Extraction Of Mandibular First Molars Research Articles

Surgical intervention of osteonecrosis of the jaws associated with bisphosphonate therapy: Report of two cases

We report herein two cases of bisphosphonate (BP)-related osteonecrosis of the jaws (BRONJ). Case 1 involved a 72-year-old man diagnosed with osteoporosis who was referred to our clinic for evaluation of swelling of the right mandibular gingiva. Clinical examination revealed a fistulous tract with pus discharge that had developed after extraction of the right mandibular first molar by his dentist. Clinical diagnosis was an infectious bone lesion associated with BP therapy. Risedronate sodium hydrate was administered orally at 2.5 mg/day from July 2005 through April 2007. Radiography revealed osteonecrosis of the jaw and a well-demarcated interface between necrotic and vital bone. BRONJ was completely removed with sequestrectomy of the mandible. The patient has been followed for 9 months since surgery and continues to do well. Case 2 involved a 62-year-old woman diagnosed with bone metastases from breast cancer who was referred to our clinic for evaluation of necrotic bone and pus discharge from the left maxillary molar region. The second maxillary left molar had been extracted by her dentist. Pamidronate sodium hydrate was administered parenterally at 90 mg/month from September 2004 through April 2006, and then zoledronate sodium hydrate at 4 mg/month from May 2006 through October 2007. Radiography revealed osteonecrosis of the jaw and maxillary sinusitis. BRONJ was completely removed with sequestrectomy of the maxilla. The patient has been followed for 5 months since surgery and continues to do well. Surgical intervention thus appears warranted to remove necrotic bone in cases of BRONJ.

A new method for extraction of mandibular first molars in rats

The aim of the present study is to describe a new technique for the mandibular first molar extraction based on tooth section in rats. One hundred and forty Wistar rats, from three different researches underwent general anaesthesia. Each animal was then positioned on a specific board and hollemback 3ss was used to make the syndesmotomy. The mandibular first molars were extracted after tooth section with carbide ¼ drills in a high-speed hand piece under constant irrigation with sterile saline solution. The mesial portion of the first molar was removed with a modified curved mosquito forceps. The distal portion was removed and the socket was closed with 5-0 nylon thread sutures using non-traumatic needles. During the first week after tooth extraction, animals were fed with regular pressed food to avoid post-operatory trauma. This technique is careful and avoid unnecessary trauma, with minimal numbers of fractures (9.3%) and accidents such as haemorrhage (2%). All the reminiscent roots could be removed by the described method. Our technique proved to be an efficient model for future researches on alveolar wound healing with minimal fractures and accidents and provided better post-extraction outcomes for the rats.

Changes in mandibular third molar angle and position after unilateral mandibular first molar extraction

Third molars often become impacted because of lack of space for their eruption. Because the third molars play an important role occlusally, premolars or second molars are sometimes extracted to create space. First molars are seldom extracted to create space, but they are occasionally extracted for other reasons, especially caries. The aim of this study was to investigate the spontaneous angular and positional changes in mandibular third molars when mandibular first molars are extracted. The sample consisted of panoramic radiographs of 107 patients (age, 18-40 years; mean, 25.69 years) who had unilateral mandibular first-molar extractions (because of caries) before age 16. Ramus relationship, impaction depth, and angulation of third molars on the extraction and nonextraction sides were assessed. A chi-square test was performed to compare the differences. The prevalence of third molars at the anterior border of the mandibular ramus was significantly greater on the extraction side than on the nonextraction side (P < .001). Third molars were positioned more occlusally in the mandible on the nonextraction side than on the extraction side (P < .001). The prevalence of vertically angulated third molars was greater on the extraction side than on the nonextraction side (P < .001). Mandibular first-molar extraction increases the space for mandibular third-molar eruption and helps the third molars move into better positions. But early extraction can lead to uncontrolled tipping of adjacent teeth into the extraction space. Only third-molar angle and position were evaluated in this study; problems such as dental asymmetry, premature contacts, and uncontrolled tipping should be assessed in the future.

Ectopic eruption of transposed mandibular permanent lateral incisors beneath primary first molars. Case report

Mandibular permanent lateral incisors showing bilateral transposition and ectopic eruption were seen beneath primary first molars on bitewing radiographs in a female aged 9 years. This report chronicles management of the case during the mixed dentition period. Appropriate space maintenance after extraction of mandibular primary first molars, cuspids and lateral incisors on both sides facilitated eruption and repositioning of the permanent lateral incisors without the need to sever supracrestal gingival fibres.

Facial neuralgia associated with recurrent herpes simplex

At least seven cases of facial neuralgia associated with recurrent herpes simplex have been reported in the medical literature. This condition has not been reported in the dental literature. A case of facial neuralgia associated with recurrent herpes simplex in a 34-year-old woman at varying intervals over a 20-year period is reported. Tension applied to the commissure on the right side of the patient's mouth during routine dental procedures can cause the neuralgia to develop, and she reports having undergone extraction of the permanent right mandibular first molar at the age of 15, when a similar neuralgia was present.