1
|
Kostares E, Kostare G, Kostares M, Tsakris A, Kantzanou M. Prevalence of surgical site infections following extraction of impacted mandibular third molars: A systematic review and meta-analysis. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024:101995. [PMID: 39084557 DOI: 10.1016/j.jormas.2024.101995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 07/20/2024] [Accepted: 07/28/2024] [Indexed: 08/02/2024]
Abstract
Our research aims to assess the prevalence of surgical site infections (SSI) following impacted mandibular third molar extractions. Two independent reviewers conducted a comprehensive systematic literature search across Medline, Scopus and Cochrane Central databases. The pooled prevalence, accompanied by 95% confidence intervals (CI), was calculated. Quality assessments, outlier and influential analyses were performed. Our meta-analysis included seventeen eligible studies, encompassing a total of 37,585 impacted mandibular third molar extractions. The overall prevalence of SSI following impacted mandibular third molar extractions was estimated at 1.7% (95% CI 1%-2.6%), indicating considerable heterogeneity among the studies. No study was identified as critically influential. This study highlights the imperative for future well-constructed prospective and retrospective investigations to deepen our understanding of the etiological nuances and refine management approaches for this prevalent postoperative complication.
Collapse
Affiliation(s)
- Evangelos Kostares
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece.
| | - Georgia Kostare
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Michael Kostares
- Department of Anatomy, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Athanasios Tsakris
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Maria Kantzanou
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| |
Collapse
|
2
|
Balel Y, Zogo A, Yıldız S, Tanyeri H. Can ChatGPT-4o provide new systematic review ideas to oral and maxillofacial surgeons? JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024:101979. [PMID: 39068990 DOI: 10.1016/j.jormas.2024.101979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Revised: 07/22/2024] [Accepted: 07/24/2024] [Indexed: 07/30/2024]
Abstract
OBJECTIVE This study aims to evaluate the capacity of ChatGPT-4o to generate new systematic review ideas in the field of oral and maxillofacial surgery. The data obtained from this study will provide evidence-based information to oral and maxillofacial surgeons regarding the academic use of GPT-4o. MATERIALS AND METHODS ChatGPT-4o was asked to provide four previously unpublished systematic review ideas each for the topics of impacted third molars, dental implants, orthognathic surgery, and temporomandibular disorders. A literature search was conducted in the PubMed database to check if the ideas generated by GPT-4o had been previously published, and the search results were compared with the ideas generated by the AI. RESULTS The PubMed database search resulted in a total of 871 publications, with 37 publications found to be related to the topics generated by GPT-4o after the first and second screening. Out of the 16 publication ideas generated by GPT-4o, 9 (56.25 %) were determined to be previously unexplored according to the PubMed database search. There was no statistically significant relationship between the presence of ChatGPT's suggestions in PubMed and the subject areas of the studies. CONCLUSION ChatGPT-4o has a high potential to be used as a valuable tool for suggesting systematic review topics in oral and maxillofacial surgery. Additionally, this tool can assist researchers not only in proposing publication ideas but also in developing the methodology of the study.
Collapse
Affiliation(s)
- Yunus Balel
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Sivas Cumhuriyet University, Sivas, Türkiye.
| | - Atakan Zogo
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, İstanbul Kent University, İstanbul, Türkiye
| | | | - Hakkı Tanyeri
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, İstanbul Kent University, İstanbul, Türkiye
| |
Collapse
|
3
|
Sánchez-Garcés MÁ, Toledano-Serrabona J, Camps-Font O, Peñarrocha-Diago M, Sánchez-Torres A, Sanmartí-Garcia G, Vegas-Bustamante E, Figueiredo R, Valmaseda-Castellón E, Gay-Escoda C, Sociedad Española de Cirugía Bucal OB. Diagnosis and indications for the extraction of third molars - The SECIB clinical practice guideline. Med Oral Patol Oral Cir Bucal 2024; 29:e545-e551. [PMID: 38368528 PMCID: PMC11249379 DOI: 10.4317/medoral.26524] [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: 01/05/2024] [Accepted: 01/15/2024] [Indexed: 02/19/2024] Open
Abstract
BACKGROUND The removal of third molars (3Ms) is the most frequent surgical procedure in the field of Oral Surgery. As a result, the Spanish Society of Oral Surgery (SECIB) aims to create a Clinical Practice Guideline (CPG) that offers evidence-based recommendations for optimal clinical practice. Specifically, the CPG will focus on providing guidance regarding the indications and criteria for clinical and radiological diagnosis of patients with 3Ms. MATERIAL AND METHODS This CPG was developed by the SECIB, following the methodological guidelines described in the methodological manual for the "Development of Clinical Practice Guidelines in the National Health System". Several PICO questions related to the diagnosis and indications for the extraction of 3Ms were formulated. The leading experts carried out the evaluation of the evidence and the formulation of specific recommendations. RESULTS A total of 17 PICO questions were evaluated, addressing the indications, prognosis, diagnosis, and cost-benefit relationship of 3M extraction. CONCLUSIONS The present Clinical Practice Guideline provides evidence-based recommendations on the diagnosis and indications for 3M extraction. These evidence-based recommendations can assist healthcare professionals and the general population in making informed decisions regarding the management of 3Ms.
Collapse
Affiliation(s)
- M-Á Sánchez-Garcés
- Faculty of Medicine and Health Sciences, School of Dentistry Campus de Bellvitge, Universitat de Barcelona C/Feixa Llarga, s/n, Pavelló Govern, 2ª planta, Despatx 2.9 08907 L'Hospitalet de Llobregat, Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Wang SY, Zhang SJ, Meng HF, Xu HQ, Guo ZX, Yan JF, Gao JL, Niu LN, Wang SL, Jiao K. DPSCs regulate epithelial-T cell interactions in oral submucous fibrosis. Stem Cell Res Ther 2024; 15:113. [PMID: 38650025 PMCID: PMC11036714 DOI: 10.1186/s13287-024-03720-5] [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: 10/21/2023] [Accepted: 04/07/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Oral submucous fibrosis (OSF) is a precancerous lesion characterized by fibrous tissue deposition, the incidence of which correlates positively with the frequency of betel nut chewing. Prolonged betel nut chewing can damage the integrity of the oral mucosal epithelium, leading to chronic inflammation and local immunological derangement. However, currently, the underlying cellular events driving fibrogenesis and dysfunction are incompletely understood, such that OSF has few treatment options with limited therapeutic effectiveness. Dental pulp stem cells (DPSCs) have been recognized for their anti-inflammatory and anti-fibrosis capabilities, making them promising candidates to treat a range of immune, inflammatory, and fibrotic diseases. However, the application of DPSCs in OSF is inconclusive. Therefore, this study aimed to explore the pathogenic mechanism of OSF and, based on this, to explore new treatment options. METHODS A human cell atlas of oral mucosal tissues was compiled using single-cell RNA sequencing to delve into the underlying mechanisms. Epithelial cells were reclustered to observe the heterogeneity of OSF epithelial cells and their communication with immune cells. The results were validated in vitro, in clinicopathological sections, and in animal models. In vivo, the therapeutic effect and mechanism of DPSCs were characterized by histological staining, immunohistochemical staining, scanning electron microscopy, and atomic force microscopy. RESULTS A unique epithelial cell population, Epi1.2, with proinflammatory and profibrotic functions, was predominantly found in OSF. Epi1.2 cells also induced the fibrotic process in fibroblasts by interacting with T cells through receptor-ligand crosstalk between macrophage migration inhibitory factor (MIF)-CD74 and C-X-C motif chemokine receptor 4 (CXCR4). Furthermore, we developed OSF animal models and simulated the clinical local injection process in the rat buccal mucosa using DPSCs to assess their therapeutic impact and mechanism. In the OSF rat model, DPSCs demonstrated superior therapeutic effects compared with the positive control (glucocorticoids), including reducing collagen deposition and promoting blood vessel regeneration. DPSCs mediated immune homeostasis primarily by regulating the numbers of KRT19 + MIF + epithelial cells and via epithelial-stromal crosstalk. CONCLUSIONS Given the current ambiguity surrounding the cause of OSF and the limited treatment options available, our study reveals that epithelial cells and their crosstalk with T cells play an important role in the mechanism of OSF and suggests the therapeutic promise of DPSCs.
Collapse
Affiliation(s)
- S Y Wang
- Department of Stomatology, Tangdu Hospital & State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration & School of Stomatology, The Fourth Military Medical University, 169 West Changle Road, Xincheng District, 710032, Xi'an, Shaanxi, P. R. China
| | - S J Zhang
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, 169 West Changle Road, Xincheng District, 710032, Xi'an, Shaanxi, P. R. China
| | - H F Meng
- Beijing SH Bio-tech Co., 100071, Beijing, P.R. China
| | - H Q Xu
- Department of Stomatology, Tangdu Hospital & State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration & School of Stomatology, The Fourth Military Medical University, 169 West Changle Road, Xincheng District, 710032, Xi'an, Shaanxi, P. R. China
- The College of Life Science, Northwest University, 710032, Xi'an, Shaanxi, P.R. China
| | - Z X Guo
- Department of Stomatology, Tangdu Hospital & State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration & School of Stomatology, The Fourth Military Medical University, 169 West Changle Road, Xincheng District, 710032, Xi'an, Shaanxi, P. R. China
| | - J F Yan
- Department of Stomatology, Tangdu Hospital & State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration & School of Stomatology, The Fourth Military Medical University, 169 West Changle Road, Xincheng District, 710032, Xi'an, Shaanxi, P. R. China
| | - J L Gao
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, 169 West Changle Road, Xincheng District, 710032, Xi'an, Shaanxi, P. R. China
| | - L N Niu
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, 169 West Changle Road, Xincheng District, 710032, Xi'an, Shaanxi, P. R. China.
| | - S L Wang
- Beijing Laboratory of Oral Health, Capital Medical University, 10 Xitoutiao, Fengtai District, 100069, Beijing, P.R. China.
- Laboratory of Homeostatic Medicine, School of Medicine, Southern University of Science and Technology, No. 1088 Xueyuan Avenue, Nanshan District, 518055, Shenzhen, P.R. China.
| | - K Jiao
- Department of Stomatology, Tangdu Hospital & State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration & School of Stomatology, The Fourth Military Medical University, 169 West Changle Road, Xincheng District, 710032, Xi'an, Shaanxi, P. R. China.
| |
Collapse
|
5
|
Huang C, Xu Y. Can concentrated growth factor prevent postoperative complications of impacted third molar surgery? A split-mouth randomized double-blind trial. Clin Oral Investig 2024; 28:234. [PMID: 38556559 DOI: 10.1007/s00784-024-05638-x] [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: 01/01/2024] [Accepted: 03/26/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVES The purpose of the present study was to evaluate the effect of concentrated growth factor (CGF) on prevention of postoperative complications in the impacted third molar extraction. MATERIALS AND METHODS A total of 25 healthy patients with symmetrical bilaterally impacted third molars (50 extraction sites) were enrolled in this split-mouth, randomized, double-blind clinical trial. Third molar extractions were performed in both sites of the mandible at the same appointment. Randomization was performed using a coin toss to choose the test and control sites. CGF was placed in the extraction socket and the socket was sutured (test group), while the contralateral socket was only sutured (control group). Each patient acted as their own control. The primary outcome were pain assessed by visual analog scale (VAS) and facial swelling on the1st, 3rd and 7th postoperative days. The secondary outcomes were bone healing in extraction sockets through alveolar bone height (ABH) and alveolar bone density (ABD) evaluated by cone beam computed tomography (CBCT) immediately after extraction and in the 3rd and 6th months. RESULTS Twenty-five patients (12 female, 13 male; mean age 29.17) with bilateral impacted third molars participated in the study. A statistically significant reduction in pain was determined on the 3rd and 7th postoperative days in the CGF sites compared to the control sites while no statistically significant difference was found between the groups on the 1st postoperative day (3rd day, p = 0.009; 7th day, p = 0.039). There were no statistically significant differences in facial swelling and bone healing between the test and control groups at different time intervals, although the data obtained were slightly favoring the CGF group (p > 0.05). There were no serious adverse effects such as infection, alveolitis, paraesthesia, fracture through the follow-up period in all of the cases. CONCLUSION The study has demonstrated the effect of CGF on relieving the severity of pain after the third molar extraction. CLINICAL RELEVANCE Placement of CGF in the extraction socket could relieve postoperative pain and reduce patient discomfort after the third molar extraction. CGF is recommended during the third molar extraction due to its good biological effects, low cost and simple preparation procedures. TRIAL REGISTRATION NUMBER ChiCTR2300077819.
Collapse
Affiliation(s)
- Cheng Huang
- Department of Stomatology, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, 1279, Sanmen Road, Shanghai, 200434, China
| | - Yuanzhi Xu
- Department of Stomatology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, 301, Middle Yanchang Road, Shanghai, 200072, China.
| |
Collapse
|
6
|
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.
Collapse
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;
| |
Collapse
|
7
|
Cardoso GB, Savegnago GDO, Hirsch WDB, Vizzotto MB, Liedke GS. Pathologic conditions associated with impacted third molars: A retrospective study of panoramic radiographs in a Southern Brazilian population. Imaging Sci Dent 2023; 53:303-312. [PMID: 38174038 PMCID: PMC10761288 DOI: 10.5624/isd.20230036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 06/27/2023] [Accepted: 07/14/2023] [Indexed: 01/05/2024] Open
Abstract
Purpose This study investigated the prevalence of developmental and acquired pathologic conditions associated with impacted third molars (3Ms) in a Southern Brazilian population and evaluated whether demographic and tooth characteristics were correlated with the presence of bone or tooth lesions. Materials and Methods Panoramic radiographs were assessed for developmental (bone-related) or acquired (tooth-related) pathoses associated with impacted upper or lower 3Ms. Data on tooth positioning, tooth development, and patient demographics were collected. A trained, calibrated postgraduate student evaluated all images. Binary and multivariate logistic regression models were used to assess associations between outcomes and the demographic and radiographic variables. The threshold for statistical significance was set at 5% (P<0.05). Results The sample comprised panoramic radiographs from 2054 patients, predominantly female (59.2%), with a mean age of 27.2 ± 11.5 years. Overall, 4066 impacted 3Ms were evaluated, revealing 471 (11.6%) developmental and 710 (17.5%) acquired pathoses. Among the developmental pathoses, 460 (95.2%) were indicative of dentigerous cysts. Male sex, lower 3M location, vertical or distoangular positioning, and incomplete root formation were associated with an elevated likelihood of developmental pathology. Lower tooth position, complete root formation, and partial eruption were linked to an increased probability of an acquired pathology in the third or second molar. Conclusion The prevalence of pathologic conditions associated with impacted 3Ms was low. Male sex, lower 3M placement, horizontal or distoangular positioning, and incomplete root formation were associated with developmental pathoses, while lower tooth position, complete root formation, and partial eruption were related to acquired pathoses.
Collapse
Affiliation(s)
- Gabriela Brum Cardoso
- Dental Sciences Post-Graduation Program, Federal University of Santa Maria, Santa Maria, Brazil
| | | | | | - Mariana Boessio Vizzotto
- Department of Surgery and Orthopedics, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | |
Collapse
|
8
|
Noro A, Snäll J, Ventä I. Factors affecting number of third molars extracted in a single visit. Acta Odontol Scand 2023; 81:597-602. [PMID: 37431966 DOI: 10.1080/00016357.2023.2228882] [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: 08/29/2022] [Accepted: 06/19/2023] [Indexed: 07/12/2023]
Abstract
OBJECTIVE This cross-sectional study evaluated the number and characteristics of third molars extracted in a single visit in primary care and their associations with patient's age and sex and operator's experience. MATERIALS AND METHODS The data included all appointments where routine and surgical extractions of third molars were performed in 2016 in primary care of the City of Helsinki. Statistics included χ2 and Mann-Whitney U tests, and binomial logistic regression. RESULTS In total of 10,894 appointments, the number of extracted third molars was 12,728, yielding an average of 1.2 third molars per visit. Mean age of patients (55% women, 45% men) at extraction was 32.2 years (range 12 - 97 years). Most appointments (83.7%, n = 9,118) comprised extraction of one, 15.8% two, 0.4% three, and 0.1% four third molars. Number of teeth extracted at a time did not differ by sex. Increasing age was associated with a reduction in the likelihood of several third molar extractions in a visit (OR 0.96; 95% confidence interval (CI) 0.96-0.97). Multiple third molars were extracted significantly more likely if the operator was experienced (OR 2.32; 95%CI 1.90-2.84). Multiple extractions were also associated with the mandible, operative extractions, unerupted teeth and caries. CONCLUSIONS Third molars were typically extracted one at a time. In health care units, it is appropriate to consider extraction of several third molars in a single visit, if need for extraction of other third molars exist. Concentrating the extractions of younger patients on experienced operators would reduce the number of patients' visits.
Collapse
Affiliation(s)
- Abiel Noro
- Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Johanna Snäll
- Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, Helsinki, Finland
| | - Irja Ventä
- Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| |
Collapse
|
9
|
Qu H, Yang Y, Tian Y, Li Z, Sun L, Chen F, Tian B. Third molar-related knowledge, attitudes, behaviors, and medical history of 904 Chinese adults: a cross-sectional survey. J Zhejiang Univ Sci B 2023; 24:896-904. [PMID: 37752091 PMCID: PMC10522566 DOI: 10.1631/jzus.b2200617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 02/07/2023] [Indexed: 09/28/2023]
Abstract
This study investigated the perceptions and medical history of third molars (M3s) and assessed the prevalence of visible M3s (V-M3s) among 904 Chinese adults. The enrolled participants were interviewed to complete a structural questionnaire focused on sociodemographic information and their understanding of, attitudes toward, behaviors regarding, and medical history with respect to M3s. In addition, the number of V-M3s in the cohort was determined by oral examination. Logistic regression analysis was performed to explore the association between individuals' sociodemographic characteristics and their perception of M3s or the presence of V-M3s. The Chi-square test was used to compare the actions taken against symptomatic M3s and the corresponding outcomes among different groups divided according to respondents' sociodemographic factors. In total, 904 completed questionnaires were gathered and analyzed. Nearly half (43.9%) of the respondents knew nothing about M3s, and only 12.7% provided correct answers to all the questions asked. Male sex, older age, occupation involving physical labor, and no previous dental experience were active factors in unawareness of M3s. Male sex was also significantly associated with the presence of at least one V-M3 and negative behavior about symptomatic M3s. In terms of medical history, 192 participants reported having had at least one M3 extracted (438 in total), and 72.6% of the M3s were removed due to the presence of related symptoms or pathologies. In conclusion, the population investigated had a shortage of knowledge about M3s and adopted negative attitudes and actions about M3-related problems.
Collapse
Affiliation(s)
- Honglei Qu
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, School of Stomatology, the Fourth Military Medical University, Xi'an 710032, China
| | - Yang Yang
- Department of Oral and Maxillofacial Surgery, The 940th Hospital of Joint Logistics Support Force of PLA, Lanzhou 730050, China
| | - Yi Tian
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, School of Stomatology, the Fourth Military Medical University, Xi'an 710032, China
| | - Zhibang Li
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, School of Stomatology, the Fourth Military Medical University, Xi'an 710032, China
| | - Lijuan Sun
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, School of Stomatology, the Fourth Military Medical University, Xi'an 710032, China
| | - Faming Chen
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, School of Stomatology, the Fourth Military Medical University, Xi'an 710032, China.
| | - Beimin Tian
- Department of Periodontology, School of Stomatology, the Fourth Military Medical University, Xi'an 710032, China.
| |
Collapse
|
10
|
Bin Rubaia’an MA, Neyaz A, Talic F, Alkhamis A, Alghabban A, Assari A. The Association Between Skeletal Facial Types and Third Molars Impaction in a Saudi Arabian Subpopulation: A CBCT Study. Clin Cosmet Investig Dent 2023; 15:143-156. [PMID: 37601239 PMCID: PMC10439799 DOI: 10.2147/ccide.s419325] [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: 05/25/2023] [Accepted: 08/04/2023] [Indexed: 08/22/2023] Open
Abstract
Purpose To assess the state of mandibular and maxillary third molars in relation to different facial types in a Saudi population using cone-beam computed tomography (CBCT) records. Patients and Methods A retrospective study was performed on CBCTs. Statistical analysis determined the relationship between impacted maxillary and mandibular third molars and different skeletal facial types. The degree of third molar impaction was evaluated. Results A total of 198 CBCTs from subjects were evaluated, with a mean age of 34.2 years. Archer II classification was found to be significantly associated with all skeletal profiles. The incidence of mesioangular impactions in lower third molar showed a notable increase in the brachyfacial group, which was statistically significant. Conclusion In conclusion, this study demonstrates that different facial types are associated with the angulation of third molar impactions.
Collapse
Affiliation(s)
| | - Aymen Neyaz
- College of Dentistry, Riyadh Elm University, Riyadh, Kingdom of Saudi Arabia
| | - Faisal Talic
- College of Dentistry, Riyadh Elm University, Riyadh, Kingdom of Saudi Arabia
| | - Ali Alkhamis
- College of Dentistry, Riyadh Elm University, Riyadh, Kingdom of Saudi Arabia
| | | | - Ahmad Assari
- Oral and Maxillofacial Surgery and Diagnostic Sciences Department, Riyadh Elm University, Riyadh, Kingdom of Saudi Arabia
| |
Collapse
|
11
|
Bruce D, Dudding T, Gormley M, Richmond RC, Haworth S. An observational analysis of risk factors associated with symptomatic third molar teeth. Wellcome Open Res 2023; 7:71. [PMID: 37577450 PMCID: PMC10422052 DOI: 10.12688/wellcomeopenres.17673.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2023] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND Third molar teeth (wisdom teeth) are a common cause of pain and infection in young adults. The study aimed to describe the prevalence of symptomatic third molar teeth and identify factors which predispose to third molar symptoms in a birth cohort. METHODS An observational study was undertaken nested in the Avon Longitudinal Study of Parents and Children (ALSPAC), a birth cohort based in south west England. The main outcomes were self-reported third molar pain, swelling and treatment for third molar problems, taken from questionnaires completed at age 23 years. The exposures including sex, dental history, socioeconomic status, diet, and genetic factors were obtained from earlier ALSPAC data. RESULTS In total 4,222 ALSPAC participants responded to one or more questions about third molar teeth. The final sample included more female participants than male participants. The majority of participants (56.6%) reported at least one episode of pain associated with their third molars. Females had greater odds than males of reporting swelling (adjusted odds ratio (OR) 1.97; 95%confidence interval (CI) 1.56, 2.51), pain (adjusted OR=1.96; 95%CI 1.56, 2.51) and receiving both non-surgical and surgical treatment (adjusted OR=2.30; 95%CI 1.62, 3.35, adjusted OR=1.54; 95%CI 1.17, 2.06 respectively). Participants with previously filled teeth had greater odds of third molar extraction. There were no strong associations between index of multiple deprivation (IMD) score or sugar intake and the third molar outcomes. There was weak evidence for a genetic contribution to third molar pain. CONCLUSIONS Symptomatic third molars are common in this age group, with over half of the participants reporting pain or other symptoms. Female participants had greater odds for third molar pain, swelling and treatment.
Collapse
Affiliation(s)
- Douglas Bruce
- Bristol Dental School, University of Bristol, Bristol, UK
| | - Tom Dudding
- Bristol Dental School, University of Bristol, Bristol, UK
- The MRC Integrative Epidemiology Unit at the University of Bristol, University of Bristol, Bristol, UK
| | - Mark Gormley
- Bristol Dental School, University of Bristol, Bristol, UK
- The MRC Integrative Epidemiology Unit at the University of Bristol, University of Bristol, Bristol, UK
| | - Rebecca C Richmond
- The MRC Integrative Epidemiology Unit at the University of Bristol, University of Bristol, Bristol, UK
| | - Simon Haworth
- Bristol Dental School, University of Bristol, Bristol, UK
- The MRC Integrative Epidemiology Unit at the University of Bristol, University of Bristol, Bristol, UK
| |
Collapse
|
12
|
Su N, Harroui S, Rozema F, Listl S, Lange JD, Heijden GJMGVD. What do we know about uncommon complications associated with third molar extractions? A scoping review of case reports and case series. J Korean Assoc Oral Maxillofac Surg 2023; 49:2-12. [PMID: 36859370 PMCID: PMC9985997 DOI: 10.5125/jkaoms.2023.49.1.2] [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: 07/14/2022] [Revised: 08/27/2022] [Accepted: 08/29/2022] [Indexed: 03/03/2023] Open
Abstract
The current study aimed to explore the types and frequencies of uncommon complications associated with third molar extractions based on a scoping review of case reports and case series. The study used an electronic literature search based on PubMed and Embase up to March 31, 2020, with an update performed on October 22, 2021. Any case reports and case series that reported complications associated with third molar extractions were included. The types of complications were grouped and the main symptoms of each type of complication were summarized. A total of 51 types of uncommon complications were identified in 248 patients from 186 studies. Most types of complications were post-operative. In the craniofacial and cervical regions, the most frequent complications included iatrogenic displacement of the molars or root fragments in the craniofacial area, late mandibular fracture, and subcutaneous emphysema. In other regions, the most frequent complications include pneumomediastinum, pneumorrhachis, pneumothorax, and pneumopericardium. Of the patients, 37 patients had life-threatening uncommon complications and 20 patients had long-term/irreversible uncommon complications associated with third molar extractions. In conclusion, a variety of uncommon complications associated with third molar extractions were identified. Most complications occurred in the craniofacial and cervical regions and were mild and transient.
Collapse
Affiliation(s)
- Naichuan Su
- Department of Oral Public Health, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam
| | - Sana Harroui
- Department of Oral Public Health, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam
| | - Fred Rozema
- Department of Oral Medicine, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam.,Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Center (UMC), Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam
| | - Stefan Listl
- Radboud Institute for Health Sciences, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.,Department of Conservative Dentistry, Section for Translational Health Economics, Heidelberg University Hospital, Heidelberg, Germany
| | - Jan de Lange
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Center (UMC), Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam
| | - Geert J M G van der Heijden
- Department of Oral Public Health, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam
| |
Collapse
|
13
|
Kim SH, Kim S, Kim YS, Song MK, Kang JY. Application of sequential multimodal analgesia before and after impacted mandibular third molar extraction: Protocol for a randomized controlled trial. Contemp Clin Trials Commun 2023; 32:101078. [PMID: 36762120 PMCID: PMC9905937 DOI: 10.1016/j.conctc.2023.101078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 11/26/2022] [Accepted: 01/15/2023] [Indexed: 01/19/2023] Open
Abstract
Background Several analgesics have been applied under various protocols to control the moderate-to-severe postoperative pain caused by the surgical extraction of an impacted mandibular third molar. However, a consensus on optimal pain management while minimizing side effects is yet to be reached. Methods This multi-center, prospective, double-blind, randomized controlled trial aims to evaluate the efficacy and safety of sequential multimodal analgesia combined with postoperative zaltoprofen along with multiple preemptive analgesics. A total of 80 participants with bilateral impacted mandibular third molar from two hospitals were randomized into two groups. Two surgical extractions were performed at one-month intervals, and in a crossover design, celecoxib or tramadol/acetaminophen was administered before one extraction and placebo before the other extraction. Following extraction, all subjects took zaltoprofen for 5 days. The outcome measures included pain at specific times, time and intensity of the first pain onset after extraction, need of rescue drugs, and occurrence and frequency of side effects. Conclusions This ongoing clinical trial was designed to provide evidence regarding a new protocol for effective postoperative pain management of a commonly performed surgical extraction. The results of this study will provide guidance to clinicians regarding the timing and combination of oral analgesics in various oral surgeries performed under local anesthesia. Trial registration KCT0005450, registered on October 7, 2020.
Collapse
Affiliation(s)
- Soo-Ho Kim
- Department of Dentistry, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea
| | - Somi Kim
- Department of Dentistry, Chungnam National University Sejong Hospital, 407, Dodam-dong, Sejong-si, 30099, South Korea
| | - Yoon-Seon Kim
- Department of Dentistry, Chungnam National University Sejong Hospital, 407, Dodam-dong, Sejong-si, 30099, South Korea
| | - Mi-Kyoung Song
- Department of Dentistry, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea
| | - Ji-Yeon Kang
- Department of Dentistry, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea,Department of Oral & Maxillofacial Surgery, College of Medicine, Chungnam National University, 266, Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea,Corresponding author. Department of Dentistry, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, 35015, South Korea.
| |
Collapse
|
14
|
Colby LE, Watson DP. Fully Guided Tooth Bud Ablation in Pigs Results in Complete Tooth Bud Removal and Molar Agenesis. J Oral Maxillofac Surg 2022; 81:456-466. [PMID: 36592934 DOI: 10.1016/j.joms.2022.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 12/09/2022] [Accepted: 12/11/2022] [Indexed: 12/31/2022]
Abstract
PURPOSE Fully guided microwave tooth bud ablation has the potential to become a minimally invasive means for managing third molars in adolescent patients. If developed, this new modality could provide improved outcomes and reduced complications compared to traditional third molar management strategies. The purpose of this 28-day longitudinal characterization study was to determine if the healing response following fully guided microwave ablation of second molar tooth buds in juvenile pigs would result in the complete removal of targeted tooth bud tissues, molar agenesis, and no significant collateral tissue damage. METHODS Investigators performed fully guided microwave ablation on 24 mandibular second molar tooth buds (#18 and #31) in seven-week-old pigs. Postablation healing assessment consisted of radiographic and histological evaluation of 3 subcohorts (consisting of 4 animals each) at 7-, 14- and 28-days post ablation. Controls were untreated, opposing maxillary second molar tooth buds. Neurological assessment was performed to determine if there was any detectible loss of inferior alveolar nerve function. RESULTS Healing processes were nearly complete at 28 days post ablation. While one tooth bud was identified as partially ablated at 14 days post treatment, all treated tooth bud tissues were replaced with trabecular new bone formation by the end of this study. There was no detectible loss of inferior alveolar nerve function. The thermal dosing strategy used in this study appears to deliver prescribed ablation volumes and-within the context of this animal model-there was no detected collateral tissue damage. CONCLUSIONS The results of this study confirm the hypothesis that healing processes following fully guided tooth bud ablation resulted in removal of targeted tooth bud tissues, complete molar agenesis, and trabecular new bone growth at 28-days post treatment.
Collapse
|
15
|
Yang Y, Tian Y, Sun LJ, Qu HL, Li ZB, Tian BM, Chen FM. The impact of Anatomic Features of Asymptomatic Third Molars on the Pathologies of Adjacent Second Molars: A Cross-sectional Analysis. Int Dent J 2022; 73:417-422. [DOI: 10.1016/j.identj.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/07/2022] [Accepted: 09/11/2022] [Indexed: 11/05/2022] Open
|
16
|
Impact of the presence of partially erupted third molars on the local radiographic bone condition. Sci Rep 2022; 12:8683. [PMID: 35606483 PMCID: PMC9127109 DOI: 10.1038/s41598-022-12729-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 05/16/2022] [Indexed: 11/18/2022] Open
Abstract
The decision on retaining or prophylactically removing asymptomatic lower third molars is still discussed in the literature. This study aimed to verify the association between asymptomatic lower third molars and local bone conditions through periapical radiographs. Based on sample size calculations, 288 radiographs were required. Dependent variables were alveolar bone crest status and radiolucency between the distal aspect of the third molar crown and the ascending mandibular ramus. Independent variables were sex, age, Pell and Gregory and Winter’s classification, angulation and distance between second and third molars, third molar side. Advanced ages (OR 1.15; CI 1.08–1.24; p < 0.001) and greater third molar angulations (OR 1.03; CI 1.01–1.04; p < 0.001) significantly increased the chance of radiographic alterations in the bone crest between second and third molars. Radiolucency distal to third molars was solely impacted by patient’s age (OR 1.05; CI 1.01–1.11; p = 0.036). Older patients and lower third molars with greater angulations about adjacent second molar should be evaluated for third molar removal because of the increased chance of alveolar bone crest alterations. Older patients should also be monitored for wider radiolucent pericoronal spaces distal to lower third molars and its consequences.
Collapse
|
17
|
Bruce D, Dudding T, Gormley M, Richmond RC, Haworth S. An observational analysis of risk factors associated with symptomatic third molar teeth. Wellcome Open Res 2022. [DOI: 10.12688/wellcomeopenres.17673.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Third molar teeth (wisdom teeth) are a common cause of pain and infection in young adults. The study aimed to describe the prevalence of symptomatic third molar teeth and identify factors which predispose to third molar symptoms in a birth cohort. Methods: An observational study was undertaken nested in the Avon Longitudinal Study of Parents and Children (ALSPAC), a birth cohort based in south west England. The main outcomes were self-reported third molar pain, swelling and treatment for third molar problems, taken from questionnaires completed at age 23 years. The exposures including sex, dental history, socioeconomic status, diet, and genetic factors were obtained from earlier ALSPAC data. Results: In total 4,222 ALSPAC participants responded to one or more questions about third molar teeth. The final sample included more female participants than male participants. The majority of participants (56.6%) reported at least one episode of pain associated with their third molars. Females had greater odds than males of reporting swelling (adjusted odds ratio (OR) 1.97; 95%confidence interval (CI) 1.56, 2.51), pain (adjusted OR=1.96; 95%CI 1.56, 2.51) and receiving both non-surgical and surgical treatment (adjusted OR=2.30; 95%CI 1.62, 3.35, adjusted OR=1.54; 95%CI 1.17, 2.06 respectively). Participants with previously filled teeth had greater odds of third molar extraction. There were no strong associations between index of multiple deprivation (IMD) score or sugar intake and the third molar outcomes. There was weak evidence for a genetic contribution to third molar pain. Conclusions: Symptomatic third molars are common in this age group, with over half of the participants reporting pain or other symptoms. Female participants had greater odds for third molar pain, swelling and treatment.
Collapse
|
18
|
Choi J. Risk factors for external root resorption of maxillary second molars associated with third molars. Imaging Sci Dent 2022; 52:289-294. [PMID: 36238707 PMCID: PMC9530300 DOI: 10.5624/isd.20220401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 04/22/2022] [Accepted: 05/02/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose This study aimed to evaluate the diagnostic performance of panoramic images compared to cone-beam computed tomography (CBCT) imaging for maxillary third molar (M3)-associated external root resorption (ERR), and to identify the risk factors of ERR on panoramic images. Materials and Methods The study population was composed of all patients who underwent panoramic imaging at Dankook University Dental Hospital from May to October 2019. In total, 397 cases of maxillary M3s in 247 patients (147 men and 100 women) were included. The diagnostic accuracy of ERR in panoramic images compared to CBCT images was evaluated using the chi-square test. To identify risk factors for ERR, dental records and panoramic findings were evaluated by logistic regression analysis. Results The diagnostic accuracy of ERR on panoramic images was 0.79 compared to CBCT images (P<0.05). Superimposition of M3s onto second molars (M2) was associated with an approximately 33 times higher risk of ERR than separated M3s (P<0.05). Impacted M3s showed a 5 times higher risk of ERR than erupted M3s (P<0.05). Conclusion ERR related to M3s is a common clinical condition, and superimposition of M3 onto M2 on panoramic images was the most important risk factor for ERR. It seemed that CBCT examinations for maxillary M3s might be indicated for ERR diagnosis especially if panoramic radiographs show superimposition of M3 onto M2. Impaction itself was also a risk factor, and it should be carefully examined.
Collapse
Affiliation(s)
- Jinwoo Choi
- Department of Oral and Maxillofacial Radiology, Dankook University College of Dentistry, Cheonan, Korea
| |
Collapse
|
19
|
Musha A, Ohno T. Subcutaneous Emphysema Caused by Third Molar Extraction. OTO Open 2021; 5:2473974X211004527. [PMID: 33855255 PMCID: PMC8010816 DOI: 10.1177/2473974x211004527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 02/26/2021] [Indexed: 11/16/2022] Open
Affiliation(s)
- Atsushi Musha
- Gunma University Heavy Ion Medical Center, Maebashi, Gunma, Japan.,Department of Oral and Maxillofacial Surgery/Plastic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Tatsuya Ohno
- Gunma University Heavy Ion Medical Center, Maebashi, Gunma, Japan
| |
Collapse
|