Third Molar Extraction Research Articles

Enhancing Lower Third Molar Surgery: Using The Piezoelectric Technique for Superior Postoperative Outcomes and Complication Prevention

Background: The surgical removal of impacted mandibular third molars is routine in oral and maxillofacial surgery and common postoperative complications are widely reported in the literature. Therefore, this prospective split-mouth study aims to compare the postoperative sequelae of piezoelectric surgery versus conventional surgery of the lower third molar, focusing on pain and swelling. Methodology: In total, 41 patients were treated under local anesthesia and surgical removal on one side of their mouth was performed using conventional rotary surgery (micromotor) while the other side’s was by piezosurgery, with an interval of 15 days from the previous procedure (82 extraction sites); in addition, pain and swelling analyses were conducted. Results: The pain analysis demonstrated a median of one day of pain in patients treated with piezoelectric surgery compared to two days with conventional surgery (p < 0.001). The probability of not feeling pain was greater in sites treated with experimental surgery on the first and second days (p < 0.001). The swelling was worse in places treated with the conventional method, with the most significant difference being the distance between the angle of the mandible and the upper lip vermilion on both days and the more subtle difference between the angle of the mandible and the anterior nasal spine on the seventh day. Conclusions: When a piezosurgical unit is used, according to the literature, is well known that it takes more time to perform the surgical extraction of third molars. Despite that, our results show that it causes less pain postoperatively, with faster improvement and a quicker reduction in swelling compared to conventional surgery.

Comparison of the efficacy of aescin and diclofenac sodium in the management of postoperative sequelae and their effect on salivary Prostaglandin E2 and serum C-reactive protein levels after surgical removal of impacted mandibular third molar: a randomized, double-blind, controlled clinical trial.

Surgical removal of an impacted third molar is one of the most common oral surgical procedures performed in dental offices. The postoperative phase is often associated with severe inflammation. Non-steroidal anti-inflammatory drugs (NSAIDs) are usually prescribed to manage postoperative discomfort. NSAIDs have been associated with gastrointestinal bleeding, renal function disturbances, and platelet count reductions. Thus, the present study demonstrates the utility of aescin in managing postoperative discomfort after the surgical removal of impacted mandibular third molars.This study aimed to correlate and compare the impact of aescin and diclofenac on salivary PGE2 levels and serum C-reactive protein levels after surgical extraction of the mandibular third molar. The study will also evaluate and compare the effectiveness of individual drug therapy in managing postoperative pain, swelling and mouth opening. The planned study is a single-center, double-blind, randomized, parallel, prospective clinical trial. Each patient will be prescribed either diclofenac sodium 150 mg/day or aescin (escin) 120 mg/day to be taken orally in divided doses for five days after surgically removing the impacted mandibular third molar.Pain will be assessed using a visual analog scale. Facial swelling and mouth opening will be recorded using a metric scale with standardized reference points. ELISA (enzyme-linked immunosorbent assay (ELISA) will be employed to measure salivary Prostaglandin E2 and serum C-reactive protein levels. All parameters will be recorded preoperatively (T0) on the second postoperative day (T1) and fifth postoperative day (T2). The proposed study is expected to show a clinically acceptable response to the administration of aescin for the management of postoperative discomfort compared to diclofenac sodium after third molar surgery.The proposed study is expected to positively manipulate the levels of salivary Prostaglandin E2 and serum C-reactive protein, which are reliable inflammatory markers.The outcome of this study may provide an efficacious and safe alternative to conventional nonsteroidal anti-inflammatory drugs for managing postoperative discomfort following third molar surgery.

Does Pederson Difficulty Index Accurately Predict the Difficulty of Mandibular Third Molar Extraction?

Abstract Context: To determine the relationship between the Pederson difficulty index and the modified Parant scale and to assess the effectiveness of the Pederson difficulty index in predicting the difficulty of mandibular third molar extractions. Settings and Design: This cross-sectional study recruited participants with indications for third molar extractions. Pederson’s difficulty index was used to evaluate the anticipated difficulty of preoperative mandibular third molar extraction. Surgical extraction of impacted third molars was done under local anesthesia and patients were then assessed postoperatively with the Modified Parant Scale. Methods: In this study, 85 participants indicated for surgical extraction of mandibular third molars under local anesthesia were enrolled between February 2018 and July 2018. The relationship between Pederson’s difficulty index modified Parant scale and duration of extraction was evaluated. Statistical Analysis Used: Sociodemographic variables of study participants were summarized with descriptive statistics. Student’s T-test was utilized for mean differences between groups and correlations were computed between Pederson and modified Parant scale. Results: This study comprised 85 participants with a mean age of 25.8 years ± 4.6, showing no significant difference across genders (P = 0.87). Pederson difficulty index demonstrated a sensitivity of 46.4% and a specificity of 89.5% and a moderate correlation (0.35, P < 0.001) was observed between Pederson difficulty index and surgery duration, ditto, between Pederson and modified Parant scores (0.36, P < 0.001). Conclusion: In conclusion, our study underscores the importance of pre-operative assessment for mandibular third molar extraction, highlighting the Pederson Difficulty Index’s moderate predictive value but emphasizing concerns about its sensitivity.

Asymmetric outcomes in bilateral maxillary impacted tooth extractions: A case report

BACKGROUND The extraction of maxillary impacted teeth is a common procedure in oral surgery, frequently complicated by oroantral communications. For less-experienced clinicians, accurately assessing the difficulty and associated risks of maxillary third molar extractions remain a significant challenge. CASE SUMMARY We present a case involving disparate outcomes following bilateral extraction of maxillary third molars. Using cone-beam computed tomography and three-dimensional software, we conducted a digital assessment of the factors contributing to extraction difficulty and risk, controlling for potential confounders. Key variables analyzed included alveolar bone volume, bone quality, crown-root angulation, and maxillary sinus mucosal thickness. Additionally, we introduce the novel concept of "tegmen bone" to quantitatively evaluate the bone mass between the teeth and the maxillary sinus. This unique case, with differing outcomes on opposite sides of the same patient, provided an opportunity to minimize extraneous variables and focus on the local anatomical factors influencing the procedures, thereby improving the precision of our analysis. CONCLUSION This case highlights the potential utility of predictive analysis in guiding the management of complex tooth extractions.

Comparing Military and Civilian Dentists' Treatment Planning Decisions: A Pilot Study.

Clinical decision-making varies among dentists. However, the literature is limited and narrow in scope regarding the variation between public and private sector dentists. Because both types of dentists' decisions can directly influence military dental readiness, it is important to understand the potential differences in diagnosis, treatment planning, and the delivery of care. The purpose of this pilot study was to compare treatment planning recommendations between civilian and military providers. Patient-level data from the 2018 Recruit Surveillance, a stratified, cross-sectional study of 1,208 randomly selected U.S. Air Force recruits, were used to evaluate treatment planning outcomes for the 2 provider groups (2 civilians; seven military providers). Treatment planning outcomes included type of noninvasive, operative, and oral surgery treatment recommended, temporomandibular disorder referrals, and orthodontic referrals. Patient demographic variables included age, gender, education, race/ethnicity, and military component ("status"). Data were examined both at the tooth level and patient level for statistical significance. Multivariate analyses were performed with statistically significant variables included in each final model for patient-level data. Data were analyzed with logistic regression and Poisson regression (alpha = 0.05). Bivariate logistic regression analyses were performed for tooth-level data. Significant differences were found between military and civilian dentists' treatment planning decisions (P < .05) for both patient-level and tooth-level data. Adjusted for significant bivariate predictors of patient demographics at the patient level, civilian dentists were more likely to refer patients for orthodontic treatment, prescribe remineralization for sound tooth surfaces, incipient caries, and carious teeth, and prescribe direct restorations for teeth with 3 to 5 carious surfaces instead of single crowns compared to military dentists. Additionally, civilian dentists were less likely to prescribe sealants for sound tooth surfaces or carious teeth. No statistically significant difference in treatment planning outcomes was observed between civilian and military dentists for sealants for incipient caries, single crowns, or extraction of third molars. At the tooth level, civilian dentists were more likely to prescribe remineralization for sound tooth surfaces, remineralization instead of sealants for carious surfaces, and extraction of third molars. No statistically significant differences were noted between civilian and military providers for recommending sealant or remineralization for teeth with incipient caries or prescribing a single crown versus placing a direct restoration on posterior teeth with 3 to 5 carious surfaces. Significant differences in treatment planning outcomes between civilian and military providers exist. Civilian providers are more likely to refer patients for orthodontic treatment and prescribe remineralization, direct restorations instead of single crowns, and third molar extractions, while military providers are more likely to prescribe sealants for sound tooth surfaces or carious teeth. Therefore, comparisons of treatment planning outcomes between civilian and military providers warrant further research.

Comparison of different flap designs in soft tissues periodontal healing after lower third molars extraction: a descriptive review

The purpose of this descriptive review was to assess post-operative periodontal outcomes of adjacent molar sites after the extraction of lower third molars, comparing different surgical techniques. The electronic search strategy was conducted on different databases (PubMed, Scopus, and Web of Science) fitting the following selection criteria: clinical human studies (RCTs, retrospective and prospective); studies comparing different flap designs (e.g., envelope, triangular, and trapezoidal flaps) for surgical extraction of lower 3rd molars; studies assessing clinical outcomes of periodontal healing at adjacent molar sites. Studies included had to present a minimum follow-up of 1 month and at least variations of probing pocket depth (PPD) at 2nd molar site between baseline and follow-up. The search strategy considered a total of 148 records: based on the predetermined eligibility criteria, 24 articles were read, and 9 were finally identified. Regarding the primary outcome considered (PPD at 2nd molar site), no significant differences in its reduction between baseline and follow-up were found comparing different flaps designs. However, the greatest clinical attachment loss (CAL) was generally reported using a trapezoidal flap. Considering the heterogeneity of studies included, after 1 to 6 months of follow-up, no substantial evidence can be assumed for or against the use of a particular flap design for the extraction of lower third molars.

Cirurgia de remoção de terceiro molar inferior associado ao L-PRF – relato de caso

Platelet-Rich Fibrin (PRF) is an autologous process, which consists of removing a blood sample taken from the patient, where it is placed in a test tube, subsequently centrifuged, and deposited in the alveolus after the extraction of the third molar. This therapy is still in progress, often used more and more in third molar extractions, where it helps in bone and tissue regeneration. The objective of this work was to perform an extraction of the lower third molar (48) and insert the PRF in the alveolus after the extraction procedure. Blood collection and centrifugation, antisepsis of the patient and assembly of the surgical table were carried out, anesthesia of the Inferior Alveolar, Buccal and Ligual Nerve, intrasucular insertion, detachment, odontosection and osteotomy under continuous irrigation and elevation of the dental element, insertion of Rich Fibrin in Collagen and socket closure with Nyolon thread. Therefore, it is concluded that PRF is a process that is still in progress, however, it is a great alternative for regeneration of alveoli after third molar extractions, due to its unique biological properties.

EVALUATION OF POSTOPERATİVE MORBİDİTY FOLLOWİNG OPERATIONS OF IMPACTED MANDIBULAR THIRD MOLARS WITH BONE RETENTION

This study is aimed to see how gender and whether tooth is placed on the right or left affected the length of the operation, edema, trismus, and discomfort after surgical extraction of an impacted mandibular third molar. This prospective study was conducted in the Inonu University. The study included 104 mandibular wisdom tooth with bone retention. There were 55 females and 49 males among the 104 patients, with 53 left and 51 right impacted mandibular third molar. The operations were performed by the same surgeon in the same operating room. The time between the incision and the suture was determined and recorded as the operation time for each procedure. Before surgery, on the 2nd postoperative day, and on the 7th postoperative day, the patients were compared in terms of facial swelling impacted mandibular third molar, discomfort, and trismus. IBM SPSS V23 was used to evaluate the data. The left impacted mandibular third molar extraction takes longer than the right impacted mandibular third molar extraction. Tooth 38, which have a longer operation time, are more prone to swelling, discomfort, and trismus. When tooths are extracted, right-handed surgeons cause less postoperative morbidity 48. We recommend that both right-handed, left-handed surgeons operate in clinics that conduct impacted tooth extractions.

A prospective randomized study on the efficacy of real-time dynamic navigation in deep horizontal mandibular third molar extractions

PurposeThis study aimed to evaluate the clinical efficacy of applying real-time dynamic navigation (RDN) in the extraction of deep horizontal mandibular impacted third molars, hypothesizing that RDN reduces surgical time and minimizes the risk of injury to adjacent anatomical structures.MethodsA prospective study was conducted on 160 patients aged between 18 and 37 years with deep horizontal impaction of the mandibular third molar. The participants were randomly assigned to either the experimental group (receiving RDN-assisted extractions) or the control group (undergoing traditional extraction methods). Preoperative planning utilized cone beam computed tomography (CBCT) and Mimics software for the accurate localization and segmentation of impacted teeth. Parametric data were analysed via an independent t test for intergroup comparisons, and significance was set to p < 0.05.ResultsIn the experimental group, an average of 11 ± 1 min was required for preoperative planning via RDN, which was not required in the control group. The setup of the navigation system took an average of 4 ± 1 min in the experimental group and 0 min in the control group. The experimental group demonstrated a significantly shorter average surgical time (22 ± 3 min) than did the control group (36 ± 3 min). The differences in the preoperative design time, surgical time, and complication rates between the two groups were statistically significant (p = 0.005). Additionally, the RDN group reported no complications related to adjacent tooth damage or nerve injury.ConclusionThe precision, safety, real-time guidance of RDN supports its use in complicated dental extractions, which would introduce a new era of oral and maxillofacial surgery.Graphical

Comparative Evaluation of Surgical Difficulty of Impacted Maxillary and Mandibular Third Molars: An Observational Study.

Introduction Extraction of the third molar is the surgical intervention most frequently performed by dental professionals. Notwithstanding a meticulously designed surgical strategy, complications may arise during extraction of the lower third molars. The primary objective of this study was to evaluate and compare the surgical difficulties encountered when managing impacted maxillary and mandibular third molars. The secondary objective was identifying the predictors of surgical difficulty in extracting the third molars from both arches. Materials and methods This study included 30 systemically healthy patients requiring upper and lower third molar extractions on the same side. The Pederson index was used to assess surgical difficulty in such patients on pre-treatment orthopantomograms. The time interval between upper and lower extraction was one week for all patients, and all extractions were performed by an experienced oral and maxillofacial surgeon. An independent t-test was performed to determine the significance of the differences between group variables. Predictors of surgical difficulty, such as sex, type of impaction, duration of surgical procedure, type of surgical procedure, fused roots, and root curvature,were assessed using multivariate analysis. Results The mean patient age was 29.93 ± 2.81 years. The mean mouth opening was 41.25 ± 3.5 mm. Chi-square test results revealed no significant differences between the maxillary and mandibular groups across all variables (p > 0.05). The independent t-test results revealed significant differences between the maxillary and mandibular groups in procedure duration (p < 0.05). The duration of the procedure was significantly longer in the mandibular group (44.13 ± 15.20 minutes) than in the maxillary group (33.33 ± 13.96 minutes). Root curvature, duration of the surgical procedure, type of surgical technique employed, and patient sex were all identified as significant predictors. Conclusion The surgical difficulty for impacted third molars was similar in both arches. The duration of the surgical procedure was longer in the mandibular arch.

A 3D-Planned Inward Fragmentation Technique for the Removal of Impacted Mandibular Third Molars: A Case Series.

Background/Objectives: The extraction of impacted mandibular third molars (M3Ms) carries significant risks, especially regarding the inferior alveolar nerve (IAN). This study aimed to evaluate the effectiveness of a 3D-planned inward fragmentation technique (3Dp-IFT) to improve surgical outcomes, reduce complications, and preserve bone structure in cases involving complex M3M impactions. Methods: Twenty-three patients aged between 18 and 36 years requiring M3M removal were included. Preoperative planning involved the use of cone-beam computed tomography (CBCT) for precise localization of the furcation area, followed by the creation of a 3D navigation template using PlastyCAD software version 1.7. The surgical procedure was performed under local anesthesia, with meticulous endoscopic assistance to ensure accurate access and minimize trauma. Postoperative outcomes, such as bone loss, pain, swelling, and mouth opening range, were carefully measured. The data were systematically organized and analyzed descriptively using Microsoft Excel. Results: No disturbances to the IAN or lingual nerve were observed. The mean buccal bone loss was 2.2 mm, with a standard deviation of 1.2 mm. Postoperative pain and swelling were generally low, with significant reductions within the first week. The use of the 3D navigation template significantly improved surgical access, enhancing safety and minimizing complications. Conclusions: The 3Dp-IFT technique represents a significant advancement in the minimally invasive removal of M3M by allowing precise access to critical anatomical areas while minimizing bone loss and postoperative complications. This approach is particularly beneficial for complex cases involving M3M near the IAN, thereby improving surgical safety and patient outcomes.

Effect of Hyaluronic Acid on Socket Healing After Lower Impacted Third Molar Tooth Extraction in 40 Dental Patients.

BACKGROUND Surgical extraction of impacted mandibular third molars is the most commonly performed procedure in oral surgery; its associated complications include sensory nerve damage, swelling, and trismus. This study aimed to evaluate the effects of hyaluronic acid (HA) on healing of the socket following extraction of the lower impacted third molar tooth in 40 dental patients. MATERIAL AND METHODS This prospective, double-blind, randomized, controlled study was carried out on 40 adult healthy patients indicated for surgical removal of bilateral impacted mandibular third molars with equal surgical difficulty (moderate surgical difficulty according to the Koerner index. Patients with right mandibular third molars were included into the study (HA) group and those with left mandibular third molars were included into the control group. Surgical removal of impacted teeth was performed at different times for each patient for proper measurement of postoperative clinical variables, including pain, swelling, and mouth opening. RESULTS Postoperative pain evaluation results using the visual analog scale (VAS) showed reduced pain levels at all observation periods. Postoperative swelling peaked in intensity within 12-48 hours, resolving between the 5th and 7th days, and there was no significant difference in pre- and postoperative measurements of interincisal opening between both groups (P>0.05). CONCLUSIONS We found that intra-socket application of hyaluronic acid after surgical extraction of impacted mandibular third molars promoted normal wound healing, and there was a clinical benefit of reduced postoperative pain and swelling.

Prophylactic third molar removal: are oral surgeons and orthodontists aligned in preventive approaches?

BackgroundThere is a general consensus among dental professionals regarding the extraction of impacted third molars in the presence of clinical symptoms. However, there is less agreement on the management of asymptomatic third molars. The objective of this study is to compare the perspectives of oral surgeons and orthodontists regarding the indications for the extraction of asymptomatic third molars. It is possible that healthcare professionals from different specialties may approach the extraction of these teeth in different ways.MethodsIn this cross-sectional study, a web-based questionnaire has been employed to collect data by inquiring about the reasons why participants prefer the extraction of asymptomatic third molars. Descriptive statistics were employed to evaluate the data obtained. The level of significance was set at P < 0.05.ResultsProphylactic extraction of partially impacted molars was more favored among the participants (P < 0.05). The orthodontists preferred prophylactic extraction due to the risk of late anterior dental crowding (LADC); however, the oral surgeons preferred pre-pregnancy extractions (P < 0.05). The extraction decision for partial impaction was higher in females when the risk of distal caries was considered. For fully impacted ones, it was higher in males when the risk of caries and pericoronitis were considered (P < 0.05).ConclusionsOrthodontists preferred extraction because of the risk of LADC and caries, while oral surgeons focused on preventing pericoronitis, pathology, focal infection, and symptoms during pregnancy. This divergence between the participants may inform the guidelines for prophylactic management of third molars. These findings may be pertinent in gender medicine.Clinical relevanceThis study has been enlightening for departments to consult each other before the extraction of a patient’s asymptomatic third molar.

Different Uses of Conscious Sedation for Managing Dental Anxiety During Third-Molar Extraction: Clinical Evidence and State of the Art.

Dental anxiety, linked to avoiding dental treatment and heightened medical and surgical risks, prompted this systematic review. The objective is to synthesize existing evidence on conscious sedation techniques employed for managing dental anxiety in patients scheduled for third molar extraction surgery, aiming to identify optimal approaches and address knowledge gaps. This systematic review followed the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" checklist and the population, investigation, comparation, outcome framework. The protocol still needs to be registered. A thorough search was conducted, incorporating MEDLINE/PubMed, EMBASE, SCOPUS, clinicaltrials.gov, and the Cochrane Database of Systematic Reviews until February 2024. Only randomized controlled trials were considered, following "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" guidelines. The risk of bias was evaluated following the Cochrane Handbook for Systematic Reviews of Interventions. Eighteen randomized controlled trials involving 2081 patients were included. Certain factors limited the feasibility of a meaningful meta-analysis, leading to a narrative synthesis. Conscious sedation with virtual reality showed an association with improved dental anxiety in 4 studies. One study reported reduced cortisol levels with midazolam compared with a placebo, whereas another noted significant variations in perioperative renin levels with remifentanil versus placebo. This review reveals inconclusive and conflicting findings regarding the role of conscious sedation in managing dental anxiety during third molar extraction surgery. Persistent uncertainties arise due to a need for consistent, standardized outcome measures. Addressing these limitations in study design is crucial for future research.

Revolutionizing orthodontics: Effective management of Class III skeletal malocclusion using innovative buccal shelf bone screws

The advent of the temporary anchorage devices has revised the envelope of discrepancy in modern orthodontic practice. Orthodontic camouflage is opted in situations where the patient is reluctant to have an invasive orthognathic surgical procedure and the associated risks or where, by the use of temporary anchorage devices, the orthodontic envelope can be expanded, and optimal orthodontic result can be obtained non surgically. In such cases, TAD’s can be used to obtain an acceptable orthodontic result with a cusp to fossa posterior relation, an optimal aesthetic outcome, and a functional occlusion. This case report showcases a camouflage treatment of a Class III non-growing patient treated by use of TAD’s, to cause clockwise rotation of maxillo- mandibular occlusal complex for achieving optimum molar relation, facial esthetics, and function.A case of skeletal and Angle’s Class III malocclusion is presented where orthodontic camouflage was carried out to deliver optimal orthodontic results. This was achieved effectively by in toto distalization of the lower arch. This was brought about with the use of two extra alveolar TAD’s placed in the buccal shelf region of the lower arch. Two 2 x 12 mm bone screws were used, after space creation by extraction of lower third molars bilaterally, and elastic chains was the chosen force delivery system. Here in toto distalization of the lower arch was achieved to end in an Angle’s class I molar and canine relationship with normal overjet and overbite. Total treatment duration was of 17 months.Challenging skeletal malocclusions can be treated non surgically by effective use of TAD’s and correct and efficient use of biomechanics.

Removal of mandibular third molars: An overview of risks, a proposal for international community and guidance.

The aim of this proposal is to (1) review the current literature, (2) shed light on the importance of creating universally accepted guidelines, (3) provide help and guidance in the decision-making process with regard to the removal of mandibular third molars (M3Ms), and (4) reduce the risk of exposing the patient to unnecessary harm and complications due to the inappropriate removal or retention of M3Ms.It is obvious that the indications for the extraction of M3Ms will continue to be an area of controversy and strong debate. The evidence for or against prophylactic extraction is ambivalent; there is evidence to accept or reject the stance against prophylactic extraction in some specific cases, and there are published articles to support both opposing views. The available guidelines on the extraction of third molars are limited in number, and are mostly tailored to fit specific settings or countries. There are no available guidelines that might be widely used to help in the decision-making process for the international community. We hope this proposal will constitute an important first step toward creating universally accepted guidance.

Edema and Trismus Assessment After Applying Kinesiotape With the Web Strip Technique Compared With Cryotherapy: A Randomized Clinical Trial.

Extraction of impacted third molars is one of the most common oral surgeries performed in the dental clinic, which is often accompanied by many complications such as edema and trismus. Many methods have been used to alleviate these complications, such as drugs or physical therapy. Kinesiotape (KT) has recently spread as a popular physical method for eliminating complications after surgical extraction of lower third molars after its long-term use in sports medicine and injuries of the musculoskeletal system. The current study aimed to study the effect of using KT (Kinesio® Holding Corporation, Albuquerque, NM, USA) on both edema and trismus after impacted third molar extraction. This study was designed as a randomized controlled clinical trial using the split-mouth technique and included 25 patients with radiographically symmetrical lower third molars from patients. All surgical extractions were performed by a single surgeon under sterile conditions according to the standard surgical protocol after that one group applied KT and the other group applied cryotherapy. Edema and trismus were measured in the first five days. Data was collected and analyzed by SPSS software (IBM Corp., Armonk, NY, USA). The mean change in the total linear facial measurements in the experimental group (Kinesio Group) was 12.32 mm three days after surgery, and then this value decreased to 6.80 mm, while the average increase in the control group (Cryo Group) was 17.00 mm after three days, then the value decreased to 9.68 mm five days after surgery. Regarding the changes in the amount of maximum mouth opening after surgery, the results were similar between the Kinesio Group and the Cryo Group, as there were no significant differences between the two groups (P<0.05). This study concluded that KT was superior to cryotherapy when studying edema. The current study also concluded that the mouth opening was similar between the two study groups.

Third Molar Extractions in Patients With Developmental Disabilities

BackgroundPatients with developmental disabilities may exhibit behavioral problems or be unable to maintain proper hygiene, potentially placing them at greater risk for infection following the extraction of third molars. PurposeThe purpose of this study was to estimate and compare the risk for surgical site infection after third molar removal between patients with and without developmental disabilities. Study design, setting, sampleThis was a retrospective cohort study of patients who underwent extraction of all four third molars at Boston Children’s Hospital from August 1, 2021, to July 31, 2023. Patients were excluded if all four third molars were not present or if all four third molars were not extracted during one visit. Predictor variableThe primary predictor variable was developmental disability status. Subjects were grouped by developmental disability, coded as present or absent. Main outcome variableThe primary outcome variable was diagnosis of a postoperative surgical site infection. Secondary outcomes included time to follow-up and infection treatment. CovariatesCovariates included age, sex, race, ethnicity, procedure setting, anesthesia type, and impaction status. AnalysesIndependent Samples T-tests, Chi-Squared tests, and Fisher’s Exact tests were used for analysis. ResultsA total of 1,896 subjects were evaluated. There were 236 subjects in the developmental disability group (72.5% male [n=171] mean age of 19.3 ± 2.7 years) and 1,660 in the non-developmental disability group (53.4% female [n=887] mean age of 19.0 ± 2.3 years). Subjects in the developmental disability group more frequently underwent their extractions in the operating room under general anesthesia (57.6% [n=136] p<0.001). The overall postoperative infection rate was 2.7% (n=52). There was no statistically significant difference in the rate of infection between the developmental disability group (0.8% [n=2]) and the non-developmental disability group (3.0% [n=50]) (p=0.057). There was no significant difference in time to follow-up between subjects who were and were not diagnosed with an infection (6.26 ± 9.39 weeks vs. 4.69 ± 10.95 weeks, p=0.434) or for subjects in the developmental disability and non-developmental disability group who had an infection (2.64 ± 0.30 weeks vs. 6.43 ± 9.76 weeks, p=0.588). Conclusions and RelevancePatients with a developmental disability do not exhibit higher rates of postoperative infections following third molar extractions when compared to patients without developmental disabilities.

Prevalence of surgical site infections following extraction of impacted mandibular third molars: A systematic review and meta-analysis

Our research aims to assess the prevalence of surgical site infections (SSI) following impacted mandibular third molar extractions. Two independent reviewers conducted a comprehensive systematic literature search across Medline, Scopus and Cochrane Central databases. The pooled prevalence, accompanied by 95% confidence intervals (CI), was calculated. Quality assessments, outlier and influential analyses were performed. Our meta-analysis included seventeen eligible studies, encompassing a total of 37,585 impacted mandibular third molar extractions. The overall prevalence of SSI following impacted mandibular third molar extractions was estimated at 1.7% (95% CI 1%-2.6%), indicating considerable heterogeneity among the studies. No study was identified as critically influential. This study highlights the imperative for future well-constructed prospective and retrospective investigations to deepen our understanding of the etiological nuances and refine management approaches for this prevalent postoperative complication.

Postoperative Complications of Third Molar Surgical Extraction in a Malaysian Sample

The most common impacted teeth in adults are the mandibular third molars which frequently require surgical extraction. There are many factors contributing to the occurrence of postoperative complications, one of which is surgeon’s experience. Hence, this study aimed to determine the prevalence of postoperative complications of third molar extractions by different level of surgical experience. Methods: A retrospective study was conducted in Kulliyyah of Dentistry, International Islamic University Malaysia. A total of 112 cases were collected from the records of surgical extraction of lower third molars performed by dental students, dental officers and specialists, collected data was transferred into special case sheets and analyzed using IBM SPSS 23. Results: From 112 cases, 64(57.1%) had presented with postoperative complications. The highest prevalence of postoperative complications was in dental students’ group 38 out of 62 patients (61.3%), followed by specialists’ group 20 out of 39 patients (51.3%) and dental officers’ group 6 out of 11 patients (51.6%). Meanwhile, the common complications observed were pain (33.9%), swelling (20.5%), trismus (12.5%), paresthesia (6.3%) and bleeding (3.0%). Conclusions: There is no statistically significant correlation between the postoperative complications and the level of surgeons’ experience.