scholarly journals Evaluation of demographic and radiological risk factors for assessment of difficulty in surgical removal of impacted mandibular third molar – A prospective study.

2019 ◽  
Vol 6 (1) ◽  
pp. 10-13
Author(s):  
Manu R. Goel ◽  
Milind D. Shringarpure ◽  
Vasant V. Shewale ◽  
Tejasvini Dehankar ◽  
Ajit Joshi
Keyword(s):  
Risk Factors ◽  
Scientific Evidence ◽  
Maxillofacial Surgery ◽  
Third Molar ◽  
Oral And Maxillofacial Surgery ◽  
Surgical Removal ◽  
Third Molars ◽  
Surgical Time ◽  
Impacted Tooth ◽  
Surgical Difficulty

The extraction of impacted third molars is among the most common surgical procedures carried out in the field of Oral and Maxillofacial Surgery. Both the patient and dentist must therefore have scientific evidence-based information concerning the estimated level of surgical difficulty of every case to consider in referring cases of impacted third molars for specialists’ handling. We have undertaken a study in which demographic and radiological variables were considered together to evaluate the risk factors for surgical difficulty in a cohort of 100 impacted mandibular third molars. There were 13 variables evaluated for surgical difficulty. Total surgical time intervention was noted at the end of each surgery. Each variable was analysed with total surgical time intervention with univariate and multiple linear regression. Out of 13 variables, 9 were found statistically significant. The most significant predictors for surgical difficulty were Body Mass Index, Depth of impacted tooth and Retromolar space. No postoperative complications were reported.

scholarly journals Removal of dental surgical bur from maxillary sinus: a case report

2018 ◽  
Vol 17 ◽  
pp. e18224
Author(s):  
Yeon Jung Kim ◽  
Ana Maria Barg da Silva ◽  
Mirko Dennys Ayala Perez ◽  
Heloisa F. Marão ◽  
Debora Pallos
Keyword(s):  
Maxillary Sinus ◽  
Clinical Case ◽  
Treatment Plan ◽  
Correct Diagnosis ◽  
Maxillofacial Surgery ◽  
Third Molar ◽  
Oral And Maxillofacial Surgery ◽  
Surgical Removal ◽  
Third Molars ◽  
Third Molar Extraction

The most commonly performed surgical procedure in Oral and Maxillofacial Surgery practices are the removal of impacted third molars. Extensive training, skill and experience allow this procedure to be performed in an atraumatic approach. The aim of this study was to drawing attention to the importance of the correct management of the complications cases of foreign body inside maxillary sinus after surgical removal of maxillary third molars. This is an unusual clinical case of a dental surgical bur accidentally displacement into the maxillary sinus during an upper third molar extraction surgery. After removal, the clinical case showed a satisfactory repair emphasizing the importance of a meticulous clinical examination to achieve a correct diagnosis and an appropriate treatment plan, which is essential for a favorable prognosis.

Frequency of Lingual Nerve Damage during Surgical Removal of Impacted 3rd Molar

2021 ◽  
Vol 15 (9) ◽  
pp. 2441-2443
Author(s):  
Wajiha Abbas ◽  
Umer Hussain ◽  
Ali Shahid ◽  
Mustafa Qadeer ◽  
Muhammad Anwaar Alam ◽  
...  
Keyword(s):  
Maxillofacial Surgery ◽  
Third Molar ◽  
Skills Training ◽  
Nerve Damage ◽  
Lingual Nerve ◽  
Dental Arch ◽  
Oral And Maxillofacial Surgery ◽  
Surgical Removal ◽  
Class Iii ◽  
Impacted Tooth

Introduction: Professional skills, training and experience is mandatory for removing impacted 3rd molars with aid of local/general anesthesia, sedation. As for symptomatic 3rd molars decision for removing is not difficult usually, but for removing asymptomatic 3rd molars decision is less clear & requiring good clinical experience. Objective: The objective this study was to determine frequency of lingual nerve damage during surgical removal of impacted 3rd molar Design: Descriptive cases series Study Setting: This study was conducted at Department of Oral and Maxillofacial Surgery, Sandeman Provincial Hospital Quetta over 6 months (April 10, 2018 till Oct 10, 2018). Materials and Methods: All 149 cases after approval of hospital ethical committee fulfilling the inclusion criteria were included in this study. After clinical and radiographic diagnosis of affected tooth like depth, position or any other difficulty, the surgical procedure was selected. An impacted tooth was labeled when it was failed to explode into the dental arch within the expected developmental window. After operation surgical sites of all patients were reviewed by the same consultant after 7 days. It was instructed to all patients that report any problem in lingual sensation; by clinical examination sensory deficits were recognized bilaterally. Results: The mean age of all cases was 29.82 ± 6.81 years with minimum and maximum age of 18 and 40 years. There were 83(55.7%) male and 66(44.3%) were females. According to types of impaction 22(14.8%) cases had Mesioangular, 10(6.7%) had Horizontal, 12(8.1%) had Vertical, 17(11.4%) had Distoangular, 14(9.4%) had Class I, 15(10.1%) had Class II, 11(7.4%) had Class III, 14(9.4%) had Class A, 16(10.7%) had Class B and 18(12.1%) cases had Class C. A total of 16(10.7%) cases had inguinal injury in this study. Conclusion: This study concludes that 10.7% cases had inguinal injury in this study. So, this procedure of impacted mandibular third molar is associated with minor but expected complications like the lingual nerve damage. Hence, preoperative and intraoperative consideration must be taken up to reduce this preventable complication. Keywords: Impacted teat, 3rd molar, surgery, complications, lingual nerve damage

scholarly journals Evaluation of Demographic, Radiological and Intraoperative Factors For Assessment of Postoperative Pain And Complications In Surgical Removal Of Impacted Mandibular Third Molar – A Prospective Study

2020 ◽  
pp. 42-52
Author(s):  
Manu R. Goel ◽  
Milind D. Shringarpure ◽  
Vasant V. Shewale ◽  
Tejasvini Dehankar ◽  
Chandrashekhar R. Bande ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Postoperative Complications ◽  
Third Molar ◽  
Surgical Removal ◽  
Third Molars ◽  
Impacted Tooth ◽  
Mandibular Third Molar ◽  
Surgical Difficulty ◽  
A Prospective Study ◽  
Root Contact

Third molars usually erupt within the age of 17 – 21years. Usually, due to the evolution of human jaws, the size is decreasing leading to the impacted tooth. An impacted tooth may lead to external resorption of the adjacent tooth, trismus, infection, etc. Many studies have been reported in the literature for evaluating the surgical difficulty and postoperative complications secondary to impacted third molars. This study includes a sample of 100 subjects evaluated for the surgical difficulty and postoperative complications. Various demographic, radiological, and intraoperative factors were evaluated which may lead to postoperative complications. Factors responsible for postoperative sequelae were also evaluated with complications. Postoperative pain after 4 hours and 7 days was assessed to mark the factors commonly responsible. Pain at 7th postoperative day was significant involving factors like fully impacted, horizontal impaction, level C, no/very little retromolar space, and root contact. Postoperative com­plications were not reported in this study.

scholarly journals Risk factors of complications subsequent third molar extractions: A prospective cohort study

2021 ◽  
Vol 24 (4) ◽  
Author(s):  
Dena Ali
Keyword(s):  
Risk Factors ◽  
Pearson Correlation ◽  
Maxillofacial Surgery ◽  
Third Molar ◽  
Oral And Maxillofacial Surgery ◽  
Surgical Removal ◽  
Chi Square ◽  
Surgical Extraction ◽  
Alveolar Osteitis ◽  
Chi Square Test

Objective: The aim of this study was to determine the complications that were associated with the surgical removal of third molars (M3s), and to assess the association of patient, anatomic, and surgical risk factors with the postoperative complications of surgically removed impacted M3s. Material and Methods: This study was a cohort prospective study conducted on patients, aged 17 and older, admitted to the oral and maxillofacial surgery clinic. All patients who needed 1 or more extractions were included and totalled 268 patients with 314 extracted teeth. Risk factors were divided into patient factors, anatomic factors and surgical factors. The postoperative complication variables mainly included: pain, alveolar osteitis, infection, bleeding, swelling, trismus. Statistical analysis used: Chi-square test was used for the bivariate analyses while Pearson correlation coefficient (1- tailed) test was used for the purpose of determining the association between the study variables. The significance of associations was considered statistically significant at P < 0.05. Results: Patients aged of 25 years and above experienced more complications, 39 (88.6%). With respect to gender, females experienced more complications, 29 (65.9%). Mandibular M3s had more complications than maxillary M3s, 34 (8.0%), followed by distoangular inclined M3s, 23 (52.3%), and last was full bony impaction, 13 (29.5%). Pain was the most frequent complication, 18 (40.9%), followed by alveolar osteitis 12 (27.3%). Conclusion: The results indicated that the most frequently complications were pain, infection, alveolar osteitis. These complications were associated with common risk factors such as age, gender, medical history, M3 angulation, impaction level, bone removal, tooth sectioning, and number of M3 removed per session. Keywords  Complications; Surgical extraction; Third molar.

scholarly journals Assessment of intraoperative risk factors for surgical difficulty in surgical extraction of impacted mandibular third molar – A prospective study.

2019 ◽  
Vol 6 (2) ◽  
pp. 41-43
Author(s):  
Manu Goel ◽  
Milind Shringarpure ◽  
Vasant Shewale ◽  
Chandrashekhar Bande ◽  
Ajit Joshi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Third Molar ◽  
Third Molars ◽  
Surgical Time ◽  
Impacted Mandibular Third Molar ◽  
Mandibular Third Molar ◽  
Surgical Extraction ◽  
Impacted Mandibular Third Molars ◽  
Surgical Difficulty ◽  
Mandibular Third Molars

The extraction of impacted third molars is among the most common surgical procedures carried out in the field of Oral and Maxillofacial Surgery. For proper planning of surgical extraction, especially for impacted mandibular third molars the estimated level of surgical difficulty of the case is important. This study was conducted to evaluate the intraoperative risk factors contributing to surgical difficulty in extraction of impacted mandibular third molars and consequently the post-operative outcome. Here, we have undertaken a study in which the intraoperative variables were considered, to evaluate their contribution for surgical difficulty and postoperative complications in surgical removal of 100 impacted mandibular third molars. Three variables were found significant associated with total surgical time intervention, i.e., surgeon’s experience (p=0.006), Inter-incisal opening (p=0.032), and cheek flexibility (p=0.004). Total surgical time intervention for ‘right side’ was higher with 49.20 ± 17.94 minutes (p=0.691). Total surgical time intervention for ‘gagging reflex present’ was 50.21 ± 17.812 (p=0.674). Multiple linear regression shows that surgeon’s experience was the only predictor (p<0.001). The surgical difficulty of impacted mandibular third molar are likely to depend on the intraoperative factors like Surgeon’s time, surgeon’s experience, check flexibility, and inter incisal mouth opening.

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.

scholarly journals Automated Prediction of Extraction Difficulty and Inferior Alveolar Nerve Injury for Mandibular Third Molar Using a Deep Neural Network

2022 ◽  
Vol 12 (1) ◽  
pp. 475
Author(s):  
Junseok Lee ◽  
Jumi Park ◽  
Seong Yong Moon ◽  
Kyoobin Lee
Keyword(s):  
Maxillofacial Surgery ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Oral And Maxillofacial Surgery ◽  
Third Molars ◽  
Radiographic Image ◽  
Common Procedure ◽  
Radiographic Images ◽  
Mandibular Third Molar ◽  
Mandibular Third Molars

Extraction of mandibular third molars is a common procedure in oral and maxillofacial surgery. There are studies that simultaneously predict the extraction difficulty of mandibular third molar and the complications that may occur. Thus, we propose a method of automatically detecting mandibular third molars in the panoramic radiographic images and predicting the extraction difficulty and likelihood of inferior alveolar nerve (IAN) injury. Our dataset consists of 4903 panoramic radiographic images acquired from various dental hospitals. Seven dentists annotated detection and classification labels. The detection model determines the mandibular third molar in the panoramic radiographic image. The region of interest (ROI) includes the detected mandibular third molar, adjacent teeth, and IAN, which is cropped in the panoramic radiographic image. The classification models use ROI as input to predict the extraction difficulty and likelihood of IAN injury. The achieved detection performance was 99.0% mAP over the intersection of union (IOU) 0.5. In addition, we achieved an 83.5% accuracy for the prediction of extraction difficulty and an 81.1% accuracy for the prediction of the likelihood of IAN injury. We demonstrated that a deep learning method can support the diagnosis for extracting the mandibular third molar.

Compound odontoma associated with dentigerous cyst in the anterior mandible – case report

RSBO ◽  
2016 ◽  
Vol 12 (1) ◽  
pp. 98
Author(s):  
Radamés Bezerra Melo ◽  
Yuri Edward de Souza Damasceno ◽  
Celio Armando Couto da Cunha Junior ◽  
Igor Vasconcelos Pontes
Keyword(s):  
Case Report ◽  
Dentigerous Cyst ◽  
Maxillofacial Surgery ◽  
Young Patients ◽  
Radiographic Examination ◽  
Oral And Maxillofacial Surgery ◽  
Surgical Removal ◽  
Impacted Tooth ◽  
Follicular Cyst ◽  
Compound Odontoma

Introduction: The dentigerous cyst, also called a follicular cyst is an odontogenic cyst that develops in association with crown of an impacted tooth, predominantly in mandibular third molars of young patients. The Odontoma is a ectomesenquimal tumor of unknown origin that are more considered developmental malformations (harmatomas) than benign neoplasms. Occasionally, the dentigerous cyst is associated with odontoma. Objective: The article aims to report a case of surgical treatment of dentigerous cyst associated with compound odontoma and unerupted tooth in anterior region of the mandible. Case report: A male patient, 17 years of age, without systemic changes, was sent to the Center for Dental Specialties of Horizonte, Ceará, Brazil, specialty of Oral and Maxillofacial Surgery, for diagnosis and treatment of oral lesions visualized after periapical radiographic examination to determine failed eruption of element 42. Observing the periapical radiograph it was possible to visualize radiopaque lesion suggestive of a compound odontoma and a cystic capsule in association with the element 42. A panoramic radiographwas requested and it was planned a surgical removal of odontoma with curettage of bone cavity and removing the cystic capsule and element 42. There were no significant postoperative complications, the suture removal was performed 7 days after surgery where it was possible to observe a good healing, no swelling and no paresthesia. Conclusion: The treatment of choice is surgical excision of the lesions with the tooth associated to the cyst, it should be performed with proper planning, avoiding injury to vital structures and should not be delayed in order to avoid possible occlusion sequelae.

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.

scholarly journals 442 COVID-19 And the Oral Surgery/Orthodontic Interface: Has A Delay in Treatment Complicated the Position of Unerupted And Ectopic Teeth Planned for Surgical Removal or Exposure?

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
R Devine ◽  
A Holden ◽  
A Felstead
Keyword(s):  
Oral Surgery ◽  
Maxillofacial Surgery ◽  
Oral And Maxillofacial Surgery ◽  
Surgical Removal ◽  
Surgical Time ◽  
Delayed Treatment ◽  
Clinically Significant ◽  
Surgery Department ◽  
Repeat Imaging ◽  
Delay In Treatment

Abstract Aim To evaluate whether there has been a change in clinical or radiographic position and the resultant occurrence of complications of unerupted and ectopic teeth due to delayed treatment during the COVID-19 pandemic Method Data was collected over a three-month period at the Royal United Hospital, Bath, Oral and Maxillofacial Surgery Department. This was via a questionnaire distributed to clinicians and prospectively completed for each surgical procedure planned for the removal or exposure of ectopic canines, premolars, and supernumerary teeth. Results A total of 20 surgical extractions or exposures were performed during the three-month period, with 33% (n = 6) having a marked difference between their expected and final position. Complications occurred in 66.6% (n = 4) of cases that demonstrated a discrepancy in location. These were an increased surgical time, increased removal of bone or a cancellation of intended treatment. This cancellation occurred as the tooth had erupted enough for non-surgical management. In cases where there was no discrepancy (n = 14), no complications were reported. Conclusions These findings suggest the delay in treatment caused by the COVID-19 pandemic has resulted in a clinically significant change in the position of ectopic teeth planned for surgical removal or exposure. Given these findings, it is crucial that clinicians be aware that radiographic investigations are diagnostic and recent. The threshold for repeat imaging in all cases which have been delayed should be low to avoid unexpected surgical complications arising from inaccuracy in tooth localisation.

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