Extraction Of Molar Teeth Research Articles

Mineralized nanofiber segments coupled with calcium-binding BMP-2 peptides for alveolar bone regeneration

Bone loss around tooth extraction sites can occur, thus making future placement of dental implants difficult. Alveolar bone regeneration can be guided by the application of a nanofibrous bone graft coupled with osteoinductive proteins/peptides, following tooth loss or tooth extraction. In the present study, we demonstrate the potential of mineralized nanofiber segments coupled with calcium-binding bone morphogenetic protein 2 (BMP-2) mimicking peptides for periodontal bone regeneration. Thin electrospun nanofiber membranes of PLGA-collagen-gelatin (2:1:1 wt ratios) were mineralized in 10× modified simulated body fluid (10× mSBF) and cryocut to segments of 20 µm. For predetermined weights of the mineralized nanofiber segments, it was possible to load various amounts of heptaglutamate E7-domain-conjugated BMP-2 peptide. Mineralized short fiber grafts (2 mg), with and without E7-BMP-2 peptides, were implanted into 2 mm × 2 mm (diameter × depth) critical-sized socket defects created in rat maxillae, following extraction of the first molar teeth. A sustained release profile of E7-BMP-2 from the mineralized nanofiber segments was recorded over 4 weeks. X-ray microcomputed tomography (µ-CT) analysis of peptide-loaded nanofiber graft filled defects revealed ∼3 times greater new bone volume and bone mineral density over 4 weeks in comparison to unfilled control defects. Further, histopathology data confirmed the formation of greater new osseous tissue in the BMP2 peptide-loaded, mineralized nanofiber segment group than that of fibrous connective tissue in the unfilled defect group. Altogether, the mineralized nanofiber segments coupled with E7-BMP-2 peptides may be an effective treatment option for alveolar bone loss and defects. Statement of SignificanceWith the high incidence of dental implants/fixtures for missing teeth, the success of the surgical procedures in restorative dentistry is dictated by the quality and quantity of the supporting alveolar bone. To address the problem of alveolar bone loss and defects due to tumor, periodontitis, or even postextraction remodeling, the present study is the first report on the application of mineralized nanofiber fragments coupled with calcium-binding osteoinductive BMP-2 peptides as a synthetic graft material for oral bone regeneration. The ease of fabrication and application of cryocut mineralized nanofiber fragments as maxillofacial bone defect fillers present a promising alternative to the current dental bone graft formulations. Furthermore, the nanofiber segments may also be utilized for several biomedical applications including hemostasis, soft tissue engineering, and wound healing.

Risk of inferior alveolar nerve injury with coronectomy vs surgical extraction of mandibular third molars-A comparison of two techniques and review of the literature

The removal of mandibular third molar teeth is one of the most common oral surgical procedures. In a significant number of patients, it carries a degree of associated morbidity, including damage to the inferior alveolar nerve (IAN). For this reason, practitioners desire the most up-to-date guidance on the most appropriate technique, informed by the best available evidence that will produce the lowest incidence of iatrogenic complications. The aim of this study was to perform a systematic review comparing the effect of coronectomy vs complete surgical extraction of mandibular third molar teeth on the risk of IAN injury and other complications in adults. Studies were identified through Embase (1980-2016) and Ovid MEDLINE (1946-2016) database searches. Search terms included coronectomy, partial root removal, deliberate vital root retention, odontectomy, surgical removal, surgical extraction, complete tooth extraction and extract. Limits of the study included humans, English language and randomised controlled trials (RCTs). Only RCTs comparing IAN damage associated with surgical extraction of mandibular third molars vs coronectomy were included. From our database searches, we identified two unique RCTs matching the inclusion criteria. Both evaluated patients who had specific radiographic signs of intimate relationships with the IAN. Upon detailed analysis, the studies were noted to exhibit a high risk of bias in many categories, thereby rendering their results inconclusive. Although evidence from two RCTs suggests that coronectomy can reduce the risk of IAN injury compared to surgical removal of high-risk mandibular third molars, the quality of evidence is insufficient to provide definitive conclusions regarding the preferred technique.

Orbital complications following extraction of mandibular molar teeth: a case report

AbstractSerious sequelae of dental infections are unusual but can be potentially life‐ or sight‐threatening. This case describes the rapid and extensive development of a fascial space infection through an uncommon route, originating in mandibular molar teeth to involve the orbital tissues. Relevant surgical anatomy and pathophysiology are discussed. Also highlighted is the multidisciplinary management of care across three surgical specialities with input from the radiology and microbiology teams.

Impaction of lower third molars and their association with age: radiological perspectives

BackgroundThird molars are the most commonly impacted teeth, and their extraction is the most commonly performed procedure in oral and maxillofacial surgery. The aim of the present study is to describe the pattern of mandibular third molar impaction and to define the most appropriate age for prophylactic extraction of mandibular third molar teeth.MethodsA total of 1198 orthopantomographs (OPGs) with 1810 impacted lower third molars were reviewed by two authors. The pattern of eruption in relation to patient’s age was examined using standard radiographic points and angles. Statistical analysis was performed using SPSS for Windows release 16.0 (SPSS Inc., Chicago, IL, USA).ResultsIn patients older than 20 years, vertical pattern of impaction was the most common (21.4%); while in young patients; horizontal impaction was more common (21.3%). Furthermore, there was a constant pattern of increase in Pell-Gregory ramus class 1 with increasing age, as the prevalence of class 1 was 0% at age 18 years compared to 54.9% at the age of 26 years.ConclusionFrequency of vertical impaction of lower third molars was seen more at an older age (> 20 years) in this study, with an increase in the retromolar space. Late extraction of mandibular third molar teeth (i.e. after the age of 20) is therefore recommended when prophylactic extraction is considered.

Impaired bone healing at tooth extraction sites in CD24-deficient mice: A pilot study.

AimTo use a micro-computed tomography (micro-CT) to quantify bone healing at maxillary first molar extraction sites, and test the hypothesis that bone healing is impaired in CD24-knockout mice as compared with wild-type C57BL/6J mice.Materials and methodsUnder ketamine-xylazine general anaesthesia, mice had either extraction of the right maxillary first molar tooth or sham operation. Mice were sacrificed 1 (n = 12/group), 2 (n = 6/group) or 4 (n = 6/group) weeks postoperatively. The right maxillae was disected. Micro-CT was used to quantify differences in bone microstructural features at extrction sites, between CD24-knockout mice and wild-type mice.ResultsCD24-Knockout mice displayed impaired bone healing at extraction sites that was manifested as decreased trabecular bone density, and decreased number and thickness of trabeculae.ConclusionsThis pilot study suggests that CD24 plays an important role in extraction socket bone healing and may be used as a novel biomarker of bone quality and potential therapeutic target to improve bone healing and density following alveolar bone injury.

Association between Bispectral Index System and airway obstruction: an observational prospective cohort analysis during third molar extractions.

Sedation regimes during oral procedures frequently associated with airway obstruction. The aim of this study was to define the association of Bispectral Index (BIS) to the depth of sedation and airway obstruction events. Forty-seven patients between 14-21 years old, who were candidates for 3rd molar teeth extraction, were enrolled in this study. Patients received a total of 4 mg midazolam, 100 microgram fentanyl followed by titrated incremental propofol in 10 mg. The Richmond Agitation Sedation Score (RASS) was used to assess the depth of sedation. Each patient was attached to BIS monitor, while clinicians were not involved in the data collection process. Apnea, airway obstruction, O2 saturation, timing and interventions for controlling the situation were recorded. All data was synchronized with BIS data monitoring. The results show that 97.5% of cases were ASA 1 and 2, with average age of 17.3 years (±1.4) and a median BMI of 26.1. By using linear regression, for every unit decrease of median RASS (less than zero), there was 1.78 decrease in mean BIS Score (P=0.045, 95% CI: 0.08-3.47). The mean BIS Index (over 1 minute) with airway obstruction was 64 (±10.2), which was significantly lower than the BIS during non-airway obstruction (77±11.6), (P<0.001). By using logistic regression analysis, for every on unit increase in BIS Index, there is 24% decrease in odds in having airway obstruction (P=0.0009, 95% CI: 0.65-8.94). This study demonstrates that the BIS could potentially be a valid continuous monitoring method to avoid airway obstruction during sedation for patients undergoing dental surgery.

Effect of preemptive intravenous ibuprofen on postoperative edema and trismus in third molar tooth extraction: A randomized controlled study.

BackgroundThis study aimed to evaluate the anti-inflammatory efficacy of preemptive intravenous ibuprofen on inflammatory complications such as edema and trismus in patients undergoing impacted mandibular third molar surgery.MethodsSixty patients were included and divided into three groups (800 mg IV ibuprofen + 50 mg dexketoprofen, 800 mg IV ibuprofen, and control). In all patients, preoperative hemodynamic values were recorded before the infusions. The operation was started at 15-min post-infusion. Evaluation of edema size on the face and mouth opening (trismus) was conducted in the preoperative period, and at postoperative 48 h and 1 week.ResultsNo difference was determined among the groups in trismus and edema size in postoperative measurements (P > 0.05). There was a difference between group 2 and group 3 only in measurement value of tragus-corner of the mouth on the postoperative day 2 (P < 0.05). A difference was found between the measurement values of trismus preoperatively and at preoperative day 2, and between postoperative day 2 and 1 week in group 3 based on time (P < 0.05). In group 3, edema on the face on postoperative day 2 increased significantly compared to that in the preoperative period (P < 0.001); in addition, edema increased significantly in groups 1 and 2 in the postoperative period but was less than that in group 3 (P < 0.001).ConclusionsIn this study, intravenous ibuprofen was determined to be more effective alone or in combination in alleviating trismus and to better limit the postoperative edema.

Large oroantral fistula repair using combined buccal and palatal flaps: a case series

AimThe aim was to detect the efficacy of combined buccal advancement and palatal rotational flaps in closure of large oroantral fistulas (OAFs) after dental extraction.Materials and methodsA 3-year prospective study was conducted between February 2014 and May 2017. A total of 11 patients with large OAF after dental extraction were included in the study. Seven patients developed OAF after dental extraction of the maxillary first molar teeth, whereas two patients developed an OAF after dental extraction of the second maxillary premolars. The last two patients developed an OAF after dental extraction of the second maxillary molars.ResultsClosure of the defect was achieved in 10 cases, whereas only one case had failure. In addition to postoperative pain, swelling, and reduction of the vestibular sulcus, one patient experienced postoperative nasal adhesions between the nasal septum and inferior turbinate.ConclusionA combined buccal and palatal flap is efficient in closure of large delayed OAF secondary to dental extraction. Further study is required to assess new bone formation after repair of large OAF using this technique.

Anatomical study of the relationship of impacted mandibular third molar root apex to inferior alveolar canal in Kurdistan population using orthopantomogram

Background and objective: Extraction of an impacted mandibular third lower molar tooth is one of the common surgical procedures that may lead to the damage of inferior alveolar nerve due to roots proximity to the mandibular canal. This study aimed to know the relative relationship and proximity of the mandibular third molar roots to the inferior alveolar canal in relation to gender, age, depth of impaction, relation with ramus, and type of angulation of the impacted tooth in Kurdistan population. Methods: A sample of 366 digital panoramic radiographs of patients with impacted mandibular third molar was studied. Panoramic radiographic signs images were evaluated for the presence of root contact with the superior border of the mandibular canal, darkening of the roots apex, deflected roots, narrow root, superimposition of the canal, interruption of the white line, diversion of the inferior alveolar canal, and narrowing of the inferior alveolar canal. The depths of impaction, relation with ramus, and type of angulation were also studied. Results: Significant relation of the proximity of the mandibular third molar roots to the inferior alveolar canal with the gender (P = 0.001) and age (P <0.001) were seen. A significant relation of the proximity of the mandibular third molar roots to the inferior alveolar canal with the depth of impaction (P <0.001), relation with the ramus (P =0.004), and angulation of impaction were also seen (P <0.001). Conclusion: Significant relation of the proximity of the mandibular third molar roots to the inferior alveolar canal with gender, age, depth of impaction, relation with the ramus, and angulation of impaction were seen.

The Anesthetic Efficacy of Articaine and Lidocaine in Equivalent Doses as Buccal and Non-Palatal Infiltration for Maxillary Molar Extraction: A Randomized, Double-Blinded, Placebo-Controlled Clinical Trial

The purpose of the present study was to evaluate the anesthetic adequacy of 4% articaine 1.8mL versus 2% lidocaine 3.6mL without palatal injection compared with the standard technique for the extraction of maxillary molar teeth. This randomized, double-blinded, placebo-controlled clinical trial included patients requiring extraction of 1 maxillary molar under local anesthesia. Patients were randomly distributed into 1 of 3 groups: group A received 4% articaine 1.8mL as a buccal injection and 0.2mL as a palatal injection, group B received 4% articaine 1.8mL plus normal saline 0.2mL as a palatal injection, and group C received 2% lidocaine 3.6mL plus normal saline 0.2mL as a palatal injection. Pain was measured during injection, 8minutes afterward, and during extraction using a visual analog scale. Initial palatal anesthesia and patients' satisfaction were measured using a 5-score verbal rating scale. Statistical analyses included descriptive statistics, analysis of variance, and Pearson χ2 test. Differences with a P value less than .05 were considered significant. Eighty-four patients were included in the study. The average pain of injection was comparable among all study groups (P=.933). Pain during extraction in the articaine group was significantly less than that experienced in the placebo groups (P<.001), although the differences between placebo groups were insignificant. Satisfaction scores were significantly higher in the articaine group compared with the placebo groups (P<.001), with comparable results between placebo groups. Although the anesthetic effects of single placebo-controlled buccal injections of 4% articaine and 2% lidocaine were comparable, the level of anesthetic adequacy was statistically less than that achieved by 4% articaine given by the standard technique. These results do not justify the buccal and non-palatal infiltration of articaine or lidocaine as an effective alternative to the standard technique in the extraction of maxillary molar teeth.

Computer-assisted system on mandibular canal detection.

A dentist always checks a patient by using panoramic radiography (PR) initially. The measurement of the minimal distance (MD) between the alveolar crest and the mandibular canal (MC) superior border is critically important before the dental implant surgery, extraction of 3rd molar teeth or any surgery in the posterior area of minimal distance (MD). However, the image of MC is not always clear to identify. A software is needed for training dentists as well as a tool of demonstration to patients in clinics precisely and quickly. Moreover, it should be able to calculate the MD between the alveolar crest and the MC superior border before dental implant. A computer-aided software system to semi-automatically detect the MC and mental foramen (MF) in the PR with minimal human interference is proposed. The result shows that the averaged relative error (RE) is 1.83% with a standard deviation of 2.31%. The results show that the proposed algorithm is able to detect the MC superior and inferior borders. This system has the potential to train young clinicians and to replace the manual work in measuring the MD between the alveolar crest and the MC superior border with a minimal human intervention.

Role of MR Neurography for the Diagnosis of Peripheral Trigeminal Nerve Injuries in Patients with Prior Molar Tooth Extraction.

Clinical neurosensory testing is an imperfect reference standard to evaluate molar tooth extraction related peripheral trigeminal neuropathy. The purpose was to evaluate the diagnostic accuracy of MR neurography in this domain and correlation with neurosensory testing and surgery. In this retrospective study, nerve caliber, T2 signal intensity ratio, and contrast-to-noise ratios were recorded by 2 observers using MR neurography for bilateral branches of the peripheral trigeminal nerve, the inferior alveolar and lingual nerves. Patient demographics and correlation of the MR neurography findings with the Sunderland classification of nerve injury and intraoperative findings of surgical patients were obtained. Among 42 patients, the mean ± SD age for case and control patients were 35.8 ± 10.2 years and 43.2 ± 11.5 years, respectively, with male-to-female ratios of 1:1.4 and 1:5, respectively. Case subjects (peripheral trigeminal neuropathy or injury) had significantly larger differences in nerve thickness, T2 signal intensity ratio, and contrast-to-noise ratios than control patients for the inferior alveolar nerve and lingual nerve (P = .01 and .0001, .012 and .005, and .01 and .01, respectively). Receiver operating characteristic analysis showed a significant association among differences in nerve thickness, T2 signal intensity ratio, and contrast-to-noise ratios and nerve injury (area under the curve, 0.83-0.84 for the inferior alveolar nerve and 0.77-0.78 for the lingual nerve). Interobserver agreement was good for the inferior alveolar nerve (intraclass correlation coefficient, 0.70-0.79) and good to excellent for the lingual nerve (intraclass correlation coefficient, 0.75-0.85). MR neurography correlations with respect to clinical neurosensory testing and surgical classifications were moderate to good. Pearson correlation coefficients of 0.68 and 0.81 and κ of 0.60 and 0.77 were observed for differences in nerve thickness. MR neurography can be reliably used for the diagnosis of injuries to the peripheral trigeminal nerve related to molar tooth extractions, with good to excellent correlation of imaging with clinical findings and surgical results.

A foreign body in the soft tissues after molar tooth extraction as an iatrogenic complication - a case report

A foreign body in the soft tissues after molar tooth extraction as an iatrogenic complication - a case report

Evaluation of autogenous tooth transplantation for replacement of the missing or unrestorable mandibular molar tooth

This study was undertaken to evaluate the functional and occlusal stability of autogenous tooth transplantation. A total of 30 patients were included. Among them, 21 participants received transplanted first molar and the remaining 9 received transplanted second molar. In all the cases, donor tooth were third molar. In each participant, extraction of un-restorable first or second molar tooth was performed which was then replaced by atrumatic extracted third molar tooth. Each third molar tooth was placed in the recipient extracted socket, followed by the evaluation of the occlusion and then stabilized with arch bar and ligature wire. Clinical follow-up evaluation was performed at 15 days, 3 and 12 months in respect to occlusal stability, tooth mobility and periodontal status. It was found that 23 transplanted tooth were successful and the remaining 7 tooth need long-term observation for the final outcome, which was statistically significant. It can be concluded that the autogenous tooth transplantation can replace missing tooth to ensure the preservation of function, aesthetic and to prevent bone resorption of the missing area of the jaw, which can lead to exceptional esthetic and functional outcome.

Investigation of bifid mandibular canal frequency with cone beam computed tomography in a Turkish population

Objectives : It is important to know anatomic location and variations of the mandibular canal (MC) for surgical treatment on mandible such as implant operations, impacted molar tooth extraction and sagittal split ramus osteotomy. The purpose of our study is to determine the configuration and incidence of bifid mandibular canal (BMC) using cone beam computed tomography (CBCT). Methods: CBCT scans of 2000 patients were retrospectively analysed. Age and gender of the patients who were included in this study were recorded. BMC was subdivided, frequency was determined. Measurements of mean lengths, superior and inferior angles were performed. The all measurements were performed by one observer in 3 times at intervals of one week to confirm intra-observer reliability. SPSS 21 (Statistical Package for Social Science 21) was used for statistical analysis. It was benefited from Chi-square test to investigate qualitative observation and from T test and one-way analysis of variance for investigation of quantative observation. Differences were considered significant at p<0.05. Results: 1122 of 2000 patients (56.1%) were females and 878 of 2000 patients (43.9%) were males. BMC was observed in 61 of 2000 patients (3.05%). Because location of MC is bilateral, 122 sides in 61 patients were studied. BMC was observed in 65 of 122 sides (53.3%). In 39 of 65 sides (60%), BMC was observed in males, in 26 of 65 (40%) sides, BMC was observed in females. Conclusion: CBCT provides important informations about MC imaging and evaluation of variations. Evaluation of MC variations frequency and informing to surgeon in surgical procedures on mandible provides advantages for successful operations.

Acute subcutaneous laterocervical emphysema and pneumomediastinum secondary to inferior third molar extraction

Subcutaneous laterocervical emphysema and pneumomediastinum are often due to head and neck surgery, but these are uncommon complications of dental procedures. The use of high-speed air-turbine headpieces during dental extractions is sometimes associated with this complication, making simple the spread of air under sublingual, submandibular, retropharyngeal, and parapharyngeal spaces, routes of communication to the mediastinum. Due to its rarity, it is not simple to recognize, often confused with other complications after oral surgery, such as allergic reaction, hematoma, and infections. We present a case of subcutaneous laterocervical emphysema and pneumomediastinum after inferior impacted third molar tooth extraction, self-limiting with a conservative therapy. We need to focus on this case because it is often misdiagnosed by physicians in emergency department as an allergic reaction. We also underline the importance of an empiric antibiotic therapy to prevent spreading of oral microorganism causing severe mediastinitis and sepsis. To avoid these complications, high-speed air-turbine headpieces should be used only when it is essential.

Effectiveness comparison of inferior alveolar nerve block anesthesia using direct and indirect technique

Local anesthesia is important to do prior to tooth extraction procedure to control the patient's pain. Local anesthetic technique in dentistry consists of topical, infiltration, and anesthetic blocks. For molar tooth extraction, mandibular block technique is used either direct or indirect. This study aimed to see if there are differences in effectiveness of inferior alveolar nerve block anesthesia techniques between direct and indirect. This clinical experimental design study used 20 patients as samples during February-April. 10 patients were taken as a group that carried out direct technique while 10 others group conducted indirect techniques. The sample selection using purposive sampling method. Pain level were measured using objective assessments (pain experienced by the patient after a given stimulus) and subjective evaluation (thick taste perceived by the patient). The average time of onset in direct and indirect techniques in each sample was 16.88 ± 5.30 and 102.00 ± 19.56 seconds (subjectively) and 22.50 ± 8.02 and 159.00 ± 25.10 (objectively). These results indicated direct techniques onset faster than indirect techniques. The average duration of direct and indirect techniques respectively was 121.63 ± 8.80 and 87.80 ± 9.96 minutes (subjectively) and 91.88 ± 8.37 and 60.20 ± 10.40 minutes (objectively). These results indicated the duration of direct technique is longer than indirect technique. There was no significant difference when viewed from anesthesia depth and aspiration level. This study indicated that direct technique had better effect than indirect technique in terms of onset and duration, while in terms of anesthesia depth and aspiration level was relatively equal. Insignificant differences were obtained when assessing anesthetic technique successful rate based on gender, age and extracted tooth.

Periodontal Wound Healing by Transplantation of Jaw Bone Marrow-Derived Mesenchymal Stem Cells in Chitosan/Anorganic Bovine Bone Carrier Into One-Wall Infrabony Defects in Beagles.

This study aims to evaluate the performance of chitosan/anorganic bovine bone (C/ABB) scaffold seeded with human jaw bone marrow-derived mesenchymal stem cells (hJBMMSCs) in supporting the healing/repair of 1-wall critical-size periodontal defects. Physical properties of the C/ABB scaffold were compared with those of the chitosan scaffold. hJBMMSCs were obtained from healthy human alveolar bone during the extraction of third molar impacted teeth. One-wall (7 × 4 mm) infrabony defects were surgically created at the bilateral mandibular third premolars and first molars in six beagles. The defects were randomly assigned to six groups and implanted with different scaffolds: 1) chitosan (C) scaffold; 2) C scaffold with hJBMMSCs (C + cell); 3) C/ABB scaffold (C/ABB); 4) C/ABB scaffold with hJBMMSCs (C/ABB + cell); 5) ABB scaffold (ABB); and 6) open flap debridement (control). The animals were euthanized 8 weeks after surgery for histologic analysis. The C/ABB scaffold had a porous structure and increased compressive strength. Both C/ABB and C/ABB + cell exhibited the newly formed cellular mixed-fiber cementum, woven/lamellar bone, and periodontal ligament. Cementum formation was significantly greater in group C/ABB + cell than in group C/ABB (2.64 ± 0.50 mm versus 0.91 ± 0.55 mm, P <0.05). For new bone (NB) height, group C/ABB + cell and C/ABB showed mean ± SD values of 2.83 ± 0.29 mm and 2.65 ± 0.52 mm and for NB area 8.89 ± 1.65 mm and 8.73 ± 1.94 mm(2), respectively. For NB (height and area), there was no significant difference between the two groups. The combination of hJBMMSCs and C/ABB scaffolds could promote periodontal repair. Future studies are expected to further optimize the combination and lead to an ideal periodontal regeneration.

Consent for third molar tooth extractions in Australia and New Zealand: a review of current practice.

Informed consent is the legal requirement to educate a patient about a proposed medical treatment or procedure so that he or she can make informed decisions. The purpose of the study was to examinethe current practice for obtaining informed consent for third molar tooth extractions (wisdom teeth) by oral and maxillofacial surgeons in Australia and New Zealand. An online survey was sent to 180 consultant oral and maxillofacial surgeons in Australia and New Zealand. Surgeons were asked to answer (yes/no) whether they routinely warned of a specific risk of third molar tooth extraction in their written consent. Seventy-one replies were received (39%). The only risks that surgeons agreed should be routinely included in written consent were a general warning of infection (not alveolar osteitis), inferior alveolar nerve damage (temporary and permanent) and lingual nerve damage (temporary and permanent). There is significant variability among Australian and New Zealand oral and maxillofacial surgeons regarding risk disclosure for third molar tooth extractions. We aim to improve consistency in consent for third molar extractions by developing an evidence-based consent form.

Morphometric analysis of the masseter muscle post unilateral lower molar exodonty: experimental study

Abstract Introduction: To check the morphological changes of the masseter muscle after surgical extraction of inferior molar teeth. Methods: 24 Wistar rats had samples of their masseter muscles analysed in the Optical Microscope (OM). The rats were randomly divided into three groups as follows: GI-15, GII-30, GII-60 days after surgical extraction of inferior molar teeth. Each group had 5 experimental and 3 normal control rats for OM observation. The OM allowed the morphometric study of the masseter muscle. The morphometric study was based on the measurement of the fiber's area by AXION-VISION software. ANOVA test was applied for data analysis. Results: No alteration was detected in all morphometric analysis of the masseter muscle. Conclusion: The masseter muscle adapts to the occlusal modiication caused by the extraction of the molar teeth during the analysed periods.