Third Molars Research Articles

Risk determination of inferior alveolar nerve injury after mandibular third molar extraction

Introduction. Extraction of impacted molars may be accompanied by complications, including inferior alveolar nerve (IAN) injury, with an incidence of up to 8.4% [3]. Among the risk factors for IAN trauma is the relationship between the molar and the mandibular canal (MC). The aim of the study is to evaluate the difficulty of extraction of impacted M3M and the risk of NAI injury based on radiological clichés. Materials and methods. A retrospective descriptive study was performed, including 25 molars. OPGs, and CBCTs of the patients were evaluated. Age, sex of patients; degree of inclusion according to Pell & Gregory; angulation of molars; Rood & Shehab signs were studied. Results. According to the degree of difficulty of the intervention, we obtained: low difficulty — 2 cases; medium — 21 cases; high — 2 cases. 84% of cases showed an association between more than one signs proposed by Rood & Shehab. The most common were loss of white line (33%), followed by MC narrowing and root darkening (22% each). The incidence of NAI injury was 8.3%. Conclusions. Risk prediction is useful in planning and facilitates decision making regarding the extraction technique of the impacted M3M.

Prevalence Of Pathologies Caused By Mandibular Third Molar Tooth Positions

Background: he aim of this study was to evaluate the pathologies caused by mandibular im-pacted third molars in individuals living in the Şanlıurfa region. Materials and Methods: In this retrospective study conducted at Harran University Faculty of Dentistry between 2018 and 2020, panoramic radiographs of 904 patients (525 females, 379 males) were analyzed. The prevalence, impaction and position of third molars, conditions and pathologies related to these teeth were evaluated. Results: 1664 mandibular third molars of 904 patients were analyzed. When the distribution by gender is examined, 42.79% are men and 57.21% are women. In terms of mandibular third molar position, 60.34% of the teeth are vertical. In terms of mandibular third molar eruption level, 61.39% of the teeth are at level A. When we look at pathologies based on teeth, there is 16.81% caries. Conclusions: While third molars may remain without any symptoms for a long period of life, they may cause caries, cysts and bone loss in adjacent teeth. Tooth extraction may be recom-mended prophylactically to prevent third molar teeth from causing greater pathology in later ages.

Comparison of distribution and frequency of impacted teeth before and during COVID-19 pandemic in dental hospital: a descriptive study

ABSTRACTIntroduction: The occurrence of the COVID-19 pandemic may affect the prevalence of patients with complaints of impacted teeth in dental hospital Faculty of Dentistry University of Indonesia (FKG UI), and there is no recent research on the distribution and frequency of impacted teeth based on age, gender, and teeth type in this hospital during the COVID-19 pandemic. This study aims to determine the distribution and frequency of impacted teeth during the COVID-19 pandemic in dental hospitals. Methods: A descriptive study uses the secondary data on impacted teeth patient's medical records. Utilizing purposive sampling, we selected participants for the research by carefully examining medical records to identify individuals that had undergone impacted tooth removal. The study used secondary data from the medical records of oral surgery patients at dental hospital FKG UI from June 2019 to June 2021, including complete patient identity, clinical diagnosis, and panoramic radiograph of the impacted teeth in June 2019 to June 2021. Diagnosis was determined through screening of medical records and panoramic radiographs. Data were analyzed using the statistical analysis software (SPSS version 21, IBM Corp.) Results: From 3,225 medical records of oral surgery patients at dental hospital FKG UI before and during COVID-19 pandemic, A total of 1292 patients were included in the study and 1496 impacted teeth cases were found. The frequency of impacted teeth cases before the pandemic was 825 (55.1%) cases; there were 671 (44.9%) cases during the pandemic. Conclusion: COVID-19 has caused a decrease in the distribution and frequency of impacted teeth cases, mostly in the middle aged patients, while more female as compared to male. The most common occurrence was in the third molars and the lowest was in the second molar tooth. Keyword : tooth, impacted, COVID-19, retrospective studies, wisdom tooth

PREEMPTIVE INTRAVENOUS IBUPROFEN AND LOCAL KETAMINE IMPROVE POSTOPERATIVE ANALGESIA FOLLOWING THIRD MOLAR SURGERY: A DOUBLE-BLIND, RANDOMIZED, PLACEBO-CONTROLLED CLINICAL STUDY

ObjectiveTo compare the efficacy of preemptive ibuprofen, local ketamine, and their combination in managing postoperative pain and trismus following third molar surgery. Materials and MethodsOne hundred patients were randomly divided into four groups. The Intrafen Group had their impacted third molars surgically removed under local anesthesia after receiving intravenous (IV) ibuprofen for preemptive effect. The Ketamine Group received an IV placebo before the surgery, and the extraction process was completed with a local anesthetic-ketamine combination. The Combined Group received preemptive IV ibuprofen before the procedure, and the surgery was performed with a local anesthetic-ketamine combination. The Control Group received an IV placebo before the procedure and then had their impacted third molars removed under local anesthesia. The Visual Analogue Scale (VAS) values, corresponding to the patients' pain levels at the 2nd and 12th postoperative hours and the total amount of analgesic dose used in the first 24 hours, were recorded, and evaluated. The maximum mouth opening of the patients was measured immediately before the procedure, and on the second and seventh postoperative days. The level of patient satisfaction in all groups was assessed during the procedure. ResultsThe mean VAS value corresponding to the 2nd-hour pain level of the combined group was statistically significantly lower than the other groups (p=0.003). A statistically significant difference was found in the mean VAS values corresponding to the pain levels of the groups, favoring the combined group compared to the other groups (p≤ 0.001). A significant difference was observed between the VAS difference values corresponding to the pain levels of the Intrafen group and the Ketamine group, favoring the Intrafen group (p=0.038). The Ketamine group consumed the most analgesic on average over the first 24 hours, whereas the Combined group consumed the least. No statistically significant difference was found between the mean trismus levels of the groups on days 0–2 (p=0.528) and days 0–7 (p=0.129). The intraoperative patient satisfaction level of the combined group was significantly higher than that of the other groups (p=0.030). ConclusionPreemptive Intrafen is an effective regimen for postoperative pain management and is superior to the local anesthetic-ketamine regimen. The most effective method to reduce postoperative pain following third molar surgery is to use a combination of these two regimens. However, none of the treatment methods used in the study had a positive effect on postoperative trismus.

MRI segmentation of tooth tissue in age prediction of sub-adults - a new method for combining data from the 1st, 2nd, and 3rd molars.

We aimed to establish a model combining MRI volume measurements from the 1st, 2nd and 3rd molars for age prediction in sub-adults and compare the age prediction performance of different combinations of all three molars, internally in the study cohort. We examined 99 volunteers using a 1.5T MR scanner with a customized high-resolution single T2 sequence. Segmentation was performed using SliceOmatic (Tomovision©). Age prediction was based on the tooth tissue ratio (high signal soft tissue + low signal soft tissue)/total. The model included three correlation parameters to account for statistical dependence between the molars. Age prediction performance of different combinations of teeth for the three molars was assessed using interquartile range (IQR). We included data from the 1st molars from 87 participants (F/M 59/28), 2nd molars from 93 (F/M 60/33) and 3rd molars from 67 (F/M 45/22). The age range was 14-24years with a median age of 18years. The model with the best age prediction performance (smallest IQR) was 46-47-18 (lower right 1st and 2nd and upper right 3rd molar) in males. The estimated correlation between the different molars was 0.620 (46 vs. 47), 0.430 (46 vs. 18), and 0.598 (47 vs. 18). IQR was the smallest in tooth combinations including a 3rd molar. We have established a model for combining tissue volume measurements from the 1st, 2nd and 3rd molars for age prediction in sub-adults. The prediction performance was mostly driven by the 3rd molars. All combinations involving the 3rd molar performed well.

FIVE-YEAR RADIOGRAPHIC FOLLOW-UP OF ASYMPTOMATIC IMPACTED THIRD MOLAR TEETH WITH COMPLETED APICAL ROOT DEVELOPMENT

Third molar teeth can stay impacted due to systemic factors, space deficiency, pathology or an anatomical obstacle. The positions, angles, follicle sizes, and impaction statuses of impacted third molars can change over time. The purpose of this study is to investigate changes in the position, inclination, angle, and follicular width of impacted third molars at the end of a 5-year follow-up on panoramic radiographs. Retrospective analyses of a total of 98 impacted third molar teeth were carried out on panoramic radiographs taken at 5-year intervals for 31 patients who presented to the Department of Oral and Maxillofacial Radiology at Faculty of Dentistry for various reasons between 2013 and 2021. The mean angle of the examined impacted third molars with the occlusal plane was 26.725±27.31° at the beginning of the 5-year follow-up and 26.399±28.46° at the end of the follow-up. There was a 5° angular change(inclination) in 4(8.2%) impacted molars. In the examinations of the panoramic radiographs taken at 5-year intervals, no pathologic change around any impacted third molar or resorption in neighboring teeth was observed. There were inclination changes in 2(4%) of the impacted molars and position changes in 11(22.4%). The changes may be occur in the position, inclination, angle, and follicular width of asymptomatic impacted teeth in time. It is important that asymptomatic impacted teeth can be followed radiographically to evaluate the effects of changes in position, inclination, angle and follicle width over time on the impacted tooth and surrounding tissues and to prevent complications that may occur after a possible impacted third molar extraction.

Innovations in the postoperative management of the third molar and use of biomaterials. A look at different studies

The extraction of third molars, commonly known as wisdom teeth, is a common surgical procedure in young adults. Given the complexity of this process, different methods were explored to improve healing, including the use of bioactive materials and platelet-rich fibrin (PRF). Recent advances have shown that PRF, especially in its variants such as A-PRF and L-PRF, can significantly accelerate the healing of hard and soft tissues, and is useful in maintaining tissue volume after extraction. This biomaterial has proven to be effective in reducing pain, inflammation and promoting bone regeneration. However, studies on its effectiveness and direct comparisons with natural healing are varied and require more in-depth analysis. The present study evaluated the effectiveness of natural healing compared to the use of PRF, focusing on lower third molar surgeries. Through a longitudinal experimental design, meta-analysis and systematic reviews of the existing literature were performed to identify, compile and compare clinical outcomes between the use of PRF and conventional healing methods. The research highlighted the potential of PRF in improving postoperative management protocols and suggested future directions for research and clinical application of these biomaterials in dentistry and other medical disciplines

Mandibular Posterior Anatomic Limit for Distalization in Patients With Various Patterns of Third Molar Impactions: A Three-Dimensional Cone Beam CT (CBCT) Study.

The aim was to compare and evaluate the variation in the mandible's posterior anatomic limits (MPAL) stratified by different third molar impaction patterns utilizing cone-beam CT (CBCT) in individuals with skeletal Class III malocclusion. The sample consisted of CBCT records of 80 samples of Class III patients categorized based on the pattern of their third molar impaction. The shortest linear distances from the distal root of the second mandibular molar to the inner cortex of the mandibular body were measured at the crown level, at the cementoenamel junction (CEJ), and at the depths of 4, 6, and 8mm from the CEJ, all parallel to the posterior occlusal line. The MPAL of the four groups were compared. The Shapiro-Wilk test for normality was performed. The Kruskal-Wallis test was performed to compare the MPAL distances between the groups. Significant differences were noted between the four groups at every level. MPAL distances decreased towards apex in all the groups and was least at the 8mm root level. The greatest MPAL distances were noted in the no-impaction group followed by the horizontal. At 8mm, the MPAL were 4.2+/-1.3 in Group 3 (Control), 3.3+/-0.9 in Group 1 and 2.7+/-0.05 mm in Group 2. Though the amount of space available for distalization was greatest for the mesioangular group at the crown level, it was least at the 8mm level compared to other groups. MPAL distances were shortest at the root level in Class III patients who had mesioangularly impacted third molars and care should be taken before attempting distalization in them.

Endodontic file separation and its management among dentists in Punjab, Pakistan

The study aimed to find the incidence and awareness of endodontic instrument separation and its management among dental house officers, postgraduate trainees, demonstrators, consultants, and general dentists. Methods: This online questionnaire-based cross-sectional study was conducted with the approval of the IRB in private and public dental hospitals and dental clinics in Punjab. The authors developed the survey tool, which comprises 24 closed-ended items regarding demographics, the incidence of file separation, and awareness about its management. The data were analyzed using IBM SPSS version 24. The Chi-Square Test was used to compare percentages of categorical variables. Results: Postgraduate trainees experienced the most instrument separations (43.6%), made the most retrieval attempts (49.2%), and experienced the most secondary errors during retrieval (52.1%) (p<0.001). Around four out of ten respondents always informed the patients (39.6%) and department (41.6%) about errors. Manual files (69.8%), stainless steel files (75.8%), and short files (60.4%) were more frequently separated, and the most frequent cause was older fatigue files (57.7%). Manual files were more frequently broken in public dental institutes (p=0.003). Two-thirds of the file separations (72.5%) occurred during cleaning and shaping in the apical third of molars (65.1%), especially in mesiolingual canal (56.4%). Bypass attempt was the most common in symptomatic teeth (47.7%). Conclusions: Preventive approaches such as limiting file reuse and constructing a glide path can reduce the occurrence of file separation. Operators should be familiar with the number of uses of the instrument before fatigue and should be trained through workshops and refresher courses.

Wisdom tooth surgery in 2023.

Wisdom tooth surgery in 2023.

Comparative evaluation for the accuracy of mandibular third molar impaction status with respect to surrounding dentoalveolar structures using orthopantomogram as against cone beam computed tomography

Mandibular third molar impaction impose a great dental problem especially to young adults. It is the most commonly impacted tooth in the entire dentition of humans. The cause of impaction may vary and may include lack of space, malposition and physical barrier on the path of eruption. This impaction can lead to different pathologies, from infection to development of cysts. Injury to the inferior alveolar nerve during extraction of mandibular third molar is also a possibility during treatment which can lead to numbness, tingling or burning sensation of the affected side. It can also have adverse effects on the adjacent second molar. Several studies have been done to determine the angulation, depth of impaction, space available between the second molar and ramus, proximity to inferior mandibular third, status of adjacent second molar using several criteria and classification using orthopantomography (OPG) and cone beam computed tomography (CBCT). But there is very little research done on the precision of both OPG and CBCT and comparisons of their diagnostic accuracy. In this study, adults above 21 years of age who have impacted mandibular third molar (IMTM) will be taken for OPG where OPG will provide two-dimensional radiography and CBCT will deliver three-dimensional radiography. Different criteria will be used to assess the status of the impaction and see the sensitivity and specificity in both OPG and CBCT. This study is important to help determine which radiographic diagnostic tool is preferable for assessing the status of impacted third molar and its relation to its surrounding structures and estimate the difficulty index for extraction of mandibular third molar impaction. It will also further help in preventing any injury or complication which can arise to the surrounding structures both during and after extraction and which will also help in achieving best possible outcome for 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.

Impacted wisdom teeth, prevalence, pattern of impaction, complications and indication for extraction: A pilot clinic study in Iraqi population

Introduction The third molars are the most frequently impacted teeth in the human oral cavity .The unerupted teeth are not, in themselves, pathological lesion but may induce pathology. Impaction can be present in different patterns and levels. Decision of removal or retention of impacted tooth is a matter of debate . Aim The aim of the present study was to evaluate the prevalence of impaction, angular position of impacted wisdom , level of impaction, agenesis and the indications for extraction. Materials and Methods A sample of 880 patients( 498 males and 382 females ) with age range between 18 to 40 years old with the mean of 28.8 . The study took place in the hospital of surgical specialization in which all patients were evaluated clinically and radiographically by OPG . Of 880 patients 411pstients showed impaction of at least one tooth (table 3) .The total number of impacted teeth in the sample were 1100 and 57 missing teeth (table 4). Result Among 880 patients , 411 (46.7%) patients showed impaction of at least one tooth , the total number of impaction was 1100 wisdom teeth . of which 428 ( 38.9%) were in the maxilla and 672 (61.09%) were in the mandible. The most prevalent angular position was vertical angular (59.81%) followed by mesioangular (18.45%). Concerning level of impaction , Level C was the most prevalent in maxilla and mandible . Agenesis of third molar was seen in 57 teeth (1.61%). Of 1100 impacted third molar ,663 were subjected to surgical removal .The most common reasons ”indications” for patient referral to our surgical department were orthodontic reasons followed by pericoronitis, while the lowest was fracture mandible. Conclusion impaction pattern , the mandibular impaction is more prevalent than maxilla with vertical impaction is the commonest followed by mesioangular impaction while the inverted impaction is negligible. Level C impaction is the most common in both maxilla and mandible. Concerning the indication for extraction , the most common indication was orthodontic followed by pericoronits , caries with the lowest prevalent were mandibular fracture and lesions even when the lesion represent the absolute indication for extraction. Oral surgeon should build his decision to extract or not extract third molars on the most canonical scientific guidelines and what is best for each individual case.

DeAPIR: Efficient and Enhanced Dental Arch-Guided Panoramic Image Reconstruction from CBCT Data

Dental CBCT and panoramic imaging play a pivotal role in dental diagnosis and treatment planning, alongside the indispensable use of computed tomography (CT) and X-ray imaging in dentistry, particularly for surgical planning. Given the widespread adoption of dental cone beam CT in clinics today, we explore a novel approach in this study—utilizing CT’s three-dimensional (3D) data to reconstruct a two-dimensional (2D) panoramic dental image. This method eliminates the requirement for an extra panoramic scan. In this work, we propose a novel framework to generate an enhanced and extended 2D panoramic view by using the dental arch extracted from 3D CBCT. Our method involves segmenting the patient’s dental arch from their 3D CBCT image by identifying horizontal slices with above-average intensity, followed by morphological operations, including dilation, Gaussian filtering, and skeletonization, to delineate the dental arch line. Additionally, we extend the dental arch beyond the wisdom teeth using quadratic curve fitting. Finally, we employ Maximum Intensity Projection on rotated cubic segments aligned with the dental arch curve to produce captivating panoramic images. The panoramic view produced using our proposed method, when compared to the results obtained from BlueSky and OpenInventor, exhibited superior enhancements and greater accuracy in panoramic visualization.

RADIOGRAPHIC EVALUATION OF OVERHANGING RESTORATIONS AMONG YEMENI PATIENTS USING CONE-BEAM COMPUTED TOMOGRAPHY (CBCT)

Background and aims: Overhanging restorations which is extension of restorative material beyond the confines of a cavity preparation may lead to various complications and risks, including increased gingival fluid flow and oral inflammation. The study aim is to use cone-beam computed tomography (CBCT) to radiographically assess the incidence of overhanging restorations in Yemeni patients. Methods: A retrospective comparative study was conducted on 404 randomly selected CBCT images dor ≥ 18 years male and female Yemeni patients referred to private radiology centers in different Yemeni cities (i.e., Sana'a, Ibb, Hodeida, Aden and Hadhramout) during the period from January 2021 to June 2022. The overhang was evaluated regarding arch (upper or lower), side (right or left), tooth location, and tooth type (central incisor (I1), lateral incisor (I2), canine (C), 1st premolar (P1), 2nd premolar (P2), 1st molar (M1), 2nd molar (M2) and 3rd molar (M3). The tooth surface was considered the statistical unit to allow an accurate comparison of periodontal variables for each restored surface. The evaluated surface points of class II restorations were mesial and distal, while those of crown restorations were mesial, distal, buccal, lingual, mesiobuccal, mesiolingual, distobuccal, and distolingual. Results: The prevalence rate of overhang was 59.8% in class II and 51.5% in crown restorations. Class II restoration overhang had no significant association with arch, side, tooth type, and tooth location; however, it had a significant association with tooth and surface point (p<0.05), indicating that it was more significantly observed in the 2nd premolar (67.5%) than the other teeth as well as in the distal surface than the mesial one (73.1% vs. 26.9%, p<0.05 Conclusion: The prevalence of class II and crown restoration overhang is considered high among Yemeni patients. Overhangs observed on class II restorations are more than those observed on crown restorations. Class II restoration overhangs are more commonly observed on the 2nd premolar as well as the distal surface. Peer Review History: Received: 8 August 2023; Revised: 19 September; Accepted: 26 October, Available online: 15 November 2023 Academic Editor: Dr. DANIYAN Oluwatoyin Michael, Obafemi Awolowo University, ILE-IFE, Nigeria, toyinpharm@gmail.com Received file: Reviewer's Comments: Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 8.0/10 Reviewers: Dr. Tamer Elhabibi, Suez Canal University, Egypt, tamer_hassan@pharm.suez.edu.eg Dr. Bilge Ahsen KARA, Ankara Gazi Mustafa Kemal Hospital, Turkey, ahsndkyc@gmail.com

Three-dimensional positional relationship between impacted mandibular third molars and the mandibular canal

ObjectiveTo observe the three-dimensional positional relationship between impacted mandibular third molars (IMTMs) and mandibular canal close contacts using cone beam computed tomography (CBCT).MethodsA total of 101 patients with IMTMs were selected who met the diagnostic criteria for 142 teeth (no bone wall imaging area between IMTMs and the mandibular canal, a high-density bone cortical imaging area only, or a ≦1 mm bone imaging area). The parameters of the rotating CBCT anode were set as follows: 110 kV, 40–50 mA; the focal point and exposure field were set as 0.3 mmh and a high-resolution zoom, respectively; the exposure time and image layer thickness were set as 5.4 s and 0.25 mm. Three-dimensional reconstruction was performed, and the position of the mandibular canal through the IMTM area was observed continuously from the coronal, horizontal and sagittal planes.ResultsWe found that the mandibular canal was interrupted below the third molar (TM) in 85 cases, accounting for 59.86% of all cases. The mandibular canal was located below the buccal and lingual curvatures in 33 and 19 cases, respectively, accounting for 23.23% and 19%. In addition, a small number of mandibular canals were also located on the buccal side of the mandibular molars (2.82%). We also found one case of direct insertion of the mandibular third molar (MTM) into the mandibular canal. In addition, the mandibular canal passed through the IMTM region with 125 close contacts at the roots (88.03%); 14 mandibular canals were in contact with all teeth and 3 were in contact with the crown.ConclusionThe use of CBCT can provide a dynamic and comprehensive understanding of the three-dimensional positional relationship of the mandibular alveolar nerve canal passing through the IMTM area, providing a high clinical reference value when extracting IMTMs and reducing the risk of injury to the inferior alveolar nerve.

Evaluation of Recombinant Human Platelet Derived Growth Factor (rhPDGF-BB) Along with Tricalcium Phosphate (β-TCP) in Impacted Mandibular 3rd Molar Sockets

Aim: The aim of this study was to evaluate efficacy of Recombinant Human Platelet derived Growth Factor (rhPDGF-BB) mixed with Tricalcium Phosphate (β-TCP) particles in mandibular 3rd molar extraction socket for bone regeneration. Setting And Design: A comparative clinical trial consisting of 10 patients who wanted to undergo the surgical extraction of mandibular 3rd molar bilaterally, were undertaken in the institutional settings, where in each patient one side of lower third molar extraction site was kept as control and in the other side graft material was used, after the approval from the institutional ethical committee. Materials And Methods: In this study 10 patients were included with mean age of 28.3 years (Ranging from (20-35 years). These were 4 male and 6 female patients. In each patient one side of lower third molar extraction site was kept as control site and in the other side graft material was used kept as study site. Hence 10 control sites were compared with 10 study sites. Selection of site for placement of graft was done randomly. In 6 patients study site was on right side and in 4 patients study site was on left side. Clinical parameters like pain, facial swelling, total number of analgesic tablets required evaluated at 48hrs and at 7th day. While, radiographically bone density was evaluated after 1st and 3rd month postoperatively. Other parameters like infection, sinus discharge, wound dehiscence, dry socket or graft leakage were also observed. Results: rh PDGF with β – TCP when used in mandibular third molar extraction socket results in rapid bone regeneration seen via increased bone density. It also results in less post-operative discomfort to the patient like pain and swelling. Complications like infection, sinus discharge, wound dehiscence, dry socket or graft leakage were not encountered and the tissue showed good acceptance with no graft rejection. Conclusions: The rh PDGF/β – TCP combination is a novel bone grafting material with excellent results and should be included in the armamentarium when bone defect is encountered.

Risk assessment of inferior alveolar nerve injury after wisdom tooth removal using 3D AI-driven models: A within-patient study

ObjectiveTo compare a three-dimensional (3D) artificial intelligence (AI)- driven model with panoramic radiography (PANO) and cone-beam computed tomography (CBCT) in assessing the risk of inferior alveolar nerve (IAN) injury after mandibular wisdom tooth (M3M) removal through a within-patient controlled trial. MethodsFrom a database of 6,010 patients undergoing M3M surgery, 25 patients met the inclusion criteria of bilateral M3M removal with postoperative unilateral IAN injury. In this within-patient controlled trial, preoperative PANO and CBCT images were available, while 3D-AI models of the mandibular canal and teeth were generated from the CBCT images using the Virtual Patient Creator AI platform (Relu BV, Leuven, Belgium). Five examiners, who were blinded to surgical outcomes, assessed the imaging modalities and assigned scores indicating the risk level of IAN injury (high, medium, or low risk). Sensitivity, specificity, and area under receiver operating curve (AUC) for IAN risk assessment were calculated for each imaging modality. ResultsFor IAN injury risk assessment after M3M removal, sensitivity was 0.87 for 3D-AI, 0.89 for CBCT versus 0.73 for PANO. Furthermore, the AUC and specificity values were 0.63 and 0.39 for 3D-AI, 0.58 and 0.28 for CBCT, and 0.57 and 0.41 for PANO, respectively. There was no statistically significant difference (p>0.05) among the imaging modalities for any diagnostic parameters. ConclusionThis within-patient controlled trial study revealed that risk assessment for IAN injury after M3M removal was rather similar for 3D-AI, PANO, and CBCT, with a sensitivity for injury prediction reaching up to 0.87 for 3D-AI and 0.89 for CBCT. Clinical significanceThis within-patient trial is pioneering in exploring the application of 3D AI-driven models for assessing IAN injury risk after M3M removal. The present results indicate that AI-powered 3D models based on CBCT might facilitate IAN risk assessment of M3M removal.

Knowledge and attitude toward oral health behavior of overseas students during the COVID-19 pandemic

BackgroundThe COVID-19 pandemic has impacted overseas students, including their oral health. Due to movement restrictions, limited living allowances, dental treatment costs, and health insurance fees, overseas students might be more concerned about their oral health. The objective of the present study was to determine the association of knowledge and attitude toward oral healthcare behavior of overseas university students staying in Thailand between January 2020 to July 2022 and explore the experiences of their oral health problems.MethodsA cross-sectional study was conducted using an online survey in English operated through the Google platform by convenience sampling among overseas Chulalongkorn University students. A newly developed self-administered questionnaire on knowledge and attitude toward oral health-related behavior and experiences in oral health problems was completed voluntarily. Descriptive statistics, Chi-square test, t-test, ANOVA, and Pearson correlations were employed using IBM SPSS version 29.ResultsOf 311 overseas students, 55.6% were male. The average age of students was 27.5 ± 4.5 years. 68.81% of students were from ASEAN countries, and 73.31% studied in non-health science programs. The study fields, health and non-health sciences, were associated with knowledge score (p < 0.001) and attitude score (p = 0.004), whereas the type of health insurance had an association with behavior score (p = 0.014) and the student’s perspective about dental visits (p = 0.014). Three hundred fifty-nine cases of oral health problems were experienced by 47.3% of overseas students. These problems consisted primarily of tooth hypersensitivity (21.2%), gingivitis (15.3%), caries (14%), cracked or broken tooth (10%), severe toothache (9%), fallen out filling (8%), and wisdom tooth pain (7.8%). There was an association between oral healthcare behavior and oral health problems (p < 0.001), and a negative correlation was found between behavior score and the number of oral health problems (p < 0.001, r=-0.204).ConclusionThe oral healthcare habits of overseas university students correlated positively with knowledge and attitude. A negative correlation was observed between behavior and the number of oral health problems. Furthermore, studying in health science programs impacted students’ knowledge and attitude toward oral health, while dental treatment coverage insurance affected decisions for dental visits.

Using social media-based telemedicine counselling to promote adherence to treatment plans after oral and maxillofacial surgeries in Nigeria

PurposeThis study aimed to determine the impact of telemedicine with WhatsApp on adherence to treatment plans amongst patients who have experienced oral and maxillofacial surgeries like implants, wisdom tooth removal, facial trauma and facial reconstruction.Design/methodology/approachThe researchers used a descriptive survey research design and sampled a total of 294 patients in Nigeria who experienced oral and maxillofacial surgeries 6 months before the study and provided responses that were used for analysis. The questionnaire was used as the instrument for data collection.FindingsThe researchers found that telemedicine for counselling after oral and maxillofacial surgeries have a significant relationship with adherence to the treatment plan. The analysis revealed a significant interactive effect of telemedicine competence F(3,290) 11.423, p = 001 ? p2 = 0.038. The more skilful patients are at telemedicine, the more likely they are to engage in it and vice versa. The participants also preferred a combination of live and recorded interaction forms. It was also found that a combination of different message forms, like audio, text and video, predicts satisfaction with telemedicine.Originality/valueThis study has shown that social media are now playing important roles in health care delivery to patients, and this may continue to expand as societies evolve.