Impacted Teeth Research Articles

Three-dimensional evaluation of dental characteristics in patients with Cleidocranial dysplasia

BackgroundCleidocranial dysplasia (CCD) is an autosomal dominant hereditary disorder. Besides skeletal abnormalities, CCD is often associated with dental complications, such as multiple supernumerary teeth and permanent teeth impaction or delayed eruption.MethodsSupernumerary teeth of axial, sagittal and coronal CBCT view was characterized in detail and 3D image reconstruction was performed. Number and location of teeth, morphology of supernumerary teeth, positional relationship between supernumerary and adjacent permanent teeth, direction of supernumerary teeth in CCD patients were analyzed.ResultsThe mean age of the 3 CCD patients in this study was 16.7 years. Among 36 supernumerary teeth, the majority of them were identified as apical side located and lingual side located. Normal orientation was the most common type in this study, followed by sagittal orientation, and horizontal orientation. Horizontal orientation teeth were all distributed in the mandible. Supernumerary teeth exhibited significantly shorter crown and dental-root lengths, as well as smaller crown mesiodistal and buccolingual diameters (P < 0.01). There was no difference in the number of supernumerary teeth between the maxilla and mandible, and the premolars region had the largest number of supernumerary teeth and the incisor region had the smallest number.ConclusionsThis study compares number and location of teeth, morphology of supernumerary teeth, positional relationship between supernumerary and adjacent permanent teeth and direction of supernumerary teeth, this study also provides a reference for the comprehensive evaluation of CCD patients before surgery.

The Influence Of Minor Surgical Intervention On Quality Of Life In Third Molar Impaction Cases

Background: There are several efforts to address impacted teeth, one of which is through a minor surgical intervention called Odontectomy. There are also several complications that may arise after Odontectomy is performed, but this usually only occurs for a few days, and patients will experience a more comfortable feeling compared to before the Odontectomy. This research aims to analyze the difference in the quality of life of patients before and after the Odontectomy surgical procedure. Material and Methods: The method employed in this research was analytical observational, using a Cross-Sectional design. The sampling technique used was Accidental sampling, which involved patients who underwent Odontectomy at Bhayangkara Hospital Semarang Indonesia in October 2023. The total sample size was 10 patients based on inclusion criteria. The research was conducted using the OHIP-14 (Oral Health Impact Profile 14) questionnaire, consisting of 14 questions from 7 dimensions. Data analysis was performed using the Wilcoxon test because the data scale was ordinal. Results: The results of this study indicated that before undergoing Odontectomy, the quality of life of patients at a moderate level was 3 individuals (30%), while those at a low level were 7 individuals (70%). After Odontectomy was performed, the quality of life of patients improved, with 1 individual (10%) at a moderate level, 9 individuals (90%) at a good level, and 1 individual (10%) at a very good level. The statistical analysis results showed that the significance value (P) was 0.005, indicating that p &lt; 0.05. Conclusion: The conclusion that can be drawn from this research is that there was a significant difference in the quality of life of patients before and after undergoing the Odontectomy procedure.

A Huge Infected Dentigerous Cyst Occupying the Maxillary Sinus

A dentigerous cyst (DC) ranks as the second most common odontogenic cyst after a radicular cyst arising from the crowns of impacted, embedded, or unerupted teeth. DC frequently causes the corresponding tooth to be displaced into an ectopic location, such as the sinus cavity in the maxilla. Surgical treatment involves extracting the tooth and enucleating the cyst using a conservative intra-oral approach or endoscopic surgery. We report a rare case of a 25-year-old woman with maxillary third molars inside the maxillary sinus attached to a dentigerous cyst and treated with Caldwell Luc surgery through an intraoral approach.

Profile and Prevalence of Oral and Maxillofacial Diseases Among Armed Forces Personnel and Their Families in Military Dental Centre, Cumilla

Background: Oral and maxillofacial diseases encompass a wide range of conditions in and around oral cavity and in maxillofacial region. It includes maxillofacial trauma, cyst and tumour of jaw bones, conditions involving impacted wisdom teeth, oral premalignant and malignant lesions, fascial space infection around maxillofacial region, temporomandibular joint disorder, dental implantology, salivary gland disorder and congenital defects of jaw bones. Maxillofacial region is more vulnerable to sustain injuries in the battlefield. In peace time, various maxillofacial diseases reduce the overall performances of the troops. The aim of this study is to delineate rank wise distribution of armed forces personnel reported with maxillofacial diseases, gender distribution, types of maxillofacial diseases, different types of surgical procedures performed and types of anesthesia used. Methods: A descriptive cross-sectional study was conducted to assess the prevalence of maxillofacial diseases among the armed forces personnel and their entitled family members during the period of 1st January 2019 to 31st December 2019 in Military Dental Centre, Cumilla. Purposive sampling technique and semi structured questionnaire was used to include the patients in this study.Data were analyzed by using Statistical Packages for Social Sciences (SPSS) version 25. Results: A total of 170 cases were evaluated and treated. Male patients were 110(65%) and female were 60(35%). Among the military personnel numbers of sainik (privates) were highest 32(35%). Impacted wisdom teeth cases were mostly found 80(47%). In case of impacted teeth mesio angular impactions were most 35(35%). In case of maxillofacial pathological conditions cystic lesions were most in number 22(39%) (n=56). Maxillofacial soft tissue laceration cases were highest 05(29%) (n=17) among all trauma patients. Surgical extraction of wisdom teeth were mostly performed surgery 80(59%) (n=138). In regards to administration of anesthesia, 128(93%) cases were performed under local anesthesia and 10(7%) were under general anesthesia. Conclusion: The present study imparts valuable perception about the types and prevalence of maxillofacial diseases and the treatment modalities among the armed forces personnel and their families in Cumilla area. Bangladesh Armed Forces Med J Vol 56 No (2) December 2023, pp 24-30

Extraction of an impacted supernumerary mesiodens tooth in a child: a clinical case report

Extraction of an impacted supernumerary mesiodens tooth in a child: a clinical case report

Evaluation of the Relationship Between the Maxillary Sinus and Nasopalatine Canal of Maxillary Impacted Canines by Cone Beam Computed Tomography

Introduction. One of the critical parameters evaluated while planning orthodontic treatment for impacted canines in clinical practice is the relationship between impacted canines and adjacent anatomical structures. The nasopalatine canal (NPC) and maxillary sinus are anatomical formations that may be in close proximity to impacted canines. This study aimed to determine the relationship between palatally impacted canines, the maxillary sinus, and the NPC. Methods. A total of 105 impacted canines from 93 patients were evaluated using cone beam computed tomography (CBCT) images. The relationship between the impacted canine teeth, maxillary sinus, and NPC was assessed inside, outside, and at the border of the maxillary sinus floor and NPC walls. The millimetric distance between the impacted canine teeth and the borders of the maxillary sinus, the NPC, and the cortical bone of the palate was measured. Additionally, NPC morphology was assessed on the axial and sagittal CBCT images. Results. Of all the impacted teeth, 47.6% (3.8% inside, 43.8% at the border) were associated with the sinus, while 42.8% (15.2% inside, 27.6% at the border) were associated with the NPC. A significant moderate negative correlation (-0.32) was observed between age and the distance between impacted left canine teeth and the cortical bone of the palate. Additionally, when a Y-shaped NPC was present, the impacted canines were predominantly situated outside the canal. Conclusions. In this study, nearly half of the canines were located inside or at the border of the maxillary sinus and the NPC. Therefore, clinicians should carefully evaluate the relationship of impacted teeth with the maxillary sinus and the NPC during both orthodontic treatment and the extraction of impacted teeth.

Non-syndromic supernumerary fourth molar: A report of two cases and review of literature

Background: Supernumerary teeth are excess teeth found in a normal dentition, with a prevalence of 0.1‒3.8% in the permanent dentition and 0.3‒0.6% in the primary dentition. This case series presents two non-syndromic supernumerary fourth molar cases in two male and female patients. Case Report: This study describes two rare supernumerary fourth molar cases. Both cases were asymptomatic and impacted in the maxillary arch. A routine panoramic radiograph revealed the presence of them for the first time. The medical and familial records of the patients were non-contributory, with no abnormalities in the extraoral examination. Conclusion: Well-developed, impacted supernumerary teeth are rare occurrences in individuals with no concurrent diseases or syndromes. Dental practitioners should know the different types of supernumerary teeth and manage them according to their type and possible complications.

Mixed reality-based technology to visualize and facilitate treatment planning of impacted teeth: Proof of concept.

We propose a method utilizing mixed reality (MR) goggles (HoloLens 2, Microsoft) to facilitate impacted canine alignment, as planning the traction direction and force delivery could benefit from 3D data visualization using mixed reality (MR). Cone-beam CT scans featuring isometric resolution and low noise-to-signal ratio were semi-automatically segmented in Inobitec software. The exported 3D mesh (OBJ file) was then optimized for the HoloLens 2. Using the Unreal Engine environment, we developed an application for the HoloLens 2, implementing HoloLens SDK and UX Tools. Adjustable pointers were added for planning attachment placement, traction direction, and point of force application. The visualization was presented to participants of a course on impacted teeth treatment, followed by a 10-question survey addressing potential advantages (5-point scale: 1 = totally agree, 5 = totally disagree). Out of 38 respondents, 44.7% were orthodontists, 34.2% dentists, 15.8% dental students, and 5.3% dental technicians. Most respondents (44.7%) were between 35 and 44 years old, and only 1 (2.6%) respondent was 55-64 years old. Median answers for six questions were 'totally agree' (25th percentile 1, 75th percentile 2) and for four questions 'agree' (25th percentile 1, 75th percentile 2). No correlation was found between age, profession, and responses. Our method generated substantial interest among clinicians. The initial responses affirm the potential benefits, supporting the continued exploration of MR-based techniques for the treatment of impacted teeth. However, the recommendation for widespread use awaits validation through clinical trials.

Efficacy of Dexamethasone Injection at Different Sites on Postoperative Sequelae After Extracting Mandibular Impacted Third Molars: A Randomized Controlled Trial

BackgroundDexamethasone, an efficacious anti-inflammatory agent, is widely used after tooth extraction. However, its optimal injection site has yet to be investigated. PurposeWe compare the efficacy of dexamethasone injection at different sites on postoperative sequelae after extracting mandibular impacted third molars (MITMs). Study design, setting, and sampleA prospective randomized controlled trial was conducted. Healthy adults with fully MITMs scheduled for extraction were included. Exclusion criteria were 1) Patients with the systemic alteration that prevented the surgical procedure; 2) pregnancy, breastfeeding, premenstrual period; 3) hypersensitivity to the drug under test; and 4) those who did not return for postoperative follow-up at one, three, and seven days. Exposure variableThe subjects were randomized to three groups. An online randomization plan generator assigned each subject to a single treatment by randomly permuting blocks. Different sites for postoperative dexamethasone injections included the buccal side of the adjacent second molar and extraction sockets. Dexamethasone injection (4 mg) on the buccal side of the adjacent second molar (group 1), an injection on the buccal side of extraction sockets (group 2), an injection of physiological saline (0.8 mL) on the buccal side of the adjacent second molar (control). Outcome variablesThe outcome variables were postoperative facial swelling, limitation of the mouth opening, postoperative pain, and postoperative quality of life evaluation. The pain was assessed using a visual analog scale (VAS) at one, three and seven days, postoperatively. The quality of life was recorded throughout the Posse scale at seven days. CovariatesThe covariates are age, sex, length of operation, and type of impacted teeth and surgery. AnalysesThe statistical analysis was performed using ANOVA, repeated measures ANOVA, Chi-square, or Fisher’s exact tests with P-values < 0.05 considered statistically significant. ResultsOur study included 58 participants with a mean age of 19.48 ± 3.31 years; group 1 (n = 24), group 2 (n = 20), and control group (n = 14). On day three postoperative, the swelling and trismus were significantly less in group one than in the other two groups (P < 0.05), and group one had an overall postoperative quality of life compared to other groups (P < 0.05). Unaffected speech function was present in 73.7% of patients in group 1, while 50% of patients in group 2 had affected speech function three days after the operation (p < 0.05). The "unable to open mouth" of the “Eating subscale” and “felt tingling” had statistical significance (p < 0.05). ConclusionsDexamethasone injections on the buccal side of the adjacent second molar can be a viable option for treating facial swelling and limitation of mouth opening after total MITMs extraction.

Dental anomalies in craniofacial microsomia and condylo-mandibular dysplasia: A retrospective study of 103 patients

IntroductionCraniofacial microsomia (CFM) and camel-hump condylo-mandibular dysplasia (CMD) are developmental disorders affecting the mandible that share common clinical features. This study aimed to investigate and compare the dental anomalies (DA) between the two entities for differential diagnosis and to propose appropriate treatment. MethodsThis retrospective cross-sectional study was based on panoramic radiographs of patients diagnosed with CFM or CMD. DA were evaluated using the classification reported by Bilge. Delayed tooth eruption on the affected side was noted based on a comparison with the contralateral side. Nolla's stages of tooth calcification were used to assess dental development. ResultsA total of 103 patients were included, 80 subjects (77.7 %) in CFM group and 23 patients (22.3 %) in CMD group. The prevalence of DA among CFM and CMD-affected patients were 80.0 % and 95.7 %, respectively. Tooth ectopia, tooth impaction, dental development delay, and delayed tooth eruption on the affected side exhibited a significant association with the two craniofacial malformations. The overall affected teeth (molars, premolars, canines) differed between the two craniofacial malformations. Dental abnormalities such as oligodontia, hyperdontia, dentin dysplasia, and anomalies of shape were seen only in subjects affected by CFM. ConclusionDA were widely observed in patients with CFM and CMD. The global distribution of affected teeth differed between the two conditions and some DA were detected only in CFM patients. When clinical diagnosis remains uncertain, some specific radiological characteristics of DA can be used to differentiate CFM from CMD.

Assessment of the positional and morphological differences of unilaterally impacted canines: A cross-sectional study

IntroductionThis study aimed to use cone beam computed tomography (CBCT) to evaluate the dimensional and morphological characteristics of unilaterally impacted canines, their effects on adjacent teeth, and differences with contralaterally erupted canines. Materials and methodsA sample of 31 patients (22 males, mean age 22.22 ± 4.82 years; 9 females, mean age 23.91 ± 5.16 years) with unilaterally impacted maxillary palatal teeth were included in the study. CBCT images were obtained using a NewTom 5 G unit in standard mode. Three-dimensional multiplanar reconstructions emulating a panoramic view and curved planar reconstructions were evaluated. Individuals were divided into two groups (low- and high-complexity) according to Ericson and Kurol's impaction complexity classification. ResultsThe crown lengths and mesiodistal crown widths of the impacted canines were similar to the symmetric canine on the opposite arch and significantly larger than adjacent lateral and premolar teeth (p<0.05). The alpha (31.33 ± 8.32) and beta angles (39.53 ± 10.31) and the 'h' height (10.11 ± 2.02) values in the low-complexity group were significantly lower than the high-complexity group (alpha angle=57.40 ± 12.15; beta angle=71.31 ± 13.94; 'h' height=14.35 ± 3.71, and alpha angle: p<0.001; beta angle: p<0.001; 'h' height: p=0.002) ConclusionThe root lengths of impacted maxillary canine teeth are significantly shorter than symmetrically erupted canine teeth regarding labiolingual crown width. As the alpha and beta angles and ‘h’ height increase, the complexity level of the impacted canine also increases.

Radiographic diagnosis of jaw lesions associated with impacted tooth: a case series

Radiographic diagnosis of jaw lesions associated with impacted tooth: a case series

Impacted maxillary permanent first molar

Abstract Tooth impaction is an abnormality that occurs when a tooth does not emerge into its place in the dental arch. Impacted permanent molar is an unusual condition that is usually detected during a routine examination. This impaction type is mostly problematic and can cause serious issues, especially when early detection and appropriate treatment are not achieved. This article highlights a case with a complaint of an ill-fitting denture, accompanied by an impacted molar that was identified during routine radiographic examination. The available treatment options include periodic follow-up, surgical exposure and orthodontic repositioning, and more invasively, surgical extraction and prosthetic replacement. The case was treated by a nonsurgical prosthodontics approach, in addition to regular follow-up, avoiding surgical interventions. This approach successfully restored both the patient’s function and esthetics. The case demonstrated the potential of prosthodontics therapy for managing impacted teeth and offering a minimally invasive and short treatment alternative to surgical and orthodontic interventions.

Obesity Phenotypes and Dental Calculus in Young Adults: CHIEF Oral Health Study.

The study aimed to examine the association of obesity phenotypes with dental calculus. Obesity has been recognized as a risk factor for kidney and gallbladder stones formation and periodontitis. We have investigated the association between obesity, metabolic risk factors, and dental calculus, which is a sequela following periodontitis. This study included 5,281 military members, aged 19-45 years, without antihypertensive medications in Taiwan. Obesity was defined as body mass index ≥27.5 kg/m2, and metabolic syndrome (MetS) was defined according to the modified ATP III criteria. Supragingival calculus in any teeth, except for impacted teeth and the third molar, was the outcome of interest. Multiple linear regression analysis with adjustments for age, sex, toxic substance use, brushing teeth frequency, and blood leukocyte counts, was used to determine the association of obesity with dental calculus numbers. Multiple logistic regression analysis was used to assess the association between obesity with or without MetS and the presence of any dental calculus. BMI was positively correlated to dental calculus numbers [β and confidence intervals (CI) = 0.023 (0.014, 0.032)]. Compared to the obesity(-)/MetS(-) group, there were dosedependent associations for the obesity(-)/MetS(+), obesity(+)/MetS(-), and obesity(+)/MetS(+) groups with the presence of any dental calculus [odds ratios (ORs): 1.08 (0.76, 1.53), 1.31 (1.08, 1.58), and 1.51 (1.20, 1.90), respectively]. Of the metabolic risk factors, abdominal obesity and hypertension were independently associated with dental calculus [ORs: 1.33 (1.13, 1.55) and 1.30 (1.11, 1.52), respectively]. This study suggests general obesity as an independent risk factor for dental calculus formation, and MetS, particularly the components of abdominal obesity, and hypertension may also increase the prevalence of dental calculus. Diet control and regular exercise might be preventive measures for the development of both obesity and dental calculus.

Case report: Detection of maxillary sinusitis with inverted impacted teeth using Cone-beam Computed Tomography

Objectives: The aim of this case report is to describe radiographically the specific features of maxillary sinusitis on CBCT radiograph. Case Report: A 20-year-old female patient came to RSGM UNPAD with a consul letter from Oral Surgery specialist for a CBCT radiography examination to see impacted teeth. The results showed radiointermediate images in the maxillary sinus which showed thickening of the sinus mucosa and an inverted impacted teeth on the right maxillary. Conclusion: Maxillary sinusitis could be assessed using extra oral radiography and CBCT. CBCT examination was used in determining the source of the lesion, the extent of the lesion, and the thickness of the maxillary sinus mucosa.

Comparison of the efficacy of tricalcium phosphate and mineralized plasmatic matrix graft for the bone defect in the distal second molar tooth after surgery of the lower impacted third molar tooth

Aim: After the extraction of mandibular horizontal and mesioangular teeth, a defect occurs in the distal part of the second molar. In this study, the effect of MPM on these defects was evaluated. Materials and methods: 36 patients randomly divided into 3 groups. The first group included MPM and PRF. The second group included B-tcp and PRF. In the 3rd group, the extraction socket was left empty. At preoperative and postoperative 6th months, periodontal pocket depth, gingival index and plaque index, and the distance between the enamel junction and crestal bone at the distal of the 2nd molar were measured by CBCT. 8 patients were removed for various reasons. 28 patients were evaluated. Results: Preoperative and postoperative periodontal pocket depths at the sixth month were 7.67 ± 1.58 mm and 4.67 ± 1.23 mm in the MPM group (p&lt;0.001); 6.60±1.96 mm and 4.70±1.34 mm in the β-TCP group (p&lt;0.001); 6.78±1.48 mm and 5.56±1.01 mm in the control group (p&lt;0.023). Bone defects preoperatively and at six months postoperatively were 7.97 ± 1.04 mm and 3.59 ± 0.66 mm in the MPM group (p&lt;0,001); 6.23 ± 1.37 mm and 2.90 ± 1.04 mm in the β-TCP group (p&lt;0.001); 6.92±0.82 mm and 4.30±0.68 mm in the control group (p&lt;0.001). Conclusion: MPM is an effective graft material to restore the periodontal health of the distal part of the second molar after impacted lower third molar surgery

Assessment of Impaction Pattern of Mandibular Third Molars in an Iranian Subpopulation: a Retrospective Cross-sectional Study

Background: Impacted teeth are teeth that cannot be indicated in their physiological position in the expected period. Impacted mandibular third molar (IMTM)is the most common tooth to be impacted. Impaction of the tooth may be accompanied by complications such as pain, swelling, caries, bone loss, and inferior alveolar canal pathology. Because of possible complications of the IMTMs,a surgical extraction may be necessary. Moreover, knowing the pattern of IMTMs can lower the possibility of complications after the surgery.This research aims to evaluate the impaction pattern of the IMTMs in the population of patients referring to the Dentistry faculty of the Guilan University of medical sciences clinic. Methods: In this retrospective analytic cross-sectional study 98 radiographs were gathered and the angulation, depth, and side of impactions, inferior alveolar canal pathology, and decay existence were evaluated. Then each factor was assessed based on age and gender. Analyzing data was done using IBM Statistical Package for the Social Sciences (SPSS) Statistics for Windows, version 21 (IBM Corp., Armonk, N.Y., USA). Conclusion: Mesioangular pattern and level B of impaction depth were the most prevalent position of the IMTMs. Most cases had unilateral impaction and right-sided impaction was more frequent than left-sided.

Computer-Guided Bone Lid Technique for Surgical Extraction of Deeply Impacted Mandibular Third Molars: A Technical Report

The extraction of mandibular impacted third molars is one of the most common procedures in oral surgery. One of the extraction methods consists of the preparation of a buccal bone lid to obtain access and remove the tooth. This technique aims to reduce bone loss, promote bone healing distal to the second molar, and increase the accessibility to the impacted tooth, particularly in cases of concomitant pathologies or proximity to the mandibular canal. The procedure benefits from the application of 3D printing technologies to produce cutting guides that, combined with piezosurgery, allow deeply impacted third molar extractions with excellent preoperative planning and extreme localisation precision, as well as predictable repositioning and fixation of the bone lid. The objective of this article is to present two clinical cases of the application of the bone lid technique to extract deeply impacted third molars using 3D printed guides with different designs and piezosurgery.

Prevalence and patterns of third molar impaction among Ethiopians in Addis Ababa: a retrospective pilot study

Tooth impaction is a condition in which a tooth does not reach its normal position and is often observed in the third mandibular molar due to inadequate space. This study aimed to investigate the prevalence and configuration of the impacted third molars with an emphasis on angular orientations in a sample of the Ethiopian population. This cross-sectional study included a retrospective analysis of 291 patient records and orthopantomography data from the archives of a private dental clinic in Addis Ababa, during the study period from December 2020 to November 2022. Demographic details and data on the position and level of the impacted third molars were evaluated using the Winter classification. Data were analyzed for frequency distribution. The prevalence of impacted third molars was 22% (n = 64), with a greater incidence on the right side (60.9%) and a higher frequency in the mandible (67.2%). Vertical angulation (32.8%), followed by mesioangular angulation (31.2%), was the most common impaction pattern. The results highlight the need for improved treatment protocols for third molar impaction, emphasizing the prevalence in the mandible and the importance of addressing vertical impaction. Regular dental check-ups are essential for assessing third molar impaction and planning appropriate management. These data can inform policymaking and treatment considerations for impacted third molars in the Ethiopian population.

A rare case of impacted mandibular distomolar: Identification and management at a remote high altitude location

Planning the surgical extraction of an impacted supernumerary tooth poses a very peculiar problem for a dental professional. The management of this unique clinical situation is quite challenging and requires meticulous preparation, especially in a remote high altitude regions. Supernumerary teeth are those which are present in excess of the normal permanent or deciduous dentition in the oral cavity. A distomolar, also commonly known as the fourth molar, is a supernumerary tooth located distal to the third molars. The occurrence of supernumerary teeth is much more frequently observed in the maxillary arch as compared to the mandible. While the distomolar is quite infrequently observed, its occurrence in the mandible is even rarer. In this article, we present an overview of distomolars along with a case report on the management of a symptomatic mandibular distomolar at a remote setup in Tangtse region of the Union Territory of Ladakh.