Mandibular Wisdom Teeth Research Articles

Efficacy of platelet rich plasma (PRP) on mouth opening and pain after surgical extraction of mandibular third molars

Introduction: Surgery of mandibular third molar teeth for removal is one of the most common procedures undertaken in oral and maxillofacial surgery departments. The complications created by the post extraction wound healing and physiological consecution of third molar surgery can affect patients' quality of life. Platelet rich plasma (PRP) is an autologous concentrate of platelets suspended in the Plasma that accelerates healing by concentration of growth factors which lessen the inflammation and as a result pain and trismus. Materials and methods: A Study was conducted on 130 patients at the department of Oral and Maxillofacial Surgery, FUCD Islamabad, for a period of 6 months after ethical approval. The patients with impacted mandibular wisdom teeth were selected and divided equally into two equal groups. The pain score was measured using the visual analogue scale (VAS) and trismus was measured using Vernier caliper before the surgery, immediately after surgery, on 3rd and 7th follow up visits. Results: The mean postoperative pain on 7th day was significantly lower in the PRP group with statistically significant P-value <0.0001. Trismus was also less reported in the PRP group with P-value <0.00065. Conclusion: Platelet Rich Plasma is effective to lessen trismus and pain after surgical removal of mandibular third molar teeth.

Bilateral pathological fracture of mandible associated with osteoradionecrosis

AbstractPathological fractures comprise <2% of mandibular fractures. Common aetiological factors include surgical procedures, osteonecrosis of the jaw, infection and tumours (Int J Oral Maxillofac Surg 27: 186–190, 1998). In preparation for radiotherapy, prophylactic extractions are carried out in advance to achieve complete mucosal coverage prior to commencing radiotherapy. We report a case of bilateral pathologic fractures of the mandibular angle in a patient 2 months after completion of radiotherapy who had undergone surgical removal of bilateral mandibular wisdom teeth a fortnight prior to radiotherapy.

Antibiotic prophylaxis for mandibular advancement with bilateral sagittal split osteotomy: a comparison of three versus four doses penicillin V

AbstractAimCompare two regimens of antibiotic prophylaxis on the development of surgical site infection (SSI) following mandibular advancement with bilateral sagittal split osteotomy (BSSO).Materials and methodsIn total, 176 patients were included. Two antibiotic regimens were administered intravenously. The first 114 patients were given penicillin V (PcV) in three doses every 8 h (PcV3‐group), and the next 62 patients were given PcV in four doses every 6 h (PcV4‐group). The same surgical protocol was followed for all patients. Development of SSI was registered at follow‐up 2 months and 1 year after surgery.ResultsA significant reduction in the rate of SSI was found in the PcV4 group compared to the PcV3‐group (P = 0.012). The infection rates were 4.8% and 19.3% respectively. A higher prevalence of SSI was found when mandibular wisdom teeth were present, but this was not statistically significant. There were no correlations between gender, age, intraoperative bleeding and operation time and the development of SSI. None of the patients developed severe infection.ConclusionThe infection rate was significantly reduced when PcV was administered in four doses, suggesting that an extended regimen of antibiotic prophylaxis is beneficial when performing mandibular advancement with BSSO.

Clinico-statistical survey of oral antimicrobial prophylaxis and surgical site infection regarding ordinary tooth extraction and mandibular wisdom tooth extraction in the dental outpatient clinic

IntroductionWe investigated the use of oral antibiotics (OA) and surgical site infection (SSI) related to extractions of ordinary teeth and mandibular wisdom teeth in a dental outpatient clinic from January 2015 to December 2019. MethodsThe following information were surveyed: (1) presence/absence of OA, (2) timing, (3) type, (4) administration period, and (5) SSI rates. ResultsThe use of OA during ordinary tooth extraction decreased from 68.3% to 41.3%, but SSI rate did not change during this period of time. Total SSI rate was 0.8% (122/14,832) on average.For mandibular wisdom tooth extraction, preoperative administration of third-generation cephalosporins decreased from 70.4% to 0.3% while that of penicillin (AMPC) increased from 0% to 98%. SSI rate was not changed after these improvements. Total SSI rate was 3.5% (180/5106) on average. The duration of OA was slightly decreased to two days in 2018 and 2019, and it was found that there was no significant difference in SSI rates between 2- and 3-day durations. Preoperative administration had 0.37 odds ratio (OR) (95% confidence interval (95%CI): 0.22–0.63) of SSI compared with postoperative administration. AMPC had 0.76 OR (95% CI: 0.55–1.04) of SSI compared with Third-generation cephalosporins and others. Timing of OA was P < 0.01. ConclusionsSSI rates did not change over time, administration period of OA decreased and the use of AMPC increased. Therefore, it seems necessary to continue to investigate the effects of SSI risk factors proactively in the future and to make efforts in the advocacy of appropriate antimicrobial use.

Prevalence of patterns of impacted third molars

Aim: As the patterns of impaction can affect the treatment plan of removing or remaining the impacted tooth, the difficulty of surgery, and the post-surgical complications, this survey aimed for assessment of the mandibular wisdom tooth impaction patterns in terms of angulation and depth in the north population of Iran. Materials and Methods: 196 Panoramic radiographs were gathered from patients attending to the department of oral and maxillofacial surgery of GUMS in 2018-2019. To perform this retrospective study the prevalence of impaction, angulation, and the level of the eruption were assessed. The data were analyzed by SPSS 16. Results: This study found that the most common pattern of impacted mandibular third molars was level B in terms of depth and mesioangular in terms of angulation. Conclusion: The current study notes the importance of determining the angulation and level of wisdom tooth in designing the pre-surgical treatment and in post-surgical complaints

Surgical techniques for the removal of mandibular wisdom teeth.

Surgical techniques for the removal of mandibular wisdom teeth.

Kinesiology Tape in Comparison with Submucosal Injection of Dexamethasone in Reducing Pain and Swelling After Surgical Removal of Impacted Lower Wisdom Teeth

The purposes of the suggested research are to assess the effectiveness of different protocols in decreasing oedema and aching post extraction of third wisdom teeth. Materials and Methods: The research involved thirty patients whom had impacted mandibular wisdom teeth of different local anatomical locations. Kinesiology adhesive tape put for one week only for 15 cases and Dexamethasone 8 mg submucosaly injected directly post operatively for other 15 cases. swelling was calculated by a tape scale means from known points and mean taken also pain evaluated by VAS using ribbon gauge degreed from 1 to 10. Calculations had been applied for the first day of surgical intervention, 3rd day and seventh day. Results: There was no significant statistical differences were documented statistically for oedema readings concerning two study methods on the reading day one, three and seven following the operation, and there were highly significant readings related to pain parameters. Conclusions: Usage of Kinesiology adhesive tape clinically was closely with a same advantageousness with Dexamethasone injection submucosaly in dropping the oedema and pain parameter, although clinically dexamethasone was better in both parameters than Kinesiology tape, so it can be used additionally in contraindicated cases of prescribing steroids for alleviating ache, oedema following to wisdom teeth surgery.

A case of extraction of mandibular wisdom teeth in patients with antiphospholipid syndrome who have severe mitral valve insufficiency

A case of extraction of mandibular wisdom teeth in patients with antiphospholipid syndrome who have severe mitral valve insufficiency

Role of Platelet-rich Plasma in the Healing of Impacted Third Molar Socket: A Comparative Study on Central India Population

The aim of the study was to compare the healing and osseous regeneration of mandibular third molar extraction sockets with and without platelet-rich plasma (PRP) with the evaluation of clinical objectives such as pain, swelling, trismus, soft tissue healing, pocket depth distal to second molar and radiological evaluation of the bony density in the postextracted third molar socket. In this prospective study, 100 patients were selected by the random sampling method from the outpatient department of oral and maxillofacial surgery in the year 2016-2017. Patients were equally allocated into intervention (transalveolar extraction followed by PRP placement) and nonintervention (transalveolar extraction without PRP placement) group as group I and group II, respectively, and evaluation parameters were considered accordingly. The statistical analysis was done using SPSS (Statistical Package for Social Sciences) Version 15.0 (IBM, USA) statistical analysis software. The pain score of patients of group I (non-PRP) was found to be higher as compared to group II (with PRP). Mean trismus of patients of group II was found to be higher than that of group I at postoperative day 7, but this difference was not found to be statistically significant. Swelling at T-Sn (Tragus-Subnasale) and T-Pog (Tragus-Pogonion) was higher among patients of group I as compared to group II. Healing in group II was two to three times faster than group I. Healing among patients of group I and group II was found to be statistically significant. The mean pocket depth of patients of group I was found to be significantly higher than that of group II at follow-up of 1 and 2 months. The bone density of patients of group II was found to be significantly higher than that of group I at 3 months and 6 months follow-up. The procedure of PRP preparation is simple and cost-effective, and can be prepared at the point of care. It had a significant impact on the postoperative healing of the third molar socket. The use of PRP application increases the bone density, healing process, and improvement in the pain and swelling, and there was a definite reduction in trismus and periodontal probing depth after the impacted mandibular wisdom teeth extraction.

Mandibular wisdom tooth extraction in a patient with May-Hegglin anomaly: Report of a case

Mandibular wisdom tooth extraction in a patient with May-Hegglin anomaly: Report of a case

Prevalence of Dental Anomalies in Orthodontic Patients Referred To Dental School of Shahid Sadoughi University of Medical Sciences, Yazd, Iran

Aim: The prevalence of dental anomalies in different ethnic groups is different. The aim of this study was to evaluate the prevalence of dental anomalies associated with different malocclusions in Yazd. Iran. Methods: In this retrospective study the census method was used (with the confidence interval of 95% and the error margin of 5%). Dental records of 450 orthodontic patients referred to dental school of Shahid Sadoughi University of Yazd, Iran between 2010 and 2015 were collected. Dental records were classified into skeletal class I, II and III malocclusions (based on ANB angle measurements on cephalograms) searching for dental anomalies related to number, size and position. Data were analyzed using t-test, ANOVA and chi-square tests. Results: A total of 405 patients, (251 females 62%, 154 males 38%) with the mean age of 15.5 ± 4.1 were assessed. 49% of patients had at least one anomaly. The most frequent anomaly was impaction (24.9%). Hypodontia was found in 14.5% of patients and mandibular wisdom tooth was the most commonly missing tooth. 2.9% of patients had supernumerary which the maxillary anterior presented the higher number of it. The frequency of dental anomalies was not different between males and females. There was no correlation between type of malocclusion and frequency of dental anomalies except for hypodontia which was significantly higher in class I malocclusion.Conclusion: The most common anomaly seen in patients referred to the school of dentistry was impaction.

Delay in the Referral of Pregnant Patients with Fascial Spaces Infection: A Cross-Sectional Observational Study from Khartoum Teaching Dental Hospital, Sudan.

Odontogenic infections have the potential to develop rapidly into deep-space infections and compromise the airway. This problem is aggravated by pregnancy because of the physiological changes. This study aimed to determine the causes of referral delay for pregnant patients presenting with fascial space infections. Ten pregnant patients with severe odontogenic infections reported to the outpatient clinic at Khartoum Teaching Dental Hospital included in the study during the study period included in the study. Patients with any systemic disease excluded. Demographic data were taken followed by history and then extraoral and intraoral examinations. A predesigned case report form was completed for each patient including the cause of referral delay, the offending teeth, space involved, and trimester at the time of presentation. The age range was from 18 to 35years, and the mean age was 26.5years SD ± 6.3. The odontogenic infections were most common in the last trimester (60%), followed by the late second trimester (40%).The most common tooth involved was the mandibular wisdom tooth (50%), and the submandibular space was the most frequently involved fascial space (70%). All patients were admitted and treated with incision and drainage under local anesthesia; the offending tooth was extracted and intravenous antibiotic and fluids were administered. Patients were on daily dressing until they were discharged on oral antibiotics. Two patients with Ludwig's angina progressed to necrotizing fasciitis. Misconceptions among women regarding dental treatment during pregnancy were the most common cause of the delay. The myths and misconceptions should be addressed by dentists and prenatal care providers about oral health during pregnancy, and obstetricians' awareness increased that oral health needs special attention during pregnancy.

MANDIBULAR WISDOM TEETH;

Objectives: This study evaluated mandibular wisdom teeth impaction frequency, angulation and associated variables among patients visiting OPD at BibiAseefaDental CollegeLarkana. Study Design: Descriptive cross sectional studyinvolving patients of 18 to 40 years of age.Setting:Radiology Department at BibiAseefa Dental College for Orthopantomogram (OPG) Radiograph.Period:1 monthfrom01-03-2016 to 31-03-2016. Materials and Methods:The prevalence of impacted mandibular third molars, type of angulation, level of impaction (according to Winters classification) and relationship with ramus (according toPell &amp; Gregory classification) and inferior alveolar nerve canal were evaluated on the OPG radiograph as well as clinically.Results: A total of 162 patients participated in this study including 68 males (42.06%) and 94 Females (57.94%). The mean age of study participants was found to be 23.09 years.The total prevalence of mandibular third molar impaction in current study was 28.57%. Thehighest number of patients were withMesioangular impactions (13.49%), followed byVertical (9.52%) and Horizontal(5.56%) no any Distoangular impaction was found in present study. The level B (15.9%) was more common followed by level C (8.7%). Moreover, Class I ramus relationship was frequently found among study participants followed by Class II and Class III respectively.Conclusion: The female patients with mandibular wisdom teeth impaction outnumbered males.The most common was the mesioangular impaction with level B depth and class I ramus relationship.

The effects of two different cold compress modes on swelling and pain among patients receiving extraction of impacted tooth of mandibular

Objective To examine the effects of two different cold compress modes (continuous cold compress and intermittent cold compress) on the pain and swelling among patients receiving extraction of impacted tooth of mandibular. Methods From January 2016 to August 2016, 64 cases of adult patients with impacted mandibular impacted wisdom teeth and 24 h in the outpatient department of Oral and Maxillofacial Surgery of Affiliated Stomatological Hospital of Fujian Medical University were selected. They were randomly assigned to the control group and the experimental group (32 cases in each group) by random digital table. The participants in the control group received the usual care plus intermittent cold compress. The participants in the experimental group received the usual care plus continuous cold compress. And the treatment was continued for 24 hours. Outcomes including pain and skin temperature were measured in the intervention cycle, and the swelling was measured at baseline, 6 hour, 12 hours,18 hours, and 24 hours after the intervention. All the participants were asked to have further consultation at 7th days after the operation. Results At 6 hour, 12 hours,18 hours, and 24 hours, the pain of the experimental group was lower than the control group, and there was significant difference (F=63.665-290.872, P<0.05). At 12 hours,18 hours, and 24 hours after the intervention, number of the swelling grades (0-I-Ⅱ-III) in the control group was 16, 14, 2, 0 cases, 11, 13, 8, 0 cases, 11, 12, 8, 1 cases,number of the swelling grades (0-I-Ⅱ-III) in the experimental group was 27, 5, 0, 0 cases, 26, 6, 0, 0 cases, 26, 6, 0, 0 cases, and there was significant difference (Z=-2.968, -4.017, -4.052, P<0.05). A positive correlation between swelling grade and time (M2=45.22, P<0.05). At 6 hour, 12 hours,18 hours, and 24 hours, the skin temperature of the experimental group was lower than the control group, and there was significant difference (F=1 735.106-23 993.33, P<0.05). Conclusions This study showed that the continuous cold compress was more effective in reducing the pain and swelling among the patients receiving extraction of impacted tooth of mandibular. Compared with the intermittent cold compress, it suggested that continuous cold compress can be integrated into usual care to reduce the pain and swelling among the patients receiving extraction of impacted tooth of mandibular. Key words: Pain; Impacted wisdom teeth; Continuous cold compress; Intermittent cold compress; Swelling

Wisdom Tooth Formation as a Method of Estimating Age in a New Zealand Population

Dental ageing relies on assumptions aboutthe progression of tooth development from the middletrimester to adulthood and relative stability of thisprocess in the face of adverse dietary, hormonal, diseaseor nutritional factors. Most studies of dental ageingemploy the method of Demirjian et al., (1973), which isbased upon an assessment of crown and root formationstages from dental radiographs. Unfortunately, thismethod has a ceiling effect at age 16, when the secondmolar attains full maturity. The aim of our study was toextend the window of ageing by using the developmentof the third molar teeth. Panoramic radiographs of 207(105 males) children aged between 7 years, 6 months and18 years formed the basis of this study. Upper and lowerleft wisdom teeth were scored according to Demirjian et al. (1973) by a single examiner. Intra-examiner reliabilitywas evaluated by repeat scoring of a randomly selected(10%) sample one week after the initial staging. Theseshowed a consistency of 76% for the mandibular data and95% for the maxillary data, giving an overall percentageof 85%. When the re-scored teeth were not consistentwith their original score, this differed only by one stage.In this population males were advanced in their thirdmolar development and this trend was more markedfor maxillary than mandibular wisdom teeth. Hence, theNew Zealand population examined, males were moreadvanced in their third molar development and thistrend was more marked for maxillary than mandibularteeth.

Success rate of first attempt 4% articaine para-apical anesthesia for the extraction of mandibular wisdom teeth

Dental extraction is one of the acts that cannot be undertaken or carried out without total analgesia. Unfortunately, the success of anesthesia is not always systematic. Failures are noted during the extraction of mandibular wisdom teeth and pain management therefore remains a challenge for their extraction. The anesthesia technique and nature of the adapted anesthetic solution are controversial. However, the most commonly used technique is the Lower Alveolar Nerve Block (IANB). This technique has disadvantages (trismus, risk of intra-arterial injection and hematoma) and a failure rate of up to 88%. In some survey, 90% of 93 practitioners had difficulty obtaining proper anesthesia. Other clinical studies have also shown overall failure rates of 37%–47%, and 15%–35% on healthy lower molars. Recent studies have evaluated the success rate of articaine at between 54% and 94%, while others have shown that for mandibular teeth, articaine is more effective in para-apical anesthesia than lidocaine. Sixty subjects were selected for the study. The aim was to evaluate the overall success rate of first intention 4% articaine para-apical anesthesia during extraction of third mandibular molars. The overall success rate of para-apical anesthesia was 87%.

Comparison of the anesthetic effects of articaine adrenaline injection and lidocaine injection in wisdom tooth extraction

Objective To compare the anesthetic effect of atocaine adrenaline injection and lidocaine injection in wisdom tooth extraction. Methods 220 patients with wisdom teeth were selected as the research subjects.According to the random table method, the patients were randomly divided into research group 110 cases (a total of wisdom teeth 132, maxillary wisdom teeth 47, mandibular wisdom tooth 85) and the control group 110 cases(a total of wisdom teeth 129, maxillary wisdom teeth 51, mandibular wisdom tooth 78). The research group received atocaine adrenaline injection, the control group received lidocaine hydrochloride injection.The effects of anesthesia, VAS score and adverse reactions in the two groups were observed. Results The total effective rate of maxillary wisdom tooth anesthesia in the research group(100.00%) was significantly higher than that in the control group(90.20%), and the difference between the two groups was statistically significant(χ2=6.358, P<0.05). The total effective rate of mandibular wisdom tooth anesthesia in the research group(100.00%) was significantly higher than that in the control group(92.31%), and the difference between the two groups was statistically significant(χ2=6.788, P<0.05). The VAS score of maxillary wisdom tooth anesthesia in the research group[(2.57±0.65)points]was significantly lower than that in the control group[(2.87±0.63)points], and the difference between the two groups was statistically significant(t=2.319, P<0.05). In the control group, there was 1 case of hematoma caused by blood vessels, and no complications occurred in the research group. Conclusion The anesthetic effects of articaine adrenaline injection in wisdom tooth extraction is better than lidocaine hydrochloride injection, without any complications, it is worthy of clinical promotion. Key words: Teeth extraction; Anesthesia; Atocaine adrenaline injection; Lidocaine hydrochloride injection

Current situation of clinical research on impacted premolars

Teeth impaction is a common developmental malformation in oral diseases. Impacted teeth are usually the canines, third molar, central incisors, premolars, and second molars. The prevalence of impaction of maxillary canines and mandibular wisdom teeth is higher than that of other teeth. Most recent studies have focused on the canines and third molars, but research on impacted premolars is limited. In clinical practice, the majority of orthodontic patients require premolar extraction. Thus, impacted premolars play important roles in orthodontic design and prognosis. This article provides an overview of recent research on impacted premolars and summarizes epidemiological features, localizations, and treatments, with the aim of guiding practitioners on orthodontic design and therapy.

Comparison of the Efficacy of Prednisolone and Dexamethasone on Reduction of Pain and Swelling after Impacted Mandibular Wisdom Teeth Surgery

Comparison of the Efficacy of Prednisolone and Dexamethasone on Reduction of Pain and Swelling after Impacted Mandibular Wisdom Teeth Surgery

The use of 3D model planning in the management of impacted teeth

AbstractThe extraction of deeply impacted mandibular wisdom teeth can be challenging and may pose a risk of damage to the Inferior Alveolar Nerve (IAN). Thorough planning helps minimise this risk whilst improving the efficiency of the surgical procedure. The use of modern imaging and modelling techniques can help mitigate this risk and improve outcomes.We discuss the case of a 61 year old male presenting to the outpatients department complaining of facial swelling and limited mouth opening. Plain film imaging revealed a deeply impacted molar with associated pathology. Subsequent 3D imaging provided more accurate location of the tooth and the close association with the IAN.Surgical planning included the construction of a 3D model of the mandible. A viewing window was created to observe both the tooth and nerve. The construction and customisation of the model allowed for practise surgery along with appropriate preoperative decision making. An acrylic guide was constructed to fit the mandible intraoperatively and guide the bone cuts in the correct position, relative to the unerupted tooth.The surgery was performed successfully using the guide intraoperatively. The tooth was removed without traumatising the IAN. The patient has since made a rapid and complete recovery after surgery with no neurosensory defect noted.