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Onuoha EO, Adekunle AA, Ajike SO, Gbotolorun OM, Adeyemo WL. Effect of manuka honey socket dressing on postoperative sequelae and complications following third molar extraction: A randomized controlled study. J Craniomaxillofac Surg 2023:S1010-5182(23)00072-0. [PMID: 37164834 DOI: 10.1016/j.jcms.2023.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 03/03/2023] [Accepted: 05/03/2023] [Indexed: 05/12/2023] Open
Abstract
To evaluate the effect of manuka honey on the healing of mandibular third molar extraction sockets. This was a prospective randomized study at a tertiary health institution in Lagos, Nigeria. All extractions were transalveolar, using the distobuccal bone guttering technique. Participants were randomized into two study groups. Group A underwent intrasocket application of manuka honey, after which sockets were completely closed using the mucosal flap, while participants in group B underwent mucosal flap closure of the socket without application of manuka honey. The primary outcome was healing of the extraction socket at 7 days postoperatively. The secondary outcomes measured were postoperative sequelae, namely pain, swelling, and trismus on postoperative days 1, 3, and 7, and socket healing complications - specifically inflamed socket, infected socket, and alveolar osteitis. In total, 112 participants completed the study, with 56 participants per group. There were no significant differences in demographic variables between both groups. On the 7th day postoperatively, 26.8% of participants in group B had an unhealed extraction site, compared with 10.3% of participants in group A (p = 0.029). A significant difference was observed between pre- and postoperative pain scores in both study groups (p = 0.001). A comparison of postoperative mean facial swelling between the two groups showed no statistically significant differences on all the review days (p = 0.66). The difference in postoperative socket healing complication rate between both groups was statistically significant (χ2 = 4.747, p = 0.029). Within the limitations of the study it seems that the application of manuka honey appears to aid earlier healing of the third molar extraction socket, with a significantly lower frequency of complications. Therefore, the application of manuka honey is recommended whenever appropriate.
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Affiliation(s)
- Emmanuel Onyebuchi Onuoha
- Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria.
| | - Adegbayi Adeola Adekunle
- Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
| | - Sunday Olusegun Ajike
- Department of Oral and Maxillofacial Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - Olalekan Micah Gbotolorun
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos/ Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
| | - Wasiu Lanre Adeyemo
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos/ Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
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Incidence of lingual nerve damage following surgical extraction of mandibular third molars with lingual flap retraction: A systematic review and meta-analysis. PLoS One 2023; 18:e0282185. [PMID: 36848347 PMCID: PMC9970109 DOI: 10.1371/journal.pone.0282185] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 02/08/2023] [Indexed: 03/01/2023] Open
Abstract
This systematic review and meta-analysis aimed to examine more recent data to determine the extent of lingual nerve injury (LNI) following the surgical extraction of mandibular third molars (M3M). A systematic search of three databases [PubMed, Web of Science and OVID] was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The inclusion criteria encompassed studies on patients who underwent surgical M3M extraction using the buccal approach without lingual flap retraction (BA-), buccal approach with lingual flap retraction (BA+), and lingual split technique (LS). The outcome measures expressed in LNI count were converted to risk ratios (RR). Twenty-seven studies were included in the systematic review, nine were eligible for meta-analysis. Combined RR for LNI (BA+ versus BA-) was 4.80 [95% Confidence Interval:3.28-7.02; P<0.00001]. The prevalence of permanent LNI following BA-, BA+ and LS (mean%±SD%) was 0.18±0.38, 0.07±0.21, and 0.28±0.48 respectively. This study concluded that there was an increased risk of temporary LNI following M3M surgical extractions using BA+ and LS. There was insufficient evidence to determine whether there is a significant advantage of BA+ or LS in reducing permanent LNI risk. Operators should use lingual retraction with caution due to the increased temporary LNI risk.
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Torof E, Morrissey H, Ball PA. The Role of Antibiotic Use in Third Molar Tooth Extractions: A Systematic Review and Meta-Analysis. Medicina (B Aires) 2023; 59:medicina59030422. [PMID: 36984426 PMCID: PMC10054344 DOI: 10.3390/medicina59030422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/14/2023] [Accepted: 02/17/2023] [Indexed: 02/25/2023] Open
Abstract
Background and Objectives: Anecdotal evidence suggested variation in practices for antibiotic prescribing around dental procedures including route of administration of antibiotics, timing of the course prescribed (before, after or both), length of course prescribed, narrow vs. broad spectrum agents prescribed, use of single or combination of antibiotics, and the use of loading doses. This review aims to investigate this disparity of practices and the absence of global and local recent consensus on the most appropriate antibiotic interventions around invasive dental procedures. Material and methods: Following PRISMA-P© methodology, a systematic review of randomised controlled clinical trials was designed, reviewed, and entered on the PROSPERO© website prior to commencement. Ethics approval was gained from the University of Wolverhampton Committee. Searches were performed using PubMed©, Science Direct™, and the Cochrane Database, plus the bibliographies of studies identified. They investigated studies examining the efficacy and safety of any antibiotic regimen tested, independent of regimen used, versus a placebo, control, or no therapy, on outcomes in post third molar extraction. Results: The primary outcome of interest was postoperative infection and secondary outcomes were other post-surgical related complications of infectious nature and antibiotic adverse events. Sixteen RCTs were identified that met the selection criteria. Antibiotic use was reported to be safe, causing few adverse events. Meta-analysis of infection events showed antibiotics reduced the risk of an infection by 69%, but routine use for prophylaxis in uncomplicated procedures was not supported, and their role in patients with comorbidities or impaired immunity remains controversial. The effect on the incidence of dry socket showed no difference based upon regimen used. No significant benefit was found with respect to reduction of intraoral inflammation, wound dehiscence, haematoma, and lymphadenopathy. Conclusion: The effect on postoperative pain reduction was inconclusive. Routine use of antibiotics around M3 extraction procedures is not supported, but their use in the presence of co-morbidities and or immunosuppression remains controversial to be confirmed by future studies.
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de Carvalho MF, de Matos Silveira G, de Carvalho PAR, Leite ICG, da Graça Naclério-Homem M. Analgesia and Side Effects of Codeine Phosphate Associated with Paracetamol Versus Oxycodone After the Extraction of Mandibular Third Molars: A Randomized Double-Blind Clinical Trial Using the Split-Mouth Model. J Maxillofac Oral Surg 2022; 21:1038-1043. [PMID: 36274876 PMCID: PMC9474989 DOI: 10.1007/s12663-022-01717-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 04/03/2022] [Indexed: 10/18/2022] Open
Abstract
Purpose To assess the analgesia and side effects of 10 mg oxycodone as compared to 30 mg of codeine phosphate associated with 500 mg of paracetamol after bilateral lower third molar extraction. Methods This is a prospective, randomized, double-blind study applied to a sample of 16 patients. They were evaluated for seven days postoperatively, and the mean score of the visual analogue scale (VAS) of pain between test and control medications was assessed by the Wilcoxon distribution. The side effects of these medications were assessed by the Q Cochran test. A p value of < .05 was considered statistically significant. Results The mean score of the VAS of pain was higher in the oxycodone side, where few patients reported the use of rescue analgesic. There was no report of rescue medication in codeine phosphate associated with paracetamol side. The most common side effects reported in both groups, predominantly in patients using the oxycodone, were drowsiness, dizziness, and headache. Conclusion The use of codeine phosphate associated with paracetamol after the extraction of impacted mandibular third molars is a better choice than oxycodone for controlling postoperative pain. Trial Registration Number and Date of Registration RBR-8ntwmyq 07/07/2021.
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Affiliation(s)
- Matheus Furtado de Carvalho
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Federal University of Juiz de Fora, Rua José Lourenço Kelmer, s/n, São Pedro, Juiz de Fora, MG CEP: 36036-900 Brazil
| | - Gabriela de Matos Silveira
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Federal University of Juiz de Fora, Rua José Lourenço Kelmer, s/n, São Pedro, Juiz de Fora, MG CEP: 36036-900 Brazil
| | - Paula Afonso Rodrigues de Carvalho
- Faculty of Medicine, Department of Public Health, Federal University of Juiz de Fora, Rua José Lourenço Kelmer, s/n, São Pedro, Juiz de Fora, MG CEP: 36036-900 Brazil
| | - Isabel Cristina Gonçalves Leite
- Faculty of Medicine, Department of Public Health, Federal University of Juiz de Fora, Rua José Lourenço Kelmer, s/n, São Pedro, Juiz de Fora, MG CEP: 36036-900 Brazil
| | - Maria da Graça Naclério-Homem
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Traumatology and Prosthesis, University of São Paulo, São Paulo, Brazil
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O'Sullivan L, Ní Ríordáin R. Patient-reported outcome measures in third molar surgery: A scoping review. Br J Oral Maxillofac Surg 2022; 60:1145-1150. [PMID: 35803785 DOI: 10.1016/j.bjoms.2022.05.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/25/2022] [Accepted: 05/30/2022] [Indexed: 10/18/2022]
Abstract
Despite a surge of interest in patient-centred outcomes (PROMs) in healthcare settings, they remain an underutilised resource in third molar surgery. Clinicians and researchers in the field of oral surgery who are interested in incorporating PROMs into their clinical practice may face challenges in instrument selection with as yet no consensus registry available. PROMs have undoubtedly transcended their original brief as research instruments, with the collection of PROMs data now a routine undertaking in many healthcare systems. Quality improvement, appropriate resource allocation, and measurement of effectiveness of interventions are but a few of their advantages. This review article presents a scoping overview of the instruments most relevant to the third molar surgery population.
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Affiliation(s)
- Laura O'Sullivan
- Cork University Dental School and Hospital, University College Cork, Ireland.
| | - Rícheal Ní Ríordáin
- Cork University Dental School and Hospital, University College Cork, Ireland; University College London, London Eastman Dental Institute, UK
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Ferreira GM, Prado LF, Santos KV, Rodrigues LG, Valladares-Neto J, Torres ÉM, Silva MA. Efficacy of two low-level laser therapy protocols following lower third molar surgery - a randomized, double-blind, controlled clinical trial. ACTA ODONTOLOGICA LATINOAMERICANA : AOL 2022; 35:31-38. [PMID: 35700539 DOI: 10.54589/aol.35/1/31] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 12/01/2021] [Indexed: 06/15/2023]
Abstract
The aim of this study was to test two low-level laser therapy protocols by evaluating pain control, swelling and trismus in the postoperative period of lower third molar surgeries. This was a randomized, double-blind, placebo-controlled, crossover trial. Patients presenting two symmetrically impacted mandibular third molars were included. One side was randomly assigned for LLLT applied immediately after surgery (T1) and then after 24 (T2) and 48 hours (T3) (Protocol A). The other side received LLLT applied immediately after surgery and placebo after 24 and 48 hours (Protocol B). LLLT was given by intraoral application (660nm, 5 J/cm2, 10 s, 20 mW, 4 points) followed by extraoral application (789 nm, 30 J/cm2, 20 s, 60 mW, 8 points). The placebo application was similar to that of the experimental side but with laser simulation. The primary outcomes were pain control, swelling and trismus intensity at T1, T2, T3 and 7 days after surgery (T4). Data were analyzedbyANOVArepeated measures and Wilcoxon test (p<.05). The final sample consisted of 21 patients (42 teeth). There were no statistical differences for pain level between protocols A and B over time (p= .909), although the amount of analgesic medication was lower with protocol A at T2 (p=.022). There were no differences in swelling (p=.958) or trismus (p=.837) between the protocols used over time. Both protocols performed similarly for pain control, swelling and trismus. Therefore, for practical reasons, a single laser application in the immediate postoperative period could be indicated for the management of postoperative discomfort in lower third molar surgery.
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Affiliation(s)
- Geovane M Ferreira
- Universidade Federal de Goiás, Faculdade de Odontologia, Departamento de Estomatologia, Goiânia, Brasil
| | - Lucianna F Prado
- Universidade Paulista, Faculdade de Odontologia, Departamento de Cirurgia, Goiânia, Brasil
| | - Kleber Vr Santos
- Universidade Federal de Goiás, Faculdade de Odontologia, Departamento de Estomatologia, Goiânia, Brasil
| | - Lívia G Rodrigues
- Universidade Federal de Goiás, Faculdade de Odontologia, Departamento de Estomatologia, Goiânia, Brasil
| | - José Valladares-Neto
- Universidade Federal de Goiás, Faculdade de Odontologia, Departamento de Reabilitação Oral, Goiânia, Brasil
| | - Érica M Torres
- Universidade Federal de Goiás, Faculdade de Odontologia, Departamento de Reabilitação Oral, Goiânia, Brasil
| | - Maria Ag Silva
- Universidade Federal de Goiás, Faculdade de Odontologia, Departamento de Estomatologia, Goiânia, Brasil.
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Le HTT, Huynh NCN, Nguyen-Ho QA, Nguyen TT, Le SH, Nguyen LTB. Effect of Photobiomodulation Therapy on Reducing Acute Pain and Inflammation Following Surgical Removal of Impacted Mandibular Third Molars: A Randomized, Split-Mouth Clinical Trial. Photobiomodul Photomed Laser Surg 2022; 40:245-251. [DOI: 10.1089/photob.2021.0110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ha Thanh-Thai Le
- Department of Oral Surgery, Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Nam Cong-Nhat Huynh
- Department of Dental Basic Sciences, and Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Quynh-Anh Nguyen-Ho
- Department of Dental Basic Sciences, and Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Thuy Thu Nguyen
- Department of Periodontology, Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Son Hoang Le
- Department of Oral Surgery, Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Ly Thi-Bich Nguyen
- Department of Oral Surgery, Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
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Al-Raisi S, Shah D, Bailey E. Analysis of outcomes and complications of 187 coronectomies. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2022. [DOI: 10.1016/j.adoms.2022.100292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Ghosh A, Aggarwal VR, Moore R. Aetiology, Prevention and Management of Alveolar Osteitis-A Scoping Review. J Oral Rehabil 2021; 49:103-113. [PMID: 34625985 DOI: 10.1111/joor.13268] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 08/09/2021] [Accepted: 09/21/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Alveolar osteitis (AO) is a poorly understood, common, painful complication following exodontia. It is sometimes managed by inappropriate prescription of antibiotics which contributes to the global threat of antimicrobial resistance. Use of intra-alveolar chlorhexidine also presents a serious risk of anaphylaxis to the patient. OBJECTIVE This scoping review aims to investigate the aetiology, prevention and management of AO and highlight the extent of inappropriate prescribing and intra-alveolar chlorhexidine use. DESIGN A scoping review was undertaken using the PRISMA guidelines. Medline, Ovid and Pubmed were searched between 2010 and 2020, from which 63 studies were selected for review that related to the aetiology, prevention or management of AO. Data were analysed for frequency of studies reporting information on risk factors for aetiology, prevention strategies and management including inappropriate management using antibiotic prescribing and intra-alveolar chlorhexidine. RESULTS Impaired immune response, surgical technique and age were identified as significant factors in the development of AO, while there is conflicting evidence regarding the effects of smoking and gender. With regard to prevention, the use of prophylactic antibiotics is not supported within the literature. Saline irrigation and eugenol pastes used preventively have been shown to be cheap and effective alternatives to chlorhexidine with no adverse effects. Hyaluronic acid and low-level laser therapies showed a significant reduction in pain and soft-tissue inflammation in the management of AO compared to Alveogyl. CONCLUSIONS Further understanding of the pathophysiology of AO is needed, in addition to large high-quality RCTs or long-term observational studies into the aetiology, prevention, and management of AO to produce up-to-date evidence-based clinical guidelines. Clinicians should also be mindful of their contribution to growing antimicrobial resistance and avoid inappropriate prescribing of antibiotics. Saline should replace chlorhexidine as the intra-alveolar irrigant of choice.
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Affiliation(s)
- Anna Ghosh
- Department of Oral and Maxillofacial Surgery, Hull Royal Infirmary, Hull, United Kingdom of Great Britain and Northern Ireland
| | - Vishal R Aggarwal
- Department of Academic Oral Surgery & Oral Medicine, University of Leeds, Leeds, United Kingdom of Great Britain and Northern Ireland
| | - Richard Moore
- Lecturer in Oral Surgery, Department of Academic Oral Surgery & Oral Medicine, University of Leeds, Leeds, United Kingdom of Great Britain and Northern Ireland
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Clinical Significance of Intraoperative Exposure of Inferior Alveolar Nerve during Surgical Extraction of the Mandibular Third Molar in Nerve Injury. J Clin Med 2021; 10:jcm10194379. [PMID: 34640397 PMCID: PMC8509309 DOI: 10.3390/jcm10194379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 09/23/2021] [Accepted: 09/23/2021] [Indexed: 11/17/2022] Open
Abstract
During extraction surgery, the inferior alveolar nerve (IAN) can occasionally be observed in the extraction socket of the mandibular third molar (M3). The purpose of this study was to investigate and compare the incidence of IAN injury in groups with and without intraoperative IAN exposure during surgical extraction of M3, and to identify additional risk factors for the IAN injury in addition to the IAN exposure. A total of 288 cases in 240 patients, who underwent surgical extraction of M3 by a single surgeon, were divided into the exposed group (n = 69) and the unexposed group (n = 219). The surgeon recorded the information regarding the procedure when the clinical observation of IAN exposure was made during the surgery. The incidence of IAN injury after the extraction surgery was significantly higher in the exposed group than in the unexposed group (4.3% versus 0%, p < 0.05). Paresthesia was recognized in three cases of the exposed group, but it showed complete recovery within three postoperative months. No case of permanent paresthesia was detected in both groups. According to the logistic regression, the only significant risk factor of IAN injury in the exposed group was the increase of age (OR 1.108, p < 0.05). Intraoperative IAN exposure during surgical extraction of M3 may show a higher incidence of IAN injury than the case without IAN exposure, representing an incidence of 4.3%. Even if the paresthesia associated with IAN exposure occurs, it is likely to be a temporary injury, and this risk may increase with age.
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Vranckx M, Geerinckx H, Gaêta-Araujo H, Leite AF, Politis C, Jacobs R. Do anatomical variations of the mandibular canal pose an increased risk of inferior alveolar nerve injury after third molar removal? Clin Oral Investig 2021; 26:931-937. [PMID: 34279700 DOI: 10.1007/s00784-021-04076-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/08/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The present study aimed to assess whether anatomical variations of the mandibular canal are associated with neurosensory disturbances of the inferior alveolar nerve (IAN) following mandibular third molar removal. METHODS Two observers compared the detection of third molar root-nerve relations and bifurcations of the mandibular canal on panoramic radiographs and CBCT images of 201 patients undergoing removal of 357 mandibular third molars. Potential neurosensory disturbances of the IAN were surveyed ten days after surgery. Fisher's Exact was performed to correlate presence of canal variations to postoperative neurosensory disturbances. Positive and negative predictive values (PPV, NPV) and likelihood ratios (LR + , LR-) were calculated. RESULTS Thirteen patients reported postoperative altered sensation of the lower lip, with 2 of them having mandibular canal bifurcations on the ipsilateral side of the injury. Fisher's Exact showed that the studied mandibular canal variations were not related to postoperative neurosensory disturbances. CBCT was superior in visualization of anatomical variations of the mandibular canal. Prevalence of bifurcations was 14% on CBCT and 7% on panoramic radiographs. In both imaging modalities and for all parameters, PPVs were low (0.04 - 0.06) and NPVs were high (0.92 - 0.98), with LR ranging around 1. CONCLUSION In the present study, the assessed mandibular canal variations had limited predictive value for IAN neurosensory disturbances following third molar removal. CLINICAL RELEVANCE While a close relation between the third molar and the mandibular canal remains a high risk factor, mandibular canal variations did not pose an increased risk of postoperative IAN injury after third molar removal.
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Affiliation(s)
- Myrthel Vranckx
- OMFS-IMPATH Research Group, , Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 7 blok a, 3000, Leuven, Belgium.
| | - Hannah Geerinckx
- OMFS-IMPATH Research Group, , Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 7 blok a, 3000, Leuven, Belgium
| | - Hugo Gaêta-Araujo
- OMFS-IMPATH Research Group, , Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 7 blok a, 3000, Leuven, Belgium
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Andre Ferreira Leite
- OMFS-IMPATH Research Group, , Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 7 blok a, 3000, Leuven, Belgium
- Department of Dentistry, Faculty of Health Sciences, University of Brasília, Brasília, Brazil
| | - Constantinus Politis
- OMFS-IMPATH Research Group, , Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 7 blok a, 3000, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, , Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 7 blok a, 3000, Leuven, Belgium
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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Vranckx M, Fieuws S, Jacobs R, Politis C. Surgical experience and patient morbidity after third molar removal. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 123:297-302. [PMID: 34260984 DOI: 10.1016/j.jormas.2021.07.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVES The present study aimed to assess differences in patients' postoperative morbidity after third molar removal in relation to the surgeon's level of experience and other intraoperative factors. MATERIAL AND METHODS Patients admitted for prophylactic removal of asymptomatic third molars were prospectively followed up on day 3 and 10 after surgery in the context of the M3BE-study. Uni- and multivariable logistic regression was performed to assess the associations between surgeon's (in)experience and postoperative discomfort. Other contributing factors were gender, age, extraction method (osteotomy or not), and number of extractions and involved jaws. RESULTS In total, 7 senior surgeons and 28 surgical residents operated 2560 patients (8672 third molars). Differences in postoperative morbidity on day 3 and 10 after surgery were small. The results showed no significant associations between surgeon's inexperience and postoperative discomfort (pain, trismus, swelling), except for persistent pain (day 10; OR 1.468; p = 0.0016). No effect was observed on the occurrence of postoperative nerve complications. It was shown that postoperative morbidity was more dependent on factors like age, gender, number of extractions and intraoperative osteotomy. CONCLUSION We may conclude that patient recovery following third molar removal is affected by other factors than surgical experience. However, surgical residents seemed to cause significantly more persisting pain problems 10 days after surgery.
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Affiliation(s)
- Myrthel Vranckx
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium.
| | - Steffen Fieuws
- L-BioStat, Leuven Biostatistics and Statistical Bioinformatics Centre, KU Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium; Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Constantinus Politis
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium
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O'Sullivan L, Ríordáin RN. Variations in reporting of clinician-reported outcome measures in third molar surgery: A focused review. Surgeon 2021; 20:e43-e50. [PMID: 33985894 DOI: 10.1016/j.surge.2021.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 03/06/2021] [Accepted: 03/25/2021] [Indexed: 11/17/2022]
Abstract
Clinician-reported outcome measures (ClinRO measures) play a fundamental role in quality assurance throughout healthcare systems. With commissioners turning ever more frequently to ClinRO data to evaluate and compare individual hospital performance and casemix, and funding decisions increasingly relying on these data, agreed core outcome sets (COS) are essential for the collection of standardised specialty-specific outcomes. Beyond their role in service commissioning, COS enable standardisation of outcomes in clinical studies, allowing comparisons to be drawn between similar trials as well as pooling of data for systematic reviews and metaanalyses. This review explores those ClinRO measures most commonly reported in the third molar literature, highlighting inconsistencies in ClinRO selection, measurement and reporting among researchers. We recognise here a prime opportunity for the specialty to address this lag in COS relative to other surgical specialties. With the Quality Outcomes in Maxillofacial Surgery (QOMS) overseeing the institution of many subspecialty-specific national databases in recent years, OMFS is well placed to develop a series of COS for each subspecialty domain for the benefit of researchers, clinicians and ultimately, patients.
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Affiliation(s)
- Laura O'Sullivan
- Cork University Dental School and Hospital, Wilton, Cork, Ireland.
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Type I Collagen-Based Devices to Treat Nerve Injuries after Oral Surgery Procedures. A Systematic Review. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11093927] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The regeneration of nerve injuries after oral surgery procedures is a quite often attempted procedure in dental medicine. Despite several proposed technical approaches, there is still a lack of consensus on which should be considered the gold standard procedure, even-though in the last decades, the use of collagen-based devices allowing a tension-free direct neurorrhaphy has been used. A systematic search of multiple electronic databases and hand searching was conducted to assess the level of evidence behind the use of type I collagen devices to treat nerve injuries after oral surgery procedures. After screening, four articles (one case series and three retrospective studies) including overall 65 patients suffering from inferior alveolar (IAN)/lingual nerve (LN) injury after mandibular wisdom tooth extraction, met the inclusion criteria and could be included. The Oxford Centre for evidence-based medicine (OCEBM) scaling system was used to evaluate the quality of the included studies. Positive clinical results in terms of sensorial improvements were recorded at least 3 months after surgery, even-though the overall level of evidence is low. The use of collagen membranes to enhance nerve regeneration in oral surgery results in promising results. Nevertheless, additional clinical comparative trials with larger sample sizes are needed.
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Chen YW, Chi LY, Lee OKS. Revisit incidence of complications after impacted mandibular third molar extraction: A nationwide population-based cohort study. PLoS One 2021; 16:e0246625. [PMID: 33617575 PMCID: PMC7899344 DOI: 10.1371/journal.pone.0246625] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 01/22/2021] [Indexed: 11/26/2022] Open
Abstract
Most of complications after impacted mandibular third molar (iLM3) extraction surgeries are transient and resolved spontaneously within one or two weeks, but some of them are more complicated and required further treatments to alleviate the symptoms. The aim of study is to revisit incidence and predictors of complications after iLM3 surgery by reviewing previous literature and investigating a population-based data. From Taiwan National Health Insurance Research Database, records of 16,609 patients who had received iLM3 extraction under ambulatory settings were retrieved for analysis. Outcomes of interest included dry socket (DS), prolonged temporomandibular joint symptoms (TMD), and surgical site infection (SSI), which necessitated additional appointments to manage. Odds ratios of having those complications between different variables were analyzed. The incidence rates of DS, TMD, and SSI were 3.6%, 0.41%, 0.17%, respectively; while they ranged from 0.33–19.14% (DS), 0–4.17% (TMD), and 0.2–5.17% (SSI) in previous studies. Logistic regression revealed DS significantly correlated with complexity of odontectomy (2.5-fold of risk) and history of gingivitis or pericoronitis (1.3-fold of risk). More TMD was found in female than male patients (0.5% versus 0.3%). However, no factors associated with SSI was found; neither did we find aging as a risk in association with any of above complications. Compared to previous studies, our data supports that surgical intervention should be considered in iLM3 with risk of gingivitis or pericoronitis to reduce the occurrence of DS. The original information in this article, which provides a “real-world” evidence, along with the organizing data we summarized from previous article, can serve as a reference for clinicians in assessing the complication risks before treatment of iLM3.
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Affiliation(s)
- Ya-Wei Chen
- School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | | | - Oscar Kuang-Sheng Lee
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
- Stem Cell Research Center, National Yang-Ming University, Taipei, Taiwan
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan
- * E-mail:
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Uzun C, Sumer AP, Sumer M. Assessment of the reliability of radiographic signs on panoramic radiographs to determine the relationship between mandibular third molars and the inferior alveolar canal. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 129:260-271. [PMID: 31983633 DOI: 10.1016/j.oooo.2019.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 08/09/2019] [Accepted: 09/01/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To assess the reliability of radiographic signs of the relationship between impacted mandibular third molars (IMTMs) and the inferior alveolar canal (IAC), and the vertical relationship between IMTM and IAC on panoramic radiographs (PRs) as risk indicators for IAC exposure during extraction. STUDY DESIGN Seven radiographic signs regarding the appearance of roots and the IAC were assessed as present or absent on PRs. The vertical relationship between IMTM and the IAC was divided into 3 levels. The correlation between radiographic data and IAC exposure during extraction was analyzed by using χ2 statistics and logistic regression analysis. RESULTS In total, 198 IMTMs were examined. In 46 cases (23.2%), the IAC was exposed during extraction. Four radiographic signs-darkening of the root, narrowing of the root, narrowing of the IAC, and diversion of the IAC-were associated with IAC exposure (P < .05). Concurrence of 2 or more of 7 radiographic signs increased the risk of IAC exposure (P < .001). The vertical relationship between IMTM and the IAC was found to be a risk indicator for IAC exposure (P < .001). No significant correlation was found between IAC exposure and inferior alveolar nerve damage (P = .148). CONCLUSIONS Panoramic radiography is useful for assessing the risk of IAC exposure during IMTM extraction.
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Affiliation(s)
- Canan Uzun
- Assistant Professor, University of Health Sciences, Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Istanbul, Turkey; Instructor, Eastern Mediterranean University, Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Famagusta, North Cyprus.
| | - Ayşe Pınar Sumer
- Professor, Department of Dentomaxillofacial Radiology, Ondokuz Mayıs University, Faculty of Dentistry, Samsun, Turkey
| | - Mahmut Sumer
- Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
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Retana A, Emery RW, Keir V. Removal of Impacted Supernumerary Teeth Using a Dynamic Surgical Navigation System: A Case Report. J Oral Maxillofac Surg 2019; 77:1130-1134. [PMID: 30738066 DOI: 10.1016/j.joms.2019.01.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Revised: 01/07/2019] [Accepted: 01/07/2019] [Indexed: 11/26/2022]
Abstract
Removal of impacted supernumerary teeth can present a unique set of challenges to the dentoalveolar surgeon. Complications associated with these challenges have been well documented in the literature. The use of dynamically guided surgical navigation technology for the removal of impacted supernumerary teeth has the potential to mitigate these challenges and improve clinical outcomes. Although not a currently Food and Drug Administration-approved indication, the use of dynamic surgical navigation systems for the removal of impacted supernumerary teeth will be elucidated in this case report.
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Affiliation(s)
- Armando Retana
- Oral and Maxillofacial Surgeon, Capital Center for Oral and Maxillofacial Surgery, Washington, DC
| | - Robert W Emery
- Senior Attending Surgeon, Department of Oral and Maxillofacial Surgery, Washington, Hospital Center, Washington, DC
| | - Victoria Keir
- Resident, Department of Dental Medicine and Oral and Maxillofacial Surgery, Brookdale University Hospital Medical Center, Brooklyn, NY.
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Alkadi S, Stassen L. Effect of One-Suture and Sutureless Techniques on Postoperative Healing After Third Molar Surgery. J Oral Maxillofac Surg 2019; 77:703.e1-703.e16. [PMID: 30611694 DOI: 10.1016/j.joms.2018.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 10/26/2018] [Accepted: 12/01/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE The wound closure technique for lower third molar surgery (LTMS) is an operative factor that influences wound healing and the occurrence of early postoperative complications. The present study investigated 2 closure techniques (partial closure using 1 suture and the suture-less technique) after use of a modified buccal envelope flap for LTMS. MATERIALS AND METHODS We performed a prospective, randomized, double-blind, split-mouth, controlled trial. Partial closure using 1 suture was compared with closure using the sutureless technique. The surgical sites were divided into 2 groups, group A (1 suture) and group B (sutureless). Each patient received both treatments at the same surgery. During the first postoperative week, all patients were asked to daily assess pain, facial swelling, and bleeding using self-assessment scales. All patients attended the follow-up appointment at 1 week to objectively assess facial swelling and wound healing and at 1 month to assess wound healing. An analysis of data was performed using the statistical package SPSS Statistics, version 24 (IBM Corp, Armonk, NY). A P value ≤ .05 was accepted as statistically significant. RESULTS A total of 37 patients with bilateral impacted third molars of similar surgical difficulty were recruited. Of the 37 patients, 34 successfully completed the study. The results showed a statistically significant difference between the 2 techniques in postoperative pain at days 5 (P = .046) and 6 (P = .034); socket healing at 1 week (P = .002) and 1 month (P = .014), and soft tissue healing at 1 week (P = .016). CONCLUSION We found the 1-suture technique for LTMS to be superior to the sutureless technique in the reduction of postoperative pain and improving wound healing during the early postoperative period. We found no difference between the 2 techniques in the reduction of postoperative swelling.
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Affiliation(s)
- Saleh Alkadi
- Specialist Oral Surgeon, Department of Oral and Maxillofacial Surgery, Dublin Dental University Hospital, Lincoln Place, Dublin, Ireland.
| | - Leo Stassen
- Professor and Chair, The National Maxillofacial Unit, St James's Hospital, Dublin, Ireland; Department of Oral and Maxillofacial Surgery, Dublin Dental University Hospital, Dublin, Ireland
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Momin M, Albright T, Leikin J, Miloro M, Markiewicz MR. Patient morbidity among residents extracting third molars: does experience matter? Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 125:415-422. [DOI: 10.1016/j.oooo.2017.12.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 12/01/2017] [Accepted: 12/13/2017] [Indexed: 01/08/2023]
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Buesa-Bárez JM, Martin-Ares M, Martínez-Rodriguez N, Barona-Dorado C, Sanz-Alonso J, Cortés-Bretón-Brinkmann J, Martínez-González JM. Masseter and temporalis muscle electromyography findings after lower third molar extraction. Med Oral Patol Oral Cir Bucal 2018; 23:e92-e97. [PMID: 29274163 PMCID: PMC5937843 DOI: 10.4317/medoral.21992] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Accepted: 12/07/2017] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND The main clinical application of electromyography is to detect abnormalities in muscle function, to assess muscle activity for purposes of recruitment, and in the biomechanics of movement. OBJECTIVES To analyze electromyography (EMG) findings for masticatory muscles during chewing following surgical extraction of lower third molars, and to determine any correlation between pain, inflammation, trismus, and the EMG data registered. MATERIAL AND METHODS This prospective study included 31 patients. Surface EMG was used to study masseter and temporalis muscle function before lower third molar extraction and 72 hours and seven days after surgery. Clinical variables, pain, inflammation, and trismus were registered before and after surgery. RESULTS Studying the area and size of the masticatory muscles, higher values were found for temporalis than masseter muscles, regardless of the surgical side, which points to the greater involvement of the temporalis muscle in mastication. Comparing the side where surgery had been performed with the non-surgical side, a sharp and statistically significant reduction in amplitude and area were noted on the surgical side reflecting major functional affectation. One week after surgery, amplitude and area had almost returned to base-line values, indicating almost complete recovery. While pain decreased progressively after surgery, inflammation peaked at 72 hours, while mouth opening reached a minimum at this time, returning to normality within the week. CONCLUSIONS Surgical extraction of lower third molars produces changes to electromyography activity that are more evident during the first hours after surgery and closely related to the intensity of pain suffered and the patient's inflammatory responses, although they are not related to mouth opening capacity.
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Affiliation(s)
- J-M Buesa-Bárez
- Faculty of Dentistry, Complutense University of Madrid, Spain, Department of Medicine and Oral Surgery, Faculty of Dentistry, Complutense University, Madrid, Plaza Ramon y Cajal s/n - 28040- Madrid, Spain,
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Emery RW, Korj O, Agarwal R. A Review of In-Office Dynamic Image Navigation for Extraction of Complex Mandibular Third Molars. J Oral Maxillofac Surg 2017; 75:1591-1600. [PMID: 28419843 DOI: 10.1016/j.joms.2017.03.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Revised: 03/06/2017] [Accepted: 03/14/2017] [Indexed: 11/19/2022]
Abstract
PURPOSE We performed a retrospective review of in-office removal of complex mandibular third molars with a dynamic image navigation system (DINS). MATERIALS AND METHODS 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. RESULTS 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. CONCLUSIONS 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.
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Affiliation(s)
- Robert W Emery
- Senior Attending Surgeon, Department of Oral and Maxillofacial Surgery, Washington Hospital Center, Washington, DC
| | - Oxana Korj
- Chief Resident, Department of Oral and Maxillofacial Surgery, Washington Hospital Center, Washington, DC.
| | - Ravi Agarwal
- Program Director, Department of Oral and Maxillofacial Surgery, Washington Hospital Center, Washington, DC
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Chidambaram R. To Err is Human, But Failing to Attempt is Negligence: The Hidden Perspectives That Limit Intravenous Antibiotic Administration During Third Molar Surgery in General Practice. Malays J Med Sci 2016; 23:90-1. [PMID: 27660551 DOI: 10.21315/mjms2016.23.4.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 03/06/2016] [Indexed: 10/20/2022] Open
Affiliation(s)
- Ramasamy Chidambaram
- Department of Prosthodontics, Faculty of Dentistry, AIMST University, Jalan Bedong Semeling, 08100, Bedong, Kedah Darul Aman, Malaysia
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Santosh P. Impacted Mandibular Third Molars: Review of Literature and a Proposal of a Combined Clinical and Radiological Classification. Ann Med Health Sci Res 2015; 5:229-34. [PMID: 26229709 PMCID: PMC4512113 DOI: 10.4103/2141-9248.160177] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Tooth impaction is a pathological situation where a tooth fails to attain its normal functional position. Impacted third molars are commonly encountered in routine dental practice. The impaction rate is higher for third molars when compared with other teeth. The mandibular third molar impaction is said to be due to the inadequate space between the distal of the second mandibular molar and the anterior border of the ascending ramus of the mandible. Impacted teeth may remain asymptomatic or may be associated with various pathologies such as caries, pericoronitis, cysts, tumors, and also root resorption of the adjacent tooth. Even though various classifications exist in the literature, none of those address the combined clinical and radiologic assessment of the impacted third molar. Literature search using the advanced features of various databases such as PubMed, Scopus, Embase, Google Scholar, Directory of Open Access Journals and Cochrane electronic databases was carried out. Keywords like impaction, mandibular third molar, impacted mandibular third molar, complications, anatomy, inferior alveolar nerve injury, lingual nerve injury were used to search the databases. A total of 826 articles were screened, and 50 articles were included in the review which was obtained from 1980 to February 2015. In the present paper, the authors have proposed a classification based on clinical and radiological assessment of the impacted mandibular third molar.
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Affiliation(s)
- P Santosh
- Department of Oral Medicine and Radiology, College of Dentistry, Al Jouf University, Sakakah, Al Jouf, Kingdom of Saudi Arabia
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24
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Veale B. Alveolar osteitis: a critical review of the aetiology and management. ACTA ACUST UNITED AC 2014. [DOI: 10.1111/ors.12130] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- B. Veale
- Oral and Maxillofacial Surgery; Charles Clifford Dental Hospital; Sheffield Teaching Hospitals; South Yorkshire UK
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Trigeminal nerve injuries after mandibular oral surgery in a university outpatient setting—a retrospective analysis of 1,559 cases. Clin Oral Investig 2014; 19:149-57. [DOI: 10.1007/s00784-014-1222-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Accepted: 03/03/2014] [Indexed: 10/25/2022]
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Kim CW, Kim SG, Park SW, Chee YJ. Evaluation of masseter muscle electromyography after surgical extraction of third molar. Oral Maxillofac Surg 2014; 19:13-8. [PMID: 24535133 DOI: 10.1007/s10006-014-0442-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 01/23/2014] [Indexed: 11/26/2022]
Abstract
PURPOSE The aims of this study were to evaluate the results of electromyographies (EMGs) of the masseter muscle after mandibular third molar surgery and to determine the relationships between clinical variables and EMG results. PATIENTS AND METHODS Seventy patients were included in the study. The parameters of the patients' masseter muscles were measured using EMG prior to operation and 7 and 21 days post-operation. Clinical variables were also recorded before and after the third molar surgeries. RESULTS When the masseter muscle EMG results from the tooth-extracted side were compared with those from the non-extracted (control) side, significant differences in the areas of voltage, power spectral densities and median frequencies (p = 0.011, 0.017 and 0.041, respectively) were found 7 days postoperatively. Additionally, there were significant associations between some clinical variables (i.e. postoperative swelling, bone reduction and pericoronitis) and the EMG results 7 days postoperatively, (p < 0.05). However, there were no significant differences 21 days postoperatively. CONCLUSION This study revealed that the postoperative changes in EMG activities were transient. Although there have been controversies about the reliability of EMG, this study showed that some EMG variables could be used to evaluate postoperative changes in masseter muscle activity.
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Affiliation(s)
- Chan-Woo Kim
- Department of Oral and Maxillofacial Surgery, Collage of Dentistry, Gangneung-Wonju National University, Jibyun-dong, Gangneung, Gangwon-do, 210-702, Republic of Korea
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Patel V, Gleeson CF, Kwok J, Sproat C. Coronectomy practice. Paper 2: complications and long term management. Br J Oral Maxillofac Surg 2013; 51:347-52. [DOI: 10.1016/j.bjoms.2012.06.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2011] [Accepted: 06/20/2012] [Indexed: 10/28/2022]
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Umar G, Obisesan O, Bryant C, Rood J. Elimination of permanent injuries to the inferior alveolar nerve following surgical intervention of the “high risk” third molar. Br J Oral Maxillofac Surg 2013; 51:353-7. [DOI: 10.1016/j.bjoms.2012.08.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Accepted: 08/14/2012] [Indexed: 10/27/2022]
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Costa MGD, Pazzini CA, Pantuzo MCG, Jorge MLR, Marques LS. Is there justification for prophylactic extraction of third molars? A systematic review. Braz Oral Res 2013. [DOI: 10.1590/s1806-83242013000100024] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Troedhan A, Kurrek A, Wainwright M, Schlichting I, Fischak-Treitl B, Ladentrog M. The transcrestal hydrodynamic ultrasonic cavitational sinuslift: Results of a 2-year prospective multicentre study on 404 patients, 446 sinuslift sites and 637 inserted implants. ACTA ACUST UNITED AC 2013. [DOI: 10.4236/ojst.2013.39078] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Halabí D, Escobar J, Muñoz C, Uribe S. Logistic regression analysis of risk factors for the development of alveolar osteitis. J Oral Maxillofac Surg 2012; 70:1040-4. [PMID: 22305872 DOI: 10.1016/j.joms.2011.11.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2011] [Revised: 11/13/2011] [Accepted: 11/18/2011] [Indexed: 10/14/2022]
Abstract
PURPOSE To assess risk factors for alveolar osteitis. MATERIALS AND METHODS A prospective nested case-control study was conducted in an urban community dental clinic in Valdivia, Chile. A cohort of 1,355 patients who underwent dental extractions was included. Eight predictor variables (risk factors), namely patient gender, hygiene, tooth location, previous surgical site infection, traumatic extraction, systemic diseases, alcohol consumption, and tobacco use, were considered in a risk factor model. A binary regression logistic analysis was performed to determine significant associations. RESULTS In total 1,302 participants completed the follow-up. Eighty incident case patients with alveolar osteitis and 80 matched control patients were included. A statistically significant association was found between traumatic extraction (odds ratio [OR], 13.1; 95% confidence interval [CI], 5.4 to 31.7), tobacco smoking after extraction (OR, 3.5; 95% CI, 1.3 to 9.0), previous surgical site infection (OR, 3.3; 95% CI, 1.4 to 7.7), and the development of alveolar osteitis. CONCLUSIONS Previous surgical site infection, traumatic extraction, and tobacco smoking are associated with an increased risk of alveolar osteitis.
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Affiliation(s)
- Diego Halabí
- School of Dentistry, Faculty of Medicine, Universidad Austral de Chile, Valdivia, Chile
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What is Evidence-Based Dentistry, and Do Oral Infections Increase Systemic Morbidity or Mortality? Oral Maxillofac Surg Clin North Am 2011; 23:491-6, v. [DOI: 10.1016/j.coms.2011.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Romeo U, Galanakis A, Lerario F, Daniele GM, Tenore G, Palaia G. Subcutaneous emphysema during third molar surgery: a case report. Braz Dent J 2011; 22:83-6. [PMID: 21519655 DOI: 10.1590/s0103-64402011000100015] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
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.
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Affiliation(s)
- Umberto Romeo
- Department of Oral Sciences, Sapienza, University of Rome, Italy.
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Jerjes W, Upile T, Hopper C. Politically driven. Br Dent J 2010; 209:423-4. [PMID: 21072071 DOI: 10.1038/sj.bdj.2010.984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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