Removal Of Molars Research Articles

Comparative Study of the Surgical Excision of Impacted Mandibular Third Molars Using Surgical Burs and an Erbium-Doped Yttrium Aluminum Garnet (Er:YAG) Laser.

Background The use of lasers has increased in the field of dentistry in recent years. However, in the field of oral and maxillofacial surgery, the use of lasers has been largely restricted to soft tissue, and less focus is placed on the use of lasers for hard tissues. Aim The present study aimed to comparatively evaluate the efficacy of a erbium-doped yttrium aluminum garnet (Er:YAG) laser for cutting the bone while removing the impacted mandibular third molar with the use of a surgical bur. Methods The study assessed 80 subjects undergoing removal of impacted mandibular third molars. The subjects were recruited from the Department of Oral and Maxillofacial Surgery, Luxmi Bai Institute of Dental Sciences and Hospital, Patiala, Punjab, India. They were randomly divided into two groups, each consisting of 40 subjects. Group I used an Er:YAGlaser to remove the bone, while Group II used a surgical bur. Assessments and comparisons were made for complications, wound healing, trismus, edema, bleeding, and pain. Results The study examined the efficacy of the Er:YAG laserfor cutting the bone and extracting the impacted mandibular third molars using a surgical bur in two groups of 80 patients each. When the laser was used in place of a surgical bur, Group I patients experienced less edema, bleeding, and discomfort; nevertheless, the difference was not statistically significant. Time taken by laser for bone cutting was significantly higher compared to the surgical bur. In Group I (laser), trismus existed for a longer time. For mouth opening, the preoperative mouth opening was comparable in the two groups with p = 0.87. Conclusion Pain, hemorrhage, and edema were lesser, and the time required for bone cutting was substantially longer in the laser group. Apart from these, laser-assisted intra-oral bone cutting should be preferred because of its less invasive nature, simpler procedure, and simpler osteotomy when compared to traditional surgical burs and also in anxiety-prone patients.

The necessity of removal of third molars involved in mandibular fractures: A retrospective study

This retrospective analysis aimed to investigate the necessity of removing the wisdom tooth in cases of angle fractures of the mandible. The study retrieved 595 mandible fractures from January 2006 to December 2021 through the Hospital Inpatient Enquiry System, of which 303 involved a fracture through the angle of the mandible, including the wisdom tooth socket. Of these, 203 (66.9%) underwent open reduction and internal fixation with retention of the third molar. The authors found that only four (2%) patients returned for the removal of plates and the retained third molar during the follow-up period. Therefore, the authors concluded that wisdom teeth removal should remain an exception during open reduction and internal fixation of mandibular angle fractures unless they hinder fracture reduction, pose a potential infection risk, or interfere with occlusal stability.

Hyaluronic acid in tooth extraction: a systematic review and meta-analysis of preclinical and clinical trials

ObjectivesTo assess whether in animals or patients with ≥ 1 tooth extracted, hyaluronic acid (HyA) application results in superior healing and/or improved complication management compared to any other treatment or no treatment.Materials and methodsThree databases were searched until April 2022. The most relevant eligibility criteria were (1) local application of HyA as adjunct to tooth extraction or as treatment of alveolar osteitis, and (2) reporting of clinical, radiographic, histological, or patient-reported data. New bone formation and/or quality were considered main outcome parameters in preclinical studies, while pain, swelling, and trismus were defined as main outcome parameters in clinical studies.ResultsFive preclinical and 22 clinical studies (1062 patients at final evaluation) were included. In preclinical trials, HyA was applied into the extraction socket. Although a positive effect of HyA was seen in all individual studies on bone formation, this effect was not confirmed by meta-analysis. In clinical studies, HyA was applied into the extraction socket or used as spray or mouthwash. HyA application after non-surgical extraction of normally erupted teeth may have a positive effect on soft tissue healing. Based on meta-analyses, HyA application after surgical removal of lower third molars (LM3) resulted in significant reduction in pain perception 7 days postoperatively compared to either no additional wound manipulation or the application of a placebo/carrier. Early post-operative pain, trismus, and extent of swelling were unaffected.ConclusionsHyA application may have a positive effect in pain reduction after LM3 removal, but not after extraction of normally erupted teeth.Clinical relevanceHyA application may have a positive effect in pain reduction after surgical LM3 removal, but it does not seem to have any impact on other complications or after extraction of normally erupted teeth. Furthermore, it seems not to reduce post-extraction alveolar ridge modeling, even though preclinical studies show enhanced bone formation.

Preinterventional Third-Molar Assessment Using Robust Machine Learning

Machine learning (ML) models, especially deep neural networks, are increasingly being used for the analysis of medical images and as a supporting tool for clinical decision-making. In this study, we propose an artificial intelligence system to facilitate dental decision-making for the removal of mandibular third molars (M3M) based on 2-dimensional orthopantograms and the risk assessment of such a procedure. A total of 4,516 panoramic radiographic images collected at the Center of Dental Medicine at the University of Zurich, Switzerland, were used for training the ML model. After image preparation and preprocessing, a spatially dependent U-Net was employed to detect and retrieve the region of the M3M and inferior alveolar nerve (IAN). Image patches identified to contain a M3M were automatically processed by a deep neural network for the classification of M3M superimposition over the IAN (task 1) and M3M root development (task 2). A control evaluation set of 120 images, collected from a different data source than the training data and labeled by 5 dental practitioners, was leveraged to reliably evaluate model performance. By 10-fold cross-validation, we achieved accuracy values of 0.94 and 0.93 for the M3M–IAN superimposition task and the M3M root development task, respectively, and accuracies of 0.9 and 0.87 when evaluated on the control data set, using a ResNet-101 trained in a semisupervised fashion. Matthew’s correlation coefficient values of 0.82 and 0.75 for task 1 and task 2, evaluated on the control data set, indicate robust generalization of our model. Depending on the different label combinations of task 1 and task 2, we propose a diagnostic table that suggests whether additional imaging via 3-dimensional cone beam tomography is advisable. Ultimately, computer-aided decision-making tools benefit clinical practice by enabling efficient and risk-reduced decision-making and by supporting less experienced practitioners before the surgical removal of the M3M.

Comparative Evaluation of Efficacy of Platelet Rich Plasma (PRP) and Platelet Rich Fibrin (PRF) in Bone Regeneration after Surgical Removal of Impacted Bilateral Mandibular Third Molars - A Comparative Study.

Aims and Objectives: To compare the efficacy of platelet rich plasma (PRP) and platelet rich fibrin (PRF) in bone regeneration after removal of impacted bilateral third molars. Materials and Methods: The study was carried out as an open clinical trial on 20 patients chosen from the ones referred to the department of Oral & Maxillofacial Surgery for surgical removal of bilateral mandibular third molar. Patients were prepared for surgical procedure, Inferior alveolar nerve block given using 2% lignocaine hydrochloride with 1:2,00,000 adrenaline. Third molar were removed by flap reflection and bone drilling. Finally, PRF in lower left mandibular third molar region and PRP in lower right mandibular third molar region was inserted and wound closure was done. Cone bean computer tomography (CBCT) was made on 1st postoperative day and 4 months after surgery to evaluate alveolar bone height and density. Result: Alveolar bone height and bone density at post-operative 1st day and 4 months were compared between PRP and PRF group. The bone density and bone volume were analyzed, and there was no significant difference between bone density in PRP and PRF at day 1 and 4th month. Conclusion: As per our study and evaluation, in our postoperative follow up there was no statistically significant differences in bone regeneration by placement of PRP and PRF in extracted socket of third molar. Thus, with this study we can conclude that PRF, would be a good option to Oral and Maxillofacial Surgeons in the near future due to ease of extraction.

Comparison of Pain Levels With Postoperative Intramuscular Administration of Single-Dose Ketoprofen Versus Diclofenac Sodium in Patients Undergoing Lower Third Molar Surgery.

Background Third molar surgeries are commonly performed in oral and maxillofacial surgery practice. Pain associated with this procedure is usually a frequent reason for patient apprehension and discomfort. Oral analgesics, though effective, do not provide sufficient pain relief in the immediate postoperative period. Aim To assess the postoperative effect on pain levels of single-dose administration of ketoprofen and diclofenac sodium as an injection in patients undergoing third molar removal surgeries. Methods This study was conducted among 30 patients divided into two groups (n=15). Patients in Group K received injection ketoprofen 100 mg and Group D included patients receiving injection diclofenac sodium 75 mg, both intramuscularly postoperatively. The intensity of pain was assessed at 30 minutes, two, six, and eight hours post-surgical removal of the impacted tooth using the visual analogue scale (VAS).The statistical data was analyzed using SPSS for Windows version 23.0 (IBM Corp., Armonk, NY, USA).The comparative statistical test adopted to compare pain scores between the two groupswas the Independent samples t-test. A p-value of <0.05 was considered to be statistically significant. Results Our study results revealed that Group K patient's VAS scores after two hours, six hours, and eight hours were 3.9± 2.7,4.5 ± 3.23,2.93 ± 2.27 respectively. In Group Dpatient's VAS scores aftertwo hours, six hours, and eight hours were 4.83± 2.82, 5.03± 2.9, 3.73 ± 2.91 respectively.Patients who were administered ketoprofen had lower pain levels when compared to patients who were given diclofenac but the difference was not statistically significant at any time point (p=0.172after eight hours). Our results depicted that the pain levels uniformly reached their maximal levels six hours after the procedure and thereafter steadily declined in both groups. Conclusion It can be concluded from the study that both the drugs ketoprofen and diclofenac sodium analyzed in this study can be used interchangeably for the reduction of pain following lower third molar surgery.

Radiological evaluation of inferior alveolar nerve displacement after removal of impacted mandibular third molars prior to sagittal split osteotomy

IntroductionWe hypothesize that the removal of mandibular third molars (M3) 6 months prior to a bilateral sagittal split osteotomy (BSSO) could allow the displacement of the inferior alveolar nerve (IAN) in a favorable lingual position. This study aimed to radiographically compare the position of IAN before and after M3 removal in patients with Class II malocclusion. Materials and methodThe CBCT images of 30 randomly selected patients (mean age 15.5 years, 19 females and 11 males) were segmented regarding the mandibular bone and the IAN canal. Mandibles were then superimposed and compared using 3D slicer (www.slicer.org). An orthonormal system was constructed, and the coordinates of IAN were assessed in the x- (horizontal axis), y- (depth axis), and z- (vertical axis) directions. ResultsThe mean changes in x- and z-values were 0.37 %, -0.09 % for the right IAN, 0.07 %, and -0.10 % for the left IAN, respectively. Y-axis was the dimension the most impacted by the M3 removal with a mean variation of -11.96 % for the right IAN, and 0.45 % for the left nerve (p1=0.74 and p2=0.04, respectively). Three patients presented a change in the IAN position superior to 1 mm on at least one coordinate axis. We observed a more important change in x-values of the right IAN in male than in female (p = 0.04), and no significant modifications regarding the other dimensions. Finally, there was no correlation between the age of the patients and the changes in IAN position. ConclusionThis study confirms the absence of influence of mandibular third molar removal on the inferior alveolar nerve route prior to BSSO.

Occurrence and Predictors of Postoperative Preauricular and Masticatory Muscle Pain Symptoms After Surgical Removal of Third Molars: A Single-Blind Randomized Controlled Trial Comparing Dental Assistants Supporting the Mandible and the Restful Jaw Device

During third molar removal, the mandible is supported by a dental assistant (DA) to counter downward forces during surgery, and with sedation, to maintain airway patency. The Restful Jaw device (PEP Design; Saint Paul) provides this support instead of the DA. This study compared the occurrence of postoperative preauricular and masticatory muscle pain symptoms (PMMPS) between the device and DAs providing mandibular support, using two outcome measures. Secondary aims identify predictors of outcome and providers' opinions of the device. In this multisite, single-blind, two-arm parallel randomized trial, participants without preoperative PMMPS had surgical removal of third molars, with sedation and bite blocks were randomly assigned to manual support or the device. The exposed group was randomly assigned to the device and the nonexposed group to manual support. The primary outcome was patient-reported PMMPS. Two secondary outcomes were pain assessed with the temporomandibular disorder Pain Screener and providers' views on the device. Outcomes were assessed at 1-, 3-, and 6-month postsurgery. The covariates are baseline demographics (eg, sex), clinical characteristics (eg, eruption status), and third molar surgeries. For occurrence of pain, generalized estimating equations assessed differences between groups. Logistic regression analysis assessed predictors of pain at 1month, per the Screener. The level for statistical significance was 5%. Enrollment was 86 and 83 participants in the device and DA groups, respectively. The average age was 20.8years; the majority were female (65%) and Caucasian (66%). The retention rate was ≥95.9%. The groups did not differ significantly for occurrence of pain using the primary and secondary outcome measures at any follow-up (P≥.46). Fully impacted molars were associated with occurrence of pain (odds ratio=3.44; 95% confidence interval 1.49-7.92; P=.004). Occurrence of pain using the primary and secondary outcome measures did not differ significantly between groups at any follow-up and was associated with removal of fully impacted third molars. Four out of five surgeons reported wanting to use the device on a regular basis when performing this procedure in sedated patients.

Patient's perception of recovery following surgical removal of mandibular third molars. A prospective european multi-center study

This study evaluated patient's perception of recovery following surgical removal of mandibular third molars (SRM3s) including analyze of potential risk factors associated with impaired convalescent. Patient related parameters combined with preoperative questionnaires including Modified Dental Anxiety Scale, Oral Health Impact Profile-14, and Decayed, Missing, Filled Teeth index were correlated with questionnaires assessing pain, swelling, trismus, sick leave, social and working isolation, physical appearance, eating and speaking ability, diet variations, sleep impairment, impaired sensation of the lip, chin, and tongue, one month following SRM3s. Totally, 412 patients (223 females, 189 males) with mean age of 29.4 years were included. Treatment satisfaction and willingness to undergo similar surgery were reported by 92% and 95%, although 21% reported that the surgery and postoperative period had been worse than expected. Mean days with pain, sick leave, and swelling were 3.6, 2.1, and 3.6, respectively. Preoperative symptoms, dental anxiety level, and prolonged surgical time were associated with increased pain and swelling (P < 0.05). Pell and Gregory classification (I-IIIC) were associated with impaired sensation of the lower lip and chin (P < 0.05). Consequently, results from this study improve the surgeon's ability to predict parameters that predisposed to impaired recovery and neurosensory disturbances following SRM3s.

Can Topical Agents (Arnica and Mucopolysaccharide Polysulfate) Reduce Postoperative Pain, Edema and Trismus Following Mandibular Third Molar Surgery?

Postoperative supplemental maintenance following mandibular third molar surgery remains an area of interest. Topical agents can modulate inflammatory processes. The aim of the present study was to determine if topical application of arnica or mucopolysaccharide polysulfate (MPSP) reduces pain, trismus, and edema following the removal of impacted mandibular third molars. A single center randomized controlled clinical trial was conducted. The patients were randomized into three groups: the control group (standard therapy [ST]: antibiotic+nonsteroidal anti-inflammatory drugs twice a day), the arnica group (arnica+ST), and the MPSP group (MPSP+ST). The patients' pain, trismus, and edema values were measured preoperatively and on postoperative days 1, 3, 5, and 10. Sex, age, and operation time were also included. Analyses included descriptive statistics, analysis of variance, post hoc tests, and determinations of intraclass correlation coefficients. Statistical significance was set at P<.05. Sixty patients with a mean age of 26.98±10.88years were included in the study; 55% were females and 45% were males. The mean operation time was 23.8±3.27minutes. According to the visual analogue scale scores (in centimeter units), the arnica and MPSP groups felt less pain than the control group until day 5 (0.6±0.88, 3.75±1.16, 4.75±1.29, and 1.05±1.10, respectively, for the arnica group; 0.35±0.59, 3.25±1.62, 5.0±1.65, and 1.50±1.32 for the MPSP group; and 1.30±1.17, 5.75±1.37, 7.05±1.10, and 3.15±1.53 for the control group; P<.05). The trismus was lower on days 1, 3, and 5 in the arnica group (-8.05±2.82, -12.15±3.1, and -2.15±1.81, respectively) than in the control group (-12±3.82, -15.65±4.81, and -4±2.81, respectively) (P<.05). The edema was lower on days 1 and 3 in the MPSP group (0.95±2.2 and 1.75±3.7, respectively) than in the control group (2.45±0.9 and 3.6±0.8, respectively) (P<.05). Arnica and MPSP had similar pain-relieving action, but arnica was more effective at reducing trismus, while MPSP was more effective at reducing edema. Topical application of arnica or MPSP may have a beneficial effect on relieving pain 5days after surgery, but arnica was also effective at reducing trismus, while MPSP was also effective at reducing edema. Both arnica and MPSP reduced postoperative sequelae.

Post-Operative Complications Associated with Impacted Mandibular Third Molar Removal

Background: The extraction of the third molar is a commonly done treatment that is often accompanied by a diverse range of difficulties. The problems most frequently observed are discomfort, paresthesia, trismus, edema, and mandibular fractures. Objective: To determine the post-operative complications associated with impacted mandibular third molar removal. Study Design: Cross sectional study. Settings: Department of Oral Pathology, Frontier Medical and Dental College, Abbottabad Pakistan. Duration: September 2022 to February 2023. Methods: The study involved cross-sectional analysis of all surgical removals of third molars. The analysis encompassed postoperative complications such as bleeding, trismus, or edema, along with demographic characteristics and the type of impaction. The collected data was organized into a tabular format and analyzed using SPSS software. Statistical significance was defined as a P-value of less than 0.05." Results: There were 133 females (59.1%) and 92 males (40.9%) in the study. In terms of age distribution, the majority of patients (60.0%) were in the 21–30 age group. Regarding retention type, advanced cases were accounted for the majority at 75.6%, simple cases at 21.8%, and complex cases at 2.7%. Among the cases, 34.7% were categorized as minimally difficult (scores 3 to 4), 57.3% fell into the moderately difficult category (scores 5 to 6), and 8.0% were classified as very difficult cases (scores 7 to 10). The data indicates that there were 129 cases of pain, accounting for 57.3% of the total complications. Paresthesia occurred in 17 cases, representing 7.6% of the complications. Mandibular fracture was rare, with only one case, making up 0.4% of the complications. Alveolar osteitis was reported in 28 cases, comprising 12.4% of the total complications. Bleeding occurred in 5 cases, accounting for 2.2% of the complications. Conclusion: The most frequently observed complication was pain, with swelling and trismus following as the next most common.

Does cone beam CT change the treatment decision for maxillary second and third molars? A prospective study.

To evaluate whether information from CBCT changes the treatment plan for maxillary second and third molars and to examine clinical and radiographic parameters with an impact on treatment decision. This prospective study included 260 maxillary third molars with superimposition onto the second molar in panoramic images (170 patients; mean age 28 years, range 16-63). An initial treatment plan was based on clinical findings and panoramic images. After CBCT, a final treatment plan was decided. Treatment was undertaken based on the final treatment plan. Through logistic regression analyses, impact of clinical and radiographic parameters on change in treatment plan, removal of the third molar vs no treatment, and removal of the second vs third molar were evaluated. The treatment plan changed in 82 cases (32%). Sixteen cases (6%) changed from removal of the third molar to removal of the second molar. Regression analyses showed that severe resorption in the second molar was significantly related to a change in treatment plan. Removal of a third molar was decided in 180 cases and regression analyses identified that mesioangulation of the third molar, marginal bone loss, superficial resorption, and age were significantly related to removal of the third molar vs no treatment. Thirty second molars were removed, and regression analyses showed that severe resorption was significantly related to removal of the second molar instead of the third molar. Parameters such as resorption evaluated in CBCT can modify the treatment decision, resulting in removal of the second and/or the third molar.

Third Molar Coronectomy vs Total Removal in Second Molar Periodontal Healing

The objective of this randomised controlled trial was to compare the periodontal healing at the distal of the adjacent second molar after coronectomy or surgical removal and the surgical morbidities of the 2 techniques. This is a pilot study of a split-mouth randomised clinical trial comparing the periodontal healing of the adjacent second molar after coronectomy or total removal of lower third molars, which was registered with the University of Hong Kong Clinical Trial Centre as HKUCTR-2948 on 21 February 2020. Cone beam computed tomography (CBCT) scans were taken preoperatively and at 6 months postoperatively. Changes in the bone level from the cemento-enamel junction, periodontal probing depth (PPD), and clinical attachment level (CAL) at the distal of the adjacent second molar were compared. Surgical morbidities in terms of pain, infection, neurologic deficit, root exposure, and need for second surgery for removal were assessed. Forty patients (22 male, 18 female) with mean age of 26.7 years were evaluated at 6 months postoperatively. Both coronectomy and total removal groups demonstrated statistically significant reduction in PPD and CAL. There was an alveolar bone gain of 1.28 ± 0.88 mm in the coronectomy group and 1.13 ± 0.73mm in the control group, which was statistically significant (P < .001 for both groups). Early findings show the periodontal healing at the adjacent second molar of coronectomy was as good as that of total removal of lower third molar. There were no differences in terms of surgical morbidities between both groups.

Does Removal of Third Molars at the Time of Sagittal Split Osteotomy Impact Intraoperative Complications? A Retrospective Review from a Single Institution and Single Surgeon from 2015 - 2021

Does Removal of Third Molars at the Time of Sagittal Split Osteotomy Impact Intraoperative Complications? A Retrospective Review from a Single Institution and Single Surgeon from 2015 - 2021

Comparative Study between Low Level Laser Therapy and Ultrasound Therapy for minimizing Postoperative Trismus after Surgical Removal of Mandibular Third Molars

Comparative Study between Low Level Laser Therapy and Ultrasound Therapy for minimizing Postoperative Trismus after Surgical Removal of Mandibular Third Molars

Surgical removal of third molars in a young adult: review of indications and surgical techniques.

Germectomy is a surgical method most typically performed in young adults. The indications for treatment are controversial. The purpose of this review was to determine the correct indications for germectomy and to discuss the advantages and disadvantages of the procedure. We reviewed the surgical techniques (anesthetic methods, patient preparation, and flap designs) and complications. Germectomy for orthodontic purposes is a common indication for surgical removal of tooth germ among young patients. Several studies have supported removal at an earlier age to produce fewer surgical complications. Several surgical techniques have been described in the literature.

739 A Service Evaluation of Post-Operative Risks for Surgical Dental Procedures Following Paediatric Out-Patient General Anaesthetic

Abstract Aim To evaluate post-operative outcomes for paediatric patients who have undergone surgical procedures under general anaesthetic in the out-patient day surgery unit. Method A retrospective evaluation of all children under 16 years old who attended for Day Surgery procedures between 1/10/22 and 31/12/22 at Guy’s Hospital, London was completed. Patient notes were assessed to identify surgical procedures, the risks the patient had been consented for pre-operatively and the incidence of post-operative risks. Results In the 2-month period, 303 patients were seen in Day Surgery. 209 completed a course of comprehensive dental care, 94 required exodontias only and 21 had a surgical extraction included in their treatment under general anaesthetic. 1 patient experienced a risk that had been planned for: an oro-antral communication following removal of an infra-occluded maxillary molar. 1 patient required an apically repositioned flap after unfavourable positioning of the orthodontic bracket during exposure and bonding of an unerupted tooth. 2 patients were offered a telephone review post-operatively and no patients required a face-to-face review. Conclusions All patients requiring dental surgical procedures should be consented for appropriate risks including damage to adjacent structures and possible altered sensation if nerve tissue is close to the expected surgical site. The possibility of oro-antral communication should also be addressed pre-operatively. Where exposure and bonding of orthodontic brackets are planned, the risk of a change in the gingival contour and health should be outlined. By comprehensively discussing possible post-operative complications, patient expectations and care can be optimised, and consent can be fully informed.

Removal or retention of nonimpacted third molars

Nonimpacted third molars (N-M3s) refer to the third molars (M3s) that completely erupt and reach the occlusal plane without rotation. Although the removal of unerupted M3s in young adults is generally approved by most dentists, the decision on removal or retention of N-M3s remains challenging as a result of unawareness of the potential harm of N-M3s. Recent studies suggested that N-M3s were associated with deteriorated effects to the health of adjacent teeth, including higher risks of caries and alveolar bone resorption. Therefore, regular monitoring and early clinical decision on N-M3s are essential to reduce the risks of adverse effects on adjacent teeth. This review is structure to give a comprehensive overview of the negative impact of N-M3s to the adjacent teeth, in order to provide rational guidelines for clinical decision-making of N-M3s.

Outcomes of Coronectomy and Total Odontectomy of Impacted Mandibular Third Molars

ObjectiveThe aim of this research was to evaluate the surgical complications and neurosensory deficits after coronectomy and the complete removal of mandibular third molars. MethodsThe study sample included patients requiring surgical removal of mandibular third molars. A coronectomy was conducted on 220 teeth showing signs of close proximity to the inferior alveolar canal. A complete extraction was performed on 218 teeth with no risk signs. The patients were evaluated at 1 week and 1, 3, 6, 12, and 24 months after surgery for pain, swelling, neurologic deficit, dry socket, postoperative bleeding, infection, root migration, and eruption. ResultsNo significant difference was noted in pain and swelling; however, bleeding and dry socket were significantly higher in the odontectomy group (P = .017). The inferior alveolar nerve deficit was higher in the odontectomy group (3.7%) than the coronectomy group (0.5%) (P = .017). The percentage and distance of root migration of coronectomised teeth at 3, 6, and 12 months were 60% (2.37 ± 0.96 mm), 66% (3.35 ± 0.86 mm), and 74% (3.85 ± 0.93 mm), respectively. ConclusionsCoronectomy is a safe procedure and should be performed when the roots are closely associated with the mandibular canal. Although root migration is common, the likelihood of root exposure is low and roots rarely need removal.

Evaluation of Anaesthetic Efficacy of Ropivacaine for the Removal of Impacted 3rd Molars- A Randomised Control Study

This study involved 20 healthy patients (ASA 1) with bilaterally impacted mandibular third molar were randomly selected of both Sexes between age group of 20-40 years. Purpose: This study was done to evaluate the efficacy of Ropivacaine in comparison with Lignocaine for mandibular anaesthesia for bilaterally impacted mandibular third molars in aspect of onset, duration of anaesthesia, analgesia and postoperative requirement of analgesics. Method: Patients received 2ml of 2% Lignocaine with adrenaline on one side and 2ml of 0.75 % plain ropivacaine on the other side at two different appointments. Pain experiences were measured by Visual Analogue Scale (VAS) and Verbal Rating Scale (VRS). Results: In ropivacaine group, the means of onset of anesthesia, duration of anaesthesia, duration of post-operative analgesia and requirement of post-operative analgesics were 5.8±2.33 min, 533.3±142.2 min, 539.6±114.7 min and 4.2±0.8 no’s respectively and there was a significant difference between these group (&lt;0.001). Conclusion: The efficacy of plain ropivacaine 0.75% is superior to 2% lignocaine with adrenaline 1:1,00,000 in terms of duration of anaesthesia and analgesia, intraoperative and post-operative pain control but the onset of action of plain ropivacaine is slightly higher. We conclude that Plain Ropivacaine 0.75% can be used as an alternative to lignocaine in third molar surgeries and other minor surgical procedures which necessitates longer duration of anaesthesia and analgesia in oral and maxillofacial region.