Assessment of Lingual Nerve Paresthesia after Removal of Mandibular Third Molar

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.

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Wisdom Tooth—Complications in Extraction

The Journal of Contemporary Dental Practice ◽

10.5005/jp-journals-10024-1484 ◽

2014 ◽

Vol 15 (1) ◽

pp. 34-36 ◽

Cited By ~ 4

Author(s):

Nishi Singh ◽

Amiya Agrawal ◽

Arvind Yadav ◽

Siddhartha Chandel ◽

Ankita Singhal

Keyword(s):

Retrospective Study ◽

Third Molar ◽

Lingual Nerve ◽

Root Tip ◽

Third Molars ◽

Wisdom Tooth ◽

Mandibular Third Molar ◽

Alveolar Osteitis ◽

Impacted Mandibular Third Molars ◽

Mandibular Third Molars

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.

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Retrospective analysis of malpositioned mandibular third molars in elderly patients

Iraqi Dental Journal ◽

10.46466/idj.v41i2.193 ◽

2019 ◽

Vol 41 (2) ◽

pp. 1-7

Author(s):

Charles E. Anyanechi ◽

Birch D Saheeb

Keyword(s):

Elderly Patients ◽

Third Molar ◽

Third Molars ◽

Hospital Records ◽

Mandibular Third Molar ◽

Surgical Extraction ◽

Alveolar Osteitis ◽

Impacted Mandibular Third Molars ◽

The Common ◽

Mandibular Third Molars

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.

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Comparison of Piezosurgery and Conventional Rotary Instruments for Removal of Impacted Mandibular Third Molars: A Randomized Controlled Clinical and Radiographic Trial

International Journal of Dentistry ◽

10.1155/2016/8169356 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 10

Author(s):

Hani Arakji ◽

Mohamed Shokry ◽

Nayer Aboelsaad

Keyword(s):

Statistical Significance ◽

Third Molar ◽

Test Site ◽

Surgical Removal ◽

Third Molars ◽

Randomized Controlled ◽

Surgical Extraction ◽

Impacted Mandibular Third Molars ◽

Mandibular Third Molars ◽

Bone Quantity

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.

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Lingual split bone technique – Revisited as a standard operating procedure for surgical removal of third molar during COVID pandemic

Journal of Academy of Dental Education ◽

10.25259/jade_3_2021 ◽

2021 ◽

Vol 7 ◽

pp. 18-22

Author(s):

Sushmitha Mohan ◽

Annamalai Thangavelu ◽

Aravindraj

Keyword(s):

Operating Procedure ◽

Third Molar ◽

Standard Operating Procedure ◽

Surgical Removal ◽

Third Molars ◽

Standard Operating ◽

Infectivity Rate ◽

Alveolar Osteitis ◽

Impacted Mandibular Third Molars ◽

Mandibular Third Molars

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.

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Is prophylactic extraction of mandibular third molar indicated? A retrospective study.

10.21203/rs.3.rs-32327/v1 ◽

2020 ◽

Author(s):

Zhouxi Ye ◽

Wenhao Qian ◽

Yubo Wu ◽

Bing Sun ◽

Zhiyao Li ◽

...

Keyword(s):

Soft Tissue ◽

Older Patients ◽

Third Molar ◽

P Value ◽

Third Molars ◽

Impacted Teeth ◽

Second Molar ◽

Mandibular Third Molar ◽

Mandibular Second Molar ◽

Mandibular Third Molars

Abstract Background To evaluate the associations of impaction patterns of mandibular third molars (M3Ms) with pathologies caused by them. Methods In this study, 262 patients with 432 impacted M3Ms were included. The pathologies include pericoronitis, mandibular second molar (M2M) caries, and M2M distal periodontal pathology. The impaction patterns of M3Ms and the pathologies were examined, and the M2Ms outcomes after the surgeries were evaluated. χ2 test was used to analyze the data and a P value of <0.05 was considered statistically significant. Results Pericoronitis was the major symptom in all patients, whereas the propensities of M2M distal caries and periodontal pathologies increased in older patients. Soft tissue impacted and vertically angulated teeth were more associated with the pericoronitis (p <0.05); Mesio-angular impacted teeth in less deep positions had greater risks of M2Ms distal caries (p <0.05); Mesio-angular and horizontal impacted teeth in relative deep positions were more likely to cause M2Ms distal periodontal pathologies (p <0.05). Conclusions Extractions of soft tissue impacted teeth in vertical angulations should be considered. While removals of mesially and horizontally angulated or bony impacted teeth could be delayed.

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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

10.36106/ijsr/1824575 ◽

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.

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Flap vs flapless technique for impacted third molar removal: A split mouth prospective randomized control study

Journal of Oral Medicine Oral Surgery Oral Pathology and Oral Radiology ◽

10.18231/j.jooo.2021.051 ◽

2021 ◽

Vol 7 (3) ◽

pp. 167-171

Author(s):

Neeraj ◽

Banshilal Beniwal ◽

Padmanidhi Agarwal ◽

Vikas Berwal ◽

Richa Malik

Keyword(s):

Healing Process ◽

Third Molar ◽

Mouth Opening ◽

Third Molars ◽

Pocket Depth ◽

Second Molar ◽

Group I ◽

Flap Design ◽

Impacted Mandibular Third Molars ◽

Mandibular Third Molars

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.

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Factors associated with spontaneous mesialization of impacted mandibular third molars after second molar protraction

The Angle Orthodontist ◽

10.2319/050919-322.1 ◽

2019 ◽

Vol 90 (2) ◽

pp. 181-186

Author(s):

Un-Bong Baik ◽

Jin Hye Kang ◽

Ui-Lyong Lee ◽

Nikhilesh R Vaid ◽

Yoon-Ji Kim ◽

...

Keyword(s):

Third Molar ◽

Regression Analyses ◽

Third Molars ◽

Second Molar ◽

Factors Associated ◽

The Third ◽

Mandibular Second Molar ◽

Impacted Mandibular Third Molars ◽

Mandibular Third Molars ◽

Mandibular First Molar

ABSTRACT Objectives: To investigate factors associated with spontaneous mesialization of impacted third molars after second molar protraction to close the space caused by a missing mandibular first molar (L-6) or retained deciduous mandibular second molars with a missing succedaneous premolar (L-E). Materials and Methods: Panoramic radiographs of patients treated with mandibular second molar protraction to close the space due to missing L-6 or L-E (14 males, 36 females, mean age = 18.6 ± 4.4 years) were analyzed before treatment (T1) and after second molar protraction (T2). Factors associated with the amount of third molar mesialization were investigated using regression analyses. Results: Mandibular second molars were protracted by 5.1 ± 2.1 mm and 5.8 ± 2.7 mm, measured at the crown and root furcation, respectively. After second molar protraction, third molars showed spontaneous mesialization by 4.3 ± 1.6 mm and 3.8 ± 2.6 mm, measured at the crown and root furcation, respectively. Nolla's stage of the third molar at T1 (B = 0.20, P = .026) and second molar protraction time (B = 0.04, P = .042) were significantly associated with the amount of third molar mesialization. Conclusions: Greater third molar mesialization was observed when Nolla's stage of the third molar was higher before treatment and when the second molar protraction time was longer.

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Prevalence of mandibular third molar impaction pattern in a private dental clinic of Sultanpur Lodhi

International Journal of Health ◽

10.14419/ijh.v3i2.5173 ◽

2015 ◽

Vol 3 (2) ◽

pp. 47

Author(s):

Pushappreet Kaur

Keyword(s):

Third Molar ◽

Third Molars ◽

Radiographic Assessment ◽

Dental Clinic ◽

Impacted Tooth ◽

Mandibular Third Molar ◽

Class 1 ◽

Impacted Mandibular Third Molars ◽

Tooth Number ◽

Mandibular Third Molars

Background: 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.Objective: 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.Methodology: 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.Results and Conclusion: 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.

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Vertical eruption patterns of impacted mandibular third molars after the mesialization of second molars using miniscrews

The Angle Orthodontist ◽

10.2319/061415-399.1 ◽

2014 ◽

Vol 86 (4) ◽

pp. 565-570 ◽

Cited By ~ 9

Author(s):

Un-Bong Baik ◽

Yoon-Ah Kook ◽

Mohamed Bayome ◽

Je-Uk Park ◽

Jae Hyun Park

Keyword(s):

Third Molar ◽

Control Group ◽

Third Molars ◽

Panoramic Radiographs ◽

Second Molar ◽

Space Closure ◽

Impacted Mandibular Third Molars ◽

Group 2 ◽

Mandibular Third Molars ◽

Group 1

ABSTRACT Objective: To investigate (1) whether vertical eruption of impacted third molars improves after mesialization of second molars and (2) what factors affect the vertical eruption of impacted third molars when space caused by missing molars is successfully closed by mesialization of the second molar using miniscrews. Materials and Methods: The treatment group (Group 1) included 52 patients who had (1) missing mandibular first molars (ML-6) or missing deciduous mandibular second molars (ML-E), (2) initially impacted mandibular third molars, and (3) successful space closure of the edentulous area with orthodontics. Panoramic radiographs at start of treatment (T1) and at time of space closure (T2) were collected. The control group (Group 2) included 46 nonedentulous patients with impacted mandibular third molars without molar protraction treatment. Panoramic radiographs with similar T1/T2 treatment times were selected. Nine measurements were obtained regarding horizontal available space, vertical eruption, and third molar angulation. Results: Third molars erupted vertically an average of 2.54 mm in Group 1 compared with 0.41 mm in Group 2. Age, gender, Nolla stage, and angle of the third molars did not show significant correlations with the vertical change of the impacted third molars, whereas the depth of third molar impaction and available space showed significant correlations. Conclusions: Impacted mandibular third molars vertically erupt as a result of uprighting with mesialization of the second molar, and vertical eruption is affected by the initial vertical location of impacted third molars and available space.

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