complications. Methods A randomized, “split-mouth”, triple-blind clinical trial was conducted. Seventeen healthy patients with a mean age of 20.94 ( ± 5.83) years had their lower asymptomatic bilateral third molars removed. Patients were randomized to receive Traumeel S or dexamethasone pre-operatively by injection into the masseter muscle; each patient acted as his/her own control. At 24, 48, 72 hours and 7 days after the surgery, the pain was evaluated according to a visual analog scale, edema through linear measurements of the face, and trismus through the maximum buccal opening. Wilcoxon statistics or paired t-test were used, and a significance level of 95% was adopted. Results For pain, the results for Traumeel S were not different (p > 0.05) from those of dexamethasone after 24 hours, 72 hours, and 7 days. For edema, the results for Traumeel S were not different (p > 0.05) from those of dexamethasone at all post-operative evaluations. For mouth opening, the results for Traumeel S were not different (p > 0.05) from those of dexamethasone at 72 hours and 7 days after third molar extraction. Conclusion With the exception of some early post-operative findings, the null hypothesis is not rejected. Traumeel S might be a good alternative approach to dexamethasone for controlling pain, edema and trismus after third molar removal.

scholarly journals Comparative Evaluation of Two Different Flap Designs and Postoperative Outcome in the Surgical Removal of Impacted Mandibular Third Molar

2017 ◽  
Vol 18 (9) ◽  
pp. 807-811 ◽  
Author(s):  
Shabeer Ahamed ◽  
A Rabi ◽  
PM Mohamed Haris ◽  
Deepu M Panickal ◽  
Venith J Pulikkottil ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Third Molar ◽  
Mouth Opening ◽  
Postoperative Outcome ◽  
Study Groups ◽  
Surgical Removal ◽  
Triangular Flap ◽  
Impacted Mandibular Third Molar ◽  
Mandibular Third Molar ◽  
Significant Difference

ABSTRACT Aim The aim of this study is to compare triangular and envelope flap designs and the postoperative outcome in the surgical removal of impacted mandibular third molar. Materials and methods A total of 50 participants were assessed clinically and were divided randomly into two groups. Group I (participants operated by triangular flap) and group II (participants operated by envelope flap), with 25 participants each between the age group of 20 and 30 years. Patient satisfaction was assessed subjectively using a graded scale from very satisfied to very unsatisfied. The degree of pain was recorded for 7 days with reference to predefined values on visual analog scale (VAS). Trismus was evaluated on the day 3, day 5, and day 7 of the postoperative period in millimeters. Quantitative data were analyzed by unpaired t-test and qualitative data were by Fischer's exact test. Results The mean overall age is 25.5 years. There was no statistically significant difference between the study groups with respect to age. There was no significant association between the patient satisfaction and flap type (p = 0.684). A significant difference between the study groups on 4th, 5th, and 6th days with respect to pain was observed, wherein fewer subjects operated with triangular flap reported pain. A highly significant difference in mouth opening was observed, with triangular flap group participants having a higher mouth opening than envelope flap subjects on day 7. Conclusion The present study indicated that participants operated by triangular flap had a better mouth opening postoperatively compared with envelope flap participants, whereas there were no significant differences in patient satisfaction and pain scores at the end of the 7th day after third molar surgery. Clinical significance Flap design is a significant factor in the surgical removal of impacted third molar, and it influences the severity of complications. Furthermore, it is important for allowing optimal visibility and access to the impacted tooth and also for subsequent healing of the surgically created defect. How to cite this article Rabi A, Haris PMM, Panickal DM, Ahamed S, Pulikkottil VJ, Haris KTM. Comparative Evaluation of Two Different Flap Designs and Postoperative Outcome in the Surgical Removal of Impacted Mandibular Third Molar. J Contemp Dent Pract 2017;18(9):807-811.

scholarly journals Alveolar Preservation with Albumin and Gentamycin-Coated Allograft after Third Molar Tooth Removal: A Randomized Clinical Trial

2021 ◽  
Vol 11 (2) ◽  
pp. 586
Author(s):  
Fanni Minya ◽  
Balint Trimmel ◽  
Laszlo Simonffy ◽  
Szabolcs Gyulai-Gaal ◽  
Zsombor Lacza ◽  
...  
Keyword(s):  
Third Molar ◽  
Test Group ◽  
Control Group ◽  
Surgical Removal ◽  
Second Molar ◽  
Bone Level ◽  
One Year ◽  
Cbct Analysis ◽  
Pocket Formation ◽  
Tooth Removal

Alveolar preservation can minimize bone resorption after tooth removal and additional topical antibiotics might also be considered. The goal of this study was to observe alveolar preservation with albumin and gentamycin-coated allograft compared to unfilled control sockets after mandibular third molar removal. Twenty-two patients were involved, 11 in the control group and 11 in the test group. CBCT analysis and micromorphometric analysis were performed. After one year, graft integration was observed with remaining graft particles. Micromorphometric analysis showed increased density and lower trabeculae formation in the grafted group. The buccal height reduction of the alveolar ridge was significantly lower when alveolar preservation was applied (control: 2.54 ± 2.01 mm, graft: 1.37 ± 1.04 mm, p < 0.05). Horizontal bone loss prevention was not significant. At the distal site of the second molar, the marginal bone level (MBL) was significantly lower in the control group. At the control group, five pockets persisted from the eight initial and all healed in the graft group. Alveolar preservation improves bone formation, helps to preserve the buccal bone crest, and minimizes MBL loss and pocket formation on the adjacent teeth. Thus, it needs to be also considered after third molar surgical removal.

scholarly journals Efficacy of various administrative techniques of methylprednisolone on oedema, trismus and pain after lower third molar surgery

2017 ◽  
Vol 5 (2) ◽  
pp. 186 ◽  
Author(s):  
Vaibhav Mukund ◽  
Sukumar Singh ◽  
Sanjeev Kumar ◽  
Rishi Rath ◽  
Siddharth Tevatia
Keyword(s):  
Third Molar ◽  
Mouth Opening ◽  
Controlled Study ◽  
Third Molar Surgery ◽  
Surgical Removal ◽  
Routes Of Administration ◽  
Group A ◽  
Maximal Mouth Opening ◽  
Level Of Significance ◽  
Group B

Due to their anatomical position, the surgical removal of impacted third molars results in oedema, pain, and trismus. The purpose of this study was to evaluate the efficacy of four different routes of administration of methylprednisolone on oedema, trismus and pain after lower third molar surgery. This randomized, perspective, and controlled study included 150 patients. The patients were randomly divided into five groups: Group A (control; no steroids), Group B (Submucosal injection), Group C (oral tablets), Group D (i.v. injection) and Group E (Intramuscular Injection). On days 2 and 7 following surgery, linear oedema was determined using facial landmarks, and maximal mouth opening was measured. Postoperative mouths opening and swelling were evaluated for each route of methylprednisolone administration and compared. The female (59%) to male (41%) ratio was 1.44; the mean age of the patients was 29.6 years. The level of significance was set at P < 0.01 for mouth opening and P < 0.05 for oedema. With regard to trismus, all four routes of administration demonstrated better efficacy in comparison to the control. While oral administration and i.v. injection of methylprednisolone achieved similar results, masseter injection provided better results in reducing oedema and trismus when compared with the control following lower third molar surgery.

scholarly journals Efficacy of hyaluronic acid gel in management of post-operative complications after removal of third molar - A Systematic review

2020 ◽  
Vol 11 (4) ◽  
pp. 6155-6163
Author(s):  
Divya Sanjeevi Ramakrishnan ◽  
Sudarssan Subramaniam Gouthaman ◽  
Janani Kandamani ◽  
Senthilnathan Periasamy
Keyword(s):  
Systematic Review ◽  
Postoperative Complications ◽  
Third Molar ◽  
Mouth Opening ◽  
Secondary Outcome ◽  
Surgical Removal ◽  
Manual Search ◽  
Operative Complications ◽  
Acid Gel ◽  
Post Operative Complications

The surgical removal of third molar is the commonly performed procedure in oral and surgery. It takes several days to recover from the complications following removal of the third molar. The common postoperative complications are pain, swelling, , alveolar after third molar removal The aim of this systematic review was to thoroughly the existing literature to evaluate the effect of socket versus extra socket application of acid gel in management of postoperative complications after third molar removal. The objective of this systematic review is to assess the efficacy of socket versus extra socket application of acid gel compared to placebo or no treatment in management of post-operative complications after removal of third molar.The data bases of PubMed, and google scholar were searched for the related topics along with a complimentary manual search of all oral surgery journals till October 2018.The data collection form was based on analysis of included studies for their quality assessment and publication bias.The primary outcome measure was post-operative pain and the secondary outcome measures were post-operative swelling &amp; post-operative mouth opening. Three articles were selected based on the inclusion criteria. The included studies were randomized controlled trials. The clinical evidence from this review shows acid gel application is found to be beneficial in reducing pain, swelling &amp; after surgical removal of third molar. After contemplating its pivotal role in various anti- inflammatory diseases, it is prudent to consider as an alternative in managing postoperative of third molar removal.

scholarly journals Efficacy of L-Ascorbic acid in the healing of extraction site after trans alveolar extraction of third molar teeth

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 1179-1182
Author(s):  
Subhashini Ramasubbu ◽  
Shivangi Gaur ◽  
Abdul Wahab P U ◽  
Madhulaxmi Marimuthu
Keyword(s):  
Wound Healing ◽  
Ascorbic Acid ◽  
Vitamin C ◽  
Third Molar ◽  
Mouth Opening ◽  
Surgical Removal ◽  
Significant Difference ◽  
Tissue Flap ◽  
Group B ◽  
Soft Tissue Flap

Wound healing monitoring after every surgery is the most vital concern to deal with. The surgical removal of the teeth involves guttering of overlying bone, splitting the tooth (odontectomy), delivery of the tooth, irrigation of the socket, achieving haemostasis and closure of the soft tissue flap. This leads to big surgical insults resulting in post-operative inflammatory response like pain and swelling, difficulty in mouth opening, fever, etc. In some cases, other rare complications, including infection, nerve damage, have also been reported. The objective of this study is to evaluate the effects of submucosal injection of vitamin c (L-Ascorbic Acid) in wound healing after trans alveolar extraction of teeth. Thirty patients requiring trans alveolar extraction of teeth were included in this study. Patients were divided into two groups, Group S (Vit c) and Group B (Control). Healing of extraction socket was observed on 3rd and 7th post-operative days. The study group (Vitamin C) had better healing indices than the controls at 7th post-op day. There was no significant difference in 3rd post-op day. There was no significant reduction in pain on 3rd and 7th post-operative days. L-Ascorbic acid injection provides satisfactory post-operative healing following trans alveolar extraction of teeth. But it does not decrease the post-operative pain following surgery.

scholarly journals Evaluation of Panoramic Radiographs in Relation to the Mandibular Third Molar and to Incidental Findings in an Adult Population

2020 ◽  
Author(s):  
Josefine Cederhag ◽  
Nina Lundegren ◽  
Per Alstergren ◽  
Xie-Qi Shi ◽  
Kristina Hellén-Halme
Keyword(s):  
Incidental Findings ◽  
Adult Population ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Patient Positioning ◽  
Vertical Position ◽  
Surgical Removal ◽  
Third Molars ◽  
Panoramic Radiographs ◽  
The Third

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.

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