Surgical Extraction of Mesio-Angularly Impacted Mandibular Third Molars:An Alternative Instrument for the Osteotomy Procedure

Abstract

<p><strong>Background:</strong> Osteotomy of the bone surrounding mesio-angularly impacted tooth is part of the surgical procedure required for their extraction and has evolved in contemporary practice from the use of mallet/chisel to dental drill.</p><p><strong>Objective:</strong> To describe the extractions of mesio-angularly impacted mandibular third molars using Crane pick dental elevator for the osteotomy procedure.</p><p><strong>Materials and Methods:</strong> This was a prospective clinical study of patients done at the Oral and Maxillofacial Surgery Clinic of our institution, over three years period. With gentle, controlled, downward force, bone was removed with Crane pick elevator to expose the mesio-angularly impacted tooth cervical line, creating buccal and distal troughs that were linked and made in cancellous bone. The clinical variables evaluated were age, gender, and reason(s) for extraction, duration of treatment/osteotomy, degree of postoperative trismus and swelling, and complaints during follow-Up.</p><p><strong>Results:</strong> The ages of the 74 patients studied ranged from 18-63 years with mean age of 32.6± 2.8 years. Majority (83.8%) were in the age category of 16-45 years (P=0.001). The duration of the surgery from incision to placement of the last suture ranged from 12.8 to 17.1 minutes with mean 14.3±1.4 minutes. The duration of the osteotomy including the delivery of the tooth from their sockets ranged from 3.2 to 7.4 minutes with mean 5.3±0.7 minutes. The younger the patient's age, the shorter the osteotomy procedure (P=0.001).</p><p><strong>Conclusion:</strong> This study showed that certain mesio-angularly impacted mandibular third molars can be extracted using only Crane pick elevator.</p>