scholarly journals Comparison of Complications of Extraction among Partially Impacted Mandibular Third Molars with or without a Buccal Flap

2021 ◽  
pp. 12-19
Author(s):  
M. Ahmed Khan ◽  
Tahera Ayub ◽  
Bibi Gulsama ◽  
Azizullah Muhammad Nawaz Qureshi ◽  
Aosaf Anwar Memon ◽  
...  
Keyword(s):  
Operative Time ◽  
Maxillofacial Surgery ◽  
Operating Time ◽  
Periodontal Pocket ◽  
Third Molars ◽  
Significant Difference ◽  
Impacted Mandibular Third Molars ◽  
Buccal Flap ◽  
Mandibular Third Molars

Objective: To compare the complications of extraction of partially impacted mandibular third molars with or without a buccal flap. Materials And Methods: A comparative cohort study was performed at Department of Oral & Maxillofacial Surgery, Institute of Dentistry, Liaquat University Hospital, Hyderabad from September 2020 to March 2021. Sixty-two patients of either gender, having age 15-50 years and recommended for extraction of partially impacted mandibular third molars were selected by non-probability consecutive sampling technique and distributed into flapless group (31 patients) and buccal flap group (31 patients). Patients were treated with standard procedures of flapless and buccal flap, operating time was noted and follow up was done at 1st day, 2nd day post-operatively for pain, swelling, trismus, whereas periodontal pocket distal to second molar was measured at 1 month and 3 months follow up interval. Results: In flapless and buccal flap group male patients were 17 (54.8%) and 18 (58.1%) and female patients were 14 (45.2%) and 13 (41.9%) respectively with mean age of 27.4 ± 9.6 and 26.7 ± 8.4 years. Statistically significant difference was obtained in flapless and buccal flap groups in terms of operative time, pain score, swelling score, pocket depth and trismus. Conclusion: Flapless technique is more effective in conditions of operative time and post-operative complications. So, flapless technique can be used frequently for elimination of incompletely impacted mandibular third molars.

scholarly journals Influence of Lidocaine including Buprenorphine for Postoperative Analgesia after the Extraction of Mandibular Third Molars: A Randomized Controlled, Double-Blind, Split-Mouth Study

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Nimrat K. Jawanda ◽  
Anand Shukla ◽  
Anupam Singh ◽  
Kalyana C. Pentapati ◽  
Srikanth Gadicherla
Keyword(s):  
Opioid Receptors ◽  
Postoperative Analgesia ◽  
Third Molar ◽  
Control Group ◽  
Third Molars ◽  
Surgical Extraction ◽  
Significant Difference ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars ◽  
And Control

Background. The presence of opioid receptors around the peripheral nerves offers the possibility of providing postoperative analgesia, thereby encouraging the study of the effect of opioids in combination with local anesthesia (LA). Studies have also reported the efficacy of peripherally administered opioids in achieving adequate analgesia in regions with inflammation. Applying the concept of peripheral opioid receptors, our study aimed to evaluate the effectiveness of opioid analgesia in managing postoperative pain. The split-mouth study was carried out to evaluate the efficacy of buprenorphine added to lidocaine 2% in providing postoperative analgesia after the surgical extraction of the impacted mandibular third molar. Materials and Methods. We conducted a randomized, double-blinded, split-mouth trial among 21 patients with impacted mandibular third molars bilaterally. In all patients, bilateral impacted mandibular third molars were extracted at different periods. The primary outcomes assessed were postoperative analgesia by the VAS score and the number of rescue analgesics consumed by patients at 24, 48, and 72 hours of interval via a questionnaire. Results. There was a statistical significant difference in postoperative analgesia duration at 24 (P = 0.012) and 48 hours (P = 0.024), respectively, between the test and control group. Even though the mean number of rescue analgesics consumed by the test group was less than that of the control group, no significant difference was seen. Conclusion. Buprenorphine added to lidocaine 2% showed a minimal decrease in the pain score and duration of postoperative analgesia with no difference in the frequency of rescue analgesics consumed between the test and control.

scholarly journals Comparative evaluation of effectiveness of 2% lignocaine hydrochloride with 1.5% potassium chloride versus 2% lignocaine hydrochloride with adrenaline bitartrate versus 2% lignocaine hydrochloride as local anaesthetic for adult patients undergoing surgical extraction of impacted mandibular third molars: a randomized controlled clinical study

2021 ◽  
Vol 27 (4) ◽  
pp. 55
Author(s):  
Rinku Kalra ◽  
Shreyas Gupte ◽  
Thomson D'Cruz ◽  
Nidhi Pandey ◽  
Drishti Shah ◽  
...  
Keyword(s):  
Potassium Chloride ◽  
Controlled Study ◽  
Depth Of Anesthesia ◽  
Third Molars ◽  
Randomized Controlled ◽  
Surgical Extraction ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars

Background and objective: Administration of some additives with local anesthetics can prolong pain free period post-operatively, thereby reducing need for post-operative analgesics and improving patient comfort. Potassium chloride was found to increase duration and quality of anesthesia in various studies on brachial plexus blockade. This study was designed to evaluate and compare the effect of 2% lignocaine with 1.5% potassium chloride, 2% lignocaine with adrenaline and 2% lignocaine (plain) in pterygomandibular nerve blocks. Materials and methods: A triple blind randomized controlled study was conducted on 120 adults, aged 18–45 years in ASA-I category, requiring surgical extraction of impacted mandibular third molars. The subjects were divided equally into 3 groups randomly by computer generated sequence; Group 1: 2% lignocaine plus 1.5% solution of potassium chloride, group 2: 2% lignocaine with 1:80,000 adrenaline and group 3: 2% plain lignocaine. Onset, duration, depth (pain) of anesthesia, patient satisfaction, systolic and diastolic blood pressures, heart rate and oxygen saturation, were evaluated and compared. Results: Onset was shortest for group1 and longest for grp3, statistically highly significant difference between the 3 groups (p < 0.01). Statistically significant difference (p < 0.05) was found in duration of surgery, duration of analgesia and VAS scores between groups 1 & 3. Duration and depth of anesthesia were comparable for groups 1 & 2. There was no statistically significant difference seen for total amount of dose used, SBP, DBP, HR and SpO2 between the 3 groups (p > 0.05). Conclusion: Potassium chloride, a physiological salt is inert and causes no local/systemic adverse effects when injected with lignocaine in physiologically permissible amounts. The combination achieves satisfactory onset, duration, depth of anesthesia without altering hemodynamic variables. Hence, it may be considered as a safe and effective additive.

scholarly journals Pattern of Angulations and Common Indications for Extraction of Impacted Mandibular Third Molar at KMU-Institute of Dental Sciences, Kohat

2019 ◽  
Vol 8 (2) ◽  
pp. 79-83
Author(s):  
Tariq Sardar ◽  
Gulrukh Sheikh ◽  
Saddique Aslam ◽  
Numan Muhammad Khan ◽  
Javed Akhtar Rana
Keyword(s):  
Maxillofacial Surgery ◽  
Third Molar ◽  
Age Group ◽  
Third Molars ◽  
Impacted Tooth ◽  
Female Ratio ◽  
Impacted Mandibular Third Molar ◽  
Mandibular Third Molar ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars

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.

Prevalence of patterns of impacted third molars

2020 ◽  
Author(s):  
Seyed Hadi Hosseini ◽  
Zahra Mazareii Fard ◽  
Donya Maleki
Keyword(s):  
Treatment Plan ◽  
Maxillofacial Surgery ◽  
Oral And Maxillofacial Surgery ◽  
Third Molars ◽  
Wisdom Tooth ◽  
Impacted Tooth ◽  
The North ◽  
Tooth Impaction ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars

Aim: As the patterns of impaction can affect the treatment plan of removing or remaining the impacted tooth, the difficulty of surgery, and the post-surgical complications, this survey aimed for assessment of the mandibular wisdom tooth impaction patterns in terms of angulation and depth in the north population of Iran. Materials and Methods: 196 Panoramic radiographs were gathered from patients attending to the department of oral and maxillofacial surgery of GUMS in 2018-2019. To perform this retrospective study the prevalence of impaction, angulation, and the level of the eruption were assessed. The data were analyzed by SPSS 16. Results: This study found that the most common pattern of impacted mandibular third molars was level B in terms of depth and mesioangular in terms of angulation. Conclusion: The current study notes the importance of determining the angulation and level of wisdom tooth in designing the pre-surgical treatment and in post-surgical complaints

scholarly journals Comparing the Effect of Facial Compression Bandage to That of Systemic Dexamethasone on Postsurgical Sequels after Extraction of Impacted Mandibular Third Molars: A Split-mouth Randomized Clinical Trial

2021 ◽  
Vol 9 (D) ◽  
pp. 160-165
Author(s):  
Ibraheem Hamadi ◽  
Nuraldeen Maher Al-Khanati ◽  
Zafin Kara Beit
Keyword(s):  
Third Molar ◽  
Study Groups ◽  
Third Molars ◽  
Dexamethasone Group ◽  
Surgical Extraction ◽  
Significant Difference ◽  
Impacted Mandibular Third Molars ◽  
The Mean ◽  
Mandibular Third Molars ◽  
Present Trial

AIM: The present study aimed to compare the clinical efficiency of facial pressure bandage, to that of intramuscular injection of dexamethasone (8 mg) on postsurgical sequels (swelling, pain, and trismus) of extraction of impacted mandibular third molar. METHODS: The study implemented a randomized split-mouth design. Patients with symmetrical bilateral impacted molars were eligible for the present trial. Sides were randomly assigned to two groups: pressure bandage group and dexamethasone group. The evaluated postsurgical sequels were extraoral swelling, trismus, and pain after 48 h and 7 days. RESULTS: The study included 42 impacted third molars (n = 42) in 21 patients with a mean age of 23.4 years. Most participants were females (66.7%). The mean postoperative swelling rates after 48 h and 7 days in pressure bandage group were found to be comparable to those of dexamethasone group. No significant difference was found in the mean rates of postoperative trismus between study groups after 48 h and 7 days. Differences in mean pain level scores between the pressure bandage group and dexamethasone group were statistically insignificant after 48 h and 7 days. CONCLUSION: The study findings showed that the effect of the pressure bandage was comparable to dexamethasone effect on the postsurgical sequels after surgical extraction of impacted mandibular third molars.

scholarly journals Correlation between CGRP Levels and the Neuropathic and Inflammatory Component of Postoperative Pain

Folia Medica ◽  
2020 ◽  
Vol 62 (2) ◽  
pp. 365-371
Author(s):  
Deyan Neychev ◽  
Tanya Sbirkova ◽  
Maria Ivanovska ◽  
Ralitsa Raycheva ◽  
Mariana Murdjeva ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Surgical Procedures ◽  
Surgical Procedure ◽  
Sensory Nerves ◽  
Surgical Removal ◽  
Strong Positive Correlation ◽  
Third Molars ◽  
Significant Difference ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars

Introduction: In surgical procedures, tissue damage results in the release of a number of bioactive substances. Calcitonin gene-related peptide (CGRP) is a peptide released from sensory nerves, which determines its role in pain sensation. Its distribution in tissues deter&shy;mines its role as a primary afferent neurotransmitter. Aim: To determine the effect of CGRP on postoperative pain and reactive inflammatory process after surgical removal of impacted mandibular third molars, as well as the factors that have influence upon the perception of pain. Materials and methods: Forty patients with bilaterally impacted mandibular third molars were included in the study. Venous blood samples were collected before and 24 hours after the surgical procedure in order to test their serum levels of CGRP and procalcitonin. Two weeks later the procedure was repeated. The difficulty of the surgical procedure, its duration and complications were assessed in all patients. Results: The influence of some of the studied factors upon postoperative pain was established. Differences in the sensation of pain between the two sexes were found when comparing pain intensity reported by the patients. Significant difference between pain inten&shy;sity after the 1st and 2nd surgical procedures (6 hours) was found in females (Z=2.63, p=0.009;), whereas in males the difference was observed at 24 hours (Z=1.99; p=0.047). Regarding the existence of sex-related association, &#1072; significant, strong positive correlation between CGRP levels after the 1st and 2nd surgical procedures (24 hours) was found in males (rxy=0.78; p=0.004), whereas in females this correlation was also significant, although moderately significant (rxy=0.44; p=0.020). CGRP levels at the first and second extractions were generally similar in males, and not as much in females. We proved significantly moderate positive association between CGRP and pulse levels measured before the second surgery (rxy=0.37, p=0.021). Conclusion: The results of our study suggest a significant role of CGRP in reactive (neurogenic) inflammation.

scholarly journals Surgical Extraction of Mesio-Angularly Impacted Mandibular Third Molars:An Alternative Instrument for the Osteotomy Procedure

2017 ◽  
Vol 6 (2) ◽  
pp. 1529
Author(s):  
Charles E. Anyanechi
Keyword(s):  
Maxillofacial Surgery ◽  
Oral And Maxillofacial Surgery ◽  
Prospective Clinical Study ◽  
Third Molars ◽  
Duration Of Treatment ◽  
Impacted Tooth ◽  
Surgical Extraction ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars ◽  
Contemporary Practice

<p><strong>Background:</strong> Osteotomy of the bone surrounding mesio-angularly impacted tooth is part of the surgical procedure required for their extraction and has evolved in contemporary practice from the use of mallet/chisel to dental drill.</p><p><strong>Objective:</strong> To describe the extractions of mesio-angularly impacted mandibular third molars using Crane pick dental elevator for the osteotomy procedure.</p><p><strong>Materials and Methods:</strong> This was a prospective clinical study of patients done at the Oral and Maxillofacial Surgery Clinic of our institution, over three years period. With gentle, controlled, downward force, bone was removed with Crane pick elevator to expose the mesio-angularly impacted tooth cervical line, creating buccal and distal troughs that were linked and made in cancellous bone. The clinical variables evaluated were age, gender, and reason(s) for extraction, duration of treatment/osteotomy, degree of postoperative trismus and swelling, and complaints during follow-Up.</p><p><strong>Results:</strong> The ages of the 74 patients studied ranged from 18-63 years with mean age of 32.6± 2.8 years. Majority (83.8%) were in the age category of 16-45 years (P=0.001). The duration of the surgery from incision to placement of the last suture ranged from 12.8 to 17.1 minutes with mean 14.3±1.4 minutes. The duration of the osteotomy including the delivery of the tooth from their sockets ranged from 3.2 to 7.4 minutes with mean 5.3±0.7 minutes. The younger the patient's age, the shorter the osteotomy procedure (P=0.001).</p><p><strong>Conclusion:</strong> This study showed that certain mesio-angularly impacted mandibular third molars can be extracted using only Crane pick elevator.</p>

scholarly journals COMPARATIVE STUDY OF ENDOSCOPIC AND MICROSCOPIC ASSISTED MYRINGOPLASTY IN TIRUMALA HOSPITALS, KADAPA

2019 ◽  
Vol 3 (5) ◽  
Author(s):  
Dr. P. Surendra Babu
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Operative Time ◽  
Operating Time ◽  
Chronic Otitis Media ◽  
Ossicular Chain ◽  
Fascia Graft ◽  
Significant Difference ◽  
The Mean

Objective: The main aim of the study is to assess the operative time, graft uptake and audiological gain and post-operative scar in the group of the patients undergoing the endoscope assisted and the microscope assisted myringoplasty in Tirumala Hospital, Kadapa. Material and Methods: Myringoplasty or type-1 tympanoplasty was performed by either the endoscope or the microscope assistance. Postaural approach was undertaken for microscope assisted myringoplasty. Underlay technique of myringoplasty was performed using temporalis fascia graft in all the patients suffering from the inactive mucosal chronic otitis media. Post operative evaluation was done in terms of operative time, graft uptake and audiological gain. The patients were followed up for a period of 6 months. The study was longitudinal in nature and comprised of 100 patients suffering from the chronic otitis media inactive mucosal disease. The patients are divided into two groups consisting of 50 in each group. One group of patients have undergone microscopic assisted myringoplasty one group undergone endoscopic assisted myringoplasty and were followed up regularly.  Study period is one year from January 2016 to December 2016 attending outpatient otolaryngology department were included in the study. Results: The operative time in the patients undergoing the endoscope assisted myringoplasty(EAM) was 45minutes whereas it was 60 minutes in the patients undergoing the microscope assisted myringoplasty(MAM). The tympanic membrane graft uptake and audiological gain was assessed at 1 month, 3months and 6 months post operatively. The successful closure of the tympanic membrane perforation was higher with the endoscope assisted myringoplasty as compared to the microscope assisted myringoplasty at 1 month, 3 months and 6 months of follow up. The mean audiological gain following myringoplasty with both the techniques used was noted. The mean audiological gain was found to be marginally better with the endoscope assisted myringoplasty at follow up of 1, 3 and 6 months as compared to the microscope assisted myringoplasty. Conclusion: The operative time was less in the endoscope assisted technique as compared to the microscope assisted technique. The post operative morbidity (evaluated in terms of post operative scar) was less in the group of patients undergoing the Transcanal endoscope assisted as compared to microscope assisted myringoplasty. There was no significant difference in either graft uptake or post-operative audiological gain in the patients undergoing myringoplasty by endoscope assisted and microscope assisted technique. The endoscope assisted myringoplasty has advantages of better assessment of ossicular chain and in the patients with canal overhang it improves the visualisation of the margins of the perforation thus obviating the need for canalplasty. Thus the endoscope assisted myringoplasty can be used as a preferred alternative to the conventional microscope assisted myringoplasty, with better post operative results and reduced operating time and morbidity of the surgical procedure. Keywords: Chronic otitis media (COM); Myringoplasty; Endoscope assisted myringoplasty; Microscope assisted myringoplasty.

scholarly journals CORRELATION OF IMPACTED MANDIBULAR THIRD MOLAR WITH INCIDENCE OF IPSILATERAL ANGLE AND CONDYLAR FRACTURES IN MANDIBULAR TRAUMA

2020 ◽  
Vol 70 (6) ◽  
pp. 1686-90
Author(s):  
Syed Yasir Ali Abidi ◽  
Adnan Babar ◽  
Kaleem Ullah Niazi ◽  
Ali Akhtar Khan ◽  
Atiqa Maryam ◽  
...  
Keyword(s):  
Maxillofacial Surgery ◽  
Armed Forces ◽  
Third Molars ◽  
Mandibular Angle ◽  
Mandibular Angle Fracture ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars ◽  
Angle Fractures ◽  
Surgery Department ◽  
Condylar Fractures

Objective: This study aims to evaluate association of impacted lower third molars with incidence of ipsilateral mandibular angle and condylar fractures. Study design: Observational study. Place of study: Maxillofacial Surgery Department Armed Forces Institute of Dentistry Materials and methods: Patients reporting to armed forces institute of dentistry maxillofacial surgery department OPD were diagnosed on the basis of history, clinical signs and symptoms and radiological examinations were categorized as Mandibular Angle and Condylar fractures and impacted lower third molars. A total number of 234 radiographs of patients were examined. Duration of study: 01 year from 01 January 2019 to 31st December 2019. Results: Out of total sample size of 234 patients, 70% (79 patients) Mandibular angle fractures occurred with patients with impacted lower third molars (112 patients) and 65% (80 patients) mandibular condylar fractures occurred with patients without impacted lower third molars (122 patients). Statistically significant P-value was 0.000 that is <0.05 that signifies positive correlation of impacted mandibular third molars to cause ipsilateral mandibular angle fractures and indirectly preventing condylar fractures. Conclusion: Patients that do not have impacted lower third molars are more prone to suffer Condylar fractures in case of mandibular trauma which is associated with more postoperative risks and morbidity as compared to mandibular angle fractures that occur more commonly in patients with impacted lower third molars. As mandibular fractures are common, practice for prophylactic removal of lower third molars should be discontinued. Keywords: Mandibular Condylar fracture, Mandibular Angle fracture, Impacted mandibular third molars

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