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Chai Y, Dong Y, Lu Y, Wei W, Chen M, Yang C. Risk Factors Associated With Inferior Alveolar Nerve Injury After Extraction of Impacted Lower Mandibular Third Molars: A Prospective Cohort Study. J Oral Maxillofac Surg 2024; 82:1100-1108. [PMID: 38821486 DOI: 10.1016/j.joms.2024.05.003] [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: 07/12/2023] [Revised: 05/07/2024] [Accepted: 05/07/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND Inferior alveolar nerve (IAN) injury is one of the complications of impacted lower mandibular third molar (LM3) extraction. Given the unknown prognosis of IAN injuries and limited treatment options, it is critical to understand the risk factors of IAN injury before LM3 extraction. PURPOSE The purpose of the study was to identify risk factors associated with IAN injury after LM3 extraction. STUDY DESIGN, SETTING, SAMPLE This was a prospective cohort study including patients who underwent LM3 extraction from May to December 2021 at the authors' institution. Patients with systemic diseases, previous maxillofacial surgeries, or sensory abnormalities were excluded. PREDICTOR VARIABLE The predictor variable is composed of several risk factors. The variables were grouped into four categories: demographic, radiographic, procedure-related, and surgeon experience. MAIN OUTCOME VARIABLE(S) The outcome variable was postoperative neurosensory disturbance coded as present or absent and was measured at 1-month (transient) and 1-year (permanent). COVARIATES Not applicable. ANALYSES The measurement data were represented by mean and standard deviation. The association of each variable with the presence of an IAN injury was tested by the χ2 test. Statistical significance was accepted at P < .05. RESULTS The study sample consisted of 705 patients (37.0% male) with an average age of 28.51 ± 6.51 years. A total of 17/705 (2.4%) and 4/705 (0.57%) patients developed transient and permanent IAN injuries. The results demonstrated that the following factors were associated with higher rates of transient injury: use of chisels during surgeries (6.4%; 95% confidence interval (CI): 2.7 to 12.3; P = .02; relative risk (RR) = 11.4), LM3s located below the IAN canal (8.7%; 95% CI: 4.3 to 15.7; P < .01; RR = 7.3), compressed contact between LM3s and the IAN canal (36.4%; 95% CI: 12.3 to 78.2; P < .001; RR = 25.4), and not using corticosteroids after surgeries (3.8%; 95% CI: 1.9 to 6.5; P = .03; RR = 3.1). The only factor associated with permanent injury was compressed contact between LM3s and the IAN canal (18.2%; 95% CI: 2.2 to 62.3; P < .001; RR = 48.2). CONCLUSION AND RELEVANCE Close proximity between LM3s and IAN canal and the use of chisels increase the risk of transient IAN injury. Corticosteroid treatment may promote nerve recovery. Compressed contact between LM3s and IAN canal is the only risk factor for permanent injury.
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Affiliation(s)
- Ying Chai
- Attending Physician, Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yabing Dong
- Resident Physician, Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yeping Lu
- Resident Physician, Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Wenbin Wei
- Attending Physician, Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Minjie Chen
- Professor, Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Chi Yang
- Professor, Department Head, Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China.
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Koç O, Er N, Karaca Ç, Bilginaylar K. Comparison of the effects of submucosal hyaluronidase and dexamethasone on postoperative edema, pain, trismus, and infection following impacted third molar surgery. BMC Oral Health 2024; 24:1018. [PMID: 39215323 PMCID: PMC11365265 DOI: 10.1186/s12903-024-04729-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 08/09/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Limiting postoperative edema, pain, trismus, and infection is crucial for smooth healing. This prospective, controlled clinical trial investigated and compared the effectiveness of dexamethasone and hyaluronidase in relieving these complications. METHODS In groups Ia and IIa, 8 mg of dexamethasone and 150 IU of hyaluronidase were administered following the removal of impacted teeth, respectively. The contralateral sides (groups Ib and IIb) were determined as control groups. Edema, pain, trismus, and infection were clinically evaluated on the 1st, 2nd, 3rd, and 7th postoperative days. RESULTS 60 patients were enrolled in the study. Hyaluronidase provided significantly more edema relief than dexamethasone on the 1st, 2nd, 3rd, and 7th postoperative days (P = 0.031, 0.002, 0.000, and 0.009, respectively). No statistical difference was found between dexamethasone and hyaluronidase in VAS and rescue analgesic intake amount values for all time points. Hyaluronidase was more effective in reducing trismus than dexamethasone on the 2nd and 3rd postoperative days (P = 0.029, 0.024, respectively). Neither of the agents significantly increased the postoperative infection rate. CONCLUSIONS Hyaluronidase can be selected when postoperative excessive edema and trismus are anticipated. Dexamethasone may be a cost-effective option if postoperative pain control is merely targeted. TRIAL REGISTRATION This trial was registered in the Clinical Trials Protocol Registration and Results System (ClinicalTrials.gov identifier number: NCT05466604) on 20/07/2022.
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Affiliation(s)
- Onur Koç
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Hacettepe University, Sıhhiye, Ankara, Turkey.
| | - Nuray Er
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Hacettepe University, Sıhhiye, Ankara, Turkey
| | - Çiğdem Karaca
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Hacettepe University, Sıhhiye, Ankara, Turkey
| | - Kanİ Bilginaylar
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Final International University, Nicosia, Cyprus
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Fernández-Martín U, Lisbona-González MJ, Vallecillo-Rivas M, Mallo-Magariños M, Herrera-Briones FJ. Effect of Preoperative Administration of Dexamethasone vs. Methylprednisolone in Surgical Extraction of Impacted Lower Third Molars: Randomized Controlled Clinical Trial. J Clin Med 2024; 13:4614. [PMID: 39200756 PMCID: PMC11355648 DOI: 10.3390/jcm13164614] [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: 07/19/2024] [Revised: 07/30/2024] [Accepted: 08/05/2024] [Indexed: 09/02/2024] Open
Abstract
Background/Objectives: Glucocorticoids are drugs that are increasingly used in oral surgery to reduce trismus, inflammation, and postoperative pain, three frequent complications after the surgical extraction of impacted lower third molars. The aim of this study was to compare the effect of 8 mg dexamethasone versus 40 mg methylprednisolone in the prevention of postoperative complications after third molar surgery. Methods: A randomized double-blind clinical trial was conducted following CONSORT guidelines. In detail, 84 patients were included in the study, who randomly received a single preoperative submucosal dose of dexamethasone (8 mg) or methylprednisolone (40 mg). The variables analyzed, as primary outcomes, were trismus, inflammation, and postoperative pain. The measurements were performed at baseline (0 h), 3 h, 7 h, 24 h, 48 h, and 7 th day using a Visual Analog Scale (VAS), Verbal Rating Scale (VRS), and the Gabka-Matsumara method. Results: Dexamethasone reduced trismus, inflammation, and postoperative pain significantly better than methylprednisolone. Conclusions: Preoperative submucosal administration of 8 mg dexamethasone is effective and safe in reducing the severity of postoperative complications following surgical extraction of impacted lower third molars.
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Affiliation(s)
- Unai Fernández-Martín
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, Colegio Máximo de Cartuja s/n, University of Granada, 18071 Granada, Spain; (U.F.-M.); (M.V.-R.); (M.M.-M.); (F.J.H.-B.)
| | - María Jesús Lisbona-González
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, Colegio Máximo de Cartuja s/n, University of Granada, 18071 Granada, Spain; (U.F.-M.); (M.V.-R.); (M.M.-M.); (F.J.H.-B.)
- Faculty of Dentistry, Colegio Máximo de Cartuja s/n, University of Granada, 18071 Granada, Spain
| | - Marta Vallecillo-Rivas
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, Colegio Máximo de Cartuja s/n, University of Granada, 18071 Granada, Spain; (U.F.-M.); (M.V.-R.); (M.M.-M.); (F.J.H.-B.)
- Faculty of Dentistry, Colegio Máximo de Cartuja s/n, University of Granada, 18071 Granada, Spain
| | - Manuel Mallo-Magariños
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, Colegio Máximo de Cartuja s/n, University of Granada, 18071 Granada, Spain; (U.F.-M.); (M.V.-R.); (M.M.-M.); (F.J.H.-B.)
| | - Francisco Javier Herrera-Briones
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, Colegio Máximo de Cartuja s/n, University of Granada, 18071 Granada, Spain; (U.F.-M.); (M.V.-R.); (M.M.-M.); (F.J.H.-B.)
- Faculty of Dentistry, Colegio Máximo de Cartuja s/n, University of Granada, 18071 Granada, Spain
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Özmen EE, Taşdemir İ. Evaluation of the effect of dental anxiety on vital signs in the order of third molar extraction. BMC Oral Health 2024; 24:841. [PMID: 39048997 PMCID: PMC11271044 DOI: 10.1186/s12903-024-04596-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 07/09/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Dental anxiety is a prevalent concern affecting patients undergoing various dental procedures, particularly surgical interventions. Understanding the impact of patients' anxiety levels on their physiological responses during dental surgeries, such as third molar impaction surgery, is crucial for optimizing patient care and outcomes. Therefore, this study aimed to investigate the effect of patients' anxiety levels on vital signs during third molar teeth impaction surgery. METHODS A cross-sectional study was conducted, including 45 randomly selected, healthy patients. Demographic information was recorded after obtaining consent from the patients prior to surgical intervention. Preoperative anxiety levels were determined using the Modified Dental Anxiety Scale (MDAS). Pupil measurements were taken from the patients before surgery, at 10 min after the surgery began, and at 10 min after the surgery ended. Systolic (SBP) and diastolic (DBP) blood pressure, pulse rate, temperature, and haemoglobin oxygen saturation (SpO2) values were recorded. RESULTS The MDAS test results were statistically significantly higher in women compared to men (p < 0.001). Positive correlations were observed between MDAS score and both preoperative pulse rate (r = 0.344, p = 0.021) and SpO2 level during the operation (r = 0.462, p = 0.001). However, no significant correlations were found between MDAS and DBP (p = 0.575), SBP (p = 0.176), fever (p = 0.238), or pupil diameter (p = 0.338). CONCLUSIONS Third molar impaction surgery induces anxiety in adult patients 20 years and older. Vital sign monitoring provides information about the patient's emotional state, both before and during the procedure. Since anxiety causes changes in vital signs during dental procedures, it is important to follow these findings to have an idea about the general condition of the patients.
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Affiliation(s)
- Elif Esra Özmen
- Ahmet Keleşoğlu Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Karamanoğlu Mehmetbey University, Karaman, 70100, Turkey.
| | - İsmail Taşdemir
- Ahmet Keleşoğlu Faculty of Dentistry, Department of Periodontology Dentistry, Karamanoğlu Mehmetbey University, Karaman, Turkey
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Kaplan V, Ciğerim L, Feslihan E, Çınarsoy Ciğerim S. Effect of a Single Dose of Deflazacort on Postoperative Pain, Swelling, and Trismus after Impacted Lower Third Molar Surgery: Randomised Clinical Trial. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1206. [PMID: 39202488 PMCID: PMC11356159 DOI: 10.3390/medicina60081206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2024] [Revised: 07/18/2024] [Accepted: 07/23/2024] [Indexed: 09/03/2024]
Abstract
Background and Objectives: The aim of this study was to investigate the efficacy of a single preoperative dose of deflazacort on pain, swelling, and trismus after impacted lower third molar surgery. Materials and Methods: This randomised, prospective, double-blind, split-mouth clinical study included 26 healthy individuals with bilaterally impacted lower third molars. Group 1 was given a placebo (single-dose vitamin C tablet), and group 2 was given a single 30 mg dose of deflazacort 1 h prior to surgery. Pain was evaluated using the visual analogue scale for 1 week postoperatively. Oedema (in mm) and trismus (in mm) were evaluated preoperatively and on postoperative days 2 and 7. The Mann-Whitney U test was applied for group analyses. p values < 0.05 were considered statistically significant. Results: Postoperative pain scores were significantly lower in the deflazacort group at the 6th and 12th hours after surgery (p < 0.05). There were no significant differences in trismus between the groups at any time point (p > 0.05). There was less oedema in the deflazacort group on postoperative days 2 and 7, without any statistically significant difference (p > 0.05). Conclusions: A single preoperative dose of 30 mg deflazacort was found to be clinically effective in reducing pain and oedema after extraction of impacted lower third molars.
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Affiliation(s)
- Volkan Kaplan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tekirdag Namik Kemal University, Tekirdag 59030, Turkey;
| | - Levent Ciğerim
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Van Yuzuncu Yil University, Van 65080, Turkey;
| | - Erkan Feslihan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tekirdag Namik Kemal University, Tekirdag 59030, Turkey;
| | - Saadet Çınarsoy Ciğerim
- Department of Orthodontics, Faculty of Dentistry, Van Yuzuncu Yil University, Van 65080, Turkey;
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Zhang MJ, Huo L, Chai Y, Wang YW, Han ZX, Liu YM, Wang HS, Wei WB, Chen MJ. Soft tissue inflammation around upper third molar cause limited mouth opening: common but overlooked. Clin Oral Investig 2024; 28:427. [PMID: 38992326 DOI: 10.1007/s00784-024-05820-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 07/03/2024] [Indexed: 07/13/2024]
Abstract
OBJECTIVES The aim of this study was to explore inflammation of soft tissue around the upper third molar as a prevalent cause of limited mouth opening, identify the clinical and radiographic features, and summarize the therapeutic effectiveness of tooth extraction. MATERIALS AND METHODS A retrospective analysis of data from 264 patients with limited mouth opening over the last five years was performed. RESULTS Among the 264 patients, 24 (9.1%) had inflammation of the soft tissue around the upper third molar, which was the second most common cause of limited mouth opening. Twenty-one of the twenty-four affected patients, with an average mouth opening of 19.1 ± 7.6 mm, underwent upper third molar extraction. Gingival tenderness around the upper third molar or maxillary tuberosity mucosa was a characteristic clinical manifestation (p < 0.05). The characteristic features on maxillofacial CT included soft tissue swelling around the upper third molar and gap narrowing between the maxillary nodules and the mandibular ascending branch. Post extraction, the average mouth opening increased to 31.4 ± 4.9 mm (p < 0.05), and follow-up CT demonstrated regression of the inflammatory soft tissue around the upper third molar. CONCLUSIONS Inflammation of soft tissue around the upper third molar is a common cause of limited mouth opening. Symptoms of pain associated with the upper third molar and distinctive findings on enhanced maxillofacial CT scans are crucial for diagnosis. Upper third molar extraction yields favorable therapeutic outcomes. CLINICAL RELEVANCE Inflammation of the soft tissue around the maxillary third molar commonly causes limited mouth opening, but this phenomenon has long been overlooked. Clarifying this etiology can reduce the number of misdiagnosed patients with restricted mouth opening and enable more efficient treatment for patients.
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Affiliation(s)
- Meng-Jie Zhang
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Zhizaoju Road 639, Shanghai, China
- National Center for Stomatology, and National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Zhizaoju Road 639, Shanghai, China
| | - Liang Huo
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Zhizaoju Road 639, Shanghai, China
- National Center for Stomatology, and National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Zhizaoju Road 639, Shanghai, China
| | - Ying Chai
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Zhizaoju Road 639, Shanghai, China
- National Center for Stomatology, and National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Zhizaoju Road 639, Shanghai, China
| | - Yi-Wen Wang
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Zhizaoju Road 639, Shanghai, China
- National Center for Stomatology, and National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Zhizaoju Road 639, Shanghai, China
| | - Zi-Xiang Han
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Zhizaoju Road 639, Shanghai, China
- National Center for Stomatology, and National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Zhizaoju Road 639, Shanghai, China
| | - Yue-Min Liu
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Zhizaoju Road 639, Shanghai, China
- National Center for Stomatology, and National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Zhizaoju Road 639, Shanghai, China
| | - Han-Shao Wang
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Zhizaoju Road 639, Shanghai, China
- National Center for Stomatology, and National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Zhizaoju Road 639, Shanghai, China
| | - Wen-Bin Wei
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Zhizaoju Road 639, Shanghai, China.
- National Center for Stomatology, and National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Zhizaoju Road 639, Shanghai, China.
| | - Min-Jie Chen
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Zhizaoju Road 639, Shanghai, China.
- National Center for Stomatology, and National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Zhizaoju Road 639, Shanghai, China.
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Barone S, Bennardo F, Salviati M, Cosentino V, Finamore R, Greco V, Madonna A, Procopio A, Antonelli A, Giudice A. Concordance Analysis of Lower Third Molar Surgery Classifications: A Comparative Study. Dent J (Basel) 2024; 12:167. [PMID: 38920868 PMCID: PMC11203060 DOI: 10.3390/dj12060167] [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: 04/19/2024] [Revised: 05/22/2024] [Accepted: 05/31/2024] [Indexed: 06/27/2024] Open
Abstract
The high frequency and complexity of mandibular third molar (M3M) surgery have led several authors to the development of classification systems for better evaluation and management in oral surgery. This study compared the classifications of Juodzabalys and Daugela et al. (JD), Sammartino et al., Chang et al., Jhamb et al., Maglione et al., and Nemsi et al. to understand the concordance between the scores of M3M surgery. Two types of analysis were conducted: the relationship between the M3M and the inferior alveolar nerve (IAN), and the overall difficulty score based on the tooth's angulation and its spatial position with the adjacent structure. The analysis of the classifications on the relationship between M3M and IAN resulted in a concordance of 26.1%. In the pairwise comparisons, the classifications of Nemsi et al. and Jhamb et al. showed the highest concordance of 59.5%. Analyzing the total scores difficulty, the JD et al., Chang et al., and Sammartino et al. classifications demonstrated a concordance level of 25.5%. A pairwise assessment revealed a higher concordance degree between the classifications of Sammartino et al. and Chang et al. (57.4%). The results highlight the limits in establishing a comprehensive and objective classification for the surgical difficulty of M3M, possibly attributed to variations in the methodology for computing total scores. An objective, automated, and non-operator-dependent classification method for assessing the surgical difficulty of M3M is still needed.
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Affiliation(s)
- Selene Barone
- Department of Health Sciences, School of Dentistry, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy; (S.B.); (F.B.); (M.S.); (V.C.); (R.F.); (V.G.); (A.M.); (A.G.)
| | - Francesco Bennardo
- Department of Health Sciences, School of Dentistry, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy; (S.B.); (F.B.); (M.S.); (V.C.); (R.F.); (V.G.); (A.M.); (A.G.)
| | - Marianna Salviati
- Department of Health Sciences, School of Dentistry, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy; (S.B.); (F.B.); (M.S.); (V.C.); (R.F.); (V.G.); (A.M.); (A.G.)
| | - Vincenzo Cosentino
- Department of Health Sciences, School of Dentistry, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy; (S.B.); (F.B.); (M.S.); (V.C.); (R.F.); (V.G.); (A.M.); (A.G.)
| | - Riccardo Finamore
- Department of Health Sciences, School of Dentistry, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy; (S.B.); (F.B.); (M.S.); (V.C.); (R.F.); (V.G.); (A.M.); (A.G.)
| | - Vincenzo Greco
- Department of Health Sciences, School of Dentistry, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy; (S.B.); (F.B.); (M.S.); (V.C.); (R.F.); (V.G.); (A.M.); (A.G.)
| | - Antonio Madonna
- Department of Health Sciences, School of Dentistry, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy; (S.B.); (F.B.); (M.S.); (V.C.); (R.F.); (V.G.); (A.M.); (A.G.)
| | - Anna Procopio
- Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy;
| | - Alessandro Antonelli
- Department of Health Sciences, School of Dentistry, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy; (S.B.); (F.B.); (M.S.); (V.C.); (R.F.); (V.G.); (A.M.); (A.G.)
| | - Amerigo Giudice
- Department of Health Sciences, School of Dentistry, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy; (S.B.); (F.B.); (M.S.); (V.C.); (R.F.); (V.G.); (A.M.); (A.G.)
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Hermida-Cabrera P, Lima-Sánchez B, Montoya-Salazar V, Oliveros-López LG, Alomar-Velasco P, Gutiérrez-Pérez JL, Torres-Lagares D, Baus-Domínguez M. Proposal and Validation of a New Index to Assess the Difficulty of Lower Third Molar Extraction. Dent J (Basel) 2024; 12:138. [PMID: 38786536 PMCID: PMC11120054 DOI: 10.3390/dj12050138] [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: 03/05/2024] [Revised: 04/21/2024] [Accepted: 05/01/2024] [Indexed: 05/25/2024] Open
Abstract
There is no current consensus on the parameters that determine the difficulty of mandibular third molar extraction in terms of the time required, which is essential to prevent complications and optimize the time of the intervention. This study aims to obtain, using the mathematical method of multiple linear regression, an equation that allows estimating the extraction time of a lower third molar according to its complexity, as well as to validate this equation in a sample of external wisdom teeth. METHODS A prospective cohort study on a sample of patients of the Master of Oral Surgery of the University of Seville in which multiple linear regression coefficients were calculated with a subsequent validation study of the results in the sample of patients operated in the Hospital Palmaplanas of Mallorca. RESULTS The regression line obtained after applying the statistical methodology to the cohort of patients from the University of Seville obtained significant dependent variables such as depth, roots, and odontosection. Once applied to the cohort of patients from the Palmaplanas Hospital in Mallorca, a regression coefficient was obtained between the data received and the estimated 0.770. CONCLUSIONS The formula proposed in this article presents significant validity in the prediction of the surgical time of extraction of the lower third molars included.
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Affiliation(s)
- Paula Hermida-Cabrera
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41009 Seville, Spain; (P.H.-C.); (B.L.-S.); (V.M.-S.); (L.-G.O.-L.); (J.-L.G.-P.)
| | - Belén Lima-Sánchez
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41009 Seville, Spain; (P.H.-C.); (B.L.-S.); (V.M.-S.); (L.-G.O.-L.); (J.-L.G.-P.)
| | - Vanessa Montoya-Salazar
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41009 Seville, Spain; (P.H.-C.); (B.L.-S.); (V.M.-S.); (L.-G.O.-L.); (J.-L.G.-P.)
| | - Luis-Guillermo Oliveros-López
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41009 Seville, Spain; (P.H.-C.); (B.L.-S.); (V.M.-S.); (L.-G.O.-L.); (J.-L.G.-P.)
| | - Pedro Alomar-Velasco
- Oral and Maxillofacial Unit, Quirónsalud Palmaplanas Hospital, 07010 Mallorca, Spain;
| | - José-Luis Gutiérrez-Pérez
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41009 Seville, Spain; (P.H.-C.); (B.L.-S.); (V.M.-S.); (L.-G.O.-L.); (J.-L.G.-P.)
- Oral and Maxillofacial Unit, Virgen del Rocio Hospital, 41013 Seville, Spain
| | - Daniel Torres-Lagares
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41009 Seville, Spain; (P.H.-C.); (B.L.-S.); (V.M.-S.); (L.-G.O.-L.); (J.-L.G.-P.)
| | - María Baus-Domínguez
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41009 Seville, Spain; (P.H.-C.); (B.L.-S.); (V.M.-S.); (L.-G.O.-L.); (J.-L.G.-P.)
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Zhang J, Zhang K, Zhou X, Ye L, Liu Y, Peng Y, Pan J. Full life cycle changes of low impacted mandibular third molar associated cystic lesions and adjacent tooth root resorption: a retrospective study. BMC Oral Health 2024; 24:515. [PMID: 38698359 PMCID: PMC11064400 DOI: 10.1186/s12903-024-04248-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 04/10/2024] [Indexed: 05/05/2024] Open
Abstract
OBJECTIVE Low impacted third molars are usually asymptomatic and are often found by X-ray examination. The removal of asymptomatic low impacted third molars is one of the most controversial clinical issues in oral and maxillofacial surgery. METHODS In this study, 806 patients with low impacted mandibular third molars (LIMTMs) (full bony impaction) were analyzed to determine the prevalence and risk factors for cystic lesions and adjacent tooth root resorption throughout the patients' entire life cycle. RESULTS The results showed that the prevalence of adjacent tooth root resorption and cystic lesions was age-related, exhibiting a trend of first increasing and then decreasing; prevalence peaked at the age of 41 to 45 years old, the prevalence rates were 12.50% and 11.11% respectively. And the lowest prevalence rate was 2.86% and 2.44% in ≥ 61 group and 56- to 60-year age group respectively. Age was an independent risk factor for adjacent tooth root resorption of LIMTMs, whereas age and impaction type (especially inverted impaction) were independent risk factors for cystic lesions. CONCLUSIONS The full life cycle management strategy for LIMTMs may need to be individualized. Surgical removal is recommended for LIMTMs in patients younger than 41 to 45 years, especially for inverted, mesioangular, and horizontally impacted LIMTMs. LIMTMs in patients older than 41 to 45 years may be treated conservatively with regular follow-up, but surgical removal of inverted impacted LIMTMs is still recommended to avoid cyst formation.
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Affiliation(s)
- Jiankang Zhang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd section of Renmin South Road, Chengdu, Sichuan, 610041, China
| | - Kun Zhang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd section of Renmin South Road, Chengdu, Sichuan, 610041, China
| | - Xueer Zhou
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd section of Renmin South Road, Chengdu, Sichuan, 610041, China
| | - Li Ye
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd section of Renmin South Road, Chengdu, Sichuan, 610041, China
| | - Yuanyuan Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Oral Radiology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Yiran Peng
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
| | - Jian Pan
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd section of Renmin South Road, Chengdu, Sichuan, 610041, China.
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Apaydın BK, Icoz D, Uzun E, Orhan K. Investigation of the relationship between the mandibular third molar teeth and the inferior alveolar nerve using posteroanterior radiographs: a pilot study. BMC Oral Health 2024; 24:371. [PMID: 38519914 PMCID: PMC10958910 DOI: 10.1186/s12903-024-04123-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 03/07/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND The most severe complication that can occur after mandibular third molar (MM3) surgery is inferior alveolar nerve (IAN) damage. It is crucial to have a comprehensive radiographic evaluation to reduce the possibility of nerve damage. The objective of this study is to assess the diagnostic accuracy of panoramic radiographs (PR) and posteroanterior (PA) radiographs in identifying the association between impacted MM3 roots and IAN. METHODS This study included individuals who had PR, PA radiographs, and cone beam computed tomography (CBCT) and who had at least one impacted MM3. A total of 141 impacted MM3s were evaluated on CBCT images, and the findings were considered gold standard. The relationship between impacted MM3 roots and IAN was also evaluated on PR and PA radiographies. The data was analyzed using the McNemar and Chi-squared tests. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of PR and PA radiographies were determined. RESULTS Considering CBCT the gold standard, the relationship between MM3 roots and IAN was found to be statistically significant between PR and CBCT (p = 0.00). However, there was no statistically significant relationship between PA radiography and CBCT (0.227). The study revealed that the most prevalent limitation of the PR in assessing the relationship between MM3 roots and IAN was the identification of false-positive relationship. CONCLUSIONS PA radiography may be a good alternative in developing countries to find out if there is a contact between MM3 roots and IAN because it is easier to get to, cheaper, and uses less radiation.
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Affiliation(s)
- Burak Kerem Apaydın
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Pamukkale University, Denizli, 20160, Turkey.
| | - Derya Icoz
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Selcuk University, Konya, 42100, Turkey
| | - Ezgi Uzun
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Pamukkale University, Denizli, 20160, Turkey
| | - Kaan Orhan
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, 06500, Turkey
- Medical Design Application and Research Center (MEDITAM), Ankara University, Ankara, 06500, Turkey
- Department of Oral Diagnostics, Faculty of Dentistry, Semmelweis University, Budapest, Hungary
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11
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Putrino A, Marinelli E, Agrillo A, Zaami S. New Perspectives in Third Molar Auto-Transplantation: Literature Review and a Case Report of Clinical, Financial and Forensic Implications. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:473. [PMID: 38541199 PMCID: PMC10972373 DOI: 10.3390/medicina60030473] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/05/2024] [Accepted: 03/11/2024] [Indexed: 07/23/2024]
Abstract
Third molar extraction is the most common procedure in oral and maxillofacial surgery. Third molars are considered less functional than other teeth and are often extracted. Sometimes, they are also used for auto-transplantation for the benefit of oral rehabilitation. Since many biological factors are involved in this surgical approach, herein, we outline a review of the biological characteristics of medico-legal/forensic interest, in addition to presenting a successful clinical case. A scoping review of currently available research data (following the principles of PRISMA-ScR or the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) on third molar auto-transplantation was conducted by drawing upon the main databases (Scopus, PubMed, Google Scholar and LILACS) to evaluate biological and clinical characteristics possibly relatable to forensic issues. All the collected data were summarized and elaborated on for the purpose of this article. A patient underwent extraction of the right upper first molar and auto-transplantation of the unerupted ipsilateral third molar. Many biologic and clinical factors are involved in the success of this clinical procedure. Knowledge of third molar anatomy, of its development and viable surgical approaches are all essential elements; just as important are the treatment of the tooth before and after transplantation and the integrity of the periodontal ligament. Follow-up of the clinical case for 5 years made it possible to verify the stability of the procedure over time. Third molar auto-transplantation is feasible and cost-effective. However, the use of third molars as donor teeth in auto-transplantation may have medico-legal implications. The lack of official protocols and consistent evidence-based guidelines for operators still prevent such a procedure from becoming mainstream; therefore, it is viewed with suspicion by clinicians and patients, even though the biological factors herein detected point to a reasonably high degree of safety. The understanding of many specific biological and clinical factors involved in the stability of third molar auto-transplantation allows for a thorough understanding of the forensic implications relevant to clinical practice. Effective communication and information provision are therefore of utmost importance, in the interest of both patients and doctors.
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Affiliation(s)
- Alessandra Putrino
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy;
| | - Enrico Marinelli
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy;
| | - Alessandro Agrillo
- Maxillofacial Surgery Unit, San Filippo Neri Hospital, 00135 Rome, Italy;
| | - Simona Zaami
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy;
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12
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Vijayakumar G, Sundaram GA, Kumar SP, Krishnan M, Krishna VK, Lakshmanan S. Comparison of the Efficacy of Corticosteroids With Enzymatic Agents in the Postoperative Sequelae for Lower Third Molar Surgery: A Prospective Study. Cureus 2024; 16:e55397. [PMID: 38562319 PMCID: PMC10984366 DOI: 10.7759/cureus.55397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 03/02/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction The presence of impacted third molars is a prevalent problem associated with varying degrees of difficulty in extraction and potential consequences, including pain, swelling, and trismus. According to studies, enzymatic combinations, such as bromelain, rutoside, trypsin, and serratiopeptidase, are known to have a very promising role in reducing inflammation and promoting wound healing. This study compared natural enzymatic agents with corticosteroids for postoperative pain, swelling, and trismus in the impacted lower third molar surgery. Objectives The present study aimed to compare the efficacy of prednisolone, a combination of trypsin, chymotrypsin, bromelain, rutoside, and papain, and serratiopeptidase in the postoperative sequelae after surgical extraction of impacted mandibular third molars. The primary objective was to assess the difference in swelling between the three groups. The secondary objectives were to assess the difference in postoperative pain and trismus between the three groups. Materials and methods A total of 150 patients who presented to the department of oral and maxillofacial surgery for surgical removal of an impacted mandibular third molar with a moderately difficult score of 5-7 in the Pederson difficulty index were chosen for a prospective study. Patients were categorized into three groups based on the postoperative drug prescribed. In group 1, prednisolone 10 mg was prescribed; in group 2, a combination of trypsin, chymotrypsin, bromelain, rutoside, and papain was prescribed; and in group 3, serratiopeptidase 15 mg was prescribed. All patients were prescribed a combination drug of aceclofenac 100 mg and paracetamol 325 mg twice daily as a standard analgesic. Swelling, pain, and trismus in each patient were recorded preoperatively and at postoperative day one and day seven. The Friedman test was employed to evaluate the variation in pain levels within the groups over time, while the Kruskal-Wallis test was utilized to investigate the disparity in pain levels between the groups. The difference in swelling and trismus within the groups across the timeline was measured by repeated measures analysis of variance (ANOVA), and the difference in swelling and trismus between the groups was measured by one-way ANOVA. A p-value below 0.05 was deemed to be statistically significant. Results Group 1 showed less swelling, pain, and trismus on both postoperative day one and day seven compared to group 2 and group 3, which was a statistically significant difference (P < 0.05). It was found that swelling, pain, and trismus measurements in postoperative day one and day seven in group 2 were comparatively less than in group 3. Neither group demonstrated any side effects or other complications during the follow-up period. Conclusion It can be concluded that the use of prednisolone postoperatively following surgical removal of the mandibular third molar provided better relief with regard to pain, trismus, and swelling compared to the enzymatic agents. Among enzymatic agents, a combination of trypsin, chymotrypsin, bromelain, rutoside, and papain was better in reducing pain, trismus, and swelling than serratiopeptidase drug.
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Affiliation(s)
- Goutham Vijayakumar
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Gidean A Sundaram
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Santhosh P Kumar
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Murugesan Krishnan
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Vinod K Krishna
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Saravanan Lakshmanan
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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Sah S, Mangat P, Kumar A, Sah N, Shivakumar GC, Di Blasio M, Cervino G, Minervini G. Stereomicroscopic evaluation of sealing ability of four different root canal sealers: an in-vitro study. BMC Oral Health 2024; 24:258. [PMID: 38378554 PMCID: PMC10877889 DOI: 10.1186/s12903-024-03913-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 01/18/2024] [Indexed: 02/22/2024] Open
Abstract
AIM To compare and evaluate the sealing ability of four different commercially available sealers to provide seal against the dye penetration test using a stereomicroscope-an in-vitro study. MATERIAL/METHOD 80 extracted single rooted mandibular premolar with single canal were used in this study. The samples were divided in 4 groups (20 in each) based on sealer. Group I (Diaproseal), Group II (apexit Plus), Group III (MTA Fillapex) and Group IV (Bio-C). The samples were analyzed using a stereomicroscope and data analysis was done with one-way Anova And post hoc Tukey's test. RESULT The mean dye penetration score was 1.2400 ± 0.778 mm for Group I. 2.6000 ± 0.897 mm for Group II, 4.2000 ± 0.923 mm for Group III and 4.225 ± 2.055 mm for Group IV. One-way Anova analysis shows that intergroup comparison was statistically significant between the four groups. The post hoc Tukey's test reveals that the difference was statistically non-significant between group III and group IV. CONCLUSION It was concluded that between the four groups the Group I (Diaproseal) showed the least dye penetration followed by Group II (Apexit Pus), Group III (MTA Fillapex) and then Group IV (Bio-C), where there was no significant difference between the Group III (MTA Fillapex) and Group IV (Bio-C).
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Affiliation(s)
- Sonam Sah
- Department of Conservative Dentistry and Endodontic Teerthanker Mahaveer Dental College and Research Centre Moradabad, Moradabad, UP, India.
| | - Panna Mangat
- Department of Conservative Dentistry and Endodontics Kalka Dental College and Hospital, Meerut, UP, India
| | - Ajay Kumar
- Unit of Oral Medicine and Radiology, Faculty of Dental Sciences, I.M.S, B.H.U. Varanasi, Varanasi, UP, India
| | - Neha Sah
- Unit of oral and maxillofacial surgery, faculty of dental sciences, I.M.S, B.H.U. Varanasi, Varanasi, UP, India
| | - Ganiga Channaiah Shivakumar
- Department of Oral Medicine & Radiology, Peoples College of Dental Sciences, Peoples University, Bhanpur, Bhopal, Madhya Pradesh, India
| | - Marco Di Blasio
- Department of Medicine and Surgery, University Center of Dentistry, University of Parma, Parma, 43126, Italy.
| | - Gabriele Cervino
- School of Dentistry, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, via Consolare Valeria, 1, Messina, 98125, Italy
| | - Giuseppe Minervini
- Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, Tamil Nadu, India.
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, 80121, Italy.
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14
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Ahmed HA, López-López J, Egido-Moreno S, Llabrés XR, Hameed M, Estrugo-Devesa A. Mandibular Third Molar Impaction and Bone Change Distal to the Second Molar: A Panoramic Radiographic Study. J Clin Med 2024; 13:906. [PMID: 38337600 PMCID: PMC10856675 DOI: 10.3390/jcm13030906] [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: 01/04/2024] [Revised: 02/01/2024] [Accepted: 02/02/2024] [Indexed: 02/12/2024] Open
Abstract
Background: The mandibular third molar is the most frequently impacted tooth. An impacted mandibular third molar (IMTM) can have negative consequences on the adjacent mandibular second molar (MSM), such as bone loss. An IMTM can be identified using orthopantomography (OPG). Our objective is to compare changes in bone level distal to the mandibular second molar (MSM) in patients with an extracted IMTM versus non-extracted IMTM using OPG. Methods: In this retrospective case-control study, 160 orthopantomograms (OPGs) of 80 patients who attended Dental Hospital of the University of Barcelona (HOUB) were randomly selected. Participants were stratified into a study group and control group. Results: Males and females experienced bone gain in the study group and bone loss in the control group. However, the difference in bone-level change was not statistically significant regarding gender in the study group. Within the study group, the age group of 29-39 years demonstrated significant (p-value = 0.042) bone gain after extraction compared to other age groups. However, the control group demonstrated bone loss in all age groups in which the difference is not statistically significant (p-value 0.794). Conclusions: Bone improvements distal to the MSM were observed after the extraction of an IMTM compared to when an IMTM was not extracted.
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Affiliation(s)
- Hassan Assiri Ahmed
- Department of Odontostomatology, Faculty of Medicine and Health Sciences, School of Dentistry, University Campus of Bellvitge, University of Barcelona, Barcelona Dental Hospital [HOUB], 08970 Barcelona, Spain or (H.A.A.); (S.E.-M.); (X.R.L.); (A.E.-D.)
- Department of Diagnostic Science and Oral Biology, Faculty of Dentistry, King Khalid University, Abha 61421, Saudi Arabia;
| | - Jose López-López
- Department of Odontostomatology, Faculty of Medicine and Health Sciences, School of Dentistry, University Campus of Bellvitge, University of Barcelona, Barcelona Dental Hospital [HOUB], 08970 Barcelona, Spain or (H.A.A.); (S.E.-M.); (X.R.L.); (A.E.-D.)
| | - Sonia Egido-Moreno
- Department of Odontostomatology, Faculty of Medicine and Health Sciences, School of Dentistry, University Campus of Bellvitge, University of Barcelona, Barcelona Dental Hospital [HOUB], 08970 Barcelona, Spain or (H.A.A.); (S.E.-M.); (X.R.L.); (A.E.-D.)
| | - Xavier Roselló Llabrés
- Department of Odontostomatology, Faculty of Medicine and Health Sciences, School of Dentistry, University Campus of Bellvitge, University of Barcelona, Barcelona Dental Hospital [HOUB], 08970 Barcelona, Spain or (H.A.A.); (S.E.-M.); (X.R.L.); (A.E.-D.)
| | - Mohammed Hameed
- Department of Diagnostic Science and Oral Biology, Faculty of Dentistry, King Khalid University, Abha 61421, Saudi Arabia;
| | - Albert Estrugo-Devesa
- Department of Odontostomatology, Faculty of Medicine and Health Sciences, School of Dentistry, University Campus of Bellvitge, University of Barcelona, Barcelona Dental Hospital [HOUB], 08970 Barcelona, Spain or (H.A.A.); (S.E.-M.); (X.R.L.); (A.E.-D.)
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15
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Antonelli A, Bennardo F, Giudice A. Breakthroughs in Oral and Maxillofacial Surgery. J Clin Med 2024; 13:685. [PMID: 38337379 PMCID: PMC10856085 DOI: 10.3390/jcm13030685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 01/18/2024] [Indexed: 02/12/2024] Open
Abstract
In the field of oral and maxillofacial surgery, continuous advances have ushered in a new era of innovation, profoundly influencing this branch of medicine [...].
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Affiliation(s)
- Alessandro Antonelli
- School of Dentistry, Department of Health Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy; (F.B.); (A.G.)
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16
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Minervini G, Franco R, Marrapodi MM, Di Blasio M, Cicciù M, Ronsivalle V. The effectiveness of chitosan as a hemostatic in dentistry in patients with antiplatelet/anticoagulant therapy: systematic review with meta-analysis. BMC Oral Health 2024; 24:70. [PMID: 38200485 PMCID: PMC10782677 DOI: 10.1186/s12903-023-03568-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 10/23/2023] [Indexed: 01/12/2024] Open
Abstract
Hemorrhage control is a crucial aspect of dental procedures, and achieving efficient hemostasis remains a key challenge. The advent of hemostatic dressings has revolutionized the field of dentistry by providing effective and convenient solutions for managing bleeding in vari-ous dental scenarios. This article aims to provide an overview of hemostatic dressings, their mechanisms of action, and their diverse applications in dentistry. We applied the following Pop-ulation, Exposure, Comparator, and Outcomes (PICO) model to assess the document eligibility. A literature search was performed on major search engines, using keywords. At the end of the search, 3 articles were selected that matched the PICO. Three items were selected after the screen-ing process, and bleeding times were analyzed between the control group and the study group. The overall effect showed a substantial and statistically significant difference with bleeding time in favour of HDD-treated patients, showing that this garrison is very useful in controlling bleed-ing for patients taking anticoagulants and antiplatelets (Mean difference - 5.61; C.I. -5.70, - 5.52); Overall, hemostatic dressings have revolutionized the management of bleeding in dentistry, offering a promising solution to achieve optimal hemostasis, improve treatment outcomes, and enhance patient care, particularly Hemcon.
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Affiliation(s)
- Giuseppe Minervini
- Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, Tamil Nadu, India
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Napoli, 81100, Italy
| | - Rocco Franco
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, 00100, Italy.
| | - Maria Maddalena Marrapodi
- Department of Woman, Child and General and Specialist Surgery, University of Campania "Luigi Vanvitelli", Naples, 80121, Italy.
| | - Marco Di Blasio
- Department of Medicine and Surgery, University Center of Dentistry, University of Parma, Via Gramsci 14, Parma, Province of Parma, 43126, Italy.
| | - Marco Cicciù
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, Catania, 95123, Italy
| | - Vincenzo Ronsivalle
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, Catania, 95123, Italy
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Poszytek D, Górski B. Relationship between the Status of Third Molars and the Occurrence of Dental and Periodontal Lesions in Adjacent Second Molars in the Polish Population: A Radiological Retrospective Observational Study. J Clin Med 2023; 13:20. [PMID: 38202026 PMCID: PMC10779953 DOI: 10.3390/jcm13010020] [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: 11/06/2023] [Revised: 12/07/2023] [Accepted: 12/17/2023] [Indexed: 01/12/2024] Open
Abstract
The aim of this study was to evaluate the effect of third molars on caries, external root resorption, and alveolar bone loss on the distal surface of adjacent second molars. A total of 2488 panoramic radiographs of adult Poles were evaluated. Third molars were classified, according to eruption status, into non-impacted, partially, or completely impacted, and according to angulation into horizontal, mesioangular, vertical, and distoangular. Completely impacted third molars were assigned as reference group. The odds ratios (ORs) and 95% confidence intervals for the occurrence of the above-mentioned pathologies were 1.39 (1.09-2.21), 6.51 (3.72-10.11), and 2.42 (1.22-4.09), respectively, for second molars with adjacent erupted third molars and 1.54 (1.11-2.82), 10.65 (7.81-20.19), and 5.21 (3.38-10.81), respectively, when partially impacted third molars were next to second molars. The ORs of lesions were significantly higher for horizontally and mesioangularly impacted third molars. Within the limitation of a radiological study, it might be concluded that the presence of erupted third molars is a risk factor for caries, while the presence of impacted third molars increases the risk of root resorption and bone loss on the distal surface of second molars.
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Affiliation(s)
- Daniel Poszytek
- Department of Periodontology and Oral Mucosa Diseases, Medical University of Warsaw, 02-097 Warsaw, Poland;
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18
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Rieder M, Remschmidt B, Schrempf V, Schwaiger M, Jakse N, Kirnbauer B. Neurosensory Deficits of the Mandibular Nerve Following Extraction of Impacted Lower Third Molars-A Retrospective Study. J Clin Med 2023; 12:7661. [PMID: 38137730 PMCID: PMC10743649 DOI: 10.3390/jcm12247661] [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: 11/15/2023] [Revised: 12/06/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Neurosensory deficits are one of the major complications after impacted lower third molar extraction leading to an impaired patient's quality of life. This study aimed to evaluate the incidence of neurosensory deficits after lower third molar extraction and compare it radiologically to the corresponding position of the inferior alveolar nerve. METHODS In a retrospective study, all patients who underwent impacted lower third molar extraction between January and December 2019 were compiled. Therefore, clinical data as well as preoperative radiological imaging were assessed. RESULTS In total, 418 patients who underwent lower third molar extractions (n = 555) were included in this study. Of these, 33 (5.9%) had short-term (i.e., within the initial 7 postoperative days) and 12 (1.3%) long-term (i.e., persisting after 12 months) neurosensory deficits documented. The inferior alveolar nerve position in relation to the tooth roots showed apical position in 27%, buccal position in 30.8%, lingual position in 35.4%, and interradicular position in 6.9%. CONCLUSIONS A statistically significant increased incidence of neurosensory deficits occurs when the inferior alveolar nerve is directly positioned lingually to the tooth roots (p = 0.01).
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Affiliation(s)
- Marcus Rieder
- Division of Oral and Maxillofacial Surgery, Department of Dental Medicine and Oral Health, Medical University of Graz, 8036 Graz, Austria;
| | - Bernhard Remschmidt
- Division of Oral and Maxillofacial Surgery, Department of Dental Medicine and Oral Health, Medical University of Graz, 8036 Graz, Austria;
| | - Vera Schrempf
- Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, 8010 Graz, Austria (M.S.); (N.J.); (B.K.)
| | - Matthäus Schwaiger
- Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, 8010 Graz, Austria (M.S.); (N.J.); (B.K.)
| | - Norbert Jakse
- Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, 8010 Graz, Austria (M.S.); (N.J.); (B.K.)
| | - Barbara Kirnbauer
- Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, 8010 Graz, Austria (M.S.); (N.J.); (B.K.)
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Almeida-Marques M, Ingold MMS, da Silva-Junior AF, Franco A, Junqueira JLC, Oenning AC. Panoramic Radiography vs. CBCT in the Evaluation of the Maxillary Third Molar Roots. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1975. [PMID: 38004024 PMCID: PMC10672905 DOI: 10.3390/medicina59111975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: A comprehensive understanding of the position of third molar roots and adjacent structures, such as the maxillary sinus (MS), is essential for safe extractions. Diagnostic imaging plays a fundamental role in achieving accurate treatment planning. This study aimed to compare panoramic radiography (PR) and cone-beam computed tomography (CBCT) for the evaluation of maxillary third molar roots and their relationship with the MS. Materials and Methods: Two trained radiologists evaluated third molar images. The number of roots, morphology (fused/conical, divergent, dilacerated, or atypical), and their relationship with the MS in PR and CBCT were registered. Descriptive and inferential statistics were performed using the weighted Kappa test. Results: Regarding the number and morphology of the roots, Kappa values showed moderate (κ = 0.42) and fair agreement (κ = 0.38), respectively. Regarding the proximity with the MS, most of the roots showed close contact (30.6%), or 1/3 of root superimposition (35%), in PR evaluation, while in CBCT, the third molars were in contact with the MS floor (32%), and with alveolar domes (27.2%). Conclusions: PR is a moderately reliable image technique to identify the number of roots and root morphology of maxillary third molars. PR, however, does not provide any radiographic signs that clearly indicate the anatomical relationship between the maxillary third molar roots and the maxillary sinus detected in CBCT images.
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Affiliation(s)
- Marcia Almeida-Marques
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Centro de Pesquisas São Leopoldo Mandic, Rua José Rocha Junqueira 13, Ponte Preta, Campinas 13045-755, Brazil
| | - Mara Magnoler Sampaio Ingold
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Centro de Pesquisas São Leopoldo Mandic, Rua José Rocha Junqueira 13, Ponte Preta, Campinas 13045-755, Brazil
| | - Alberto Ferreira da Silva-Junior
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Centro de Pesquisas São Leopoldo Mandic, Rua José Rocha Junqueira 13, Ponte Preta, Campinas 13045-755, Brazil
| | - Ademir Franco
- Division of Forensic Dentistry, Faculdade São Leopoldo Mandic, Centro de Pesquisas São Leopoldo Mandic, Rua José Rocha Junqueira 13, Ponte Preta, Campinas 13045-755, Brazil
| | - José Luiz Cintra Junqueira
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Centro de Pesquisas São Leopoldo Mandic, Rua José Rocha Junqueira 13, Ponte Preta, Campinas 13045-755, Brazil
| | - Anne Caroline Oenning
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Centro de Pesquisas São Leopoldo Mandic, Rua José Rocha Junqueira 13, Ponte Preta, Campinas 13045-755, Brazil
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20
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Pardo A, Signoriello A, Corrà M, Favero V, De’Manzoni Casarola R, Albanese M. Six-Month Soft Tissues Healing after Lower Third Molar Extraction: Comparison of Two Different Access Flaps. J Clin Med 2023; 12:7017. [PMID: 38002631 PMCID: PMC10672238 DOI: 10.3390/jcm12227017] [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: 09/25/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND As specific flap designs performed for lower third molar extractions usually influence periodontal healing of the adjacent first and second molars, this study aimed to evaluate the periodontal conditions of these sites after 6 months post-surgery. METHODS Forty patients, aged 14-30 years, were included. Surgical extraction of the lower third molar was performed through a flap with papilla detachment (a modified envelope technique with detachment of gingival papilla between the first and second molars) or a trapezoidal flap (characterized by mesial- and distal-releasing incisions). Periodontal parameters at the first and second molar sites were assessed for visible plaque index, bleeding on probing, recession, probing pocket depth, and clinical attachment loss before surgery (T0), one month (T1), and six months after extraction (T2). RESULTS No statistical differences were found for the plaque and bleeding indexes between the two flaps at each observation time and considering both time intervals. For recession, no statistical differences were found between the two flaps considering the final time interval. For probing pocket depth at the second molar site, both techniques registered a significant increase between T0 and T1, followed by a decrease up to T2. For clinical attachment loss, mean values assessed for the first and second molar sites demonstrated evidently increased values between T0 and T1, followed by moderate decreases up to T2. CONCLUSIONS Considering short (T1) and mid-term (T2) follow-ups, a specific flap design does not seem to particularly influence periodontal healing six months after surgery.
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Affiliation(s)
- Alessia Pardo
- Dentistry and Maxillofacial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy; (M.C.); (V.F.); (R.D.C.); (M.A.)
| | - Annarita Signoriello
- Dentistry and Maxillofacial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy; (M.C.); (V.F.); (R.D.C.); (M.A.)
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21
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Javid K, Mourão CF, Mello-Machado RC, Sartoretto SC, Torres M, Stellet Lourenço E, Leite PEC, Granjeiro JM, Alves GG, Calasans-Maia MD. Clinical and Biochemical Evaluation of the Use of Alb-PRF versus L-PRF in Mandibular Third Molar Extractions: A Split-Mouth Randomized Clinical Trial. J Funct Biomater 2023; 14:505. [PMID: 37888172 PMCID: PMC10607814 DOI: 10.3390/jfb14100505] [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: 09/13/2023] [Revised: 09/29/2023] [Accepted: 10/08/2023] [Indexed: 10/28/2023] Open
Abstract
Bone tissue engineering seeks biomaterials that enable cell migration, angiogenesis, matrix deposition, and tissue regeneration. Blood concentrates like platelet-rich fibrin (L-PRF) offer a cost-effective source of cells and growth factors to enhance healing. The present study aimed to evaluate heated serum albumin with liquid PRF (Alb-PRF) and L-PRF clinically and biochemically after placement in dental sockets following mandibular third molar extraction. In a controlled, split-mouth study involving 10 volunteers, 20 extracted molars were treated with either Alb-PRF or L-PRF. Post-extraction, pain, trismus, infection presence, and swelling were measured. The concentrations of different analytes in the surgical sites were also examined. The data were statistically analyzed, with significance defined at p < 0.05 (t-test). No significant difference was noted between the groups for pain and trismus, but Alb-PRF showed a significant reduction in swelling on day seven. The Alb-PRF group showed lower levels of pro-inflammatory cytokines (GM-CSF, IL-1b, IL-6, IFNy, IL-8, IL-15, RANTES, and MIP-1a) after seven days, with only higher expressions of MIP-1b, IL-1b, and MCP-1 found in the L-PRF group. Differences were observed in the release of analytes between L-PRF and Alb-PRF, with Alb-PRF significantly reducing edema after seven days. Alb-PRF reduced edema, while L-PRF increased inflammatory cytokines. When compared to L-PRF, Alb-PRF reduced edema and the release of inflammatory cytokines, suggesting promising effects in socket healing while underscoring the role of growth factors and cytokines in potential applications of blood concentrates.
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Affiliation(s)
- Kayvon Javid
- Graduate Program in Dentistry, Fluminense Federal University, Niterói 24020-140, Brazil
| | - Carlos Fernando Mourão
- Department of Periodontology, Tufts University School of Dental Medicine, Boston, MA 02111, USA
| | | | | | - Madelaine Torres
- Graduate Program in Dentistry, Fluminense Federal University, Niterói 24020-140, Brazil
| | | | - Paulo Emilio Correa Leite
- Clinical Research Unit, Antonio Pedro Hospital, Fluminense Federal University, Niterói 24033-900, Brazil
| | - José Mauro Granjeiro
- Department of Oral Surgery, Fluminense Federal University, Niterói 24020-140, Brazil
| | - Gutemberg Gomes Alves
- Department of Biotechnology, Fluminense Federal University, Niterói 24033-900, Brazil
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