Third Molars Research Articles

Effectiveness of platelet-rich fibrin in third molar extractions: a randomized controlled split-mouth study

ObjectivesTo date, studies have only investigated the use of platelet-rich fibrin (PRF) after removal of third molars from the mandible or maxilla. Removal of the upper and lower third molars is typically combined into one session per side; therefore, this study aimed to investigate influence on PRF.Materials and methodsThis prospective, single-blinded, randomized controlled, clinical trial (split-mouth design) included 25 patients. After third molar removal, the test group’s sockets were treated with solid PRF clots, whereas the control group’s sockets were conventionally treated. The primary outcome was swelling, which was measured digitally and analogously. Secondary outcomes included trismus, pus, hematoma, and clinical attachment loss (CAL) of the second molars on days 1, 3, 7, and 14. Patient-centered outcome measures and the consumption of painkillers and antibiotics were recorded on days 0–7. The t-test for paired samples, Wilcoxon test, and Chi-Square test were used for statistical analyses.ResultsSwelling was significantly lower on day 14 in the test group (p < 0.05). No statistically significant differences were observed in pain, trismus, and CAL. In the test group, the number of painkillers taken and the number of days of intake were significantly lower (p < 0.05).ConclusionsPRF caused a reduction of painkiller consumption and in the days painkillers were needed. PRF significantly considerably reduced swelling after 14 days. Owing to the lack of differences in other parameters, the integration of PRF application into routine wisdom tooth removal is critical.Clinical relevancePRF affects the long-term outcomes of third molar removal by reducing swelling and reducing as well as shortening painkiller consumption.Trial registrationclinicaltrials.gov (NCT05089812).

Prevention of postoperative contracture of the masticatory muscles using a multifunctional gnathic device when removing retinated teeth

Full rehabilitation of patients after atypical extraction of wisdom teeth is not among the priority issues in dentistry, however, the duration and severity of postoperative inflammatory contracture of the masticatory muscles significantly affects the duration of the postoperative period, increasing the patient’s period of disability. Numerous studies indicate the advisability of local effects on tissues in order to improve blood and lymph circulation in the area of inflammation, which enhances the exchange of intercellular fluid and relaxes the masticatory muscles. A method of adaptive myogymnastics for early rehabilitation of patients is proposed and proved the effectiveness of its use.

EVALUATION OF POSTOPERATİVE MORBİDİTY FOLLOWİNG OPERATIONS OF IMPACTED MANDIBULAR THIRD MOLARS WITH BONE RETENTION

This study is aimed to see how gender and whether tooth is placed on the right or left affected the length of the operation, edema, trismus, and discomfort after surgical extraction of an impacted mandibular third molar. This prospective study was conducted in the Inonu University. The study included 104 mandibular wisdom tooth with bone retention. There were 55 females and 49 males among the 104 patients, with 53 left and 51 right impacted mandibular third molar. The operations were performed by the same surgeon in the same operating room. The time between the incision and the suture was determined and recorded as the operation time for each procedure. Before surgery, on the 2nd postoperative day, and on the 7th postoperative day, the patients were compared in terms of facial swelling impacted mandibular third molar, discomfort, and trismus. IBM SPSS V23 was used to evaluate the data. The left impacted mandibular third molar extraction takes longer than the right impacted mandibular third molar extraction. Tooth 38, which have a longer operation time, are more prone to swelling, discomfort, and trismus. When tooths are extracted, right-handed surgeons cause less postoperative morbidity 48. We recommend that both right-handed, left-handed surgeons operate in clinics that conduct impacted tooth extractions.

Mandibular second molar impaction: introducing a novel and validated 3D classification system

BackgroundMandibular second molar (M2M) impaction is a clinically significant manifestation of eruption disturbance in dental development. The primary aim of this study was to investigate the impact of the three-dimensional (3D) characterization on clinical and therapeutic decisions for M2M impaction. The secondary aim was to introduce a validated 3D classification system incorporating both surgical and orthodontic parameters.MethodsBidimensional (2D) and 3D radiological records of 15 impacted M2M were collected and deidentified. Ten experienced clinicians (5 oral surgeons;5 orthodontists) categorized each case, first based on 2D records and then with 3D scans. The degree of orthodontic and surgical difficulty in treating impacted M2M was evaluated using a novel classification system based on anatomical and radiological features. The primary outcome variable was the assessment of differences in diagnosis and decision-making protocol using 2D or 3D records, where clinical relevance ranged from 0 to 4. The secondary outcome variable was the validation analysis of the proposed 3D classification system to determine the concordance among the clinicians. Descriptive statistics and multivariable inferential analysis based on Akaike information criterion (AIC) were performed (α = 0.05).Results3D examination allowed a better visualization of M2M impaction with higher clinical relevance for diagnosis of M2M root relationship to alveolar nerve and lingual plate, height to alveolar crest, depth, and inclination relative to the first molar and position relative to the third molar (range:2.69–3.43). The proposed 3D classification of M2M impaction changed clinical decisions regarding surgical-orthodontic approach, biomechanics, patient education, and treatment time estimate (range:2.59–3.33). In the validation analysis of the classification, no evidence of inter- or intra-group (surgeon/orthodontist) bias in score attribution occurred: the model with the minimum AIC was the null model (AIC = 718.04).Conclusion3D evaluation of impacted M2Ms could enhance diagnostic accuracy, and a classification system was proposed and validated by a group of experienced surgeons and orthodontists with high concordance.

Prevalence and predictive parameters of external root resorption caused by retained wisdom teeth

ObjectivesThe aim of this study was to estimate the prevalence and severity of external root resorption (RR) caused by retained third molars (M3), to compare the sensitivity of panoramic radiography (PAN) and cone beam computed tomography (CBCT) and to determine predictive factors for root resorption.Materials and methodsIn a retrospective cross-sectional analysis, we included patients (N = 367) who underwent PAN and CBCT imaging between December 2017 and July 2019. Previous orthodontic treatment, age, gender, superimposition of second molars (M2) and M3 on PAN, retention depth, inclination angle and vertical level of contact with the M2 were used as predictor variables. The outcome variable was RR of the M2, graded according to Ericson et al. [1]. Subgroup analyses compared patients with and without suspected resorption in the PAN.ResultsWhile less than 5% of PANs suggested RR associated with M3, CBCT showed RR in 20% of all M2 with adjacent retained M3. The angle of inclination of M3, patient age and vertical level of molar contact emerged as predictive parameters, with mesial inclination, older age and deeper retention associated with increased severity of M2.ConclusionWithin the limitations of our study, these data confirm the poor performance of PAN in the diagnosis of RR. CBCT may be helpful in detecting RR in mesioangulated and deeply retained M3 in elderly patients, even when PAN did not suggest pathology.Clinical relevanceOur study may help to decide whether CBCT should be considered prior to M3 surgery.

NEDD4L affects stability of the CHEK2/TP53 axis through ubiquitination modification to enhance osteogenic differentiation of periodontal ligament stem cells

ABSTRACT Background Checkpoint kinase 2 (CHEK2) and its regulated tumor protein p53 (TP53) have been correlated with osteogenic differentiation of osteoblast-like cells. Based on bioinformatics predictions, this study aims to investigate the effect of the CHEK2/TP53 axis on osteogenic differentiation of periodontal ligament stem cells (PDLSCs) and to explore the regulatory mechanism. Methods PDLSCs were isolated from human impacted wisdom teeth, and they were cultured in normal medium (NM) or osteogenic medium (OM). Protein levels of CHEK2 and TP53 were examined using western blot analysis. Osteogenic differentiation ability of PDLSCs was analyzed by measuring marker proteins (RUNX2, OCN, and OSX), ALP activity, and ALP staining. Molecular interaction between NEDD4 like E3 ubiquitin protein ligase (NEDD4L) and CHEK2 was examined by ubiquitination and co-immunoprecipitation assays. Gain- and loss-of function assays of NEDD4L, CHEK2, and TP53 were performed to analyze their function in osteogenic differentiation of PDLSCs. A rat model of mandibular bone defect was generated for in vivo validation. Results NEDD4L was upregulated, while CHEK2 and TP53 were downregulated in PDLSCs cultured in OM. CHEK2 protected TP53 from degradation, while NEDD4L reduced CHEK2 protein level by ubiquitination modification. NEDD4L silencing reduced osteogenic differentiation ability of PDLSCs both in vitro and in vivo, which was restored by CHEK2 silencing. By contrast, CHEK2 overexpression blocked the osteogenic differentiation of PDLSCs in vitro. Conclusion This study demonstrates that NEDD4L affects protein stability of the CHEK2/TP53 axis through ubiquitination modification, thus increasing osteogenic differentiation of PDLSCs.

Exploration of oral hygiene practices, oral health status, and related quality of life of individuals residing in the Rorya district of Tanzania, East Africa.

Oral health substantially impacts individuals' quality of life, making it an important target for global health interventions. This research describes oral health status, practices, and beliefs within the Rorya district of Tanzania to understand barriers to care. To quantify physical oral health status, intraoral examinations were conducted on adults, noting the Decayed Missing and Filled Teeth (DMFT) and Comprehensive Periodontal Inflammatory Burden Index (CPBI). Oral Health-Related Quality of Life (OHRQoL) and semi-structured interviews were conducted to understand oral hygiene behaviors and beliefs. Data was analyzed via two-sample t-tests, Pearson's statistics, and NVIVO. A purposive sample (n = 139) of participants self-reported to reside in either Burere (n = 32), Nyambogo (n = 52), or Roche (n = 55) were assessed. A two-sample t-test revealed females (n = 67; x¯ = 7.1; SD = 5.4; p < 0.05) have a significantly higher DMFT score than males (n = 72; x¯ = 3.7; SD = 3.9). Moreover, the OHRQoL score of females (n = 67; x¯ = 12.10; SD = 14; p < 0.05) were significantly higher than males (n = 72; x¯ = 10.16; SD = 3). In contrast, males have significantly higher CPBI scores (x¯ = 3.8; SD = 1.5; p=<0.05) than females (x¯ = 3.0; SD = 1.3). Additionally, older age groups presented higher GI and PISA scores, while the younger group (20-30 years) displayed the highest mean DMFT score. The themes that emerged from semi-structured interviews were "pearls of laughter guarded by wisdom teeth," "whispered tales of oral tides and communal echoes," and "tales of the tooth fairy." In this community, proper oral health maintenance techniques are vital yet frequently disregarded, mainly due to disparities in access to resources, reflected in oral health scores. Addressing this is a crucial intervention, presenting an opportunity to uplift overall well-being. Moreover, gender and age disparities in oral health highlight the urgent need for tailored interventions.

Relationship between mandibular arch parameters and third molar impaction

Relationship between mandibular arch parameters and third molar impaction

Association between Patterns of Mandibular Third Molar Impaction and Various complications in the Adjacent Second Molar Using Cone Beam Computed Tomography: A Retrospective Study

Association between Patterns of Mandibular Third Molar Impaction and Various complications in the Adjacent Second Molar Using Cone Beam Computed Tomography: A Retrospective Study

Acute Pain Management Following Mandibular Third Molar Exodontia: A Bibliometric Analysis of Randomized Controlled Trials

Introduction and aimsTo reveal the evolution of pain management strategies following mandibular third molar (M3M) exodontia, examine the geographic contribution of research, and explore future developments through a bibliometric analysis. MethodsA comprehensive search was conducted in various leading databases. Data on bibliometrics, participant demographics, and agent regimens were extracted for eligible studies. Descriptive bibliometrics, citation analysis, and keyword bursts were performed to assess the research outputs, distribution, and emerging hotspots. ResultsA total of 173 randomized control trials from 2004 to 2024 were included. The number of publications showed a consistent upward trend since 2007. Brazil exhibited the most publications and citations. Germany presented the highest mean citations per publication. Brazil, Spain, and Italy showed the closest collaboration. Appropriately 14,391participants with 14,710 extracted M3M were enrolled. Nonsteroidal anti-inflammatory drugs (NSAIDs) were the most extensively studied analgesics, followed by glucocorticoids, opioids, and paracetamol. NSAIDs and paracetamol were predominantly administered orally, whereas glucocorticoids and opioids were primarily applied topically (P < .001). Studies on opioids significantly predated the studies using other agents. Adverse events were found in 50.87% of the included studies, where nausea and vomiting were the most frequently reported. Tramadol and piroxicam have drawn increasing interest in recent years. ConclusionsThis study revealed information on the research outputs, distribution, and future developments of analgesic agents following M3M exodontia. Brazil exhibited the highest level of productivity and recorded the most citations. NSAIDs generated the largest amount of research and are emerging as a benchmark for comparative studies. Oral administration is the most frequently used approach for agent delivery. Nausea and vomiting are the most commonly reported adverse effects. Clinical relevanceThe bibliometric analysis offers insights into the field of pain management following mandibular 3rd molar exodontia and how it has evolved. Tramadol and piroxicam have become research hotspots in recent years.

Prevalence and pattern of third molars impaction in a large Yemeni sample: a retrospective study.

The prevalence of teeth impaction varies substantially between different populations, and the impaction of third molars is the most commonly recorded. This study aimed to explore the prevalence and pattern of the third molars impactions among Yemeni population. This was a retrospective radiographic study conducted in Yemen between 2022 and 2023. The digital panoramic radiographs were collected from two major X-ray centers in Yemen. The angular position and depth of the impacted third molars were assessed according to the classifications of Winter and of Pell and Gregory, respectively. All radiographs were evaluated twice by one investigator in a two-week interval, and Kappa test was used for intra-rater reliability. Gender-wise differences, differences between both sides, and differences between maxilla and mandible were analyzed using Chi-squared tes with odds ratio (OR) for the risk of impaction. A P-value < 0.05 was considered significant. Panoramic radiographs of 6338 individuals were included. Their mean age was 35.1 ± 13.3 years andand 63.9% were females. A total of 25,352 sites (quadrants) were screened for the presence of thirds molars. Among which, 14,003 third molars (55.3%) were present in one or more sites. There were 1440 individuals (23%) with a total of 2828 impacted third molars (20% of the existing third molars). Females were less likely to have third molar impaction (OR = 0.46, CI95% = 0.4-0.52). Impaction of the mandibular third molars was significantly more frequent than the maxillary ones (OR = 1.15, CI95% = 1.04-1.26; P = 0.005). Horizontal and mesioangular impactions were statistically more frequent in the lower molars compared to the upper ones (P < 0.001 each). Contrastingly, vertical (P = 0.015), distoangular, and other impactions (P < 0.001 each)were statistically more frequent in the maxilla. Levels A and B were more frequent in the lower third molars, while level C was predominating in the upper molars (P < 0.001 each). The prevalence of third molars impaction is more frequent in males and mandibular arch. The angulation and level of impaction seem to be more complicated in the maxillary arch.

Level of knowledge of undergraduate students in surabaya city about third molar impaction and management

Background: Dental and oral health issues in Indonesia are among the most, with a prevalence of 25.9% and caries as the main problem reaching 45.3% in 2018. Undergraduate students experience impaction the most because third molars grow at the age of 17-21 years and the roots are complete at 18-25 years. Odontectomy is needed to treat impacted teeth, which if left untreated can cause serious complications such as pain, swelling, caries, pericoronitis, and tumors. Objective: To create a valid and reliable questionnaire about the knowledge of undergraduate students in Surabaya regarding impaction of third molars and its management. Methods: This study is a questionnaire study with a descriptive observational approach with cross-sectional study. Result: The validity and reliability test shows that all 15 questions have r values exceeding 0.361, confirming their validity and reliability. Specifically, the r values for the questions range from 0.462 to 0.577. These results indicate that the questionnaire is effective for assessing the knowledge level of undergraduate students in Surabaya regarding third molar impaction and its management. Each question meets the necessary criteria, making the instrument a reliable tool for the intended evaluation. Conclusion: This research concludes that the questionnaire assessing the knowledge of Surabaya undergraduate students about third molar impaction is valid, as the calculated r value exceeds the r table value.

Wisdom Tooth Extraction Training for Dental Students: Step-by-Step or All-in-One?

Aims/Background For inexperienced dental students, impacted wisdom tooth extraction is a complex procedure involving a series of intricate steps. This study compared the effectiveness of step-by-step and all-in-one teaching methods for dental students learning impacted wisdom tooth extraction, by evaluating their practical abilities, understanding, and learning satisfaction. Methods Fifty dental students were randomly assigned to either a step-by-step teaching group (Group S) or an all-in-one teaching group (Group A) for impacted wisdom tooth extraction training. Their skills were assessed using the Assessment of Competency in Exodontia Skills (ACES) scoring system, and their theoretical knowledge was tested in a test. The students also completed a questionnaire to gauge their satisfaction regarding the teaching method received. Results The students in Group S demonstrated superior performance in clinical procedures compared to Group A, evidenced by the significantly higher ACES scores (p < 0.05). There was no significant difference in theoretical exam scores between the two groups (p > 0.05). The students in Group S reported higher general satisfaction (p < 0.05), suggesting a preference for the step-by-step approach. The results also showed that satisfaction toward hands-on practice and teaching sessions significantly contributed to general satisfaction, while satisfaction with mastery of clinical skills did not. Conclusion The step-by-step teaching method was more effective in improving students' clinical skills and augmenting their satisfaction during impacted wisdom tooth extraction training. Our findings support the use of incremental learning approaches in dental education to enhance both clinical competencies and students' learning experiences.

Patients’ reasons for consulting a general practitioner at the time of having dental problems: a qualitative study

IntroductionMany patients consult general practitioners instead of dentists for their oral and dental problems every year. This study aims to find the reasons why patients consult general practitioners when they have dental problems.MethodsThe sample consisted of patients visiting dentists and general practitioners in Kerman, Iran. A thematic interview guide, semi-structured questions, and a mind map that allowed for structured and open-ended questions were prepared and used for the interviews. All interviews were recorded and transcribed verbatim by a final-year student. Data collection, transcription, and analysis were conducted simultaneously to allow for new topics to be raised and theoretical saturation to be reached. When researchers determined that sufficient information was available for analysis and understanding of patient opinions and beliefs, the interview process was stopped. As all audio conversations were recorded with the participant’s permission, no note-taking was done during the interviews, which allowed for greater focus on the participants’ conversation. The obtained data was analyzed using the content analysis.ResultsA total of 52 patients were included in this study. The codes related to patients participating in this research, along with the number of respondent groups related to each code were as follows: patient’s perceptions of general practitioner(GP) and dental practitioner’s scope of work [21], flawed dental system (34), dental anxiety [28], financial considerations [25], and more accessibility to GPs (31). Dental abscesses and dental pain were reported as the most common reasons for consulting GPs.ConclusionMost participants agreed that dental problems are more effectively treated by dentists. Reasons for visiting a general practitioner included lack of a specific dentist, dissatisfaction with dental treatments, lack of a dentist nearby, absence of emergency dental care, and familiarity with a physician. The most common reasons for visits were toothache and dental abscesses. Patients also sought treatment for TMJ pain, referred nerve pain, wisdom tooth pain, numbness and tingling in the jaw, gum inflammation, oral lesions, and ulcers. Furthermore, other factors such as opening hours, appointment systems and waiting time can also affect patient’s consult behaviors regarding dental problems.

Inverted and impacted mandibular third molar: A rare case report

A tooth is considered to be impacted when it fails to erupt fully or emerge partially. Impaction is most common with wisdom teeth because they are the last tooth to erupt in the oral cavity. An impacted tooth is embedded within soft tissue or bone for various reasons. Tooth may also become twisted, tilted, or displaced as they try to emerge in closed space resulting in impaction. A tooth is said to be inversed when it is placed reversed and seated upside down. In the mandible, ascending ramus is the most common site for third molars. Inversion of the impacted tooth is a rare condition. In this literature, a very rare case of inverted and impacted mandibular third molar has been reported in a 28-year-old female patient with swelling and pus discharge, considering the associated symptoms, surgical removal was performed.

Comparison of the mandibular retromolar space in adults with different sagittal skeletal types and eruption patterns of the mandibular third-molar: a cone-beam computed tomography study

BackgroundThe mandibular retromolar space (RMS) has not been extensively studied in relation to various sagittal skeletal classes and patterns of third-molar eruption. The objective of this study was to test the null hypothesis that there is no difference in the mandibular RMS among normodivergent subjects with different skeletal classes and patterns of mandibular third-molar eruption, using cone-beam computed tomography (CBCT).MethodA total of 105 normodivergent patients (20–40 years) were included in this study. Participants were categorized into Class I, II and III groups based on ANB and further impacted and erupted groups based on the eruption patterns of the mandibular third molars. Measurements of the mandibular RMS were taken at four planes parallel to the occlusal plane, along the cusp line. Comparative analyses were conducted among the three sagittal groups and between the impacted and erupted groups.ResultsThe Class II group exhibited a statistically smaller RMS (P < 0.05). RMS was found to be larger in third-molar erupted group (P < 0.05). The rates of root contact and third-molar impaction was significantly higher in Class II group. (P < 0.05)ConclusionsThe null hypothesis was rejected. Patients with Skeletal Class II tend to have a smaller mandibular RMS and a higher prevalence of root contact and third-molar impaction. The presence of impacted mandibular third molars was correlated with a shorter RMS.Trial registrationRetrospectively registered.

Estimating the Extraction Time of an Upper Third Molar: Proposal and Validation of Results.

Background: Numerous studies in the literature have aimed to evaluate the difficulty level of removing third molars. However, most of these studies have focused on the lower third molars, which can lead to complications. There is a lack of a method to determine the complexity of upper third molar extraction. Therefore, this study's objective was to develop an equation using multiple linear regression to estimate the extraction time of an upper third molar based on its complexity. Methods: This study involved patients enrolled in the Master of Oral Surgery program at the University of Seville. To determine their relationship with surgical time, the researchers analyzed various factors, such as depth, root morphology, and the need for odontosection. They then validated their findings by studying patients treated at Palmaplanas Hospital in Mallorca. Results: The cohort analysis from the University of Seville revealed significant associations between surgical time and the identified factors. A regression equation design was performed to predict the total duration of surgical intervention for wisdom teeth extraction. This equation incorporates several independent variables, represented by Xi, together with a constant term, C, and the corresponding coefficients, Bi, which weight the impact of each variable on the intervention time. The results are as follows: -0.312 (spatial relationship), 0.651 (depth), -0.443 (bone and mucosa integrity), 0.214 (roots), -0.745 (ostectomy), 0.713 (odontosection), and -0.426 (suture). Upon application of the statistical methodology to the Palmaplanas Hospital cohort, a regression coefficient of 0.770 was determined. This indicates a strong correlation between the input data and the estimated surgical time. Conclusions: In conclusion, the proposed formula demonstrates notable validity in predicting the surgical time required to extract upper third molars.

Smear Layer Removing and Pulp Dissolving Ability of Sodium Hypochlorite Mixed with Two Etidronate-Containing Irrigants in Continuous Chelation Technique

The study aimed to assess the effect of two etidronate-containing irrigants and EDTA on the ability of sodium hypochlorite (NaOCl) to remove the smear layer and dissolve organic tissues. This study evaluated the following solutions: distilled water, 3% NaOCl, 3% NaOCl + EDTA, and 3% NaOCl mixed with etidronate powder from two manufacturers [Dual Rinse, (DR); IsraDent, (ID)] to obtain 9%, 15%, and 18% solutions. To assess the proteolytic activity, bovine muscle tissue samples (56.1 ± 5.4 mg; n = 10 per group) were immersed in the tested solutions for 15 min. Absolute weight changes and percentages of weight changes (wt%) were calculated. To assess smear layer removal, the root canals of human wisdom teeth were instrumented, irrigated with the tested solutions (n = 10 per group), and evaluated using SEM. Statistical analysis employed an ANOVA with a post-hoc Tukey test and paired t-test, the Kruskal–Wallis test with a pairwise Wilcoxon rank sum test, and the Friedman test with a pairwise Wilcoxon signed-rank test. The mean weight loss in the NaOCl group comprised 17.3 mg (32 wt%). Sequential use of NaOCl and EDTA resulted in a significant increase in proteolytic activity of the former (57 wt%), while mixing these solutions led to a reduction of proteolytic activity (17 wt%). All NaOCl/DR groups exhibited a significantly greater dissolution activity than that of NaOCl alone, with the mean weight loss ranging from 23.3 mg (40 wt%) to 24 mg (41 wt%). ID9% and ID15% significantly decreased the proteolytic activity of NaOCl. In most groups, the apical thirds of the root canals demonstrated a significantly heavier smear layer compared to the middle and coronal thirds. The most effective smear layer removal was observed after irrigation with NaOCl combined with EDTA or DR (all concentrations); however, in the NaOCl + EDTA and DR18% groups, it was accompanied by moderate to severe erosion. Irrigation with ID did not result in smear layer removal or dentin erosion. In conclusion, the smear layer removal and pulp dissolving effects of continuous chelation using etidronate were manufacturer/composition-dependent. DR9% combined with NaOCl demonstrated the most promising results.

A Retrospective Analysis of 1311 Oral Surgery Procedures Performed in a Pediatric Hospital in Barcelona: A Study of Their Characteristics and Age-Related Diagnoses.

Background: Oral surgery involves the diagnosis and surgical treatment of diseases affecting the soft and hard tissues of the oral cavity and encompasses a wide range of surgical interventions. The aim of this investigation was to study the characteristics and age-related diagnoses of these oral surgeries, as well as to describe the surgical procedures performed in a pediatric oral and maxillofacial surgery service. Methods: A descriptive, retrospective, observational, and relational study was conducted on children and adolescents aged from 0 to 22 years who were treated in a pediatric oral and maxillofacial surgery service at a children's hospital. Results: We analyzed 1311 surgical interventions (51.4% were on boys and 48.6% on girls), consisting of 24.8% soft tissue surgeries, 65.9% bone and dental tissue surgeries, and 9.3% mixed tissue surgeries. The most common pathologies were tooth eruption disorders (65.9%), followed by ankyloglossia (20.5%). The most frequent treatment was wisdom teeth extraction (31.3%). A statistically significant association (p < 0.05) was found between surgical treatments and variables such as age, sex, tissue type, and biopsy. Conclusions: This study enhances our understanding of pediatric oral surgery, emphasizing that the most common pathology is altered tooth eruption, while the most frequent surgical intervention is the extraction of wisdom teeth at different stages of development.

Prophylactic third molar removal: are oral surgeons and orthodontists aligned in preventive approaches?

BackgroundThere is a general consensus among dental professionals regarding the extraction of impacted third molars in the presence of clinical symptoms. However, there is less agreement on the management of asymptomatic third molars. The objective of this study is to compare the perspectives of oral surgeons and orthodontists regarding the indications for the extraction of asymptomatic third molars. It is possible that healthcare professionals from different specialties may approach the extraction of these teeth in different ways.MethodsIn this cross-sectional study, a web-based questionnaire has been employed to collect data by inquiring about the reasons why participants prefer the extraction of asymptomatic third molars. Descriptive statistics were employed to evaluate the data obtained. The level of significance was set at P < 0.05.ResultsProphylactic extraction of partially impacted molars was more favored among the participants (P < 0.05). The orthodontists preferred prophylactic extraction due to the risk of late anterior dental crowding (LADC); however, the oral surgeons preferred pre-pregnancy extractions (P < 0.05). The extraction decision for partial impaction was higher in females when the risk of distal caries was considered. For fully impacted ones, it was higher in males when the risk of caries and pericoronitis were considered (P < 0.05).ConclusionsOrthodontists preferred extraction because of the risk of LADC and caries, while oral surgeons focused on preventing pericoronitis, pathology, focal infection, and symptoms during pregnancy. This divergence between the participants may inform the guidelines for prophylactic management of third molars. These findings may be pertinent in gender medicine.Clinical relevanceThis study has been enlightening for departments to consult each other before the extraction of a patient’s asymptomatic third molar.