Predicting pathology in impacted mandibular third molars

Directory of Open Access Journals (Sweden)

Aveek Mukherji

2017-01-01

Full Text Available Introduction: The rising incidence of the impacted mandibular third molars and their association with pathologies is now considered a public health problem. Aims and Objectives: The objective of this study was to assess the position of impacted mandibular third molars that are prone to developing pathologies and to determine the frequency and type of pathological conditions associated with these impacted teeth to facilitate planning for their prophylactic removal. Materials and Methods: Consecutive panoramic radiographs and clinical examination of 300 patients with impacted mandibular third molars were collected. They were segregated according to Pell and Gregory’s classification, Winter’s classification, and according to their state of eruption. These were correlated with associated pathologies based on clinical and radiological criteria. Statistical Analysis Used: Descriptive statistics included computation of percentages, mean, and standard deviations. The statistical test applied for the analysis was Pearson’s Chi-square test (χ2. For this test, confidence interval and P value were set at 93% and ≤0.03, respectively. Results: The pathology most commonly associated with impacted third molars was pericoronitis, which had the highest frequency of occurrence in partially erupted, distoangular, and IA positioned (as per Pell and Gregory classification impacted teeth. Impacted mandibular third molars, which were in IA position, placed mesially, and partially erupted, were prone to develop pathologies such as dental caries and periodontitis. Conclusion: The clinical and radiographical features of impacted third molar may be correlated to the development of their pathological complications. The partially impacted mandibular third molars with mesioangularly aligned in IA position have the highest potential to cause pathological complications.

Epidemiological Status of Third Molars in an Iranian Population

Directory of Open Access Journals (Sweden)

Mahnaz Sheikhi

2016-07-01

Full Text Available Background Impaction of third molars is a common phenomenon. The incidence of impacted third molars varies in different populations. Objectives The aim of this study is to assess radiographic status (root development degree, angulation, and eruption level of the third molar in Iranian population via panoramic radiographs. Patients and Methods 647 patients, ranging in age from 17 - 25, were selected from three regions of Iran. Based on their panoramic radiographs, their root development degree, angulation, and eruption levels were analyzed. Results The angulation of upper third molars were vertical (44.6%, distoangular (44.1%, mesioangular (10.7%, and horizontal (0.6%. For lower third molars, the angulation was mesioangular (44.5%, vertical (33.8%, distoangular (12.2%, and horizontal (9.5%. The eruption levels of maxillary third molars were C > A> B, and for mandibular third molars they were A > B> C. The order of root development prevalence of the maxillary and mandibular third molars was complete > 2/3 > 1/3. Conclusions The most common status of impaction of the third molars in the maxilla was vertical angulation, level C of eruption, and complete root formation. In the mandible it was mesioangular, level A of eruption, and complete root formation. Since the study sample consists of patients from the north, middle, and south of Iran, the sample can represent the whole population of Iran.

Coronectomy of Deeply Impacted Lower Third Molar: Incidence of Outcomes and Complications after One Year Follow-Up

Directory of Open Access Journals (Sweden)

Jimoh Olubanwo Agbaje

2015-06-01

Full Text Available Objectives: The purpose of present study was to assess the surgical management of impacted third molar with proximity to the inferior alveolar nerve and complications associated with coronectomy in a series of patients undergoing third molar surgery. Material and Methods: The position of the mandibular canal in relation to the mandibular third molar region and mandibular foramen in the front part of the mandible (i.e., third molar in close proximity to the inferior alveolar nerve [IAN] or not was identified on panoramic radiographs of patients scheduled for third molar extraction. Results: Close proximity to the IAN was observed in 64 patients (35 females, 29 males with an impacted mandibular third molar. Coronectomy was performed in these patients. The most common complication was tooth migration away from the mandibular canal (n = 14, followed by root exposure (n = 5. Re-operation to remove the root was performed in cases with periapical infection and root exposure. Conclusions: The results indicate that coronectomy can be considered a reasonable and safe treatment alternative for patients who demonstrate elevated risk for injury to the inferior alveolar nerve with removal of the third molars. Coronectomy did not increase the incidence of damage to the inferior alveolar nerve and would be safer than complete extraction in situations in which the root of the mandibular third molar overlaps or is in close proximity to the mandibular canal.

Endodontic management of a mandibular third molar fused with a fourth molar.

Science.gov (United States)

Turell, I L; Zmener, O

1999-05-01

Developmental anomalies in permanent molars frequently require surgical intervention. A case of a mandibular third molar fused with a fourth molar which was successfully treated with conservative endodontic therapy is reported.

Taking advantage of an unerupted third molar: a case report

Directory of Open Access Journals (Sweden)

Igor Figueiredo Pereira

Full Text Available ABSTRACT Introduction: Treatments with dental surgery seek to displace tooth to the correct position within the dental arch. Objective: To report a clinical case that took advantage of an unerupted third molar. Case history: A male patient, 18 years of age, was referred by his dentist to evaluate the third molars. The clinical exam revealed no visible lower third molars. The computed tomography (CT exam showed the presence of a supernumerary tooth in the region of the mandibular ramus, on the left side, and impaction of the third molar, which was causing root resorption on the second molar, thus making it impossible to remain in the buccal cavity. The preferred option, therefore, was to remove both second molar and the supernumerary tooth, in addition to attaching a device to the third molar during surgery for further traction. Results: After 12 months, the third molar reached the proper position. Conclusion: When a mandibular second permanent molar shows an atypical root resorption, an impacted third molar can effectively substitute the tooth by using an appropriate orthodontic-surgical approach.

Dental age assessment of young Iranian adults using third molars: A multivariate regression study.

Science.gov (United States)

Bagherpour, Ali; Anbiaee, Najmeh; Partovi, Parnia; Golestani, Shayan; Afzalinasab, Shakiba

2012-10-01

In recent years, a noticeable increase in forensic age estimations of living individuals has been observed. Radiologic assessment of the mineralisation stage of third molars is of particular importance, with regard to the relevant age group. To attain a referral database and regression equations for dental age estimation of unaccompanied minors in an Iranian population was the goal of this study. Moreover, determination was made concerning the probability of an individual being over the age of 18 in case of full third molar(s) development. Using the scoring system of Gleiser and Hunt, modified by Köhler, an investigation of a cross-sectional sample of 1274 orthopantomograms of 885 females and 389 males aged between 15 and 22 years was carried out. Using kappa statistics, intra-observer reliability was tested. With Spearman correlation coefficient, correlation between the scores of all four wisdom teeth, was evaluated. We also carried out the Wilcoxon signed-rank test on asymmetry and calculated the regression formulae. A strong intra-observer agreement was displayed by the kappa value. No significant difference (p-value for upper and lower jaws were 0.07 and 0.59, respectively) was discovered by Wilcoxon signed-rank test for left and right asymmetry. The developmental stage of upper right and upper left third molars yielded the greatest correlation coefficient. The probability of an individual being over the age of 18 is 95.6% for males and 100.0% for females in case four fully developed third molars are present. Taking into consideration gender, location and number of wisdom teeth, regression formulae were arrived at. Use of population-specific standards is recommended as a means of improving the accuracy of forensic age estimates based on third molars mineralisation. To obtain more exact regression formulae, wider age range studies are recommended. Copyright © 2012 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Maxillary second molar impaction in the adjacent ectopic third molar: Report of five rare cases

Science.gov (United States)

Souki, Bernardo Q.; Cheib, Paula L.; de Brito, Gabriela M.; Pinto, Larissa S. M. C.

2015-01-01

Maxillary second molar impaction in the adjacent ectopic third molar is a rare condition that practitioners might face in the field of pediatric dentistry and orthodontics. The early diagnosis and extraction of the adjacent ectopic third molar have been advocated, and prior research has reported a high rate of spontaneous eruption following third molar removal. However, some challenges in the daily practice are that the early diagnosis of this type of tooth impaction is difficult with conventional radiographic examination, and sometimes the early surgical removal of the maxillary third molar must be postponed because of the risks of damaging the second molar. The objective of this study is to report a case series of five young patients with maxillary second molar impaction and to discuss the difficulty of early diagnosis with the conventional radiographic examination, and unpredictability of self-correction. PMID:26321848

Maxillary second molar impaction in the adjacent ectopic third molar: Report of five rare cases

Directory of Open Access Journals (Sweden)

Bernardo Q Souki

2015-01-01

Full Text Available Maxillary second molar impaction in the adjacent ectopic third molar is a rare condition that practitioners might face in the field of pediatric dentistry and orthodontics. The early diagnosis and extraction of the adjacent ectopic third molar have been advocated, and prior research has reported a high rate of spontaneous eruption following third molar removal. However, some challenges in the daily practice are that the early diagnosis of this type of tooth impaction is difficult with conventional radiographic examination, and sometimes the early surgical removal of the maxillary third molar must be postponed because of the risks of damaging the second molar. The objective of this study is to report a case series of five young patients with maxillary second molar impaction and to discuss the difficulty of early diagnosis with the conventional radiographic examination, and unpredictability of self-correction.

The contemporary management of third molars.

Science.gov (United States)

Hyam, D M

2018-03-01

The management of third molars requires a significant assessment and decision process both for the patient and the clinician. The clinician must always identify the indication for third molar surgery, assess the risks of the proposed procedure, and then modify their plan to account for the patient's current and future health, their social and financial setting, and the patient's tolerance of risk. In doing this, the clinician can tailor a solution to meet the individual patient's needs. This decision to remove a third molar is made in the fluid setting of the patient's quality of life and requires regular review. This article gives the clinician the tools, the matrix, and the confidence to guide patients through this process, and outlines some of the pitfalls and common points of bias within the process. © 2018 Australian Dental Association.

Presence of third molars in orthodontic patients from northern Greece

Directory of Open Access Journals (Sweden)

Barka G

2012-05-01

Full Text Available Georgia Barka,1 Georgios Tretiakov,1 Theodosios Theodosiou,2 Ioulia Ioannidou-Marathiotou31School of Dentistry, 2Biostatistics, Department of Informatics, School of Natural Sciences, 3Department of Orthodontics, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, GreeceObjective: The purpose of the present study was to investigate the frequency of presence of third molar teeth and their distribution in each jaw and each side, according to sex, in a group of orthodontic patients with permanent dentition from northern Greece.Methods: The sample included panoramic radiographs from 220 patients with permanent dentition (mean age 13.62 ± 1.81. The Χ2 test was used to assess the relationships between the variables, and the Fisher's exact test was used in cases where the expected frequencies in each cell were <5.Results: The frequency of third molar presence was 79.1%, and 20.9% was the frequency of third molar agenesis. Intersexual differences in the number of third molars was not statistically significant. There was a correlation between the distribution of third molars on the right and the left side (Fisher's exact test = 100.788; P = 0. The two sides showed the same tendency toward the presence or absence of third molars. A correlation was also found between the distribution of maxillary and mandibular third molars (Fisher's exact test = 24.372; P = 0. In each jaw, the presence or absence of third molars was highly related to the number of third molars found in the other jaw.Conclusion: The present results showed that in this orthodontic group of northern Greek patients, presence accounted for 79.1% and agenesis for 20.9%. No significant difference was found between the frequencies of third molar presence on the left and right sides in either the maxilla or mandible.Keywords: third molars, presence, orthodontic population, Greeks

Autotransplantation of Mandibular Third Molar: A Case Report

Directory of Open Access Journals (Sweden)

Pabbati Ravi kumar

2012-01-01

Full Text Available Autogenous transplantation is a feasible, fast, and economical option for the treatment of nonsalvageable teeth when a suitable donor tooth is available. This paper presents successful autotransplantation of a mature mandibular left third molar (38 without anatomical variances is used to replace a mandibular left second molar (37. The mandibular second molar was nonrestorable due to extensive root caries and resorption of distal root. After extraction of mandibular second and third molars, root canal therapy was done for the third molar extraorally, and the tooth was reimplanted into the extracted socket of second molar site. After one year, clinical and radiographic examination revealed satisfactory outcome with no signs or symptoms suggestive of pathology. In selected cases, autogenous tooth transplantation, even after complete root formation of the donor tooth, may be considered as a practical treatment alternative to conventional prosthetic rehabilitation or implant treatment.

Assessment of legal adult age of 18 by measurement of open apices of the third molars: Study on the Albanian sample.

Science.gov (United States)

Cameriere, Roberto; Santoro, Valeria; Roca, Roberta; Lozito, Piercarlo; Introna, Francesco; Cingolani, Mariano; Galić, Ivan; Ferrante, Luigi

2014-12-01

The third molar tooth is one of the few anatomical structures in development available for estimating the age of individuals in the late adolescence. This study tests the accuracy of Cameriere's cut-off value of the third molar index (I3M) in assessing legal adult age of 18 years in an Albanian sample. For this purpose, a sample of orthopantomograms (OPTs) of 286 living subjects (152 female and 134 male) aged between 15 and 22 years was analyzed. Intra-rater and inter-raters agreement of I3M were 0.998 and 0.998, respectively and Cohen Kappa for intra-rater and inter-rater agreement in decision on adult or minor was 1.0 and 1.0, respectively. Age distribution gradually decreases as I3M increases in both males and females. The mean age of females is higher than that of males when I3M is between 0.04 and 0.08. Sensitivity test for males was 94.1%, with a 95% confidence interval (95% CI) 85.6-98.4%, and specificity was 90.9% (95%CI 81.3-96.6%). The proportion of correctly classified individuals was 92.5%, with a 95%CI of (86.7%, 96.4%). For females, the sensitivity test was 75.4%, with a 95%CI of (63.1%, 85.2%) and specificity was 96.6%, with a 95%CI of (90.3%, 99.3%). The proportion of correctly classified individuals was 87.5%, with a 95%CI of (81.2%, 92.3%). The results indicate that Cameriere's cut-off value of the third molar index (I3M=0.08) is useful in discriminating between Albanian adults and juveniles, and encourage us to test its suitability for determining the adult age in individuals from other populations. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Angulation change of the third molar tooth in orthodontic treatment

Directory of Open Access Journals (Sweden)

Ardiansyah S. Pawinru

2017-04-01

Full Text Available Objective : Impaction of the third molar tooth mandibular is often found in patients with orthodontic treatment. In orthodontic treatment, extraction cases of impaction of the third molar tooth are usually performed, but the patients often refuse this extraction. Extraction of premolar has a good effect on the third molar mandibular angulation during treatment. Material and Methods : This study is a retrospective clinical study with descriptive analytic to find out the effect of the first mandibular premolar tooth extraction to angulation change of the third molar mandibular in orthodontic treatment with a standard edgewise method. Angulation change was performed by comparing the third molar mandibular angulation before and after orthodontic treatment with panoramic radiographs. Angulation of the third molar tooth mandibular was calculated from the angle formed between the long axis of the tooth with the reference line infraorbita. Results : The sample comprised 60 of impacted mandibular third molar region of the left and right regions of 30 patients who had been treated declared cured in clinic of orthodontic specialist of Dentistry Faculty Padjadjaran University. The sample was divided into three (3 groups of patients before treatment angulation of the third molar tooth mandibular under 300, 300 to 600 and above 60o, then measured change of angulation and observed whether it increased, fixed or decreased. Results were analyzed by T- test and Wilcoxon test showed that there was a significant change in angulation of the third molar mandibular in orthodontic treatment with the first premolar tooth mandibular extraction. Conclusion : This study is that the first premolar tooth mandibular extraction affects the angulation of the third molar tooth mandibular after orthodontic treatment.

Dental age assessment of adolescents and emerging adults in United Kingdom Caucasians using censored data for stage H of third molar roots.

Science.gov (United States)

Boonpitaksathit, Teelana; Hunt, Nigel; Roberts, Graham J; Petrie, Aviva; Lucas, Victoria S

2011-10-01

The root of the third permanent molar is the only dental structure that continues development after completion of growth of the second permanent molar. It is claimed that the lack of a clearly defined end point for completion of growth of the third permanent molar means that this tooth cannot be used for dental age assessment. The aim of this study was to estimate the mean age of attainment of the four stages (E, F, G, and H) of root development of the third molar. The way in which the end point of completion of stage H can be identified is described. A total of 1223 dental panoramic tomographs (DPTs) available in the archives of the Eastman Dental Hospital, London, were used for this study. The ages of the subjects ranged from 12.6 to 24.9 years with 63 per cent of the sample being female. Demirjan's tooth development stages (TDSs), for the first and second molars, were applied to the third molars by a single examiner. For each of stages E, F, and G and for stage H censored data, the mean ages of the males and females were compared, separately within each tooth morphology type using the two sample t-test (P ages of the upper and lower third molars on each side, separately for each gender. The mean age of attainment and the 99 per cent confidence interval (CI) for each TDS were calculated for each third molar. The final stage H data were appropriately censored to exclude data above the age of completion of root growth. The results showed that, for each gender, the age in years at which individuals attained each of the four TDSs was approximately normally distributed. The mean age for appropriately censored data was always lower than the corresponding mean age of the inappropriately censored data for stage H (male UR8 19.57, UL8 19.53, LL8 19.91, and LR8 20.02 and female UR8 20.08, UL8 20.13, LL8 20.78, and LR8 20.70). This inappropriately censored data overestimated the mean age for stage H. The appropriately censored data for the TDSs of the third molar may be

Rare occurrence of the left maxillary horizontal third molar impaction ...

African Journals Online (AJOL)

Rare occurrence of the left maxillary horizontal third molar impaction, the right maxillary third molar vertical impaction and the left mandibular third molar vertical impaction with inferior alveolar nerve proximity in a 30 year old female: a case report.

Human dental age estimation combining third molar(s) development and tooth morphological age predictors.

Science.gov (United States)

Thevissen, P W; Galiti, D; Willems, G

2012-11-01

In the subadult age group, third molar development, as well as age-related morphological tooth information can be observed on panoramic radiographs. The aim of present study was to combine, in subadults, panoramic radiographic data based on developmental stages of third molar(s) and morphological measurements from permanent teeth, in order to evaluate its added age-predicting performances. In the age range between 15 and 23 years, 25 gender-specific radiographs were collected within each age category of 1 year. Third molar development was classified and registered according the 10-point staging and scoring technique proposed by Gleiser and Hunt (1955), modified by Köhler (1994). The Kvaal (1995) measuring technique was applied on the indicated teeth from the individuals' left side. Linear regression models with age as response and third molar-scored stages as explanatory variables were developed, and morphological measurements from permanent teeth were added. From the models, determination coefficients (R (2)) and root-mean-square errors (RMSE) were calculated. Maximal-added age information was reported as a 6 % R² increase and a 0.10-year decrease of RMSE. Forensic dental age estimations on panoramic radiographic data in the subadult group (15-23 year) should only be based on third molar development.

Piezoelectric Versus Conventional Rotary Techniques for Impacted Third Molar Extraction: A Meta-analysis of Randomized Controlled Trials.

Science.gov (United States)

Jiang, Qian; Qiu, Yating; Yang, Chi; Yang, Jingyun; Chen, Minjie; Zhang, Zhiyuan

2015-10-01

Impacted third molars are frequently encountered in clinical work. Surgical removal of impacted third molars is often required to prevent clinical symptoms. Traditional rotary cutting instruments are potentially injurious, and piezosurgery, as a new osteotomy technique, has been introduced in oral and maxillofacial surgery. No consistent conclusion has been reached regarding whether this new technique is associated with fewer or less severe postoperative sequelae after third molar extraction.The aim of this study was to compare piezosurgery with rotary osteotomy techniques, with regard to surgery time and the severity of postoperative sequelae, including pain, swelling, and trismus.We conducted a systematic literature search in the Cochrane Library, PubMed, Embase, and Google Scholar.The eligibility criteria of this study included the following: the patients were clearly diagnosed as having impacted mandibular third molars; the patients underwent piezosurgery osteotomy, and in the control group rotary osteotomy techniques, for removing impacted third molars; the outcomes of interest include surgery time, trismus, swelling or pain; the studies are randomized controlled trials.We used random-effects models to calculate the difference in the outcomes, and the corresponding 95% confidence interval. We calculated the weighted mean difference if the trials used the same measurement, and a standardized mean difference if otherwise.A total of seven studies met the eligibility criteria and were included in our analysis. Compared with rotary osteotomy, patients undergoing piezosurgery experienced longer surgery time (mean difference 4.13 minutes, 95% confidence interval 2.75-5.52, P piezosurgery groups.The number of included randomized controlled trials and the sample size of each trial were relatively small, double blinding was not possible, and cost analysis was unavailable due to a lack of data.Our meta-analysis indicates that although patients undergoing piezosurgery

Pattern of third molar impaction in a Saudi population

Directory of Open Access Journals (Sweden)

Ali H Hassan

2010-10-01

Full Text Available Ali H Hassan11Department of Preventive Dental Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi ArabiaObjective: To evaluate the current pattern of third molar impaction in a sample of Saudi patients.Methods: One thousand thirty-nine orthopantomograms (OPG of patients ranging in age from 19 to 46 years (536 males and 503 females were evaluated to determine the frequency of impacted third molars, their levels of eruption, and their angulations.Results: Four hundred twenty-two (40.5% of the 1039 OPG showed at least one impacted third molar, with no significant difference between males (222; 52.6% and females (200; 47.4% (P = 0.284. The most common number of impacted third molars per OPG was one (72.5%. Impacted third molars were 1.64 times more likely to occur in the mandible than in the maxilla. The most common angulation of impaction in the mandible was the mesial (33.4%, while the most common angulation in the maxilla, was the vertical (49.6%. Level B impaction was the most common in both maxilla (48.2% and mandible (67.7%. There was no significant difference in the frequency of impaction between the right and left sides in both jaws.Conclusion: The pattern of third molar impaction in the western region of Saudi Arabia is characterized by a high prevalence of impaction that is greater in the mandibles and with no sex predilection.Keywords: third molar, impaction, prevalence, Saudi 

Association of the Mandibular Third Molar Position to the Pericoronitis

Directory of Open Access Journals (Sweden)

Tsvetan Tsvetanov

2018-02-01

Full Text Available Introduction: Pericoronitis is inflammation of the soft tissues surrounding the crown of a partially erupted tooth. Objective: To provide measurement of lower third molar angulation and determine relationship between mandibular third molar position and presence of pericoronitis. Material and methods: We studied 104 patients with lower third molar pericoronitis with clinical manifestations and measurement of lower third molar angulation. The mean age of patients was 25.7 years (range 18-35 years. Results: In this study was used the following statistical analysis, Pearson correlation coefficient and Spearman’s correlation coefficient (nonparametric version of the Pearson correlation coefficient for measure of the linear correlation between two variables - pericoronitis and angulation of the lower third molars. The chi-square test was used to assesses case incidences. The level of significance was p<0.05. 36.04% of partially impacted mandibular third molars were mesioangular followed by the vertical (25.47%, horizontal (18.97%, distoangular (9.21%, buccal (5.42% and lingual (3.79% position. The lowest part of the mandibular third molars is located in the ramus of mandible (1.08%. The present study was found in relation to mesioangular, distoangular, vertical impaction and pericoronitis (p<0.05. Conclusion: We conclude that the position of lower third molar may be able to be associated with presence of pericoronitis.

Estimation of legal age using calcification stages of third molars in living individuals.

Science.gov (United States)

Streckbein, Philipp; Reichert, Isabelle; Verhoff, Marcel A; Bödeker, Rolf-Hasso; Kähling, Christopher; Wilbrand, Jan-Falco; Schaaf, Heidrun; Howaldt, Hans-Peter; May, Andreas

2014-12-01

The increased number of adolescents and young adults with unknown or inaccurately given date of birth is a current issue in justice and legal medicine. The objective of this study was to determine the extent to which third molar calcification stages assessed on panoramic X-rays could be useful as additional criteria for forensic age estimation in living individuals, focusing on the legally important ages 17 and 18. In a retrospective multi-center study, the developmental stage of each individual's third molar was analyzed using Demirjian's scale in 2360 cases. Additionally, sex, age and ancestry were assessed. Individuals with the lowest calcification stage of all present molars in stage H were ≥18 years with a likelihood of ≥99.05% in the female (n=388), and ≥99.24% in the male (n=482) population. The lowest calcification stage of all present third molars proved to be useful as an additional reliable criterion for the determination of an age ≥18 years. Copyright © 2014 Forensic Science Society. Published by Elsevier Ireland Ltd. All rights reserved.

Prevalent of root resorption of second molar adjustment the impacted third molar in prepiacal and panoramic radiographs

Directory of Open Access Journals (Sweden)

Mohammad Ebrahimi Saravi

2013-10-01

Full Text Available   Background and Aims: Impacted third molar reduces the bone level in the distal aspect of second molar, and sometimes it can lead to root resorption of the adjacent tooth. The purpose of this study was to determine this resorption using panoramic and periapical radiographs.   Materials and Methods: In this cross-sectional descriptive study 54 patient (28 men, 26 women above 15 years old with the average of 22 years in Oral and Maxillofacial Department of Tehran University were studied. A periapical radiography from the third molar and a panoramic radiograph were taken from each patient (Because of their routine use and evaluation of accuracy of panoramic compared with periapical, and the magnitude of the root resorption for the second molar was determined by 2 observers and written in a questionnaire. Data were analyzed using Fisher test.   Results: The prevalence of the root resorption of the second molar adjacent to the impacted third molar in the panoramic and the periapical radiographies, with respect to the limitation of the sample size were 46.3% and 31.5%, respectively, with 95% confidence(P>0.05. Most of these resorptions were in the cervical third of the second molar roots and in cases in which the third molars were mesially oriented or horizontal. There was also no significant difference between panoramic and periapical radiographs.   Conclusion: Due to the increased risk of the resorption of the second molar adjacent to the third molar, extraction of the impacted third molars, especiall y mesially oriented or horizontal ones are recommended.

Use of third molar transplantation for closure of the oroantral communication after tooth extraction: a report of 2 cases.

Science.gov (United States)

Kitagawa, Yoshimasa; Sano, Kazuo; Nakamura, Mikiko; Ogasawara, Toshiyuki

2003-04-01

This clinical report introduces a promising and unique method for the immediate closure of the oroantral communication (OAC) after tooth extraction: the use of the transplanted third molar with closed apices. In 2 adult patients, OAC caused by the extraction of an upper molar was immediately closed by using a transplanted third molar with complete root formation. After tooth extraction at the recipient site, OAC with perforated mucosa of the sinus floor was confirmed and the donor third molar was transferred to the prepared recipient socket. Endodontic therapy of the transplanted third molar began at 3 weeks after surgery, and prosthetic treatment was completed at 5 months after the operation. These 2 patients were carefully observed both clinically and radiographically. Closure of the OAC was successfully performed, and the transplanted teeth became fixed with the passage of time in these 2 patients. Root resorption did not occur, and good functional results were obtained without any complications. Tooth transplantation of a mature third molar for closure of the OAC is a simple and excellent method because the transplanted tooth not only closes the communication to the maxillary sinus, but it also satisfactorily functions at the recipient site during mastication, even in adult patients.

Changes in heart rate during third molar surgery

NARCIS (Netherlands)

Hollander, M. H. J.; Schortinghuis, J.; Vissink, A.

2016-01-01

Anxiety is an undesirable psychological phenomenon. Patients are usually anxious when subjected to third molar surgery, but the pattern of anxiety is unknown. The aim of this study was to assess the intensity and course of anxiety during third molar surgery. This study included 48 consecutive

An evaluation of third molar eruption for assessment of chronologic age: A panoramic study.

Science.gov (United States)

Tuteja, Monica; Bahirwani, Shraddha; Balaji, P

2012-01-01

The identity of a person can be established by assessing one's age, and in order to be entitled to civil rights and social benefits, verification of the chronological age is required and thereby age estimation has gained an increasing significance in recent years. Tooth eruption is one of the criteria of developmental morphology that can be evaluated by either clinical examination or by evaluation of dental radiographs to determine the dental age. The present study was aimed to evaluate the reliability of the third molar eruption stage as a parameter for forensic age estimation in living subjects. The stage of wisdom tooth eruption in 77 male and 73 female Indian subjects aged between 12-26 years was determined by subjecting them to conventional orthopantomograms and was interpreted to assess the third molar eruption stages to evaluate the dental age. Predicted minimum age and mean age of the study sample were found to be significant predictors (Page. Minimum age was able to explain 58.3% of the variation in actual age and the mean age was able to explain 60.3% of variation in actual age. Third molar is fairly a reliable indicator to determine the age of alveolar, gingival, and complete emergence of third molar in the occlusal plane in adolescents and young adults. Minimum and most probable ages of examined subjects can also be evaluated using third molar eruption stage.

Dental age estimation in Japanese individuals combining permanent teeth and third molars.

Science.gov (United States)

Ramanan, Namratha; Thevissen, Patrick; Fleuws, Steffen; Willems, G

2012-12-01

The study aim was, firstly, to verify the Willems et al. model on a Japanese reference sample. Secondly to develop a Japanese reference model based on the Willems et al. method and to verify it. Thirdly to analyze the age prediction performance adding tooth development information of third molars to permanent teeth. Retrospectively 1877 panoramic radiographs were selected in the age range between 1 and 23 years (1248 children, 629 sub-adults). Dental development was registered applying Demirjian 's stages of the mandibular left permanent teeth in children and Köhler stages on the third molars. The children's data were, firstly, used to validate the Willems et al. model (developed a Belgian reference sample), secondly, split ino a training and a test sample. On the training sample a Japanese reference model was developed based on the Willems method. The developed model and the Willems et al; model were verified on the test sample. Regression analysis was used to detect the age prediction performance adding third molar scores to permanent tooth scores. The validated Willems et al. model provided a mean absolute error of 0.85 and 0.75 years in females and males, respectively. The mean absolute error in the verified Willems et al. and the developed Japanese reference model was 0.85, 0.77 and 0.79, 0.75 years in females and males, respectively. On average a negligible change in root mean square error values was detected adding third molar scores to permanent teeth scores. The Belgian sample could be used as a reference model to estimate the age of the Japanese individuals. Combining information from the third molars and permanent teeth was not providing clinically significant improvement of age predictions based on permanent teeth information alone.

Permanent first molar extraction in adolescents and young adults and its effect on the development of third molar.

Science.gov (United States)

Halicioglu, Koray; Toptas, Orcun; Akkas, Ismail; Celikoglu, Mevlut

2014-01-01

The aim of the present study was to determine the prevalence of permanent first molar (P1M) extraction among Turkish adolescents and young adult subpopulation, and to investigate the effects of P1M extraction on development of the third molars (3Ms) in the same quadrant. A retrospective study including 2,925 panoramic radiographs (PRs) taken from patients (aged 13-20 years) who were examined to identify cases of had at least one maxillary or mandibular P1Ms extracted was performed. Additionally, 294 PRs with the maxillary or mandibular unilateral loss of a P1M were used to assess the developmental grades of the 3Ms. Statistical analyses were performed by means of parametric tests after performing a Shapiro-Wilks normality test to the data. A total of 945 patients (32.3 %) presented with at least one P1M extraction with no gender difference (P = 0.297). There were more cases of mandibular P1Ms extracted (784 patients, 1,066 teeth) than maxillary P1Ms extracted (441 patients, 549 teeth) (P development of the 3Ms on the extraction side, in the both maxilla and mandible, was significantly accelerated when compared with the contralateral teeth (P = 0.000, P = 0.000, respectively). No statistically significant differences were found in the differences in the developmental of the 3Ms between the maxilla and mandible (P = 0.718). High prevalence of P1Ms extraction among Turkish adolescents and young adults shows a need for targeted dental actions, including prevention and treatment. The development of the 3Ms on the extraction side, in the both maxilla and mandible, was significantly accelerated. To date, no information about prevalence of P1Ms extraction among Turkish adolescents and young adults is documented. In addition, the present study has a larger population and complementary information about 3Ms development than previous studies.

Age estimation in the living: Transition analysis on developing third molars.

Science.gov (United States)

Tangmose, Sara; Thevissen, Patrick; Lynnerup, Niels; Willems, Guy; Boldsen, Jesper

2015-12-01

A radiographic assessment of third molar development is essential for differentiating between juveniles and adolescents in forensic age estimations. As the developmental stages of third molars are highly correlated, age estimates based on a combination of a full set of third molar scores are statistically complicated. Transition analysis (TA) is a statistical method developed for estimating age at death in skeletons, which combines several correlated developmental traits into one age estimate including a 95% prediction interval. The aim of this study was to evaluate the performance of TA in the living on a full set of third molar scores. A cross sectional sample of 854 panoramic radiographs, homogenously distributed by sex and age (15.0-24.0 years), were randomly split in two; a reference sample for obtaining age estimates including a 95% prediction interval according to TA; and a validation sample to test the age estimates against actual age. The mean inaccuracy of the age estimates was 1.82 years (±1.35) in males and 1.81 years (±1.44) in females. The mean bias was 0.55 years (±2.20) in males and 0.31 years (±2.30) in females. Of the actual ages, 93.7% of the males and 95.9% of the females (validation sample) fell within the 95% prediction interval. Moreover, at a sensitivity and specificity of 0.824 and 0.937 in males and 0.814 and 0.827 in females, TA performs well in differentiating between being a minor as opposed to an adult. Although accuracy does not outperform other methods, TA provides unbiased age estimates which minimize the risk of wrongly estimating minors as adults. Furthermore, when corrected ad hoc, TA produces appropriate prediction intervals. As TA allows expansion with additional traits, i.e. stages of development of the left hand-wrist and the clavicle, it has a great potential for future more accurate and reproducible age estimates, including an estimated probability of having attained the legal age limit of 18 years. Copyright © 2015

Bilateral maxillary fused second and third molars: a rare occurrence.

Science.gov (United States)

Liang, Rui-Zhen; Wu, Jin-Tao; Wu, You-Nong; Smales, Roger J; Hu, Ming; Yu, Jin-Hua; Zhang, Guang-Dong

2012-12-01

This case report describes the diagnosis and endodontic therapy of maxillary fused second and third molars, using cone-beam computed tomography (CBCT). A 31-year-old Chinese male, with no contributory medical or family/social history, presented with throbbing pain in the maxillary right molar area following an unsuccessful attempted tooth extraction. Clinical examination revealed what appeared initially to be a damaged large extra cusp on the buccal aspect of the distobuccal cusp of the second molar. However, CBCT revealed that a third molar was fused to the second molar. Unexpectedly, the maxillary left third molar also was fused to the second molar, and the crown of an unerupted supernumerary fourth molar was possibly also fused to the apical root region of the second molar. Operative procedures should not be attempted without adequate radiographic investigation. CBCT allowed the precise location of the root canals of the right maxillary fused molar teeth to permit successful endodontic therapy, confirmed after 6 months.

Prevention of alveolar osteitis after third molar surgery: Comparative ...

African Journals Online (AJOL)

Prevention of alveolar osteitis after third molar surgery: Comparative study of the ... for surgical extraction of lower third molar were prospectively, consecutively, and ... Information on demographic, types and level of impaction, indications for ...

Forensic age estimation based on development of third molars: a staging technique for magnetic resonance imaging.

Science.gov (United States)

De Tobel, J; Phlypo, I; Fieuws, S; Politis, C; Verstraete, K L; Thevissen, P W

2017-12-01

discern minors from adults was better for males than for females, with specificities of 96% and 73% respectively. Age estimations based on the proposed staging method for third molars on MRI showed comparable reproducibility and performance as the established methods based on radiographs.

MANAGEMENT OF MANDIBULAR THIRD MOLAR SURGERY TO PRESERVE PERIODONTAL HEALTH OF SECOND MOLAR

Directory of Open Access Journals (Sweden)

Elitsa G. Deliverska

2017-06-01

Full Text Available Background: Extraction of impacted third molar violates surrounding soft and bony tissues. Various surgical approaches and surgical technics have an important impact on the periodontal health of the adjacent second molar. Purpose: The aim of this review is to analyse the causes that can affect postoperative periodontal outcomes for the mandibular second molars (LM2 adjacent to the impacted/ semi impacted mandibular third molars (LM3. Material and Methods: Electronic searches were conducted through the MEDLINE (PubMed, Scopus, etc. databases to screen all relevant articles published from inception to April 2017. Results: Different flap techniques had no significant impact on the probing depth reduction or on the clinical attachment level of LM2. Szmyd and paramarginal flap designs may be the most effective in reducing the probing depth after third molar surgery, and the envelope flap may be the least effective. Use of bone substitutes and guided tissue regeneration therapy has been proposed, to eliminate or prevent these periodontal defects, but there is still no consensus on their predictability or clinical benefit. Higher costs and the risk of postoperative inflammatory complications should also be taken into proper account, as with any surgical procedure. “Orthodontic extraction” is indicated for that impacted M3 that present a high risk of postoperative periodontal defects at the distal aspect of adjacent M2. Conclusion: Risk factors associated with bone loss following lower third molar extraction includes age, the direction of the eruption, preoperative bone defects, and resorbtion of the LM2 root surface. Prevention of such periodontal defects continues to challenge clinicians.

Radiographic evaluation of third molar development in 6 to 24 year olds

International Nuclear Information System (INIS)

Jung, Yun Hwa; Cho, Bong Hae

2014-01-01

This study investigated the developmental stages of third molars in relation to chronological age and compared third molar development according to location and gender. A retrospective analysis of panoramic radiographs of 2490 patients aged between 6 and 24 years was conducted, and the developmental stages of the third molars were evaluated using the modified Demirjian's classification. The mean age, standard deviation, minimal and maximal age, and percentile distributions were recorded for each stage of development. A Mann-Whitney U test was performed to test the developmental differences in the third molars between the maxillary and mandibular arches and between genders. A linear regression analysis was used for assessing the correlation between the third molar development and chronological age. The developmental stages of the third molars were more advanced in the maxillary arch than the mandibular arch. Males reached the developmental stages earlier than females. The average age of the initial mineralization of the third molars was 8.57 years, and the average age at apex closure was 21.96 years. The mean age of crown completion was 14.52 and 15.04 years for the maxillary and the mandibular third molars, respectively. The developmental stages of the third molars clearly showed a strong correlation with age. The third molars developed earlier in the upper arch than the lower arch; further, they developed earlier in males than in females.

Autologous Platelet-rich Plasma after Third Molar Surgery.

Science.gov (United States)

Gandevivala, Adil; Sangle, Amit; Shah, Dinesh; Tejnani, Avneesh; Sayyed, Aatif; Khutwad, Gaurav; Patel, Arpit Arunbhai

2017-01-01

The aim of this study is to compare the efficacy of autologous platelet-rich plasma (PRP) in the third molar impactions, with respect to: pain, swelling, healing, and periodontal status distal to the second molar in patients who need surgical removal of bilateral impacted mandibular third molars. Twenty-five patients of both sexes aged between 16 and 60 years who required bilateral surgical removal of their impacted third molars and met the inclusion criteria were included in the study. After surgical extraction of the third molar, primary closure was performed in the control group, whereas PRP was placed in the socket followed by primary closure in the case group. The outcome variables were pain, swelling, wound healing, and periodontal probe depth that were follow-up period of 2 months. Quantitative data are presented as mean. Statistical significance was checked by t -test. There was a difference in the pain (0.071) and facial swelling (0.184), reduction between test and control on day 3, but it was not found to be significant. Periodontal pocket depth (0.001) and wound healing (0.001) less in case group compared with the control group was found to be significant. The use of PRP lessens the severity of immediate postoperative sequelae and decreases preoperative pocket depth.

Human dental age estimation using third molar developmental stages: does a Bayesian approach outperform regression models to discriminate between juveniles and adults?

Science.gov (United States)

Thevissen, P W; Fieuws, S; Willems, G

2010-01-01

Dental age estimation methods based on the radiologically detected third molar developmental stages are implemented in forensic age assessments to discriminate between juveniles and adults considering the judgment of young unaccompanied asylum seekers. Accurate and unbiased age estimates combined with appropriate quantified uncertainties are the required properties for accurate forensic reporting. In this study, a subset of 910 individuals uniformly distributed in age between 16 and 22 years was selected from an existing dataset collected by Gunst et al. containing 2,513 panoramic radiographs with known third molar developmental stages of Belgian Caucasian men and women. This subset was randomly split in a training set to develop a classical regression analysis and a Bayesian model for the multivariate distribution of the third molar developmental stages conditional on age and in a test set to assess the performance of both models. The aim of this study was to verify if the Bayesian approach differentiates the age of maturity more precisely and removes the bias, which disadvantages the systematically overestimated young individuals. The Bayesian model offers the discrimination of subjects being older than 18 years more appropriate and produces more meaningful prediction intervals but does not strongly outperform the classical approaches.

Age of majority assessment in Dutch individuals based on Cameriere's third molar maturity index.

Science.gov (United States)

Boyacıoğlu Doğru, Hatice; Gulsahi, Ayşe; Çehreli, Sevi Burçak; Galić, Ivan; van der Stelt, Paul; Cameriere, Roberto

2018-01-01

Radiological examination of the third molar is done in living individuals for estimation of chronological age, especially in the late adolescence. The aim of this study was to assess the application of Cameriere's third molar maturity index (I 3M ) to determine whether an individual is 18 years or older (adult) or younger than 18 years (minor) in a sample of Dutch individuals. The sample consisted of panoramic images of 360 individuals aged between 14 and 22 years old. Three observers performed the measurements. Gender was not statistically significant in discriminating adults and minors. The highest value of the Youden index of the receiver operating curve analysis was for the value of I 3M age assessment in a Dutch population. Copyright © 2017 Elsevier B.V. All rights reserved.

Radiographic evaluation of third molar development in 6- to 24-year-olds

Science.gov (United States)

Jung, Yun-Hoa

2014-01-01

Purpose This study investigated the developmental stages of third molars in relation to chronological age and compared third molar development according to location and gender. Materials and Methods A retrospective analysis of panoramic radiographs of 2490 patients aged between 6 and 24 years was conducted, and the developmental stages of the third molars were evaluated using the modified Demirjian's classification. The mean age, standard deviation, minimal and maximal age, and percentile distributions were recorded for each stage of development. A Mann-Whitney U test was performed to test the developmental differences in the third molars between the maxillary and mandibular arches and between genders. A linear regression analysis was used for assessing the correlation between the third molar development and chronological age. Results The developmental stages of the third molars were more advanced in the maxillary arch than the mandibular arch. Males reached the developmental stages earlier than females. The average age of the initial mineralization of the third molars was 8.57 years, and the average age at apex closure was 21.96 years. The mean age of crown completion was 14.52 and 15.04 years for the maxillary and the mandibular third molars, respectively. Conclusion The developmental stages of the third molars clearly showed a strong correlation with age. The third molars developed earlier in the upper arch than the lower arch; further, they developed earlier in males than in females. PMID:25279338

The usefulness of Belgian formulae in third molar-based age assessment of Indians.

Science.gov (United States)

Bhowmik, Biyas; Acharya, Ashith B; Naikmasur, Venkatesh G

2013-03-10

The third molars are one of few useful predictors for assessing the degree of maturity in adolescence and young adulthood. It has application in age estimation in the age group of 14-23 years, in general, and in juvenile/adult status prediction, in particular. Using a 10-stage grading of third molars, Gunst et al. developed regression formulae on a large sample of Belgians (n=2513) for estimating age. Their research has been recommended as a 'reference study' in age estimation guidelines. The present study has ventured to determine if estimating age in Indians using the Belgian formulae produced results comparable to those reported in the Belgian study; in addition, this study attempts to determine if the same formulae predicted juvenile/adult status (age aged between 14 and 23 years. The OPGs included a mix of one, two, three and four third molars. In total, 916 teeth were assessed using the same 10-stage grading. Age in each OPG was estimated by applying the relevant Belgian regression formulae (regression formulae are available for one, two, three and four third molars). To determine if the formulae produced age estimates comparable to those in the Belgian study, the percentage of Indian subjects whose actual age fell within the 68% confidence interval (CI) (calculated from the ± 1 S.D. value available for each Belgian formula) was ascertained. If ≥ 68% of Indian subjects' age fell inside this interval, it indicates that the Belgian formulae are applicable in Indians. To assess the suitability of the Belgian formulae in predicting juvenile/adult status in Indians, the accuracy of the age estimation per se was not considered, rather, the number of correct age predictions only was noted. Overall, ≈ 74% of Indian subjects' actual age fell within the 68% CI; with regards to the Belgian formulae being able to correctly predict juvenile/adult status, 78% of all subjects were categorized to the correct age group (age estimation per se of Indians; however, the

Relationship between mandibular condyle and angle fractures and the presence of mandibular third molars.

Science.gov (United States)

Mah, Deuk-Hyun; Kim, Su-Gwan; Moon, Seong-Yong; Oh, Ji-Su; You, Jae-Seek

2015-02-01

We retrospectively evaluated the impact of mandibular third molars on the occurrence of angle and condyle fractures. This was a retrospective investigation using patient records and radiographs. The sample set consisted of 440 patients with mandibular fractures. Eruption space, depth and angulation of the third molar were measured. Of the 144 angle fracture patients, 130 patients had third molars and 14 patients did not. The ratio of angle fractures when a third molar was present (1.26 : 1) was greater than when no third molar was present (0.19 : 1; odds ratio, 6.58; Pcondyle fractures patients, the third molar was present in 84 patients and absent in 57 patients. The ratio of condyle fractures when a third molar was present (0.56 : 1) was lower than when no third molar was present (1.90 : 1; odds ratio, 0.30; Pfractures with third molars and the ratio of condyle fractures without a third molar were statistically significant. The occurrence of angle and condyle fractures was more affected by the continuity of the cortical bone at the angle than by the depth of a third molar. These results demonstrate that a third molar can be a determining factor in angle and condyle fractures.

Variant Root Morphology of Third Mandibular Molar in Normal and ...

African Journals Online (AJOL)

isaac kipyator

2017-11-12

Nov 12, 2017 ... ABSTRACT. The mandibular third molar poses a challenge to dental surgeons due to it's unpredictable morphology ... treatment in the School of Dental Sciences since 2010. ... mandibular third molar include presence of three.

Incidence of root canal treatment of second molars following adjacent impacted third molar extraction

Directory of Open Access Journals (Sweden)

Yener Oguz

2016-03-01

Conclusion: Although the incidence is minimal, iatrogenic subluxation injuries occurring during the surgical removal of impacted third molars can lead to pulpal complications and a requirement for root canal treatment of adjacent second molars.

Fibrous epulis associated with impacted lower right third molar

Directory of Open Access Journals (Sweden)

Ni Putu Mira Sumarta

2009-12-01

Full Text Available Background: Epulis or epulides are lesions associated with gingival tissues. Fibrous epulis is a type of hyperplastic fibrous tissue mass located at the gingival which is slow growing, painless, having same color as the oral mucosa and firm on palpation. Anterior regions of the oral cavity are the frequently affected sites as these areas are more prone to be affected by calculus deposition and poor plaque control due to frequent teeth malposition. Removal of any irritating factors and excision of the lesion are the usual treatments. Purpose: This case report presents a rare case of fibrous epulis which occurred in the posterior region of the oral cavity and associated with impacted lower third molar. Case: A case of fibrous epulis at the lower right third molar area of three months duration is presented. The mass was slow growing, painless and on examination it was a pedunculated mass overlying the unerupted lower right third molar, having same color with the oral mucosa and firm on palpation. Clinically, the lesion was diagnosed as fibrous epulis associated with impacted lower right third molar. Case management: The treatment were surgical excision of the epulis and removal of the lower right third molar. The histopathology result showed tissue with squamous epithelial lining, achanthotic fibrous connective tissue, mononuclear inflammatory cells and few capillaries without signs of malignancy. This is consistent with the diagnosis of fibrous epulis. Conclusion: Fibrous epulis, although frequently occurred at the anterior region of the oral cavity, may rarely grow at the area of lower third molar. This phenomenon supports the theory that epulis can grow on any surface of oral mucous membrane as long as local irritants are present.

Age of patient at the extraction of the third molar.

Science.gov (United States)

Kautto, A; Vehkalahti, M M; Ventä, I

2018-04-13

The purpose of this study was to assess the age of patients at the time of extraction of third molars. Our data included all routine and surgical extractions of third molars (n=8199 teeth) performed by general and specialist dentists of the public oral health services of the city of Helsinki over the period 2013-2014. Measurements included patient's age, gender, the identified third molar, the type of anaesthesia, the method of extraction, and the diagnosis at extraction. Patients' ages ranged from 10 to 99years. We found significant differences between younger and older age groups: third molar extractions occurred more often for women than for men below the age of 30years (Page of 40years, but the corresponding prevalences reversed after the age of 40years. Diagnoses at extraction differed between younger and older patients. We conclude that the treatment pattern of third molars at public health services varies greatly over a lifetime, and that a greater variety exists than had been reported previously from oral and maxillofacial units. Copyright © 2018 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Dental age estimation in living individuals using 3.0 T MRI of lower third molars.

Science.gov (United States)

Guo, Yucheng; Olze, Andreas; Ottow, Christian; Schmidt, Sven; Schulz, Ronald; Heindel, Walter; Pfeiffer, Heidi; Vieth, Volker; Schmeling, Andreas

2015-11-01

In order to increase the validity of age estimation in adolescents and young adults when there is no legitimation for X-ray examinations, it seems desirable to be able to assess the mineralization of third molars using X-ray-free imaging procedures. In the present study, the mineralization stages of lower third molars were determined prospectively in 269 male and 248 female individuals aged 12 to 24 years using 3.0 T MRI. The classification system of Demirjian et al. was used to determine the stages. This study presents the minima and maxima, means and standard deviations, median values, and lower and upper quartiles separately for both sexes, for the mineralization stages B-H. Statistically significant sex differences were observed for the mineralization stages C, E, F, and G, and a faster developmental rate was observed for males. It was concluded that magnetic resonance imaging is an X-ray-free alternative to orthopantomography when assessing mineralization of third molars.

Fusión de un tercer molar mandibular con un cuarto molar supernumerario Fusion of mandibular third molar with supernumerary fourth molar

Directory of Open Access Journals (Sweden)

C. López Carriches

2008-10-01

Full Text Available La fusión dental es la unión de dos gérmenes dentales normalmente separados, mientras que la geminación se define como el intento de división de un único germen dental. La fusión y geminación de molares es poco frecuente en la dentición permanente. Describimos un caso clínico de un tercer molar inferior derecho fusionado a un cuarto molar supernumerario en un paciente varón de 36 años que ha presentado repetidos episodios de pericoronaritis. Tras el estudio radiológico se realiza la exodoncia del cordal semiincluido bajo anestesia local. Llevamos a cabo una revisión bibliográfica al respecto.Dental fusion is the union of two tooth buds that normally are separated, while gemination is defined as an attempt by a single tooth bud to divide. The fusion and gemination of molars is uncommon in permanent teeth. We report a clinical case of a right lower third molar fused to a supernumerary fourth molar in a 36-year-old male patient with repeated episodes of inflammation. After the radiologic study, the semi-impacted third molar was extracted under local anesthesia. The literature was reviewed.

Radiographic correlation of dental and skeletal age: Third molar, an age indicator.

Science.gov (United States)

Suma, Gn; Rao, Balaji B; Annigeri, Rajeshwari G; Rao, Dayashankara Jk; Goel, Sumit

2011-01-01

Age estimation plays a great role in forensic investigations, orthodontic and surgical treatment planning, and tooth transplantation. Teeth offer an excellent material for age determination by stages of development below the age of 25 years and by secondary changes after the age of 25 years. Third molar is often not included for this purpose due to its notorious developmental patterns. The aim of this study was to evaluate the development of third molar anlage in relation to skeletal maturities and the chronological age. One hundred and fifty-six young individuals, 78 males and 78 females, were selected. The stages of development of all the third molars in every individual were determined from panoramic radiographs. The skeletal development was assessed using hand wrist radiographs. Data were analyzed statistically for mean value, standard deviation and the relationship between the recorded characteristics. A STRONG CORRELATION WAS FOUND BETWEEN THIRD MOLAR DEVELOPMENT AND SKELETAL MATURITY (IN MALES: r=0.88, Pthird molar and 0.89 for mandibular third molar, Page, developmental stages of third molars and maturation of epiphyses of hand. Any of the three parameters could be used for the assessment of other maturities.

Western Saudi adolescent age estimation utilising third molar development.

Science.gov (United States)

Alshihri, Amin M; Kruger, Estie; Tennant, Marc

2014-07-01

The aim of this study was to establish reference data on third molar morphology/development for age estimation in Western Saudi adolescents, between ages 14 and 23 years of old. The orthopantomograms of 130 individuals (males and females), were examined, and the stage of third molar development were evaluated. Mean ages, standard deviations, and percentile distributions are presented for each stage of development. The mean estimated age for all participants (n = 130) was 219.7 months, and this differed significantly (P age (226.5 months). Deviations of predicted age from real age showed 28.5% of all participants had their age estimated within 1 year (±12 months) of their chronological age. Most (43%) had their age underestimated by more than 12 months and the remaining 28.5% had their age overestimated by more than 12 months of their chronological age. Differences in left-right symmetry information of third molars were detected and were higher in the maxilla (92%) than in the mandible (82%). For all molars reaching stage "H" most individuals (males and females) were over the age 18 years of old. Males reach the developmental stages earlier than females. Third molar tooth development can be reliably used to generate mean age and the estimated age range for an individual of unknown chronological age. Further studies with large populations are needed for better statistical results.

Age estimation using development of third molars in South Indian population: A radiological study.

Science.gov (United States)

Priyadharshini, K Indra; Idiculla, Jose Joy; Sivapathasundaram, B; Mohanbabu, V; Augustine, Dominic; Patil, Shankargouda

2015-05-01

To assess the estimation of chronological age based on the stages of third molar development following the eight stages (A-H) method of Demirjian et al. in Chennai population of South India. A sample consisting of 848 individuals (471 males and 377 females) aged between 14 and 30 years was randomly selected for the clinical evaluation and 323 orthopantomograms with clinically missing third molars were taken for radiological evaluation using Demirjian's method from a Chennai population of known chronological age and sex. Statistical analysis was performed using Pearson's Chi-square test and mean values were compared between the study groups using t-test or analysis of variance (ANOVA) followed by Tukey's highly significant difference (HSD). In the present study, P age of having clinically completely erupted maxillary third molars was 22.41 years in male subjects and 23.81 years in female subjects and that of mandibular third molars was 21.49 years in male subjects and 23.34 years in female subjects. Mandibular third molars were clinically missing more often in females than in males. Eruption of mandibular third molars was generally ahead of the emergence of maxillary third molars into the oral cavity. Third molar development between male and female subjects showed statistically significant differences at calcification stage F and stage G in maxillary third molars and stage F in mandibular third molars (P third molar eruption reached Demirjian's formation stages earlier in males than in females. It is suggested that in future studies, to increase the accuracy of age determination, indications of sexual maturity and ossification should also be evaluated in addition to third molar mineralization.

Sublingual piroxicam in the management of postoperative pain after surgical removal of impacted mandibular third molar.

Science.gov (United States)

Mohammad, Shadab; Singh, Vibha; Wadhwani, Puneet; Tayade, Himanshu P; Rathod, Onkar K

2012-01-01

Surgical removal of impacted mandibular third molar is one of the most commonly performed procedures in oral and maxillofacial surgical practice. The role of preoperative and postoperative medications for management of postoperative complications has been extensively evaluated. To assess the therapeutic effect of a single dose of 40 mg sublingual piroxicam (study group) vs 150 mg oral diclofenac (50 mg thrice a day) (control group) in patients undergoing surgical removal of impacted mandibular third molar. A total of 100 patients with asymptomatic impacted mandibular third molars were randomized into two groups. One group received two 20-mg tablets of piroxicam once daily on the first and second postoperative days, followed by one 20-mg tablet on the third post-operative day. The other group received one tablet of diclofenac 50 mg orally thrice daily on the first, second, and third post-operative days. Repeated extraoral examinations were done for continuous assessment of swelling, trismus, and reduction in pain. Overall impression of the treating physician and the patient regarding efficacy of study drugs were recorded at the end of the study. In the piroxicam group there was >50% reduction in pain on all three days postoperatively. The incidence of swelling and trismus was found to be higher in the control group as compared to the study group. Adverse events, such as gastrointestinal (GI) disturbances, were significantly higher in the diclofenac group (11%) as compared to the piroxicam group (0%). Two sublingual piroxicam 20 mg tablets once daily has better efficacy and tolerability profile than diclofenac 50 mg one tablet thrice daily in the management of pain after surgical removal of impacted mandibular third molar.

The third molar as an age marker in adolescents: new approach to age evaluation.

Science.gov (United States)

Rozkovcova, Eva; Dostalova, Tatjana; Markova, Marie; Broukal, Zdenek

2012-09-01

Adolescence is a relatively short period between childhood and adulthood. It is very difficult to determine adulthood based on biological indicators. The third molar may be considered a potential age marker for the period between the ages of 16-21. Our study evaluated a set of 1700 panoramic radiographs of individuals aged between 5 and 21 years. Results confirmed the statistically significant difference in the course of third molars development. The mean deviation for individuals with one third molar agenesis is -0.98 years, for individuals with two third molars agenesis -1.89 years, and with three molars agenesis -3.28 years. Thus, the extent of the deviation is directly proportional to the number of unformed third molars. The calculation of age according to the mean of stages of all third molars could lead to the underestimation of age. No intergender differences were found. Age determination using third molars could be used for forensic purposes. © 2012 American Academy of Forensic Sciences.

Impacted third molar transplantation on the malpracticed extraction socket.

Science.gov (United States)

Kim, Soung Min; Amponsah, Emmanuel K

2017-12-01

Autotransplantation with or without endodontic therapy is regarded as an alternative treatment option for the replacement of missing teeth. A primary responsibility of a maxillofacial surgeon is to reverse any malpractice to promote successful outcomes and improve the patient's quality of life. This paper presents a malpractice case of incorrect extraction of the lower second molar instead of the impacted third molar. A simple technique of transplanting the impacted third molar to the site of the extracted second molar is introduced by a maxillofacial specialist in Ghana. By making an intentional root socket and fixation without using additional appliances, a novel second molar was achieved with complete recovery. This patient was followed after transplant for a four-year period with the best satisfaction. A grant of the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea. (HI15C0689).

Human dental age estimation using third molar developmental stages: does a Bayesian approach outperform regression models to discriminate between juveniles and adults?

OpenAIRE

Thevissen, P. W.; FIEUWS, Steffen; Willems, G.

2010-01-01

Dental age estimation methods based on the radiologically detected third molar developmental stages are implemented in forensic age assessments to discriminate between juveniles and adults considering the judgment of young unaccompanied asylum seekers. Accurate and unbiased age estimates combined with appropriate quantified uncertainties are the required properties for accurate forensic reporting. In this study, a subset of 910 individuals uniformly distributed in age between 16 and 22 years ...

Patterns of third-molar agenesis and associated dental anomalies in an orthodontic population.

Science.gov (United States)

Celikoglu, Mevlut; Bayram, Mehmet; Nur, Metin

2011-12-01

The aim of this study was to investigate the frequency of dental anomalies in orthodontic patients with different patterns of third-molar agenesis, comparing them with patients without third-molar agenesis. A sample of 374 patients with agenesis of at least 1 third molar was divided into 4 groups according to the third-molar agenesis pattern, and a control group of 98 patients without third-molar agenesis was randomly selected from the patient archives. Panoramic radiographs and cast models were used to determine the associated dental anomalies, such as hypodontia, hyperdontia, impaction, dilaceration, microdontia, ectopic eruption, transposition, and transmigration. The Pearson chi-square and Fisher exact tests were used to determine the differences in the distribution of the associated dental anomalies among the groups. The prevalence of agenesis of other teeth (11.2%, n = 42) was significantly greater in our study sample (groups 1-4) than in the control group (group 5) (4.1%, n = 4; P dental anomalies in patients with agenesis of 3 and 4 third molars compared with the control group. Permanent tooth agenesis, microdontia of maxillary lateral incisors, and total dental anomalies are more frequently associated with agenesis of 4 third molars than with the presence of third molars. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Lingual nerve injury following surgical removal of mandibular third molar

Directory of Open Access Journals (Sweden)

Abduljaleel Azad Samad

2017-12-01

Full Text Available Background and objective: The close proximity of lingual nerve in relation to the lingual cortical bone of the posterior mandibular third molar is clinically important because lingual nerve may be subjected to trauma during surgical removal of the impacted lower third molar. This prospective study aimed to evaluate the incidence of lingual nerve paresthesia following surgical removal of mandibular third molar in College of Dentistry, Hawler Medical University. Methods: A total of 116 third molars surgery were carried out under local anesthesia for 116 patients for removal of lower mandibular teeth Using Terence Ward's incision made in all cases, and after that, the buccal flap was reflected, lingual tissues had been retracted during bone removal with a periosteal elevator. The sensory disturbance was evaluated on the 7th postoperative day by standard questioning the patients: “Do you have any unusual feeling in your tongue, lingual gingiva and mucosa of the floor of the mouth?" Results: One patient experienced sensory disturbance, the lingual nerve paresthesia incidence was 0.9% as a transient sensory disturbance, while no patient of permanent sensory disturbance. Conclusion: The incidence of injury to the lingual nerve can be minimized by careful clinical evaluation, surgeon’s experience, surgical approach and knowledge about anatomical landmarks during surgical removal of an impacted lower third molar tooth.

Third molar cut-off value in assessing the legal age of 18 in Saudi population.

Science.gov (United States)

AlQahtani, Sakher; Kawthar, Alemad; AlAraik, Ayman; AlShalan, Ahmad

2017-03-01

Teeth plays a major role in forensic sciences especially in age assessment of an individual, which can be used to aid in criminal or civil matters. The importance of teeth comes from their ability to survive inhumation well and because they are hardly affected by exogenous and endogenous factors. Third molars are the only teeth still developing after the age of 14 years and during the legal age of adulthood, which is 18 years. The consequences of criminal violation can strongly affect the individual's life, it is important to set different parameters to decide whether an individual is a minor or an adult in the absence of documents. Depending on the different legal requirement, such parameters can set above 90% probability for criminal matters and from 51% to civil matters. The aim of this research was to find the cut-off value of third molar development for the legal age of 18 amongst Saudi individuals using the third molar maturity index method by Cameriere et al. (2008) [17]. This was a cross sectional study on 300 archived orthopantomogram (OPG) of healthy Saudi patients between the ages 14 and 22 years attending the Dental Hospital at King Saud University, Riyadh, Saudi Arabia. All OPGs were taken by PLANMECA - ProMax machine and evaluated by the Romaxis software. The inclusion criteria were good quality OPGs taken during the course of treatment. All patients were healthy with no systemic diseases or disorders with the presence of third molars and clear root apex. The lower left mandibular third molar (LL3rdM) was assessed using third molar maturity index (I3m) to determine if the individual is younger or older than 18 years old. The cut-off value of I3m for the Saudi population was (I3mage of adulthood in Saudi population and the cut-off value of I3m is similar to other populations. Although dental age assessment by means of third molar development is useful, it still has its limitation because of its variation in position, morphology and development

C-reactive protein a better indicator of inflammation after third molar ...

African Journals Online (AJOL)

operative pain and pre-operative levels of C-reactive and post-operative pain and swelling in impacted third molar surgery. Materials and Methods: In this prospective study subjects were patients indicated for mandibular third molar extraction.

X-RAY MEASUREMENTS OF IMPACTED MANDIBULAR THIRD MOLARS

Directory of Open Access Journals (Sweden)

Petya G. Kanazirska

2017-03-01

Full Text Available The X-ray diagnostics is essential in case of retention of teeth. An important condition for proper treatment plan for impacted third molars of the mandible is the determination of the type of retention in the jaw in accordance with their medio-distal inclination and the space available for eruption (retromolar space. Purpose: The purpose of this article is to present an objective method for determination of the medio-distal inclination and the space for eruption of the third molars of the mandible. Materials and methods: The studied patients with impacted third molars of the mandible are 127, aged 17 through 60. They were examined with Cone-beam Computed Tomography (CBCT. On the orthopantomography, obtained after the scanning as a reconstructed image, we defined the medio-distal inclination and space for eruption of the third molars of the mandible. For this purpose, we summarized several methods. Results: The most common inclination of the third molars of the mandible with retained eruption is the medial one at 120 teeth (61.5% ± 3.5. Second in frequency is the vertical one-34 teeth (17.4% ± 2.7, followed by the distal inclination– 21 teeth (10.8% ± 2.2. With the lowest frequency are the teeth which are positioned horizontally –20 teeth (10.3% ± 2.2. Shortage of retromolar space is established for173 teeth (88.7% ± 2.3. In 22 teeth (11.3% ± 2.3 there is enough space in the jaw for eruption. Conclusion: An objective method for determination of the medio-distal inclination of the teeth and the space available for eruption is introduced for the first time in Bulgaria. By determining the inclination of impacted wisdom teeth under this methodology one can avoid the subjective factor–the seventh tooth. It is not a reference plane, because it can also be tilted or missing. With the help of the developed method the retromolar point can be determined more objectively.

Variant root morphology of third mandibular molar in normal and ...

African Journals Online (AJOL)

The mandibular third molar poses a challenge to dental surgeons due to it's unpredictable morphology which leads to increased difficulty during its extraction. The root morphology of the third molar is considered to be the most variable in the human dentition. The study aims to document these variations which will be useful ...

Relationship of third molar movement during orthodontic treatment and root angulation

Directory of Open Access Journals (Sweden)

Morteza Oshagh

2012-01-01

Conclusion: The relation between the amount of third molar movement and its root angulation was not statistically significant. Therefore movement of third molars during orthodontic treatment should not be assumed as an etiologic factor of root angulations.

Subcutaneous emphysema during third molar surgery: a case report

OpenAIRE

Romeo, Umberto; Galanakis, Alexandros; Lerario, Francesco; Daniele, Gabriele Maria; Tenore, Gianluca; Palaia, Gaspare

2011-01-01

Extraction of third molars is the most common surgical procedure performed in oral surgery on a daily basis and, despite surgical skills and expertise, complications may occur. Complications observed during or after third molar removal may include pain, swelling, bleeding, infection, sinus perforation and nerve damage. Fortunately, with a proper management and a good surgical technique, the incidence of such events is low. Subcutaneous emphysema associated with dental extraction occurs when t...

Roentgenographic studies on the growth and development of lower third molars in Korean female

Energy Technology Data Exchange (ETDEWEB)

Lim, Hyoung Soon; Lee, Sung Woo [Department of Dental Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

1976-11-15

The author obtained the following results through the studies on 1012 roentgenograms of lower third molar regions of Korean female; 1. The rate of presence of lower third molars was 78.9 percent. 2. The period that crowns of lower third molars become completed was 16.1 years. 3. The period that completion of apices of lower third molars become completed was over 27 years.

Psychological impact of third molar surgery: a 1-month prospective study

NARCIS (Netherlands)

de Jongh, Ad; van Wijk, Arjen J.; Lindeboom, Jerome A.

2011-01-01

To prospectively examine the psychological impact of surgical third molar removal, and to identify possible psychological risk factors for the development of dental anxiety and symptoms of psychological trauma. Patients (N = 71) scheduled for surgical mandibular third molar removal were assessed

Assessment of age of majority by measurement of open apices of the third molars using Cameriere's third molar maturity index.

Science.gov (United States)

Sharma, Preeti; Wadhwan, Vijay; Ravi Prakash, S M; Aggarwal, Pooja; Sharma, Neeraj

2017-01-01

Evaluation of biological age of a living subject around the legal cutoff age for adulthood has become a grave concern for forensic experts in India, mainly due to the consequences of criminal obligations in judicial proceedings. Thus, this study was planned to examine the open apices of third molars in discriminating between individuals who are aged 18 years or older and who are not 18 years or older and to assign a cutoff for estimation of the age of 18 years. Orthopantomographs of 1062 individuals (14 and 23 years) were assessed, to verify Cameriere's third molar maturity index (I 3M ). The apical ends of the roots of the left mandibular third molar were analyzed. If the apical ends of the roots are completely closed, then I 3M is zero; otherwise, it is calculated as the sum of the distances between the inner sides of the two open apices divided by the tooth length. The sensitivity of the test for 0.08 value was 74.7% for males and 66% for females. Specificity was 83.6% for males and 79.6% for females. The probability that an Indian individual with an I 3M age in Indian population.

Effect of age, sex and level of surgical difficulty on inflammatory complications after third molar surgery.

Science.gov (United States)

Osunde, Otasowie D; Saheeb, Birch D

2015-03-01

Patients' factors such as age and sex and surgical variables such as level of difficulty have been linked with surgical outcome in third molar surgery. The aim of this study was to determine the effect of these variables on inflammatory complications in patients undergoing third molar surgery. Patients referred to our institution for surgical extraction of their impacted lower third molar between January 2007 and December 2008 were the subjects of the study. Patients' demographics as well as types of impaction, indication and level of difficulty based on Pederson criteria were obtained. Post operative pain, swelling and mouth opening limitation were evaluated at day 1, day 2, day 3, day 5 and 1 week after the surgery and analyzed. A p value of less than 0.05 was considered significant. A total of 150 patients aged 16-38 years (25.9 ± 4.47) met the inclusion criteria. Male accounted for 66 (44.0 %) while females were 84 (56.0 %), giving male to female ratio of 1:1.3. Age, sex and difficulty index had no effect on pain and trismus throughout the periods of postoperative evaluation (p > 0.05). Postoperative swelling was not affected by gender but patients above 25 years who had high scores of difficulty index had more facial swelling. The results of this study shows that age, gender and the level of surgical difficulty have no effect on pain and mouth opening limitation after third molar surgery.

Clinical and orthopantomographic evaluation of mandibular third molar

Directory of Open Access Journals (Sweden)

F K Saraswati

2010-01-01

Full Text Available Objective: To evaluate sensitivity of orthopentograph (OPG in assessing the number and morphology of roots of the mandibular third molar. Materials and Methods : The study population consisted of 100 ILTMs (impacted lower third molars ranging from 18 to 42 years with equal sex distribution. All the teeth were subsequently extracted , collected and compared with OPG features for position, numb,er, morphology, and relation to mandibular canal. Conclusion: In conclusion, a large sample study is suggested with techniques like Clark′s and right angle technique which determines the three-dimensional orientation of the impacted teeth.

Using cone beam computed thomography in planning the extraction of impacted third molars

Directory of Open Access Journals (Sweden)

Vlahović Zoran

2016-01-01

Full Text Available The panoramic radiography is the most used diagnostic imaging method in planning impacted lower third molar extractions. However, often panoramic radiography does not provide enough information in treatment planning for performing safely surgical extraction of impacted third molars. CBCT (Cone beam computed tomography provides more precise information in diagnostic analysis especially for planning surgical procedures where complications can be expected due to close relationship between mandibular canal and lower impacted third molars. The aim of this study is comparative analysis of panoramic radiography and CBCT in evaluating the topographic relationship between mandibular canal and impacted third molars. The study included 50 patients with close relationship between mandibular canal and impacted third molars detected using panoramic radiography. After panoramic radiography analysis CBCT was performed in order to diagnose, plan and prevent complications during the surgical tooth extraction. CBCT examination considered comparative analysis with panoramic radiography, marking, volume rendering and assessment of mandibular canal in buccolingual direction. Out of total patients where suprimposition of mandibular canal and impacted third molar on panoramic radiography was detected, in 32 patients mandibular chanal was localised on lingual side. Mandibular canal was positioned at bucal side in 18 of 50 patients. Results of this research indicate that panoramic radiography can be useful in everyday practice for diagnosis, planning and preparing lower third molar extractions, but in cases where close relationship between mandibular canal and lower third molars is detected CBCT is recommended as more precise radiographic imaging method in order to prevent complications.

Prevalence of Third Molar Agenesis: Associated Dental Anomalies in Non-Syndromic 5923 Patients.

Science.gov (United States)

Sujon, Mamun Khan; Alam, Mohammad Khursheed; Rahman, Shaifulizan Abdul

2016-01-01

The aim of this study was to investigate the prevalence of third molar agenesis and other associated dental anomalies in Bangladeshi population and to investigate the relationship of other dental anomalies with the third molar presence/agenesis. A retrospective study was performed using panoramic radiographs of 5923 patients, who ranged in age from 10 to 50 years. All radiographs were analyzed by Planmeca Romexis® 3.0 software (Planmeca Oy, Helsinki, Finland). Pearson chi-square and one way ANOVA (Post Hoc) test were conducted. The prevalence of third molar agenesis was 38.4%. The frequency of third molar agenesis was significantly higher in females than males (p dental anomalies was 6.5%, among them hypodontia was 3.1%. Prevalence of third molar agenesis varies in different geographic region. Among the other dental anomalies hypodontia was more prevalent.

Histopathologic Evaluation of Follicular Tissues Associated with Impacted Third Molars

Directory of Open Access Journals (Sweden)

M. Khorasani

2008-06-01

Full Text Available Objective: The aim of the present study was to histopathologically evaluate follicular tissues of third molars with pericoronal radiolucenciesof less than 2 millimeters.Materials and Methods: In this descriptive analytic study, 100 impacted third molars with normal follicular spaces were removed and their pericoronaltissues submitted for histopathologic examination. Different characteristicsof the epithelium and connective tissue were evaluated in all cases. Statisti-cal analysis was performed using chi square and Mann-Whitney tests.Results: In our study sample, 74% of the patients were female and 26% were male, ranging in age from 13 to 54 years (mean, 25.3 years. Lining epithelium was observed in 69% of the specimens of which 31%, 23% and 14% was cuboidal, squamous and columnar, respectively. A significant re-lationship was found between the presence of squamous epithelium and pa-tient age (P<0.05. Nonspecific chronic inflammation was the only patho-logic finding observed in 44% of the specimens. Inflammation was signifi-cantly associated with age and squamous metaplasia (P<0.05.Conclusion: Considering that pathologic lesions were not observed in anyof the studied cases, unerupted third molars should not be removed unless there is a clinical indication to do so, or in case the impacted molar shows evidence of pathological changes. Follow-up is suggested for asympto-matic impacted third molars.

Application of third molar development and eruption models in estimating dental age in Malay sub-adults.

Science.gov (United States)

Mohd Yusof, Mohd Yusmiaidil Putera; Cauwels, Rita; Deschepper, Ellen; Martens, Luc

2015-08-01

The third molar development (TMD) has been widely utilized as one of the radiographic method for dental age estimation. By using the same radiograph of the same individual, third molar eruption (TME) information can be incorporated to the TMD regression model. This study aims to evaluate the performance of dental age estimation in individual method models and the combined model (TMD and TME) based on the classic regressions of multiple linear and principal component analysis. A sample of 705 digital panoramic radiographs of Malay sub-adults aged between 14.1 and 23.8 years was collected. The techniques described by Gleiser and Hunt (modified by Kohler) and Olze were employed to stage the TMD and TME, respectively. The data was divided to develop three respective models based on the two regressions of multiple linear and principal component analysis. The trained models were then validated on the test sample and the accuracy of age prediction was compared between each model. The coefficient of determination (R²) and root mean square error (RMSE) were calculated. In both genders, adjusted R² yielded an increment in the linear regressions of combined model as compared to the individual models. The overall decrease in RMSE was detected in combined model as compared to TMD (0.03-0.06) and TME (0.2-0.8). In principal component regression, low value of adjusted R(2) and high RMSE except in male were exhibited in combined model. Dental age estimation is better predicted using combined model in multiple linear regression models. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Impaction of lower third molars and their association with age: radiological perspectives.

Science.gov (United States)

Ryalat, Soukaina; AlRyalat, Saif Aldeen; Kassob, Zaid; Hassona, Yazan; Al-Shayyab, Mohammad H; Sawair, Faleh

2018-04-04

Third molars are the most commonly impacted teeth, and their extraction is the most commonly performed procedure in oral and maxillofacial surgery. The aim of the present study is to describe the pattern of mandibular third molar impaction and to define the most appropriate age for prophylactic extraction of mandibular third molar teeth. A total of 1198 orthopantomographs (OPGs) with 1810 impacted lower third molars were reviewed by two authors. The pattern of eruption in relation to patient's age was examined using standard radiographic points and angles. Statistical analysis was performed using SPSS for Windows release 16.0 (SPSS Inc., Chicago, IL, USA). In patients older than 20 years, vertical pattern of impaction was the most common (21.4%); while in young patients; horizontal impaction was more common (21.3%). Furthermore, there was a constant pattern of increase in Pell-Gregory ramus class 1 with increasing age, as the prevalence of class 1 was 0% at age 18 years compared to 54.9% at the age of 26 years. Frequency of vertical impaction of lower third molars was seen more at an older age (> 20 years) in this study, with an increase in the retromolar space. Late extraction of mandibular third molar teeth (i.e. after the age of 20) is therefore recommended when prophylactic extraction is considered.

COMPLICATIONS AFTER EXTRACTION OF IMPACTED THIRD MOLARS - LITERATURE REVIEW

Directory of Open Access Journals (Sweden)

Elitsa G. Deliverska

2016-07-01

Full Text Available Third molar surgery is the most common procedure performed by oral and maxillofacial surgeons worldwide. This article addresses the incidence of specific complications and, where possible, offers a preventive or management strategy. Complications, such as pain, dry socket, swelling, paresthesia of the lingual or inferior alveolar nerve, bleeding, and infection are most common. Factors thought to influence the incidence of complications after third molar removal include age, gender, medical history, oral contraceptives, presence of pericoronitis, poor oral hygiene, smoking, type of impaction, relationship of third molar to the inferior alveolar nerve, surgical time, surgical technique, surgeon experience, use of perioperative antibiotics, use of topical antiseptics, use of intra-socket medications, and anaesthetic technique. For the general dental practitioner, as well as the oral and maxillofacial surgeon, it is important to be familiar with all the possible complications after this procedure. This improves patient education and leads to prevention, early recognition and management.

Fate of third molar in line of mandibular angle fracture - Retrospective study

Directory of Open Access Journals (Sweden)

Preetha Balaji

2015-01-01

Conclusion: The present study fails to identify any concrete factors that would predict the failure of the retained third molar that were involved in the line of mandibular fractures. The proof presented here, especially with low complication rates indicate that all impacted third molar along the line of fracture be removed and unless necessary, the partially erupted teeth would also be extracted. In such a situation, the rate of infection and survival of the third molar would have been entirely different.

Analysis of 1202 orthopantograms to evaluate the potential of forensic age determination based on third molar developmental stages.

Science.gov (United States)

Willershausen, B; Löffler, N; Schulze, R

2001-09-28

A total of 1202 orthopantograms of young dental patients were analyzed to assess the correlation of third molar root development with chronological age. The investigated patients were treated at a university dental clinic on an outpatient basis, included a variety of demographic characteristics (600 males and 602 females, 28% of other than central European background), and were 15-24 years old when the radiographs were obtained. Radiographs in which more than one third molar were either missing due to agenesia or extraction, or not evaluable because of deep destruction or marked tilting, were not included in the analysis. Our findings show that the growth patterns of third molars, based on seven defined stages of root development, did correlate with chronological age; age estimation when applied to a specific individual would involve a margin of error of +/- 2-4 years. There were no significant differences between the left and right jaw segments, but the stage of root development was generally more advanced in the upper than in the lower third molars. Root development was also more advanced among boys than among girls of the same age. There were no apparent differences in growth patterns based on national/ethnic background. While only 2.5% of 18-year-olds revealed fully developed third molars in all four quadrants, this percentage leaped to 38.4% among the 21-year-olds. To summarize, while the developmental stage of third molars is not per se a highly useful indicator of chronological age in juveniles and young adults, it is nevertheless a valuable supplementary parameter given the scarcity of other available age indicators.

The incidence of cysts and tumors associated with impacted third molars

Directory of Open Access Journals (Sweden)

A T Vigneswaran

2015-01-01

Full Text Available Incidence of cysts and tumors associated with lower impacted third molars are very low prevalence, which might be because of the fact that most pathologies go unnoticed as many practitioners discard the erupted tissue after surgical removal of the impacted teeth rather than sending the tissue for histopathological examination. Our aim was to evaluate the patients who came for third molar surgical removal with due therapeutic prophylacis and an incidental finding. A proper study protocol both inclusion and exclusion criteria was strictly followed for all the cases, which were included in the study. The period of study was 6 years and the total number of cases assessed were 2778 patients out of which 70 cases reported pathology associated with the impacted third molars. Among 70 cases 61.4% were reported as cyst and tumors and 38.6% of the cases had chronic inflammatory reaction, including two cases with normal dental follicle. High incidence rate of pathology associated with third molar occurred between age group of 20 and 30 years older age groups showed very low incidence. Most common site of impaction was found to be left side of mandible and positions were vertical and distoangular impactions. Thus was male predominance in the younger groups. The examination is necessary whether the third molars impacted cases were symptomatic or asymptomatic

Mineralization of mandibular third molars can estimate chronological age--Brazilian indices.

Science.gov (United States)

de Oliveira, Fernando Toledo; Capelozza, Ana Lúcia Álvares; Lauris, José Roberto Pereira; de Bullen, Izabel Regina Fischer Rubira

2012-06-10

Forensic age estimation is an important element of anthropological research, as it produces one of the primary sources of data that researchers use to establish the identity of a person living or the identity of unknown bodily remains. The aim of this study was to determine if the chronology of third molar mineralization could be an accurate indicator of estimated age in a sample Brazilian population. If so, mineralization could determine the probability of an individual being 18 years or older. The study evaluated 407 panoramic radiographs of males and females from the past 5 years in order to assess the mineralization status of the mandibular third molars. The evaluation was carried out using an adaptation of Demirjian's system. The results indicated a strong correlation between chronological age and the mineralization of the mandibular third molars. The results indicated that modern Brazilian generation tends to demonstrate an earlier mandibular third molar mineralization than older Brazilian generation and people of other nationalities. Males reached developmental stages slightly earlier than females, but statistically significant differences between the sex were not found. The probability that an individual with third molar mineralization stage H had reached an age of 18 years or older was 96.8-98.6% for males and females, respectively. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

P Elevator: An Innovatively Designed Elevator for Extraction of Third Molars.

Science.gov (United States)

Singh, Pradeep; Xiao, Shui Sheng; Ajmera, Deepal Haresh

2015-01-01

To modify the conventional straight elevator with a unique and innovative design in respect to approach and accessibility during extraction for patients with abrasions around corners of the mouth and with thick buccal mucosa, without causing overstretching of angles of the mouth. The shank of the straight elevator in the shape of a 'U' was modified, giving it a shape similar to 'P' in the English alphabet hence it is named the P Elevator. The P elevator utilises a 'U' shaped bend in the shank of the conventional straight elevator making space for the buccal soft tissues and the angle of the mouth, to accommodate properly in the 'U' shank. The application of this elevator in the successful removal of third molars is described. Two hundred patients underwent extraction of third molars with the P elevator including 166 patients with disimpaction of all third molars, 23 patients with abrasion around the angle of the mouth, and 11 patients with thick buccal mucosa. Satisfactory results were obtained in all the cases with no postoperative complications. The P elevator permits prudent, meticulous, innovative and proficient extraction of third molars in patients with thick buccal mucosa and abrasions around the angle of the mouth, without overstretching the corners of the mouth. We introduce novel applications of the P elevator in third molar extraction that provide substantial advantages over a conventional straight elevator.

Temporal abscess after third molar extraction in the mandible.

Science.gov (United States)

de Oliveira Neto, Patrício José; de Souza Maliska, Maximiana Cristina; Sawazaki, Renato; Asprino, Luciana; de Moraes, Márcio; Moreira, Roger William Fernandes

2012-03-01

Dental infections resulting before or after third molar removal are complications in which the maxillofacial surgeon may have to initiate an earlier management. The severe dental infections resulting before or after this procedure is one of the few life-threatening complications in which the maxillofacial surgeon may have to initiate an earlier management. Infections involving the temporal space are rare and infrequently reported. Infections in this space have also been observed secondary to maxillary sinusitis, maxillary sinus fracture, temporomandibular arthroscopy, and drug injection, although more commonly associated to third molar infections. A 22-year-old man had undergone extraction of tooth 38 secondary to pericoronaritis by a general dentist. Physical examination of his face demonstrated severe trismus, pain, and swelling in temporal region. A CT scan showed an inflammatory area into the temporal space. He was started on IV cephalosporin, but the clinical course of the patient was not satisfactory. Incision and drainage were performed from an extraoral and intraoral approach. After discharged, the antibiotic was switched to clindamycin IO 600 mg. The retromaxillary and temporal infections are quite common after maxillary molar extractions but not after mandibular third molar, the spread mechanism of ascension must be involved with the virulence of microorganisms, but more studies are necessary to clarify this occurrence.

[Evaluation of the results of high-speed handpiece and minimally invasive extraction in impacted mandibular third molar extraction].

Science.gov (United States)

Yang, Ying-yang; DU, Sheng-nan; Lv, Zong-kai

2015-08-01

To compare the results of high-speed handpiece and minimally invasive extraction in impacted mandibular third molar extraction. From May 2011 to May 2014, 83 patients undergoing impacted mandibular third molar extraction were enrolled into the study and randomly divided into 2 groups: 42 patients in group A (experimental group) and 41 patients in group B (control group). Group B underwent extraction with traditional method and group A underwent high-speed handpiece and minimally invasive extraction of the impacted mandibular third molar. The occurrences of the root fracture, gingival laceration, tooth mobility, lingual bone plate fracture, jaw fracture and dislocation of temporomandibular joint during operation and lower lip numbness, dry socket, facial swelling and limitation of mouth opening after operation were observed and compared between 2 groups. The operation time, integrity of extraction sockets, VAS pain score and satisfaction from patients were collected and compared. SPSS 19.0 software package was used for statistical analysis. The occurrences of root fracture, gingival laceration, tooth mobility, lingual bone plate fracture, jaw fracture, and dislocation of temporomandibular joint during operation in group A significantly decreased compared with group B (Pextraction sockets, VAS pain scores and satisfaction scores in group A improved significantly compared with group B (Phandpiece and minimally invasive extraction should be widely used in impacted mandibular third molar extraction, due to the advantages of simple operation, high efficiency, minimal trauma, and few perioperative complications.

Root and Canal Morphology of Mandibular Third Molars in an Iranian Population

Directory of Open Access Journals (Sweden)

Maryam Kuzekanani

2012-06-01

Full Text Available Background and aims. A through knowledge of the root canal morphology is required for successful endodontic therapy. The aim of this study was to investigate the root and canal morphology of mandibular third molars in Kerman, a province in southeast of Iran. Materials and methods. One-hundred-fifty extracted mandibular third molars were collected randomly from different dental clinics in Kerman. The root canal anatomy and morphology of each tooth was carefully studied using a clearing technique. Root number and morphology, number of canals per root, root canal configuration according to Vertucci classification, and incidence of dilacerated roots and C-shaped canals in mandibular third molars were evaluated under stereomicroscope with ×2 to ×3 magnifications. Results. From the total of 150 mandibular third molars studied, 21% had one root. The majority of teeth (73% had two roots. 5.5% of the teeth had three roots. The incidence of C-shaped canal was 3.5% in this study and 8% of the teeth had at least one dilacerated root. Conclusion. Although root canal anatomy and morphology of mandibular third molars is very variable having two roots seems to be the normal anatomy for these teeth.

Magnetic resonance imaging of third molars: developing a protocol suitable for forensic age estimation.

Science.gov (United States)

De Tobel, Jannick; Hillewig, Elke; Bogaert, Stephanie; Deblaere, Karel; Verstraete, Koenraad

2017-03-01

Established dental age estimation methods in sub-adults study the development of third molar root apices on radiographs. In living individuals, however, avoiding ionising radiation is expedient. Studying dental development with magnetic resonance imaging complies with this requirement, adding the advantage of imaging in three dimensions. To elaborate the development of an MRI protocol to visualise all third molars for forensic age estimation, with particular attention to the development of the root apex. Ex vivo scans of porcine jaws and in vivo scans of 10 volunteers aged 17-25 years were performed to select adequate sequences. Studied parameters were T1 vs T2 weighting, ultrashort echo time (UTE), fat suppression, in plane resolution, slice thickness, 3D imaging, signal-to-noise ratio, and acquisition time. A bilateral four-channel flexible surface coil was used. Two observers evaluated the suitability of the images. T2-weighted images were preferred to T1-weighted images. To clearly distinguish root apices in (almost) fully developed third molars an in plane resolution of 0.33 × 0.33 mm 2 was deemed necessary. Taking acquisition time limits into account, only a T2 FSE sequence with slice thickness of 2 mm generated images with sufficient resolution and contrast. UTE, thinner slice T2 FSE and T2 3D FSE sequences could not generate the desired resolution within 6.5 minutes. Three Tesla MRI of the third molars is a feasible technique for forensic age estimation, in which a T2 FSE sequence can provide the desired in plane resolution within a clinically acceptable acquisition time.

Piezosurgery vs High Speed Rotary Handpiece: a comparison between the two techniques in the impacted third molar surgery.

Science.gov (United States)

Bartuli, F N; Luciani, F; Caddeo, F; DE Chiara, L; DI Dio, M; Piva, P; Ottria, L; Arcuri, C

2013-01-01

The aim of the Study was to compare the impacted third molar surgical technique by means of the high speed rotary handpiece with the piezoelectric one. 192 patients have been selected among those who had to undergo a third molar surgical extraction. These patients' surgeries have been performed by means of one of the techniques, randomly chosen. Each patient has undergone the same analgesic therapy (paracetamol 1000 mg tablets). Each surgery has been performed by the same surgeon. The patients were asked to fill in a questionnaire concerning the postoperative pain ("happy face pain" rating scale). The average duration of the surgeries performed by means of the high speed rotary handpiece was 32 minutes, while the duration of the ones performed by means of the piezoelectric handpiece was much longer (54 minutes). The postoperative pain values were almost equal. In conclusion, the osteotomy performed by means of the traditional technique still represents the gold standard in the impacted third molar surgery. The piezoelectric technique may be an effective choice, especially for the less skilled surgeons, in order to guarantee the protection of the delicate locoregional anatomical structures.

Prospective study establishing a management plan for impacted third molar in patients undergoing hematopoietic stem cell transplantation

OpenAIRE

Yamagata, Kenji; Onizawa, Kojiro; Yanagawa, Toru; Takeuchi, Yasutoshi; Hasegawa, Yuichi; Chiba, Shigeru; Bukawa, Hiroki

2011-01-01

ObjectiveAlthough dental treatment before hematopoietic stem cell transplantation (HSCT) is essential to prevent serious infections from oral sources, the best management plan for impacted third molar (ITM) is unclear.Study designThis study was planned to establish a management plan for ITM. Eighty-four candidates for HSCT therapy were consecutively enrolled in the prospective trial. The management plan, which was evidence based and prospectively decided, was to extract the symptomatic ITMs a...

Relationship between post-extraction pain and acute pulpitis: a randomised trial using third molars.

Science.gov (United States)

Zhang, Wei; Dai, Yong-Bo; Wan, Peng-Cheng; Xu, Dong-Dong; Guo, Yi; Li, Zhi

2016-12-01

The aim of the present study was to examine the relationship between post-extraction pain and acute pulpitis in third molars. This study was a randomised controlled trial. Sixty patients requiring removal of a single maxillary third molar with acute pulpitis were included and randomly divided into two groups: group A (n = 30); and group B (n = 30). In group A, third molars were directly extracted, and group B received endodontic therapy (pulp chamber opening and drainage) and underwent extraction 24 hours later, aiming to eliminate the acute inflammation. Another 30 patients requiring removal of a single maxillary third molar and with the same inclusion criteria but without caries or acute pulpitis were recruited into group C, in which the maxillary third molars were also directly extracted. The level of postoperative pain reported each day among the three groups was statistically evaluated. On the first, second and third days after surgery, there was a statistically significant difference between group A and group B and between group A and group C, but there was no statistically significant difference between group B and group C. The results of the present study indicate that there is more pain when third molars with acute pulpitis are directly removed compared with the pain level of the removal of third molars without acute pulpitis. © 2016 FDI World Dental Federation.

Mandibular third molar development after mantle radiation in long-term survivors of childhood Hodgkin's disease

International Nuclear Information System (INIS)

McGinnis, J.P. Jr.; Hopkins, K.P.; Thompson, E.I.; Hustu, H.O.

1987-01-01

Sequential panoramic radiographs were assessed for mandibular third molar development in 47 long-term survivors of childhood Hodgkin's disease after treatment with 37 Gy mantle field radiation. To make a comparison, panoramic radiographs of 149 healthy, nonirradiated children were reviewed for the presence of mandibular third molars. In children between the ages of 7 and 12 years, bilateral agenesis of mandibular third molars was more frequent in patients who had been treated with mantle radiation than in nonirradiated patients. Unilateral agenesis, crown hypoplasia, and root growth impairment of mandibular third molars were also found. Similar, apparent, radiation-induced developmental anomalies were noted in maxillary third molars of the irradiated patients

Morphometric evaluation of external root resorption of mandibular second molar teeth adjacent to the impacted third molars in CBCT imaging of Tehran\\'s population between 2011-2014

Directory of Open Access Journals (Sweden)

Fatemeh Ezoddini Ardakani

2017-04-01

Full Text Available Introduction: Presence of external root resorption in second molars associated with impacted mandibular third molars was not rare. The neglect of this issue may leads to penetration of the pulp and loss of the second molars. The aim of this study was to investigate the incidence and risk factors affecting the external root resorption in second molars associated with mandibular impacted third molars were inclined mesially and horizontally by Cone Beam Computer Tomography (CBCT images. Methods: In this cross sectional study the samples consisted of 231 scans with mesially and horizontally impacted mandibular third molars. Incidence of external root resorption of second molars and the effects of age, gender and clinical parameters such as location and intensity of external root resorption were considered. Moreover, depth and inclination of impacted mandibular third molar were evaluated by CBCT. The data were analyzed by Chi-square test. Results: The overall incidence of external root resorption in the second molars was 22.08%. Incidence of external root resorption in second molars was significantly related to gender and inclination of third molar. The relations between external root resorption and impaction depth of third molar or the patient's age was not statistically significant. However, the relationship between external root resorption and the intensity or depth of impacted third molar and location of root resorption was statistically meaningful. Conclusion: Patient’s gender and horizontal inclination of third molars are the most important factors affecting the presence of external root resorption in the second molars associated with mesially and horizontally impacted mandibular third molars.

Cameriere's third molar maturity index in assessing age of majority.

Science.gov (United States)

Galić, Ivan; Lauc, Tomislav; Brkić, Hrvoje; Vodanović, Marin; Galić, Elizabeta; Biazevic, Maria Gabriela Haye; Brakus, Ivan; Badrov, Jozo; Cameriere, Roberto

2015-07-01

Estimation of chronological age of an individual is one of the main challenges in forensic science. Legally to be able to treat a person as a minor or an adult, it is necessary to determine whether their age of majority (if they are older or younger than 18, in most countries). Methods for estimating age are especially important when an individual in question lacks personal documents or other means of identification. As the dental age differs in various populations, the aim of this study was to evaluate applicability of third molar method for assessing age of majority in Croatia. Cameriere's third molar maturity index (I3M) value of 0.08, measured by the open apices of the teeth, was verified in sample of 1336 panoramic images aged between 14 and 23 years. Chronological age gradually decreased as I3M increased in both genders. Males showed statistically significant advanced maturation when I3M was between 0.0 and 0.3 value. The results indicate that the sensitivity of the test for 0.08 value was 84.3% (95%CI 80.6%, 87.5%) for females and 91.2% (95%CI 88.7%, 93.1) for males. Specificity was 95.4% (95%CI 92.5%, 97.5%) and 91.9% (95%CI 88.8%, 94.3%). The proportions of accurately classified males were 88.8% and that of females 91.5%. The estimated post-test probabilities, of individuals, in other word the probability that a Croatian individual with an I3Mthird molar maturity index should be used as a determinant of the age of majority in Croatia. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Evaluation of third molar development in the estimation of chronological age.

Science.gov (United States)

Soares, Caio Belém Rodrigues Barros; Figueiroa, José Natal; Dantas, Renata Moura Xavier; Kurita, Lúcio Mitsuo; Pontual, Andréa dos Anjos; Ramos-Perez, Flávia Maria de Moraes; Perez, Danyel Elias da Cruz; Pontual, Maria Luiza dos Anjos

2015-09-01

The purpose of this study was to evaluate the correlation between chronological age and the degree of third molar mineralization by Demirjian's developmental stages (Demirjian et al., 1973) using panoramic radiography. From a total of 11.396 digital panoramic radiographs of patients from three oral radiology private clinics from the northeast region of Brazil, obtained from January to June 2009, 2097 radiographic images from patients aged between 6 and 22 years were selected. The images were analyzed individually by two obsevers using a 21-inch computer screen and Windows Picture and Fax Viewer. Reliability was achieved by intra- and interobserver evaluation, using the Kappa test. Chronological age, calcification stage, gender and third molar were interrelated using a multiple linear regression model, considering age as a response variable. There was reliability with Demirjian et al.'s developmental stage assesment, displaying a significant relationship between mineralization stages and patients' age (Page and the calcification stage taking gender and localization of the third molar into consideration. It is possible to estimate chronological age based on Demirjian's stage of a third molar, regardless of gender and location. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Association between third mandibular molar impaction and degree of root development in adolescents

DEFF Research Database (Denmark)

Lauesen, Søren Rødsgaard; Andreasen, Jens O; Gerds, Thomas Alexander

2013-01-01

of the mandibular third molar region from 132 subjects (71 male and 61 female) from 15 to 20 years of age. Based on the films, 264 lower third molars were classified into an eruption and an impaction group. Root development was recorded according to a quantitative method described by Haavikko (1970......: Delayed mandibular third molar root development is associated with impaction. Radiographs taken at age 15 may predict the risk of impaction and thereby guide decision making for the orthodontist or the oral and maxillofacial surgeon.......Abstract Objective: To compare the root development and the growth rate of the mandibular third molar (M3 inf) in individuals where the M3 inf erupted vs individuals exhibiting M3 inf impaction. Materials and Methods: Serial standardized intraoral radiographs (Eggen technique) were taken annually...

Influence of unilateral maxillary first molar extraction treatment on second and third molar inclination in Class II subdivision patients

NARCIS (Netherlands)

Livas, Christos; Pandis, Nikolaos; Booij, Johan Willem; Halazonetis, Demetrios J.; Katsaros, Christos; Ren, Yijin

Objective: To assess the maxillary second molar (M2) and third molar (M3) inclination following orthodontic treatment of Class II subdivision malocclusion with unilateral maxillary first molar (M1) extraction. Materials and Methods: Panoramic radiographs of 21 Class II subdivision adolescents (eight

New quantitative classification of the anatomical relationship between impacted third molars and the inferior alveolar nerve

International Nuclear Information System (INIS)

Wang, Wei-Quan; Chen, Michael Y. C.; Huang, Heng-Li; Fuh, Lih-Jyh; Tsai, Ming-Tzu; Hsu, Jui-Ting

2015-01-01

Before extracting impacted lower third molars, dentists must first identify the spatial relationship between the inferior alveolar nerve (IAN) and an impacted lower third molar to prevent nerve injury from the extraction. Nevertheless, the current method for describing the spatial relationship between the IAN and an impacted lower third molar is deficient. Therefore, the objectives of this study were to: (1) evaluate the relative position between impacted lower third molars and the IAN; and (2) investigate the relative position between impacted lower third molars and the IAN by using a cylindrical coordinate system. From the radiology department’s database, we selected computed tomography images of 137 lower third molars (from 75 patients) requiring removal and applied a Cartesian coordinate system by using Mimics, a medical imaging software application, to measure the distribution between impacted mandibular third molars and the IAN. In addition, the orientation of the lower third molar to the IAN was also measured, but by using a cylindrical coordinate system with the IAN as the origin. According to the Cartesian coordinate system, most of the IAN runs through the inferior side of the third molar (78.6 %), followed by the lingual side (11.8 %), and the buccal side (8.9 %); only 0.7 % is positioned between the roots. Unlike the Cartesian coordinate system, the cylindrical coordinate system clearly identified the relative position, r and θ, between the IAN and lower third molar. Using the cylindrical coordinate system to present the relationship between the IAN and lower third molar as (r, θ) might provide clinical practitioners with a more explicit and objective description of the relative position of both sites. However, comprehensive research and cautious application of this system remain necessary

Effect of Submucosal Injection of Dexamethasone on Post-operative Sequelae of Third Molar Surgery

Directory of Open Access Journals (Sweden)

S P Deo

2011-06-01

Full Text Available Introduction: This study was carried out to evaluate the effects of a single pre-operative sub-mucosal injection of dexamethasone after third molar surgery to see the effects on post-operative discomfort. Methods: This study was a prospective, double-blind, randomized, clinical trial. The subjects were forty patients who underwent surgical removal of the mandibular impacted third molar under local anesthesia and after being randomly assigned to receive either an 8 mg dexamethasone as submucosal injection or a normal saline injection into the lower buccal vestibule adjacent to the third molar. The maximum interincisal distance and facial contours were measured at the baseline and post-surgically on Day 2 and 7. Post-operative pain was evaluated subjectively using a visual analog scale and objectively by counting the number of analgesic tablets used. All subjects were operated upon by the same investigator to minimize the difference from inter-operator variability. Results: There was a signicant difference in the measurements of the degree of swelling and trismus between the two groups on the 2nd post-operative day. In contrast, there was no statistically signicant difference between the groups on the 7th post-operative day. The test group also used fewer analgesics post-operatively. Conclusions: Submucosal injection of dexamethasone after third molar surgery is effective in reducing postoperative swelling and trismus. It also delays the onset of post-operative pain. Keywords: dexamethasone, submucosal injection, third molar, third molar surgery, third molar extraction

Evaluation of third molar development and its relation to chronological age: a panoramic radiographic study.

Science.gov (United States)

Zandi, Mohammad; Shokri, Abbas; Malekzadeh, Hamid; Amini, Payam; Shafiey, Parastu

2015-06-01

Third molar development, in comparison to other teeth in the dentition, has the greatest variation in morphology, anatomical position, and time of development and eruption, and its reliability for chronological age estimation is controversial. The aim of the present study was to evaluate third molar development and its relation to chronological age using panoramic radiography. A total of 2536 digital panoramic radiographs of individuals aged between 5 and 26 years were selected. The developmental status of the third molars was assessed using eight-stage developmental scoring proposed by Demirjian et al., with one modification: a stage 0 was added. The collected data were entered into a checklist and subjected to statistical analyses. The mean ages of the first appearance of third molar bud, complete crown formation, and root apex closure were around 9, 14, and 22 years, respectively. In both jaws, third molar development occurred symmetrically, and sexual dimorphism was observed at some developmental stages. Finally, two formulas were presented to estimate age of the juveniles and adolescents based on their gender and developmental stages of the third molars, and validated on a second sample consisting of 523 individuals aged between 8 and 22. Assessment of third molar development was found to be a reliable method for age estimation of individuals between 11 and 22 years. Because of possible ethnic and geographic differences in third molar development, population specific researches were recommended.

Image analysis of the eruptive positions of third molars and adjacent second molars as indicators of age evaluation in Thai patients.

Science.gov (United States)

Mahasantipiya, Phattaranant May; Pramojanee, Sakarat; Thaiupathump, Trasapong

2013-12-01

This study was performed to determine the relationship between the stage of tooth eruption (both vertical and mesio-angular) and chronological age. Indirect digital panoramic radiographs were used to measure the distances from the dentinoenamel junction (DEJ) of the second molars to the occlusal plane of the second molar teeth and of the adjacent third molars in 264 Thai males and 437 Thai females using ImageJ software. The ratio of those distances was calculated by patient age, and the correlation coefficient of the ratio of the third molar length to the second molar length was calculated. The correlation between the height of the vertically erupted upper third molar teeth and age was at the intermediate level. The age range of ≥15 to age determined from the eruptional height and actual chronological age was statistically significant. The mean age of the female subjects, in which the position of the right upper third molar teeth was at or above the DEJ of the adjacent second molar but below one half of its coronal height was 19.9±2.6 years. That for the left side was 20.2±2.7 years. The mean ages of the male subjects were 20.1±3.3 years and 19.8±2.7 years for the right and left sides, respectively. It might be possible to predict chronological age from the eruption height of the wisdom teeth.

Piezosurgery versus Rotatory Osteotomy in Mandibular Impacted Third Molar Extraction

Science.gov (United States)

Bhati, Bharat; Kukreja, Pankaj; Kumar, Sanjeev; Rathi, Vidhi C.; Singh, Kanika; Bansal, Shipra

2017-01-01

Aim: The aim of this study is to compare piezoelectric surgery versus rotatory osteotomy technique in removal of mandibular impacted third molar. Materials and Methods: Sample size of 30 patients 18 males, 12 females with a mean age of 27.43 ± 5.27. Bilateral extractions were required in all patients. All the patients were randomly allocated to two groups in one group, namely control group, surgical extraction of mandibular third molar was done using conventional rotatory osteotomy and in the other group, namely test group, extraction of lower third molar was done using Piezotome. Results: Parameters assessed in this study were – mouth opening (interincisal opening), pain (visual analog scale VAS score), swelling, incidence of dry socket, paresthesia and duration of surgery in both groups at baseline, 1st, 3rd, and 7th postoperative day. Comparing both groups pain scores with (P piezosurgery group (51.40 ± 17.9) minutes compared to the conventional rotatory group with a mean of (37.33 ± 15.5) minutes showing a statistically significant difference (P = 0.002). Conclusion: The main advantages of piezosurgery include soft tissue protection, optimal visibility in the surgical field, decreased blood loss, less vibration and noise, increased comfort for the patient, and protection of tooth structures. Therefore, the piezoelectric device was efficient in decreasing the short-term outcomes of pain and swelling although taking longer duration than conventional rotatory technique it significantly reduces the associated postoperative sequelae of third molar surgery. PMID:28713729

Radiographic assessment of third molars development and it's relation to dental and chronological age in an Iranian population.

Science.gov (United States)

Monirifard, Mohamad; Yaraghi, Navid; Vali, Ava; Vali, Asana; Vali, Amrita

2015-01-01

The aim of the present study was to estimate chronological age based on third molar development and to determine the association between dental age and third molar calcification stages. In this cross-sectional study, 505 digital panoramic radiographs of 223 males (44.2%) and 282 females (55.8%) between the age of 6 and 17 were selected from patients who were treated in Departments of Pediatrics and Orthodontics of Isfahan University of Medical Sciences between the years of 2009 and 2013. Correlation between chronological age and third molar development was analyzed with SPSS 21 using Spearman's Rank correlation coefficient, Chi-square test and multiple regression statistical tests (P third molars demonstrated a highly significant correlation with dental age (P age were mandibular left third molar in males and mandibular right third molar in females (r s = 0.072). When multiple regression was used to predict dental age based on molar calcification stage, the only significant correlation was between maxillary left third molar in males (P third molars in females. Relationship between chronological age and molars development stage was significant in all age subgroups and in both gender (P third molars and dental age in males. Results showed that third molar calcification stage can be used as an age predictor and in general mandibular teeth seems to be more reliable for this purpose in both genders and in all ages.

Four osteotomy methods with piezosurgery to remove complicated mandibular third molars: a retrospective study.

Science.gov (United States)

Ge, Jing; Yang, Chi; Zheng, Jia-Wei; He, Dong-Mei; Zheng, Ling-Yan; Hu, Ying-Kai

2014-11-01

Piezosurgery has been used widely in oral and maxillofacial surgery, but there has been no report systematically describing an osteotomy method with piezosurgery for complicated mandibular third molar removal. The aim of this study was to introduce 4 osteotomy methods using piezosurgery and evaluate their effects. A retrospective study was conducted of patients with a complicated impacted mandibular third molar requiring extraction. The predictor variable was the extraction technique. Four osteotomy methods using piezosurgery were tested according to different impaction types: method 1 involved complete bone removal; method 2 involved segmental bone removal; method 3 involved bone removal combined with tooth splitting; and method 4 involved block bone removal. Outcome variables were success rate, operative time, major complications (including nerve injury, mandible fracture, severe hematoma, or severe edema), and serious pyogenic infection. Data were analyzed using descriptive statistics. The study was composed of 55 patients with 74 complicated impacted mandibular third molars. All impacted mandibular third molars were removed successfully. The average surgical time was 15 minutes (range, 8 to 26 minutes). Thirty-eight molars (51.4%) were extracted by method 1, 18 molars (24.3%) by method 2, 12 molars (16.2%) by method 3, and 6 molars (8.1%) by method 4. Two cases (2.7%) developed postoperative infections and recovered within 1 week using drainage and antibiotic administration. The 4 osteotomy methods with piezosurgery provide effective ways of removing complicated impacted mandibular third molars. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Changes in the Position of Mandibular Third Molars Following Extraction and Non-Extraction Orthodontic Treatments

Directory of Open Access Journals (Sweden)

Maryam Poosti

2012-09-01

Full Text Available Introduction: Impaction of third molars can be associated with a number of sequelae, each requiring a different type of treatment. The purpose of this study was to assess the changes in the position of lower third molars following extraction and non-extraction orthodontic treatments. Methods: Pre- and post-treatment panoramic radiographs of 26 class I malocclusion patients (4 male and 22 female who were treated on a non-extraction basis were compared with those of 30 class I malocclusion patients (5 male and 25 female who received orthodontic treatment following the extraction of all first premolars. In each group, the lower third molar angulations and their distance from the lower border of the mandible were assessed. Results: Paired t-tests and independent t-tests detected significant changes in the position of the lower third molars in the extraction group. Both the left and right molars became more upright and their distance from the lower border of the mandible increased. Similar changes were only seen in the position of the right mandibular third molars in the non-extraction group. Conclusion: Tooth extractions can bring about favorable changes in the position of mandibular third molars and possibly reduce their incidence of impaction.

Changes in the Position of Mandibular Third Molars Following Extraction and Non-Extraction Orthodontic Treatments

Directory of Open Access Journals (Sweden)

Maryam Poosti

2013-01-01

Full Text Available Introduction: Impaction of third molars can be associated with a number of sequelae, each requiring a different type of treatment. The purpose of this study was to assess the changes in the position of lower third molars following extraction and non-extraction orthodontic treatments. Methods: Pre- and post-treatment panoramic radiographs of 26 class I malocclusion patients (4 male and 22 female who were treated on a non-extraction basis were compared with those of 30 class I malocclusion patients (5 male and 25 female who received orthodontic treatment following the extraction of all first premolars. In each group, the lower third molar angulations and their distance from the lower border of the mandible were assessed. Results: Paired t-tests and independent t-tests detected significant changes in the position of the lower third molars in the extraction group. Both the left and right molars became more upright and their distance from the lower border of the mandible increased. Similar changes were only seen in the position of the right mandibular third molars in the non-extraction group. Conclusion: Tooth extractions can bring about favorable changes in the position of mandibular third molars and possibly reduce their incidence of impaction

Actitud terapéutica ante sacos foliculares de terceros molares incluídos Therapeutic approach to impacted third molar follicles

Directory of Open Access Journals (Sweden)

R. González García

2005-04-01

Full Text Available El quiste dentígero o folicular es un quiste odontogénico del desarrollo. Está revestido por el epitelio del folículo dentario, y suele estar en relación con un diente permanente incluído. Presentamos el caso clínico de un paciente en el que se observa la aparición de un quiste dentígero a partir del saco folicular de un tercer molar incluído no exodonciado, y lo comparamos con la evolución de un cordal incluído y su saco folicular contralaterales en los que se realizó la exodoncia. El tratamiento definitivo del quiste dentígero asociado a un tercer molar incluído es quirúrgico, con la exodoncia de la pieza y enucleación del quiste. Los sacos foliculares mayores de 2 mm asociados a terceros molares incluídos evolucionan en numerosas ocasiones a quistes foliculares. Está indicada la exodoncia de dichos cordales para evitar la evolución a quiste dentígero.The dentigerous cyst or follicular cyst is a developmental odontogenic cyst. It is covered by the epithelium of the dental follicle, and it tends to be related to an impacted permanent tooth. The case report of a patient who was seen to develop a dentigerous cyst arising from the follicle of an impacted non-extracted third molar is presented. This is then compared with the evolution of the contralateral impacted third molar and its follicle that was extracted. The definitive treatment for a dentigerous cyst associated with an impacted third molar is surgical, the extraction of the tooth and enucleation of the cyst. Follicles measuring more+ than 2 mm and that are associated with impacted third molars often develop into follicular cysts. The extraction of these third molars is indicated in order to avoid the development of a dentigerous cyst

The effect of low-level laser therapy on trismus and facial swelling following surgical extraction of a lower third molar.

Science.gov (United States)

Aras, Mutan Hamdi; Güngörmüş, Metin

2009-02-01

The purpose of this study was to evaluate the effect of low-level laser therapy (LLLT) on postoperative trismus and edema after the removal of mandibular third molars. Thirty-two patients who were to undergo surgical removal of lower third molars were studied. Patients were randomly allocated to two groups, LLLT and placebo. Patients in the LLLT group received 12 J (4 J/cm(2)) low-level laser irradiation to the operative side intraorally 1 cm from the target tissue, and to the masseter muscle extraorally immediately after surgery. In the placebo group the handpiece was inserted into the operative side intraorally and was applied to the masseter muscle extraorally each for 1 min, but laser power was not activated. Inter-incisal opening and facial swelling were evaluated on postoperative days 2 and 7. Student's t-test used to analyze the data. It was determined that the trismus and the swelling in LLLT group were significantly less than in the placebo group on postoperative days 2 and 7. Within the limitations of this study it can be concluded that LLLT can be beneficial for the reduction of postoperative trismus and swelling after third molar surgery.

Image analysis of the eruptive positions of third molars and adjacent second molars as indicators of age evaluation in Thai patients

Energy Technology Data Exchange (ETDEWEB)

Mahasantipiya, Phattaranant May; Pramojanee, Sakarat; Thaiupathump, Trasapong [Chiang Mai University, Chiang Mai (Thailand)

2013-12-15

This study was performed to determine the relationship between the stage of tooth eruption (both vertical and mesio-angular) and chronological age. Indirect digital panoramic radiographs were used to measure the distances from the dentinoenamel junction (DEJ) of the second molars to the occlusal plane of the second molar teeth and of the adjacent third molars in 264 Thai males and 437 Thai females using ImageJ software. The ratio of those distances was calculated by patient age, and the correlation coefficient of the ratio of the third molar length to the second molar length was calculated. The correlation between the height of the vertically erupted upper third molar teeth and age was at the intermediate level. The age range of ≥15 to <16 years was noted to be the range in which the correlation between the chronological age determined from the eruptional height and actual chronological age was statistically significant. The mean age of the female subjects, in which the position of the right upper third molar teeth was at or above the DEJ of the adjacent second molar but below one half of its coronal height was 19.9±2.6 years. That for the left side was 20.2±2.7 years. The mean ages of the male subjects were 20.1±3.3 years and 19.8±2.7 years for the right and left sides, respectively. It might be possible to predict chronological age from the eruption height of the wisdom teeth.

Image analysis of the eruptive positions of third molars and adjacent second molars as indicators of age evaluation in Thai patients

International Nuclear Information System (INIS)

Mahasantipiya, Phattaranant May; Pramojanee, Sakarat; Thaiupathump, Trasapong

2013-01-01

This study was performed to determine the relationship between the stage of tooth eruption (both vertical and mesio-angular) and chronological age. Indirect digital panoramic radiographs were used to measure the distances from the dentinoenamel junction (DEJ) of the second molars to the occlusal plane of the second molar teeth and of the adjacent third molars in 264 Thai males and 437 Thai females using ImageJ software. The ratio of those distances was calculated by patient age, and the correlation coefficient of the ratio of the third molar length to the second molar length was calculated. The correlation between the height of the vertically erupted upper third molar teeth and age was at the intermediate level. The age range of ≥15 to <16 years was noted to be the range in which the correlation between the chronological age determined from the eruptional height and actual chronological age was statistically significant. The mean age of the female subjects, in which the position of the right upper third molar teeth was at or above the DEJ of the adjacent second molar but below one half of its coronal height was 19.9±2.6 years. That for the left side was 20.2±2.7 years. The mean ages of the male subjects were 20.1±3.3 years and 19.8±2.7 years for the right and left sides, respectively. It might be possible to predict chronological age from the eruption height of the wisdom teeth.

Demirjian's method in the estimation of age: A study on human third molars.

Science.gov (United States)

Lewis, Amitha J; Boaz, Karen; Nagesh, K R; Srikant, N; Gupta, Neha; Nandita, K P; Manaktala, Nidhi

2015-01-01

The primary aim of the following study is to estimate the chronological age based on the stages of third molar development following the eight stages (A to H) method of Demirjian et al. (along with two modifications-Orhan) and secondary aim is to compare third molar development with sex and age. The sample consisted of 115 orthopantomograms from South Indian subjects with known chronological age and gender. Multiple regression analysis was performed with chronological age as the dependable variable and third molar root development as independent variable. All the statistical analysis was performed using the SPSS 11.0 package (IBM ® Corporation). Statistically no significant differences were found in third molar development between males and females. Depending on the available number of wisdom teeth in an individual, R (2) varied for males from 0.21 to 0.48 and for females from 0.16 to 0.38. New equations were derived for estimating the chronological age. The chronological age of a South Indian individual between 14 and 22 years may be estimated based on the regression formulae. However, additional studies with a larger study population must be conducted to meet the need for population-based information on third molar development.

Third molar maturity index (I3M) for assessing age of majority in a black African population in Botswana.

Science.gov (United States)

Cavrić, Jelena; Galić, Ivan; Vodanović, Marin; Brkić, Hrvoje; Gregov, Jelena; Viva, Serena; Rey, Laura; Cameriere, Roberto

2016-07-01

Assessment of legal age, also known as age of majority, is a controversial issue as there are few body biomarkers or evidence during late adolescence differentiating a subject from being a minor or adult. The third molar was recognized as a suitable site for age examination in late adolescence. We analyzed the development of the left mandibular third molar by the third molar maturity index (I3M) and a specific cut-off value of I3M = 0.08, established by Cameriere et al. in 2008 and used it for discriminating between minors and adult black Africans from Gaborone, Botswana. A final sample of panoramic radiographs (OPTs) of 1294 people (582 males and 712 females) aged between 13 and 23 years was evaluated. The real age decreased as I3M gradually increased. There was no statistically significant difference in the third molar development evaluated using I3M between males and females (p > 0.05) across different I3M classes. Results of 2 × 2 contingency tables for different cut-off values indicated that I3M = 0.08 was useful in discriminating between adults and minors. Precisely, for I3M = 0.08, the values of accuracy or overall fraction of correctly classified were 0.91 in males with a 95 % confidence interval (95 % CI) of 0.88 to 0.93 and 0.92 (95 % CI, 0.90 to 0.93) in females. Values of sensitivity of the test or the proportion of participants being 18 years and older were 0.88 (95 % CI, 0.87 to 0.90) in males and 0.88 (95 % CI, 0.90 to 0.93) in females, while values of specificity or proportion of individuals younger than 18 who have I3M age of 18 years in Botswana. Further studies should address the usefulness of this method and specific cut-off for different adolescent populations.

An endodontic management of mandibular third molar with five root canals

OpenAIRE

Dakshita Joy Sinha; Ashish Amit Sinha

2014-01-01

The existence of several anatomical variations in the root canal system may contribute to failure of the root canal therapy. The planning and performing of endodontic therapy requires knowledge of the internal dental morphology. This paper reports the case of a left mandibular third molar that presented with five root canals; a case of unusual root canal morphology so as to demonstrate the anatomic variations in mandibular third molars. Root canal therapy and case management are described. Th...

Third molar development: evaluation of nine tooth development registration techniques for age estimations.

Science.gov (United States)

Thevissen, Patrick W; Fieuws, Steffen; Willems, Guy

2013-03-01

Multiple third molar development registration techniques exist. Therefore the aim of this study was to detect which third molar development registration technique was most promising to use as a tool for subadult age estimation. On a collection of 1199 panoramic radiographs the development of all present third molars was registered following nine different registration techniques [Gleiser, Hunt (GH); Haavikko (HV); Demirjian (DM); Raungpaka (RA); Gustafson, Koch (GK); Harris, Nortje (HN); Kullman (KU); Moorrees (MO); Cameriere (CA)]. Regression models with age as response and the third molar registration as predictor were developed for each registration technique separately. The MO technique disclosed highest R(2) (F 51%, M 45%) and lowest root mean squared error (F 3.42 years; M 3.67 years) values, but differences with other techniques were small in magnitude. The amount of stages utilized in the explored staging techniques slightly influenced the age predictions. © 2013 American Academy of Forensic Sciences.

Antibiotic prophylaxis in third molar surgery: a review

NARCIS (Netherlands)

Oomens, Marjolijn A. E.; Forouzanfar, Tymour

2012-01-01

Objective. Controversy exists about the efficacy of antibiotic prophylaxis in preventing complications after lower third molar surgery. For evidence-based recommendation, a review was performed on clinical trials reporting the use of antibiotic prophylaxis compared with no treatment or placebo with

Antibiotic prophylaxis in third molar surgery: a review

NARCIS (Netherlands)

Oomens, M.A.E.; Forouzanfar, T.

2012-01-01

Objective Controversy exists about the efficacy of antibiotic prophylaxis in preventing complications after lower third molar surgery. For evidence-based recommendation, a review was performed on clinical trials reporting the use of antibiotic prophylaxis compared with no treatment or placebo with

Histopathologic changes in soft tissue associated with radiographically normal impacted third molars

Directory of Open Access Journals (Sweden)

Kotrashetti Vijayalakshmi

2010-01-01

Full Text Available Background: The incidence of impacted or embedded third molars accounts for approximately 98%. Since 1948, there are studies reporting pathological changes in an asymptomatic dental follicle. Controversy still exists for removal of asmptomatic impacted teeth. Hence, this study was performed to histologically evaluate soft tissue pathosis in the pericoronal tissues of impacted third molars with pericoronal radiolucency measuring up to 2.5 mm on orthopantomographs. Materials and Methods: Forty-one asymptomatic impacted third molars with follicular space of up to 2.5 mm on radiographs were included. The disimpacted teeth and the follicular tissues were obtained for histological examination. Results: Age of the patients ranged from 14 to 25 years. Of 41 tissues evaluated, histopathological reports of 18 follicles were suggestive of dentigerous cyst, two follicles showed odontogenic keratocyst, one follicle each of calcifying epithelial odontogenic cyst, ameloblastoma-like proliferation, odontogenic myxoma and odontogenic fibroma. Conclusion: This study showed 58.5% of asymptomatic cases with definite pathological changes. Hence, thorough clinical and radiographic examination should be carried out for all impacted third molars and the dental follicular tissue should be submitted for histopathological evaluation.

[Surgery of lower third molars and lesions of the lingual nerve].

Science.gov (United States)

Chiapasco, M; Pedrinazzi, M; Motta, J; Crescentini, M; Ramundo, G

1996-11-01

The authors describe a technical expedient applied during the removal of totally or partially impacted lower third molars, in order to prevent lingual nerve damage. EXPERIMENTAL ASSAY: Retrospective study. The sample includes 1835 extractions of totally or partially impacted lower third molars, performed on 1030 patients, 493 males and 537 females, aging between 12 and 72 years. All the operations were carried out under local anaesthesia with standardization of the surgical protocol. A mucoperiosteal paramarginal flap was used in case of germectomy, whereas a mucoperiosteal marginal flap with mesial releasing incision was used in case of fully mature teeth. Ostectomy and tooth sectioning were performed using a round and fissure bur respectively, assembled on a straight low-speed handpiece and under irrigation with sterile saline. The authors reported only one case of transient lingual nerve paresthesia (0.05%) which occurred in a 19-years old female presenting a totally impacted third molar mesial-lingual inclination. Symptoms disappeared spontaneously one week postoperatively. Therefore the overall incidence of permanent nerve damage was equal to 0%. The data reported in literature show a lingual nerve lesion incidence ranging between 0% and 22%. With this simple surgical expedient the incidence of permanent lingual damage was 0%. Thus, it is the authors' opinion that this simple expedient should be applied in all cases of impacted third molar removal.

Staging of third molar development in relation to chronological age of 5-16 year old Indian children.

Science.gov (United States)

Hegde, Sapna; Patodia, Akash; Dixit, Uma

2016-12-01

The usefulness of the developmental status of the third molar has been studied in assessment of the chronological age of adolescents in whom the development of the other permanent teeth is nearly complete. However, little is known about the timing and pattern of third-molar development in the Indian population. This study aimed to stage the third molar development in relation to chronological age of 5-16year old Indian children. In this cross-sectional observational study, the status of third molar development in relation to chronological age of 1139 Indian children aged 5-16 years was evaluated radiographically, using Orhan's modification of Demirjian's method. The frequency of occurrence of the third molars varied from 47% to 70%. Crypt formation, crown completion and root completion occurred as early as 5.4, 8.7 and 15.0 years, respectively. No significant differences based on gender or side were observed in third-molar development (p>0.05). For most stages, maxillary third molars were slightly more advanced than their mandibular counterparts (p>0.05). Considering the high degree of variability observed in third molar genesis and development, the usefulness of this tooth in age determination studies may be very limited in the age group studied. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Which route of antibiotic administration should be used for third molar surgery? A split-mouth study to compare intramuscular and oral intake.

Science.gov (United States)

Crincoli, V; Di Comite, M; Di Bisceglie, M B; Petruzzi, M; Fatone, L; De Biase, C; Tecco, S; Festa, F

2014-01-01

To compare the effectiveness of two different routes of antibiotic administration in preventing septic complications in patients undergoing third molar extraction. Twenty-four healthy patients requiring bilateral surgical removal of impacted mandibular third molars were successfully enrolled for this study. Depth of impaction, angulation, and relationship of the lower third molars with the mandibular branch had to be overlapping on both sides. A split-mouth design was chosen, so each patient underwent both the first and second surgeries, having for each extraction a different antibiotic route of administration. The second extraction was carried out 1 month later. To compare the effects of the two routes of antibiotic administration, inflammatory parameters, such as edema, trismus, pain, fever, dysphagia and lymphadenopathy were evaluated 2 and 7 days after surgery. Side effects of each therapy were evaluated 48 h after surgery. Oral and intramuscular antibiotic therapies overlap in preventing post-operative complications in dental surgery (p>0.05), even if the oral intake, seems to promote the onset of significant gastrointestinal disorders (p=0.003). This study could help dentists in their ordinary practice to choose the right route of antibiotic administration in the third molar surgery. At the same effectiveness, the higher cost and the minor compliance of the patient seem not to justify a routine antibiotic intramuscular therapy, reserving it for patients with gastrointestinal disorders.

Autotransplantation of a mandibular third molar: A case report

Directory of Open Access Journals (Sweden)

Elham Najafi

2017-09-01

Full Text Available Tooth autotransplantation defines as transition of one tooth from one position to another, in same individual. It is a biological procedure in which teeth have the potential to induce alveolar bone growth. It can be applied in patients before adolescence growth is finished. It significantly reduces time and cost compared to implants. Healing rapidly occurs and function is regained almost immediately. Our case was a 15-year-old male that his left mandibular third molar transplanted to the second molar sight after extraction of second molar because of unrestorable crown. During 9 month follow up transplanted tooth was asymptomatic, functional and responsive to sensibility tests. (Cold test, EPT.

The chronological age estimation of third molar mineralization of Han population in southwestern China.

Science.gov (United States)

Qing, Maofeng; Qiu, Lihua; Gao, Zhi; Bhandari, Kishor

2014-05-01

The purpose of the study was to estimate the chronology of third molar mineralization in Han population of southwestern China and find its unique characteristics so that it would provide a reference in several legal cases like forensic age estimation. The study used Demirjian's staging method to study 2192 orthopantomograms of 984 male and 1208 female subjects aged between 8 and 25 years. The statistical data was analyzed by Student's t test and ANOVA. The conclusions of the study are: (1) The chronological mineralization age of third molars of Han population in Southwestern China is similar to the Turkish and the Japanese, was earlier than the Austrian and Han of South China, but later than the Spanish. (2) The mineralization timing of the third molars between two sides in maxilla or mandible has no significant differences in the same gender group. (3) There is no significant difference in mineralization of third molars between male and female, except for tooth 48 in Demirjian's stage E. (4) The mineralization of third molar in maxilla is earlier than mandible. Copyright © 2014 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

[Establish Assessment Model of 18 Years of Age in Chinese Han Population by Mandibular Third Molar].

Science.gov (United States)

Fan, Fei; Dai, Xin-hua; Wang, Liang; Li, Yuan; Zhang, Kui; Deng, Zhen-hua

2016-02-01

To explore the value of estimating chronologic age based on the grades of mandibular third molar development. To evaluate whether mandibular third molar could be used as an indicator for estimating the age under or over 18 years. The mineralization status of mandibular third molar of 1 845 individuals aged 10 - 30 was graded and marked based on Demirjian's classification of grades reformed by Orhan. Gender difference was examined by t-test. A cubic regression model was established to analyze the correlation between third molar and chronologic age. Each grade of age cumulative distribution diagram and ROC curve was respectively performed to evaluate the relationship between third molar and the age of 18. Using Bayes discriminant analysis, an equation was established for estimating the age of 18. The inner-rater reliability was 0.903. Statistical analysis showed a moderate correlation between age and grade. Significant differences of both genders were found only in grade D and H (P Third molar development shows a high correlation with age, and combined with other indicators, it can be used to estimate the age of 18.

Prevention of Localized Osteitis in Mandibular Third-Molar Sites Using Platelet-Rich Fibrin

Directory of Open Access Journals (Sweden)

Donald R. Hoaglin

2013-01-01

Full Text Available Purpose. To review our experience utilizing platelet rich fibrin (PRF, which is reported to aid in wound healing of extraction sites, for the prevention of localized osteitis following lower third-molar removal. Materials and Methods. PRF was placed in the mandibular third-molar extraction sites, 200 sites total, on 100 consecutive patients treated in our practice, by the authors. The patients were managed with standard surgical techniques, intraoperative IV antibiotic/steroid coverage, and routine postoperative narcotic analgesics/short-term steroid coverage. All patients were reevaluated for localized osteitis within 7–10 days of the surgery. A comparison group consisted of 100 consecutive patients who underwent bilateral removal of indicated mandibular wisdom teeth and did not receive PRF placement within the lower third molar surgical sites. Results. The incidence of localized osteitis (LO following removal of 200 lower third molars with simultaneous PRF placement within the extraction site was 1% (2 sites out of 200. The group of patients whose mandibular 3rd molar sockets were not treated with PRF demonstrated a 9.5% (19 sites out of 200 incidence of localized osteitis. The latter group also required 6.5 hours of additional clinical time to manage LO than the study group who received PRF. Conclusions. This retrospective review demonstrated that preventative treatment of localized osteitis can be accomplished using a low cost, autogenous, soluble, biologic material, PRF, that PRF enhanced third-molar socket healing/clot retention and greatly decreased the clinical time required for postoperative management of LO.

CT analyses of the location of the maxillary third molar in relation to panoramic radiographic appearance

International Nuclear Information System (INIS)

Obayashi, Naofumi; Ariji, Yoshiko; Goto, Masakazu; Izumi, Masahiro; Naitoh, Munetaka; Kurita, Kenichi; Shimozato, Kazuo; Ariji, Eiichiro

2009-01-01

We compared the relationship between anatomical structures analyzed by panoramic radiographs and CT images of uninfected impacted maxillary third molars and investigated the pathway of infection originating from pericoronitis of maxillary third molars. Patients (n=62) with uninfected impacted maxillary third molars and patients (n=8) with odontogenic infection originating from pericoronitis of the maxillary third molars were selected from an image database. CT and panoramic images were evaluated separately by an oral surgeon and a radiologist for the vertical position of the tooth, the presence of bone around the crown, proximity to the maxillary sinus, visibility of masticatory muscles, and mesiodistal and buccopalatal inclinations. In uninfected patients, a significant correlation was observed between the vertical positions evaluated by the two methods. Of the third molars, 79 (63.7%) were identified as vertical type on both panoramic and CT images. Regarding the maxillary sinus, of the 19 molars classified as the separate type on panoramic images, 2 (10.5%) were identified as the close type on CT. CT examination revealed the involvement of buccal cortical plates and the buccal space in the majority of infected patients. CT images revealed that 94 molars (75.8%) showed vertical type on the buccopalatal inclination and that 45 impacted molars (36.3%) showed bone defects in the buccal area. Infections originating from pericoronitis of the maxillary third molar showed involvement of the buccal cortical plates, the buccal space, and other spaces, which were clearly depicted on CT images. (author)

CHANGES IN SERUM LEVELS OF IL-6 IN THE EARLY POSTOPERATIVE PERIOD AFTER PREEMPTIVE ANALGESIA WITH NIMESULIDE, METAMIZOLE SODIUM AND PLACEBO IN REMOVAL OF IMPACTED MANDIBULAR THIRD MOLARS

Directory of Open Access Journals (Sweden)

Deyan Zdravkov Neychev

2016-08-01

Full Text Available Abstract Objective: The objective of this study is to determine the change in IL-6 serum levels in patients undergoing preemptive analgesia and surgical removal of an impacted mandibular third molar. Study Design: This is a prospective, double-blind, placebo-controlled study in 80 patients who had an atypical extraction of an impacted mandibular third molar. Results: After surgical removal of impacted mandibular third molars, elevated levels of IL-6 in the early postoperative period were found, and the highest level was 14 pg/ml. Conclusion: Postoperative IL-6 levels rise regardless of the medication used for preemptive analgesia. In the group treated with nimesulide, a trend to reducing IL-6 levels was observed, but further study in a larger number of patients is needed.

Subcutaneous emphysema during third molar surgery: a case report.

Science.gov (United States)

Romeo, Umberto; Galanakis, Alexandros; Lerario, Francesco; Daniele, Gabriele Maria; Tenore, Gianluca; Palaia, Gaspare

2011-01-01

Extraction of third molars is the most common surgical procedure performed in oral surgery on a daily basis and, despite surgical skills and expertise, complications may occur. Complications observed during or after third molar removal may include pain, swelling, bleeding, infection, sinus perforation and nerve damage. Fortunately, with a proper management and a good surgical technique, the incidence of such events is low. Subcutaneous emphysema associated with dental extraction occurs when the air from the high-speed dental handpiece is forced into the soft tissue through the reflected flap and invades the adjacent tissues, leading to swelling, crepitus on palpation and occasionally spreading through the tissue spaces of the fascial planes. Although rare, iatrogenic subcutaneous emphysema can have serious and potentially life-threatening consequences. Care should be taken when using air-driven handpieces. The access of air into the facial tissues is not limited to tooth extractions, but may also occur through other portals of entrance, such as endodontically treated teeth, periodontium and lacerations of intraoral soft tissues. When subcutaneous emphysema occurs, it must be quickly diagnosed and properly managed to reduce the risk of further complications. This report presents a case of subcutaneous emphysema occurred during extraction of a mandibular third molar extraction with the use of an air turbine handpiece. Case management is described and issues relative to the diagnosis and prevention of this surgical complication are discussed.

Digital radiographic evaluation of mandibular third molar for age estimation in young adults and adolescents of South Indian population using modified Demirjian's method.

Science.gov (United States)

Mohammed, Rezwana Begum; Koganti, Ravichandra; Kalyan, Siva V; Tircouveluri, Saritha; Singh, Johar Rajvinder; Srinivasulu, Enganti

2014-09-01

In recent years, it has become increasingly important to determine the age of living people for a variety of reasons, including identifying criminal and legal responsibility and for many other social events such as birth certificate, marriage, beginning a job, joining the army and retirement. The aim of this study was to assess the developmental stages of mandibular third molar for estimation of dental age (DA) in different age groups and to evaluate the possible correlation between DA and chronological age (CA) in South Indian population. Digital orthopantomography of 330 subjects (165 males, 165 females) who fit the study and the criteria were obtained. Assessment of mandibular third molar development was performed using Demirjian et al., modified method and DA was assessed using tooth specific stages. The present study showed a significant correlation between DA and CA in both males and females. Third molar development commenced around 9 years and root completion takes place around 18.9 years in males and in females 9 years and 18.6 years respectively. Demirjian modified method underestimated the mean age of males by 0.8 years and females by 0.5 years and also showed that females mature earlier than males in selected population. Digital radiographic assessment of mandibular third molar development can be used to generate mean DA using Demirjian modified method and also the estimated age range for an individual of unknown CA. Since the Demirjian method is based on French-Canadian population, to enhance the accuracy of forensic age estimates based on third molar development, the use of population-specific standards is recommended.

Pathological (late) fractures of the mandibular angle after lower third molar removal: a case series.

Science.gov (United States)

Cutilli, Tommaso; Bourelaki, Theodora; Scarsella, Secondo; Fabio, Desiderio Di; Pontecorvi, Emanuele; Cargini, Pasqualino; Junquera, Luis

2013-04-30

Pathological (late) fracture of the mandibular angle after third molar surgery is very rare (0.005% of third molar removals). There are 94 cases reported in the literature; cases associated with osseous pathologies such as osteomyelitis or any local and systemic diseases that may compromise mandibular bone strength have not been included. We describe three new cases of pathological (late) fracture of the mandibular angle after third molar surgery. The first patient was a 27-year-old Caucasian man who had undergone surgical removal of a 3.8, mesioangular variety, class II-C third molar 20 days before admission to our clinic. The fracture of his left mandibular angle, complete and composed, occurred during chewing. The second patient was a 32-year-old Caucasian man. He had undergone surgical removal of a 3.8, mesioangular variety, class II-B third molar 22 days before his admission. The fracture, which occurred during mastication, was studied by computed tomography that showed reparative tissue in the fracture site. The third patient was a 36-year-old Caucasian man who had undergone surgical removal of a 3.8, vertical variety, class II-C third molar 25 days before the observation. In this case the fracture of his mandibular angle was oblique (unfavorable), complete and composed. The fracture had occurred during chewing. We studied the fracture by optical projection tomography and computed tomography.All of the surgical removals of the 3.8 third molars, performed by the patients' dentists who had more than 10 years of experience, were difficult. We treated the fractures with open surgical reduction, internal fixation by titanium miniplates and intermaxillary elastic fixation removed after 6 weeks. The literature indicates that the risk of pathological (late) fracture of the mandibular angle after third molar surgery for total inclusions (class II-III, type C) is twice that of partial inclusions due to the necessity of ostectomies more generous than those for partial

Management of Unilaterally Impacted Permanent Mandibular First, Second and Third Molars

Directory of Open Access Journals (Sweden)

Rohit Mehrotra

2014-01-01

Full Text Available This case report describes the treatment of a teenage patient with simultaneous impaction of all three right mandibular permanent molars. The impacted first and second mandibular molars were surgically exposed and orthodontically erupted into good alignment and occlusion while the impacted third molar in the same quadrant was extracted. The unique clinical presentation, various treatment alternatives, the decision making process in finalizing the treatment plan and its clinical implementation are discussed.

Human age estimation combining third molar and skeletal development.

Science.gov (United States)

Thevissen, P W; Kaur, J; Willems, G

2012-03-01

The wide prediction intervals obtained with age estimation methods based on third molar development could be reduced by combining these dental observations with age-related skeletal information. Therefore, on cephalometric radiographs, the most accurate age-estimating skeletal variable and related registration method were searched and added to a regression model, with age as response and third molar stages as explanatory variable. In a pilot set up on a dataset of 496 (283 M; 213 F) cephalometric radiographs, the techniques of Baccetti et al. (2005) (BA), Seedat et al. (2005) (SE), Caldas et al. (2007) and Rai et al. (2008) (RA) were verified. In the main study, data from 460 (208 F, 224 M) individuals in an age range between 3 and 26 years, for which at the same day an orthopantogram and a cephalogram were taken, were collected. On the orthopantomograms, the left third molar development was registered using the scoring system described by Gleiser and Hunt (1955) and modified by Köhler (1994) (GH). On the cephalograms, cervical vertebrae development was registered according to the BA and SE techniques. A regression model, with age as response and the GH scores as explanatory variable, was fitted to the data. Next, information of BA, SE and BA + SE was, respectively, added to this model. From all obtained models, the determination coefficients and the root mean squared errors were calculated. Inclusion of information from cephalograms based on the BA, as well as the SE, technique improved the amount of explained variance in age acquired from panoramic radiographs using the GH technique with 48%. Inclusion of cephalometric BA + SE information marginally improved the previous result (+1%). The RMSE decreased with 1.93, 1.85 and 2.03 years by adding, respectively, BA, SE and BA + SE information to the GH model. The SE technique allows clinically the fastest and easiest registration of the degree of development of the cervical vertebrae. Therefore, the choice of

Factors associated with complications of removal of third molars: a transversal study.

Science.gov (United States)

Barbosa-Rebellato, Nelson-Luis; Thomé, Ana-Carolina; Costa-Maciel, Cássia; Oliveira, Jaina; Scariot, Rafaela

2011-05-01

The purpose of this study is to estimate the overall frequency of complications associated with third molars (M3) removal and to identify the risk factors associated with these complications. To the transversal analysis, a researcher confidentially reviewed the records of all M3 surgery patients. The predictor variables were demographic (i.e. age and gender), localization and position of third molar, bone removal and tooth sectioning. 210 patients had one or more third molars teeth removed, a total of 605 teeth. The sample's mean age was 21.6±9.2 years, with 1,4 woman to 1 man. Postoperative complications were recorded in 54 extractions of third molars. The most common complications were infection (42.6%), followed by radicular fractures (11.1%) and gingival alterations (11.1%). Complications were significantly affected by 3 factors: age over 25 years old (p=0.002--OR 2.21), location (p=0.006--OR 2.36), bone removal (p=0.002--OR 3.03) and tooth sectioning (p=0.00002--OR 3.59). The results of these analyses suggest that age, location of the tooth, bone removal and tooth sectioning appear to be associated with a higher complication rate for M3 extractions.

Prediction of postoperative pain after mandibular third molar surgery

DEFF Research Database (Denmark)

Rudin, Asa; Eriksson, Lars; Liedholm, Rolf

2010-01-01

To evaluate the predictive potential of preoperative psychological and psychophysiological variables in estimating severity of postoperative pain following mandibular third molar surgery (MTMS). Methods: Following ethical committee approval and informed consent, 40 consecutive patients scheduled...

Forensic age estimation based on magnetic resonance imaging of third molars: converting 2D staging into 3D staging.

Science.gov (United States)

De Tobel, Jannick; Hillewig, Elke; Verstraete, Koenraad

2017-03-01

Established methods to stage development of third molars for forensic age estimation are based on the evaluation of radiographs, which show a 2D projection. It has not been investigated whether these methods require any adjustments in order to apply them to stage third molars on magnetic resonance imaging (MRI), which shows 3D information. To prospectively study root stage assessment of third molars in age estimation using 3 Tesla MRI and to compare this with panoramic radiographs, in order to provide considerations for converting 2D staging into 3D staging and to determine the decisive root. All third molars were evaluated in 52 healthy participants aged 14-26 years using MRI in three planes. Three staging methods were investigated by two observers. In sixteen of the participants, MRI findings were compared with findings on panoramic radiographs. Decisive roots were palatal in upper third molars and distal in lower third molars. Fifty-seven per cent of upper third molars were not assessable on the radiograph, while 96.9% were on MRI. Upper third molars were more difficult to evaluate on radiographs than on MRI (p third molars were equally assessable on both imaging techniques (93.8% MRI, 98.4% radiograph), with no difference in level of difficulty (p = .375). Inter- and intra-observer agreement for evaluation was higher in MRI than in radiographs. In both imaging techniques lower third molars showed greater inter- and intra-observer agreement compared to upper third molars. MR images in the sagittal plane proved to be essential for staging. In age estimation, 3T MRI of third molars could be valuable. Some considerations are, however, necessary to transfer known staging methods to this 3D technique.

Evaluation of telemedicine systems for impacted third molars diagnosis

Directory of Open Access Journals (Sweden)

Duka Miloš

2009-01-01

Full Text Available Background/Aim. In the last twenty years significant advances have been made in the fields of information and telecommunication technology in health care applications, with a positive impact on the health care practice. The need for remote diagnosis and planning of interventions is of special importance in military health care, and health management of immobile persons, and those with special needs. In cases such as these, availability of specialist health care is mainly limited by geographic and financial factors. The aim of this study was to investigate practical usability of telemedicine approaches in everyday management of oral surgery patients in terms of reliability of established diagnosis and indications for oral surgery treatment of the third molars. Methods. Our experimental randomized study enrolled 432 randomly selected patients of both genders, aged 20 to 87 years, undergoing panoramic radiography for some reason in the Centre for Dental Radiography in Belgrade. In addition to radiography, photographs of the face and mouth cavity were taken. These images were uploaded to the web server specially dedicated to the study purposes, and then transmitted to teledentists, i.e. oral surgeons, who made remote diagnoses. Diagnostic agreement was determined by way of the Cohen's kappa coefficient, and diagnostic sensitivity (SE, specificity (SP, and effectiveness (EFF were also established. Statistical significance was determined and comparisons performed by using the z-test, and testing of non-parametric characteristics by using the McNemar's χ2 test for p = 0.05 significance cut-off. Results. The results obtained by analyzed images and diagnostic assessment of the clinical diagnosis (kappa = 0.99, SE = 99%, SP = 99%, EFF = 99%, for 95% CI indicate an almost complete diagnostic agreement. The differences in diagnosis were not statistically significant. Conclusion. Diagnostic assessment of the clinical diagnosis of impacted or semi

Evaluation of the distortion rate of panoramic and peri apical radiographs in erupted third molar inclination

International Nuclear Information System (INIS)

Ezoddini Ardakani, F.; Zangouie Booshehri, M.; Behniafar, B.

2011-01-01

Panoramic and peri apical radiographs are normally used in impacted third molar teeth surgeries. The aim of the present study was to evaluate and compare the distortion of the erupted third molar teeth on panoramic and peri apical radiographs. Patients and Methods: A total of 44 radiographs were obtained of 22 patients (age range, 18-24 years) referred to the faculty of dentistry for orthodontic treatment. A plaster cast was prepared and panoramic radiography was taken for all patients to plan the orthodontic treatment and peri apical radiography was taken for investigation of tooth structure details. Therefore, a total of 66 views and samples were studied by two methods: 1) Measuring the angle between the longitudinal plane of the third molar and occlusal plane. 2) Measuring the angle between the longitudinal plane of second and third molar. Finally, 132 records were evaluated by one individual. Results: There was no significant statistical difference between the mean position of the third molar on panoramic, peri apical radiographs and the casts. However, measurements of the third molars on peri apical radiographs were slightly closer to the measurements of the casts compared to the panoramic radiographs. Conclusion: Distortion does not have a specific effect on the diagnosis of the position of the third erupted molars by peri apical or panoramic radiographs, though various studies have shown that these radiographs have an amount of distortion and peri apical radiographical distortion is less than that in panoramic radiography.

Age of majority assessment in Dutch individuals based on Cameriere's third molar maturity index

NARCIS (Netherlands)

Boyacıoğlu Doğru, H.; Gulsahi, A.; Burçak Çehreli, S.; Galić, I.; van der Stelt, P.; Cameriere, R.

2018-01-01

Radiological examination of the third molar is done in living individuals for estimation of chronological age, especially in the late adolescence. The aim of this study was to assess the application of Cameriere's third molar maturity index (I3M) to determine whether an individual is 18 years or

Incidence of trismus in transalveolar extraction of lower third molar

Directory of Open Access Journals (Sweden)

Gowri Balakrishnan

2017-01-01

Full Text Available Background: Conventional mandibular third molar removal produces tissue trauma that induces an inflammatory reaction, leading to postoperative sequelae, the most common ones being trismus which influences the patient's quality of life in the postoperative period. Identifying the factors determining trismus after mandibular third molar extraction helps us to evaluate and correlate the incidence of trismus with morphological and surgical factors that are associated with its incidence in the postoperative period. Methodology: Patients referred to our institution for surgical removal of their impacted lower third molar between November 2014 and February 2015 were the participants of the study. Type of impaction, indication, and level of difficulty based on Pedersen criteria were obtained. Postoperative pain, swelling, and mouth opening (MO limitations were evaluated at postoperative day (POD 0, POD1, POD3, POD5, and POD7 and were analyzed. P < 0.05 was considered statistically significant. Result and Conclusion: In this study, out of fifty patients, only nine patients had experienced limited MO during postoperative period when the duration of procedure exceeded 30 min. However, it occurred as cumulative of pericoronitis and tooth sectioning done. The postoperative trismus was more significant in disto-angular impaction (P < 0.05 due to postoperative sequelae, swelling and pain.

Dental age estimation from the developmental stage of the third molars in western Chinese population.

Science.gov (United States)

Li, Guo; Ren, Jiayin; Zhao, Shuping; Liu, Yuanyuan; Li, Na; Wu, Wanhong; Yuan, Shanshan; Wang, Hu

2012-06-10

The purpose of this study is to provide reference data about estimating dental age from third molars of the western Chinese population for comparing with other populations and being applied to the age estimation of western Chinese juveniles and adolescents. A total of 2078 digital panoramic radiographs of 989 male and 1089 female Chinese subjects aged between 5 and 23 years were examined. The mineralization status of the third molars was assessed using the formation stages described by Demirjian et al. with two modifications. The results showed that the development of third molars in the western Chinese population was likely to begin at age 5 in both males and females. The third molars 28 and 48 showed significantly higher frequency in females than in males. The third molars 18 in the stage 1, 38 in the stages 1, A and G, and 48 in the stage H showed significantly older average age in females than in males. The Demirjian's stages C and D could be used as a reference stage to determine dichotomously whether a western Chinese is more likely to be under or above age 14 or 16, respectively. This study provided reference data for the age estimation of western Chinese juveniles and adolescents by the mineralization stages of the third molar. Apart from forensic age determination in living subjects, the presented reference data can also be used for age estimations of unidentified corpses and skeletons. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Impacted mandibular third molars and their influence on mandibular angle and condyle fractures--a retrospective study.

Science.gov (United States)

Gaddipati, Rajasekhar; Ramisetty, Sudhir; Vura, Nandagopal; Kanduri, Rajeev Reddy; Gunda, Vinay Kumar

2014-10-01

Previous retrospective analyses prove that impacted mandibular third molars (M3s) increase the risk of angle fractures and decrease the risk of concomitant fractures to the condyle. A retrospective cohort was designed for patients reported to the Department of Oral and Maxillofacial Surgery from January 2011 till June 2013. The study variables are presence or absence of third molar, if it is present, their position, classified using the Pell and Gregory system; angulation, classified using Shiller's method. The outcome variables were angle and condyle fractures. Hospital records and panoramic radiographs were used to determine and classify these variables. The study sample comprised of 118 mandibular angle and condyle fractures in 110 patients. Database was constructed and analysed using SPSS version 10.0. This present retrospective study concluded that the presence of impacted third molar predisposes the angle to fracture and reduces the risk of a concomitant condylar fracture. However absence of impacted third molar increases the risk of condylar fracture. The highest incidence of angle fracture was observed in position A impacted mandibular third molars. And there is no significant relationship, concerning ramus position and angulation of impacted mandibular third molars with the angle fracture. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Impacted Mandibular Third Molars: Review of Literature and a ...

African Journals Online (AJOL)

were screened, and 50 articles were included in the review. Causes of ... impaction rate is higher for third molars when compared with other teeth. The mandibular .... Hence, the surgical extraction of these impacted teeth has become the most ...

Endodontic therapy of a mandibular third molar with 5 canals: a case report.

Science.gov (United States)

Silberman, Adrian; Heilborn, Carlos; Cohenca, Nestor

2009-06-01

Endodontic treatment of third molars often becomes part of comprehensive treatment plans, as it represents a more conservative and less invasive approach than its therapeutic alternatives. The frequency of anatomic variations in mandibular molars, particularly root canal configuration, requires 2 periapical radiographs from different angles. Upon reading and interpretation of the radiographs, the clinician should consider the anatomy and level of difficulty of the endodontic procedure and refer the patient to an endodontist, if deemed necessary. The present article discusses the successful treatment and preservation of a mandibular third molar with 5 root canals, as well as methods for its clinical management.

Root and Canal Morphology of Mandibular Third Molars in an Iranian Population

OpenAIRE

Maryam Kuzekanani; Jahangir Haghani; Hossein Nosrati

2012-01-01

Background and aims A through knowledge of the root canal morphology is required for successful endodontic ther-apy. The aim of this study was to investigate the root and canal morphology of mandibular third molars in Kerman, a prov-ince in southeast of Iran. Materials and methods One-hundred-fifty extracted mandibular third molars were collected randomly from different dental clinics in Kerman. The root canal anatomy and morphology of each tooth was carefully studied using a clearing tech-ni...

Central sensitization phenomena after third molar surgery: A quantitative sensory testing study

DEFF Research Database (Denmark)

Jensen, T.S.; Norholt, S.E.; Svensson, P.

2008-01-01

Background: Surgical removal of third molars may carry a risk of developing persistent orofacial pain, and central sensitization appears to play an important role in the transition from acute to chronic pain. Aim: The aim of this study was to investigate sensitization (primarily central sensitiza......Background: Surgical removal of third molars may carry a risk of developing persistent orofacial pain, and central sensitization appears to play an important role in the transition from acute to chronic pain. Aim: The aim of this study was to investigate sensitization (primarily central...... sensitization) after orofacial trauma using quantitative sensory testing (QST). Methods: A total of 32 healthy men (16 patients and 16 age-matched control subjects) underwent a battery of quantitative tests adapted to the trigeminal area at baseline and 2, 7, and 30 days following surgical removal of a lower...... impacted third molar. Results: Central sensitization for at least one week was indicated by significantly increased pain intensity evoked by intraoral repetitive pinprick and electrical stimulation (p

Pre-operative assessment of impacted mandibular third molar and inferior alveolar canal using orthopantomograhpy and cone beam computed tomography

Directory of Open Access Journals (Sweden)

Mahmuda Akter

2016-12-01

Full Text Available The aim of this study was to assess the proximity and relation of impacted mandibular third molar and inferior alveolar canal on orthopantomogram and cone beam computed tomography (CBCT. Sixty impacted mandibular third molars having close proximity with the  inferior alveolar canal were included. CBCT images were done to determine the exact location and relationship of impacted third molar tooth and inferior alveolar canal. We assessed the radiographic signs from orthopantomogram, the course of  inferior alveolar canal and proximity to the third molar tooth in CBCT. The buccal course of  inferior alveolar canal was most frequently detected (n=36 in CBCT findings. The impacted lower third molar roots were 55% contact with the  inferior alveolar canal and 45% separate from the canal. On orthopantomogram, the following signs were strongly correlated with actual contact: Superimposed relationship between the third molar and the inferior alveolar canal. CBCT is useful as a presurgical planning in patients with impacted mandibular third molar showing close proximity to the  inferior alveolar canal.

Bilateral maxillary fused second and third molars: a rare occurrence

OpenAIRE

Liang, Rui-Zhen; Wu, Jin-Tao; Wu, You-Nong; Smales, Roger J; Hu, Ming; Yu, Jin-Hua; Zhang, Guang-Dong

2012-01-01

This case report describes the diagnosis and endodontic therapy of maxillary fused second and third molars, using cone-beam computed tomography (CBCT). A 31-year-old Chinese male, with no contributory medical or family/social history, presented with throbbing pain in the maxillary right molar area following an unsuccessful attempted tooth extraction. Clinical examination revealed what appeared initially to be a damaged large extra cusp on the buccal aspect of the distobuccal cusp of the secon...

An endodontic management of mandibular third molar with five root canals

Directory of Open Access Journals (Sweden)

Dakshita Joy Sinha

2014-01-01

Full Text Available The existence of several anatomical variations in the root canal system may contribute to failure of the root canal therapy. The planning and performing of endodontic therapy requires knowledge of the internal dental morphology. This paper reports the case of a left mandibular third molar that presented with five root canals; a case of unusual root canal morphology so as to demonstrate the anatomic variations in mandibular third molars. Root canal therapy and case management are described. This report highlights the importance of looking for additional roots and root canals so as to enable clinicians to treat a case successfully, which might have ended in failure.

Accidents and complications associated to third molar surgeries performed by dentistry students.

Science.gov (United States)

Azenha, Marcelo Rodrigues; Kato, Rogerio Bentes; Bueno, Renan Barros Lima; Neto, Patricio Jose Oliveira; Ribeiro, Michel Campos

2014-12-01

The aim of this work is to demonstrate the accidents and complications rates on third molars surgeries performed by senior dentistry students. A retrospective study of 122 patient charts submitted to third molars surgeries was done. Patient age, gender, dental in arch position, and accidents/complications were considered with the charts presenting incomplete dates being excluded from the study. After all, 88 patients (210 surgeries) were included. The majority of the patients were female (70.4 %), with the average age of 24 years. Mandibular molars represented more than half of the surgical procedures (56.2 %), with teeth at vertical position the most found (60.3 %). The cases of accidents and complications totalized 10.4 % of all performed procedures, being hemorrhage (1.9 %), root fractures (1.9 %), and maxillary tuberosity fracture (1.9 %) the most found. Suture dehiscence (1.4 %), dry socket (1.4 %), oroantral communications (0.9 %), paresthesia (0.9 %), and infection (0.4 %) were also observed. Surgeons' inexperience was not considered a determinant factor to modify the rates of accidents and complications at third molars surgeries when compared to previous works developed by experienced surgeons. It is important to highlight the necessity of the students' knowledge of the most adequate treatments of each of the accidents and complications.

Hypohyperdontia: Agenesis of three third molars and mandibular centrals associated with midline supernumerary tooth in mandible

Directory of Open Access Journals (Sweden)

Sivakumar Nuvvula

2010-01-01

Full Text Available Agenesis of teeth in a patient who also presents with a supernumerary tooth is one of the rare numerical anomalies in human dentition. Agenesis of third molars was shown to be associated with other missing permanent teeth. A review of literature on hypodontia including third molar agenesis, hyperdontia and a concomitant presence of these two conditions which is termed as hypohyperdontia is presented along with a case showing agenesis of three third molars, both mandibular central incisors and a midline supernumerary tooth.

Comparison of clinical parameters and environmental noise levels between regular surgery and piezosurgery for extraction of impacted third molars

OpenAIRE

Chang, Hao-Hueng; Lee, Ming-Shu; Hsu, You-Chyun; Tsai, Shang-Jye; Lin, Chun-Pin

2015-01-01

Impacted third molars can be extracted by regular surgery or piezosurgery. The aim of this study was to compare clinical parameters and device-produced noise levels between regular surgery and piezosurgery for the extraction of impacted third molars. Methods: Twenty patients (18 women and 2 men, 17–29 years of age) with bilateral symmetrical impacted mandibular or maxillary third molars of the same level were included in this randomized crossover clinical trial. The 40 impacted third molar...

An Unusual Complication After the Extraction of a Maxillary Third Molar: Extensive Subcutaneous Emphysema. A Case Report

Directory of Open Access Journals (Sweden)

Emrah Soylu

2016-09-01

Full Text Available Third molar surgery is one of the most frequently performed procedures in oral and maxillofacial surgery. Various complications including pain, bleeding, infection, edema, hematoma, perforation of the maxillary sinus, and subcutaneous emphysema (SE can occur after third molar surgery. Cervicofacial subcutaneous emphysema (CSE most often occurs after the extraction of third molars, especially when using high-speed air-turbine drills and air syringes, or during dental laser treatment or even after endodontic treatment. This report presents the diagnosis and treatment protocol of a CSE in a 42-year-old healthy male patient that occurred after extraction of a totally erupted upper third molar with just a straight elevator and extraction forceps.

Non‑third molar related pericoronitis in a sub‑urban Nigeria ...

African Journals Online (AJOL)

2013-02-28

Feb 28, 2013 ... Chronic pericoronitis was the most common presentation (73.3%). No case was reported in the primary dentition and the premolar. No case was ..... Impacted lower third molars and periodontal health. An epidemiological ...

Co-relation of variables as determined from panoramic radiograph and evaluating their significance in eruption of permanent mandibular third molar

Directory of Open Access Journals (Sweden)

Kushal Amin

2008-01-01

Full Text Available Purpose of the Study: Purpose of the study is to investigate whether the variables associated with the permanent mandibular third molar (PMM3 and arch dimensions could be co-related and significantly differentiated between a fully erupted and mesially impacted PMM3 among a set of Indian population. Study Design: A standardized panoramic radiograph was taken of subjects of age 21 years and above. Patients with missing tooth from mandibular arch, subjects undergoing or having history of orthodontic treatment, subjects having disto-angular, horizontal or vertical impacted PMM3 were excluded from the study. Subjects were divided into 2 groups: (1 mesially impacted PMM3 and (2 vertically erupted PMM3. Following measurements were taken from acetate paper tracing of standardized panoramic radiograph: (1 Angulation of long axis of PMM3 to permanent mandibular second molar (theta (2 Angulation of PMM 3 to base of mandible (theta 2 (3 Gonial angle (theta 3 (4 Mesio-distal width of PMM 3 (5 Retro molar space. From these measurements Ganss ratio (retro molar space /PMM3 crown width. was calculated. Results and Conclusion: Results revealed that angle theta 1, angle theta 2, retro molar space and Ganss ratio were positively co-related and highly significant variables associated with the mesially and vertically erupted teeth as measured on panoramic radiograph. Using these variables a long-term study can be carried out to predict the ultimate position of lower third molar in the arch so that if there is a probability of the tooth being impacted at a later age, a prophylactic germectomy can be performed at an early age.

Comparison of the clinical efficacy of methylprednisolone with ibuprofen and ibuprofen alone on the postoperative sequelae of surgical removal of impacted third molar

Directory of Open Access Journals (Sweden)

Navneet Kaur

2014-01-01

Full Text Available Purpose: The aim of the study was to compare the clinical efficacy of methylprednisolone with ibuprofen to ibuprofen alone on the postoperative sequelae of surgical removal of impacted third molars. Materials and Methods: The present study was conducted on the 35 patients requiring surgical extraction of bilateral impacted third molars attending the Outpatient Department of Oral and Maxillofacial Surgery, Guru Nanak Dev Dental College and Research Institute. The impacted teeth were removed in two sessions at least 3 weeks apart. The selected patients were randomly put on regimen 1 or regimen II at either the first or second surgery in accordance with randomization plan. The measurements and recordings for pain, swelling, and interincisal distance (mouth opening, were made on 1 st , 3 rd , and 7 th day postoperatively on the scales designed for the purpose. The data recorded was compiled and put to statistical analysis. Results: It was observed from the present study that postoperative sequelae, that is, pain, swelling, and trismus was significantly less in the regimen I group than regimen II group on the 1 st and 3 rd postoperative day. Conclusion: The results of this study substantiate the fact that a single class of drugs (nonsteroidal anti-inflammatory drug (NSAID is less effective in controlling postoperative inflammatory sequelae than the combination of ibuprofen (NSAID and methylprednisolone (corticosteroid following the third molar surgery. Therefore, this pharmaceutical combination should be considered for attenuation of postoperative sequelae in healthy patients undergoing surgical removal of impacted mandibular third molar.

The efficacy of hyaluronic acid in postextraction sockets of impacted third molars: A pilot study.

Science.gov (United States)

Yilmaz, N; Demirtas, N; Kazancioglu, H O; Bayer, S; Acar, A H; Mihmanli, A

2017-12-01

This study aims to evaluate the effectiveness of local hyaluronic acid (HA) administration to surgically remove impacted third molar sockets and measure pain, swelling, and trismus. The study included a total of 25 healthy patients aged 18-29 years with asymptomatic bilaterally impacted lower third molars. All cases have been performed under local anesthesia. In the study group, 0.8% HA (Gengigel®) was applied in the postextraction sockets of the right third molars and in the control group nothing was applied to the extraction sockets of the left third molars. Postoperative pain, trismus, and swelling were evaluated on the 1st, 3rd, and 7th postoperative days. No difference was determined between groups in facial swelling and maximum mouth opening. However, the amount of pain significantly reduced in HA groups according to visual analog scale (P = 0.001). The results of this study showed that HA can produce an analgesic action in postextraction sockets after surgical removal of impacted teeth and therefore it has a clinical benefit to reduce usage of nonsteroidal anti-inflammatory drugs after dentoalveolar surgery.

Predicting lower third molar eruption on panoramic radiographs after cephalometric comparison of profile and panoramic radiographs

DEFF Research Database (Denmark)

Begtrup, Anders; Grønastøð, Halldis Á; Christensen, Ib Jarle

2012-01-01

and to find a simple and reliable method for predicting the eruption of the mandibular third molar by measurements on panoramic radiographs. The material consisted of profile and panoramic radiographs, taken before orthodontic treatment, of 30 males and 23 females (median age 22, range 18-48 years......Previous studies have suggested methods for predicting third molar tooth eruption radiographically. Still, this prediction is associated with uncertainty. The aim of the present study was to elucidate the association between cephalometric measurements on profile and panoramic radiographs...... the length from the ramus to the incisors (olr-id) showed a statistically significant correlation. By combining this length with the mesiodistal width of the lower second molar, the prediction of eruption of the lower third molar was strengthened. A new formula for calculating the probability of eruption...

Dentigerous Cystic Changes in the Follicles Associated with Radiographically Normal Impacted Mandibular Third Molars

OpenAIRE

Ashok Dongol; Alok Sagtani; Mehul Rajesh Jaisani; Arpita Singh; Ashish Shrestha; Anju Pradhan; Pradeep Acharya; Anjani Kumar Yadav; Ram Prasad Yadav; Arun Kumar Mahat; Iccha Kumar Maharjan; Leeza Pradhan

2018-01-01

Objective. To assess the incidence of dentigerous cystic changes in the follicles of radiographically normal impacted mandibular third molars. Methods. One hundred and thirteen follicles obtained after surgical removal of impacted mandibular third molars with radiolucency of less than 2.5 mm in the radiograph were sent for histopathologic evaluation to evaluate pathologic changes. Results. The incidence of dentigerous cystic changes observed was 15.9%, that is, 18 out of 113 patients (51 male...

Radiographic assessment of agenesis, impaction, and pararadicular radiolucencies in relation with third molar in Nashik City of Maharashtra

Directory of Open Access Journals (Sweden)

Bhushan Sukdeo Ahire

2016-01-01

Full Text Available Introduction: The third molar develops entirely after birth and also it is the last tooth to erupt in all ethnic groups despite racial variations in the eruption sequence. Tooth development with effects on tooth size, shape, position, and total absence is affected due to environmental factors, systemic diseases, genetic polymorphisms, and teratogens. Aims and Objectives: The aim of this study was to assess the prevalence of agenesis, impaction, and pararadicular radiolucencies in relation with third molars. Materials and Methods: One hundred digital orthopantomograph (OPG scans of patients of age ranging from 18 to 25 years were selected randomly from the digital OPG database of the Department of Oral Medicine and Radiology, and then assessment and analysis were carried out. Results: Overall agenesis rate was about 14.5%. Bilateral agenesis of maxillary and mandibular third molars was about 14% and 13%, respectively. Overall impaction rate was about 21.92%. Mesioangular impaction rate was about 57.33% whereas distoangular impaction rate was about 26.66%. Prevalence of pararadicular radiolucencies was only about 0.8% with mandibular predilection. Conclusion: As the agenesis of the third molars is increasing, they can be considered as vestigial. Prevalence of impaction of the third molars is increasing. Pararadicular radiolucencies are mostly seen with mandibular third molar.

Evaluating success of autotransplantation of embedded/impacted third molars harvested using piezosurgery: a pilot study.

Science.gov (United States)

Nagori, Shakil Ahmed; Jose, Anson; Bhutia, Ongkila; Roychoudhury, Ajoy

2014-11-01

To evaluate the success of autogenous transplantation of embedded/impacted third molars harvested using piezosurgery. This prospective pilot study enrolled 20 healthy patients with non-restorable first/second molars and a caries-free retrievable embedded/impacted third molar. Piezosurgery was used for removing inter-radicular bone at the recipient socket as well as for bone removal around the donor teeth. After an average follow-up of 16.4 months (SD = 1.9), 18 cases were successful with formation of periodontal ligament around the teeth. One tooth was lost due to infection at 1 month. One patient was lost to follow-up. There was no root resorption or ankylosis in any of the cases. In six donor teeth with complete root formation, root canal treatment was carried out. All the remaining teeth responded positively with vitality testing. Piezosurgery is an effective device if embedded/impacted third molars are to be harvested for successful autogenous transplantation.

Effect of piezoelectric instruments on healing propensity of alveolar sockets following mandibular third molar extraction

OpenAIRE

Shang-Jye Tsai; Yen-Liang Chen; Hao-Hueng Chang; Yow-Chyun Shyu; Chun-Pin Lin

2012-01-01

Background/purpose: The purpose of this study was to investigate whether the use of piezoelectric instruments affected the healing propensity of alveolar sockets after mandibular third molar extraction, compared with conventional rotary instruments. Materials and methods: Thirty patients with impacted bilateral symmetrical mandibular third molars participated in this investigation. We conducted a randomized, crossover study using conventional rotary instruments for extraction on one side a...

Relationship between fracture of mandibular condyle and absence of unerupted mandibular third molar-a retrospective study.

Science.gov (United States)

Rajan, Ritesh; Verma, Dinesh Kumar; Borle, R M; Yadav, Abhilasha

2016-06-01

The purpose of the present study was to find, if there exists, a co-relation between presence of unerupted mandibular third molar and fracture of mandibular condyle. A retrospective, multicenter study was done collecting the data of all mandibular condyle fractures treated from November 2006 till August 2015. Data was collected from the patient's records and radiographs for the following information: age, sex, etiology of fracture, presence and state of lower third molars, and associated fracture. The results were subjected to statistical analysis. Out of 180 patients of condylar fracture, unerupted third molars were present in 35 (19.44 %) cases compared to 145 (80.55 %) cases of condylar fracture where the unerupted third molars were not present. The difference was statistically significant (p fracture was seen in 4 (11.4 %) cases, bilateral condylar fracture associated with other mandibular fractures in 9 (25.7 %) cases, isolated unilateral condylar fracture in 0 (0.0 %) cases, and unilateral condylar fracture associated with other mandibular fractures in 17 (48.5 %) cases and condylar fracture associated with mid face fractures in 5 (14.2 %) cases. In the unerupted third molar absent group, isolated bilateral condylar fracture was seen in 5 (3.4 %) cases, bilateral condylar fracture associated with other mandibular fractures in 30 (20.6 %) cases, isolated unilateral condylar fracture in 24 (16.5 %) cases, unilateral condylar fracture associated with other mandibular fractures in 73 (50.34 %) cases, and condylar fracture associated with mid face fractures in 13(8.96 %) cases. The difference between the groups was statistically significant (p = 0.032). This study suggests that the fractures of mandibular condylar region have a significantly higher incidence in patients without an unerupted mandibular third molar.

Age assessment based on third molar mineralisation : An epidemiological-radiological study on a Central-European population.

Science.gov (United States)

Hofmann, Elisabeth; Robold, Matthias; Proff, Peter; Kirschneck, Christian

2017-03-01

The method published in 1973 by Demirjian et al. to assess age based on the mineralisation stage of permanent teeth is standard practice in forensic and orthodontic diagnostics. From age 14 onwards, however, this method is only applicable to third molars. No current epidemiological data on third molar mineralisation are available for Caucasian Central-Europeans. Thus, a method for assessing age in this population based on third molar mineralisation is presented, taking into account possible topographic and gender-specific differences. The study included 486 Caucasian Central-European orthodontic patients (9-24 years) with unaffected dental development. In an anonymized, randomized, and blinded manner, one orthopantomogram of each patient at either start, mid or end of treatment was visually analysed regarding the mineralisation stage of the third molars according to the method by Demirjian et al. Corresponding topographic and gender-specific point scores were determined and added to form a dental maturity score. Prediction equations for age assessment were derived by linear regression analysis with chronological age and checked for reliability within the study population. Mineralisation of the lower third molars was slower than mineralisation of the upper third molars, whereas no jaw-side-specific differences were detected. Gender-specific differences were relatively small, but girls reached mineralisation stage C earlier than boys, whereas boys showed an accelerated mineralisation between the ages of 15 and 16. The global equation generated by regression analysis (age = -1.103 + 0.268 × dental maturity score 18 + 28 + 38 + 48) is sufficiently accurate and reliable for clinical use. Age assessment only based on either maxilla or mandible also shows good prognostic reliability.

Accuracy in the legal age estimation according to the third molars mineralization among Mexicans and Columbians.

Science.gov (United States)

Costa, José; Montero, Javier; Serrano, Sarai; Albaladejo, Alberto; López-Valverde, Antonio; Bica, Isabel

2014-11-01

This study aims to assess the accuracy of age estimation according to two cut-off points of Demirjian's developmental stages (G and H) in the wisdom teeth, using panoramic radiographs from Colombian and Mexican teenagers. The degree of maturation of the third molars was classified according to Demirjian in 8 stages (from A to H) by a blinded trained assessor. The sensitivity, specificity and efficacy of two cut-off points (G and H) were calculated for both samples. The orthopantomographies of 316 subjects, 171 Colombians (54.1%) and 145 Mexicans (45.9%), were analyzed. The stage H was found to be the best threshold for detecting juveniles (because the high specificity) in all the third molars assessed. The specificity was higher for lower third molars than for upper third molars, but no asymmetrical discrepancy was noted. The stage H is the best cut-off point for detecting the adulthood when a high-specificity test is required. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Ibuprofen versus Acetaminophen in Controlling Postoperative Impacted Third Molar Tooth Extraction Pain

International Nuclear Information System (INIS)

Khan, I.; Bukhari, S. G. A.; Ahmad, W.; Rubbab,; Junaid, M.

2013-01-01

Objectives: To compare the efficacy of ibuprofen and acetaminophen in reducing postoperative third molar extraction pain in patients reporting to Armed Forces Institute of Dentistry. Study design: Randomized controlled trial. Place and duration of study: The study was carried out on patients who presented for surgical removal of impacted teeth at Armed Forces Institute of Dentistry Rawalpindi (AFID) from February 2008 to March 2--9 at the Department of Oral Surgery, Armed Forces Institute of Dentistry Rawalpindi. Patients and methods: One hundred and forty patients requiring surgical removal of mandibular impacted teeth were equally divided into two groups. Surgical extraction of third molar tooth was performed under local anesthesia. Patients in group A were given ibuprofen and in group B were given acetaminophen at 6 hourly intervals. First dose was given 3 hours postoperatively. Each patient rated pain on a visual analog scale at baseline and then at 12, 24, 48 and 72 hours postoperatively. Results: There was statistically significant difference (p=0.025) during first 12 hours with ibuprofen group showing better efficacy but afterwards there was no significant difference in the efficacy of both drugs. Conclusions: Ibuprofen is more effective in controlling severe third molar extraction pain as compared to acetaminophen but has similar efficacy in controlling moderate pain. (author)

Assessment of the relationship between the mandibular third molar and the mandibular canal using panoramic radiograph and cone beam computed tomography

International Nuclear Information System (INIS)

Jung, Yun Hoa; Nah, Kyung Soo; Cho, Bong Hae

2008-01-01

The purpose of this study is to evaluate the position of the mandibular canal in relation to the mandibular third molar by cone beam CT in cases showing a close relationship between the third molar and the mandibular canal on the panoramic radiograph. The panoramic images and cone beam CT scans of 87 impacted mandibular third molars in 60 patients were evaluated to assess the tooth relationship to the mandibular canal. The clearness of the canal wall and the vertical depth of the lower third molar were evaluated on panoramic radiographs. The lower third molars were assessed using cone beam CT to determine the proximity and position of the canal relative to the roots. In the 66 cases where the canal wall was unclear on the panoramic radiographs, 58 (87.9%) of the third molars had contact between the canal and root; 34 (51.5%) canals were showed an inferior position and 22 (33.3%) showed a linguoinferior position on cone beam CT. Interruption of the canal wall on panoramic radiographs was highly predictive of contact between the mandibular canal and the third molar. Cross sectional CT may be indicated for localization of the mandibular canal in such cases.

The effect of a separate consultation on anxiety levels before third molar surgery

NARCIS (Netherlands)

van Wijk, Arjen; Lindeboom, Jerome

2008-01-01

The present study tested the effect of a separate consultation with an oral and maxillofacial surgeon on levels of anxiety before third molar extraction. Patients were randomly assigned to either the experimental or the control group. Experimental subjects received standard information about third

Pain Control Following Impacted Third Molar Surgery with Bupivacaine Irrigation of Tooth Socket: A Prospective Study

Directory of Open Access Journals (Sweden)

Reza Khorshidi Khiavi

2010-12-01

Full Text Available Background and aims. The surgical removal of the lower third molars is a procedure generally followed by side effects such as postoperative pain. The aim of this study was to evaluate the efficacy of socket irrigation with an anesthetic solution in relieving pain following impacted third molar surgery. Materials and methods. Thirty-four patients (17 males and 17 females, aged 18-24 years, with bilateral impacted lower third molars were selected. Both third molars were extracted in one surgical session. Tooth sockets in each patient were rinsed randomly either with 4 mL of 0.5% bupivacaine hydrochloride plain (without vasoconstrictor anesthetic solution or 4 mL of normal saline, used as control. The patients were instructed not to use analgesics as long as possible, and if not, they were instructed to use an analgesic, and record the time. Pain severity was assessed using a visual analogue pain scale (VAPS at 1-, 6-, 12-, and 24-hour intervals post-operatively. Data were analyzed using Pearson’s chi-square test and P <0.05 was considered statistically significant. Results. Post-operative pain difference between the two groups was statistically significant at 1-, 6-, 12- and 24-hour postoperative intervals (P <0.05. Post-operative pain increased in both groups to a maximum 12 hours after surgery with significant improvements after that. Conclusion. Based on the results, the irrigation of surgery site with bupivacaine after third molar surgery significantly reduces post-operative pain.

Incidence of cystic changes in impacted lower third molar

Directory of Open Access Journals (Sweden)

Shridevi R Adaki

2013-01-01

Full Text Available Objective: To assess the incidence of cystic changes in the impacted lower third molar (ILTM in which the pericoronal (follicular space is less than 2.5 mm as measured from the radiograph. The relationship between the cystic changes and patient′s age, sex, and angular position and contact of ILTM with adjacent tooth was also evaluated. Materials and Methods: Follicular space less than 2.5 mm as measured from the panoramic radiograph was included in the study. A total of 73 tissue samples collected during the extraction ILTM were examined histopathologically. Then the data were analyzed for associations with age, sex, angular position, and contact of the ILTM with an adjacent tooth. Results: There were 37 male and 36 female patients, age ranging from 17 to 35 years (mean 23.95 years. Out of 73 specimens, 17 (23.3% showed cystic changes; among them 16 (22.1% showed dentigerous cysts and 1 (1.2% showed odontogenic keratocysts. Most of the cystic changes occurred in the 26-30 year age range. The cystic changes showed male predominance but could not gain statistical significance. The relationship between cystic changes and angular position was statistically significant (P < 0.05. Higher probability was found in distoangular positioned ILTM. The relationship between cystic changes and communication of ILTM with the second molar was not statistically significant. Conclusion: Incidence of cystic changes in ILTM justifies extraction of the impacted tooth associated with symptoms. The decision to extract or not to extract impacted third molar should be individualized, rather than generalized.

Is Overweight a Risk Factor for Adverse Events during Removal of Impacted Lower Third Molars?

Directory of Open Access Journals (Sweden)

Ricardo Wathson Feitosa de Carvalho

2014-01-01

Full Text Available Being overweight is recognised as a significant risk factor for several morbidities; however, the experience of the dentistry faculties focusing on this population is still low. The aim of the present study was to determine the occurrence of adverse events during removal of impacted lower third molars in overweight patients. A prospective cohort study was carried out involving overweight patients subjected to surgical removal of impacted lower third molar as part of a line of research on third molar surgery. Predictor variables indicative of the occurrence of adverse events during surgery were classified by their demographic, clinical, radiographic, and surgical aspects. Descriptive and bivariate statistics were computed. In total, 140 patients fulfilled the eligibility criteria, and 280 surgeries were performed. Patients’ mean age was 25.1 ± 2.2  years, and the proportion of women to men was 3 : 1. Eight different adverse events during surgery were recorded. These events occurred in approximately 29.3% of cases and were significantly associated with predictor variables (P < 0.05. Excess weight is recognised as a risk factor for the high rate of adverse events in impacted third molar surgery. The study suggests that overweight patients are highly likely to experience morbidities.

Case Report. Practical Advantages of CBCT in the Surgical Treatment of Impacted Lower Third Molar

Directory of Open Access Journals (Sweden)

Ormenișan Alina

2017-03-01

Full Text Available Introduction: The imaging method of cone beam is an improved, extremely accurate computed tomography applicable in the whole field of dentistry. Due to its ability to locate the exact position of the impacted teeth, CBCT software has an important role in the management of difficult cases of impacted third molar. In some situations, the lower third molar is quite near to the inferior alveolar nerve that the surgical extraction can present a high risk of post-operative sensitive impairs of the skin and mucosa of the lower lip and chin on the same side. Presentation of case series: Our study tried to assess the contribution of CBCT in the pre-operative evaluation and further treatment of patients with impacted third molars in mandibular bone with high risk of inferior alveolar nerve injury. The paper presents three clinical cases showing positive signs on standard OPG, which exhibit indicators of a potential contact between the inferior alveolar nerve and the impacted lower third molars. For an improved exploration Dental CT Scan, DICOM image acquisition program, and 3D reconstruction with a special software were used. Conclusions: The study showed that compared with panoramic radiography, CBCT improve the evaluation of the surgical risk and allow a more accurate planning of surgery.

Effect of low-level laser therapy after extraction of impacted lower third molars.

Science.gov (United States)

Ferrante, Maurizio; Petrini, Morena; Trentini, Paolo; Perfetti, Giorgio; Spoto, Giuseppe

2013-05-01

The aim of this study is to evaluate the effectiveness of the low-level laser therapy (LLLT) in the control of pain, swelling, and trismus associated with surgical removal of impacted lower third molars. Thirty patients were randomized into two treatment groups, each with 15 patients-group test (LLLT) and a group control (no-LLLT)-and were told to avoid any analgesics 12 h before the procedure. In group test, the 980-nm diode-laser (G-Laser 25 Galbiati, Italy) was applied, using a 600-μm handpiece, intraorally (lingual and vestibular) at 1 cm from the involved area and extraoral at the insertion point of the masseter muscle immediately after surgery and at 24 h. The group control received only routine management. Parameters used for LLLT were: continuous mode, at 300 mW (0.3 W) for a total of 180 s (60 s × 3) (0.3 W × 180 s=54 J). Group test showed improvement in the interincisal opening and remarkable reduction of trismus, swelling and intensity of pain on the first and the seventh postoperative days. Although LLLT has been reported to prevent swelling and trismus following the removal of impacted third molars, some of these studies reported a positive laser effect while others did not. All references to the use of laser therapy in the postoperative management of third molar surgery employ different methodologies and, in some, explanations as to selection of their respective radiation parameters are not given. This study has demonstrated that LLLT, with these parameters, is useful for the reduction of postoperative discomfort after third-molar surgery.

Strategies used to inhibit postoperative swelling following removal of impacted lower third molar

Directory of Open Access Journals (Sweden)

Francesco Sortino

2011-01-01

Full Text Available Postoperative swelling following different surgical strategies is an area of great interest. The main part of literature on the topic deals with swelling after extraction of low impacted third molar. In this review, we have analyzed publications of the last 20 years with a pubmed search using the following key words: impacted third molar, swelling third molar, wisdom tooth, edema jaw, corticosteroids and extraction third molar, antibiotic prophylaxis and tooth extraction. Attention has often been focused on corticosteroid therapy administered by diverse routes (orally, IV, IM, topically and at different time schedules (before or after surgery or both. This investigation revealed how the use of different molecules and dosages makes the obtained results hardly comparable. Similar conclusions can be drawn from studies aimed at evaluating the efficacy of antibiotic therapy administered either before or after surgery. A complete review has also to take into account different surgical strategies used including various flaps, no traumatic osteothomy, and primary or secondary closure. The use of pharmacological therapy and application of an ice pack is critical in the postoperative period and has always provided positive results. However, even if it is difficult to come to definite conclusions, due to the variability of the design of studies analyzed, the postoperative discomfort identified with edema, pain and trismus following wisdom tooth removal is influenced by various factors such as the difficulty of the surgical procedure involved, age and gender of the patient, and experience of the surgeon. The pharmacological therapy when performed with corticosteroids seems to improve control of the postoperative swelling related with this kind of surgeries.

Correlation between chronological age and third molar developmental stages in an Iranian population (Demirjian method).

Science.gov (United States)

Khosronejad, Aria; Navabi, Manijeh; Sakhdari, Shirin; Rakhshan, Vahid

2017-01-01

Third molar development is the only available tool for estimating the age of individuals after puberty. Since this tooth has very high interethnic variability, formulas calculated to estimate the age from its development stages cannot be generalized to other populations and should be adjusted for each region. Therefore, this study was conducted to evaluate this method in a sample of Tehran individuals for the first time, and also to compare the development of third molars across sexes and arches, and to estimate cutoff developmental stages for legal minor/major identification. A total of 150 dental patients aged between 15 and 25 years old were prospectively enrolled, and their Demirjian stages were recorded. The associations between chronological age and Demirjian stages were evaluated. Dental formation was compared between sexes and jaws. Cutoff stages were determined to identify legal minor/major cases (above or below 18 years old). Age estimation formula was found for this population. Of the 150 included patients, 56 were males. The difference between the ages of males and females at each given developmental stage was nonsignificant ( P > 0.05), except for the H stage. Age difference between same stage teeth of the maxilla and mandible was nonsignificant. Each of the G and H stages was significantly above 18 years old ( P age were above 90% (all P Third molar development was positively affected by the chronological age ( P = 0.000) and being maxillary ( P = 0.000) but not sex ( P = 0.113). Regression formula for age estimation was: age = 6.52+ (0.64 × sex) + (0.32 × arch) + (1.86 × Demirjian stage). Development of third molar might complete after the age 22. Iranian individuals with third molars at the G and H stages are likely above 18 while those at E and F are likely below 18. Pace of molar development differs for jaws, but intergender differences are open to further investigations.

Extensive Subcutaneous Emphysema After Extraction of a Mandibular Third Molar: A Case Report

Directory of Open Access Journals (Sweden)

Jung-Chang Kung

2009-10-01

Full Text Available Surgical emphysema is an uncommon but potentially serious complication of third molar removal and other oral procedures. The purpose of this case report is to remind dentists of the risk of surgical emphysema. Surgical emphysema developed in a 32-year-old female after removal of a mandibular third molar using a high-speed dental hand-piece. Because of the extent of the swelling, the patient was admitted for observation. Because of progressive swelling, a submandibular surgical incision and drainage was performed, which led to rapid resolution. The diagnosis and differential diagnosis of surgical emphysema are discussed to draw dentists' attention to the management and prevention of this complication.

Consent for third molar tooth extractions in Australia and New Zealand: a review of current practice.

Science.gov (United States)

Badenoch-Jones, E K; Lynham, A J; Loessner, D

2016-06-01

Informed consent is the legal requirement to educate a patient about a proposed medical treatment or procedure so that he or she can make informed decisions. The purpose of the study was to examine the current practice for obtaining informed consent for third molar tooth extractions (wisdom teeth) by oral and maxillofacial surgeons in Australia and New Zealand. An online survey was sent to 180 consultant oral and maxillofacial surgeons in Australia and New Zealand. Surgeons were asked to answer (yes/no) whether they routinely warned of a specific risk of third molar tooth extraction in their written consent. Seventy-one replies were received (39%). The only risks that surgeons agreed should be routinely included in written consent were a general warning of infection (not alveolar osteitis), inferior alveolar nerve damage (temporary and permanent) and lingual nerve damage (temporary and permanent). There is significant variability among Australian and New Zealand oral and maxillofacial surgeons regarding risk disclosure for third molar tooth extractions. We aim to improve consistency in consent for third molar extractions by developing an evidence-based consent form. © 2016 Australian Dental Association.

Third molar mineralization in relation to chronologic age estimation of the Han in central southern China.

Science.gov (United States)

Liu, Ying; Geng, Kun; Chu, Yanhao; Xu, Mindi; Zha, Lagabaiyila

2018-03-03

The purpose of this study is to provide a forensic reference data about estimating chronologic age by evaluating the third molar mineralization of Han in central southern China. The mineralization degree of third molars was assessed by Demirjian's classification with modification for 2519 digital orthopantomograms (1190 males, 1329 females; age 8-23 years). The mean ages of the initial mineralization and the crown completion of third molars were around 9.66 and 13.88 years old in males and 9.52 and 14.09 years old in females. The minimum ages of apical closure were around 16 years in both sexes. Twenty-eight at stage C and stage G and 38 and 48 at stage F occurred earlier in males than in females. There was no significant difference between maxillary and mandibular teeth in males and females except that stage C in males. Two formulas were devised to estimate age based on mineralization stages and sexes. In Hunan Province, the person will probably be over age 14, when a third molar reaches the stage G. The results of the study could provide reference for age estimation in forensic cases and clinical dentistry.

Comparison of clinical parameters and environmental noise levels between regular surgery and piezosurgery for extraction of impacted third molars.

Science.gov (United States)

Chang, Hao-Hueng; Lee, Ming-Shu; Hsu, You-Chyun; Tsai, Shang-Jye; Lin, Chun-Pin

2015-10-01

Impacted third molars can be extracted by regular surgery or piezosurgery. The aim of this study was to compare clinical parameters and device-produced noise levels between regular surgery and piezosurgery for the extraction of impacted third molars. Twenty patients (18 women and 2 men, 17-29 years of age) with bilateral symmetrical impacted mandibular or maxillary third molars of the same level were included in this randomized crossover clinical trial. The 40 impacted third molars were divided into a control group (n = 20), in which the third molar was extracted by regular surgery using a high-speed handpiece and an elevator, and an experimental group (n = 20), in which the third molar was extracted by piezosurgery using a high-speed handpiece and a piezotome. The clinical parameters were evaluated by a self-reported questionnaire. The noise levels produced by the high-speed handpiece and piezotome were measured and compared between the experimental and control groups. Patients in the experimental group had a better feeling about tooth extraction and force delivery during extraction and less facial swelling than patients in the control group. However, there were no significant differences in noise-related disturbance, extraction period, degree of facial swelling, pain score, pain duration, any noise levels produced by the devices under different circumstances during tooth extraction between the control and experimental groups. The piezosurgery device produced noise levels similar to or lower than those of the high-speed drilling device. However, piezosurgery provides advantages of increased patient comfort during extraction of impacted third molars. Copyright © 2014. Published by Elsevier B.V.

Inferior Alveolar Nerve Injury after Mandibular Third Molar Extraction: a Literature Review

Directory of Open Access Journals (Sweden)

Rafael Sarikov

2014-12-01

Full Text Available Objectives: The purpose of this study was to systematically review the comprehensive overview of literature data about injury to the inferior alveolar nerve after lower third molar extraction to discover the prevalence of injury, the risk factors, recovery rates, and alternative methods of treatment. Material and Methods: Literature was selected through a search of PubMed electronic databases. Articles from January 2009 to June 2014 were searched. English language articles with a minimum of 6 months patient follow-up and injury analysis by patient’s reporting, radiographic, and neurosensory testing were selected. Results: In total, 84 literature sources were reviewed, and 14 of the most relevant articles that are suitable to the criteria were selected. Articles were analyzed on men and women. The influence of lower third molar extraction (especially impacted on the inferior alveolar nerve was clearly seen. Conclusions: The incidence of injury to the inferior alveolar nerve after lower third molar extraction was about 0.35 - 8.4%. The injury of the inferior alveolar nerve can be predicted by various radiological signs. There are few risk factors that may increase the risk of injury to the nerve such as patients over the age of 24 years old, with horizontal impactions, and extraction by trainee surgeons. Recovery is preferable and permanent injury is very rare.

Neurovascular plexus theory for "escape pain phenomenon" in lower third molar surgery

Directory of Open Access Journals (Sweden)

Gururaj Arakeri

2015-06-01

Full Text Available Pain during extraction of impacted mandibular third molars which can occur despite adequate local anesthesia is termed as "escape pain phenomenon". Recently, it was described during elevation of a mesioangular impacted mandibular third molar and also while curetting an extracted third molar socket. This phenomenon has been overlooked, as it was previously considered secondary to pressure effect on the inferior alveolar neurovascular bundle (IANB. However, it is unlikely that the pain impulses originate from direct pressure on the IANB, as the nerve is blocked more proximally at its entry into the mandible. The authors speculated that the occasional presence of a neurovascular plexus (NVP independent of the IANB causes the escape of a pain impulse upon stimulation by root pressure or instrumentation. To validate the presence of such a plexus, a meticulous literature search and review were performed. The search revealed evidence of the occasional presence of a NVP consisting of auriculotemporal and/or retromolar neural filaments. The plexus may be present around the inferior alveolar artery or embedded within the IANB, and does not innervate the tooth. This plexus likely propagates pain impulses only upon stimulation by compression or instrumentation in the apical area of the tooth socket. This theory explains the absence of pain during tooth sectioning and bone guttering in the presence of a complete inferior alveolar nerve block.

Management of third molar teeth from an endodontic perspective

OpenAIRE

Hany Mohamed Aly Ahmed

2012-01-01

Third molar teeth are subject to many dental complications because of their most posterior location, aberrant occlusal anatomy and abnormal eruption patterns. Owing to these anatomical limitations, their extraction remains the treatment of choice for many dental practitioners. Despite being a common dental procedure, minimum intervention and retaining every functional component of the dental arch are of prime importance in contemporary dental practice. As such, this review aims to discuss the...

Darkening of third molar roots on panoramic radiographs: is it really predominantly thinning of the lingual cortex?

Science.gov (United States)

Szalma, J; Vajta, L; Lempel, E; Jeges, S; Olasz, L

2013-04-01

This study investigated the exact intra-alveolar aetiology of a panoramic high-risk sign, darkening of the third molar roots. 83 mandibular third molar surgical removals demonstrating dark bands on the third molar roots in preoperative radiographs were included in this prospective study. Exposure of the inferior alveolar nerve (IAN), the root morphology of the third molar (e.g. groove or hook) and the integrity of the mandibular canal or lingual cortical wall were observed. Differences between single (increased radiolucency alone) and multiple darkening cases (increased radiolucency with accompanying 'high risk' signs) and between IAN exposure and groove formation were analysed. In 38 cases (45.8%), the IAN was visible during the operation. Groove was present in 37.4% of cases. 26.5% of the cases showed lingual cortical thinning, while specious root conformation explained the formation of darkening on the radiographic images of an additional 9.6% of the cases. IAN exposure (Pformation (Pformation of the root than lingual cortical thinning. Copyright © 2012 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Fusion of mandibular third molar with supernumerary fourth molar

OpenAIRE

López Carriches, C.; Leco Berrocal, I.; Baca Pérez-Bryan, R.

2008-01-01

La fusión dental es la unión de dos gérmenes dentales normalmente separados, mientras que la geminación se define como el intento de división de un único germen dental. La fusión y geminación de molares es poco frecuente en la dentición permanente. Describimos un caso clínico de un tercer molar inferior derecho fusionado a un cuarto molar supernumerario en un paciente varón de 36 años que ha presentado repetidos episodios de pericoronaritis. Tras el estudio radiológico se realiza la exodoncia...

A mandibular third molar with three mesial roots: a case report.

Science.gov (United States)

Plotino, Gianluca

2008-02-01

Although its most common configuration is 2 roots and 3 root canals, mandibular molars might have many different combinations. A case of unusual root canal morphology is presented to demonstrate anatomic variations in mandibular molars. Endodontic therapy was performed in a mandibular third molar with 3 separate mesial roots. The appearance of the pulp chamber floor revealed 4 separate canal orifices. Radiographically the 4 root canals ended in their own distinct foramen. Many reports deal with 3 orifices or 3 independent canals in the mesial root, but none described 3 mesial canals in 3 separate mesial roots, indicating a rare anatomic configuration. This report points out the importance of looking for additional canals and unusual canal morphology, because knowledge of their existence might occasionally enable clinicians to treat a case successfully that otherwise might have ended in failure.

Piezosurgery for the lingual split technique in mandibular third molar removal: a suggestion.

Science.gov (United States)

Pippi, Roberto; Alvaro, Roberto

2013-03-01

The lingual split technique is a surgical procedure for extraction of impacted mandibular third molar throughout a lingual approach. The main disadvantage of this technique is the high rate of temporary lingual nerve injury mainly because of the trauma induced by the lingual flap retraction. The purpose of this paper is to suggest the use of piezosurgery in performing the lingual cortical plate osteotomy of the third molar alveolar process. Surgical procedure was performed under general anesthesia, and it lasted approximately 60 minutes. After the buccal and lingual full-thickness flaps were incised and elevated, a piezosurgical device was used for osteotomy. A well-defined bony window was then removed, and it allowed the entire tooth was extracted in a lingual direction. The patient did not show any neurological postoperative complication. Lingual and inferior alveolar nerve functionality was normal before as well as after surgery. The use of piezoelectric surgery seems to be a good option in removing lower third molars when a lingual access is clearly indicated. The only disadvantage of this technique can be represented by an operating time lengthening possibly because of a lower power cut of the piezoelectric device, to the high mineralization of the mandibular cortical bone and to the use of inserts with a low degree of sharpening.

A Systematic Review on Effect of Single-Dose Preoperative Antibiotics at Surgical Osteotomy Extraction of Lower Third Molars

DEFF Research Database (Denmark)

Marcussen, Karoline Brørup; Laulund, Anne Sofie; Jørgensen, Henrik L

2016-01-01

PURPOSE: We conducted a systematic review of randomized controlled trials (RCTs) to evaluate the effectiveness of a single dose of preoperative antibiotic administered perorally, intravenously, intramuscularly, or topically for preventing infection and alveolar osteitis in lower third molar...... that penicillin V was effective in reducing the incidence of alveolar osteitis (OR = 0.1; 95% CI, 0.03 to 0.30; P ≤ .0001). CONCLUSIONS: A single oral dose of 2 g of amoxicillin before lower third molar osteotomy surgical extraction significantly decreased the incidence of SSI. A single dose of 0.8 g...... of penicillin V before lower third molar osteotomy surgical extraction significantly decreased the incidence of alveolar osteitis....

Comparison of the Influence of Two Flap Designs on Periodontal Healing after Surgical Extraction of Impacted Third Molars

Directory of Open Access Journals (Sweden)

Seyed Ahmad Arta

2011-03-01

Full Text Available Background and aims. Impacted lower third molar is found in 90% of the general population. Impacted lower third molar surgery may result in periodontal complications on the distal surface of the adjacent second molar. The aim of this study was to evaluate the effect of flap design on the periodontal status of the second molar after lower third molar surgery. Materials and methods. Twenty patients, with an age range of 18-26 years, participated in the present study. The inclusion criteria consisted of the presence of bilateral symmetrical impacted third molars on panoramic radiographs. The subjects were randomly divided into two groups. The impactions on the left and right sides were operated by Szmyd and triangular flaps, respectively. Postoperative management and medications were similar for both groups. The subjects were evaluated at two-week, one-month, and six-month postoperative intervals by a surgeon who was blind to the results. Data was analyzed by t-test using SPSS 11 software. Results. There were no significant differences in clinical attachment loss, pocket depth, bone level, plaque index, and free gingival margin between the two flaps (p>0.05. Conclusion. The results of the present study did not show any differences in pocket depth, clinical attachment level, bone level and FGM (free gingival margin between the two flap designs under study.

Dispositivo de seguridad para controlar mejor el tercer molar impactado durante exodoncia: Una nueva técnica Security device for a better control of impacted third molars during exodontia: A new technique

Directory of Open Access Journals (Sweden)

F. Hernández Altemir

2005-04-01

Full Text Available El desplazamiento accidental del tercer molar impactado es una complicación que ocurre de vez en cuando durante la exodoncia. La recuperación de estos dientes accidentalmente desplazados puede ser compleja debido a la mala visibilidad y el espacio limitado. Describimos una técnica fácil basada en un sistema de anclaje para controlar mejor los terceros molares impactados durante la exodoncia.Accidental displacement of impacted third molars is a complication that occasionally occurs during exodontia. The retrieval of these accidentally displaced third molars may be complex due to poor visibility and limited space. We describe an easy technique for a better control of impacted third molars during exodontia based on an anchoring system.

Double versus single cartridge of 4% articaine infiltration into the retro-molar area for lower third molar surgery.

Science.gov (United States)

Sawang, Kamonpun; Chaiyasamut, Teeranut; Kiattavornchareon, Sirichai; Pairuchvej, Verasak; Bhattarai, Bishwa Prakash; Wongsirichat, Natthamet

2017-06-01

There are no studies regarding 4% articaine infiltration injection into the retro-molar area for an impacted lower third molar (LITM) surgery. This study aimed to evaluate the efficacy of infiltration using 1.7 ml (single cartridge: SC) of 4% articaine versus 3.4 ml (double cartridges: DC) of 4% articaine with 1:100,000 epinephrine in LITM surgery. This study involved 30 healthy patients with symmetrical LITM. The patients were assigned to receive either a DC or SC of 4% articaine with 1:100,000 epinephrine as a local anesthetic for each operation. Onset, duration, profoundness, need for additional anesthetic administration, total volume of anesthetic used, vitality of the tooth, and pain score during operation were recorded. The DC of 4 % articaine had a significantly higher success rate (83.3%) than did the SC (53.3%; P molar region can be an alternative anesthetic for LITM surgery.

New models for age estimation and assessment of their accuracy using developing mandibular third molar teeth in a Thai population.

Science.gov (United States)

Duangto, P; Iamaroon, A; Prasitwattanaseree, S; Mahakkanukrauh, P; Janhom, A

2017-03-01

Age estimation using developing third molar teeth is considered an important and accurate technique for both clinical and forensic practices. The aims of this study were to establish population-specific reference data, to develop age prediction models using mandibular third molar development, to test the accuracy of the resulting models, and to find the probability of persons being at the age thresholds of legal relevance in a Thai population. A total of 1867 digital panoramic radiographs of Thai individuals aged between 8 and 23 years was selected to assess dental age. The mandibular third molar development was divided into nine stages. The stages were evaluated and each stage was transformed into a development score. Quadratic regression was employed to develop age prediction models. Our results show that males reached mandibular third molar root formation stages earlier than females. The models revealed a high correlation coefficient for both left and right mandibular third molar teeth in both sexes (R = 0.945 and 0.944 in males, R = 0.922 and 0.923 in females, respectively). Furthermore, the accuracy of the resulting models was tested in randomly selected 374 cases and showed low error values between the predicted dental age and the chronological age for both left and right mandibular third molar teeth in both sexes (-0.13 and -0.17 years in males, 0.01 and 0.03 years in females, respectively). In Thai samples, when the mandibular third molar teeth reached stage H, the probability of the person being over 18 years was 100 % in both sexes.

What Constitutes a Clinically Important Pain Reduction in Patients after Third Molar Surgery?

Directory of Open Access Journals (Sweden)

Wilhelmus JJM Martin

2013-01-01

Full Text Available BACKGROUND: For patients with surgical third molar removal, it is unknown what constitutes a clinically important change in patients’ visual analogue scale (VAS reports of pain intensity.

Dentigerous Cystic Changes in the Follicles Associated with Radiographically Normal Impacted Mandibular Third Molars

Directory of Open Access Journals (Sweden)

Ashok Dongol

2018-01-01

Full Text Available Objective. To assess the incidence of dentigerous cystic changes in the follicles of radiographically normal impacted mandibular third molars. Methods. One hundred and thirteen follicles obtained after surgical removal of impacted mandibular third molars with radiolucency of less than 2.5 mm in the radiograph were sent for histopathologic evaluation to evaluate pathologic changes. Results. The incidence of dentigerous cystic changes observed was 15.9%, that is, 18 out of 113 patients (51 males and 62 females, with the maximum incidence of cystic changes seen in the follicular space size of 0.5 mm. The mean age of the patients included was 27.8 ± 8.1. The most common indication for extraction among the patients in this study was recurrent pericoronitis (95%. There were no statistically significant differences in occurrence of cystic changes based on age, gender, angulation, relation to ramus, depth, side of impaction, and follicle size (P>0.05. Conclusion. Dental follicles obtained from surgically removed impacted mandibular third molars should be submitted for histopathologic examination irrespective of the radiographic size of the follicle.

Effectiveness of preemptive analgesia on postoperative pain following third molar surgery: Review of literatures

Directory of Open Access Journals (Sweden)

Akira Yamaguchi

2013-11-01

Full Text Available We investigated the efficacy of preemptive analgesia for mandibular third molar surgery by, reviewing of randomized controlled trials. In many of the studies, the preemptive use of NSAIDs before, tooth extraction demonstrated that the postoperative pain was better controlled beyond the expected, effect time, compared without such preemptive use. On the other hand, some studies reported that, compared to the administration before removal of the tooth, postoperative administration was, associated with better suppression of postoperative pain. This suggests that in postoperative pain after, removal of mandibular third molars, peripheral sensitization caused by reactive inflammation, following the tooth extraction and secondary central sensitization are more important factors than, direct central sensitization caused by surgical tissue damage. Accordingly, when a mandibular third, molar is removed, central sensitization due to tissue damage should be suppressed by, preadministration of analgesics. In order then to suppress postoperative peripheral sensitization, the, readministration of analgesics is considered more effective. Furthermore, although acid NSAIDs are, effective analgesics, the associated adverse events are of concern. Accordingly, acetaminophen (1000 mg, which, is devoid of anti-inflammatory effects but is a weak cyclooxygenase inhibitor, can be used for, preemptive analgesia administration.

Prospective study establishing a management plan for impacted third molar in patients undergoing hematopoietic stem cell transplantation.

Science.gov (United States)

Yamagata, Kenji; Onizawa, Kojiro; Yanagawa, Toru; Takeuchi, Yasutoshi; Hasegawa, Yuichi; Chiba, Shigeru; Bukawa, Hiroki

2011-02-01

Although dental treatment before hematopoietic stem cell transplantation (HSCT) is essential to prevent serious infections from oral sources, the best management plan for impacted third molar (ITM) is unclear. This study was planned to establish a management plan for ITM. Eighty-four candidates for HSCT therapy were consecutively enrolled in the prospective trial. The management plan, which was evidence based and prospectively decided, was to extract the symptomatic ITMs and to leave the asymptomatic ones untreated, regardless of their impacted position. Eighty-seven ITMs were observed in 35 patients. The ITMs were in the maxilla of 25 patients and the mandible of 28 patients. Dental extraction of 7 teeth was performed in 6 patients without complications. All of the patients received the scheduled HSCT therapy and none experienced odontogenic infection while myelosuppressed. This management plan for ITM appears to be appropriate for pre-HSCT patients. Moreover, the experienced dental provider is suggested as a necessary and valuable part of the HSCT team. Crown Copyright © 2011. Published by Mosby, Inc. All rights reserved.

Evaluation of skeletal and dental age using third molar calcification, condylar height and length of the mandibular body.

Science.gov (United States)

Kedarisetty, Sunil Gupta; Rao, Guttikonda Venkateswara; Rayapudi, Naveen; Korlepara, Rajani

2015-01-01

To identify the most reliable method for age estimation among three variables, that is, condylar height, length of mandibular body and third molar calcification by Demirjian's method. Orthopantomograms and lateral cephalograms of 60 patients with equal gender ratio were included in the study, among each gender 15 subjects were below 18 years and 15 subjects were above 18 years. Lateral cephalograms were traced, height of condyle and mandibular body are measured manually on the tracing paper, OPG's were observed on radiographic illuminator and maturity score of third molar calcification was noted according to Demirjian's method. All the measurements were subjected to statistical analysis. The results obtained are of no significant difference between estimated age and actual age with all three parameters (P > 0.9780 condylar height, P > 0.9515 length of mandibular body, P > 0.8611 third molar calcification). Among these three, length of mandibular body shows least standard error test (i.e. 0.188). Although all three parameters can be used for age estimation, length of mandibular body is more reliable followed by height of condyle and third molar calcification.

Interdisciplinary management of an adult patient with class II div 1 Malocclusion, Anterior Open Bite and multiple missing molars

Directory of Open Access Journals (Sweden)

Rohit Mehrotra

2014-01-01

Full Text Available This case report describes the esthetic and functional rehabilitation of a female patient in her mid forties having Class II Div 1 malocclusion, anterior open bite and multiple missing molars, with orthodontics and implant prosthodontics. The patient had bilaterally missing upper first and third molars and lower first and second molars. Orthodontic treatment using skeletal anchorage was performed to retract and align the upper anteriors and correct the open bite. In the upper arch, first molar spaces were closed and no prosthesis was needed. In the lower arch, the anteriors and premolars were aligned and implants were placed bilaterally to replace the missing molars and provide proper occlusion with the upper posteriors. Significant improvement in the occlusion, smile and facial esthetics was achieved. This article highlights the importance of an interdisciplinary team approach for providing optimum treatment to many adult patients.

Cervical and mediastinal emphysema secondary to third molar extraction.

Science.gov (United States)

Goodnight, J W; Sercarz, J A; Wang, M B

1994-01-01

A dramatic case of infected emphysema involving multiple deep cervical and mediastinal fascial planes following surgical extraction of a lower third molar in an otherwise healthy man is presented. The differential diagnosis and management of this condition are discussed, specifically contrasting it to necrotizing fasciitis. The direct cause of this complication was the use of an air turbine handpiece and air syringe for the tooth extraction. It is advised that air turbine handpieces and air syringes not be used during minor oral surgical procedures.

Radiologic assessment of third molar tooth and spheno-occipital synchondrosis for age estimation: a multiple regression analysis study.

Science.gov (United States)

Demirturk Kocasarac, Husniye; Sinanoglu, Alper; Noujeim, Marcel; Helvacioglu Yigit, Dilek; Baydemir, Canan

2016-05-01

For forensic age estimation, radiographic assessment of third molar mineralization is important between 14 and 21 years which coincides with the legal age in most countries. The spheno-occipital synchondrosis (SOS) is an important growth site during development, and its use for age estimation is beneficial when combined with other markers. In this study, we aimed to develop a regression model to estimate and narrow the age range based on the radiologic assessment of third molar and SOS in a Turkish subpopulation. Panoramic radiographs and cone beam CT scans of 349 subjects (182 males, 167 females) with age between 8 and 25 were evaluated. Four-stage system was used to evaluate the fusion degree of SOS, and Demirjian's eight stages of development for calcification for third molars. The Pearson correlation indicated a strong positive relationship between age and third molar calcification for both sexes (r = 0.850 for females, r = 0.839 for males, P < 0.001) and also between age and SOS fusion for females (r = 0.814), but a moderate relationship was found for males (r = 0.599), P < 0.001). Based on the results obtained, an age determination formula using these scores was established.

[The anesthetic effects of Gow-Gates technique of inferior alveolar nerve block in impacted mandibular third molar extraction].

Science.gov (United States)

Yang, Jieping; Liu, Wei; Gao, Qinghong

2013-08-01

To evaluate the anesthetic effects and safety of Gow-Gates technique of inferior alveolar nerve block in impacted mandibular third molar extraction. A split-mouth study was designed. The bilateral impacted mandibular third molar of 32 participants were divided into Gow-Gates technique of inferior alveolar nerve block (Gow-Gates group) and conventional technique of inferior alveolar nerve block (conventional group) randomly with third molar extracted. The anesthetic effects and adverse events were recorded. All the participants completed the research. The anesthetic success rate was 96.9% in Gow-Gates group and 90.6% in conventional group with no statistical difference ( P= 0.317); but when comparing the anesthesia grade, Gow-Gates group had a 96.9% of grade A and B, and conventional group had a rate of 78.1% (P = 0.034). And the Gow-Gates group had a much lower withdrawn bleeding than conventional group (P = 0.025). Two groups had no hematoma. Gow-Gates technique had a reliable anesthesia effects and safety in impacted mandibular third molar extraction and could be chosen as a candidate for the conventional inferior alveolar nerve block.

Frequency of lingual nerve injury in mandibular third molar extraction: A comparison of two surgical techniques

International Nuclear Information System (INIS)

Shad, S.; Abbasi, M.M.

2015-01-01

Background: Surgical removal of impacted mandibular third molar is associated with a number of complications including postoperative bleeding, dry socket, postoperative infection, and injury to regional nerves. Lingual nerve damage is one of the main complications. To prevent this complication different techniques had been used. Lingual flap reflection is one of these procedures in which lingual soft tissue is reflected and retracted deliberately, the nerve is identified and is kept out of the surgical field. The objective of this study was to evaluate a surgical technique for third molar removal which is associated with minimum frequency of lingual nerve damage. Method: A randomized controlled trial was performed. A total of 380 patients with impacted mandibular third molars were included in this study. Each patient was allotted randomly by blocked randomization to group A where procedure was performed by reflection and retraction of lingual flap in addition to buccal flap and group B where procedure was performed by retraction of buccal flap only. Results: Lingual nerve damage occurred in 8.94 percentage in Group A in which lingual flap retraction was performed but damage was reversible. In group B, 2.63 percentage lingual nerve damage was observed and nature of damage was permanent. The difference was statistically significant (p=0.008). Conclusions: Lingual flap retraction poses 3.4 times increased risk of lingual nerve damage during extraction of mandibular third molar when lingual flap is retracted but the nature of damage is reversible. (author)

The chronology of the radiographic visibility of the periodontal ligament and the root pulp in the lower third molars.

Science.gov (United States)

Timme, M; Timme, W H; Olze, A; Ottow, C; Ribbecke, S; Pfeiffer, H; Dettmeyer, R; Schmeling, A

2017-07-01

Eruption and mineralization of third molars are the main criteria for dental age estimation in living adolescents. As the validation of completion of the 18th year of life appears not to be possible with the forensically necessary probability even if all the third molars of a person are completely mineralized, degenerative dental characteristics might be used for this purpose. In previous publications by Olze et al. (2010a,b) the radiographic visibility of the periodontal ligament and the root pulp in lower third molars were suggested as methods for this purpose. The aim of this study was to validate these characteristics in a large study population with a wide age range. In a material of 2346 orthopantomograms of 1167 female and 1179 male Germans aged from 15 to 70years the radiographic visibility of the root pulp in the lower third molars with completed mineralization were studied according to stage classifications proposed by Olze et al. (2010a,b). 1541 orthopantomograms of 705 females and 836 males with a sufficient quality of the radiograph showed at least one third molar. The suitability of the studied characteristics for age estimation in living individuals could be confirmed. Males and females presenting stage 1 of both characteristics were older than 18years of life. Males and females presenting stage 2 of both characteristics were older than 21years of life. The high number of missing third molars in the studied age group (46-60%) must be considered as a limitation of the methods. In further studies the influence of ethnicity, dietary habits and modern dental health care on the characteristics in question should be investigated. Copyright © 2017 The Chartered Society of Forensic Sciences. Published by Elsevier B.V. All rights reserved.

Mandibular canal branches supplying the mandibular third molar observed on cone beam computed tomographic images: Reports of four cases

Energy Technology Data Exchange (ETDEWEB)

Lee, Jae Seo; Yoon, Suk Ja; Kang, Byung Cheol [Department of Oral and Maxillofacial Radiology, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju (Korea, Republic of)

2009-12-15

Bifid mandibular canal can be an anatomic variation. This condition can lead to complication when performing mandibular anesthesia or during extraction of lower third molar, placement of implants and surgery in the mandible. Four patients underwent preoperative imaging for extraction of third molars using CBCT (CB Mercuray, Hitachi, Japan). The axial images were processed with CBworks program 2.1 (CyberMed Inc., Seoul, Korea). The branches for supplying the lower third molar were identified mainly on cross-sectional and panoramic images of CBCT. Since the location and configuration of mandibular canal variations are important in any mandibular surgical procedures, we report 4 cases of bifid mandibular canal with panoramic and the CBCT images.

Coronectomy of the mandibular third molar: Respect for the inferior alveolar nerve

NARCIS (Netherlands)

Kouwenberg, A. J.; Stroy, L. P. P.; Rijt, E. D. Vree-V. D.; Mensink, G.; Gooris, P. J. J.

2016-01-01

The aim of this study was to evaluate the outcomes of coronectomy as an alternative surgical procedure to complete removal of the impacted mandibular third molar in patients with a suspected close relationship between the tooth root(s) and the mandibular canal. A total of 151 patients underwent

Efficacy of Codeine When Added to Paracetamol (Acetaminophen) and Ibuprofen for Relief of Postoperative Pain After Surgical Removal of Impacted Third Molars: A Double-Blinded Randomized Control Trial.

Science.gov (United States)

Best, Adrian D; De Silva, R K; Thomson, W M; Tong, Darryl C; Cameron, Claire M; De Silva, Harsha L

2017-10-01

The use of opioids in combination with nonopioids is common practice for acute pain management after third molar surgery. One such combination is paracetamol, ibuprofen, and codeine. The authors assessed the efficacy of codeine when added to a regimen of paracetamol and ibuprofen for pain relief after third molar surgery. This study was a randomized, double-blinded, placebo-controlled trial conducted in patients undergoing the surgical removal of at least 1 impacted mandibular third molar requiring bone removal. Participants were randomly allocated to a control group (paracetamol 1,000 mg and ibuprofen 400 mg) or an intervention group (paracetamol 1,000 mg, ibuprofen 400 mg, and codeine 60 mg). All participants were treated under intravenous sedation and using identical surgical conditions and technique. Postoperative pain was assessed using the visual analog scale (VAS) every 3 hours (while awake) for the first 48 hours after surgery. Pain was globally assessed using a questionnaire on day 3 after surgery. There were 131 participants (36% men; control group, n = 67; intervention group, n = 64). Baseline characteristics were similar for the 2 groups. Data were analyzed using a modified intention-to-treat analysis and, for this, a linear mixed model was used. The model showed that the baseline VAS score was associated with subsequent VAS scores and that, with each 3-hour period, the VAS score increased by an average of 0.08. The treatment effect was not statistically meaningful, indicating there was no difference in recorded pain levels between the 2 groups during the first 48 hours after mandibular third molar surgery. Similarly, the 2 groups did not differ in their global ratings of postoperative pain. Codeine 60 mg added to a regimen of paracetamol 1,000 mg and ibuprofen 400 mg does not improve analgesia after third molar surgery. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights

[Comparison of piezosurgery and chisel osteotomy in the extraction of mandibular impacted third molars].

Science.gov (United States)

Gao, Yongbo; Jiang, Ai; Li, Boyou; Yang, Liming

2011-08-01

To study the effect of piezosurgery in the extraction of mandibular impacted third molars. 228 mandibular impacted third molars with relative difficulty for extraction according to the scheme of degree of difficulty for extraction were included in the study, and were divided into two groups (114 teeth each group): Test group (treated by piezosurgery), control group (treated by traditional chisel osteotomy). The surgery time and pain, restriction of mouth opening and facial swelling after surgery, were evaluated in both groups. The average surgery time was (16 +/- 5.2) min in test group and (30 +/- 8.7) min in control group. The surgery time, pain, facial swelling rate, and restriction of mouth opening were lower than control group (Ppiezosurgery was significantly shorter and the complications are obviously reduced.

Efficacy of Platelet-Rich Fibrin After Mandibular Third Molar Extraction: A Systematic Review and Meta-Analysis.

Science.gov (United States)

Al-Hamed, Faez Saleh; Tawfik, Mohamed Abdel-Monem; Abdelfadil, Ehab; Al-Saleh, Mohammed A Q

2017-06-01

To assess the effect of platelet-rich fibrin (PRF) on the healing process of the alveolar socket after surgical extraction of the mandibular third molars. PubMed, the Cochrane Central Register of Controlled Trials, Scopus, and relevant journals were searched using a combination of specific keywords ("platelet-rich fibrin," "oral surgery," and "third molar"). The final search was conducted on November 2, 2015. Randomized controlled clinical trials, as well as controlled clinical trials, aimed at comparing the effect of PRF versus natural healing after extraction of mandibular third molars were included. Five randomized controlled trials and one controlled clinical trial were included. There were 335 extractions (168 with PRF and 167 controls) in 183 participants. Considerable heterogeneity in study characteristics, outcome variables, and estimated scales was observed. Positive results were generally recorded for pain, trismus, swelling, periodontal pocket depth, soft tissue healing, and incidence of localized osteitis, but not in all studies. However, no meta-analysis could be conducted for such variables because of the different measurement scales used. The qualitative and meta-analysis results showed no significant improvement in bone healing with PRF-treated sockets compared with the naturally healing sockets. Within the limitations of the available evidence, PRF seems to have no beneficial role in bone healing after extraction of the mandibular third molars. Future standardized randomized controlled clinical trials are required to estimate the effect of PRF on socket regeneration. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

What constitutes a clinically important pain reduction in patients after third molar surgery?

NARCIS (Netherlands)

Martin, W.J.J.M.; Ashton-James, C.E.; Skorpil, N.E.; Heymans, M.W.; Forouzanfar, T.

2013-01-01

BACKGROUND: For patients with surgical third molar removal, it is unknown what constitutes a clinically important change in patients’ visual analogue scale (VAS) reports of pain intensity. OBJECTIVES: To determine what constitutes a clinically important change in pain intensity on a VAS following

The effect of a separate consultation on anxiety levels before third molar surgery

NARCIS (Netherlands)

van Wijk, A.J.; Lindeboom, J.A.H.

2008-01-01

Objectives. The present study tested the effect of a separate consultation with an oral and maxillofacial surgeon on levels of anxiety before third molar extraction. Study design. Patients were randomly assigned to either the experimental or the control group. Experimental subjects received standard

Postsurgical consequences in lower third molar surgical extraction using micromotor and piezosurgery.

Science.gov (United States)

Mistry, Freddy Kersi; Hegde, Nidarsh Diwakar; Hegde, Mithra Nidarsh

2016-01-01

One of the most critical and crucial steps in surgical extraction is cutting the bone or osteotomy, for which many techniques are used, e.g., chisels and mallet, rotary instruments, and ultrasound bone-cutting instruments. If they are not used judiciously, they can be hazardous. To assess the efficiency of piezosurgery unit over micromotor while performing surgical extraction of lower third molars by assessing the time taken for the surgery and measuring postoperative parameters such as pain, trismus, and swelling. Thirty patients having bilateral impacted third molars with the same difficulty index were selected for the study. One side surgical removal was done using micromotor and other side by piezosurgery with an interval of 15 days. After each surgery, time taken to finish was measured and patients were followed up on postoperative days 1, 3, 5, 7, and 15 for assessing pain, trismus, and swelling. Data obtained were statistically analyzed. The mean time taken for the micromotor group is 37.90 min whereas by the piezosurgery group is 54.63 min, showing a statistically significant difference ( P < 0.001). Furthermore, there is statistically significant difference ( P < 0.001) in the level of pain, trismus, and swelling on postoperative days 1, 3, 5, and 7. Even the intragroup comparison of piezosurgical group for trismus and swelling showed no statistically significant difference on postoperative day 7, indicating faster recovery of trismus and swelling. On postoperative day 15, there was no difference in any parameter in both groups indicating complete symptom-free recovery in both groups. It takes more time to perform surgical extraction of third molars when piezosurgical unit is used. Despite that, it causes less pain postoperatively with faster improvement in trismus and quicker reduction in swelling.

Replacing Heavily Damaged Teeth by Third Molar Autotransplantation With the Use of Cone-Beam Computed Tomography and Rapid Prototyping.

Science.gov (United States)

Verweij, Jop P; Anssari Moin, David; Wismeijer, Daniel; van Merkesteyn, J P Richard

2017-09-01

This article describes the autotransplantation of third molars to replace heavily damaged premolars and molars. Specifically, this article reports on the use of preoperative cone-beam computed tomographic planning and 3-dimensional (3D) printed replicas of donor teeth to prepare artificial tooth sockets. In the present case, an 18-year-old patient underwent autotransplantation of 3 third molars to replace 1 premolar and 2 molars that were heavily damaged after trauma. Approximately 1 year after the traumatic incident, autotransplantation with the help of 3D planning and rapid prototyping was performed. The right maxillary third molar replaced the right maxillary first premolar. The 2 mandibular wisdom teeth replaced the left mandibular first and second molars. During the surgical procedure, artificial tooth sockets were prepared with the help of 3D printed donor tooth copies to prevent iatrogenic damage to the actual donor teeth. These replicas of the donor teeth were designed based on the preoperative cone-beam computed tomogram and manufactured with the help of 3D printing techniques. The use of a replica of the donor tooth resulted in a predictable and straightforward procedure, with extra-alveolar times shorter than 2 minutes for all transplantations. The transplanted teeth were placed in infraocclusion and fixed with a suture splint. Postoperative follow-up showed physiologic integration of the transplanted teeth and a successful outcome for all transplants. In conclusion, this technique facilitates a straightforward and predictable procedure for autotransplantation of third molars. The use of printed analogues of the donor teeth decreases the risk of iatrogenic damage and the extra-alveolar time of the transplanted tooth is minimized. This facilitates a successful outcome. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Keratocystic odontogenic tumor with impacted maxillary third molar involving the right maxillary antrum:An unusual case report

Directory of Open Access Journals (Sweden)

Abhishek Gupta

2011-01-01

Full Text Available The odontogenic keratocyst (OKC, first described by Phillipsen in 1956, has metamorphosized as a keratocystic odontogenic tumor (KCOT as reported in WHO classification of head and neck tumors in 2005. KCOT is a benign intraosseous neoplasm of the jaw and its occurrence in maxilla is unusual and its appearance in maxillary antrum along with maxillary impacted third molar is very uncommon. This article reports a case of KCOT associated with impacted maxillary third molar in right maxillary antrum and describes its rare site of occurrence.

Observation of positional relation between mandibular third molars and the mandibular canal on limited cone beam computed tomography

International Nuclear Information System (INIS)

Hashizume, Atsuko; Nakagawa, Yoichi; Ishii, Hisako; Kobayashi, Kaoru

2004-01-01

We describe the preoperative use of limited cone beam computed tomography (CT) with a dental CT scanner for the assessment of mandibular third molars before extraction. Cone beam CT provides 42.7-mm-high and 30-mm-wide rectangular solid images, with a resolution of less than 0.2 mm. The positional relationship between the mandibular third molars and the mandibular canal was examined by dental CT. Sixty-eight lower third molars of 62 patients whose teeth were superimposed on the mandibular canal on periapical or panoramic radiographs were studied. Dental CT scans clearly demonstrated the positional relationship between the mandibular canal and the teeth. The mandibular canal was located buccally to the roots of 16 teeth, lingually to the roots of 27 teeth, inferiorly to the roots of 23 teeth, and between the roots of 2 teeth. The presence of bone between the mandibular canal and the teeth was not noted in 7 of 16 buccal cases, 24 of 27 lingual cases, and 10 of 23 inferior cases on dental CT scans, suggesting that the canal was in contact with the teeth. Fifty-nine of the 68 mandibular third molars were surgically removed, and postoperative transient hypoesthesia occurred in 4 patients. Dental CT scans showed no bone between the mandibular canal and the teeth in all 4 patients. Hypoesthesia was not related to the bucco-lingual location of the mandibular canal or to the extent of bone loss between the canal and the teeth. However, hypoesthesia did not occur in patients with bone between the mandibular canal and the teeth. Thus, information on the distance between the canal and teeth on dental CT scans was useful for predicting the risk of inferior alveolar nerve damage. Because of its high resolution and low radiation dose, cone beam CT was useful for examination before mandibular third molar surgery. (author)

The effect of informed consent on stress levels associated with extraction of impacted mandibular third molars.

Science.gov (United States)

Casap, Nardy; Alterman, Michael; Sharon, Guy; Samuni, Yuval

2008-05-01

To evaluate the effect of informed consent on stress levels associated with removal of impacted mandibular third molars. A total of 60 patients scheduled for extraction of impacted mandibular third molars participated in this study. The patients were unaware of the study's objectives. Data from 20 patients established the baseline levels of electrodermal activity (EDA). The remaining 40 patients were randomly assigned into 2 equal groups receiving either a detailed document of informed consent, disclosing the possible risks involved with the surgery, or a simplified version. Pulse, blood pressure, and EDA were monitored before, during, and after completion of the consent document. Changes in EDA, but not in blood pressure, were measured on completion of either version of the consent document. A greater increase in EDA was associated with the detailed version of the consent document (P = .004). A similar concomitant increase (although nonsignificant) in pulse values was monitored on completion of both versions. Completion of overdisclosed document of informed consent is associated with changes in physiological parameters. The results suggest that overdetailed listing and disclosure before extraction of impacted mandibular third molars can increase patient stress.

Anatomical study of the relationship of impacted mandibular third molar root apex to inferior alveolar canal in Kurdistan population using orthopantomogram

Directory of Open Access Journals (Sweden)

Fedil Andraws Yalda

2017-12-01

Full Text Available Background and objective: Extraction of an impacted mandibular third lower molar tooth is one of the common surgical procedures that may lead to the damage of inferior alveolar nerve due to roots proximity to the mandibular canal. This study aimed to know the relative relationship and proximity of the mandibular third molar roots to the inferior alveolar canal in relation to gender, age, depth of impaction, relation with ramus, and type of angulation of the impacted tooth in Kurdistan population. Methods: A sample of 366 digital panoramic radiographs of patients with impacted mandibular third molar was studied. Panoramic radiographic signs images were evaluated for the presence of root contact with the superior border of the mandibular canal, darkening of the roots apex, deflected roots, narrow root, superimposition of the canal, interruption of the white line, diversion of the inferior alveolar canal, and narrowing of the inferior alveolar canal. The depths of impaction, relation with ramus, and type of angulation were also studied. Results: Significant relation of the proximity of the mandibular third molar roots to the inferior alveolar canal with the gender (P = 0.001 and age (P <0.001 were seen. A significant relation of the proximity of the mandibular third molar roots to the inferior alveolar canal with the depth of impaction (P <0.001, relation with the ramus (P =0.004, and angulation of impaction were also seen (P <0.001. Conclusion: Significant relation of the proximity of the mandibular third molar roots to the inferior alveolar canal with gender, age, depth of impaction, relation with the ramus, and angulation of impaction were seen.

Age estimation using the radiographic visibility of the periodontal ligament in lower third molars in a Portuguese population.

Science.gov (United States)

Sequeira, Catarina-Dourado; Teixeira, Alexandra; Caldas, Inês-Morais; Afonso, Américo; Pérez-Mongiovi, Daniel

2014-12-01

The mineralization of third molars has been used repeatedly as a method of forensic age estimation. However, this procedure is of little use beyond age 18, especially to determinate if an individual is older than 21 years of age; thus, the development of new approaches is essential. The visibility of the periodontal ligament has been suggested for this purpose. The aim of this work was to determine the usefulness of this methodology in a Portuguese population. Periodontal ligament visibility was assessed in the lower third molars, using a sample of 487 orthopantomograms, 228 of which belonging to females and 259 to males, from a Portuguese population aged 17 to 31 years. A classification of four stages based on the visual phenomenon of disappearance of the periodontal ligament of fully mineralized third molars was used. For each stage, median, variance, minimal and maximal age were assessed. The relationship between age and stage of periodontal ligament had a statistical significance for both sexes. In this population, stage 3 can be used to state that a male person is over 21 years-old; for females, another marker should be used. This technique can be useful for determining age over 21, particularly in males. Differences between studies are evident, suggesting that specific population standards should be used when applying this technique. Key words:Forensic sciences, forensic odontology, age estimation, third molar, periodontal ligament.

Tercer molar ectópico a nivel de región infraorbitaria-seno maxilar Ectopic third molar of the maxillary sinus-infraorbital region

Directory of Open Access Journals (Sweden)

C. Moreno García

2007-06-01

Full Text Available Introducción. Los cordales ectópicos son aquellos incluidos en posiciones inusuales o desplazados a distancia de su normal localización anatómica. La erupción ectópica de un diente dentro de la cavidad oral es común pero en otros lugares es raro. La erupción ectópica puede ir asociada con alteraciones en el desarrollo, procesos patológicos o yatrogenia. Caso Clínico. Mujer de 56 años de edad con tercer molar superior derecho ectópico a nivel de región infraorbitaria-seno maxilar. Presentaba dolor e inflamación hemifacial derecha de larga evolución y resistente a tratamiento médico. Se realizó exéresis quirúrgica de dicho cordal mediante abordaje de Caldwell-Luc. Discusión. En muchos casos la etiología de un cordal ectópico no puede ser identificada. La mayor parte de las veces son asintomáticos y diagnosticados mediante estudios radiológicos. Conclusión. La indicación de la exodoncia en el caso de un diente ectópico en general viene determinada por la presencia de sintomatología o en prevención de futuras complicaciones.Introduction. Ectopic third molar teeth are those that are impacted in unusual positions, or that have been displaced and are at a distance from their normal anatomic location. Ectopic eruption of a tooth within the oral cavity is common, but rare in other sites. Ectopic eruption can be associated with developmental disturbances, pathologic processes or iatrogenic activity. Case Report. Female, fifty-six years old, with an upper right ectopic third molar located in the maxillary sinus-infraorbital region. She presented with pain and inflammation of the right side of her face that she had been experiencing for along time and which had been resistant to treatment. Surgical excision was carried out of the third molar tooth using the Caldwell-Luc approach. Discussion. In many cases the etiology of ectopic third molars cannot be identified. Generally they are asymptomatic and diagnosed by radiology

Agenesia de terceros molares en pacientes de la Facultad de Odontología de la UNAM Agenesia of the third molars in patients of the Faculty of Odontology of the National Autonomous University of Mexico

Directory of Open Access Journals (Sweden)

Raúl Díaz Pérez

2008-12-01

Full Text Available ANTECEDENTES: los terceros molares o serotinos son los últimos dientes en erupcionar; su presencia genera diversas patologías como apiñamiento, pericoronitis y dolor, generalmente por falta de espacio en los maxilares. Según la filogenia humana son considerados dientes en vías de extinción. Cada vez más presentan una erupción retrasada e incluso ausencia por falta de formación. OBJETIVO: determinar la frecuencia de agenesia de terceros molares en pacientes de la Facultad de Odontología de la Universidad Nacíonal Autónoma de México. MÉTODOS: se examinaron 915 ortopantomografías de pacientes de 16 a 24 años y se realizó el diagnóstico de presencia de los terceros molares, se recabó información sociodemográfica y se analizó la asociación con el sexo usando X². RESULTADOS: el 20 % de la muestra presentó agenesia de los 4 terceros molares, 56 % tuvo los 4, y 24 % solo de 1 a 3, además se encontró que el sexo no determina la presencia de los terceros molares (X²= 0,503, p= 0,478. CONCLUSIONES: la frecuencia de agenesia de terceros molares fue del 20 % y esta es independiente del sexo.ANTECEDENTS: the third molars are the last teeth to erupt. Their presence generate diverse pathologies as crowding, pericoronitis and pain, generally due to the lack of space in the maxillae. According to human phylogeny, they are considered teeth on the way to extinction. They present an increasingly delayed eruption and even absence due to lack of formation, OBJECTIVE: to determine the frequency of agenesia of the third molars in patients of the Faculty of Odontology of the National Autonomous University of Mexico. METHODS: 915 orthopantomographies of patients aged 16-24 were examined and the diagnosis of presence of the third molars was made. Sociodemographic information was necessary and the association with sex was analyzed by using X2. RESULTS: 20 % of the sample presented agenesia of the 4 third molars, 56 % had the 4, and 24 % only from

Autotransplantation of Mandibular Third Molar with Buccal Cortical Plate to Replace Vertically Fractured Mandibular Second Molar: A Novel Technique.

Science.gov (United States)

Zufía, Juan; Abella, Francesc; Trebol, Ivan; Gómez-Meda, Ramón

2017-09-01

Tooth replacement often leads to inadequate vertical volume in the recipient site bone when a tooth has been extracted because of a vertical root fracture (VRF). This case report presents the autotransplantation of a mandibular third molar (tooth #32) with the attached buccal cortical plate to replace a mandibular second molar (tooth #31) diagnosed with a VRF. After extraction of tooth #31, the recipient socket was prepared based on the size measured in advance with cone-beam computed tomographic imaging. The precise and calculated osteotomy of the cortical bone of tooth #32 allowed for the exact placement of the donor tooth in the position of tooth #31. The total extraoral time was only 25 minutes. The block was fixed to the recipient socket with an osteosynthesis screw and splinted with a double resin wire for 8 weeks. At the 6-month follow-up, the screw was removed, and the stability of the tooth and the regeneration obtained throughout the vestibular area were confirmed. At the 2-year follow-up, the transplanted tooth was asymptomatic and maintained a normal bone level. Advantages of autotransplantation over dental implants include maintenance of proprioception, possible orthodontic movements, and a relatively low cost. This case report demonstrates that an autotransplantation of a third molar attached to its buccal cortical plate is a viable option to replace teeth with a VRF. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Comparative Efficacy of Amoxicillin/Clavulanic Acid and Levofloxacin in the Reduction of Postsurgical Sequelae After Third Molar Surgery: A Randomized, Double-Blind, Clinical Trial in a Nigerian University Teaching Hospital.

Science.gov (United States)

Ndukwe, Kizito Chioma; Braimah, Ramat Oyebunmi; Owotade, John Foluso; Aregbesola, Stephen Babatunde

2016-01-01

The most common sequelae after surgical removal of mandibular third molar are pain, trismus, swelling, and dysphagia. However, these symptoms can also signal the onset of surgical site infection and alveoli osteitis. The aim of this study was to evaluate the efficacy of prophylactic amoxicillin/clavulanic acid and levofloxacin and preemptive therapy of amoxicillin/clavulanic acid in the reduction of postinflammatory complications, surgical site infection, and alveolar osteitis following the third molar surgery. A total of 135 patients were randomized into three equal groups: Group A (preemptive therapy of amoxicillin/clavulanic acid) with preoperative dose of 875/125 mg amoxicillin/clavulanic acid followed by 500/125 mg amoxicillin/clavulanic acid 12 hourly for 5 days, Group B (amoxicillin/clavulanic acid prophylaxis) with a single preoperative dose of amoxicillin/clavulanic acid 875/125 mg tablets, and Group C (levofloxacin prophylaxis) with a single preoperative dose of levofloxacin 1000 mg tablets. All patients had ostectomy using surgical handpiece and burs and received same analgesics (tabs ibuprofen 400 mg 8 hourly for 3 days). No case of surgical site infection or alveoli osteitis was recorded in the study groups. There were no statistically significant differences between the treatment groups with regard to pain, mouth opening, postoperative facial dimension, and body temperature. Amoxicillin/clavulanic acid as a single preoperative bolus should be adequate for the prevention of postoperative wound infection and alveoli osteitis following the third molar extraction as there is no need for an extension of the antibiotic. Moreover, levofloxacin can be utilized as prophylaxis in patients undergoing mandibular third molar extraction if such patients are allergic to penicillins.

Comparative efficacy of amoxicillin/clavulanic acid and levofloxacin in the reduction of postsurgical sequelae after third molar surgery: a randomized, double-blind, clinical trial in a Nigerian university teaching hospital

Directory of Open Access Journals (Sweden)

Kizito Chioma Ndukwe

2016-01-01

Full Text Available Background: The most common sequelae after surgical removal of mandibular third molar are pain, trismus, swelling, and dysphagia. However, these symptoms can also signal the onset of surgical site infection and alveoli osteitis. The aim of this study was to evaluate the efficacy of prophylactic amoxicillin/clavulanic acid and levofloxacin and preemptive therapy of amoxicillin/clavulanic acid in the reduction of postinflammatory complications, surgical site infection, and alveolar osteitis following the third molar surgery. Patients and Methods: A total of 135 patients were randomized into three equal groups: Group A (preemptive therapy of amoxicillin/clavulanic acid with preoperative dose of 875/125 mg amoxicillin/clavulanic acid followed by 500/125 mg amoxicillin/clavulanic acid 12 hourly for 5 days, Group B (amoxicillin/clavulanic acid prophylaxis with a single preoperative dose of amoxicillin/clavulanic acid 875/125 mg tablets, and Group C (levofloxacin prophylaxis with a single preoperative dose of levofloxacin 1000 mg tablets. All patients had ostectomy using surgical handpiece and burs and received same analgesics (tabs ibuprofen 400 mg 8 hourly for 3 days. Results: No case of surgical site infection or alveoli osteitis was recorded in the study groups. There were no statistically significant differences between the treatment groups with regard to pain, mouth opening, postoperative facial dimension, and body temperature. Conclusion: Amoxicillin/clavulanic acid as a single preoperative bolus should be adequate for the prevention of postoperative wound infection and alveoli osteitis following the third molar extraction as there is no need for an extension of the antibiotic. Moreover, levofloxacin can be utilized as prophylaxis in patients undergoing mandibular third molar extraction if such patients are allergic to penicillins.

Effect of age, impaction types and operative time on inflammatory tissue reactions following lower third molar surgery

Directory of Open Access Journals (Sweden)

Obi Emeka V

2011-04-01

Full Text Available Abstract Background Postoperative mobidity following third molar surgery is affected by a number of factors. The study of these factors is essential for effective planning and limitation of morbidity. The aim of this study was to determine the effect of age, type of impaction and operative time on immediate postoperative tissue reactions following mandibular third molar surgery. Methods Consecutive patients with impacted mandibular third molar teeth were studied. All the third molars were classified according to Winter's classification. Surgical extraction was performed on all the patients by a single surgeon under local anaesthesia. The operation time was determined by the time lapse between incision and completion of suturing. Postoperative pain, swelling and trismus were evaluated. Results There were 120 patients with an age range of 19-42 years. Patients in the age range of 35-42 years recorded a lower pain score (p = 0.5 on day 1. The mouth opening was much better in the lower age group on day 2 and 5 (p = 0.007 and p = 0.01 respectively. Pain, swelling and trismus increased with increasing operative time. Distoangular impaction was significantly associated with higher VAS score on day 1 and 2 (p = 0.01, 0.0, 04. Distoangular and horizontal impaction are associated with a higher degree of swelling and reduced mouth opening on postoperative review days. Vertical impaction was associated with the least degree of facial swelling and best mouth opening. Conclusions Increasing operating time and advancing age are associated with more postoperative morbidity, likewise distoangular and horizontal impaction types.

An automated technique to stage lower third molar development on panoramic radiographs for age estimation: a pilot study.

Science.gov (United States)

De Tobel, J; Radesh, P; Vandermeulen, D; Thevissen, P W

2017-12-01

Automated methods to evaluate growth of hand and wrist bones on radiographs and magnetic resonance imaging have been developed. They can be applied to estimate age in children and subadults. Automated methods require the software to (1) recognise the region of interest in the image(s), (2) evaluate the degree of development and (3) correlate this to the age of the subject based on a reference population. For age estimation based on third molars an automated method for step (1) has been presented for 3D magnetic resonance imaging and is currently being optimised (Unterpirker et al. 2015). To develop an automated method for step (2) based on lower third molars on panoramic radiographs. A modified Demirjian staging technique including ten developmental stages was developed. Twenty panoramic radiographs per stage per gender were retrospectively selected for FDI element 38. Two observers decided in consensus about the stages. When necessary, a third observer acted as a referee to establish the reference stage for the considered third molar. This set of radiographs was used as training data for machine learning algorithms for automated staging. First, image contrast settings were optimised to evaluate the third molar of interest and a rectangular bounding box was placed around it in a standardised way using Adobe Photoshop CC 2017 software. This bounding box indicated the region of interest for the next step. Second, several machine learning algorithms available in MATLAB R2017a software were applied for automated stage recognition. Third, the classification performance was evaluated in a 5-fold cross-validation scenario, using different validation metrics (accuracy, Rank-N recognition rate, mean absolute difference, linear kappa coefficient). Transfer Learning as a type of Deep Learning Convolutional Neural Network approach outperformed all other tested approaches. Mean accuracy equalled 0.51, mean absolute difference was 0.6 stages and mean linearly weighted kappa was

Radiation absorbed doses at radiographic examination of third molars.

Science.gov (United States)

Rehnmark-Larsson, S; Stenström, B; Julin, P; Richter, S

1982-01-01

The radiation absorbed doses to critical organs, i.e. the thyroid and salivary glands and the gonadal region, were measured at radiographic examination of third molars. A tissue equivalent phantom was used together with ionization chamber detectors and TLDs. In the maxilla three, and in the mandible four different projections were used; also an extraoral lateral view. The greatest thyroid dose, 35 muGy, came from a mandibular disto-oblique projection with the circular tube collimator and Ultra-Speed film. the thyroid dose from an extraoral lateral view with high sensitivity screens was 3.7 muGy. The doses in different parts of the parotid gland from the disto-oblique mandibular projection with Ultra-Speed film ranged between 2.65 and 0.052 mGy. The corresponding doses in the submandibular gland were 1.74 mGy beneath the mandible and 0.458 mGy in the fovea. A rectangular tube collimator reduced the doses by approximately 50%. the Ekta-Speed film required approximately 40% lower exposure than the Ultra-Speed film. Without shielding the gonadal doses from a complete examination of four third molars were of the same order of magnitude as from a full survey with intraoral films, i.e. 3-7 muGy. A horizontal radiation shield reduced the thyroid doses by between 12 and 46% and the gonadal doses by between 50 and 95%. The reduction effect from the shield was relatively greater when using the larger aperture of the tube collimator. Combinations of leaded aprons and soft leaded collars reduced the thyroid doses by between 15 and 42% and the gonadal doses by two orders of magnitude.

Prevalence of C-shaped canals in mandibular second and third molars in a central India population: A cone beam computed tomography analysis.

Science.gov (United States)

Wadhwani, Shefali; Singh, Mahesh Pratap; Agarwal, Manish; Somasundaram, Pavithra; Rawtiya, Manjusha; Wadhwani, P K

2017-01-01

To evaluate the prevalence of C-shaped root canals in mandibular molars using cone beam computed tomography (CBCT) in a subpopulation of Central India. CBCT scans of patients from diagnostic imaging center were selected in accordance with the criteria given by Fan et al . (2004) for C-shaped canals. A total of 238 CBCT scans fulfilled the inclusion criteria and thereby divided into two groups: Group 1: Images showing C-shaped canal configuration in mandibular second molars. Group 2: Images showing C-shaped canal configuration in mandibular third molars. The frequency and distribution of canals and their configuration along with the position of lingual/buccal grooves in the images were evaluated, and the data was analyzed. CBCT evaluation showed that 9.7% of second molars and 8% of third molars had C-shaped canals. A prominent buccal groove was seen in these teeth. The data showed a significant difference ( P = 0.038) for the presence of such anatomy on the right side for mandibular third molars. The study showed a significant prevalence of C-shaped canal configuration in the subpopulation studied.

Impacted Mandibular Third Molar, Associated Pathoses, and Their Relation to Angulation and Impaction Depth: A Cone Beam CT Study

Directory of Open Access Journals (Sweden)

Movahhedian N

2018-03-01

Full Text Available Statement of problem: prophylactic removal of the impacted lower third molar (ILTM is controversial and accompanying pathologic conditions play an important role. Objectives: The aim of the present study is to evaluate the prevalence of commonly found pathoses associated with ILTM in relation to angulation and impaction depth in cone beam computed tomography (CBCT. Materials and Methods: We evaluated CBCT of 500 ILTMs from 235 females (57% and 177 males (43% for the presence of caries on the second and third molars, external root resorption (ERR of the second molar, and follicular spaces (FS >5 mm in diameter in relation to angulation and impaction depth according to Pell and Gregory and Winter’s classifications, respectively. Results: We observed that 55.6% of ILTM had at least one detectible lesion. ERR was the most frequent pathologic condition (31.2%, followed by caries on the second (26% and third (13.4% molars, and FS >5 mm (2.4%. ERR was the only pathology influenced by angulation. There was significantly more ERR in mesioangular ILTMs (40.5%, P5 mm (P=0.035. There were more caries on the second molar (P=0.013 and FS >5 mm (P<0.001 in class III. Conclusions: Prophylactic removal of ILTMs (especially in mesioangular or horizontal impactions could be suggested considering the potential for pathologic changes in ILTMs and the propensity for these teeth to cause ERR in second molars.

The selective and non-selective cyclooxygenase inhibitors valdecoxib and piroxicam induce the same postoperative analgesia and control of trismus and swelling after lower third molar removal

Directory of Open Access Journals (Sweden)

V. Benetello

2007-08-01

Full Text Available We compared the clinical efficacy of orally administered valdecoxib and piroxicam for the prevention of pain, trismus and swelling after removal of horizontally and totally intrabony impacted lower third molars. Twenty-five patients were scheduled to undergo removal of symmetrically positioned lower third molars in two separate appointments. Valdecoxib (40 mg or piroxicam (20 mg was administered in a double-blind, randomized and crossed manner for 4 days after the surgical procedures. Objective and subjective parameters were recorded for comparison of postoperative courses. Both agents were effective for postoperative pain relief (N = 19. There was a similar mouth opening at suture removal compared with the preoperative values (86.14 ± 4.36 and 93.12 ± 3.70% of the initial measure for valdecoxib and piroxicam, respectively; ANOVA. There was no significant difference regarding the total amount of rescue medication taken by the patients treated with valdecoxib or piroxicam (173.08 ± 91.21 and 461.54 ± 199.85 mg, respectively; Wilcoxon test. There were no significant differences concerning the swelling observed on the second postoperative day compared to baseline measures (6.15 ± 1.84 and 8.46 ± 2.04 mm for valdecoxib and piroxicam, respectively; ANOVA or on the seventh postoperative day (1.69 ± 1.61 and 2.23 ± 2.09 mm for valdecoxib and piroxicam, respectively; ANOVA. The cyclooxygenase-2 selective inhibitor valdecoxib is as effective as the non-selective cyclooxygenase inhibitor piroxicam for pain, trismus and swelling control after removal of horizontally and totally intrabony impacted lower third molars.

Clinician-related factors behind the decision to extract an asymptomatic lower third molar. A cross-sectional study based on Spanish and Portuguese dentists.

Science.gov (United States)

Alves-Pereira, D; Pereira-Silva, D; Figueiredo, R; Gay-Escoda, C; Valmaseda-Castellón, E

2017-09-01

Scientific literature estimates that around 18 to 40 % of asymptomatic third molars are extracted. The aims of the present study were to determine the indications for extraction of asymptomatic lower third molars in a sample of Spanish and Portuguese dentists, and to relate these indications to the clinicians' training and professional experience. A survey consisting of 15 cases of asymptomatic lower third molars was emailed to Portuguese and Spanish dentists. The clinicians were asked to assess the level of difficulty of the extractions and to make a reasoned recommendation based on the panoramic radiographs, gender and age of the patients. 381 clinicians filled in the questionnaires. Most of the professionals had over 13 years of clinical experience. The number of Spanish clinicians with postgraduate degrees in Oral Surgery was significantly higher. On average, 42% of respondents recommended extraction of asymptomatic third molars. The indication for extraction was significantly higher among Portuguese dentists. Clinical experience was negatively correlated with the perceived extraction difficulty (pPortuguese dentists were more in favour of removing asymptomatic lower third molars than the Spanish dentists, although the latter had a higher proportion of professionals with postgraduate studies in Oral Surgery.

A Retrospective Radiographic Survey of Pathology Associated with Impacted Third Molars among Patients Seen in Oral & Maxillofacial Surgery Clinic of College of Dentistry, Riyadh.

Science.gov (United States)

Khawaja, Naveed Ahmad; Khalil, Hesham; Parveen, Kauser; Al-Mutiri, Abdulmajeed; Al-Mutiri, Saif; Al-Saawi, Abdullah

2015-04-01

The purpose of this study is to determine the type and frequency of pathological conditions around third molar teeth among randomly selected patient's records in Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, Riyadh. Totally, 281 patient panoramic radiographs were selected with detectable pathology among 570 files of patients seen in oral and maxillofacial surgery clinics 2 years retrospectively. Almost 17-55 years age (mean age 25.43) was selected. The following radiographs were analyzed for all pathology associated impacted teeth; dental caries, bone resorption, periodontitis, and apical pathology. The study found caries, external bone resorption and periodontitis are highly frequent to mesioangular and horizontal in mandibular impacted third molar compared to maxillary impacted third molar. Overall result evaluated that tooth #28 related periodontitis is significant (P = 0.021), and tooth #38 related bone resorption, tooth #48 related root caries, bone resorption and apical pathology are highly significant (P = 0.000) comparing to others. This study also concluded the high frequency of root caries, bone resorption and apical pathology reported in relation to mandibular impacted third teeth. Significant results were also achieved with periodontitis in relation to mesiangular and vertical angulation of left impacted maxillary third molars. Prophylactic removal of impacted third molars is recommended in many studies to avoid future risk of associated pathology. Retained asymptomatic impacted third molars imply pathology that could be difficult in later ages as less morbidity in younger ages.

Aspartic acid racemization in dentin of the third molar for age estimation of the Chaoshan population in South China.

Science.gov (United States)

Chen, Shisheng; Lv, Yanyi; Wang, Dian; Yu, Xiaojun

2016-09-01

Aspartic acid racemization in teeth has been increasingly used to estimate chronological age with a considerably high accuracy in forensic practice. The Chaoshan population in South China is relatively isolated in geography, and has specific lifestyle and dietary inhibits. It is still unknown whether this method is suitable for this population. The aim of this study was to analyze the relationship between chronological age and the d/l aspartic acid ratio in dentin in the third molar tooth of the Chaoshan population. Fifty-eight non-carious third molar teeth (31 mandibles and 27 maxillae), from 58 living individuals of known age (24 males and 34 females), were retrieved. Dentin was extracted from these teeth. The d- and l-aspartic acids in dentins were separated and detected by high performance liquid chromatography (HPLC). Linear regression was performed between the d/l aspartic acid ratio of dentins and chronological age. Results showed that the correlation coefficient (r) was 0.969, and the mean absolute error (MAE) was 2.19 years, its standard deviation (SD) was ±1.53 years, indicating excellent correlation. There was no significant difference in racemization rates of dentin between sexes (P=0.113, F=2.6), or between mandibles and maxillae (P=0.964, F=0.000). Results indicate that the ratio of the d and l forms of aspartic acid of dentins, in the third molar, is closely correlated with chronological age, special lifestyle do no obviously affect the accuracy of the age estimations by aspartic acid racemization of the dentin in the third molar and that aspartic acid racemization in the third molar dentin can be used as an accurate method to estimate chronological age in the Chaoshan population in South China. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Autotransplantation of Third Molars With Platelet-Rich Plasma for Immediate Replacement of Extracted Non-Restorable Teeth: A Case Series.

Science.gov (United States)

Gonzalez-Ocasio, Jorge; Stevens, Mark

2017-09-01

The aim of this study was to examine the use of platelet-rich plasma (PRP) for autotransplantation of third molars as a successful technique to provide immediate tooth structure for space maintenance and masticatory function when premature loss of a permanent tooth occurs and other dental restorative options are not indicated. This study included 10 healthy patients 10 to 17 years of age with at least 1 immature third molar (one to two thirds of root formation) used to replace extracted non-restorable teeth. Eleven third molars were transplanted and adapted to sockets of the extracted teeth with the adjunct of PRP. Transplanted teeth were stabilized to the adjacent teeth using orthodontic wires and dental composite for 1 month. Patients were followed for 1 year. Function, tooth vitality, root development, and periodontal health were recorded. All 10 patients had functioning asymptomatic transplanted teeth, with physiologic tooth mobility after splint removal at 1 month and after 1 year. All 10 patients had positive tooth vitality (by cold test) at 3, 6, and 12 months; all transplants showed positive root development (average growth, 2.01 mm) confirmed and measured using periapical radiographs. No patients required root canal therapy at any point in the study. Periodontal assessments were performed at the scheduled follow-up appointments with circumferential periodontal probing. Periodontal health was maintained because probing depths were shallower than 4 mm during the 1-year follow-up. Autotransplantation of immature third molars with PRP shows excellent results and should be considered a viable option for premature loss of permanent molars. PRP might have other advantages, such as root promotion and neurosensory development. Published by Elsevier Inc.

Clinical efficacy of computed tomography and coronectomy for prevention of postoperative inferior alveolar nerve injury occurring after impacted mandibular third molar surgery

International Nuclear Information System (INIS)

Hata, Tsuyoshi; Mandai, Toshiko; Ishida, Kohsei; Deguchi, Hiroyo; Hosoda, Masaru

2012-01-01

Our aim was to evaluate the clinical efficacy of computed tomography and coronectomy for preventing postoperative inferior alveolar nerve injury after impacted mandibular third molar surgery. Among the patients who visited Kawasaki Medical School Hospital between January 2009 and December 2010, 12 patients with high-risk signs of inferior alveolar nerve injury on panoramic imaging were examined for the extraction of impacted mandibular third molar by computed tomography (CT). CT examinations were performed in order to examine the relationship between the root apex of impacted mandibular third molar and inferior alveolar canal for 16 teeth. Based on the imaging findings, the patients were informed about treatment methods and their consent was obtained. We compared the CT and panoramic findings and discussed the relationship between the impacted third molar and the inferior alveolar nerve. Medical records were also examined for the presence of abnormal postoperative complications. Interruption of the cortical white line of the inferior alveolar canal was identified in 13 panoramic radiographs, and bending of the inferior alveolar canal was observed in 2 panoramic radiographs. CT findings indicated type 2 inferior alveolar nerve proximity in 13 teeth, and there was no proximity in 3 teeth. The observation was selected in 10 teeth showing nerve proximity in CT findings. Traditional third molar removal was performed for the 3 teeth with no nerve proximity. Coronectomy was performed in 3 teeth with nerve proximity. The clinical course was uneventful. To prevent inferior alveolar nerve injury, coronectomy may be a better means of removing the crown of an impacted third molar while leaving the roots intact, in cases where teeth might be in proximity with the inferior alveolar nerve. (author)

Patients’ satisfaction and prevalence of complications on surgical extraction of third molar

Directory of Open Access Journals (Sweden)

Lee CTY

2015-02-01

Full Text Available Crystal TY Lee, Shinan Zhang, Yiu Yan Leung, Samantha KY Li, Cissy C Tsang, Chun-Hung Chu Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, People’s Republic of China Objectives: To study patients’ satisfaction and prevalence of complications in surgical extraction of impacted third molar by senior dentists and recently graduated dentists in a university dental clinic. Method: Patients who had impacted third molar extraction in a university dental clinic by two associate dentists who had <2 years of experience and two senior dentists who had >15 years of experience were evaluated in this study. Patients’ age, sex, history of pericoronitis, tooth extracted, and radiographic assessment of the impacted tooth were recorded. Immediately after suture removal, the patients were invited to indicate their satisfaction on a Likert scale of 1–5. Results: A total of 546 patients received extraction, and 251 patients were operated by associate dentists. Patient satisfaction was higher among those who had noncomplicated surgery (P=0.007, short treatment time (P<0.001, and had no postsurgical emergency appointments (P<0.001. The prevalence of seeking postsurgical emergency appointments was 9.2%. The reasons were severe pain (4.8%, swelling (2.6%, bleeding (2.4%, alveolar osteitis (0.9%, paresthesia (0.9, and trismus (0.5%. The prevalence of postsurgical complication(s in associate dentists and senior dentists was 11.6% and 7.1%, respectively (P=0.050. The mean satisfaction scores for associate dentists and senior dentists were 4.17 and 3.95, respectively (P=0.002. Conclusion: Although a higher rate of postsurgical complications was observed among the patients treated by the recently graduated dentists, their patients’ satisfaction scores were higher than that of the senior dentists. Around 9% of patients attended postsurgical emergency appointments, and their common reason was severe pain. Keywords: dental satisfaction, dentistry

A geometric morphometric analysis of hominin upper second and third molars, with particular emphasis on European Pleistocene populations.

Science.gov (United States)

Gómez-Robles, Aida; Bermúdez de Castro, José María; Martinón-Torres, María; Prado-Simón, Leyre; Arsuaga, Juan Luis

2012-09-01

The study of dental morphology by means of geometric morphometric methods allows for a detailed and quantitative comparison of hominin species that is useful for taxonomic assignment and phylogenetic reconstruction. Upper second and third molars have been studied in a comprehensive sample of Plio- and Pleistocene hominins from African, Asian and European sites in order to complete our analysis of the upper postcanine dentition. Intraspecific variation in these two molars is high, but some interspecific trends can be identified. Both molars exhibit a strong reduction of the distal cusps in recent hominin species, namely European Homo heidelbergensis, Homo neanderthalensis and Homo sapiens, but this reduction shows specific patterns and proportions in the three groups. Second molars tend to show four well developed cusps in earlier hominin species and their morphology is only marginally affected by allometric effects. Third molars can be incipiently reduced in earlier species and they evince a significant allometric component, identified both inter- and intraspecifically. European Middle Pleistocene fossils from Sima de los Huesos (SH) show a very strong reduction of these two molars, even more marked than the reduction observed in Neanderthals and in modern human populations. The highly derived shape of SH molars points to an early acquisition of typical Neanderthal dental traits by pre-Neanderthal populations and to a deviation of this population from mean morphologies of other European Middle Pleistocene groups. Copyright © 2012 Elsevier Ltd. All rights reserved.

Comparative Evaluation of Immediate Post-Operative Sequelae after Surgical Removal of Impacted Mandibular Third Molar with or without Tube Drain - Split-Mouth Study.

Science.gov (United States)

Kumar, Barun; Bhate, Kalyani; Dolas, R S; Kumar, Sn Santhosh; Waknis, Pushkar

2016-12-01

Third molar surgery is one of the most common surgical procedures performed in general dentistry. Post-operative variables such as pain, swelling and trismus are major concerns after impacted mandibular third molar surgery. Use of passive tube drain is supposed to help reduce these immediate post-operative sequelae. The current study was designed to compare the effect of tube drain on immediate post-operative sequelae following impacted mandibular third molar surgery. To compare the post-operative sequelae after surgical removal of impacted mandibular third molar surgery with or without tube drain. Thirty patients with bilateral impacted mandibular third molars were divided into two groups: Test (with tube drain) and control (without tube drain) group. In the test group, a tube drain was inserted through the releasing incision, and kept in place for three days. The control group was left without a tube drain. The post-operative variables like, pain, swelling, and trismus were calculated after 24 hours, 72 hours, 7 days, and 15 days in both the groups and analyzed statistically using chi-square and t-test analysis. The test group showed lesser swelling as compared to control group, with the swelling variable showing statistically significant difference at post-operative day 3 and 7 (p≤ 0.05) in both groups. There were no statistically significant differences in pain and trismus variables in both the groups. The use of tube drain helps to control swelling following impacted mandibular third molar surgery. However, it does not have much effect on pain or trismus.

Effect of tube drainage compared with conventional suturing on postoperative discomfort after extraction of impacted mandibular third molars.

Science.gov (United States)

Koyuncu, B Ö; Zeytinoğlu, M; Tetik, A; Gomel, M M

2015-01-01

The aim of this prospective randomised study was to assess the effects of tube drainage on postoperative discomfort after the extraction of impacted mandibular third molars. We studied 40 patients (11 men and 29 women) 18 years or older (mean (SD) 21 (3), range 18-29) who required extraction of mandibular third molars. We used a randomised crossover design by which if a drain was inserted on one side, then the other side was managed without a drain on a later occasion. Pain, swelling, and mouth opening were evaluated after 48 h and 7 days postoperatively in both groups. Facial swelling (p=0.001), pain p=0.001), and trismus (p=0.001) were significantly less common in the drained group compared with those not drained. We conclude that the use a tube drain is of benefit in minimising postoperative swelling, pain, and trismus after extraction of mandibular third molars. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Economic and health implications of routine CBCT examination before surgical removal of the mandibular third molar in the Danish population

DEFF Research Database (Denmark)

Petersen, L B; Rose Olsen, Kim; Matzen, L H

2015-01-01

representative dental clinics in the regions of Denmark were visited by two observers, who registered the total number of patients in each clinic, the number of removed mandibular third molars from patients' files together with the age and gender of these patients. The data were collected from 2008 to 2014......OBJECTIVES: This epidemiological study aimed to analyse economical and societal consequences in Denmark if CBCT is used routinely as a diagnostic method before removal of the mandibular third molar. Furthermore, the aim was to calculate the excess cancer incidence from this practice. METHODS: 17....... The total number of removed mandibular third molars in Denmark each year was derived from the collected data and information on patients' contacts with dentists from Statistics Denmark as a sum of contributions from each region. The contribution of a region was obtained as the number of removed mandibular...

Dental computed tomographic imaging as age estimation: morphological analysis of the third molar of a group of Turkish population.

Science.gov (United States)

Cantekin, Kenan; Sekerci, Ahmet Ercan; Buyuk, Suleyman Kutalmis

2013-12-01

Computed tomography (CT) is capable of providing accurate and measurable 3-dimensional images of the third molar. The aims of this study were to analyze the development of the mandibular third molar and its relation to chronological age and to create new reference data for a group of Turkish participants aged 9 to 25 years on the basis of cone-beam CT images. All data were obtained from the patients' records including medical, social, and dental anamnesis and cone-beam CT images of 752 patients. Linear regression analysis was performed to obtain regression formulas for dental age calculation with chronological age and to determine the coefficient of determination (r) for each sex. Statistical analysis showed a strong correlation between age and third-molar development for the males (r2 = 0.80) and the females (r2 = 0.78). Computed tomographic images are clinically useful for accurate and reliable estimation of dental ages of children and youth.

Prediction of postoperative pain after mandibular third molar surgery

DEFF Research Database (Denmark)

Rudin, Asa; Eriksson, Lars; Liedholm, Rolf

2010-01-01

. Standardized surgery was performed during local anesthesia. Postoperative pain management was with rescue paracetamol and ibuprofen. The patients were instructed to record each day their pain at rest and during dynamic conditions, and their requirement of analgesics for 14 days following surgery.......To evaluate the predictive potential of preoperative psychological and psychophysiological variables in estimating severity of postoperative pain following mandibular third molar surgery (MTMS). Methods: Following ethical committee approval and informed consent, 40 consecutive patients scheduled...... for MTMS were included. Preoperative psychometric indicators of anxiety, depression, and vulnerability were evaluated by patient questionnaires. Thermal thresholds and heat pain perception (1 second phasic stimuli: 44 degrees C to 48 degrees C) were evaluated with quantitative sensory testing techniques...

Radiographic evaluation of bone regeneration after the application of plasma rich in growth factors in a lower third molar socket: a case report

Science.gov (United States)

2009-01-01

A 42-year-old Mediterranean male presented complaining of inability to sustain good oral care at the posterior aspect of the lower right jaw. The main problems were food impaction in the area and the subsequent malodor. The patient reported remarkable medical history. Clinical examination revealed local erytherma with noticeable bone defect distal to the second molar with obvious defect in the mesial wall of the third molar; the penetration depth was found to be up to 6 mm. Radiological evaluation confirmed the defect and it was attributed to the mesioangularly partially impacted lower third molar. It was decided that third molar should be extracted and concentrate of the patient's growth factors (PRGF) to be applied into the bony defect to stimulate bone regeneration and promote healing. The third molar tooth was, then, removed surgically and the PRGF, which was prepared preoperatively, was implanted in the socket. At the first postoperative day, moderate pain was the main complaint and was controlled by NSAIDs. One week postoperatively, the sutures were removed and there was good tissue healing on examination. On the fiftieth postoperative day, radiographic evaluation took place and showed noticeable enhancement of density and radio-opacity in the third molar socket area, in comparison with the baseline image. Further, clinical examination showed significant reduction of periodontal pocketing and evidence of new bone formation. In conclusion, PRGF was very successful in stimulating bone regeneration and promote healing following dental extraction. PMID:20062651

Correlational study of impacted and non-functional lower third molar position with occurrence of pathologies

Directory of Open Access Journals (Sweden)

Igor Batista Camargo

2016-09-01

Full Text Available Abstract Background Lower third molar (M3 eruption is unpredictable. The purpose of this study was to correlate radiographic position of M3 on a preexistent film with the current clinical, histopathological, and radiographic findings. Methods A retrospective cohort study was performed. The sample was collected from a database of patients covered by Medical Fund of Brazilian Army. Radiographs were obtained a minimum of 5 years prior to the presurgical visit and after their clinical exam. The primary outcome variables were the teeth positions using Pell and Gregory/Winter classifications on panoramic X-rays. Those variables were analyzed at both the beginning (T0 and end of the study (T1. Clinical assessments and histopathological study of the thirds that were extracted were performed only at T1. Correlation between the teeth positions were related to the clinical, histopathological, and radiographic parameters using statistical analysis tests with significance set at p < 0.05. Results Twenty-six patients with 49 M3 were assessed over 10 months. Mean age was 14.92 years at T0 and 21.87 years at T1. The average time between T0 and T1 was 6.77 years. A significant relationship (p = 0.024 was found between the presences of root resorption on the second molar if M3 presented in an IB horizontal position at T1. There was also a significant correlation (p = 0.039 between dental crowding of the anterior lower teeth with IIIB position at T0 and if the patient finished orthodontic treatment without lingual retainers. Conclusions Lower M3 in position IIIB seen in a teenager and IB seen in an adult is more likely to have negative consequences and should be followed closely.

4% lidocaine versus 4% articaine for inferior alveolar nerve block in impacted lower third molar surgery.

Science.gov (United States)

Boonsiriseth, Kiatanant; Chaimanakarn, Sittipong; Chewpreecha, Prued; Nonpassopon, Natee; Khanijou, Manop; Ping, Bushara; Wongsirichat, Natthamet

2017-03-01

No study has compared lidocaine with articaine, each at a concentration of 4% and combined with epinephrine. The purpose of this study was to compare the effectiveness of 4% lidocaine with that of 4% articaine, with a concentration of 1:100,000 epinephrine added to each, in an inferior alveolar nerve block for surgery on impacted lower third molars. This study was conducted at the Faculty of Dentistry, Mahidol University in Bangkok, Thailand. The randomized, single-blind, comparative split-mouth study was carried out in patients with symmetrically impacted lower third molars, as identified on panoramic radiographs. Each patient underwent surgery for the removal of the lower third molars by the same surgeon under local anesthesia at two separate visits, 3 weeks apart. The onset and duration of local anesthesia, intra-operative pain, surgical duration, and number of additional anesthetics administered were recorded. The subjective and objective onset of action for the local anesthetics showed statistically significant differences (P inferior alveolar nerve block was clinically more effective in the onset of subjective and objective anesthesia as compared with the use of 4% lidocaine. Based on the pain scores from the visual analogue scale, 4% lidocaine provided more analgesia during the procedure, and patients noted less intra-operative pain than with 4% articaine; however, the difference was not clinically significant.

Laser vs bur for bone cutting in impacted mandibular third molar surgery: A randomized controlled trial.

Science.gov (United States)

Passi, Deepak; Pal, Uma Shankar; Mohammad, Shadab; Singh, Rakesh Kumar; Mehrotra, Divya; Singh, Geeta; Kumar, Manoj; Chellappa, Arul A L; Gupta, Chandan

2013-01-01

The aim of this study was to assess the feasibility of Er: YAG laser in bone cutting for removal of impacted lower third molar teeth and compare its outcomes with that of surgical bur. The study comprised 40 subjects requiring removal of impacted mandibular third molar, randomly categorized into two equal groups of 20 each, who had their impacted third molar removed either using Er: YAG laser or surgical bur as per their group, using standard methodology of extraction of impacted teeth. Clinical parameters like pain, bleeding, time taken for bone cutting, postoperative swelling, trismus, wound healing and complications were compared for both groups. Clinical parameters like pain, bleeding and swelling were lower in laser group than bur group, although the difference was statistically not significant. However, postoperative swelling showed significant difference in the two groups. Laser group required almost double the time taken for bone cutting with bur. Trismus persisted for a longer period in laser group. Wound healing and complications were assessed clinically and there was no significant difference in both the groups. Based on the results of our study, the possibility of bone cutting using lasers is pursued, the osteotomy is easily performed and the technique is better suited to minimally invasive surgical procedures. The use of Er: YAG laser may be considered as an alternative tool to surgical bur, specially in anxious patients.

Nonsyndromic Bilateral Multiple Impacted Supernumerary Mandibular Third Molars: A Rare and Unusual Case Report

Directory of Open Access Journals (Sweden)

G. Siva Prasad Reddy

2013-01-01

Full Text Available A supernumerary tooth is that which is present additionally to the normal series and can be found in any region of the dental arch. An impacted tooth is defined as the one which is embedded in the alveolus, so that its eruption is prevented, or the tooth is locked in position by bone or the adjacent teeth. The occurrence of multiple supernumerary teeth in only one patient in the absence of an associated systemic condition or syndrome is considered as a rare phenomenon. The occurrence of supernumerary teeth in the lower molar region is rare. A prevalence of less than 2% of cases occurring in this region has been estimated. Their occurrence presents a clinical problem for orthodontists and oral surgeons. The cause, frequency, complications, and surgical operation of impacted teeth are always interesting subjects for study and research. An impacted tooth can result in caries, pulp disease, periapical and periodontal disease, temporomandibular joint disorder, infection of the fascial space, root resorption of the adjacent tooth, and even oral and maxillofacial tumours. The management of impacted wisdom teeth has changed over the past 20 years from removal of nonsymptomatic third molars to simple observation. The aim of this paper is to present a rare case of bilateral multiple impacted supernumerary mandibular third molars.

Radiologic study of mandibular third molar of Korean youths

International Nuclear Information System (INIS)

Ahn, Hyung Kyu

1982-01-01

The author has made a study on the classification of the mandibular 3rd molars of Korean youths through dental radiography by means of Pell and Gregory's classification and on the prevalence of the dental caries of distal surface of the mandibular 2nd molar adjacent to the mandibular 3rd molars turned anteriorly. The results are as follow; 1. It was found that the largest case number was class I (272 cases, 52.9%) in the relation of the tooth to the ramus of the mandible and 2nd molar. 2. The mesio-angular position was the largest number (239 cases, 46.5%) in the relation of the long axis of the impacted mandibular 3rd molar to the long axis of the 2nd molar. 3. The mesio-angular position of class I was the largest number (140 cases, 27.2%) in the relation of the tooth to the ramus of the mandible and 2nd molar and the long axis of the impacted mandibular 3rd moral to the long axis of the 2nd molar. 4. The average angle of the long axis of mandibular 3rd molar in mesioangular position or horizontal position to the occlusal plane was 143 W 5. Mandibular 3rd molar with lesion such as dental cries or pericoronitis was 73 cases (14.2). 6. The caries incidence rate of the distal surface of the 2nd molar was about 3.1%.

Cone beam volume tomography: an imaging option for diagnosis of complex mandibular third molar anatomical relationships.

Science.gov (United States)

Danforth, Robert A; Peck, Jerry; Hall, Paul

2003-11-01

Complex impacted third molars present potential treatment complications and possible patient morbidity. Objectives of diagnostic imaging are to facilitate diagnosis, decision making, and enhance treatment outcomes. As cases become more complex, advanced multiplane imaging methods allowing for a 3-D view are more likely to meet these objectives than traditional 2-D radiography. Until recently, advanced imaging options were somewhat limited to standard film tomography or medical CT, but development of cone beam volume tomography (CBVT) multiplane 3-D imaging systems specifically for dental use now provides an alternative imaging option. Two cases were utilized to compare the role of CBVT to these other imaging options and to illustrate how multiplane visualization can assist the pretreatment evaluation and decision-making process for complex impacted mandibular third molar cases.

Endodontic management of mandibular third molar with three mesial roots using spiral computed tomography scan as a diagnostic aid: a case report.

Science.gov (United States)

Tomar, Deepak; Dhingra, Anil; Tomer, Anil; Sharma, Shalini; Sharma, Vivek; Miglani, Anjali

2013-05-01

Aberrant root canal anatomy is diagnostically and clinically challenging for clinicians. The most common root canal configuration of human molars is 2 roots and 3 canals, but various combinations may still exist. Third molars are known to have the most unusual anatomy among human teeth. Restorative, prosthetic, and orthodontic considerations often require endodontic treatment of third molars in order for them to be retained as functional components of the dental arch. The present case report demonstrates unusual root canal morphology of the mandibular third molar. Roentgenographic examination, which included spiral CT scan, revealed 3 separate mesial roots in tooth #48 with 3 independent canals and 3 canal orifices, indicating an endodontic rarity. The present case report puts impetus on exploration of additional canals using advanced diagnostic aids, such as spiral computed tomography, which can have a huge impact on the successful outcome of endodontic therapy. Copyright © 2013 Elsevier Inc. All rights reserved.

A Clinical and Cephalometric Study of the Influence of Mandibular Third Molars on Mandibular Anterior Teeth

Directory of Open Access Journals (Sweden)

Tara Ramprakash Kavra

2013-01-01

Various linear and angular measurements from true lateral cephalograms were compared to find the labial inclination of the lower anterior teeth and it was found that it was influenced by the presence of lower third molars.

Pneumomediastinum and subcutaneous emphysema following surgical extraction of mandibular third molars: three case reports.

Science.gov (United States)

Horowitz, I; Hirshberg, A; Freedman, A

1987-01-01

Three cases of subcutaneous emphysema following surgical extraction of lower third molars are presented. In two of the cases, pneumomediastinum developed. The direct cause of these complications is the combination of the use of an air turbine dental handpiece and the flap design. The propagation of the emphysema and means for its prevention are discussed.

Evaluation of a New Surgical Technique for Closing Oroantral Fistula Using Auto-transplanted Upper Third Molar: A 1-Year Follow-Up Study.

Science.gov (United States)

Assad, Mounzer; Alkhaled, Maysaa; Alhajj, Mohammed N

2018-03-01

Oroantral fistula (OAF) is considered a frequent complication in dental practice. Many surgical techniques/methods have been proposed to close it. The aim of this study was to evaluate the auto-transplantation of upper third molar for closing OAF. Twenty patients participated in this study aged between 20 and 40 years old. The OAF was closed by auto-transplantation of upper third molar placed directly in the socket of the extracted tooth. Results were evaluated clinically and radiographically through the period of observation which lasted for 1 year. Final results showed that the success rate of closing OAF was 95% while the success rate of upper third molar auto-transplantation was 90%. This technique is simple, applicable, provides immediate replacement of the missing tooth, and does not require complicated instruments or procedures.

Cleaning and decompression of inferior alveolar canal to treat dysesthesia and paresthesia following endodontic treatment of a third molar

Directory of Open Access Journals (Sweden)

Rudy Scala

2014-01-01

Full Text Available Endodontic overfilling involving the mandibular canal may cause an injury of the inferior alveolar nerve (IAN. We report a case of disabling dysesthesia and paresthesia of a 70-year-old man after endodontic treatment of his mandibular left third molar that caused leakage of root canal filling material into the mandibular canal. After radiographic evaluation, extraction of the third molar and distal osteotomy, a surgical exploration was performed and followed by removal of the material and decompression of the IAN. The patient reported an improvement in sensation and immediate disappearance of dysesthesia already from the first postoperative day.

Cleaning and decompression of inferior alveolar canal to treat dysesthesia and paresthesia following endodontic treatment of a third molar.

Science.gov (United States)

Scala, Rudy; Cucchi, Alessandro; Cappellina, Luca; Ghensi, Paolo

2014-01-01

Endodontic overfilling involving the mandibular canal may cause an injury of the inferior alveolar nerve (IAN). We report a case of disabling dysesthesia and paresthesia of a 70-year-old man after endodontic treatment of his mandibular left third molar that caused leakage of root canal filling material into the mandibular canal. After radiographic evaluation, extraction of the third molar and distal osteotomy, a surgical exploration was performed and followed by removal of the material and decompression of the IAN. The patient reported an improvement in sensation and immediate disappearance of dysesthesia already from the first postoperative day.

Adult or not? Accuracy of Cameriere's cut-off value for third molar in assessing 18 years of age for legal purposes.

Science.gov (United States)

Cameriere, R; Pacifici, A; Viva, S; Carbone, D; Pacifici, L; Polimeni, A

2014-09-01

The discovery of reliable means to determine the age of an individual is a fundamental objective in forensic medicine, in consideration of the constant increase of illegal immigration into the European community. In 2008 Cameriere et al. developed a method based on the relationship between age and the third molar index (I3m), which assesses the degree of maturation of the third molar through measurements made on orthopantomography. The purpose of this work was to test the accuracy of Cameriere's cut-off for I3m as a tool to assess full age (18) on a new sample of living subjects. Orthopantomographs of 287 Italian living subjects aged between 13 and 22 years have been randomly selected and included in the study. Identification number, gender, date of birth and date of execution of the radiograph were recorded for each patient on a Microsoft Excel® spreadsheet. Radiographs were digitalized and analyzed using a computerized image-processing program (Adobe® Photoshop® CS4). The results show that the sensitivity of the test was 84.1% and the specificity was 92.5%. The estimated post-test probability was 90.1%, with a confidence interval of 95% (83.6%, 95.2%). Thus, the probability that a person being positive to the test has 18 or more years of age was 90.1%. The results highlight the contribution of Cameriere's cut-off value for the I3m in the assessment of full age, always remembering that the simultaneous employment of previously introduced complementary methods is essential for the purpose.

Analgesic efficacy of lysine clonixinate plus tramadol versus tramadol in multiple doses following impacted third molar surgery.

Science.gov (United States)

Perez-Urizar, J; Martínez-Rider, R; Torres-Roque, I; Garrocho-Rangel, A; Pozos-Guillen, A

2014-03-01

This study compared the analgesic and anti-inflammatory efficacy, trismus control, and tolerability of the combination of lysine clonixinate and tramadol (LCT) versus tramadol (T) alone after surgical removal of impacted mandibular third molars. This study was a double-blind, randomized clinical trial, including two study groups of 20 patients each, who exhibited acute pain subsequent to surgical extraction of two mandibular third molars. Pain intensity was quantified over a 96-h period using a visual analogue scale and a 5-point verbal rating scale. Secondary indicators of analgesic and anti-inflammatory efficacy, trismus control, and tolerability were determined. Patients administered LCT exhibited better therapeutic effects that those administered T. Fifty percent of patients in the LCT group rated this therapy as 'excellent analgesia' compared with only 10% in the T group. The onset of the analgesic effect of LCT was significantly faster, without any therapeutic failures. There were no significant differences between the groups with regard to anti-inflammatory effect or trismus. The results of this study suggest that the postsurgical analgesic efficacy of LCT in combination (LC 125 mg + T 25 mg) is superior to that obtained with T alone, administered at the standard dose of 50 mg, for up to 96 h after the extraction of both impacted mandibular third molars. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Percutaneous self-injury to the femoral region caused by bur breakage during surgical extraction of a patient's impacted third molar.

Science.gov (United States)

Yu, Tae Hoon; Lee, Jun; Kim, Bong Chul

2015-10-01

Extraction of an impacted third molar is one of the most frequently performed techniques in oral and maxillofacial surgery. Surgeons can suffer numerous external injuries while extracting a tooth, with percutaneous injuries to the hand being the most commonly reported. In this article, we present a case involving a percutaneous injury of the surgeon's femoral region caused by breakage of the fissure bur connected to the handpiece during extraction of the third molar. We also propose precautions to prevent such injuries and steps to be undertaken when they occur.

Molar development in sheep: morphology, radiography, microhardness

International Nuclear Information System (INIS)

Milhaud, G.; Nezit, J.

1991-01-01

The chronology of molar development is studied from radiographic and macroscopic observations on 48 south Pre-Alps were living under optimal nutritional conditions. It was found that the first molar started its development in utero, the second molar at one month after birth, and the third molar, at 9-10 months. The first molar emerged into the oral cavity at 3 months, the second at 9 months and the third molar at 18 months. The first molar began the development of its roots at 6-7 months, the second molar at 11-12 months and the third molar at 20-22 months. The first molar reached completion of the growth of its roots at 3.5-4 years, the second and the third molars at about 6 years. The molars show the particularity of being functional during the three months which follow their eruption although the development of the crown is not completed. Then the accelerated wear is only partially compensated by the growth of the roots. The study also shows how the combined effects of wear and dentine deposit in the pulp cavity affect the morphology of molars. It reveals the marked hardness of enamel (240 Vickers units) and the low resistance of dentine at the surface of attrition (30 Vickers units)

Molar height and dentoalveolar compensation in adult subjects with skeletal open bite.

Science.gov (United States)

Kucera, Josef; Marek, Ivo; Tycova, Hana; Baccetti, Tiziano

2011-07-01

To evaluate the skeletal and dentoalveolar components in adult subjects with skeletal open bite in the presence or absence of dental compensation. The study sample included 69 adult female subjects who belonged to three groups according to skeletal vertical relationships and overbite. A total of 15 variables (5 angular, 10 linear) were evaluated. Values in the dentally compensated open bite group (COBG), the dentally noncompensated open bite group (NCOBG), and the control group with normal vertical skeletal relationships and overbite (CG) were compared by means of parametric statistics. The COBG and the NCOBG showed significantly greater incisor and molar heights in both jaws than the CG. No significant difference in upper or lower molar height was found between COBG and NCOBG. Incisor height was significantly greater in COBG than in NCOBG. Elongation in the incisor region was accompanied by significant narrowing of the lower anterior alveolar process in both skeletal open bite groups. Proclination of the upper incisors was significantly smaller in the COBG than in the other groups. Dentoalveolar components consisting of incisor elongation and inclination play a significant role in compensating for skeletal open bite configuration in adult subjects. Increased molar height is a common finding in adults with skeletal open bite.

A three-dimensional finite element analysis of molar distalization with a palatal plate, pendulum, and headgear according to molar eruption stage

Science.gov (United States)

Kang, Ju-Man; Park, Jae Hyun; Bayome, Mohamed; Oh, Moonbee; Park, Chong Ook; Mo, Sung-Seo

2016-01-01

Objective This study aimed to (1) evaluate the effects of maxillary second and third molar eruption status on the distalization of first molars with a modified palatal anchorage plate (MPAP), and (2) compare the results to the outcomes of the use of a pendulum and that of a headgear using three-dimensional finite element analysis. Methods Three eruption stages were established: an erupting second molar at the cervical one-third of the first molar root (Stage 1), a fully erupted second molar (Stage 2), and an erupting third molar at the cervical one-third of the second molar root (Stage 3). Retraction forces were applied via three anchorage appliance models: an MPAP with bracket and archwire, a bone-anchored pendulum appliance, and cervical-pull headgear. Results An MPAP showed greater root movement of the first molar than crown movement, and this was more noticeable in Stages 2 and 3. With the other devices, the first molar showed distal tipping. Transversely, the first molar had mesial-out rotation with headgear and mesial-in rotation with the other devices. Vertically, the first molar was intruded with an MPAP, and extruded with the other appliances. Conclusions The second molar eruption stage had an effect on molar distalization, but the third molar follicle had no effect. The application of an MPAP may be an effective treatment option for maxillary molar distalization. PMID:27668192

A Four-Year Monocentric Study of the Complications of Third Molars Extractions under General Anesthesia: About 2112 Patients

Directory of Open Access Journals (Sweden)

A. Guerrouani

2013-01-01

Full Text Available Introduction. The aim of this study was to assess the complications resulting from third molar extraction under general anesthesia. Material and Methods. The retrospective study included all patients who underwent impacted third molars extraction from January 2008 until December 2011. 7659 third molars were extracted for 2112 patients. Postoperative complications were retrieved from medical files. Results. No complications were related to general anesthesia. The most frequent postoperative complication was infection (7.15%. Lingual nerve injuries affected 1.8% of the patients. All of them were transient and were not related to tooth section. Inferior alveolar nerve injuries were reported in 0.4% of the cases. 95.8% of these patients were admitted for one-day ambulatory care, and only two patients were readmitted after discharge from hospital. Discussion. This surgical technique offers comfort for both surgeons and patients. Risks are only linked to the surgical procedure as we observed no complication resulting from general anesthesia. One-day hospitalization offers a good balance between comfort, security, and cost. The incidence of complications is in agreement with the literature data, especially regarding pain, edema, and infectious and nervous complications. It is of utmost importance to discuss indications with patients, and to provide them with clear information.

Impact of informed consent on patient decisions regarding third ...

African Journals Online (AJOL)

Purpose: We investigated whether the order in which patients learned about complication risks affected their anxiety about and willingness to undergo the removal of their third molar. Materials and Methods: In total, 171 patients (65 males, 106 females) were included in the study. The distributions of gender and the position ...

Management of Chronic Hyperplastic Pulpitis in Mandibular Molars of Middle Aged Adults- A Multidisciplinary Approach

Science.gov (United States)

Lingeswaran, Somiya; Ari, Geetha; Thyagarajan, Ramakrishnan; Logaranjani, Anitha

2016-01-01

The molar tooth of children and young adults is a common site for chronic hyperplastic pulpitis (pulp polyp). It rarely occurs in middle aged adults. This condition is usually characterized by extensive involvement of the pulp, dictating the extraction of involved tooth. Extraction of permanent molars can lead to transient or permanent malocclusion, aesthetic, phonetic and functional problems. Here we report a case of pulp polyp in mandibular first molar of a 33-year-old woman that grew into the carious cavity. The aim of this case report is to describe the diagnosis of a chronic hyperplastic pulpitis involving the permanent molar as well as to describe its management in order to preserve them as a functional unit of the dentition. PMID:26894192

Measure of frequency of alveolar osteitis using two different methods of osteotomy in mandibular third molar impactions: a double-blind randomized clinical trial

International Nuclear Information System (INIS)

Rashid, H.; Amin, M.; Hussain, A.; Azam, K.

2018-01-01

Dento-alveolar surgical procedures involving third molar teeth are the most common surgical procedure in the field of surgery. The objective of this research was to analyse the impact of surgery on the incidence of alveolar osteitis after surgical removal of mandibular third molar and to compare two different bone cutting methods following impacted mandibular third molar surgery. Methods: This double blinded randomized clinical trial was executed at the OPD of Department of Oral and Maxillofacial Surgery, Dow University of Health Sciences, Karachi. The study duration was four months. It was conducted on 60 patients needing unilateral mandibular third molar impaction removal. Patients were randomized to two groups (i.e., physio dispenser group and slow speed handpiece group) before surgery. The surgical procedure was performed under local anaesthesia by using standardized cross infection protocol. The frequency of alveolar osteitis was evaluated on third-day postoperatively. Alveolar osteitis was diagnosed and confirmed by patient's history and clinical evaluation. Post-operative sequelae were observed and recorded objectively. Results: Out of 60 patients', five patients experienced alveolar osteitis, and the incidence rate was 8.3%. A significant p-value of 0.000 was calculated using binomial test for comparison of alveolar osteitis among both groups. Inter-examiner reliability was assessed by kappa and good (62%) agreement, which was found among the examiners, who diagnosed alveolar osteitis clinically. Post-operative sequelae were insignificant in slow speed hand piece group. Conclusion: It was observed that alveolar osteitis was reported in physio-dispenser group; similarly, post-operative complications were also more in this group as compared with slow speed-hand piece group. No surgical complications were observed in slow speed-hand piece group suggesting slow speed hand piece mode of osteotomy to be safer for third molar extraction as compared with

Periodontal considerations in the use of bonds or bands on molars in adolescents and adults.

Science.gov (United States)

Boyd, R L; Baumrind, S

1992-01-01

This longitudinal study compared the periodontal status of bonded and banded molars in 20 adult and 40 adolescent patients before, during and after treatment with fixed orthodontic appliances. Plaque accumulation (measured by the Plaque Index), gingival inflammation (measured by the Gingival Index and the bleeding tendency), and pocket depth were assessed by one examiner at sites along the mesio-buccal line angle of the maxillary right first molar and the mandibular left first molar. Assessments were made immediately prior to the placement of fixed appliances (pretreatment), at 1, 3, 6, 9, 12 and 18 months after appliances were placed; and 3 months after appliances were removed (posttreatment). Loss of attachment between the pretreatment and posttreatment visits also was determined. At pretreatment, no significant differences were found in gingival inflammation between maxillary and mandibular banded and bonded molars. During treatment, both maxillary and mandibular banded molars showed significantly (p less than 0.05) greater gingival inflammation and plaque accumulation than did bonded molars. Three months after appliance removal, the maxillary molars that had been banded continued to show significantly more gingival inflammation and loss of attachment than did the maxillary molars that had been bonded. When all banded and bonded teeth were grouped by patient age, mean values for plaque accumulation and gingival inflammation in the maxillary molar regions were significantly greater for adolescents than for adults.

Ectopic third molar in maxillary sinus: A rare case report

Directory of Open Access Journals (Sweden)

Abhishek Sinha

2017-01-01

Full Text Available Ectopic tooth eruption in a non-dental area is a rare entity, and is most common in oral cavity. There have been a few case reports of teeth erupting in mandibular condyle, chin, palate, coronoid process, and maxillary sinus. Ectopic tooth in the maxillary sinus are found incidentally on routine radiological examination, same time they can be symptomatic and associated with pathologies usually dentigerous cyst or odontogenic keratocyst. Facial pain, purulent rhinorrhoea, epistaxis, headache, swelling, and epiphora-related naso-lacrimal duct obstruction can also be seen. By Caldwell-Luc procedure the ectopic teeth within the maxillary sinus are often removed. In this study, a case of ectopic maxillary third molar tooth on right maxillary sinus is presented.

Proliferation of epithelial rests of Malassez following auto-transplantation of third molars: a case report

Directory of Open Access Journals (Sweden)

Schepers Serge

2010-10-01

Full Text Available Abstract Introduction Auto-transplantation of third molars is frequently undertaken in order to restore a perfect occlusion and to improve mastication following a substantial loss of molars. However, little is known about the precise role of the periodontal membrane during this procedure. Therefore, we investigated if the epithelial rests of Malassez persist in the periodontal ligament of auto-transplanted teeth and, if so, whether these may show signs of a neuro-epithelial relationship. Case presentation We report a case of a 21-year-old Caucasian woman who underwent an auto-transplantation of two third molars. After two years, renewed progressive caries of the auto-transplanted teeth led to the removal of the auto-transplanted elements. The periodontal ligament was removed and studied with a light and transmission electron microscope. Conclusion In this report we examined the ultrastructure of the periodontal ligament after auto-transplantation in order to see if the periodontal ligament recovers completely from this intervention. We observed fully developed blood vessels and a re-innervation of the epithelial rests of Malassez which were proliferating following auto-transplantation. This proliferation might be critical in the remodelling of the alveolar socket in order to provide a perfect fit for the transplanted tooth. In order to minimalise the damage to the epithelial rests of Malassez, the extraction of the tooth should be as atraumatic as possible in order to provide an optimal conservation of the periodontal ligament which will be beneficial to the healing-process.

Radiographic evaluation of third-molar development in relation to the chronological age of Turkish children in the southwest Eastern Anatolia region.

Science.gov (United States)

Karataş, Orhan H; Öztürk, Fırat; Dedeoğlu, Numan; Çolak, Cemil; Altun, Oğuzhan

2013-10-10

To study the chronological age of third-molar mineralisation of Turkish children from the southwest Eastern Anatolia region, the Demirjian staging method was used to determine the stage of the mineralisation of four third molars (18, 28, 38 and 48) and to compare third-molar development by sex and age with the results of previous studies. The study comprised 832 Turkish children from the southwest Eastern Anatolia region aged 6-16 years based on radiological evidence from digital orthopantomograms. The mean age of the 832 patients was 11.03±1.98 years, with 424 males (mean age, 10.97±1.97) and 408 females (mean age, 11.09±2.00). The orthopantomograms were scored by two observers. The Wilcoxon matched-pairs signed-rank test used to assess intra- and inter-observer assessment revealed strong agreement between both observers' measurements. Statistical analysis of the association between sex and age was performed with the Mann-Whitney U-test and the Wilcoxon test. Regression analysis was performed to obtain regression formulae for calculating the dental and the chronological age. The statistical analysis showed a strong correlation between age and third-molar development in males (R(2)=0.61) and females (R(2)=0.63). New equations (age=7.49+0.69, development stage (DS) 38+0.70, DS18) were derived for estimation of the chronological age. The results showed that there was no significant difference in mineralisation between 18 and 28 and 38 and 48 in males or females. For both sexes, the dental age was lower than the chronological age. Males reached the developmental stages earlier than females. In the whole population, the boys' and the girls' dental ages were 0.84 years and 0.16 years earlier, respectively, than their chronological ages. The use of third-molar teeth as a developmental marker is suitable, particularly when comparing the obtained standard deviation with other skeletal-age calculation techniques. Copyright © 2013 Elsevier Ireland Ltd. All rights

Accuracy of an equation for estimating age from mandibular third molar development in a Thai population

Energy Technology Data Exchange (ETDEWEB)

Verochana, Karune; Prapayasatok, Sangsom; Janhom, Apirum; Mahasantipiya, Phattaranant May; Korwanich, Narumanas [Faculty of Dentistry, Chiang Mai University, Chiang Mai (Thailand)

2016-03-15

This study assessed the accuracy of age estimates produced by a regression equation derived from lower third molar development in a Thai population. The first part of this study relied on measurements taken from panoramic radiographs of 614 Thai patients aged from 9 to 20. The stage of lower left and right third molar development was observed in each radiograph and a modified Gat score was assigned. Linear regression on this data produced the following equation: Y=9.309+1.673 mG+0.303S (Y=age; mG=modified Gat score; S=sex). In the second part of this study, the predictive accuracy of this equation was evaluated using data from a second set of panoramic radiographs (539 Thai subjects, 9 to 24 years old). Each subject's age was estimated using the above equation and compared against age calculated from a provided date of birth. Estimated and known age data were analyzed using the Pearson correlation coefficient and descriptive statistics. Ages estimated from lower left and lower right third molar development stage were significantly correlated with the known ages (r=0.818, 0.808, respectively, P≤0.01). 50% of age estimates in the second part of the study fell within a range of error of ±1 year, while 75% fell within a range of error of ±2 years. The study found that the equation tends to estimate age accurately when individuals are 9 to 20 years of age. The equation can be used for age estimation for Thai populations when the individuals are 9 to 20 years of age.

Accuracy of an equation for estimating age from mandibular third molar development in a Thai population

International Nuclear Information System (INIS)

Verochana, Karune; Prapayasatok, Sangsom; Janhom, Apirum; Mahasantipiya, Phattaranant May; Korwanich, Narumanas

2016-01-01

This study assessed the accuracy of age estimates produced by a regression equation derived from lower third molar development in a Thai population. The first part of this study relied on measurements taken from panoramic radiographs of 614 Thai patients aged from 9 to 20. The stage of lower left and right third molar development was observed in each radiograph and a modified Gat score was assigned. Linear regression on this data produced the following equation: Y=9.309+1.673 mG+0.303S (Y=age; mG=modified Gat score; S=sex). In the second part of this study, the predictive accuracy of this equation was evaluated using data from a second set of panoramic radiographs (539 Thai subjects, 9 to 24 years old). Each subject's age was estimated using the above equation and compared against age calculated from a provided date of birth. Estimated and known age data were analyzed using the Pearson correlation coefficient and descriptive statistics. Ages estimated from lower left and lower right third molar development stage were significantly correlated with the known ages (r=0.818, 0.808, respectively, P≤0.01). 50% of age estimates in the second part of the study fell within a range of error of ±1 year, while 75% fell within a range of error of ±2 years. The study found that the equation tends to estimate age accurately when individuals are 9 to 20 years of age. The equation can be used for age estimation for Thai populations when the individuals are 9 to 20 years of age

Accuracy of an equation for estimating age from mandibular third molar development in a Thai population.

Science.gov (United States)

Verochana, Karune; Prapayasatok, Sangsom; Janhom, Apirum; Mahasantipiya, Phattaranant May; Korwanich, Narumanas

2016-03-01

This study assessed the accuracy of age estimates produced by a regression equation derived from lower third molar development in a Thai population. The first part of this study relied on measurements taken from panoramic radiographs of 614 Thai patients aged from 9 to 20. The stage of lower left and right third molar development was observed in each radiograph and a modified Gat score was assigned. Linear regression on this data produced the following equation: Y=9.309+1.673 mG+0.303S (Y=age; mG=modified Gat score; S=sex). In the second part of this study, the predictive accuracy of this equation was evaluated using data from a second set of panoramic radiographs (539 Thai subjects, 9 to 24 years old). Each subject's age was estimated using the above equation and compared against age calculated from a provided date of birth. Estimated and known age data were analyzed using the Pearson correlation coefficient and descriptive statistics. Ages estimated from lower left and lower right third molar development stage were significantly correlated with the known ages (r=0.818, 0.808, respectively, P≤0.01). 50% of age estimates in the second part of the study fell within a range of error of ±1 year, while 75% fell within a range of error of ±2 years. The study found that the equation tends to estimate age accurately when individuals are 9 to 20 years of age. The equation can be used for age estimation for Thai populations when the individuals are 9 to 20 years of age.

Considerations of mandibular angle fractures during and after surgery for removal of third molars: a review of the literature.

Science.gov (United States)

Chrcanovic, Bruno Ramos; Custódio, Antônio Luís Neto

2010-06-01

Angle fractures are quite common considering that the angle of the mandible forms an area of lower resistance which contains a thicker upper border, a thin basilar bone, and the presence of an impacted mandibular third molar. Common complications of mandibular third molar surgery include alveolar osteitis (dry socket), secondary infection, nerve dysfunction, and hemorrhage. Reports of mandibular fracture during and after third molar removal are uncommon. The purpose of this paper is to discuss the risk and predisposing factors that should be analyzed regarding the possibility of immediate and late mandibular angle fractures and their need for surgical treatment as a means through which to remove impacted molars. This study is based on a thorough review of the literature as well as on one immediate and one late mandibular angle fracture as described by the authors' own personal experience. The danger of an immediate jaw fracture can be avoided by means of proper instrumentation and by refraining from excessive force on the bone. The tooth should be sectioned in such a way as to minimize the extent of bone removal and force caused by instrumentation. The danger of a late jaw fracture can be avoided by precise diagnosis in cases of patients over 25 years of age, particularly men, whose tooth roots are superimposed on or adjacent to the inferior alveolar canal on a panoramic image, any local pathology and systemic disease or medications which may impair bone strength, and patients who present bruxism and are active athletes.

A finite element analysis of the stress distribution to the mandible from impact forces with various orientations of third molars*

Science.gov (United States)

Liu, Yun-feng; Wang, Russell; Baur, Dale A.; Jiang, Xian-feng

2018-01-01

Objective: To investigate the stress distribution to the mandible, with and without impacted third molars (IM3s) at various orientations, resulting from a 2000-Newton impact force either from the anterior midline or from the body of the mandible. Materials and methods: A 3D mandibular virtual model from a healthy dentate patient was created and the mechanical properties of the mandible were categorized to 9 levels based on the Hounsfield unit measured from computed tomography (CT) images. Von Mises stress distributions to the mandibular angle and condylar areas from static impact forces (Load I-front blow and Load II left blow) were evaluated using finite element analysis (FEA). Six groups with IM3 were included: full horizontal bony, full vertical bony, full 450 mesioangular bony, partial horizontal bony, partial vertical, and partial 450 mesioangular bony impaction, and a baseline group with no third molars. Results: Von Mises stresses in the condyle and angle areas were higher for partially than for fully impacted third molars under both loading conditions, with partial horizontal IM3 showing the highest fracture risk. Stresses were higher on the contralateral than on the ipsilateral side. Under Load II, the angle area had the highest stress for various orientations of IM3s. The condylar region had the highest stress when IM3s were absent. Conclusions: High-impact forces are more likely to cause condylar rather than angular fracture when IM3s are missing. The risk of mandibular fracture is higher for partially than fully impacted third molars, with the angulation of impaction having little effect on facture risk. PMID:29308606

Cryotherapy and Topical Minocycline as Adjunctive Measures to Control Pain After Third Molar Surgery: An Exploratory Study

Science.gov (United States)

Gelesko, Savannah; Long, Leann; Faulk, Jan; Phillips, Ceib; Dicus, Carolyn; White, Raymond P.

2013-01-01

Purpose To assess the impact of cryotherapy or topical minocycline on patients’ perceptions of recovery from pain after third molar surgery in an exploratory comparative-effectiveness study. Patients and Methods Subjects aged at least 14 years who were having all 4 third molars removed were enrolled in 3 separate institutional review board–approved studies. Study groups included subjects treated with a passively applied cold wrap for 24 hours postoperatively, subjects treated with topical minocycline during surgery, and subjects enrolled in a nonconcurrent comparison group who had received neither topical minocycline nor directed cryotherapy. Third molar surgery was performed in all cases by trained surgeons using the same protocol. An exact Kruskal-Wallis test was used to compare the distributions of the worst and average pain scores and a Fisher exact test to compare verbal responses from Gracely pain scales among the 3 groups for postsurgical days (PSDs) 1 to 3. Results This study comprised 51 cryotherapy subjects (2005–2009), 63 minocycline subjects (2003–2004), and 92 comparison-group subjects (2002–2006) who were treated at academic centers and in community practices across the United States (N = 206). Demographic descriptors were similar among all groups. For PSDs 1 through 3 (unadjusted), the highest scores for worst pain (6–7 [out of 7] on Likert-type scale) were reported less frequently in each of the study groups than in subjects in the comparison group, although the numbers of subjects reporting the highest scores were few. The distribution of pain outcomes was significantly different among the 3 groups for worst pain and affective words on PSD 1 (P = .04 for both). However, the small number of subjects who reported the highest pain scores precluded adequate multivariate statistical analyses for all outcomes on PSD 1 to 3. Conclusions Data from this exploratory study suggest that adjunctive therapy to decrease postoperative pain�

Characteristic findings on panoramic radiography and cone-beam CT to predict paresthesia after extraction of impacted third molar.

Science.gov (United States)

Harada, Nana; Beloor Vasudeva, Subash; Matsuda, Yukiko; Seki, Kenji; Kapila, Rishabh; Ishikawa, Noboru; Okano, Tomohiro; Sano, Tsukasa

2015-01-01

The purpose of this study was to compare findings on the relationship between impacted molar roots and the mandibular canal in panoramic and three-dimensional cone-beam CT (CBCT) images to identify those that indicated risk of postoperative paresthesia. The relationship between impacted molars and the mandibular canal was first classified using panoramic images. Only patients in whom the molar roots were either in contact with or superimposed on the canal were evaluated using CBCT. Of 466 patients examined using both panoramic and CBCT images, 280 underwent surgical extraction of an impacted molar, and 15 of these (5%) reported postoperative paresthesia. The spatial relationship between the impacted third molar root and the mandibular canal was determined by examining para-sagittal sections (lingual, buccal, inter-radicular, inferior, and combinations) obtained from the canal to the molar root and establishing the proximity of the canal to the molar root (in contact with or without loss of the cortical border and separate). The results revealed that darkening of the roots with interruption of the mandibular canal on panoramic radiographs and the inter-radicular position of the canal in CBCT images were characteristic findings indicative of risk of postoperative paresthesia. These results suggest that careful surgical intervention is required in patients with the above characteristics.

Autotransplantation of immature third molars using a computer-aided rapid prototyping model: a report of 4 cases.

Science.gov (United States)

Jang, Ji-Hyun; Lee, Seung-Jong; Kim, Euiseong

2013-11-01

Autotransplantation of immature teeth can be an option for premature tooth loss in young patients as an alternative to immediately replacing teeth with fixed or implant-supported prostheses. The present case series reports 4 successful autotransplantation cases using computer-aided rapid prototyping (CARP) models with immature third molars. The compromised upper and lower molars (n = 4) of patients aged 15-21 years old were transplanted with third molars using CARP models. Postoperatively, the pulp vitality and the development of the roots were examined clinically and radiographically. The patient follow-up period was 2-7.5 years after surgery. The long-term follow-up showed that all of the transplants were asymptomatic and functional. Radiographic examination indicated that the apices developed continuously and the root length and thickness increased. The final follow-up examination revealed that all of the transplants kept the vitality, and the apices were fully developed with normal periodontal ligaments and trabecular bony patterns. Based on long-term follow-up observations, our 4 cases of autotransplantation of immature teeth using CARP models resulted in favorable prognoses. The CARP model assisted in minimizing the extraoral time and the possible Hertwig epithelial root sheath injury of the transplanted tooth. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Measure Of Frequency Of Alveolar Osteitis Using Two Different Methods Of Osteotomy In Mandibular Third Molar Impactions: A Double-Blind Randomized Clinical Trial.

Science.gov (United States)

Rashid, Hina; Hussain, Azmina; Sheikh, Abdul Hafeez; Azam, Kehkishan; Malik, Sofia; Amin, Muhammad

2018-01-01

Dento-alveolar surgical procedures involving third molar teeth are the most common surgical procedure in the field of surgery. The objective of this research was to analyse the impact of surgery on the incidence of alveolar osteitis after surgical removal of mandibular third molar and to compare two different bone cutting methods following impacted mandibular third molar surgery.. This double blinded randomized clinical trial was executed at the OPD of Department of Oral and Maxillofacial Surgery, Dow University of Health Sciences, Karachi. The study duration was four months. It was conducted on 60 patients needing unilateral mandibular third molar impaction removal. Patients were randomized to two groups (i.e., physio dispenser group and slow speed handpiece group) before surgery. The surgical procedure was performed under local anaesthesia by using standardized cross infection protocol. The frequency of alveolar osteitis was evaluated on thirdday postoperatively. Alveolar osteitis was diagnosed and confirmed by patient's history and clinical evaluation. Post-operative sequelae were observed and recorded objectively. Out of 60 patients', five patients experienced alveolar osteitis, and the incidence rate was 8.3%. A significant pvalue of 0.000 was calculated using binomial test for comparison of alveolar osteitis among both groups. Inter-examiner reliability was assessed by kappa and good (62%) agreement, which was found among the examiners, who diagnosed alveolar osteitis clinically. Post-operative sequelae were insignificant in slow speed hand piece group. It was observed that alveolar osteitis was reported in physio-dispenser group; similarly, post-operative complications were also more in this group as compared with slow speed-hand piece group. No surgical complications were observed in slow speed-hand piece group suggesting slow speed hand piece mode of osteotomy to be safer for third molar extraction as compared with physio-dispenser.

Comparison of Articaine and Lidocaine for Buccal Infiltration After Inferior Alveolar Nerve Block For Intraoperative Pain Control During Impacted Mandibular Third Molar Surgery.

Science.gov (United States)

da Silva-Junior, Geraldo Prisco; de Almeida Souza, Liane Maciel; Groppo, Francisco Carlos

In order to compare the efficacy of lidocaine and articaine for pain control during third molar surgery, 160 patients presenting bilateral asymptomatic impacted mandibular third molars were selected. They received 1.8 mL of 2% lidocaine with epinephrine 1:100,000 during inferior alveolar nerve block. In group 1 (n = 80), an infiltrative injection of 0.9 mL of 2% lidocaine with epinephrine 1:100,000 was performed in buccal-distal mucosa of the third molar. Group 2 (n = 80) received 0.9 mL of 4% articaine with epinephrine 1:100,000 in the contralateral side. All procedures were performed at the same visit, by a single operator, in a double-blind and parallel design. The duration of each surgery and the moment when the patient expressed pain were noted. Data were analyzed by nonpaired t test and chi-square test (alpha = 5%). Duration of surgery did not differ (p = .83) between Groups 1 (19.8 ± 2.3 minutes) and 2 (19.7 ± 3.0 minutes). Pain was expressed more in group 1 (26.3%) than in group 2 (10%) (odds ratio = 3.2, p = .0138). In both groups, tooth sectioning was the most painful event (p inferior alveolar nerve block in controlling intraoperative pain related to impacted mandibular third molar surgery.

A Novel Proforma for Clinical and Radiographic Evaluation of Impacted Third Molars Prior to Surgical Removal

Directory of Open Access Journals (Sweden)

Dhuvad Jigar M

2017-02-01

Full Text Available Background: Dental surgeons and resident doctors of oral surgery who encounter the complex situation during the third molar removal, such as those in unexpected areas, often have limited resources to provide a structured care. Therefore, there is always a need for simple, easy to memorize, situate into practice, comprehensive and cost-effective “Proforma of third molar evaluation” required. Objective: The purpose of this paper was to facilitate the residents of oral and maxillofacial surgery and the dentists throughout their preliminary phase, by organizing the comprehensive proforma for evaluating upper and lower wisdom tooth impactions, access and anticipate the difficulty, judge intraoperative tribulations they might encounter and hence, prepare an appropriate treatment plan. Materials and methods: The available literature relevant to oral and maxillofacial surgery in online database of the United States National Library of Medicine: PubMed (http://www. ncbi.nlm.nih.gov/pubmed/ was investigated. The inclusion criterion was to review the published clinical papers, abstracts, and evidence based reviews on “Preoperative Evaluation of Impacted Third Molar”. Results: Thirty-six articles found with the search term “Preoperative Evaluation of Impacted Third Molar” in the literature were searched. Thirteen articles met the inclusion criteria for the study. The relevant data extracted and discussed. Conclusion: The advantages of the proforma uses were reported for inpatient care with correct diagnosis, treatment, follow up and prevention of the any superfluous complications further and improved the quality of patient care.

Three-dimensional cone-beam computed tomography: A new approach to the diagnosis and treatment planning of impacted mandibular third molars

International Nuclear Information System (INIS)

Kanazirska, P.; Yordanov, G.; Angelova, I.; Kanazirski, N.

2017-01-01

Cone Beam Computed Tomography (CBCT) is a relatively new method in dental practice which raises a more precise diagnosis and correct treatment plan. The image of the impacted teeth and surrounding structures with CBCT are with better quality and informativity than the conventional imaging-diagnostic methods . The use of CBCT to determine the ratio of the impacted teeth to the mandibular canal is necessary for the prevention of complications associated with iatrogenic trauma to the vascular- nerve bundle. The aim of this study was to determine the anatomic relationship between the roots of impacted third molars and mandibular canal using CBCT imaging. The studied patients with impacted third molars of the mandible are 127, aged 17 through 60.They were examined with Cone-beam Computed Tomography (CBCT). From the 195 impacted third molar with the - higher frequency are those in which the channel is below their roots-107 teeth (54.9%). The second frequency are the teeth where the channel is located lingually-57 (29.2%). Follow the teeth, in which the channel has a buccal location-25 (12.8%). With the lowest frequency are cases in which the mandibular canal is between the roots of impacted teeth-6 teeth (3.1%).At 132 teeth (67.7%) mandibular canal is at a distance of 1 mm. At 63 teeth (32.3%) the channel is at a distance of over 1 mm. The high resolution cuts in different planes and three-dimensional reconstructions made substantially as set forth preferred for different specialists in dentistry. Precise measurements of the bone around the mandibular canal prevent damage to neurovascular bundle. This makes the method preferred for planning appropriate treatment. Key words: Cone Beam Computed Tomography. Impacted Third Molars. Mandibular Canal [bg

Comparison of clinical parameters and environmental noise levels between regular surgery and piezosurgery for extraction of impacted third molars

Directory of Open Access Journals (Sweden)

Hao-Hueng Chang

2015-10-01

Conclusion: The piezosurgery device produced noise levels similar to or lower than those of the high-speed drilling device. However, piezosurgery provides advantages of increased patient comfort during extraction of impacted third molars.

Comparative evaluation of surgical outcome after removal of impacted mandibular third molars using a Piezotome or a conventional handpiece: a prospective study.

Science.gov (United States)

Goyal, Manoj; Marya, Karan; Jhamb, Aakarsh; Chawla, Sonia; Sonoo, Priyanshu Ranjan; Singh, Veenita; Aggarwal, Anuj

2012-09-01

Our aim was to compare the use of a conventional rotary handpiece and a Piezosurgical unit for extraction of lower third molars. We studied 40 patients, who were allocated alternately to have the third molar removed with either the handpiece or the Piezosurgical unit. Pain, trismus, and oedema were evaluated at baseline and then postoperatively, together with paraesthesiae, on postoperative days 1, 3, 5, 7, and 15. Damage to surrounding tissue was checked on the same day whereas dry socket was evaluated from postoperative day 3 onwards. More patients complained of pain in the conventional group, they also required more analgesics, and they developed trismus more often than in the Piezosurgery group. There was also significantly more postoperative swelling in the conventional group. Patients were also evaluated using the subjective Postoperative Symptom Severity (PoSSe) scale. Our results suggest that apart from some inherent limitations with the Piezotome, it is a valuable alternative for extraction of third molars. Copyright © 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Effects of platelet-rich fibrin and piezosurgery on impacted mandibular third molar surgery outcomes.

Science.gov (United States)

Uyanık, Lokman Onur; Bilginaylar, Kani; Etikan, İlker

2015-07-26

The aim of this study was the comparision of postoperative outcomes in impacted mandibular third molars that were treated using either platelet-rich fibrin (PRF), a combination of PRF and piezosurgery, or conventional rotatory osteotomy. The study included 20 patients; 40 extractions of impacted mandibular third molars were performed. Patients were divided into two main groups. In group A (n = 20), traditional surgery was performed on one side (Group 1, n = 10); traditional surgery was performed, and PRF was administered to the extracted socket on the other side of same patient (Group 2, n = 10). In group B (n = 20), on one side, piezosurgery was used for osteotomy, and PRF was administered (Group 3, n = 10); on the other side of same patient, traditional surgery was performed (Group 4, n = 10). Parameters assessed at baseline for each patient included pain, the number of analgesics taken, trismus, and cheek swelling. These variables were also assessed on postoperative days 1, 2, 3, and 7. Statistical analysis revealed a significant reduction in postoperative pain (sum of 1(st), 2(nd), 3(rd) and 7(th) days) and trismus (on postoperative day 1) in group 2 (traditional surgery + PRF group), and in postoperative pain, the number of analgesics taken (sum of 1(st), 2(nd),3(rd) and 7(th) days) and trismus (on postoperative day 1) in group 3 (piezosurgery + PRF group) compared to groups 1 and 4 (traditional surgery groups), (p ≤ 0.05). However, swelling on postoperative days 1, 3, and 7 did not differ among the groups (p > 0.05). Only difference was on second day between groups 1-4 and 2-4 (p ≤ 0.05). The results of our study have shown that the use of PRF with traditional surgery and PRF combined with piezosurgery significantly reduced pain during the postoperative period. In addition, PRF in combination with piezosurgery significantly decreased the number of analgesics taken. Both operations also significantly decreased

A rare variant of internal anatomy of a third mandibular molar: a case report.

Science.gov (United States)

Nimigean, V; Nimigean, Vanda Roxana; Sălăvăstru, D I

2011-01-01

The several anatomical variations existing in the root canal system may contribute to failure of the root canal therapy. Knowledge of the internal dental morphology is a complex and extremely important point for planning and performing endodontic therapy. This paper reports the case of a left mandibular third molar that presented only one dental conical root and only one aberrant radicular canal with an initial annular portion situated in the coronar third of the root and a linear portion at the level of the other two thirds of the dental root, which opened through an apical foramen. Root canal therapy and case management are described. Features like wide crown access, adequate illumination and use of exploring files where important for successful completion of the endodontic treatment. The treatment was performed through conventional methods. This clinical case constitutes a rare anatomical variant of internal radicular morphology.

Bilateral lower second molar impaction in teenagers: An emergent problem?

Directory of Open Access Journals (Sweden)

Shinohara Elio

2010-01-01

Full Text Available The frequency of simultaneously impacted second and third molars in teenagers is increasing and becoming a common occurrence in adolescent oral surgery practice. The traditional treatment is the removal of the third molar by conventional access but repositioning of the surgical flap to the distal face of the first molar can predispose to complications such as pericoronitis and delayed healing of the attached gingiva. We present a case in which we use the germectomy approach to remove the impacted third molar for the eruption of the second molar through a vestibular incision. This incision offers excellent bone exposure and exit route for the third molar without disturbing the gingiva attached architecture on the distal face of the first molar providing good healing environment.

Image and surgery-related costs comparing cone beam CT and panoramic imaging before removal of impacted mandibular third molars

DEFF Research Database (Denmark)

Petersen, Lars Bo; Olsen, Kim Rose; Christensen, Jennifer Heather

2014-01-01

resource utilization. Differences in resources used for surgical and post-surgical management were calculated for each patient. Results: Converted to monetary units, the total costs for panoramic imaging equalized (sic)49.29 and for CBCT examination (sic)184.44. Modifying effects on this outcome......Objectives: The aim of this prospective clinical study was to derive the absolute and relative costs of cone beam CT (CBCT) and panoramic imaging before removal of an impacted mandibular third molar. Furthermore, the study aimed to analyse the influence of different cost-setting scenarios...... on the outcome of the absolute and relative costs and the incremental costs related to surgery. Methods: A randomized clinical trial compared complications following surgical removal of a mandibular third molar, where the pre-operative diagnostic method had been panoramic imaging or CBCT. The resources implied...

Experience versus complication rate in third molar surgery

Directory of Open Access Journals (Sweden)

Al-Khawalde Mohammed

2006-05-01

Full Text Available Abstract Objectives The records of 1087 patients who underwent surgical removal of third molar teeth were prospectively examined to analyse the possible relationship between postoperative complications and the surgeon's experience parameter. Method and materials Seven surgeons (three specialists in surgical dentistry [specialists SD] and four oral and maxillofacial Senior House Officers [OMFS residents] carried out the surgical procedures. For each patient, several variables were recorded including age, gender, radiographic position of extracted teeth, treating surgeon, duration of surgery and postoperative complications. Results Analysis of the data revealed some differences in the incidence of complications produced by the specialists SD and OMFS residents. The main statistically relevant differences were increase the incidences of trismus, nerve paraesthesia, alveolar osteitis and infection in the resident-treated group, while the specialist-treated group showed higher rates of post-operative bleeding. Conclusion The higher rate of postoperative complications in the resident-treated group suggests that at least some of the complications might be related to surgical experience. Further work needs to compare specialists of training programmes with different years of experience, using large cross – sectional studies.

Accuracy of Cameriere's cut-off value for third molar in assessing 18 years of age.

Science.gov (United States)

De Luca, S; Biagi, R; Begnoni, G; Farronato, G; Cingolani, M; Merelli, V; Ferrante, L; Cameriere, R

2014-02-01

Due to increasingly numerous international migrations, estimating the age of unaccompanied minors is becoming of enormous significance for forensic professionals who are required to deliver expert opinions. The third molar tooth is one of the few anatomical sites available for estimating the age of individuals in late adolescence. This study verifies the accuracy of Cameriere's cut-off value of the third molar index (I3M) in assessing 18 years of age. For this purpose, a sample of orthopantomographs (OPTs) of 397 living subjects aged between 13 and 22 years (192 female and 205 male) was analyzed. Age distribution gradually decreases as I3M increases in both males and females. The results show that the sensitivity of the test was 86.6%, with a 95% confidence interval of (80.8%, 91.1%), and its specificity was 95.7%, with a 95% confidence interval of (92.1%, 98%). The proportion of correctly classified individuals was 91.4%. Estimated post-test probability, p was 95.6%, with a 95% confidence interval of (92%, 98%). Hence, the probability that a subject positive on the test (i.e., I3Mage or older was 95.6%. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Valeriana officinalis L. for conscious sedation of patients submitted to impacted lower third molar surgery: A randomized, double-blind, placebo-controlled split-mouth study

Directory of Open Access Journals (Sweden)

Marcos Luciano Pimenta Pinheiro

2014-01-01

Full Text Available Introduction: Anxiety is one of the components of patient stress in the dental office and is recognized as one of the main factors that negatively affect treatment. The control of anxiety can be performed through conscious sedation, for which benzodiazepine is the drug of choice in dental practice, however present side-effects. Objective: The objective of the following study is to evaluate the efficacy of Valeriana officinalis L. (Valerian for control of anxiety during the third molar surgery. Materials and Methods: A single oral dose of either Valerian (100 mg or placebo was randomly administered 1 h before each surgical procedure to 20 volunteers between 17 and 31 years of age. Anxiety level was assessed by physiological parameters (blood pressure and heart rate [HR] and the observation of signs. Descriptive analysis, Chi-square test, Friedman test, Wilcoxon test and effect size test were performed (P < 0.05. Results: According to the researcher′s (80% and surgeon′s (75% evaluations, the patients treated with Valerian were calmer and more relaxed during surgery. Valerian had a greater effect on the maintenance of systolic blood pressure and HR after surgery. Conclusion: Valerian was more effective at controlling anxiety than a placebo when used for the conscious sedation of adult patients submitted to impacted lower third molar surgery.

Multivariate analysis of factors affecting presence and/or agenesis of third molar tooth.

Directory of Open Access Journals (Sweden)

Mohammad Khursheed Alam

Full Text Available To investigate the presence and/or agenesis of third molar (M3 tooth germs in orthodontics patients in Malaysian Malay and Chinese population and evaluate the relationship between presence and/or agenesis of M3 with different skeletal malocclusion patterns and sagittal maxillomandibular jaw dimensions. Pretreatment records of 300 orthodontic patients (140 males and 160 females, 219 Malaysian Malay and 81 Chinese, average age was 16.27±4.59 were used. Third-molar agenesis was calculated with respect to race, genders, number of missing teeth, jaws, skeletal malocclusion patterns and sagittal maxillomandibular jaw dimensions. The Pearson chi-square test and ANOVA was performed to determine potential differences. Associations between various factors and M3 presence/agenesis groups were assessed using logistic regression analysis. The percentages of subjects with 1 or more M3 agenesis were 30%, 33% and 31% in the Malaysian Malay, Chinese and total population, respectively. Overall prevalence of M3 agenesis in male and female was equal (P>0.05. The frequency of the agenesis of M3s is greater in maxilla as well in the right side (P>0.05. The prevalence of M3 agenesis in those with a Class III and Class II malocclusion was relatively higher in Malaysian Malay and Malaysian Chinese population respectively. Using stepwise regression analyses, significant associations were found between Mx (P<0.05 and ANB (P<0.05 and M3 agenesis. This multivariate analysis suggested that Mx and ANB were significantly correlated with the M3 presence/agenesis.

Acute inflammation in horizontal incompletely impacted third molar with radiolucency in the elderly

Directory of Open Access Journals (Sweden)

Minoru Yamaoka

2009-07-01

Full Text Available Minoru Yamaoka, Yusuke Ono, Masahiro Takahashi, Masahide Ishizuka, Takayuki Uchihashi, Kouichi Yasuda, Takashi Uematsu, Kiyofumi FurusawaMatsumoto Dental University, Oral and Maxillofacial Surgery, Shiojiri, Nagano, JapanAbstract: Although radiolucency has been shown as a risk of infection, the poorly understood effects of aging on radiolucency correlate with acute pericoronitis, which has a high risk of infection extending any complications. We reviewed the records of 346 consecutive patients aged more than 41 years to evaluate whether pericoronal radiolucency below the crown in mandibular horizontal incompletely impacted third molars is related to acute inflammation. The frequency of acute inflammation in teeth with pericoronal radiolucency below the crown was similar to that in teeth without; however, the odds ratio of acute inflammation exhibited in women aged more than 61 years compared to women aged 41–50 years was 9.77 (95% confidence interval [CI]: 1.67–57.29; P <<0.05, and in women aged more than 61 years compared to women aged 51–60 years was 26.25 (95% CI: 2.94–234.38; P < 0.01. The odds ratio of severe acute inflammation exhibited in men aged more than 61 years compared to men aged 41–50 years was 16.67 (95% CI: 1.76–158.27; P < 0.01. These odds ratios indicate an association of acute pericoronitis, including the severe forms of acute inflammation that result from pericoronitis, with pericoronal radiolucency below the crown in the elderly.Keywords: radiolucency, mandible, third molar, acute inflammation, aging

Forced extrusion for removal of impacted third molars close to the mandibular canal Extrusión forzada para extraer los terceros molares impactados cerca del canal mandibular

Directory of Open Access Journals (Sweden)

Dennis Flanagan DDS

2012-03-01

Full Text Available Impacted mandibular third molars can be located in close proximity to the mandibular canal. This creates a risk for the nerve or artery injury. These are contained in the canal. However, the impacted third molar can be moved coronally by orthodontic means, after removal of overlying bone, and safely extracted. The orthodontic intervention slowly moves the tooth apex away from the mandibular canal and reduces the potential for a neural injury. This method may be useful for older patients with root apices that approximate or are actually located in the mandibular canal. This technique needs further study. There is a theoretical potential for neural or arterial injury from physical contact of the tooth apex as it moves by or through the mandibular canal.Los terceros molares inferiores impactados pueden localizarse muy cerca del canal mandibular. Esto constituye un riesgo de lesión del nervio o la arteria, que se localizan dentro del canal. No obstante, el tercer molar impactado puede desplazarse en dirección coronal con ortodoncia, tras ostectomía del hueso suprayacente, y extraerse sin riesgos. La intervención ortodóncica desplaza lentamente el ápice del diente fuera del canal mandibular y reduce la posibilidad de lesión neural. Este método puede ser útil para pacientes de edad avanzada con ápices dentales que se aproximan o en realidad se localizan en el canal mandibular. La técnica necesita un estudio adicional. Hay la posibilidad teórica de lesión neural o arterial a partir del contacto físico del ápice del diente a medida que se desplaza a través del canal mandibular.

Piezosurgery or conventional rotatory instruments for inferior third molar extractions?

Science.gov (United States)

Piersanti, Luigi; Dilorenzo, Matteo; Monaco, Giuseppe; Marchetti, Claudio

2014-09-01

The purpose of this study was to compare the discomfort and surgical outcomes of a piezosurgery device with those of rotatory instruments in lower third molar extraction. A split-mouth, randomized, unblinded clinical study was designed; the 2 molars had to have the same extraction difficulty score. The test side was extracted using a piezosurgery technique and the control side was extracted using a conventional handpiece. The primary endpoint was patient discomfort evaluated with the Postoperative Symptom Severity (PoSSe) scale, which was administered to each patient; secondary endpoints were pain, trismus, swelling, and surgical time evaluation. Paired-samples t test and repeated-measures analysis of variance were used to compare outcomes within patients. Ten consecutive patients (6 female, 4 male; mean age, 22.4 ± 2.3 yr) were recruited. The total score on the PoSSe scale was significantly lower for piezosurgery compared with the conventional rotating handpiece (24.7 ± 10.3 vs 36.0 ± 7.6; t = -4.27; P = .002). Moreover, postoperative swelling 1 week after surgery was significantly lower for piezosurgery than for the conventional rotating handpiece (2.75 ± 0.23 vs 3.1 ± 0.39 cm; t = -2.63; P = .027). Piezosurgery was associated with less postoperative discomfort and yielded better results for swelling. Piezosurgery seems to be a good technique in daily surgical practice, especially if applied in the critical steps in which safety and respect for soft tissue, bone, and nerves are necessary. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Morphologic study of the maxillary molars. Part II: Internal anatomy.

Science.gov (United States)

Pécora, J D; Woelfel, J B; Sousa Neto, M D; Issa, E P

1992-01-01

The internal anatomy of three hundred and seventy (370) decalcified and cleared human maxillary molars was studied. Seventy-five percent of the first molars, 58% of the second molars and 68% of the third molars studied presented three (3) root canals and 25% of the first molars, 42% of the second molars and 32% of the third molars presented four (4) root canals. The authors observed that the incidence of two root canals in the mesiobuccal root was higher in second maxillary molars than in first maxillary molars.

Analgesic efficacy and safety of intravenous paracetamol (acetaminophen) administered as a 2g starting dose following third molar surgery

DEFF Research Database (Denmark)

Juhl, Gitte Irene; Nørholt, Sven E.; Tønnesen, Else Kirstine

2006-01-01

BACKGROUND: The recommended dose for intravenous (IV) paracetamol injection in adults is 1g, however pharmacokinetic and pharmacodynamic findings suggest that a better analgesia could be obtained with a 2g starting dose. METHODS: A single-centre, randomised, double-blind, placebo-controlled, 3......-parallel group study was performed to demonstrate the analgesic efficacy and safety of IV paracetamol 2g. Following third molar surgery, patients reporting moderate to severe pain received a single 15-min infusion of either IV paracetamol 2g, IV paracetamol 1g or placebo. Efficacy and safety were evaluated...... over 8h. Laboratory tests were performed before and 48h after drug administration. RESULTS: Two hundred and ninety seven patients (132=IV paracetamol 2g; 132=IV paracetamol 1g; 33=placebo) were randomised and completed the study. The summed pain relief over 6h (TOTPAR6) was significantly superior...

Analgesic efficacy of lysine clonixinate, paracetamol and dipyrone in lower third molar extraction: a randomized controlled trial.

Science.gov (United States)

Noronha, Vladimir-Reimar-Augusto-de Souza; Gurgel, Gladson-de Souza; Alves, Luiz-César-Fonseca; Noman-Ferreira, Luiz-Cláudio; Mendonça, Lisette-Lobato; Aguiar, Evandro-Guimarães de; Abdo, Evandro-Neves

2009-08-01

The purpose of this study is to compare the analgesic effect of lysine clonixinate, paracetamol and dipyrone after lower third molar extraction. The sample consisted of 90 individuals with clinical indication for inferior third molar extraction. The mean age of the sample was 22.3 years (DP +/-2.5). The individuals received the medication in unidentified bottles along with the intake instructions. The postoperative pain parameters were measured according to the Visual Analogical Scale (VAS) and the data was evaluated using the Kruskal-Wallis Test and Friedman Test, with the latter used to test different time intervals for each one of the drugs. The final sample consisted of 64 individuals, including 23 males (45.9%) and 41 females (64.1%) The mean age of the entire sample was 22.3 years (+/-2.5). The average length of the procedures was 33.9 minutes (+/-9.8). The distribution of mean values for this variable showed little variance for the different drugs (p=0.07). Lysine Clonixinate did not show any substantial impact on the postoperative pain control when compared to other drugs.

Quality of analgesia after lower third molar surgery: A randomised, double-blind study of levobupivacaine, bupivacaine and lidocaine with epinephrine

Directory of Open Access Journals (Sweden)

Brajković Denis

2015-01-01

Full Text Available Background/Aim. Surgical extraction of lower third molars is followed by mild or severe postoperative pain which peaks at maximal intensity in the first 12 hours and has a significant impact on a patient’s postoperative quality of life. The use of long-acting local anaesthetics is a promising strategy to improve postoperative analgesia. The aim of the present study was to investigate analgesic parameters and patient satisfaction after using 0.5% levobupivacaine (Lbup, 0.5% bupivacaine (Bup and 2% lidocaine with epinephrine 1:80,000 (Lid + Epi for an inferior alveolar nerve block following lower third molar surgery. Methods. A total of 102 patients (ASA I were divided into three groups, each of which received either 3 mL of Lbup, Bup or Lid + Epi. The intensity of postoperative analgesia was measured using a verbal rating scale (VRS. The total amounts of rescue analgesics were recorded on the first and during seven postoperative days. Patients satisfaction was noted using a modified verbal scales. Results. A significantly higher level of postoperative pain was recorded in Lid + Epi group compared to Bup and Lbup groups. No significant differences were seen between Bup and Lbup, but a significant reduction in the need for rescue analgesics was seen postoperatively in both Lbup and Bup (50% in comparison with Lid + Epi (80% in the first 24 hours. The same significant trend in rescue analgesic consumption was recorded for seven postoperative days. Patients’ overall satisfaction was significantly lower for Lid + Epi (10% than for Lbup (56% and Bup (52%. Conclusion. The use of a new and long-acting local anaesthetic 0.5% levobupivacaine is clinically relevant and effective for an inferior alveolar nerve block and postoperative pain control after third molar surgery. In our study Lbup and Bup controled postoperative pain more efficiently after lower third molar surgery compared to Lid + Epi. [Projekat Ministarstva nauke Republike Srbije, br. 175021

Test ifm kursus (Dorthe) - Patient discomfort and retakes in periapical examination of mandibular third molars using digital receptors and film

DEFF Research Database (Denmark)

Matzen, Louise Hauge; Christensen, Jennifer; Wenzel, Ann

2009-01-01

OBJECTIVE: The aim was to compare patient discomfort and evaluate the frequency of retakes using intraoral digital receptors and conventional film for radiographic examination of mandibular third molars. STUDY DESIGN: Both mandibular third molar regions were examined in 110 patients with 2 of 5...... digital intraoral receptors. Discomfort was scored on a visual analog scale (VAS) for each receptor and for film as a reference. If the whole tooth was not imaged on the digital image, a retake was performed using film. t Tests evaluated differences in VAS score, chi-squared tests evaluated differences...... in frequency of remakes, and logistic regression analyses evaluated factors predisposing for retake. RESULTS: No significant difference existed in VAS scores between right and left sides for film (P = .24). The digital receptors were more uncomfortable than film (P

Is the Level of Nitric Oxide in the Dental Follicular Tissues of Impacted Third Molars With a History of Recurrent Pericoronitis a True Marker of Oxidative Stress?

Science.gov (United States)

Hendek, Meltem Karsiyaka; Şenses, Fatma; Kisa, Üçler; Aksoy, Nurkan; Tekin, Umut

2017-10-01

Nitric oxide (NO) is an indicator of oxidative stress in several tissues. Its role in dental follicular (DF) tissues of impacted third molars with a history of recurrent pericoronitis is not well elucidated. The present study compared NO levels between inflamed and noninflamed DF tissues of impacted third molars with a history of recurrent pericoronitis. A cross-sectional study was designed. The study sample included inflamed DF tissues (test group) with certain local inflammatory symptoms, such as pain, tenderness, swelling, and erythema and noninflamed DF tissues (control group) without local inflammatory symptoms of impacted mandibular third molars. Each patient contributed only 1 specimen to the samples. All tissues samples were biochemically investigated for NO levels as an indicator of oxidative stress. The primary predictor variable was inflammatory status; secondary predictor variables were age and gender. The primary outcome variable was NO level. Descriptive and comparative analyses were conducted. The test group consisted of 57 patients (28 men, 29 women; mean age, 23.28 ± 5.16 yr) and the control group consisted of 57 patients (30 men, 27 women; mean age, 23.02 ± 5.42 yr). No relevant intergroup differences were noted for demographic findings such as age and gender. NO levels were significantly higher in inflamed DF tissues of impacted third molars than in noninflamed DF tissues (P stress and the necessity to remove impacted mandibular third molars with a history of recurrent pericoronitis. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Third molar surgery: the patient's and the clinician's perspective

Directory of Open Access Journals (Sweden)

Jerjes Waseem

2009-10-01

Full Text Available Abstract Background In this report, the problems of third molar surgery have been reviewed from the perspective of both patient and clinician; additionally an overall analysis of preoperative imaging investigations was carried out. Specifically, three main areas of interest were investigated: the prediction of surgical difficulty and potential complications; the assessment of stress and anxiety and finally the assessment of postoperative complications and the surgeon's experience. Findings In the first study, the prediction of surgical difficulty and potential injury to the inferior alveolar nerve was assessed. This was achieved by examining the patient's orthopantomograms and by using the Pederson Difficulty Index (PDI. Several radiological signs were identified and a classification tree was created to help predict the incidence of such event. In the second study, a prospective assessment addressing the patient's stress and anxiety pre-, intra- and postoperatively was employed. Midazolam was the active drug used against placebo. Objective and subjective parameters were assessed, including measuring the cortisol level in saliva. Midazolam was found to significantly reduce anxiety levels and salivary cortisol was identified as an accurate anxiety marker. In the third study, postoperative complications and the surgeon's experience were examined. Few patients in this study suffered permanent nerve dysfunction. Junior surgeons reported a higher complication rate particularly in trismus, alveolar osteitis, infection and paraesthesia over the distributions of the inferior alveolar and lingual nerves. In apparent contrast, senior surgeons reported higher incidence of postoperative bleeding. Discussion These studies if well employed can lead to favourable alteration in patient management and might have a positive impact on future healthcare service.

Evaluation of the relationship between mandibular third molar and mandibular canal by different algorithms of cone-beam computed tomography.

Science.gov (United States)

Mehdizadeh, Mojdeh; Ahmadi, Navid; Jamshidi, Mahsa

2014-11-01

Exact location of the inferior alveolar nerve (IAN) bundle is very important. The aim of this study is to evaluate the relationship between the mandibular third molar and the mandibular canal by cone-beam computed tomography. This was a cross-sectional study with convenience sampling. 94 mandibular CBCTs performed with CSANEX 3D machine (Soredex, Finland) and 3D system chosen. Vertical and horizontal relationship between the mandibular canal and the third molar depicted by 3D, panoramic reformat view of CBCT and cross-sectional view. Cross-sectional view was our gold standard and other view evaluated by it. There were significant differences between the vertical and horizontal relation of nerve and tooth in all views (p < 0.001). The results showed differences in the position of the inferior alveolar nerve with different views of CBCT, so CBCT images are not quite reliable and have possibility of error.

Comparative study of intravenous Tramadol versus Ketorolac for preventing postoperative pain after third molar surgery--a prospective randomized study.

Science.gov (United States)

Gopalraju, Prathibha; Lalitha, Ramanujapuram Manikarnike; Prasad, Kavitha; Ranganath, Krishnappa

2014-07-01

The aim of this comparative, prospective, randomized, controlled study was to evaluate two different regimens of analgesics: a preoperative intravenous dose of either Tramadol or Ketorolac given 10 min prior to surgery to assess their impact on clinical recovery after third molar surgery. Forty patients requiring surgical extraction of unilateral impacted mandibular third molars similar in position were enrolled in the study. Patients were randomly divided into two groups based on permuting the numbers. Patients in Group 1 and Group 2 were administered either Tramadol 50 mg or Ketorolac 30 mg, intravenously, 10 min prior to surgery. The difference in postoperative pain was assessed by four primary points: pain intensity as measured by a 10 mm visual analogue scale hourly for 12 h, median time to rescue analgesics, number of analgesics consumed and patient's overall 5-point global assessment scale. Throughout the 12 h investigation period, patients treated with Ketorolac reported significantly lower pain intensity scores, significantly longer time to rescue analgesics (Acetaminophen 500 mg) and less intake of postoperative analgesics. In Group 2, 40% of the patient had good overall assessment as compared to Group 1 where only 25% of patients had good overall assessment. The current study shows that pre-emptive use of Inj. Ketorolac 30 mg intravenously can reduce the severity of the postoperative sequelae of asymptomatic impacted mandibular third molar surgery. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Effect of 0.2% Chlorhexidine Gel on Frequency of Dry Socket Following Mandibular Third Molar Surgery: A Double-Blind Clinical Trial Clinical Trial

Directory of Open Access Journals (Sweden)

Baratollah Shaban

2014-09-01

Full Text Available Introduction: Alveolar osteitis (AO is one of the most common postoperative complications after third molar surgery. Various techniques have been used to reduce the risk of AO. The aim of the current study was to evaluate the effect of Chlorhexidine (CHX bioadhesive gel in preventing the development of AO. Methods: Patients with bilateral impacted mandibular third molars underwent surgical extraction of both teeth. One socket was randomly received CHX gel and the contralateral socket served as the control. The outcome variable was development of AO and the CHX gel application was the predictor variable. Data were analyzed using chi-square test with the confidence interval of 95%. Results: 41 patients (27 females and 14 males with mean age of 24.15 ± 5.02 years underwent 82 surgeries. Total of 11 sockets (13.41% developed AO. The frequency of AO in CHX gel (2 cases, 4.87% side was significantly lower than control (9 cases, 21.95% side (P-value < 0.05. No side effects observed following CHX gel application. Conclusion: Application of CHX gel could be an effective approach to reduce the risk of developing AO following mandibular third molar surgery.

Autotransplantation of third molars with completely formed roots into surgically created sockets and fresh extraction sockets: a 10-year comparative study.

Science.gov (United States)

Yu, H J; Jia, P; Lv, Z; Qiu, L X

2017-04-01

The aim of this study was to analyze and compare the long-term clinical outcomes of mature third molar autotransplantation in surgically created sockets and fresh extraction sockets with regard to survival and functional success rates. A total of 65 third molars with completely formed roots were autotransplanted in 60 patients (average age 33.1 years). Thirty-six of the teeth were autotransplanted into surgically created sockets with or without guided bone regeneration (GBR; delayed autotransplantation), while 29 were autotransplanted into fresh extraction sockets (immediate autotransplantation; control group). All patients underwent annual clinical and radiographic examinations (average follow-up 9.9 years, range 7-13 years). The survival rates for the control, GBR, and no GBR groups were 93.1%, 95.2%, and 80.0%, respectively, with no significant differences among the groups. There were no statistically significant differences among the groups with regard to the frequency of inflammatory root resorption or root ankylosis. Age did not influence the clinical outcomes. These results suggest that the autotransplantation of third molars with completely formed roots is effective in both surgically created and fresh extraction sockets and provides a high long-term success rate if cases are selected and treated appropriately. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Clinical evaluation of piroxicam-FDDF and azithromycin in the prevention of complications associated with impacted lower third molar extraction.

Science.gov (United States)

Graziani, F; Corsi, L; Fornai, M; Antonioli, L; Tonelli, M; Cei, S; Colucci, R; Blandizzi, C; Gabriele, M; Del Tacca, M

2005-12-01

Combined treatments with non-steroidal anti-inflammatory drugs and antibiotics may offer significant benefits in the prevention of pain and infections associated with oral surgery. In this study, piroxicam and azithromycin were administered to patients undergoing dental extraction to examine the efficacy of piroxicam in the prevention of post-operative pain and inflammatory complications, either in the absence or in the presence of a concomitant antibiotic treatment. Thirty patients were randomly assigned to three groups and treated for 3 days, before impacted lower third molar removal, as follows: (1) sublingual piroxicam-FDDF (fast dissolving dosage formulation) 20 mg/day; (2) oral azithromycin 500 mg/day; (3) piroxicam-FDDF 20 mg/day plus azithromycin 500 mg/day. Oral acetaminophen (500 mg tablets) was allowed as rescue analgesic medication. Pain intensity was evaluated on a 100-mm visual-analogue scale after dental extraction (day 1), and at days 2, 3, 7 after surgery. Edema and trismus were estimated at days 2 and 7. At days 1 and 2, pain intensity was significantly lower in patients treated with piroxicam-FDDF, either alone (p antibiotic may reduce the influence of piroxicam on post-operative inflammation, without affecting its beneficial effect on surgical pain.

Impacted Mandibular Third Molars: A Retrospective Study of 1198 Cases to Assess Indications for Surgical Removal, and Correlation with Age, Sex and Type of Impaction-A Single Institutional Experience.

Science.gov (United States)

Patel, Shital; Mansuri, Saloni; Shaikh, Faizan; Shah, Taksh

2017-03-01

To study the incidence of mandibular third molar impaction in relation to type and side of impaction, age and sex of patients and indications for its surgical removal through data collected from a single institute over a period of 3 and half years. The records of 1198 patients who underwent the surgical removal of impacted mandibular third molars were reviewed retrospectively. Records were divided into groups according to sex, age, type and side of impaction. Radiographs were studied to determine angular position of impacted mandible third molar. We found that there was a high incidence of mesioangular lower third molar impaction (33.97 %), highest number of patients were found in 15-30 years of age group (48.33 %), a left side (56.93 %) was more commonly involved, female predominance (63.44 %) was observed and recurrent pericoronitis (33.81 %) was the most common indication. Awareness of the indications for surgical removal of impacted mandibular third molar to the patients will help to avoid future risk of complications and morbidity associated with the same. This will not only help in saving time and money but also prevents the psychological trauma associated with delayed treatment. Removal of only symptomatic IMTM seems to be the logical choice in view of financial constraint in developing countries like India but at the same time early removal offers freedom from future complications in selected cases. So surgeons should apply a meticulous approach in selecting the patients for SRIMTM.

Can a single pain rating replace a multiple pain rating in third molar surgery studies? Analysis of 220 patients

NARCIS (Netherlands)

Martin, W.J.J.M.; Heymans, M.W.; Skorpil, N.E.; Forouzanfar, T.

2012-01-01

This study describes the comparison of multiple and single pain ratings in patients after surgical removal of the third molar. Correlation and agreement analysis were performed between the average pain intensity measured three times a day over a period of 7 days and one single pain rating

Radiation doses in examination of lower third molars with computed tomography and conventional radiography.

Science.gov (United States)

Ohman, A; Kull, L; Andersson, J; Flygare, L

2008-12-01

To measure organ doses and calculate effective doses for pre-operative radiographic examination of lower third molars with CT and conventional radiography (CR). Measurements of organ doses were made on an anthropomorphic head phantom with lithium fluoride thermoluminescent dosemeters. The dosemeters were placed in regions corresponding to parotid and submandibular glands, mandibular bone, thyroid gland, skin, eye lenses and brain. The organ doses were used for the calculation of effective doses according to proposed International Commission on Radiological Protection 2005 guidelines. For the CT examination, a Siemens Somatom Plus 4 Volume Zoom was used and exposure factors were set to 120 kV and 100 mAs. For conventional radiographs, a Scanora unit was used and panoramic, posteroanterior, stereographic (scanogram) and conventional spiral tomographic views were exposed. The effective doses were 0.25 mSv, 0.060 mSv and 0.093 mSv for CT, CR without conventional tomography and CR with conventional spiral tomography, respectively. The effective dose is low when CT examination with exposure factors optimized for the examination of bone structures is performed. However, the dose is still about four times as high as for CR without tomography. CT should therefore not be a standard method for the examination of lower third molars. In cases where there is a close relationship between the tooth and the inferior alveolar nerve the advantages of true sectional imaging, such as CT, outweighs the higher effective dose and is recommended. Further reduction in the dose is feasible with further optimization of examination protocols and the development of newer techniques.

Does prophylactic administration of systemic antibiotics prevent postoperative inflammatory complications after third molar surgery?

Science.gov (United States)

Halpern, Leslie R; Dodson, Thomas B

2007-02-01

To estimate and compare the frequencies of inflammatory complications after third molar (M3) surgery in subjects receiving intravenous prophylactic antibiotics or saline placebo. Using a placebo-controlled, double-blind, randomized clinical trial, the investigators enrolled a sample composed of subjects who required extraction of at least 1 impacted M3 and requested intravenous sedation or general anesthesia. The predictor variable was treatment group classified as active treatment (penicillin or clindamycin for penicillin-allergic subjects) or placebo (0.9% saline). Study medications were randomly assigned. Both surgeon and subject were blinded to treatment assignment. The medication was administered intravenously prior to any incision. The outcome variable was postoperative inflammatory complication classified as present or absent and included alveolar osteitis (AO) or surgical site infection (SSI). Other variables were demographic, anatomic, or operative. Descriptive and bivariate statistics were computed. Statistical significance was set at P < or = .05, single-tailed test of hypothesis. The sample was composed of 118 subjects (n = 59 per study group). In the active treatment group, there were no postoperative inflammatory complications. In the placebo group, 5 subjects (8.5%) were diagnosed with SSI, (P = .03). No subject met the case definition for AO. All SSIs were associated with the removal of partial bony or full bony impacted mandibular M3s. In the setting of third molar removal, these results suggest that the use of intravenous antibiotics administered prophylactically decrease the frequency of SSIs. The authors cannot comment on the efficacy of intravenous antibiotics in comparison to other antibacterial treatment regimens, eg chlorhexidine mouthrinse or intrasocket antibiotics.

Radiolucency below the crown of mandibular horizontal incompletely impacted third molars and acute inflammation in men with diabetes

Directory of Open Access Journals (Sweden)

Minoru Yamaoka

2009-05-01

Full Text Available Minoru Yamaoka, Yusuke Ono, Masahide Ishizuka, Kouichi Yasuda, Takashi Uematsu, Kiyofumi FurusawaOral and Maxillofacial Surgery, Matsumoto Dental University, Shiojiri, Nagano 399-0781, JapanAbstract: Although mandibular third molar has a high risk of infection extending any complications, the influence of diabetes on radiolucency and acute inflammation in pericoronitis remains unclear. The present study was to evaluate whether radiolucency below the crown is related to acute inflammation in mandibular horizontal incompletely impacted third molars and to review the records of 140 men more than 45 years with and without diabetes. The odds ratio of exhibiting acute inflammation was 3.38 (95% CI: 1.13–10.16, p < 0.05 and that of exhibiting severe acute inflammation was 15.38 (95% CI: 3.56–66.49, p < 0.0001, indicating an association of acute pericoronitis in diabetes. The frequency of radiolucency below the crown and below the root in diabetics was similar to that in nondiabetics. However, the odds ratio of exhibiting both radiolucency below the crown and acute inflammation under the diabetic condition was 4.85 (95% CI: 1.60–14.73, p < 0.01, whereas that of diabetics showing both radiolucency below the root and acute inflammation was 0.46 (95% CI: 0.06–3.74, p = 0.74. Radiolucency below the crown and acute inflammation were associated with diabetes, but that below root and acute inflammation were not associated with diabetes, indicating that the region below the crown carries susceptibility to acute pericoronitis, whereas the periodontium shows a protective effect against acute pericoronitis.Keywords: radiolucency, acute inflammation, mandible, third molar, diabetes, periodontium

Bilateral pneumothorax with extensive subcutaneous emphysema manifested during third molar surgery. A case report.

Science.gov (United States)

Sekine, J; Irie, A; Dotsu, H; Inokuchi, T

2000-10-01

This report describes a case of bilateral pneumothorax with extensive subcutaneous emphysema in a 45-year-old man that occurred during surgery to extract the left lower third molar, performed with the use of an air turbine dental handpiece. Computed tomographic scanning showed severe subcutaneous emphysema extending bilaterally from the cervicofacial region and the deep anatomic spaces (including the pterygomandibular, parapharyngeal, retropharyngeal, and deep temporal spaces) to the anterior wall of the chest. Furthermore, bilateral pneumothorax and pneumomediastinum were present. In our patient, air dissection was probably caused by pressurized air being forced through the operating site into the surrounding connective tissue.

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

Science.gov (United States)

Shokry, Mohamed; Aboelsaad, Nayer

2016-01-01

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 paired t-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. PMID:27597866

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

Directory of Open Access Journals (Sweden)

Hani Arakji

2016-01-01

Full Text Available 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 paired t-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.

Comparative effect of tube drain on post operative inflammatory complications of impacted mandibular third molar surgery College Hospital, Ibadan, Nigeria.

Science.gov (United States)

Obimakinde, O S; Fasola, A O; Arotiba, J T; Okoje, V N; Obiechina, A E

2010-09-01

Swelling, pain and trismus are acute reversible inflammatory complications of impacted mandibular third molar (M3) surgery. They contribute to the deterioration of quality of life and loss of several useful working hours. This study aimed to investigate whether the use of a surgical drain following M3 surgery can minimise these inflammatory complications. Eighty consecutive patients who gave consent were enrolled into the study. Patients were assigned into two groups (drain and no drain) by systematic sampling method which was modified to ensure matching of patients by age, sex and spatial relationship of the impacted mandibular third molar. The patients in the drain group (n=40) had a Foley's catheter drain inserted into the wound after the surgical procedure while the patients in the no drain group (n=40) had their wound closed without the use of drain. All patients had primary wound closure with 3.0 black silk sutures after the procedure. Demographic data, cheek dimension and maximal mouth opening were recorded before the procedure. Pain, swelling and trismus were evaluated in the two groups at 24 hours, 48 hours and 7th day after surgery. Post operative swelling and visual analogue scale score for pain were comparatively lesser in the drain group patients. The maximal interincisal distance was also more in the drain group patients. The findings from this study indicated that there is a significant benefit of using a surgical drain in minimising postoperative oedema, pain and trismus following surgical removal of impacted mandibular third molar.

Efficacy of low-level laser therapy in the management of pain, facial swelling, and postoperative trismus after a lower third molar extraction. A preliminary study.

Science.gov (United States)

López-Ramírez, Marta; Vílchez-Pérez, Miguel Angel; Gargallo-Albiol, Jordi; Arnabat-Domínguez, Josep; Gay-Escoda, Cosme

2012-05-01

Pain, swelling, and trismus are the most common complications after surgical removal of impacted lower third molars. The aim of this study was to evaluate the analgesic and anti-inflammatory effects of a low-level laser therapy (Laser Smile™, Biolase®, San Clemente, USA) applied to the wound appeared after the surgical removal of impacted lower third molars. A prospective, randomized, and double-blind study was undertaken in 20 healthy patients with two symmetrically impacted lower third molars. The application of a low-level laser was made randomly on one of the two sides after surgery. The experimental side received 5 J/cm(2) of energy density, a wavelength of 810 nm, and an output power of 0.5 W. On the control side, a handpiece was applied intraorally, but the laser was not activated. Evaluations of postoperative pain, trismus, and swelling were made. The sample consisted of 11 women and nine men, and mean age was 23.35 years (18-37). The pain level in the first hours after surgery was lower in the experimental side than in the placebo side, although without statistically significant differences (p = 0.258). Swelling and trismus at the 2nd and 7th postoperative days were slightly higher in the control side, although not statistically significant differences were detected (p > 0.05). The application of a low-level laser with the parameters used in this study did not show beneficial affects in reducing pain, swelling, and trismus after removal of impacted lower third molars.

Empleo racional de la coronectomía en la extracción de terceros molares incluidos Rational application of coronectomy when treating lower impacted third molar

Directory of Open Access Journals (Sweden)

C. Recio Lora

2009-08-01

Full Text Available Los terceros molares son los dientes que, con más frecuencia, sufren el fracaso de su erupción y quedan incluidos o retenidos dentro de los maxilares. Un gran porcentaje de nuestros pacientes presentan los cordales incluidos y, de ellos, una parte importante se acompaña de patología que hace aconsejable su tratamiento quirúrgico. La técnica de la coronectomía aplicada al tercer molar incluido fue descrita por primera vez por Ecuyer y Debien en 1984 como la eliminación parcial de dicho diente, dejando deliberadamente parte de su raíz en el interior de la mandíbula. Fue propuesta para evitar la lesión del nervio dentario inferior (NDI en aquéllos casos en los que existía una íntima relación entre ambas estructuras anatómicas. Aunque el objetivo de la técnica es muy claro, no está libre de controversia, ya que el cirujano debe valorar la posibilidad de una complicación infecciosa de origen pulpar. Presentamos un caso clínico exitoso de esta técnica, junto al análisis de la postura ante la técnica de los distintos autores, así como sus ventajas e inconvenientes.Third molars are the teeth that most frequently fail to erupt and remain impacted or retained inside the bone. A large percentage of our patients have impacted wisdom teeth and many of these patients also have pathologies that require surgical treatment. Applied coronectomy technique of the impacted third molar was first described by Ecuyer and Debien in 1984. The described it as partial elimination of the tooth in question, deliberately leaving part of the root inside the bone. This was proposed to avoid injuring the inferior dental nerve in cases where there was a close relationship between the two anatomical structures. Although the objective of the procedure is very clear, it is still controversial. Therefore, the surgeon should evaluate the possibility of an infectious complication of pulpar origin. We present the successful clinical case that uses this technique

The radiographic visibility of the root pulp of the third lower molar as an age marker.

Science.gov (United States)

Pérez-Mongiovi, Daniel; Teixeira, Alexandra; Caldas, Inês Morais

2015-09-01

The aim of this work was to determine the usefulness of the visibility of the dental pulp in lower third molars in forensic age estimation. Dental pulp visibility on lower third molars was assessed using a sample of 487 orthopantomograms. Intra and inter-observer agreement was determined using the Cohen's kappa test. A descriptive analysis of the stages according to age was done. The relationship between age and stage attainment was assessed using Chi square test and the strength and direction of the linear relationship between pulp visualization stage and chronological age was evaluated using Spearman rank order correlation (rho). Equations for predicting an age above 21 years were developed using logistic regression. The level of significance was defined at p age and stage attainment had statistical significance for both sexes (p age estimation successfully predicted age over 21 in 96.2% of the females and in 96.9% of the males. However, only 19.6 and 27.0% of predictions were accurate for the group that was younger than 21, for females and males, respectively. The accuracy of predictions for the group younger than 21 years of age was low, meaning that this methodology may not be suitable for age estimation. Still, stage 3 alone proved to be a suitable age marker for determining an age over 21 years.

An evaluation of canal curvature at the apical one third in type II mesial canals of mandibular molars

Directory of Open Access Journals (Sweden)

Hye-Rim Yun

2012-05-01

Full Text Available Objectives The purpose of this study was to evaluate the buccolingual curvature at the apical one third in type II mesial canals of mandibular molars using the radius and angle of curvature. Materials and Methods Total 100 mandibular molars were selected. Following an endodontic access in the teeth, their distal roots were removed. #15 H- or K-files (Dentsply Maillefer were inserted into the mesiobuccal and mesiolingual canals of the teeth. Radiographs of the teeth were taken for the proximal view. Among them, type II canals were selected and divided into two subgroups, IIa and IIb. In type IIa, two separate canals merged into one canal before reaching the apex and in type IIb, two separate canals merged into one canal within the apical foramen. The radius and angle of curvature of specimens were examined. Results In type II, mean radius of curvature in mesiolingual and mesiobuccal canals were 2.82 mm and 3.58 mm, respectively. The radius of the curvature of mesiolingual canals were significantly smaller than that of mesiobuccal canals in type II, and especially in type IIa. However, there were no statistically significant differences in radius of curvature between mesiobuccal and mesiolingual canals in type IIb and there were no significant differences in angle of curvature between type IIa and IIb. Conclusion In this study, type II mesial canals of mandibular molars showed severe curvature in the proximal view. Especially, mesiolingual canals of type IIa had more abrupt curvature than mesiobuccal canals at the apical one third.

Clinical and Radiographic Characteristics as Predictive Factors of Swelling and Trismus after Mandibular Third Molar Surgery: A Longitudinal Approach

Directory of Open Access Journals (Sweden)

José Manuel Pérez-González

2018-01-01

Full Text Available Introduction. Factors that contribute to swelling and trismus are complex, and they are originated by surgical trauma. The aim of the present study was to determine whether clinical and radiographic factors could predict the level of swelling and trismus after lower third molar surgery, through longitudinal approach. Methodology. A prospective longitudinal trial was carried out. Forty-five patients of both genders with clinical and radiographic diagnosis of asymptomatic mandibular impacted third molar and with no intake of analgesic or anti-inflammatory drugs 12 h prior to surgery were recruited and evaluated in a 72 h follow-up period. A mixed repeated measures model and backward and restricted maximal likelihood methods were used to analyze the data. Results. Male gender, body mass index (BMI, the relation to the lingual and buccal walls, and age were determinants for predicting postoperative swelling and for exerting a significant influence (P<0.05. Conclusions. This study suggests the association of male gender, the relation to lingual and buccal walls, BMI, and age with measurement of swelling.

Radiation absorbed doses at radiographic examination of third molars

International Nuclear Information System (INIS)

Rehnmark-Larsson, S.; Stenstroem, B.; Julin, P.; Richter, S.; Huddinge University Hospital

1981-01-01

The radiation absorbed doses to critical organs, i.e. the thyroid and salivary glands and the gonadal region, were measured at radiographic examination of third molars. A tissue equivalent phantom was used together with ionization chamber detectors and TLDs. The greatest thyroid dose, 35 μGy, came from a mandibular disto-oblique projection with the circular tube collimator and Ultra-Speed film. The doses in different parts of the parotid gland from the disto-oblique mandibular projection with Ultra-Speed film ranged between 2.65 and 0.052 mGy. the corresponding doses in the submandibular gland were 1.74 mGy beneath the mandible and 0.458 mGy in the fovea. A rectangular tube collimator reduced the doses by approximately 50 %. The Ekta-Speed film requirted approximately 40 % lower exposure than the Ultra-Speed film. A horizontal radiation shield reduced the thyroid doses by between 12 and 46 % and the gonadal doses by between 50 and 95 %. The reduction effect from the shield was relatively greater when using the larger aperture of the tube collimator. Combinations of leaded aprons and soft leaded collars reduced the thyroid doses between 15 and 42 % and the gonadal doses by two orders of magnitude. (Authors)

THE EFFECTS OF AMOXICILLIN WITH OR WITHOUT CLAVULANIC ACID ON THE POSTOPERATIVE COMPLAINTS AFTER THIRD MOLAR SURGERY: A RETROSPECTIVE CHART ANALYSIS

Directory of Open Access Journals (Sweden)

Alparslan ESEN

2017-04-01

Full Text Available Purpose: The aim of this chart-based retrospective study was to evaluate the effects of orally administered amoxicillin alone or amoxicillin combined with clavulanic acid on the frequency of post-operative complications and patients’ comfort after mandibular third molar surgery. Materials and Methods: The records of patients who had undergone lower third molar surgery between October 2014 and December 2015 were examined. A total of 62 patients who had fully impacted teeth in mesioangular position and who had been prescribed same type and dose of anti-inflammatory drug were included in this study. Among them, 32 subjects were found to have been prescribed 500 mg amoxicillin trihydrate orally every 8 h for 5 days (Group A and 30 patients 500 mg amoxicillin trihydrate plus 125 mg potassium clavulanate orally every 8 h for 5 days postoperatively (Group AC. Post-operative pain levels, swelling, presence of trismus, frequency of alveolar osteitis and quality of life (QoL scores were gathered from patients’ charts and were statistically compared. Results: Analysis of the variables showed that there were no significant differences between the Groups A and AC regarding pain levels, swelling, trismus and QoL scores. The frequency of alveolar osteitis was found to be 1.6% in the Group A, however, no significant difference was observed among study groups. Conclusion: Within the limitations of this retrospective chart review, it can be stated that amoxicillin and amoxicillin with clavulanic acid might provide similar outcome in terms of patient comfort following third molar surgery.

Combining wrist age and third molars in forensic age estimation: how to calculate the joint age estimate and its error rate in age diagnostics.

Science.gov (United States)

Gelbrich, Bianca; Frerking, Carolin; Weiss, Sandra; Schwerdt, Sebastian; Stellzig-Eisenhauer, Angelika; Tausche, Eve; Gelbrich, Götz

2015-01-01

Forensic age estimation in living adolescents is based on several methods, e.g. the assessment of skeletal and dental maturation. Combination of several methods is mandatory, since age estimates from a single method are too imprecise due to biological variability. The correlation of the errors of the methods being combined must be known to calculate the precision of combined age estimates. To examine the correlation of the errors of the hand and the third molar method and to demonstrate how to calculate the combined age estimate. Clinical routine radiographs of the hand and dental panoramic images of 383 patients (aged 7.8-19.1 years, 56% female) were assessed. Lack of correlation (r = -0.024, 95% CI = -0.124 to + 0.076, p = 0.64) allows calculating the combined age estimate as the weighted average of the estimates from hand bones and third molars. Combination improved the standard deviations of errors (hand = 0.97, teeth = 1.35 years) to 0.79 years. Uncorrelated errors of the age estimates obtained from both methods allow straightforward determination of the common estimate and its variance. This is also possible when reference data for the hand and the third molar method are established independently from each other, using different samples.

Inflammatory process decrease by gallium-aluminium-arsenide (GaAlAs) low intensity laser irradiation on postoperative extraction of impacted lower third molar

International Nuclear Information System (INIS)

Atihe, Mauricio Martins

2002-01-01

This study aimed the observation of inflammatory process decrease by the use of GaAlAs Low Intensity Laser (λ=830 nm; 40 mW) irradiation. Five patients were selected and submitted to surgery of impacted lower third molars, both right and left sides at different occasions. On a first stage, a tooth of a random chosen side - right or left - was extracted by conventional surgery, without LILT. The inflammatory process was measured at postoperative on the first, third and seventh days. This side was then called 'control side'. After 21 days, period in which the inflammatory process of the first surgery was terminated, the other side surgery took place, this time using LILT (4 J at four spots) at postoperative, first and third days. As the previous surgery, the inflammatory process was also measured at postoperative on the first, third and seventh days. This side was called 'experimental or lased side'. The inflammatory process was evaluated by measuring its four characteristic signs: swelling, pain, color and temperature. It was clearly observed a decrease for swelling, pain and color on the lased side which presented significant inference and descriptive statistics. It can be concluded that GaAlAs Low Intensity Laser (λ=830 nm) can surely be used as an additional and important anti-inflammatory source on impacted lower third molar surgeries. (author)

A comparative study of surgical drain placement and the use of kinesiologic tape to reduce postoperative morbidity after third molar surgery.

Science.gov (United States)

Genc, Aysenur; Cakarer, Sirmahan; Yalcin, Basak Keskin; Kilic, Beril Berivan; Isler, Sabri Cemil; Keskin, Cengizhan

2018-04-19

Our aim was to compare the effects of the surgical drain and kinesiotape applications on postoperative morbidity after mandibular third molar surgery in a split-mouth study design. A single-centre, split-mouth study was performed in 23 patients who needed surgical removal of bilateral mandibular third molars. Each patient was treated with a drain tube on one side of the mandible and Kinesio tape (KT) on the contralateral side. Swelling was significantly greater in the KT group than in the drain group throughout the study period. The groups did not differ significantly in the amount of trismus at any time point. The Visual Analogue Scale (VAS)-measured pain intensity was significantly lower in the drainage group. Patients with KT had greater postoperative discomfort than those with a drain tube. All patients were generally satisfied with their treatments. Although both treatments were useful, a surgical drain was significantly more effective at reducing swelling and pain intensity than Kinesio tape. The effects of both on trismus were similar.

COMPARISON OF DIAGNOSTIC CAPABILITIES OF ORTHOPANTOMOGRAPHY AND CONE BEAM COMPUTED TOMOGRAPHY IN DETERMINING THE TOPOGRAPHIC RELATIONSHIP BETWEEN IMPACTED MANDIBULAR THIRD MOLARS AND MANDIBULAR CHANNEL

Directory of Open Access Journals (Sweden)

Petya G. Kanazirska

2017-05-01

Full Text Available Impacted teeth are a common pathology in dental practice. With the greatest frequency is third molars impaction of the upper and lower jaw. Essential for the proper treatment plan has an accurate assessment of the situation of these teeth in the jaw, as well as their relationship with surrounding structures. Of great importance is to determine the position of impacted third molars of the lower jaw to the mandibular channel, in order to prevent complications related to vascular-nerve bundle in this channel. This review article presents a significant X-ray features published by several authors in the literature. Compare the diagnostic capabilities between two-dimensional method –Orthopantomography (OPG and three-dimensional Cone-beam computed tomography (CBCT.

A Comparative Clinical Evaluation of the Effect of Preoperative and Postoperative Antimicrobial Therapy on Postoperative Sequelae after Impacted Mandibular Third Molar Extraction

Directory of Open Access Journals (Sweden)

Olurotimi Akanbi Olojede

2014-07-01

Full Text Available Objectives: To compare the effect of preoperative and postoperative antibiotics therapy on postoperative sequelae after impacted mandibular third molar extractions. Material and Methods: This was a prospective study conducted at Department of Oral and Maxillofacial Surgery of the Lagos University Teaching Hospitalon consecutive patients with impacted third molar extractions for a 12 month period. Group I (n = 31 had administration of 1 gram of oral metronidazole and 1 gram of amoxicillin capsules 30 minutes preoperative and Group II (n = 31 had 500 milligrams of amoxicillin capsule 8 hourly and 400 milligrams of metronidazole tablets administered post operatively for 5 days. Pain, facial swelling and mouth opening assessment were done postoperatively and on days 1, 3 and 7. Results: The general pattern of postoperative pain, regardless of antimicrobial use revealed that pain increased from day 1 to day 3 postoperatively and began to decrease in intensity subsequently up to the seventh day. There was however a statistically significant difference (P = 0.0001 between the two groups on the 7th postoperative day with the subjects in Group I showing lower pain intensity. The mean difference of the facial width on days 1 and 3 was significant (P = 0.04 and P = 0.0001 respectively with subjects in Group II having a reduced facial width compared to those in Group I. Conclusions: This study suggested that the administration of preoperative or postoperative antibiotics showed no marked differences in the degree of postoperative sequaele that occur after impacted mandibular third molar extractions.

Restorasi Resin Komposit Menggunakan Pasak Tapered Self Threading Pada Molar Ketiga Kiri Mandibula

Directory of Open Access Journals (Sweden)

Ellen Krisanti

2013-06-01

Composite Resin Restoration Using Tapered Self Threading Poston Left Mandibular Third Molar. Root canal morphology of mandibular third molar has more complex variation than the other molars. In third molar, the extraction teeth are often executed; however, the third molar can be maintained in other conditions. One visit root canal treatment is a therapy option for this case. The purpose of this case report is to show the success of one visit root canal treatment in third molar with pulp necrosis by restoring the composite resin through tapered self-treading post. A 20 year-old female patient who came to the Prof Soedomo RSGM, FKG UGM complained about the pain when chewing food on her third molar and positive in percussion. The radiographs showed that there was an incomplete restoration. There was a gap between cavities with restoration. The treatment plan for this case was one visit root canal treatment and composite resin with tapered self-threading post as final restoration. From the case, it can concluded that one visit root canal treatment results in a smaller chance for microorganism recontamination than the multi-visit in order to ensure the success of the treatment. Direct composite resin restoration with tapered self-threading dowel is an alternative restoration after endodontic treatment because it works out faster and more retentive.

Postoperative socket irrigation with drinking tap water reduces the risk of inflammatory complications following surgical removal of third molars: a multicenter randomized trial

NARCIS (Netherlands)

Ghaeminia, H.; Hoppenreijs, T.J.; Xi, T.; Fennis, J.P.; Maal, T.J.J.; Berge, S.J.; Meijer, G.J.

2017-01-01

OBJECTIVES: The primary aim of the present study was to evaluate the effectiveness of postoperative irrigation of the socket with drinking tap water on inflammatory complications following lower third molar removal. MATERIAL AND METHODS: A multicenter randomized controlled trial was carried out from

Management of Surgical Third Lower Molar Extraction and Postoperative Progress in Patients With Factor VII Deficiency: A Clinical Protocol and Focus on This Rare Pathologic Entity.

Science.gov (United States)

Passarelli, Pier Carmine; Pasquantonio, Guido; D'Addona, Antonio

2017-10-01

The purpose of the present study was to analyze the management of surgical third molar extraction and postoperative progress in patients with a diagnosis of factor VII deficiency. Close collaboration between the oral-maxillofacial surgeon and hematologist will allow the team to categorize the risk and operate safely, thereby minimizing the incidence and severity of intraoperative and postoperative complications. The present retrospective study included 7 patients with factor VII deficiency who had undergone third lower molar surgery. Their factor VII deficiency ranged from 10.5 to 21.0%. Recombinant activated factor VII (rFVIIa) (coagulation factor VIIa [recombinant]; NovoSeven RT; Novo Nordisk, Bagsvaerd, Denmark) was transfused intravenously in a single dose of 25 μg/kg body weight, 30 minutes before surgical extractions. After the surgery, betamethasone, an analgesic, and an ice pack were administered. Pretreatment with recombinant activated factor VII resulted in excellent hemostasis. No hemorrhagic complications and no postoperative major bleeding were observed. The extraction of the third lower molar appears to be a safe procedure for patients with factor VII deficiency when appropriate prophylaxis with rFVIIa is used. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Assessment of regeneration of bone in the extracted third molar sockets augmented using xenograft (CollaPlugTN Zimmer in comparison with the normal healing on the contralateral side

Directory of Open Access Journals (Sweden)

Murugan Ranganathan

2017-01-01

Full Text Available Introduction: Alveolar bone resorption is a significant clinical problem. Bone loss in third molar region following extraction or surgical removal not only leads to periodontal problems in second molar region but also it may lead to some serious problems like increased incidence of angle fractures. In order to reduce the risks following third molar surgery, the socket should be augmented with bone grafts. In recent days guided tissue regeneration is the most accepted and successful technique followed many authors and its efficacy has been proved. Materials and Methods: Based upon our clinical experience, the use of bio absorbable collagen wound dressing such as CollaPlugTN has achieved quick healing and more primary wound coverage. Amongst the graft materials collagen is preferable due to its high biocompatibility and hemostatic ability. This study was done to assess the regeneration of bone in the extracted third molar sockets using xenograft (CollaPlugTN-Zimmer which was compared with the normal healing on the contra lateral side. The assessment was done to analyze post-operative healing complications and to compare the bone density formed between control site and implant site radiologically. Conclusion: On this basis of this study, the use of collaplugTN appears to be beneficial to the patient in postoperative wound healing and also for better bone formation. The use of this material was advantageous because of its simplicity of application cost effectiveness and availability. There is enhanced wound healing and early bone formation.

Assessment of Regeneration of Bone in the Extracted Third Molar Sockets Augmented Using Xenograft (CollaPlugTN Zimmer) in Comparison with the Normal Healing on the Contralateral Side.

Science.gov (United States)

Ranganathan, Murugan; Balaji, M; Krishnaraj, R; Narayanan, Vivek; Thangavelu, Annamalai

2017-11-01

Alveolar bone resorption is a significant clinical problem. Bone loss in third molar region following extraction or surgical removal not only leads to periodontal problems in second molar region but also it may lead to some serious problems like increased incidence of angle fractures. In order to reduce the risks following third molar surgery, the socket should be augmented with bone grafts. In recent days guided tissue regeneration is the most accepted and successful technique followed many authors and its efficacy has been proved. Based upon our clinical experience, the use of bio absorbable collagen wound dressing such as CollaPlug TN has achieved quick healing and more primary wound coverage. Amongst the graft materials collagen is preferable due to its high biocompatibility and hemostatic ability. This study was done to assess the regeneration of bone in the extracted third molar sockets using xenograft (CollaPlug TN -Zimmer) which was compared with the normal healing on the contra lateral side. The assessment was done to analyze post-operative healing complications and to compare the bone density formed between control site and implant site radiologically. On this basis of this study, the use of collaplugTN appears to be beneficial to the patient in postoperative wound healing and also for better bone formation. The use of this material was advantageous because of its simplicity of application cost effectiveness and availability. There is enhanced wound healing and early bone formation.

[Lincomycin applied to the alveolus on TCP carrier and its effect on wound healing after surgical extraction of a third molar].

Science.gov (United States)

Wiśniewska, Izabela; Slósarczyk, Anna; Myśliwiec, Leszek; Sporniak-Tutak, Katarzyna

2009-01-01

The dental surgeon is often confronted by complications particularly after extraction ofunerupted lower third molars. The most common complication is alveolar periostitis. The healing process after extraction is accompanied by physiologic atrophy of the alveolus involving on the average 30% of bone tissue. Beta-tricalcium phosphate (TCP) is a synthetic material used in medicine to fill up bone defects caused by pathologic processes. The properties of TCP are appropriate for the material to be used as a carrier for drugs, in particular antibiotics. This study was undertaken to determine whether lincomycin applied to the alveolus on TCP carrier can be used to accelerate wound healing and reduce inflammation after surgical extraction of a third molar. We enrolled 80 patients (males and females between the age of 18 and 50 years) who underwent extraction of a third molar at the Department of Dental Surgery, Pomeranian Medical University in Szczecin. Surgical difficulty in the patients according to the Pederson scale corresponded to grade 2 or 3 (medium or high difficulty). The study group consisted of 40 patients who received lincomycin on TCP. Beta-tricalcium phosphate (300-700 microm pores) obtained from the Department of Technology of Ceramics and Refractories, AGH University of Science and Technology in Cracow, was soaked with 500 mg of lincomycin in solution and applied to the dental alveolus after tooth extraction. The alveolus was tightly sutured. The control group comprised 40 patients not treated with lincomycin. The patients reappeared for examination on the first, third, and seventh day after surgery. Attention during follow-up was directed to alveolar periostitis, pain, and trismus. Pain intensity was assessed with the 10-degree Visual Analog Scale (VAS). We analyzed the subjective pain intensity reported during follow-up by the patients. In the study group, 20 patients reported no pain 24 hours after extraction. On the third day after surgery, alveolar

Analyses of anatomical relationship between mandibular third molar roots and variations in lingual undercut of mandible using cone-beam computed tomography

Directory of Open Access Journals (Sweden)

Sertac Aktop

2017-09-01

Conclusion: The narrow angulation of the lingual balcony region and the relationship between roots and lingual soft tissues should be noted to avoid undesirable complication of displacement of a tooth or fragment into sublingual, submandibular, and pterygomandibular spaces. There was no relation in the floor of the mouth between the position of the impacted third molar roots and different lingual undercut angulation variations.

A study to evaluate the changes in 3rd molar angulation with extraction of four premolars in class II malocclusion therapy

Directory of Open Access Journals (Sweden)

Özge Uslu-Akçam

2015-01-01

Full Text Available Aim: The objectives of the study are to evaluate the changes in third molar angulation during orthodontic treatment with extraction of premolars in Class II malocclusions, and to evaluate the relationship between the angulation of third molars and positional changes of incisors and molars. Materials and Methods: This study was conducted on lateral cephalograms and dental panoramic tomograms of 30 patients (mean age 13.48 years with skeletodental Class II malocclusion treated with four first premolar extractions. Twenty-four cases were treated with edgewise, and six were treated with Begg technique. The changes in the eruption pattern of the third molars were observed at the beginning of the treatment (T1 and at the end of the treatment (T2. The changes in the anteroposterior position of the incisors and molars, original molar space, and mesiodistal third molar angulation were tested by paired t-test. Results: The positional changes of the upper/lower incisors and first molars and original molar space were found similar in edgewise and Begg technique. Original molar space was increased in both jaws during orthodontic treatment. Long axis angle of the upper right third molar due to occlusal plane was increased nonsignificantly. Lower right third molars uprighted significantly. A positive correlation was found between the inclination of the lower right third molars and position of lower incisors and first molars. Conclusion: Treatment with extraction of premolars result in a greater space in the third molar region as a result of the mesial movement of the molars during space closure.

[Orthodontic Management of the Impacted Mandibular Second Molar Tooth].

Science.gov (United States)

Mah, Michael; Takada, Kenji

2016-09-01

When the mandibular permanent second molar becomes impacted, it is identified as a malocclusion that needs treatment as it often leads to unwanted complications such as caries and periodontitis of the adjacent permanent first molar. Other less common complications include root resorption of the adjacent first molar root or continued root development to be in close proximity to the inferior dental alveolar nerve. This paper seeks to differentiate various levels of severity of impaction and review treatment options that are considered clinically available for the proper management of the impacted mandibular permanent second molar. Treatment options that will be discussed in this article include timing of second molar removal for replacement by the third molar, relief of impaction via second premolar removal, surgical repositioning and the combination of third molar removal, surgical exposure and orthodontic uprighting of the impacted tooth. Depending on the severity of the impaction, most impactions can be easily and predictably corrected with nickel titanium archwires or auxillary open coil springs or uprighting springs. Uncommonly, the mandibular permanent second molar can become severely impacted and in close proximity to the inferior dentoalveolar nerve. In these instances, the use of temporary anchorage devices such as microimplants has shown to be successful in uprighting the severely impacted mandibular permanent second molars. © EDP Sciences, SFODF, 2016.

Clinical trial evaluating the effectiveness of biocompound IMMUNEPOTENT CRP in the third-molar extraction

Directory of Open Access Journals (Sweden)

Moises A. Franco-Molina

2017-01-01

Full Text Available A controlled, parallel, randomized and comparative trial was carried out to evaluate the anti-inflammatory efficacy of IMMUNEPOTENT CRP versus ibuprofen in patients after third-molar surgery over seven days. The anti-inflammatory efficacy of IMMUNEPOTENT CRP was evaluated using the method of Amin and Laskin, and the analysis of cytokine production (IL-2, IL-4, IL-6, IL-10, TNF-α, INF-γ in saliva was done by flow cytometry. The swelling process after surgery was significant (p < 0.05 and the treatments with IMMUNEPOTENT CRP or ibuprofen controlled this process properly; no difference between the groups was found (p < 0.05. Both treatments were shown to modulate the cytokine production. These results demonstrate the anti-inflammatory activity of the natural compound IMMUNEPOTENT CRP and suggest it could be used in clinical dental practice.

Effect of low-dose dexketoprofen trometamol and paracetamol on postoperative complications after impacted third molar surgery on healthy volunteers: A pilot study

Science.gov (United States)

Durmus, Ercan; Kiresi, Demet

2014-01-01

Objectives: The aim of the present study was to investigate the analgesic and anti-inflammatory effects of dexketoprofen trometamol (DT) and paracetamol on deep acute somatic pain and inflammation in patients undergoing impacted third molar surgery. This study was planned to present benefits that we could obtain with low burden of drug. Study Design: Effects of drugs, which were administered preemptively before the procedure, on pain, mouth-opening limitation, and swelling were assessed by visual analogue scale (VAS), magnetic resonance imaging (MRI), and mouth-opening measurement. Following surgery, time intervals when the patients first need to receive the drug were measured. Results: The VAS scores of the patients were lower in the side treated with DT than that in the paracetamol treated side. There was no significant difference between the groups in terms of mouth-opening limitation. MRI recordings revealed that swelling was lower in the side treated with paracetamol than DT treated side. Conclusions: Administration of the drugs before surgery contributed to the postoperative patient comfort. The analgesic activity of 12.5 mg dose of DT was similar to, even better than, the analgesic activity of 500 mg dose of paracetamol; however, DT had insufficient anti-inflammatory efficacy. Key words:Dexketoprofen trometamol, paracetamol, magnetic resonance imaging. PMID:25129247

A Review of In-Office Dynamic Image Navigation for Extraction of Complex Mandibular Third Molars.

Science.gov (United States)

Emery, Robert W; Korj, Oxana; Agarwal, Ravi

2017-08-01

We performed a retrospective review of in-office removal of complex mandibular third molars with a dynamic image navigation system (DINS). A retrospective review was conducted of cases completed from 2010 to 2014 by a single oral and maxillofacial surgeon. The average age of the patients was 47 years (range, 27 to 72 years). Extraction complexity was classified with Juodzbalys and Daugela's classification system. The included study cases had complexity scores of 9 or greater. Each patient received custom intraoral splints to secure the tracking array and underwent cone beam computed tomography image acquisition. All surgical procedures were performed with a precalibrated tracking straight handpiece under dynamic navigation. All 25 cases were treated successfully with the use of the DINS. Twelve of these cases were associated with pathologic lesions. Three patients were noted to have inferior alveolar nerve paresthesia. One patient sustained a pathologic fracture at week 2. Postoperative infections were noted in 7 cases, 2 of which had a pre-existing infection. One patient reported temporary limitation of mouth opening. A coronectomy was performed in 1 case. We present results using a new technology, the DINS, for removal of complex mandibular third molars. Potential advantages are 1) improved visualization and localization of anatomic structures such as the inferior alveolar nerve, lingual cortical plate, and adjacent roots; 2) improved control during osteotomy; 3) decreased surgical access requirements and reduction in overall bone removal; 4) ability to perform complex procedures successfully in an in-office setting; 5) decreased surgical time resulting from improved visualization; and 6) potential use as a teaching tool. Possible limitations of the use of an in-office DINS include increased cost, increased time attributed to presurgical planning, initial learning curve, and optical array interference by the surgeon or assistants during surgery. Copyright �

Efficacy of piroxicam for postoperative pain after lower third molar surgery associated with CYP2C8*3 and CYP2C9

Directory of Open Access Journals (Sweden)

Calvo AM

2017-07-01

Full Text Available Adriana Maria Calvo, Paulo Zupelari-Gonçalves, Thiago José Dionísio, Daniel Thomas Brozoski, Flávio Augusto Faria, Carlos Ferreira Santos Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil Objective: Nonsteroidal anti-inflammatory drugs (NSAIDs are metabolized by the cytochrome P450 enzymes (CYPs, predominantly CYP2C8 and CYP2C9. The aim of this study was to evaluate the possible association of polymorphisms in the CYP2C8*3 and CYP2C9 genes with the clinical efficacy of oral piroxicam (20 mg daily for 4 days after lower third molar surgeries with regard to postoperative pain, swelling, trismus, adverse reactions, need for rescue medication and the volunteer’s overall satisfaction. Materials and methods: For this purpose, 102 volunteers were genotyped for CYP2C8*3 and CYP2C9 polymorphisms. Briefly, genomic DNA was isolated from saliva collected from volunteers subjected to invasive lower third molar surgeries, and the preoperative, intraoperative and postoperative parameters were collected and analyzed. Results: An equal amount of piroxicam sufficiently managed postoperative pain and inflammatory symptoms, with visual analog pain scores typically <40 mm for all genotypes investigated. Furthermore, only two out of 102 volunteers heterozygous for CYP2C8*3 and CYP2C9*3 reported adverse side effects. Conclusion: In general, slow metabolizers of piroxicam, who were volunteers with mutant alleles, were indifferent from normal metabolizers with the wild-type alleles and therefore did not require specialized piroxicam doses to manage postoperative pain and inflammation. Keywords: piroxicam, lower third molar surgery, P450, CYP2C8, CYP2C9, pharmacogenetics 

The Efficacy and Clinical Safety of Various Analgesic Combinations for Post-Operative Pain after Third Molar Surgery: A Systematic Review and Meta-Analysis.

Directory of Open Access Journals (Sweden)

Alvin Ho Yeung Au

Full Text Available To run a systematic review and meta-analysis of randomized clinical trials aiming to answer the clinical question "which analgesic combination and dosage is potentially the most effective and safe for acute post-operative pain control after third molar surgery?".A systematic search of computer databases and journals was performed. The search and the evaluations of articles were performed by 2 independent reviewers in 3 rounds. Randomized clinical trials related to analgesic combinations for acute post-operative pain control after lower third molar surgery that matched the selection criteria were evaluated to enter in the final review.Fourteen studies with 3521 subjects, with 10 groups (17 dosages of analgesic combinations were included in the final review. The analgesic efficacy were presented by the objective pain measurements including sum of pain intensity at 6 hours (SPID6 and total pain relief at 6 hours (TOTPAR6. The SPID6 scores and TOTPAR6 scores of the reported analgesic combinations were ranged from 1.46 to 6.44 and 3.24 - 10.3, respectively. Ibuprofen 400mg with oxycodone HCL 5mg had superior efficacy (SPID6: 6.44, TOTPAR6: 9.31. Nausea was the most common adverse effect, with prevalence ranging from 0-55%. Ibuprofen 200mg with caffeine 100mg or 200mg had a reasonable analgesic effect with fewer side effects.This systematic review and meta-analysis may help clinicians in their choices of prescribing an analgesic combination for acute post-operative pain control after lower third molar surgery. It was found in this systematic review Ibuprofen 400mg combined with oxycodone HCL 5mg has superior analgesic efficacy when compared to the other analgesic combinations included in this study.

Molecular analysis of 16S rRNA genes identifies potentially periodontal pathogenic bacteria and archaea in the plaque of partially erupted third molars.

Science.gov (United States)

Mansfield, J M; Campbell, J H; Bhandari, A R; Jesionowski, A M; Vickerman, M M

2012-07-01

Small subunit rRNA sequencing and phylogenetic analysis were used to identify cultivable and uncultivable microorganisms present in the dental plaque of symptomatic and asymptomatic partially erupted third molars to determine the prevalence of putative periodontal pathogens in pericoronal sites. Template DNA prepared from subgingival plaque collected from partially erupted symptomatic and asymptomatic mandibular third molars and healthy incisors was used in polymerase chain reaction with broad-range oligonucleotide primers to amplify 16S rRNA bacterial and archaeal genes. Amplicons were cloned, sequenced, and compared with known nucleotide sequences in online databases to identify the microorganisms present. Two thousand three hundred two clones from the plaque of 12 patients carried bacterial sequences from 63 genera belonging to 11 phyla, including members of the uncultivable TM7, SR1, and Chloroflexi, and difficult-to-cultivate Synergistetes and Spirochaetes. Dialister invisus, Filifactor alocis, Fusobacterium nucleatum, Porphyromonas endodontalis, Prevotella denticola, Tannerella forsythia, and Treponema denticola, which have been associated with periodontal disease, were found in significantly greater abundance in pericoronal compared with incisor sites. Dialister invisus and F nucleatum were found in greater abundance in sites exhibiting clinical symptoms. The archaeal species, Methanobrevibacter oralis, which has been associated with severe periodontitis, was found in 3 symptomatic patients. These findings have provided new insights into the complex microbiota of pericoronitis. Several bacterial and archaeal species implicated in periodontal disease were recovered in greater incidence and abundance from the plaque of partially erupted third molars compared with incisors, supporting the hypothesis that the pericoronal region may provide a favored niche for periodontal pathogens in otherwise healthy mouths. Copyright © 2012 American Association of Oral and

Placebo-controlled randomized clinical trial of the effect two different low-level laser therapies (LLLT)--intraoral and extraoral--on trismus and facial swelling following surgical extraction of the lower third molar.

Science.gov (United States)

Aras, Mutan Hamdi; Güngörmüş, Metin

2010-09-01

The purpose of this study is to compare the effects of extraoral and intraoral low-level laser therapies (LLLT) on postoperative trismus and oedema following the removal of mandibular third molars. Forty-eight patients who were to undergo surgical removal of their lower third molars were studied. Patients were randomly allocated to one of three groups: extraoral LLLT, intraoral LLLT, or placebo. In the study, a Ga-Al-As diode laser device with a continuous wavelength of 808 nm was used, and the laser therapy was applied by using a 1 x 3-cm handpiece. The flat-top laser beam profile was used in this therapy. For both of the LLLT groups, laser energy was applied at 100 mW (0.1 W) for a total of 120 s (0.1 W x 120 s = 12 J). Patients in the extraoral-LLLT group (n = 16) received 12-J (4 J/cm(2)) low-level laser irradiation, and the laser was applied at the insertion point of the masseter muscle immediately after the operation. Patients in the intraoral-LLLT group (n = 16) received 12-J (4 J/cm(2)) low-level laser irradiation intraorally at the operation site 1 cm from the target tissue. In the placebo group (n = 16), the handpiece was inserted intraorally at the operation site and then was touched extraorally to the masseter muscle for 1 min at each site (120 s total), but the laser was not activated. The size of the interincisal opening and facial swelling were evaluated on the second and seventh postoperative days. At the second postoperative day, trismus (29.0 +/- 7.6 mm [p = 0.010]) and swelling (105.3 +/- 5.0 mm [p = 0.047]) in the extraoral-LLLT group were significantly less than in the placebo group (trismus: 21.1 +/- 7.6 mm, swelling: 109.1 +/- 4.4 mm). Trismus (39.6 +/- 9.0 mm [p = 0.002]) in the extraoral-LLLT group at the seventh postoperative day was also significantly less than in the placebo group (29.0 +/- 6.2 mm). However, at the seventh postoperative day in the intraoral-LLLT group, only trismus (35.6 +/- 8.5 [p = 0.002]) was significantly less than

CANINE ECTOPIC TREATMENT WITH FIRST MOLAR EXTRACTION

Directory of Open Access Journals (Sweden)

Angelica Margo

2015-06-01

Full Text Available Decision to extract or not and the type of tooth must be analyzed carefully in orthodontic treatment. Preferable tooth to be extracted was the tooth with large caries or restoration. Usually the type of tooth to be extracted was second molar (if the third molar appears, incisor, first molar, and combination of several teeth. Orthodontic treatment with molar extraction is more difficult to treat and the result is usually compromise. There are several considerations in extracting first molar such as tooth with large caries or restoration, hypoplasia, periapical disease, large discrepancy, high maxilla-mandibular plane angle, and cases with anterior open bite. Nowadays, orthodontic cases with molar extraction do not prolong the treatment time compared to premolar extraction case, but the anchorage system must be considered carefully. The present case was treated with extraction of first molar to solve anterior crowding with maximum anchorage at the upper jaw and using Nance Holding Appliance.

Is The Late Mandibular Fracture From Third Molar Extraction a Risk Towards Malpractice? Case Report with the Analysis of Ethical and Legal Aspects

Directory of Open Access Journals (Sweden)

Weuler dos Santos Silva

2017-06-01

Full Text Available Objectives: The present study reports a case of late mandibular fracture due to third molar extraction and highlights the inherent clinical, ethical and legal aspects related to this surgical complication. Material and Methods: A female patient underwent surgical procedure for the extraction of the mandibular right third molar. Two days after the surgery the patient reported pain and altered occlusion in the right side of the mandible. After clinical and radiographic re-examination, the diagnosis of late mandibular fracture was established. A second surgery, under general anaesthesia, was performed for the fixation of the mandibular bone. Results: The fractured parts were reduced and fixed with locking plate systems and 2 mm screws following load-sharing principles. The masticatory function showed optimal performance within 7 and 21 days after the surgery. Complete bone healing was observed within 1 year of follow-up. Conclusions: For satisfactory surgical outcomes, adequate surgical planning and techniques must be performed. Signed informed consents explaining the risks and benefits of the treatment must be used to avoid ethical and legal disputes in dentistry.

Third Molar Agenesis, Prevalence, Distribution and Association with Other Dental Anomalies

OpenAIRE

Herrera-Atoche, José Rubén; Colomé-Ruiz, Gabriel Eduardo; Escoffié-Ramírez, Mauricio

2013-01-01

La agenesia de terceros molares se ha reportado en un 24,3% en México. La agenesia dental está asociada a otras anomalías dentales debido a su origen genético. El objetivo del presente estudio fue determinar la prevalencia y distribución de agenesia de terceros molares así como establecer su asociación con otras anomalías dentales en una población ortodóntica. La muestra incluyó 670 pacientes ortodónticos de 9 a 20 años de edad. Se excluyeron pacientes con tratamiento ortodóntico previo y con...

Efficacy of platelet rich plasma and hydroxyapatite crystals in bone regeneration after surgical removal of mandibular third molars.

Science.gov (United States)

Kaur, Preeti; Maria, Anisha

2013-03-01

This study evaluates the efficacy of platelet rich plasma (PRP) & porous hydroxyapatite crystals in bone regeneration after surgical removal of mandibular third molar with the help of radiographs and its comparison with control side. A total of 40 patients; both male and female aged between 18 and 35 years, who had impacted mandibular third molars were randomly selected for this study. Twenty patients were taken for control group and 20 patients for study group. The extraction socket of the study group was packed with PRP and hydroxyapatite granules and that of control group was sutured without PRP and hydroxyapatite. The bone density of both extraction sockets were evaluated radiographically using gray level histogram and compared periodically on immediate postoperative day, 1st and 3rd month postoperatively and postoperative sequelae of both the control group and study group in terms of oedema & pain or any other adverse reactions were also assessed. Data suggested evidence of early bone formation and maturation radiographically in study group as compared to control group. The percentage of facial swelling was numerically greater on the control side as compared to the study side, Pain was also assessed with VAS and it was found that the severity of pain was equal in both study and control groups and the results were not significant. This study clearly indicated a definitive improvement in the wound healing, increase in bone density, which signifies and highlights the use of PRP and hydroxyapatite granules, certainly as a valid method in inducing and accelerating bone regeneration.

A rare case of retained fourth molar teeth in maxilla and mandible. Case report

Directory of Open Access Journals (Sweden)

Rahnama Mansur

2014-06-01

Full Text Available The study presents a case of the rarely occurring totally retained fourth molar teeth simultaneously in maxilla and mandible. The appearance of supernumerary teeth is a relatively uncommon dental anomaly and it is rare for patients to have impacted fourth molars in two quadrant. The aim of this work is to describe the presence of unilateral (right fourth molars in the maxilla and the mandible in a young female patient aged 24 years. Orthopantomogram revealed impacted lower third molars but also unerupted unilateral (right upper and lower fourth molars. Before orthodontic treatment, the patient was subsequently admitted for removal of third and fourth impacted upper and lower molars under local anesthesia.

Comparison of the analgesic efficacy of preoperative/postoperative oral dexketoprofen trometamol in third molar surgery: A randomized clinical trial.

Science.gov (United States)

Esparza-Villalpando, Vicente; Chavarria-Bolaños, Daniel; Gordillo-Moscoso, Antonio; Masuoka-Ito, David; Martinez-Rider, Ricardo; Isiordia-Espinoza, Mario; Pozos-Guillen, Amaury

2016-09-01

The aim of this study was to compare the efficacy of preoperative and postoperative dexketoprofen trometamol for pain control after third molar surgery. Sixty subjects indicated for impacted mandibular third molar surgery were randomly assigned to two groups: preoperative (group 1, n = 30) and postoperative (group 2, n = 30) administration. Group 1 received 25 mg of dexketoprofen trometamol 30 min before surgery and 1 placebo capsule (same color and size with active drug) immediately after surgery. Group 2 received the placebo capsule 30 min before surgery and 25 mg of dexketoprofen trometamol immediately after surgery. Pain intensity was assessed using a numeric rating scale (NRS) during the first 8 h. The time of the need for a second dose of dexketoprofen trometamol, after the first administration, was recorded. The data were analyzed using mixed-model repeated-measures (MMRM), Wilcoxon rank-sum, and Kaplan-Meier analysis. After the 8 h period, no statistically significant difference was observed in the intensity of pain (MMRM, p = 0.41); and no significant difference in the time for a second dose (p = 0.956). In conclusion, preoperative administration of dexketoprofen trometamol is a reasonable clinical approach that is as effective as conventional postoperative pharmacological treatment, with the advantage of allowing early analgesia before pain develops. (ClinicalTrials.gov: NCT02380001). Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Mandibular second molar with 3 mesial canals and a radix paramolaris

Directory of Open Access Journals (Sweden)

N Ragavendran

2014-01-01

Full Text Available Mandibular first molar commonly has two roots, the mesial and the distal root. Surprisingly in some mandibular first molar has an unusual extra third root in between mesial and distal root. This extra root is the most commonly seen in lingual side and is called as radix entomolaris. If this extra root is seen on the buccal side, it is termed as radix paramolaris (RP, which is a very rare phenomenon. Recently, various case report studies has shown the presence of third canal in the mesial and distal roots of mandibular molars. They are named as middle mesial and middle distal canal, respectively. Here, we present a case report of mandibular second molar showing three canals in the mesial root and a RP.

Endodontic treatment of an unusual connation of permanent mandibular molars: a case report.

Science.gov (United States)

Liu, Shengbo; Fan, Bing; Peng, Bin; Fan, Mingwen; Bian, Zhuan

2006-10-01

A 27-year-old patient with an anomalous mandibular molar was referred for endodontic therapy. Clinical and radiographic examination revealed the connation of a second mandibular molar with a third molar. Challenging endodontic therapy was performed in the unusual connated molars. A 2-year recall showed good treatment result.

Evaluation of adjunctive effect of low-level laser Therapy on pain, swelling and trismus after surgical removal of impacted lower third molar: A double blind randomized clinical trial.

Science.gov (United States)

Farhadi, Farrokh; Eslami, Hosein; Majidi, Alireza; Fakhrzadeh, Vahid; Ghanizadeh, Milad; KhademNeghad, Sahar

2017-09-30

Wisdom teeth remains impacted in the jaw due to several reasons and surgery of impacted wisdom teeth is one of the most common surgeries in dental clinics. Pain, swelling and trismus are the common complications after this surgery which affect quality of life. In articles, various methods are introduced to control immediate inflammatory-response associated with third-molar surgery. The aim of this study is to evaluate the adjunctive effect of low-level laser Therapy on pain, swelling and trismus after surgical removal of impacted lower third molar. This double-blind randomized controlled trial (RCT) was conducted on two groups of 24 patients (age range of 18-35) that had referred to surgical ward of Faculty of Dentistry, Tabriz University of Medical Sciences for surgery of their mandibular third molar(2015-16). All the subjects were systemically healthy and had at least one impacted mandibular third molar. After surgery, in experimental group, the laser was applied intraorally (inside the tooth socket) and extraorally (at the insertion point of the masseter muscle) immediately after surgery in contact with the target area for 25 seconds each. The laser energy was 2.5 J per area with an energy density of 5 J/ cm 2 at the surface of the probe (spot size= 0.5 cm 2 ). In the other group, as the control group, it was pretended to radiate. Trismus, pain, and swelling were evaluated on the first and seventh days after surgery. The obtained data were evaluated using SPSS 16 software and independent samples T-test. In the group where LLLT had been used, P> 0.05 was calculated for pain, swelling, and trismus on days 1 and 7 after surgery that was not statistically significant. Under limitations of this study, using low-power laser with mentioned parameters, clinically reduces pain, swelling and trismus after surgical removal of impacted mandibular wisdom, but not statistically significant.

Molar Uprighting: A Considerable and Safe Decision to Avoid Prosthetic Treatment

Science.gov (United States)

Raveli, Taísa Boamorte; Raveli, Dirceu Barnabé; de Mathias Almeida, Kelei Cristina; Pinto, Ary dos Santos

2017-01-01

Background: Tipped lower molar over edentulous space is very common in orthodontics practice when adults seek treatment. The segmented arch technique features a predictable force system that provides a controlled release of force that can produce light and continuous tooth movement. Case Description: A female adult patient, who lost a permanent lower first molar, needed correction of the position of her permanent first molar place. Instead of making space for rehabilitation, it was closed after second molar uprighting and a balanced interdigitation was created without prosthetics. The patient was successfully treated with segmented arch technique using root correction spring activated with geometry VI to promote uprighting of a tipped molar and Niti spring coil to promote space closure. Practical Implications: Segmented arch technique is known to provide predictable light and continuous forces, which is very much indicated in adult treatment. There are several things to consider when orthodontically treating adult patients. Their periodontal conditions might not be ideal, less bone apposition may occur, and side effects of orthodontic tooth movement are expected. Thus, a predictable and controlled orthodontic treatment is needed. PMID:29114332

Effectiveness of Green Tea Mouthwash in Postoperative Pain Control Following Surgical Removal of Impacted Third Molars: Double Blind Randomized Clinical Trial

Directory of Open Access Journals (Sweden)

Majid Eshghpour

2013-07-01

Full Text Available Background:Pain following surgical removal of impacted molars has remained an important concern among practitioners. Various protocols have been proposed to reduce postoperative pain. However, each one has special side effects and limitations. As green tea possesses anti-inflammatory and antibacterial properties, the aim of the current study was to evaluate the effectiveness of green tea mouthwash in controlling postoperative pain.Materials and methods:In a study with split-mouth and double blind design, 44 patients in need of bilateral removal of impacted third molars underwent randomized surgical extraction; following one surgery patients rinsed with a green tea mouthwash from the first to seventh postoperative day and after other extraction rinsed with placebo mouthwash in the same duration. Both patients and surgeon were blinded to the type of mouthwash. The predictor variable was type of mouthwash and primary outcome variable was postoperative pain measured by visual analogue scale (VAS during first week after surgery. In addition, number of analgesics patients used after surgery recorded. To measure the effect of green tea mouthwash, repeated measures test with confidence interval of 95% was performed.Results:Total of 43 patients with mean age of 24 years underwent total of 86 surgeries. VAS value had no statistically difference prior rinsing among groups (P-value > 0.05. However, the mean value of VAS following rinsing with green tea was statistically lower than placebo in postoperative days of 3–7 (P-value < 0.05. In addition, while rinsing with green tea, patients took significantly lower number of analgesics after surgery (P-value < 0.05. No side effects reported.Conclusion:Green tea mouthwash could be an appropriate and safe choice to control postoperative pain after third molar surgery.

Application of age assessment based on the radiographic visibility of the root pulp of lower third molars in a northern Chinese population.

Science.gov (United States)

Guo, Yu-Cheng; Chu, Guang; Olze, Andreas; Schmidt, Sven; Schulz, Ronald; Ottow, Christian; Pfeiffer, Heidi; Chen, Teng; Schmeling, Andreas

2018-05-01

The purpose of the present study was to explore the potential application of radiographic visibility of the root pulp in lower third molars in a northern Chinese population, in order to determine if this methodology can be used to prove whether a person has surpassed the thresholds of 18 and 21 years of age. A total of 1300 orthopantomograms comprising equal numbers of females and males evenly distributed between the ages of 15 and 40 years were analyzed. The radiographic visibility of the root pulp of the lower third molars was assessed using the stages described by Olze et al. (2010). Stage 1 first appeared at 19.25 years in males and at 20.73 years in females. The earliest appearance of stage 2 happened at 22.33 years in males and at 22.41 years in females. Stage 3 was achieved first at 26.45 years in males and at 27.66 years in females. It was concluded that stages 1, 2, and 3 can be used to show that a person is over 18 years of age. If stages 2 or 3 are determined, it is possible to prove that an individual has already attained the age of 21 years.

Unusal canal configuration in maxillary and mandibular second molars

Directory of Open Access Journals (Sweden)

Ramachandran Ragunathan

2016-01-01

Full Text Available This clinical article describes three different case reports of maxillary and mandibular second molars with the unusual anatomy of single root with a single canal and their endodontic management. An unusual case of bilateralism is observed in the first two cases in the form of single-rooted second mandibular molars in both the quadrant of the same patient. The presence of maxillary second molar with single root and single canal in the third case is unusual.

Endodontic treatment of a mandibular first molar with three mesial canals and broken instrument removal.

Science.gov (United States)

Faramarzi, Farhad; Fakhri, Hamidreza; Fakri, Hamidreza; Javaheri, Homan H

2010-04-01

To succeed in any dental procedure, the clinician's awareness of the patient's dental anatomy and its variations is crucial. In endodontic therapy, obtaining full information about the root canals' variations can affect the outcome substantially. This case report presents the endodontic treatment of a mandibular first molar exhibiting three mesial root canals with 4 mm of a separated K-file in the coronal third of the mesiolingual canal on an 18-year-old female patient. This case demonstrates the importance of locating additional canals in any roots undergoing endodontic treatment and how the clinician's awareness of aberrant internal anatomy may change the treatment results.

A Comparative Study on the Efficacy of Submucosal Injection of Dexamethasone Versus Methylprednisolone in Reducing Postoperative Sequelae After Third Molar Surgery.

Science.gov (United States)

Lim, Daniel; Ngeow, Wei Cheong

2017-11-01

To compare the efficacy of preoperative submucosal injection of 4 mg of dexamethasone versus 40 mg of methylprednisolone in reducing postoperative sequelae after surgical removal of impacted mandibular third molars. This prospective, randomized, double-blind study included 65 patients who required surgical removal of impacted mandibular third molars with Class II or position B impaction (Pell and Gregory classification). Patients were randomly assigned to 1 of 3 groups: dexamethasone, methylprednisolone, or placebo (control). Surgery was performed with patients under local anesthesia. Baseline measurements were obtained preoperatively, and subsequent assessments were made on postoperative day 1, 2, 5, and 7 to measure postoperative facial swelling by use of 2 linear measurements: interincisal mouth opening width and visual analog scale score for pain. The amount of analgesics consumed was recorded. Wound healing also was assessed on postoperative day 7. Descriptive and multivariate statistics were computed, and significance was set at P Kruskal-Wallis test), whereas the methylprednisolone group had significantly less pain (P Kruskal-Wallis test) and consumed a lower amount of analgesics (P test) during the early postoperative days. The study findings suggest that a single preoperative dose of dexamethasone versus methylprednisolone was equally effective in reducing postoperative swelling and trismus. Pain control by these corticosteroids, however, was variable. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Three dimensional analysis of impacted maxillary third molars: A cone-beam computed tomographic study of the position and depth of impaction

Energy Technology Data Exchange (ETDEWEB)

De Andrade, Priscila Ferreira; Silva, Jesca Neftali Nogueira; Sotto-Maior, Bruno Sales; Devito, Karina Lopes; Assis, Neuza Maria Souza Picorelli [Faculty of Dentistry, Federal University of Juiz de Fora, Juiz de Fora (Brazil); Ribeiro, CleideGisele [Faculty of Medical and Health Sciences - SUPREMA, Juiz de Fora (Brazil)

2017-09-15

The classification of impacted maxillary third molars (IMTMs) facilitates interdisciplinary communication and helps estimate the degree of surgical difficulty. Thus, this study aimed to develop a 3-dimensional classification of the position and depth of impaction of IMTMs and to estimate their prevalence with respect to gender and age. This cross-sectional retrospective study analyzed images in sagittal and coronal cone-beam computed tomography (CBCT) sections of 300 maxillary third molars. The proposed classification was based on 3 criteria: buccolingual position (buccal, lingual, or central), mesial-distal position (mesioangular, vertical, or distoangular), and depth of impaction (low, medium, or high). CBCT images of IMTMs were classified, and the associations of the classifications with gender and age were examined using analysis of variance with the Scheffé post-hoc test. To determine the associations among the 3 classifications, the chi-square test was used (P<.05). No significant association of the classifications with gender was observed. Age showed a significant relationship with depth of impaction (P=.0001) and mesial-distal position (P=.005). The most common positions were buccal (n=222), vertical (n=184), and low (n=124). Significant associations among the 3 tested classifications were observed. CBCT enabled the evaluation of IMTMs in a 3-dimensional format, and we developed a proposal for a new classification of the position and depth of impaction of IMTMs.

Endodontic therapy for a fused mandibular molar.

Science.gov (United States)

Rotstein, I; Moshonov, J; Cohenca, N

1997-06-01

Variations in tooth morphology present a clinical challenge when endodontic treatment is required. A case of conservative endodontic therapy for a fused mandibular second and third molar is presented.

Effect of third molar surgery on oral health-related quality of life in the first postoperative week using Dutch version of oral health impact profile-14

NARCIS (Netherlands)

van Wijk, A.; Kieffer, J.M.; Lindeboom, J.H.

2009-01-01

Purpose: The present study investigated the effect of third molar surgery on oral health-related quality of life, related to pain and clinical variables, in the first postoperative week using the Dutch version of the 14-item Oral Health Impact Profile. Materials and Methods: A total of 50 patients,

A randomized clinical trial to compare the efficacy of submucosal aprotinin injection and intravenous dexamethasone in reducing pain and swelling after third molar surgery: a prospective study.

Science.gov (United States)

Arakeri, Gururaj; Rai, Kirthi Kumar; Shivakumar, H R; Jayade, Bhushan

2013-03-01

The purpose of this study was to compare two different groups of drugs, aprotinin and dexamethasone for its efficacy in reducing post operative swelling and pain after third molar surgery. Fifty consecutive patients requiring surgical removal of single mandibular third molar (class II position B) under local anesthesia were randomly divided into two groups, each group consisting of 25 patients. One group was administered 8 mg dexamethasone through intravenous route pre-operatively. The other group received 1 ml of Aprotinin through submucosal route in operating area after the onset of local anesthesia. Swelling was assessed by measuring facial contours at baseline and at 1st, 3rd and 7th post-operative days. Pain was measured on the 1st, 3rd and 7th post-operative days using visual analog scale. Based on statistical analysis (paired t test and Wilcoxon's signed ranking test), the results showed statistically significant difference in post operative swelling and pain on 3rd postoperative day in dexamethasone group as compared to aprotinin group. The results of present study showed a similar reduction in the severity of pain and swelling at the aprotinin and dexamethasone sites on 1st and 7th postoperative day. It was also noticed that the aprotinin promoted a greater reduction of swelling and pain on 3rd postoperative day. It appeared that, benefits of aprotinin against the risks of dexamethasone and its efficacy in controlling pain and swelling after third molar surgery makes aprotinin to be a valuable alternative to dexamethasone.

Evaluation of the anatomical alterations of lower molars mesial root?s apical third

OpenAIRE

FRÖNER Izabel Cristina; IMPERADOR Cristina Aparecida; SOUZA Luiz Gustavo de

1999-01-01

The anatomical apex of the mesial root of the lower molars presents a morphological complexity related to the number and shape of the root canals as well as of the apical foramen and isthmus presence. The knowledge of the complexity of the endodontic system of the molar root area is essencial to select more carefully the best instrumentation and obturation technique, to obtain a more successful endodontic therapy.

Evaluation of the anatomical alterations of lower molars mesial root?s apical third

Directory of Open Access Journals (Sweden)

FRÖNER Izabel Cristina

1999-01-01

Full Text Available The anatomical apex of the mesial root of the lower molars presents a morphological complexity related to the number and shape of the root canals as well as of the apical foramen and isthmus presence. The knowledge of the complexity of the endodontic system of the molar root area is essencial to select more carefully the best instrumentation and obturation technique, to obtain a more successful endodontic therapy.

Root canal morphology of primary molars: a micro-computed tomography study.

Science.gov (United States)

Fumes, A C; Sousa-Neto, M D; Leoni, G B; Versiani, M A; da Silva, L A B; da Silva, R A B; Consolaro, A

2014-10-01

This was to investigate the root canal morphology of primary molar teeth using micro-computed tomography. Primary maxillary (n = 20) and mandibular (n = 20) molars were scanned at a resolution of 16.7 μm and analysed regarding the number, location, volume, area, structured model index (SMI), area, roundness, diameters, and length of canals, as well as the thickness of dentine in the apical third. Data were statistically compared by using paired-sample t test, independent sample t test, and one-way analysis of variance with significance level set as 5%. Overall, no statistical differences were found between the canals with respect to length, SMI, dentine thickness, area, roundness, and diameter (p > 0.05). A double canal system was observed in the mesial and mesio-buccal roots of the mandibular and maxillary molars, respectively. The thickness in the internal aspect of the roots was lower than in the external aspect. Cross-sectional evaluation of the roots in the apical third showed flat-shaped canals in the mandibular molars and ribbon- and oval-shaped canals in the maxillary molars. External and internal anatomy of the primary first molars closely resemble the primary second molars. The reported data may help clinicians to obtain a thorough understanding of the morphological variations of root canals in primary molars to overcome problems related to shaping and cleaning procedures, allowing appropriate management strategies for root canal treatment.

Effect of third molar surgery on oral health-related quality of life in the first postoperative week using Dutch version of Oral Health Impact Profile-14

NARCIS (Netherlands)

van Wijk, Arjen; Kieffer, Jacobien M.; Lindeboom, Jerome H.

2009-01-01

The present study investigated the effect of third molar surgery on oral health-related quality of life, related to pain and clinical variables, in the first postoperative week using the Dutch version of the 14-item Oral Health Impact Profile. A total of 50 patients, referred to the Department of

Third Molars on the Internet: A Guide for Assessing Information Quality and Readability.

Science.gov (United States)

Hanna, Kamal; Brennan, David; Sambrook, Paul; Armfield, Jason

2015-10-06

Directing patients suffering from third molars (TMs) problems to high-quality online information is not only medically important, but also could enable better engagement in shared decision making. This study aimed to develop a scale that measures the scientific information quality (SIQ) for online information concerning wisdom tooth problems and to conduct a quality evaluation for online TMs resources. In addition, the study evaluated whether a specific piece of readability software (Readability Studio Professional 2012) might be reliable in measuring information comprehension, and explored predictors for the SIQ Scale. A cross-sectional sample of websites was retrieved using certain keywords and phrases such as "impacted wisdom tooth problems" using 3 popular search engines. The retrieved websites (n=150) were filtered. The retained 50 websites were evaluated to assess their characteristics, usability, accessibility, trust, readability, SIQ, and their credibility using DISCERN and Health on the Net Code (HoNCode). Websites' mean scale scores varied significantly across website affiliation groups such as governmental, commercial, and treatment provider bodies. The SIQ Scale had a good internal consistency (alpha=.85) and was significantly correlated with DISCERN (r=.82, Psoftware estimates were associated with scientific information comprehensiveness measures.

[The health of adults undergoing an eviction process].

Science.gov (United States)

Bolívar Muñoz, Julia; Bernal Solano, Mariola; Mateo Rodríguez, Inmaculada; Daponte Codina, Antonio; Escudero Espinosa, Cecilia; Sánchez Cantalejo, Carmen; González Usera, Isis; Robles Ortega, Humbelina; Mata Martín, José Luis; Fernández Santaella, M Carmen; Vila Castellar, Jaime

2016-01-01

To analyze perceived health status and other health-related indicators in the adult population in Granada (Spain) undergoing an eviction process from their homes, whether rented or owned, in comparison with health indicators in the general adult population in Andalusia. A cross-sectional survey was administered by trained staff. The survey included instruments from the Andalusian Health Survey 2011 for measuring variables related to physical and mental health, as well as health-related habits. We compared the results with those obtained from the Andalusian general population through the Andalusian Health Survey. A bivariate analysis using the χ2 test and a multivariate logistic regression analysis were conducted. We obtained a total sample of 205 people in the process of eviction. A total of 59.5% (n=122) were women, and 40.5% (n=83) were men. Participants were more likely to have poor health (odds ratio [OR]: 12.63, 95% confidence interval [95%CI]: 8.74-18.27), have cardiovascular diseases (OR: 3.08; 95%CI: 1.54- 6.16), or to smoke (OR: 1.68; 95% CI: 1.21-2.33) compared with the Andalusian general population. Most of the health indicators analyzed showed a worse outcome for women undergoing an eviction process. Our results suggest that, in the current context of economic crisis, people undergoing a process of eviction in Granada and its metropolitan area show poorer health than the Andalusian general population. Further research is needed on health and evictions from different methodological approaches, for a better understanding of the topic. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

Biostimulation effect of low-level laser on healing process after third molar surgery, based on biochemical markers in saliva

Science.gov (United States)

Kroulikova, Veronika; Dostálová, Tatjana; Podzimek, Stepan

2015-02-01

Third molar extractions in general anesthesia have become a standard procedure in dentistry. There is an effort to shorten healing time and decrease the number of complications as well as increase comfort after the treatment. Low-level lasers are known for their analgesic, anti-inflammatory, and stimulatory effect. The aim of the study is to evaluate the effect of low-level laser after surgery in general anesthesia reducing the patient's discomfort, i.e. mainly pain, and also, to monitor the biostimulation process. Our study included 79 patients treated at the Department of Maxilofacial Surgery, diagnosed with third molar retention. Diode low-level laser radiation (wavelength 830 nm, output power 270 mW, probe aperture of 6.4 mm2) with dose ~ 3 mJ was applied. The control group was treated by using placebo - red light. The exposure time was 11 seconds immediately after the suture; the treatment was repeated every day for the following 3 days. To evaluate the effect of laser biostimulation, the objective markers for immunological determination of healing - sIgA and lysozyme in non-stimulated saliva of patients - were used. The sIgA decreases after laser application from 546.91 mg/l to 304. 91mg/l and in the control group from 602.25mg/l to 425.62 mg/l. The results were statistically significant. The level of lysozyme decreases from 54.27 mg/l to 2.45mg/l after laser biostimulation, from 304.371mg/l to 11.08mg/l after placebo effect. The study has confirmed a low-level laser healing effect not directly related to pain.

Evaluation of the effects of platelet-rich fibrin and piezosurgery on outcomes after removal of ımpacted mandibular third molars.

Science.gov (United States)

Bilginaylar, K; Uyanik, L O

2016-07-01

We compared postoperative outcomes after the removal of 80 impacted mandibular third molars in 59 patients. In the control group, osteotomies were done with traditional burs (n=20). The second group had traditional osteotomies and platelet-rich fibrin (PRF) placed into the socket of the extracted tooth (n=20). The third group had piezosurgery (n=20), and the fourth had piezosurgery and PRF placed in the extraction socket (n=20). Baseline variables were assessed preoperatively and included pain, the number of analgesics taken, trismus, and swelling. These were also assessed on postoperative days 1, 2, 3, and 7. There was a significant reduction (ppiezosurgery alone group this was the case only on day 3. There was no significant difference in swelling and trismus between the control and other groups. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Evaluation of autogenous tooth transplantation for replacement of the missing or unrestorable mandibular molar tooth

Directory of Open Access Journals (Sweden)

Wahiduj Jaman

2017-06-01

Full Text Available This study was undertaken to evaluate the functional and occlusal stability of autogenous tooth transplantation. A total of 30 patients were included. Among them, 21 participants received transplanted first molar and the remaining 9 received transplanted second molar. In all the cases, donor tooth were third molar. In each participant, extraction of un-restorable first or second molar tooth was performed which was then replaced by atrumatic extracted third molar tooth. Each third molar tooth was placed in the recipient extracted socket, followed by the evaluation of the occlusion and then stabilized with arch bar and ligature wire. Clinical follow-up evaluation was performed at 15 days, 3 and 12 months in respect to occlusal stability, tooth mobility and periodontal status. It was found that 23 transplanted tooth were successful and the remaining 7 tooth need long-term observation for the final outcome, which was statistically significant. It can be concluded that the autogenous tooth transplantation can replace missing tooth to ensure the preservation of function, aesthetic and to prevent bone resorption of the missing area of the jaw, which can lead to exceptional esthetic and functional outcome.

Evaluation of the anatomical alterations of lower molars mesial root’s apical third

OpenAIRE

FRÖNER, Izabel Cristina; IMPERADOR, Cristina Aparecida; SOUZA, Luiz Gustavo de

1999-01-01

The anatomical apex of the mesial root of the lower molars presents a morphological complexity related to the number and shape of the root canals as well as of the apical foramen and isthmus presence. The knowledge of the complexity of the endodontic system of the molar root area is essencial to select more carefully the best instrumentation and obturation technique, to obtain a more successful endodontic therapy. A presente pesquisa analisa in vitro as alterações anatômicas dos 4 mm apic...