scholarly journals Removal of Deeply Impacted Mandibular Molars by Sagittal Split Osteotomy

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Erol Cansiz ◽  
Sabri Cemil Isler ◽  
B. Alper Gultekin
Keyword(s):  
Case Report ◽  
Inferior Alveolar Nerve ◽  
Frequency Of Occurrence ◽  
Third Molars ◽  
Impacted Teeth ◽  
Bone Removal ◽  
Sagittal Split Osteotomy ◽  
Occlusal Surfaces ◽  
Osteotomy Technique ◽  
Mandibular Third Molars

Mandibular third molars are the most common impacted teeth. Mandibular first and second molars do not share the same frequency of occurrence. In rare cases the occlusal surfaces of impacted molars are united by the same follicular space and the roots pointing in opposite direction; these are called kissing molars. In some cases, a supernumerary fourth molar can be seen as unerupted and, in this case, such a supernumerary, deeply impacted fourth molar is seen neighboring kissing molars. The extraction of deeply impacted wisdom molars from the mandible may necessitate excessive bone removal and it causes complications such as damage to the inferior alveolar nerve and iatrogenic fractures of the mandible. This case report describes the use of the sagittal split osteotomy technique to avoid extensive bone removal and protect the inferior alveolar nerve during surgical extruction of multiple impacted teeth.

scholarly journals Radiographic Assessment of Impacted Mandibular Third Molar- An Ex-vivo study

2021 ◽  
pp. 67-77
Author(s):  
Ujwala B. Kale ◽  
Anita D. Munde ◽  
Sunil S. Mishra ◽  
J. Farooqui Anjum Ara ◽  
Pooja B. Nayak ◽  
...  
Keyword(s):  
Ex Vivo ◽  
Preoperative Evaluation ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Radiographic Evaluation ◽  
Surgical Removal ◽  
Third Molars ◽  
Impacted Teeth ◽  
Group I ◽  
Mandibular Third Molars

Background: Mandibular third molars are the most commonly impacted teeth and frequently associated with various pathologies including infection, traumatic, inflammatory and cystic lesions necessitating their surgical removal. To avoid complications, clinical and radiographic evaluation of impacted teeth is essential to provide information about tooth anatomy, position and condition of the surrounding bone. Aim: To evaluate impacted mandibular third molars (IMTM) with the help of panoramic radiographs for the type of impaction, available third molar space, level of eruption, and relation to the inferior alveolar nerve (IAN). Materials and Methods: Total 600 patients were selected and were divided into three groups; group I (18-27 years), group II (28-37 years), and group III (>38 years). Digital OPG were traced and evaluated for angulations, third molar space, level of eruption, and relation of third molar roots to IAN canal. The observations were subjected to statistical analysis using Chi-square test. Results: Out of 600 samples, 306 (51%) were males and 294 (49%) were females. Out of 1079 third molar sites, mesioangular impaction (40.22%) was the most common. Class II relation (84.24%) for third molar space and level A of eruption (45.69%) were most frequent. In true relation, interruption of the white line of the IAN canal (20.85%) was the most frequent relation of the IMTM roots to the IAN canal and others (false/no relation) was the most common in all relations. Conclusion: Panoramic radiography is a relatively safe, reliable, inexpensive, and readily accessible technique for preoperative evaluation of IMTM and their relation to IAN canal.

scholarly journals Clinical assessment of impacted lower third molars at Ekpan, Delta State in Nigeria

2020 ◽  
Vol 3 (2) ◽  
pp. 352-355
Author(s):  
Mabel Okiemute Etetafia ◽  
Ese Anibor ◽  
Martins Obaroefe
Keyword(s):  
Third Molar ◽  
Third Molars ◽  
Impacted Tooth ◽  
Female Ratio ◽  
Impacted Teeth ◽  
Pull Out ◽  
Carious Lesions ◽  
Surgical Extraction ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars

Introduction: Diagnosis and management of impacted mandibular third molars call for a cogent appraisal and treatment choice both for the sick person and the dental practitioner. This academic work scrutinized the pattern as well as treatment of impacted mandibular third molars at the Teem Clinic and Dental Centre, Ekpan, Delta State, in Nigeria.Materials and Methods: This cross-sectional survey involved 131 cases who reported impacted mandibular third molars. The age, gender, impacted tooth, type of impaction, pathological conditions, and treatment proffered were recorded.Results: The male to female ratio was 0.8:1, with an age range of 10 to 40 years. Of the lower third molar impactions 58 (42.0%) were mesioangular, 5 (3.6%) horizontal, 18 (13.0%) vertical and 57 (41.3%) were distoangular. A total of 47 (34.1%) quested for dental attention following varying degrees of pain induced by pericoronitis. Teeth removal was accomplished for 76 (55.0%) owing to carious lesions on the impacted teeth, proximate tooth, or both. Surgical extraction was the option taken in 69 (50.0 %) with caries on the impacted teeth while 3 (2.2%) had to pull out of their teeth done owing to carious lesions on the bordering second molars. In 3 (2.2%) both the impacted third molar and the proximate second molar were decayed. Conclusions: The prevailing indication for pulling out impacted mandibular third molars was acute pericoronitis. Mesioangular sort of impaction was most recurrent and ought to be considered for theplausibility of frequentness of complications.

scholarly journals Coronectomy - A viable alternative to prevent inferior alveolar nerve injury

2015 ◽  
Vol 11 (3) ◽  
pp. 1-5
Author(s):  
Alok Sagtani ◽  
Reshu Agrawal Sagtani ◽  
Mehul Jaisani ◽  
Leeza Pradhan
Keyword(s):  
Nerve Injury ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Viable Alternative ◽  
Third Molars ◽  
Dry Socket ◽  
Root Exposure ◽  
Mandibular Third Molars ◽  
Inferior Alveolar Nerve Injury

Background and Objectives: Coronectomy is a relatively new method to prevent the risk of Inferior Alveolar Nerve (IAN) injury during removal of lower third molars with limited scientific literature among Nepalese patients. Thus, a study was designed to evaluate coronectomy regarding its use, outcomes and complications.Materials and Methods: A descriptive study was conducted from December 2012 to December 2013 among patients attending Department of Oral and Maxillofacial Surgery, College of Dental Sciences, BP Koirala Institute of Health Sciences, Dharan, Nepal for removal of mandibular third molars. After reviewing the radiograph for proximity of third molar to the IAN, coronectomy was advised. A written informed consent was obtained from the patients and coronectomy was performed. Patients were recalled after one week. The outcome measures in the follow-up visit were primary healing, pain, infection, dry socket, root exposure and IAN injury. The prevalence of IAN proximity of lower third molars and incidence of complications were calculated.Results: A total 300 mandibular third molars were extracted in 278 patients during the study period. Out of 300 impacted mandibular third molar, 41 (13.7%) showed close proximity to inferior alveolar nerve . The incidence of complications and failed procedure was 7.4% among the patients who underwent coronectomy. During the follow up visit, persistent pain and root exposure was reported while other complications like inferior alveolar nerve injury, dry socket and infection was not experienced by the study patients.Conclusion: With a success rate of 92.6% among the 41 patients, coronectomy is a viable alternative to conventional total extraction for mandibular third molars who have a higher risk for damage to the inferior alveolar nerve.JCMS Nepal. 2015;11(3):1-5.

scholarly journals Cone beam CT and treatment decision of mandibular third molars: removal vs. coronectomy—a 3-year audit

2020 ◽  
Vol 49 (3) ◽  
pp. 20190250 ◽  
Author(s):  
Louise Hauge Matzen ◽  
Julie Suhr Villefrance ◽  
Sven Erik Nørholt ◽  
Jesper Bak ◽  
Ann Wenzel
Keyword(s):  
Cone Beam Ct ◽  
Inferior Alveolar Nerve ◽  
Treatment Decision ◽  
Close Relation ◽  
Mandibular Canal ◽  
Panoramic Image ◽  
Third Molars ◽  
Sensory Disturbances ◽  
Mandibular Third Molars ◽  
The Impact

Objectives: To assess: (1) the workflow in the treatment decision process of mandibular third molars based on a panoramic image and CBCT and (2) the impact of radiographic markers in CBCT on the decision to perform coronectomy. Methods: 1437 teeth in 917 patients (mean age 27.8 years, range 18–72) underwent clinical and panoramic examination. If there was an indication for removal of the tooth, and signs of a close relation to the inferior alveolar nerve were present in the panoramic image, a CBCT was performed. Treatment decision based on panoramic image and CBCT was calculated. Statistical analyses were performed to assess whether signs in CBCT had an impact on the treatment decision “coronectomy”. Moreover, the actually operated teeth and post-operative sensory disturbances were assessed and discussed in relation to the radiographic method. Results: Based on the panoramic image, in 462 cases it was decided not to treat, 553 were scheduled for surgery, and 422 referred for a CBCT examination. “No bony separation between the tooth and mandibular canal” seen in CBCT was the main factor influencing the decision to perform a coronectomy (odds ratio = 56.8, p < 0.001). 840 mandibular third molars had undergone surgical intervention, 152 had a coronectomy and 688 were fully removed. Six patients perceived a sensory disturbance of the inferior alveolar nerve: one permanent and five temporary. Conclusion: 29% of the examined cases were referred for a CBCT and of these, the majority were scheduled for coronectomy based on the sign “no bony separation between the tooth and mandibular canal” seen in CBCT.

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