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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.
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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
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Bernabeu-Mira JC, Peñarrocha-Oltra D, Peñarrocha-Diago M. Coronectomy of impacted mandibular third molars: a clinical and radiological retrospective case series study with 2-9 years of follow-up. Med Oral Patol Oral Cir Bucal 2024; 29:e180-e186. [PMID: 37622428 PMCID: PMC10945869 DOI: 10.4317/medoral.26159] [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: 05/25/2023] [Accepted: 07/29/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Impacted mandibular third molars occasionally are in intimate relation to the inferior alveolar nerve (IAN). Coronectomy has been proposed as a good alternative to prevent injury of the IAN. The present study evaluates the clinical and radiological outcomes of impacted mandibular third molars presenting radiographic signs associated with a high risk of IAN injury, and which were treated with the coronectomy technique. MATERIAL AND METHODS A retrospective case series evaluated the outcomes of coronectomies of impacted mandibular third molars. The inclusion criteria were: available preoperative, immediate postoperative and two-year panoramic radiographs, preoperative cone-beam computed tomography (CBCT), and a complete case history. The clinical evaluation comprised intraoperative complications (mobilized fragments of root and damage to adjacent structures), short-term complications (sensory alterations and postoperative infection), and long-term complications (infection or oral exposure). The IAN position with respect to the roots, root shape, eruption status, third molar position, radicular-complex migration and bone above roots were radiographically evaluated as well. RESULTS Approximately a total of 2000 mandibular third molars were removed from 2011 to 2022. Of these, 39 molars in 34 patients were partially extracted using the coronectomy technique. The mean age was 36 years (range 22-77), and the mean follow-up was 28 months (range 24-84). There were two short-term postoperative infections. One of them was resolved through reintervention to remove the roots after antibiotic treatment, while the other required hospital admission and removal of the roots. One case of short-term transient lingual paresthesia was also recorded. Two long-term oral exposures were detected, and the root fragments had to be extracted. There were no permanent sensory alterations. CONCLUSIONS In our case series of 39 impacted mandibular molars in intimate contact with the IAN and treated with the coronectomy technique, the number of complications was low (two infections and a single case of transient lingual paresthesia), and no permanent sensory alterations were observed. Prospective studies, especially randomized clinical trials, are needed to compare this technique with conventional extraction.
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Affiliation(s)
- J-C Bernabeu-Mira
- Department of Stomatology Faculty of Medicine and Dentistry, University of Valencia Gascó Oliag 1, 46010. Valencia, Spain
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Nie T, Chang B, Tian L, Cao S, Wang J, Qi H, Gao L. Correlation of Complex Impacted Mandibular Teeth with Pericoronitis and Effect of Minimally Invasive Tooth Extraction on Patients' Long-term Outcome of Masticatory Ability. Emerg Med Int 2022; 2022:6389900. [PMID: 36299854 PMCID: PMC9592224 DOI: 10.1155/2022/6389900] [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: 07/28/2022] [Accepted: 09/10/2022] [Indexed: 12/02/2022] Open
Abstract
Objective To explore the correlation of complex impacted mandibular teeth and pericoronitis, as well as the effect of minimally invasive tooth extraction on patients' long-term outcomes of masticatory ability. Methods A total of 101 patients with complex impacted teeth who were treated in our hospital from March 2019 to June 2021 were selected and divided into the control group (n = 55) and the observation group (n = 46) according to the different treatment methods. The patients in the control group were given conventional extraction treatment, and the patients in the observation group were given minimally invasive extraction treatment. The clinicopathological features of patients complicated by pericoronitis were observed and the relationship between complex impacted mandibular teeth and pericoronitis was discussed. Additionally, we made statistics on operative time (OT), intraoperative blood loss (IBL), dental socket integrity score, and adverse reactions (ARs) and compared the clinical efficacy between the observation group and control group. The Visual Analogue Scale (VAS) and Oral Health Impact Profile scale (OHIP-14) were utilized for pain assessment and oral health status evaluation, respectively. Bite force (BF) and masticatory efficiency were also measured. Results OG showed less OT and IBL than CG, with a higher dental socket integrity score (P < 0.05). In addition, OG outperformed CG with a higher overall response rate and a lower incidence of ARs (P < 0.05). The pretreatment VAS score, mouth-opening degree, and OHIP-14 score differed insignificantly between groups (P > 0.05). After treatment, the VAS score of OG decreased, while the mouth-opening degree and OHIP-14 score increased (P < 0.05). Finally, the mastication ability was higher in OG at 7 days postoperatively, but there was no difference between groups at 6 months postoperatively (P > 0.05). Conclusion Complex mandibular impacted teeth can easily induce pericoronitis, so clinicians should pay attention to the influencing factors of pericoronitis. Minimally invasive surgery for complex impacted mandibular teeth can effectively improve treatment outcomes, accelerate patient rehabilitation, and provide more effective protection for patients' oral health and masticatory ability, which is worth promoting in clinical use.
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Affiliation(s)
- Tinghong Nie
- Department of Stomotology, Tianjin Baodi Hospital/Baodi Clinical College of Tianjin Medical University, Tianjin 301800, China
| | - Bojie Chang
- Department of Stomotology, Tianjin Baodi Hospital/Baodi Clinical College of Tianjin Medical University, Tianjin 301800, China
| | - Lili Tian
- Department of Stomotology, Tianjin Baodi Hospital/Baodi Clinical College of Tianjin Medical University, Tianjin 301800, China
| | - Shansong Cao
- Department of Stomotology, Tianjin Baodi Hospital/Baodi Clinical College of Tianjin Medical University, Tianjin 301800, China
| | - Junjie Wang
- Department of Stomotology, Tianjin Baodi Hospital/Baodi Clinical College of Tianjin Medical University, Tianjin 301800, China
| | - Haitao Qi
- Department of Stomotology, Tianjin Baodi Hospital/Baodi Clinical College of Tianjin Medical University, Tianjin 301800, China
| | - Lirong Gao
- Department of Stomotology, Tianjin Baodi Hospital/Baodi Clinical College of Tianjin Medical University, Tianjin 301800, China
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Raqe Alqhtani N, Mohammed AlThobaiti S, Khalid AlOwais H, Abdulrhman Alabdulkarim M, Abdullah Aldossary R, Tabassum N, AlOtaibi M, Almeslet A. Knowledge and Attitude Among the Saudi Dentists Towards Coronectomy of Impacted Mandibular Third Molars. Clin Cosmet Investig Dent 2022; 14:113-121. [PMID: 35591923 PMCID: PMC9113033 DOI: 10.2147/ccide.s356754] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 04/23/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Compared to the complete extraction of impacted third molars that are in close proximity to the mandibular canal, the coronectomy procedure is used as an alternative, owing to its minimal risk of damaging the Inferior alveolar nerve. Despite clear coronectomy concepts mentioned in the literature, the procedure is debatable. This study aimed to assess the knowledge and attitude towards the coronectomy procedure among dentists in Saudi Arabia. Patients and Methods The 16 close-ended questionnaire was distributed electronically to 377 dentists over the country. It included the demographic data and the options given to their patients with complicated impacted third molars, and the number of coronectomy they have performed. The retrieved data were exported and transferred to the SPSS software program for analysis. The Chi-squared and Fisher’s exact tests were used as appropriate for comparisons. A P-value <0.05 was considered significant. Results Only 54 (15%) participants performed coronectomy procedure, and only 28.3% of the participants advised their patients to do coronectomy. Nearly two-thirds of the participants (71.9%) were aware of coronectomy procedures, with no significant differences (P> 0.05) between the groups. About 68.9% of the participants agreed that coronectomy aims to protect inferior alveolar nerve damage. More than 60% of participants believed that coronectomy is a reliable technique, while 40.6% of participants claimed that they were capable of deciding whether to do coronectomy or extraction. No significant differences were found between the groups concerning most of the study variables (P> 0.05). Conclusion Knowledge of Saudi dentists towards coronectomy is good, while their attitude is still low. More learning strategies about coronectomy should be implemented.
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Affiliation(s)
- Nasser Raqe Alqhtani
- Department of Oral and Maxillofacial Surgery and Diagnostic Science, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | | | | | | | | | - Nafeesa Tabassum
- Department of Diagnostic Sciences, College of Dentistry, Dar Al Uloom University, Riyadh, Saudi Arabia
| | - Mohammed AlOtaibi
- Department of Oral and Maxillofacial Surgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Asma Almeslet
- Department of Oral Maxillofacial Surgery and Diagnostic Sciences, Riyadh Elm University, Riyadh, Saudi Arabia
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Does the Coronectomy a Feasible and Safe Procedure to Avoid the Inferior Alveolar Nerve Injury during Third Molars Extractions? A Systematic Review. Healthcare (Basel) 2021; 9:healthcare9060750. [PMID: 34207131 PMCID: PMC8234010 DOI: 10.3390/healthcare9060750] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 05/31/2021] [Accepted: 06/16/2021] [Indexed: 11/16/2022] Open
Abstract
This systematic review aimed to review the literature on the coronectomy technique and evaluate the incidence of success and complications as a surgical approach for inferior third molars. Online databases were searched for data on the frequency of inferior alveolar nerve damage, lingual nerve damage, root migration, pain, infection, dry socket, and extraction of the remaining root, and data on the necessity of reintervention were also extracted. Randomized clinical trials, controlled clinical trials, prospective cohort studies, and prospective and retrospective studies with or without the control group were intercepted. This systematic review was registered in PROSPERO (CDR 42020135485). Sixteen papers analyzed 2176 coronectomies in total, and only five of them were judged as appropriate according to methodological quality assessment. The incidence of inferior alveolar nerve injury was documented in 0.59% of the procedures, lingual nerve injury in 0.22%, infection 3.95%, dry socket 1.12%, extraction of the root 5.28%, and reintervention 1.13%. The pain was the most reported, in 22.04% of the population. This study provides an overview of the clinical success and complications of coronectomy, and their prevalence. A coronectomy may be considered a low-risk procedure and an option for treatment to avoid potential damage to nervous structures. However, patients should still undergo a full screening and evaluation of postsurgical procedures.
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Cosola S, Kim YS, Park YM, Giammarinaro E, Covani U. Coronectomy of Mandibular Third Molar: Four Years of Follow-Up of 130 Cases. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E654. [PMID: 33261207 PMCID: PMC7760348 DOI: 10.3390/medicina56120654] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/17/2020] [Accepted: 11/21/2020] [Indexed: 01/10/2023]
Abstract
Inferior wisdom teeth extraction surgery may have some complications that, in some cases, could be prevented by a correct diagnosis and minimal surgery. Coronectomy is a technique used for wisdom teeth surgery where only the crown is extracted and the root/roots are left in situ. This procedure may be controversial, but it could limit the common risks of the extraction procedure. Nowadays, the indication and contraindication of this technique are debated, and clinicians normally extract the entire tooth. The following case series includes the data and follow-up radiographs of 130 patients who received a coronectomy, reporting the safety of the procedure. After a mean follow-up period of four years, no complications occurred. A total of 13 patients showed mobile roots but had no complications or symptoms. The roots migrated in a mesial or coronal direction in 31 patients; in 4 cases, they were removed because of patient preference. Coronectomy is a useful oral surgical procedure in certain complicated cases of mandibular wisdom tooth extraction.
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Affiliation(s)
- Saverio Cosola
- Department of Stomatology, Tuscan Stomatologic Institute, Foundation for Dental Clinic, Research and Continuing Education, 55042 Forte dei Marmi, Italy; (S.C.); (U.C.)
| | - Young Sam Kim
- Gangam Dental Office, Seoul 06614, Korea; (Y.S.K.); (Y.M.P.)
| | - Young Min Park
- Gangam Dental Office, Seoul 06614, Korea; (Y.S.K.); (Y.M.P.)
- Department of Oral and Maxillo-Facial Surgery, Seoul National University, Seoul 06614, Korea
| | - Enrica Giammarinaro
- Department of Stomatology, Tuscan Stomatologic Institute, Foundation for Dental Clinic, Research and Continuing Education, 55042 Forte dei Marmi, Italy; (S.C.); (U.C.)
| | - Ugo Covani
- Department of Stomatology, Tuscan Stomatologic Institute, Foundation for Dental Clinic, Research and Continuing Education, 55042 Forte dei Marmi, Italy; (S.C.); (U.C.)
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Sureshkannan P, Kuriadom ST, Venkataramana V, Thangavelu A, Thiruneelakandan S. Alternative Approach to Prevent Inferior Alveolar Nerve Injury in Lower Third Molar Surgery: A Pilot Study on Coronectomy. J Pharm Bioallied Sci 2020; 12:S415-S418. [PMID: 33149497 PMCID: PMC7595465 DOI: 10.4103/jpbs.jpbs_123_20] [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: 02/04/2020] [Revised: 02/07/2020] [Accepted: 03/06/2020] [Indexed: 11/30/2022] Open
Abstract
Context: Injury to inferior alveolar nerve (IAN) in lower third molar (L3M) surgery may lead to unpleasant sensation or anesthesia of lower lip. Considering the quality of life of the patient and the litigations faced by the dentist, alternative treatment approaches to odontectomy have been studied by various researchers. Coronectomy is one such option to prevent the nerve injury. Aims: The aim of this study was to assess the efficacy of coronectomy to reduce nerve injury during L3M surgery in high-risk cases as per radiological signs. Settings and Design: A pilot study was conducted in the oral surgery department of Rajah Muthiah Dental College, Annamalai Nagar, Chidambaram, India to evaluate coronectomy and its usefulness. Materials and Methods: Sixty-five patients who satisfied the inclusion and exclusion criteria for coronectomy were included in the study. The patients were followed up to 1-year period. Statistical Analysis Used: Descriptive statistics was used. Results: None of the patients in the study group had IAN impairment. Conclusions: Coronectomy is a safe alternative for complete odontectomy in high-risk L3M surgery cases. Root migration, infection, and need for second surgery are potential complication. Further studies with more samples and variables need to be performed.
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Affiliation(s)
- Prabakaran Sureshkannan
- Department of Oral and Maxillofacial Surgery, Thumbay Hospital, Gulf Medical University, Dubai, United Arab Emirates
| | - Sam Thomas Kuriadom
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Ajman University, Ajman, United Arab Emirates
| | | | - Annamalai Thangavelu
- Department of Oral and Maxillofacial Surgery, Raja Muthiah Dental College, Annamalai University, Chidambaram, Tamilnadu, India
| | - Sambandham Thiruneelakandan
- Department of Oral and Maxillofacial Surgery, Raja Muthiah Dental College, Annamalai University, Chidambaram, Tamilnadu, India
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Dallaserra M, Cuéllar J, Villanueva J. [Coronectomy for lower third molars surgery]. Medwave 2020; 20:e7956. [PMID: 32678812 DOI: 10.5867/medwave.2020.06.7957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 06/07/2020] [Indexed: 11/27/2022] Open
Affiliation(s)
- Matías Dallaserra
- Departamento de Cirugía y Traumatología Bucal y Maxilofacial, Facultad de Odontología, Universidad de Chile; Centro Cochrane Asociado de la Facultad de Odontología, Universidad de Chile; Unidad de Cirugía Máxilo Facial, Hospital Clínico San Borja Arriarán, Santiago, Chile; Proyecto Epistemonikos, Santiago, Chile
| | - Javier Cuéllar
- Unidad de Cirugía Máxilo Facial, Hospital Clínico San Borja Arriarán, Santiago, Chile; Proyecto Epistemonikos, Santiago, Chile
| | - Julio Villanueva
- Departamento de Cirugía y Traumatología Bucal y Maxilofacial, Facultad de Odontología, Universidad de Chile; Centro Cochrane Asociado de la Facultad de Odontología, Universidad de Chile; Unidad de Cirugía Máxilo Facial, Hospital Clínico San Borja Arriarán, Santiago, Chile; Proyecto Epistemonikos, Santiago, Chile. . Address: Centro Evidencia UC, Pontificia Universidad Católica de Chile, Diagonal Paraguay 476, Santiago, Chile
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Matzen LH, Villefrance JS, Nørholt SE, Bak J, Wenzel A. Cone beam CT and treatment decision of mandibular third molars: removal vs. coronectomy-a 3-year audit. Dentomaxillofac Radiol 2019; 49:20190250. [PMID: 31778318 DOI: 10.1259/dmfr.20190250] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To assess: (1) the workflow in the treatment decision process of mandibular third molars based on a panoramic image and CBCT and (2) the impact of radiographic markers in CBCT on the decision to perform coronectomy. METHODS 1437 teeth in 917 patients (mean age 27.8 years, range 18-72) underwent clinical and panoramic examination. If there was an indication for removal of the tooth, and signs of a close relation to the inferior alveolar nerve were present in the panoramic image, a CBCT was performed. Treatment decision based on panoramic image and CBCT was calculated. Statistical analyses were performed to assess whether signs in CBCT had an impact on the treatment decision "coronectomy". Moreover, the actually operated teeth and post-operative sensory disturbances were assessed and discussed in relation to the radiographic method. RESULTS Based on the panoramic image, in 462 cases it was decided not to treat, 553 were scheduled for surgery, and 422 referred for a CBCT examination. "No bony separation between the tooth and mandibular canal" seen in CBCT was the main factor influencing the decision to perform a coronectomy (odds ratio = 56.8, p < 0.001). 840 mandibular third molars had undergone surgical intervention, 152 had a coronectomy and 688 were fully removed. Six patients perceived a sensory disturbance of the inferior alveolar nerve: one permanent and five temporary. CONCLUSION 29% of the examined cases were referred for a CBCT and of these, the majority were scheduled for coronectomy based on the sign "no bony separation between the tooth and mandibular canal" seen in CBCT.
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Affiliation(s)
- Louise Hauge Matzen
- Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Denmark, Europe
| | - Julie Suhr Villefrance
- Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Denmark, Europe
| | - Sven Erik Nørholt
- Section of Oral Surgery and Oral Pathology, Department of Dentistry and Oral Health, Aarhus University, Denmark, Europe.,Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Denmark, Europe
| | - Jesper Bak
- Section of Oral Surgery and Oral Pathology, Department of Dentistry and Oral Health, Aarhus University, Denmark, Europe
| | - Ann Wenzel
- Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Denmark, Europe
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Staderini E, Patini R, Guglielmi F, Camodeca A, Gallenzi P. How to Manage Impacted Third Molars: Germectomy or Delayed Removal? A Systematic Literature Review. ACTA ACUST UNITED AC 2019; 55:medicina55030079. [PMID: 30917605 PMCID: PMC6473914 DOI: 10.3390/medicina55030079] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 03/05/2019] [Accepted: 03/22/2019] [Indexed: 11/16/2022]
Abstract
Objectives: The aim of this systematic review is to evaluate and compare the risks and benefits of germectomy and delayed removal of third molars and develop a patient management algorithm for second molar eruption in syndrome/incompliant patients. Materials and Methods: A literature search was performed in the following databases; the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Scopus, and Web of Science. Last search was done on July 2nd, 2018 including articles published from the last 18 years. The search aimed to identify all relevant studies written in English language. Gray literature was excluded. Risk of bias was evaluated with specific predetermined criteria. This systematic literature review was reported according to the PRISMA-P statement and was registered in the PROSPERO database with the following protocol ID: 104261. Results: Literature search war performed on July 2018 and updated on February 2019. A total of 1610 articles were screened. After abstract screening and discarding duplicates, 86 full-text articles were obtained and subjected to additional evaluation. Four articles were included in the review. Three studies were considered as having a medium risk of bias and one was assessed as at high risk. Due to the heterogeneity of presenting results and a very low number of included studies a quantitative analysis was not possible. Only qualitative analysis was made. Considering the limited number of studies included and the level of risk of bias there is no sufficient evidence to state the benefits of preventive removal of impacted third molars, especially in patients with poor oral hygiene due to intellectual disability. Early germectomy represents an elective approach of pathologic alteration of tooth germ; orthodontic issues meet appropriate indication for a delayed removal. Conclusions: Given the best evidence-based information regarding patients’ medical condition, we highlight the need to provide an ethical-based comprehensive approach in the diagnostic workflow and the assessment of treatment outcome.
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Affiliation(s)
- Edoardo Staderini
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Institute of Dentistry and Maxillofacial Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
| | - Romeo Patini
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Institute of Dentistry and Maxillofacial Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
| | - Federica Guglielmi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Institute of Dentistry and Maxillofacial Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
| | - Andrea Camodeca
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Institute of Dentistry and Maxillofacial Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
| | - Patrizia Gallenzi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Institute of Dentistry and Maxillofacial Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
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Matzen LH, Berkhout E. Cone beam CT imaging of the mandibular third molar: a position paper prepared by the European Academy of DentoMaxilloFacial Radiology (EADMFR). Dentomaxillofac Radiol 2019; 48:20190039. [PMID: 30810357 DOI: 10.1259/dmfr.20190039] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Lack of evidence on the use of CBCT for management of mandibular third molars in Radiation Protection guideline no. 172 of the European Commission made the European Academy of DentoMaxilloFacial Radiology (EADMFR) decide to update the recommendations of the guideline. METHODS AND MATERIALS A literature search was performed addressing the following questions: (1) does CBCT change the treatment of the patient?; (2) does CBCT reduce the number of post-operative sensory disturbances of the inferior alveolar nerve?; and (3) can CBCT predict the risk for a post-operative sensory disturbance of the inferior alveolar nerve? RESULTS: Since the European Commission published the guideline in 2012 several high-evidence studies on the use of CBCT before removal of mandibular third molars have been conducted including five randomized controlled clinical trials and one meta-analysis. Present literature allows to propose recommendations with highest level of evidence. CONCLUSION New and up-to-date evidence-based recommendations advocate that CBCT imaging of the mandibular third molar should not be applied as a routine method before removal of mandibular third molars and therefore, CBCT imaging should only be applied when the surgeon has a very specific clinical question in an individual patient case that cannot be answered by conventional (panoramic and/or intraoral) imaging.
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Affiliation(s)
- Louise Hauge Matzen
- 1 Department of Dentistry and Oral Health, Section of Oral Radiology, Aarhus University , Aarhus , Denmark
| | - Erwin Berkhout
- 2 Department of Oral Radiology and Radiation Protection, Academic Center for Dentistry, VU University & University of Amsterdam , The Netherlands
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CORONECTOMY AS A METHOD FOR SURGICAL TREATMENT OF IMPACTED MANDIBULAR THIRD MOLARS: INDICATIONS AND OWN CLINICAL STUDIES OF POSTOPERTIVE PERIOD. WORLD OF MEDICINE AND BIOLOGY 2019. [DOI: 10.26724/2079-8334-2019-2-68-117-121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Alves FA, Serpa MS, Delgado-Azañero W, de Almeida OP. Coronectomy - An alternative approach to remove impacted teeth in oncological patients. J Clin Exp Dent 2018; 10:e992-e995. [PMID: 30386505 PMCID: PMC6203898 DOI: 10.4317/jced.55231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 09/02/2018] [Indexed: 11/05/2022] Open
Abstract
Background Coronectomy involves the section of the tooth crown leaving the roots in the socket. Possibility of inferior alveolar nerve injury and mandibular fracture are the main indications for this approach. Herein, we describe a case series of coronectomy to highlight its indication in normal and oncological patients. Material and Methods A total of 9 patients were submitted to coronectomy, 6 of them were oncological. Three patients were evaluated before head and neck radiotherapy (HNRT), 2 after HNRT and 1 before bone marrow transplantation. Results Mean age of the patients was 49 years, most of them male (n=7). Lower third molars were the main teeth that received this procedure, and all cases presented intimate anatomic relationship between the roots and the mandibular canal. Moreover, three cases also presented evident mandibular fracture risk in removing the tooth. During the follow-up period, none complications were observed related to coronectomy and oncological treatment. Conclusions Coronectomy is a safe approach including for cancer patients and it should be considered in high-risk impacted teeth extractions. Key words:Coronectomy, impacted teeth, oncological patients, postoperative complications.
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Affiliation(s)
- Fabio-Abreu Alves
- DDS, PhD, Head of Stomatology Department, A. C. Camargo Cancer Center, São Paulo, Brazil. Professor of the Department of Stomatology, University of São Paulo, School of Dentistry, São Paulo, Brazil
| | - Marianna-Sampaio Serpa
- DDS, MSc, PhD student, Department of Stomatology, A. C. Camargo Cancer Center, São Paulo, Brazil
| | - Wilson Delgado-Azañero
- DDS, PhD, Emeritus Professor of Oral Pathology, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Oslei-Paes de Almeida
- DDS, PhD, Professor of Oral Pathology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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Verner FS, Marlière DAA, Junqueira RB, Freitas DQ. Are different imaging methods affecting the treatment decision of extractions of mandibular third molars? Methodological and statistical issues. Dentomaxillofac Radiol 2018; 47:20180043. [PMID: 29565688 DOI: 10.1259/dmfr.20180043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Francielle Silvestre Verner
- 1 Department of Dentistry, Federal University of Juiz de Fora/Governador Valadares Campus , Governador Valadares , Brazil
| | - Daniel Amaral Alves Marlière
- 2 Division of Oral and Maxillofacial Surgery, Piracicaba Dental School, State University of Campinas , Piracicaba , Brazil
| | - Rafael Binato Junqueira
- 1 Department of Dentistry, Federal University of Juiz de Fora/Governador Valadares Campus , Governador Valadares , Brazil
| | - Deborah Queiroz Freitas
- 3 Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, State University of Campinas , Piracicaba , Brazil
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