impacted mandibular third molars
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Author(s):  
Anna Starzyńska ◽  
Magdalena Kaczoruk-Wieremczuk ◽  
Michele Antonio Lopez ◽  
Pier Carmine Passarelli ◽  
Paulina Adamska

Surgical removal of impacted mandibular third molars constitutes one of the most frequently performed procedures within oral surgery. This surgery procedure is associated with many post-operative complications. Advanced platelet-rich fibrin (A-PRF) belongs to the second generation of platelet concentrates and is rich in numerous growth factors. The aim of this study was to assess the influence of A-PRF on selected clinical features following the surgical removal of impacted mandibular third molars. The research was conducted on 100 generally healthy patients, who underwent a lower third molar odontectomy in Department of Oral Surgery, Medical University of Gdańsk, Poland, between 2018 and 2019. The research group consisted of 50 patients (immediate A-PRF socket filling) and control group (50 patients without A-PRF socket filling). During the study, the following clinical features were assessed: pain (visual analog scale), analgesics intake, the presence of trismus, edema, hematomas within the surrounding tissues (e.g., cheek), prevalence of pyrexia, dry socket, secondary bleeding, presence of hematomas, skin warmth in the post-operative area, and bleeding time observed by the patient were analyzed on the 3rd, 7th, and 14th day after the procedure. There was a significant association between A-PRF socket filling and pain intensity, the analgesics intake, trismus, and edema on the 3rd and the 7th day (p < 0.05). The presence of hematomas and skin warmth on the 3rd day after the surgery (p < 0.05) were also statistically associated with A-PRF use. The study showed that in reducing the incidence of postoperative complications, A-PRF was more important than the position of the tooth or the duration of the procedure. The growth factors in A-PRF reduce postoperative complications, such as pain, trismus, edema, analgesics intake, presence of hematomas, and skin warmth, after mandibular wisdom teeth odontectomy.


Biology ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 1348
Author(s):  
C. Burnice Nalina Kumari ◽  
Thiagarajan Ramakrishnan ◽  
Pradeep Devadoss ◽  
Rajaram Vijayalakshmi ◽  
Khalid J. Alzahrani ◽  
...  

The study aims to assess the efficacy of using collagen membrane in the treatment of distal periodontal defects of mandibular second molars following the removal of mesioangularly or horizontally impacted mandibular third molars surgically. Forty sites in twenty patients with bilaterally impacted mandibular third molars (mesioangular or horizontal) were considered for the study. In 20 test sites (Group A), after surgical removal of the mandibular third molar, a resorbable collagen membrane barrier was placed on the distal aspect of the mandibular second molar to cover the post-surgical bone defect. In the other control 20 sites (Group B), the same surgical procedure was repeated without placing any membrane barrier. The clinical parameters recorded were Oral Hygiene Index Simplified (OHI-S), Probing pocket depth (PPD), Clinical attachment level (CAL), and radiographic assessment of alveolar bone level (ABL). OHI-S score of most of the patients was observed to be satisfactory. Group A was observed to achieve a statistically significant reduction in PPD, CAL, and ABL gain compared to Group B. The improvements indicated that the use of collagen membrane facilitates early wound stabilization and promotes primary closure of the defect. This recovery is achieved through its unique property to assist fibrinogenesis over osteoconduction. Further longitudinal studies are needed to confirm the present findings.


2021 ◽  
Vol 15 (12) ◽  
pp. 3253-3256
Author(s):  
M Arshman Khan ◽  
Talib Hussain ◽  
Bilal Z. Babar ◽  
Sikandar J. Bajwa ◽  
S. Ghani ◽  
...  

Aim: To analyse early recognition of the distal cervical caries of mandibular second molar caused by impacted mandibular third molar, to correlate oral health and caries status and to find out the average age groups and gender affected by impacted third molar Methods: A cross-sectional survey of 300 participants was conducted over a 15-month period at Rehmat Memorial Hospital, Abbottabad. 300 participants having impacted third molar having distal cervical caries in mandibular second molar were analyzed clinically and radiographically. Data was analyzed using SPSS version 23.0 Results: the demographic data of 300 patients with impacted mandibular third molars were analyzed. 64% were male and 36% female that have extractions due to impaction. Caries caused in more than half of participants by mesioangular impaction, which was 52%, 3% due to distoangular, 26% due to distal, and 18% due to horizontal impaction. In 63.25% of cases, teeth were lost due to caries, periodontitis caused 20.25% of tooth loss, pericoronitis 7.75%, orthodontics 3.75%, prosthodontics 1.2%, trauma 1%, and other factors were 2.5%. study reveals that 30.5 % of the extractions were done from 21 and 30 years and 23 %of extractions were performed. 40% of those who took part in the study did not brush their teeth. Socioeconomic status also has a great impact on tooth extractions. Conclusion: After conducting this study, it was concluded that there was a relationship between the prevalence of distal cervical caries in mandibular second molars and the placement of neighbouring impacted mandibular third molars. As a result, the extraction of mandibular third molars should be done to avoid cavities and premature tooth loss in the neighboring molar. Key words: Third molar impaction, distoangular, distal cervical caries, extraction, 2nd molar caries


Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2282
Author(s):  
Rakhi Issrani ◽  
Namdeo Prabhu ◽  
Mohammed Sghaireen ◽  
Hasna Rasheed Alshubrmi ◽  
Amal Mohamed Alanazi ◽  
...  

Background: Pre-operative radiographic assessment of the anatomical relationship between the roots of the mandibular third molar and the inferior alveolar nerve (IAN) is a must to minimize the risk of IAN injury during surgery. Objectives: To compare the radiographic signs of digital orthopantomogram (OPG) and cone-beam computed tomography (CBCT). An additional objective was to assess the cortex status between the mandibular canal and third molar on CBCT images in relation to the demographic characteristics, region (right or left side), and angulation of mandibular molar. Methodology: In this retrospective study, a total of 350 impacted mandibular third molars with a close relationship between the inferior alveolar canal (IAC) and impacted mandibular third molars on digital OPG were further referred for CBCT imaging for assessment of the position of the mandibular canal. The study was conducted between August 2018 and February 2020. Digital OPGs were evaluated for radiographic signs like interruption of the mandibular canal wall, darkening of the roots, diversion of the mandibular canal, and narrowing of the mandibular canal. The age and sex of patients, site of impacted third molar, Winter’s classification of mandibular third molar, position of IAC relative to impacted molar, and the radiographic markers of OPG were assessed for cortical integrity using CBCT. Chi square testing was applied to study the values of difference and binomial logistic regression was done to assess the factors associated with cortication. Statistical significance was set at p ≤ 0.05. Results: Among 350 patients, 207 (59.1%) were male and 143 (40.9%) were female with a mean age of 36.8 years. The most common OPG sign was interruption of white line, seen in 179 (51.1%) cases. In total, 246 cases (70.3%) showed an absence of canal cortication between the mandibular canal and the impacted third molar on CBCT images. Cortication was observed in all cases with a combination of panoramic signs which was statistically significant (p = 0.047). Cortication was observed in 85 (50.6%) cases where IAC was positioned on the buccal side, 11 (16.9%) in cases of inferiorly positioned IAC, and just 8 (7.6%) for cases of lingually positioned IAC which was statistically significant (p = 0.003). Statistically insignificant (p > 0.05) results were noted for cortex status in CBCT images with regards to the age, sex, site, and angulation of impacted third molars. Conclusion: CBCT imaging is highly recommended for those cases where diversion of the mandibular canal is observed on OPG and when the roots are present between canals.


Author(s):  
V. Usha ◽  
G. Rajabackiyam ◽  
K. Prabhu Sankar ◽  
Varun Muthuraman ◽  
Aravind Christo ◽  
...  

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.


2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Nimrat K. Jawanda ◽  
Anand Shukla ◽  
Anupam Singh ◽  
Kalyana C. Pentapati ◽  
Srikanth Gadicherla

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.


Author(s):  
Gholamreza Shirani ◽  
Mohammad Reza Reshadi

Purpose: This study aimed to assess the effect of light-emitting diode (LED) phototherapy on pain and trismus following surgical extraction of impacted mandibular third molars. Materials and Methods: This double-blind randomized controlled clinical trial evaluated 50 patients between 20 to 35 years requiring extraction of their impacted mandibular third molars. The patients were randomized into two groups of LED phototherapy and control by flipping a coin. Patients in the LED group underwent LED phototherapy immediately after surgery with red light at 618nm wavelength, 20 mW/cm2 power density and 4 J/cm2 energy density in continuous-wave mode (irradiated area: 3.15cm×1.5cm=4.725cm2). The LED device was used in off mode in the control group (as placebo). The level of postoperative pain was measured by the numerical rating scale, and trismus of patients was evaluated by measuring the maximum mouth opening (MMO). The two groups were compared by the Mann-Whitney and NPar tests. Results: The mean difference in MMO postoperatively, compared with baseline, was lower in the LED group than the placebo group but not significantly (P=0.465). The two groups were not significantly different regarding the level of pain. Conclusion: LED phototherapy with the parameters applied in this study failed to significantly decrease the level of pain and trismus following surgical extraction of impacted mandibular third molars.


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