Extraction Of Third Molar Teeth Research Articles

Piezosurgery and classical surgical techniques in surgical extraction of third molar teeth

Piezosurgery and classical surgical techniques in surgical extraction of third molar teeth

Coronectomy Sequale: A 5-Year Follow-up Study

The extraction of symptomatic mandibular third molar (M3M) teeth that exhibit radiographic signs of involvement with the inferior alveolar canal (IAN) carries significant risk of morbidity that can be avoided with coronectomy. This treatment modality allows the surgeon to limit or eliminate the risk of temporary and permanent damage to the IAN. Few studies have investigated the long-term sequelae of the coronected root. This retrospective observational cohort study was carried out to assess and report on the status of the coronected root following a coronectomy procedure.

Neuropraxia following Nonsurgical Removal of Impacted Third Molar

Extraction of mandibular third molar teeth are frequently associated with complications. The nature of the complication depends on the age of patient, extent of surger y, expertise of the surgeon and the anatomy of the neurovascular bundle surrounding the tooth. Paresthesia is an one such unpleasant complication which is not only related to functional sensory loss in the region innervated by the nerve but also having a psychosocial impact on the patient. This case repor t tends to highlight a neuropraxic injury following nonsurgical extraction of a mandibular third molar and return of sensory response following neuropraxic injury Neuropraxia following Nonsurgical Removal of Impacted Third Molar (PDF Download Available). Available from: https://www.researchgate.net/publication/282051978_Neuropraxia_following_Nonsurgical_Removal_of_Impacted_Third_Molar [accessed Nov 13 2017].

Effects of the topical hemostatic agent Ankaferd Blood Stopper on the incidence of alveolar osteitis after surgical removal of an impacted mandibular third molar

Alveolar osteitis (AO) is a commonly seen post-operative complication during the wound-healing period after permanent tooth extraction or surgical removal of impacted third molar teeth. The aim of this clinical study was to evaluate the effects of administration of the topical hemostatic agent Ankaferd Blood Stopper (ABS) into the socket on AO formation after impacted mandibular third molar extraction. Bilaterally, 100 half-impacted mandibular third molars were extracted in 50 patients. Then, 1.0 mL ABS was administered to achieve hemostasis in one half of the sockets and as a control, the other half was irrigated with 1.0 mL physiological serum after surgery. There was no statistically significant difference in terms of AO formation ( P > 0.05) between the extraction sites. However, the postoperative pain in ABS administration sites was higher than in the other sites for the first 2 days after surgery ( P < 0.05). The results showed that ABS administration did not increase the incidence of AO formation. Thus, ABS can be used safely for hemostasis after impacted mandibular third molar surgery.

Impact of Local Application of Clindamycin in Preventing Dry Socket after Third Mandibular Molar Extraction

Extraction of third mandibular tooth is one of the most commonly performed surgical procedures in oral surgery. One of the most common complications following the extraction of third mandibular molar teeth is dry socket (alveolar osteitis). Dry socket is the delayed healing of the wound of the alveolar bone after dental extractions. The purpose of this study was to determine if the intra-alveolar application of Clindamycin could reduce the incidence of dry socket following the extraction of third mandibular molar tooth. Patients who qualified for the prospective, randomized, double-masked, placebo-controlled trial were randomly divided into 2 groups, each group 30 patients. The first group (30 patients) included smokers and the second group (30 patients) included non smokers. Both groups had the mandibular third molar extracted in both sides at the same time. In total, 120 third molars were extracted. The left site was a study group in which we applied the clindamycin and the right site was a control group. The patients were also divided by gender. Dry socket occurred in 3.3% of cases for patients whom were given Clindamycin, regardless of their smoking habits, as opposed to 31.7% for those who did not receive the antibiotic. Results clearly showed that Clindamycin had a huge impact on reducing dry socket regardless of smoking habits.

Injury of submandibular gland and lingual nerve as complication third molar tooth extraction in mandible : a case report

제3대구치는 가장 늦게 생성되고, 맹출에 필요한 공간이 부족하여 부분 매복된 경우가 많다. 인류가 진화하면서 악 골의 크기는 점차 감소하였고, 이로 인해 제3대구치의 매 복 빈도는 더욱 증가하고 있다. 특히 하악 제3대구치는 정 상적으로 맹출한 경우에도 주변 연조직에 둘러싸여 치관 주위염을 일으키는 경우가 많고, 감염, 인접치아 우식 등의 이유로조기에 발치를시행하고 있다. 이러한 하악 제3대구치의 발치는 시술과 술후 관리 과정 에서 많은 합병증을 유발할 수 있다. 출혈과 부종, 동통 이 외에도 치근 파절 및 인접치 손상, 치조골 골절, 하치조 신 경 손상, 악관절 장애 등을 유발할 수 있으며, 최근에는 특 이적 합병증도 문헌적으로 보고되고 있다. 발치 후 농양형 성 및 전위, 술후의 발작성 어지럼증, 경막하 농흉 발생 등 이 그대표적 예이다. 매복치의 발치는 외과적으로 접근하는 경우가 많고, 이 에 따른 경조직과 연조직의 부가적 손상 가능성이 높기 때 문에, 주변 해부학적 구조물에 대한 이해가 선행되어야 한 다. 특히 하악골의 경우 여러 신경과 혈관, 구강저 타액선 등이 복잡하게 근접하여, 직접적 손상을 받을 수 있다. 실 제 Mason은 하악 제3대구치 발치의 합병증으로 하악 설측 피질골의 파괴 및 설신경의 직접적 손상을 보고하였다. 그 러나 악하선과 연관되어서는 발치 시 파절된 치아의 악하 공극으로의 함입을 제외하고는 직접적 손상에 대해 보고 된 바가 없다. 이는 악하선의 위치가 하악지 피질골 내측 에 존재하고, 도관경로에 여러 근육과 신경이 존재해 직접 적 손상의증례가 흔치않은 것으로사료된다. 이에 본 증례 보고에서는 부분 매복된 제3대구치를 발치 한 후 악하선과 설신경 손상이 나타난 환자의 증례를 통해, 발치 합병증으로 타액선과 설신경의 직접적인 손상 가능 성을 확인하고그 해결방안을모색하고자 한다. 이 상 화 150-713 서울특별시영등포구여의도동 62 가톨릭대학교여의도성모병원구강악안면외과 Sang-Hwa Lee Department of Oral and Maxillofacial Surgery, Yeouido St. Mary’s Hospital, The Catholic University of Korea, 62 Yeouido-dong, Yeongdeungpo-gu, Seoul, 150-713, Korea TEL: +82-2-3779-2014 FAX: +82-2-769-1689 E-mail: justina@catholic.ac.kr 하악 제3대구치 발치 시 합병증으로 발생할 수 있는 악하선과 설신경 손상: 증례보고

Risk factors associated with injury to the inferior alveolar and lingual nerves following third molar surgery — revisited

Approximately one percent of patients experienced sensory dysfunction two years after extraction of lower third molar teeth.

ECG variations in patients pre- and post-local anaesthesia and analgesia

To determine the incidence of ECG abnormalities in a healthy adults undergoing a surgical extraction of third molar teeth pre-and post-operatively and to study the effect of local anaesthetics, surgical stress and analgesics on cardiac rhythm. One hundred and ninety-eight healthy adult patients taking part in a clinical trial of analgesics were randomly selected for this study. All patients required the removal of at least one impacted mandibular wisdom tooth under local anaesthetic. An ECG was taken at a screening visit and repeated post-operatively 30 minutes after analgesia was given. The effects of analgesia were also monitored to ascertain whether any changes were related to pain experience or the analgesic itself. ECG abnormalities were detected in 44 patients at the screening visit. Of these patients, 20 showed rsR complex patterns, seven showed non-specific ST elevation, six patients had an abnormal P wave axis, three patients presented with single atrial premature beats and three patients showed a short PR interval. Other minor abnormalities were occasionally seen. The results recorded were of minimal clinical significance and the numbers are in line with previous research. Post-operative abnormalities were seen in 60 patients. Nineteen patients showed rsR complex patterns, sinus arrhythmias were seen in 11 individuals, seven patients showed non-specific ST elevation and six patients had an abnormal P-wave axis. Other minor abnormalities were occasionally seen. Although the results were not statistically significant, some of the patients did show clinically relevant abnormalities which necessitated referral to a cardiologist. These included: marked ST elevation; marked ST depression and one case of Right Bundle Branch Block (RBBB).

701 RANDOMISED, PLACEBO-CONTROLLED, PARALLEL-GROUP STUDY OF THE EFFECT OF SB-705498, A TRPV1 RECEPTOR ANTAGONIST, ON PAIN FOLLOWING THIRD MOLAR TOOTH EXTRACTION

European Journal of PainVolume 13, Issue S1 p. S202-S202 701 RANDOMISED, PLACEBO-CONTROLLED, PARALLEL-GROUP STUDY OF THE EFFECT OF SB-705498, A TRPV1 RECEPTOR ANTAGONIST, ON PAIN FOLLOWING THIRD MOLAR TOOTH EXTRACTION J. Palmer, J. Palmer GlaxoSmithKline Research & Development, Harlow, United KingdomSearch for more papers by this authorR. Lai, R. Lai GlaxoSmithKline Research & Development, Harlow, United KingdomSearch for more papers by this authorN. Thomas, N. Thomas GlaxoSmithKline Research & Development, Harlow, United KingdomSearch for more papers by this authorJ. Bullman, J. Bullman GlaxoSmithKline Research & Development, Harlow, United KingdomSearch for more papers by this authorZ. Ali, Z. Ali GlaxoSmithKline Research & Development, Harlow, United KingdomSearch for more papers by this authorA. Baines, A. Baines GlaxoSmithKline Research & Development, Harlow, United KingdomSearch for more papers by this authorJ. Appleby, J. Appleby GlaxoSmithKline Research & Development, Harlow, United KingdomSearch for more papers by this author J. Palmer, J. Palmer GlaxoSmithKline Research & Development, Harlow, United KingdomSearch for more papers by this authorR. Lai, R. Lai GlaxoSmithKline Research & Development, Harlow, United KingdomSearch for more papers by this authorN. Thomas, N. Thomas GlaxoSmithKline Research & Development, Harlow, United KingdomSearch for more papers by this authorJ. Bullman, J. Bullman GlaxoSmithKline Research & Development, Harlow, United KingdomSearch for more papers by this authorZ. Ali, Z. Ali GlaxoSmithKline Research & Development, Harlow, United KingdomSearch for more papers by this authorA. Baines, A. Baines GlaxoSmithKline Research & Development, Harlow, United KingdomSearch for more papers by this authorJ. Appleby, J. Appleby GlaxoSmithKline Research & Development, Harlow, United KingdomSearch for more papers by this author First published: 12 January 2012 https://doi.org/10.1016/S1090-3801(09)60704-7Citations: 2Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume13, IssueS1September 2009Pages S202-S202 RelatedInformation

Are soldiers at increased risk of third molar symptoms when on operational tour in Iraq? A prospective cohort study

Introduction Acute pericoronitis is a painful, debilitating infection that is most commonly found among young adults with erupting mandibular third molars. Pathology related to third molar teeth represents a significant cause of morbidity for soldiers deploying on operations. Amongst British and American troops in the first Gulf War and on deployments to Bosnia and Kosovo, symptoms from third molars were the second most common cause of emergency dental attendances (1). Upper respiratory tract infections and stress are the important predisposing factors for pericoronitis (2, 3). The potential of dental emergencies to reduce combat effectiveness is a major concern to the U.S. Army; dental emergencies have been shown to loose duty time, decrease unit effectiveness, disrupt routine care and cause hindrance to the military mission (4). In the 1960s a policy of prophylactic removal of third molars in all military personnel was advocated (5). However, the benefits of preventing third molar pathology by prophylactic removal must be weighed against the risks of complications. These include pain, infection, bleeding, swelling, and permanent lingual nerve and inferior alvelolar nerve paraesthesia (6). Over the past decade, National Institute of Clinical Excellence (NICE) (7) and Royal Colleges have published a number of guidelines on indications for the extraction of third molar teeth. (7, 8, 9). They advise not to remove asymptomatic teeth and to avoid prophylactic removal of lower third molars. These guidelines have led to a significant reduction in the number of referrals and the numbers of third molar teeth extracted in civilian practice (10). In general, these guidelines have been adopted by the Armed Forces. However, each case is assessed individually and the serviceman’s accessibility to dental care and the effects of the potential third molar pathology on their military duties are taking into consideration. To compare the incidence of third molar symptoms and assess if pre-deployment screening could be improved, we undertook a prospective cohort study between soldiers on operations in Iraq on Operation Telic (OP TELIC) with those stationed in the United Kingdom (UK). Northern Ireland (N. Ireland) was chosen to represent the UK as although it is still a theatre of operations, in the current political environment, a posting there gives a period of relative stability. No other units currently serving in the United Kingdom or Germany are likely to experience a similar period of uninterrupted time without being deployed elsewhere either on operations or on exercise. Correspondence to: Major J Breeze Trainee in Oral and Maxillofacial Surgery, King’s College Hospital, London SE1 9RT Email johno_breeze@hotmail.co.uk 102 JR Army Med Corps 153(2): 102-104 102-104 Are Soldiers 26/7/07 13:55 Page 102

A Subanalgesic Dose of Morphine Eliminates Nalbuphine Anti-Analgesia in Postoperative Pain

The agonist-antagonist kappa-opioid nalbuphine administered for postoperative pain produces greater analgesia in females than in males. In fact, males administered nalbuphine (5 mg) experience pain greater than those receiving placebo, suggesting the existence of an anti-analgesic effect. These sexually dimorphic effects on postoperative pain can be eliminated by coadministration of a fixed ratio of the prototypical opioid receptor antagonist naloxone with nalbuphine, implying a role for opioid receptors in the anti-analgesic as well as analgesic effects of nalbuphine. In the present study, we further evaluated the role of opioid receptors in the sex-specific effects on pain produced by nalbuphine by coadministering a dose of morphine low enough that it does not produce analgesia. After extraction of bony impacted third molar teeth, nalbuphine (5 mg) was administered alone or in combination with either of 2 low doses of morphine (2 mg or 4 mg). Both doses of morphine reversed nalbuphine-induced anti-analgesia in males, but only the lower dose (2 mg) reached statistical significance. Neither dose affected nalbuphine-induced analgesia in females, and when administered alone in either males or females, morphine (2 mg) had no analgesic effect. Though not observed in females, the effect of morphine in males argues that, like naloxone, low-dose morphine may act as an anti-analgesia opioid receptor antagonist. Previously, we reported that the nalbuphine produces both analgesic and anti-analgesic effects and that the opioid antagonist naloxone can enhance nalbuphine analgesia by selectively antagonizing the anti-analgesic effect. Here we show that morphine, given in a subanalgesic dose, reverses nalbuphine-induced anti-analgesia in males, perhaps by a similar mechanism.

A comparative study of cone-beam computed tomography and conventional panoramic radiography in assessing the topographic relationship between the mandibular canal and impacted third molars

To evaluate the diagnostic accuracy of cone-beam CT compared with panoramic images in predicting neurovascular bundle exposure during extraction of impacted mandibular third molars. Cone-beam CT and panoramic images of 142 impacted mandibular third molars were prospectively evaluated to assess tooth relationship to the mandibular canal. These interpretations were then correlated with intraoperative findings. The sensitivity and specificity of the 2 modalities in predicting neurovascular bundle exposure at extraction were calculated and compared. The diagnostic criterion for panoramic images was defined using multivariate logistic regression analysis. In predicting the exposure, the sensitivity and specificity were 93% and 77% for cone-beam CT, and 70% and 63% for panoramic images, respectively. Cone-beam CT was significantly superior to panoramic images in both sensitivity and specificity. Cone-beam CT was significantly superior to panoramic images in predicting neurovascular bundle exposure during extraction of impacted mandibular third molar teeth.

Neuroleptics Antagonize Nalbuphine Antianalgesia

To evaluate the role of σ receptors in the sexually dimorphic antianalgesic effect of agonist-antagonist κ opioids, 2 neuroleptics, haloperidol, a σ receptor antagonist, and chlorpromazine, which has minimal effect at σ receptors, were administered with the agonist-antagonist κ opioid nalbuphine in patients with postoperative pain. Before surgical extraction of bony impacted mandibular third molar teeth, patients received haloperidol (1 mg), chlorpromazine (10 mg), or placebo by oral administration. After surgery, the pain intensity did not differ significantly between the 3 treatment groups, suggesting lack of analgesic effect produced by either haloperidol or chlorpromazine. All patients were then administered nalbuphine (5 mg, intravenous). As previously reported, the group that did not receive a preoperative neuroleptic exhibited sexually dimorphic analgesia, with women experiencing greater analgesia than men. Antianalgesia was also observed, with men experiencing late onset increased pain compared with baseline, starting approximately 1 hour after nalbuphine administration. Both neuroleptics blocked nalbuphine antianalgesia, resulting in enhanced analgesia and elimination of the sex differences. Because chlorpromazine and haloperidol enhanced nalbuphine analgesia and eliminated sexual dimorphism, the receptor at which neuroleptics act to antagonize the “antianalgesia” might be a common site of action to both drugs. Perspective This study demonstrates that neuroleptics can block the antianalgesic effect of agonist-antagonist κ opioids. These findings could help inform the development of novel analgesics.

Dental emergency rates at an expeditionary medical support facility supporting Operation Enduring Freedom.

The purpose of this study was to report the dental emergency rate and the distribution of cause of dental emergencies at an Expeditionary Medical Support +25 medical facility during a 6-month deployment in support of Operation Enduring Freedom. A retrospective cohort analysis of 1,972 soldiers stationed at Seeb Air Base, Sultanate of Oman, was accomplished from a phased deployment from March to September 2002. Procedures were divided into 11 categories: endodontic, extraction of teeth other than third molars, extraction of third molar teeth, restoration of teeth (caries), restoration of broken teeth (not caries), orthodontic bracket/wire problem, sensitive teeth, temperomandibular pain, periodontal, oral pathology, and prosthodontic. One hundred thirty-five dental emergency visits were recorded, corresponding to a rate of 137 dental emergencies per 1,000 soldiers per year. Most of the emergencies (34.8%) were due to caries. Pain from third molars was the second most common reason for visiting the dental clinic (19.3%).

A comparative study of sevoflurane sedation with nitrous oxide sedation for dental surgery

Abstract. This study compares the use of inhalation sedation using sevoflurane (group S) with inhalation sedation using nitrous oxide (group N) in patients undergoing bilateral extraction of third molar teeth under local anaesthesia. The study was designed as a cross-over study. Seventeen ASA I, day surgery patients were studied. Patients were randomly allocated to receive either 8 l/min 50% nitrous oxide in oxygen (group N) or same flow of 1% sevoflurane (group S) for the first procedure. Each patient then had the alternate method of sedation for the second procedure. There were no significant differences between the methods in patient co-operation and surgeon's satisfaction with sedation. Psychomotor tests were comparable in both groups. The patients were significantly more sedated in the group S compared to group N ( P=0.004). Significantly more patients complained of an unpleasant odour group S ( P< 0.01) but none withdrew from the study for this reason. No adverse cardiorespiratory effects resulted from sevoflurane or nitrous oxide sedation. Both methods gave good amnesia during the procedure. There was high acceptance of both methods and the patients rated the technique as equally satisfactory. We conclude that inhalation sedation with sevoflurane is a suitable alternative method to nitrous oxide sedation.

Action of naloxone on gender-dependent analgesic and antianalgesic effects of nalbuphine in humans

Previously, we have shown that the κ-opioid analgesic nalbuphine, when administered at a low dose to treat postoperative pain after extraction of impacted third molar teeth, produced a marked increase in pain in men, whereas in women the effect of this dose was similar to placebo. In the current study, employing the same postoperative model, we found that coadministration of naloxone, which had no analgesic action administered alone, not only reversed the expected pain-enhancing effect of nalbuphine in men, but produced a similar degree of long-lasting analgesia in both sexes. This result further suggests that, at the dose employed, although naloxone antagonizes the pain-enhancing effect, it does not antagonize the analgesic effect of nalbuphine. Although observed only in men, this antianalgesic action also might be present in women but offset by a similar degree of analgesia, thus explaining the lack of analgesia in women produced by this dose of nalbuphine alone. Such action would suggest that the previously reported gender differences in κ-mediated analgesia might, in fact, be explained by a gender difference in κ-mediated antianalgesia. By avoiding side effects associated with μ-opioid analgesics, this drug combination might become an important new pharmacological therapy for pain relief.

Codafen continus ® analgesia for dental day surgery (comparison of codafen continus vs. diclofenac)

Satisfactory postoperative analgesia for intermediate day surgical procedures is a challenge for anaesthetists. This prospective, randomized, double-blind study examined the efficacy of a new combined analgesic tablet for dental day cases. Codafen continus ® is an analgesic preparation containing ibuprofen controlled release 300 mg and codeine phosphate normal release 20 mg. This combination was compared with diclofenac 75 mg for pain relief following day case extraction of third molar teeth. There were no differences between the two preparations with respect to the amount of analgesia provided as measured by categorical pain scores and the use of escape analgesia. The study confirmed that analgesia provided by codafen continus was as effective as diclofenac 75 mg and no serious side-effects were noted.

Intra‐operative patient‐controlled sedation and patient attitude to control

Intra-operative patient controlled sedation with propofol (bolus dose 18 mg over 5.4 s; lockout period 1 min) has been compared to continuous propofol infusion (3.6 mg.kg-1.h-1) in a randomised crossover study of 38 ASA 1 or 2 day surgery patients undergoing two-stage bilateral extraction of third molar teeth under local anaesthesia (76 procedures). Mean (SD) propofol used (mg.kg-1) was less with patient-controlled sedation (2.39 (1.28) than with the infusion (2.58 (0.84)) but the difference was not statistically significant. There were only minor differences between the methods in postoperative recovery of cognitive function and no differences for patient cooperation and surgeon's satisfaction with sedation. Patient-controlled sedation was preferred by 19 patients, continuous infusion by 10, with nine indifferent. Preferences, expressed as mild, moderate or strong, were significantly stronger for patient-controlled sedation (p < 0.05). Sedation was no deeper than eyelid closure with response to command in all 76 procedures. This level was reached in all 38 infusion cases but in only 26 cases with patient-controlled sedation, where 12 patients remained less sedated (p < 0.01). Patient-controlled sedation with propofol provided safe sedation and was strongly preferred over the infusion by a large proportion of patients.

Dexamethasone reduces pain and swelling following extraction of third molar teeth

Extraction of multiple third molar teeth can cause significant postoperative pain, swelling and trismus, which may result in delayed hospital discharge. We have examined the effect of a single prophylactic dose of oral dexamethasone 8 mg on these complications, in a randomised double-blind study of 50 adult patients. The number of extractions performed and the operative approach were standardised. Dexamethasone resulted in a significant reduction in pain 4 h postoperatively, and eliminated the need for opioid analgesia in the postoperative period. The incidence of severe swelling was also reduced significantly, but there was no effect on trismus. Postoperative nausea and vomiting were significantly lower in the dexamethasone group. We conclude that the use of prophylactic oral dexamethasone is useful in reducing postoperative analgesia requirements in this group of patients, and may facilitate surgery performed on a day case basis.

A randomised double blind comparative study of low level laser therapy following surgical extraction of lower third molar teeth

A randomised, double blind comparative study was undertaken to assess the efficacy of low level laser therapy in the reduction of postoperative pain and swelling in patients undergoing the extraction of bilaterally impacted mandibular third molar teeth. Healing of the sockets was also compared after 1 week. A group of 64 patients had one randomly-selected operation side treated with a semi-conductor laser and the other side with an apparently identical but non-operating model. Complete data were obtained from 52 of the 64 patients. The results showed that there was no evidence of a difference in pain and swelling on the third day after operation between laser and placebo sides. There was no difference between the two sides when they were assessed for healing 7 days after surgery.