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Wei Y, Guo R, Zhao S. The clinical study and multi-factor analysis of temporomandibular joint disorder induced by tooth extraction. Curr Probl Surg 2024; 61:101554. [PMID: 39168539 DOI: 10.1016/j.cpsurg.2024.101554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 06/23/2024] [Accepted: 06/24/2024] [Indexed: 08/23/2024]
Affiliation(s)
- Yunpeng Wei
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Ruitong Guo
- Department of Pharmacy, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School,Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Sufeng Zhao
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China.
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Kostares E, Kostare G, Kostares M, Kantzanou M. Prevalence of fibrinolytic alveolitis following extraction of impacted mandibular third molars: A systematic review and meta-analysis. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101810. [PMID: 38432484 DOI: 10.1016/j.jormas.2024.101810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/06/2024] [Accepted: 02/29/2024] [Indexed: 03/05/2024]
Abstract
Our research aims to assess the prevalence of alveolar osteitis (AO) following impacted mandibular third molar extractions and investigate the impact of potential moderating factors on this occurrence. Two independent reviewers conducted a comprehensive systematic literature search across Medline, Scopus, and Google Scholar databases. The pooled prevalence, accompanied by 95 % confidence intervals (CI), was calculated. Quality assessments, outlier and influential analyses were performed. Subgroup and meta-regression analysis were conducted in order the effect of categorical and continuous variables on the estimated prevalence to be investigated. Our meta-analysis included twenty-eight eligible studies, encompassing a total of 41,859 impacted mandibular third molar extractions. The overall prevalence of dry socket (DS) following impacted mandibular third molar extractions was estimated at 6.7 % (95 % CI 4.6-9.1 %), indicating considerable heterogeneity among the studies. No study was identified as critically influential, and meta-regression analysis did not pinpoint any potential sources of heterogeneity. 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, Athens 115 27, Greece.
| | - Georgia Kostare
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens 115 27, Greece
| | - Michael Kostares
- Department of Anatomy, Medical School, National and Kapodistrian University of Athens, Athens 115 27, Greece
| | - Maria Kantzanou
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens 115 27, Greece
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Ruiz-Roca J, Rodríguez-Molinero J, Javaloyes-Vicente P, Pereira-Lopes O, Gay-Escoda C. Use of CBCT and panoramic radiography in the prediction of alterations in sensivity of the inferior alveolar nerve in third molars: A retrospective cross-sectional study. Saudi Dent J 2024; 36:1105-1110. [PMID: 39176156 PMCID: PMC11337963 DOI: 10.1016/j.sdentj.2024.06.001] [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: 11/19/2023] [Revised: 05/31/2024] [Accepted: 06/02/2024] [Indexed: 08/24/2024] Open
Abstract
Objectives We investigated which type of orthopantomography (OPG) was best able to predict neurological alterations of the inferior alveolar nerve (IAN) during extraction of a lower third molar (3 M). Methods We analysed cone beam computed tomographies (CBCTs) that were performed at a private dental clinic in Cartagena, Spain over five consecutive years. The CBCTs, together with their corresponding OPGs, had been prescribed for the surgical extraction of a lower 3 M. Results We analysed a total of 342 CBCTs and their corresponding OPGs. After explaining the risk of changes in the IAN sensitivity, 37 patients refused to undergo surgical extraction. The incidence of sensitivity alterations in the 332 dental extractions was 62 (19%): 44 were paraesthesias of the IAN, and 18 were associated with darkening of the root and interruption of the cortical line. Conclusion When an OPG revealed darkening of the root and interruption of the cortical line, the risk of contact between the lower 3 M and the IAN-that is, the probability of changes in IAN sensitivity-increased by over three-fold.
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Affiliation(s)
- J.A. Ruiz-Roca
- Faculty of Dentistry, Department of Dermatology, Stomatology and Radiology, University of Murcia, Spain
| | - J.A. Rodríguez-Molinero
- Faculty of Health Sciences, Department of Nursery and Stomatology, IDIBO Research Group, Rey Juan Carlos University, Alcorcón, Madrid, Spain
| | - P. Javaloyes-Vicente
- Faculty of Dentistry, Department of Dermatology, Stomatology and Radiology, University of Murcia, Spain
| | - O. Pereira-Lopes
- Faculty of Health Sciences, Department of Oral Medicine and Oral Surgery, University Fernando Pessoa, Oporto, Portugal
| | - C. Gay-Escoda
- Chairman and Professor of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Barcelona, Spain
- Coordinator/Researcher at the IDIBELL (Bellvitge Biomedical Research Institute), Barcelona, Spain
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Godovanets OI, Davydenko IS, Muryniuk TI, Fedoniuk LY. Histological and immunohistochemical characteristic of the gingival stroma in the portion of the third molars in children of various age. POLSKI MERKURIUSZ LEKARSKI : ORGAN POLSKIEGO TOWARZYSTWA LEKARSKIEGO 2024; 52:153-160. [PMID: 38642350 DOI: 10.36740/merkur202402103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/22/2024]
Abstract
OBJECTIVE Aim: To evaluate the state of the gingival stromal elements in the portion of the third molars requiring extraction of these teeth due to orthodontic indications considering the stage of tooth germ formation. PATIENTS AND METHODS Materials and Methods: The surgery to extract third molars due to orthodontic indications was performed on 95 children aged 11 to 18 years. The three groups of observation were isolated according to clinical-radiological signs: І (n=30) - children aged 11-13 years; ІІ (n=35) - children aged 13-16 years, and ІІІ (n=30) - children aged 16-18 years. During surgery, the samples of gums were taken from the adjacent areas for examination. The samples were fixed, dehydrated, paraffinized for further histological processing. Immunohistochemical methods were used according to the protocols supplied by a producer. In particular, by means of immunohistochemical method, Ki-67, CD-34 antigens and vimentin with primary antibodies against them were determined. The primary antibodies were visualized by the polymeric visualization system with diaminobenzidine giving a brown color to the places of location of the antigens examined. The data obtained were statistically processed. RESULTS Results: The results of the study showed that specific gravity of the vascular bed in the gingival papillary layer of children was the most variable. It ranges from (12,7±0,09) % at the stage of "D" root formation to (54,8±0,17) % at the "H" stage. Lower concentrations of CD-34 antigens and vimentin are found in the endotheliocytes of children aged 13-16 and 16-18 years, compared to the children aged 11-13 years (p<0,05). No changes were found in the specific volume of the blood vessels, CD-34 antigens and vimentin in the reticular gingival layer of children from the groups of observation. CONCLUSION Conclusions: Therefore, the conducted histological and immunohistochemical study of the connective gingival tissues in the portion of the third molars in children enables to draw a conclusion that in the process of formation of the root of this tooth a number of changes occur in the gingival stroma. They include an increase of the blood flow volume in the papillary gingival layer on the background of a decreased concentration of CD-34 genes and vimentin, a longer stage of development of the third molar root. The specific volume of the islets of neoangiogenesis of the papillary gingival layer is the largest in children aged 13-16 years.
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Damasceno YSS, Espinosa DG, Normando D. Is the extraction of third molars a risk factor for the temporomandibular disorders? A systematic review. Clin Oral Investig 2020; 24:3325-3334. [PMID: 32776170 DOI: 10.1007/s00784-020-03277-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 04/04/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND The aim of this study was to evaluate through a systematic review the extraction of third molars as a risk factor for temporomandibular disorders (TMDs). TYPES OF STUDIES REVIEWED Randomized and nonrandomized controlled clinical trials where patients underwent third molar extraction and with qualitative evaluation of TMDs before and after extraction were included. RESULTS After applying the inclusion criteria, seven nonrandomized clinical studies were included. QUIPS tool showed that four articles presented a moderate and three a high risk of bias (RoB). Six studies reported that TMDs presented higher level after removal of third molars ranging from OR, 1.81 to 2.15/RR, 2.1. However, one study showed no significant association. GRADE showed heterogeneity in relation to general results, which means that confidence in the estimated effects varied from low to moderate GRADE. The quality of clinical recommendations decreased especially due to the risk of bias in some of the included studies evaluated with the QUIPS tool. CONCLUSIONS AND PRACTICAL IMPLICATIONS Third molar extraction can be associated with the development of TMD signs and symptoms. Furthermore, TMD can be aggravated according to the third molar location, the degree of impaction and surgical difficulty, age, and gender. This systematic review highlights the need to perform randomized clinical trials with diagnostic criteria and standardized surgical procedures.
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Affiliation(s)
- Yohana Sandy Souza Damasceno
- Department of Orthodontics, Dental School, Faculty of Dentistry, Federal University of Pará (UFPA), Augusto Correa St., no 1, Belém, Pará, 66075-110, Brazil
| | - Daybelis González Espinosa
- Department of Orthodontics, Dental School, Faculty of Dentistry, Federal University of Pará (UFPA), Augusto Correa St., no 1, Belém, Pará, 66075-110, Brazil
- Facultad de Odontologi, Universidad Católica Redemptoris Mater, Managua, Nicaragua
| | - David Normando
- Department of Orthodontics, Dental School, Faculty of Dentistry, Federal University of Pará (UFPA), Augusto Correa St., no 1, Belém, Pará, 66075-110, Brazil.
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Restrepo Rendon LF, Meneses Tamayo F, Vivares Builes AM. Complicaciones quirúrgicas y posquirúrgicas en la exodoncia de terceros molares inferiores: estudio retrospectivo. ACTA ODONTOLÓGICA COLOMBIANA 2019. [DOI: 10.15446/aoc.v9n1.72842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introducción: el tercer molar es el último diente en erupcionar en la secuencia de la dentición permanente, el cual concluye el proceso de formación en edades comprendidas entre los 16 a los 25 años. En ocasiones la vía de erupción de estos puede presentar alteraciones en su posición, ocasionando discrepancias y patologías al paciente. Objetivo: establecer las complicaciones quirúrgicas y posquirúrgicas más frecuentes y su relación con la posición radiográfica en terceros molares mandibulares en pacientes intervenidos quirúrgicamente en una Clínica Universitaria de la ciudad de Medellín, durante el periodo junio de 2016 a junio de 2017. Materiales y métodos: se realizó un estudio observacional descriptivo de análisis retrospectivo, donde se evaluaron 206 historias clínicas de pacientes atendidos en el servicio de cirugía oral para procedimientos de exodoncias quirúrgicas de terceros molares inferiores. Resultados: en términos de las complicaciones no se presentaron hemorragias intraoperatorias. Las complicaciones intraoperatorias reportadas hacen referencia a instrumentos rotatorios fracturados 0,5% (n= 1) y laceración de tejidos blandos durante la cirugía 0,5% (n= 1). Para las complicaciones posquirúrgicas se encontraron hemorragia y dehiscencia de la herida 0,5% (n= 1), edema 0,5% (n= 1) e injurias al tejido blando en la zona quirúrgica 0,5% (n= 1). Los demás pacientes no reportaron ninguna complicación quirúrgica o posquirúrgica. Conclusiones: las complicaciones quirúrgicas y posquirúrgicas tienen una prevalencia baja en la institución universitaria. No se encontró relación directa en cuanto a una variable específica con algún tipo de complicación.
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Miclotte I, Agbaje J, Spaey Y, Legrand P, Politis C. Incidence and treatment of complications in patients who had third molars or other teeth extracted. Br J Oral Maxillofac Surg 2018; 56:388-393. [DOI: 10.1016/j.bjoms.2018.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 02/04/2018] [Indexed: 10/17/2022]
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An Observational Cohort Study on Delayed-Onset Infections after Mandibular Third-Molar Extractions. Int J Dent 2017; 2017:1435348. [PMID: 28607555 PMCID: PMC5457748 DOI: 10.1155/2017/1435348] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 04/30/2017] [Indexed: 11/18/2022] Open
Abstract
Objectives The purpose of the present study was to investigate the occurrence and clinical features of delayed-onset infections after mandibular third-molar extractions. Method and Materials An observational cohort study was conducted on 179 patients undergoing mandibular third-molar extraction between January 2013 and December 2015, for a total of 217 extractions. Data were recorded at the time of extraction (T0), on suture removal seven days later (T1), and 30 days after the extraction, when patients were contacted and asked about their healing process (T2). The statistical analysis was performed with nonparametric tests. A p value lower than 0.05 was considered statistically significant. Results Eight delayed-onset infections were recorded, amounting to 3.7% of all extractions. The median time elapsing from the extraction to the delayed-onset infection was 35 days (IQR 28–40; min 24–max 49). Younger age and longer surgical procedures seemed to be more often associated with this complication. Conclusion Delayed-onset infections after third-molar extractions are relatively rare postoperative complications characterized by a swelling, usually with a purulent discharge. Patients should be informed of this possibility, which might develop even several weeks after the extraction.
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