Wisdom Tooth Extraction Research Articles

Prevention of postoperative contracture of the masticatory muscles using a multifunctional gnathic device when removing retinated teeth

Full rehabilitation of patients after atypical extraction of wisdom teeth is not among the priority issues in dentistry, however, the duration and severity of postoperative inflammatory contracture of the masticatory muscles significantly affects the duration of the postoperative period, increasing the patient’s period of disability. Numerous studies indicate the advisability of local effects on tissues in order to improve blood and lymph circulation in the area of inflammation, which enhances the exchange of intercellular fluid and relaxes the masticatory muscles. A method of adaptive myogymnastics for early rehabilitation of patients is proposed and proved the effectiveness of its use.

Wisdom Tooth Extraction Training for Dental Students: Step-by-Step or All-in-One?

Aims/Background For inexperienced dental students, impacted wisdom tooth extraction is a complex procedure involving a series of intricate steps. This study compared the effectiveness of step-by-step and all-in-one teaching methods for dental students learning impacted wisdom tooth extraction, by evaluating their practical abilities, understanding, and learning satisfaction. Methods Fifty dental students were randomly assigned to either a step-by-step teaching group (Group S) or an all-in-one teaching group (Group A) for impacted wisdom tooth extraction training. Their skills were assessed using the Assessment of Competency in Exodontia Skills (ACES) scoring system, and their theoretical knowledge was tested in a test. The students also completed a questionnaire to gauge their satisfaction regarding the teaching method received. Results The students in Group S demonstrated superior performance in clinical procedures compared to Group A, evidenced by the significantly higher ACES scores (p < 0.05). There was no significant difference in theoretical exam scores between the two groups (p > 0.05). The students in Group S reported higher general satisfaction (p < 0.05), suggesting a preference for the step-by-step approach. The results also showed that satisfaction toward hands-on practice and teaching sessions significantly contributed to general satisfaction, while satisfaction with mastery of clinical skills did not. Conclusion The step-by-step teaching method was more effective in improving students' clinical skills and augmenting their satisfaction during impacted wisdom tooth extraction training. Our findings support the use of incremental learning approaches in dental education to enhance both clinical competencies and students' learning experiences.

Estimating the Extraction Time of an Upper Third Molar: Proposal and Validation of Results.

Background: Numerous studies in the literature have aimed to evaluate the difficulty level of removing third molars. However, most of these studies have focused on the lower third molars, which can lead to complications. There is a lack of a method to determine the complexity of upper third molar extraction. Therefore, this study's objective was to develop an equation using multiple linear regression to estimate the extraction time of an upper third molar based on its complexity. Methods: This study involved patients enrolled in the Master of Oral Surgery program at the University of Seville. To determine their relationship with surgical time, the researchers analyzed various factors, such as depth, root morphology, and the need for odontosection. They then validated their findings by studying patients treated at Palmaplanas Hospital in Mallorca. Results: The cohort analysis from the University of Seville revealed significant associations between surgical time and the identified factors. A regression equation design was performed to predict the total duration of surgical intervention for wisdom teeth extraction. This equation incorporates several independent variables, represented by Xi, together with a constant term, C, and the corresponding coefficients, Bi, which weight the impact of each variable on the intervention time. The results are as follows: -0.312 (spatial relationship), 0.651 (depth), -0.443 (bone and mucosa integrity), 0.214 (roots), -0.745 (ostectomy), 0.713 (odontosection), and -0.426 (suture). Upon application of the statistical methodology to the Palmaplanas Hospital cohort, a regression coefficient of 0.770 was determined. This indicates a strong correlation between the input data and the estimated surgical time. Conclusions: In conclusion, the proposed formula demonstrates notable validity in predicting the surgical time required to extract upper third molars.

A Retrospective Analysis of 1311 Oral Surgery Procedures Performed in a Pediatric Hospital in Barcelona: A Study of Their Characteristics and Age-Related Diagnoses.

Background: Oral surgery involves the diagnosis and surgical treatment of diseases affecting the soft and hard tissues of the oral cavity and encompasses a wide range of surgical interventions. The aim of this investigation was to study the characteristics and age-related diagnoses of these oral surgeries, as well as to describe the surgical procedures performed in a pediatric oral and maxillofacial surgery service. Methods: A descriptive, retrospective, observational, and relational study was conducted on children and adolescents aged from 0 to 22 years who were treated in a pediatric oral and maxillofacial surgery service at a children's hospital. Results: We analyzed 1311 surgical interventions (51.4% were on boys and 48.6% on girls), consisting of 24.8% soft tissue surgeries, 65.9% bone and dental tissue surgeries, and 9.3% mixed tissue surgeries. The most common pathologies were tooth eruption disorders (65.9%), followed by ankyloglossia (20.5%). The most frequent treatment was wisdom teeth extraction (31.3%). A statistically significant association (p < 0.05) was found between surgical treatments and variables such as age, sex, tissue type, and biopsy. Conclusions: This study enhances our understanding of pediatric oral surgery, emphasizing that the most common pathology is altered tooth eruption, while the most frequent surgical intervention is the extraction of wisdom teeth at different stages of development.

Necrotizing Fasciitis of Odontogenic Origin in a Patient with Unknown Diabetes Mellitus: A Case Report and Literature Overview

Necrotizing fasciitis (NF) is a life-threatening emergency that requires prompt and aggressive surgery with broad-spectrum antibiotherapy and resuscitation. This report aims to raise the index of suspicion for NF allowing early diagnosis mainly in patients with diabetes mellitus and who received non-steroid-anti-inflammatory. A 52-year-old man, without noticeable illness, was admitted for progressive submandibular swallowing, following wisdom tooth extraction, with extensive cervical redness centred by skin depression. The patient’s chief complaint was a sore throat, trismus and intensive pain leading to self-administration of non-steroid-anti-inflammatory drugs. Laboratory tests revealed an unknown diabetes mellitus. Enhanced Computed Tomography revealed the disappearance of fascial planes and tissular swelling containing multi-space emphysema with an airway compromise. The patient underwent surgical debridement of the involved fascial spaces and necrotic tissues until normal bleeding was obtained combined with intensive resuscitation and 37 inpatient days allowed patient rescue without soft tissue sequelae. Thus, Odontogenic NF should be suspected in patients with diabetes mellitus who have taken non-steroid-anti-inflammatory medication especially when there are discrepancies between signs of toxicity and deceptive clinical symptoms of an odontogenic infection. Computed tomography is crucial for prompt diagnosis, therapeutic management and postoperative assessment. Removal of the odontogenic focus simultaneously combined with thorough surgical debridement with broad-spectrum antibiotherapy and resuscitation improves survival rates and reduces visceral morbidity and soft tissue sequelae. Otherwise, Oral health education and care mainly in high-risk patients remain a key to prevent this serious health problem.

Application of Concentrated Growth Factors in Combination with Bio-Oss for Extraction of Mandibular Proximal Impacted Wisdom Teeth

In this study, we investigate the combined application of concentrated growth factor (CGF) and Bio-Oss (BO) for the treatment of periodontal bone defect (BD) after extraction of impacted wisdom teeth. Firstly, we assess the osteogenic properties of CGF in periodontal ligament stem cells (PDLSCs). The concentration-dependent effect of CGF on enhancing the activity of PDLSCs has been demonstrated. Furthermore, CGF effectively promotes differentiation and enhances the osteogenic function of PDLSCs, leading to improved expression of related osteogenic proteins. Subsequently, a total of 64 patients with loss of alveolar bone in the second molar, who received treatment at our hospital between July 2020 and July 2023, are included. They are randomly divided into a BO group (treated with BO) and a CGF/BO group (treated with CGF+BO). We observe that the combined application of CGF and BO demonstrated superior efficacy in alleviating pain, reducing swelling, and preventing dry socket incidence. In addition, it exhibited enhanced effectiveness in restoring periodontal tissue, including reducing probing depth, gingival depth, and clinical attachment loss. It also displayed better inhibition of gingival inflammatory response and gingival bleeding. Furthermore, it could enhance the restoration of periodontal BD, such as increasing the width of the alveolar bone and root depth, reducing the vertical distance from the apex of the alveolar ridge, as well as improving dental function. Therefore, the combined application of CGF and BO holds great potential in periodontal BD therapy for promoting the regeneration of periodontal bone, thus restoring dental function.

Concomitant Extraction of Wisdom Teeth with Bilateral Sagittal Split Osteotomy (BSSO): A Case Series

Aim: Aim:To investigate the incidence of postoperative complications (including pain, nerve damage, swelling and infection) associated with the concomit an textraction of wisdom teeth at the time of bilateral sagittal split osteotomy procedures. Materials and Methods: A retrospective evaluation of eight patients who underwent concomitant removal of their lower wisdom teeth (either fully erupted, partially or fully bone impacted) at the time of their surgical procedure (Bilateral sagittal split osteotomy with/without LeFort 1 procedure/genioplasty). All patients presented to the Oral and Maxillofacial Surgery Department at Case Western Reserve University. Postoperative complications (including pain, nerve dysfunction, swelling and infection) were examined at regular follow-up appointments after their surgical procedure. Results: A total of eight patients were examined for post operative complications. All patients confirmed the presence of mild pain/discomfort/swelling in the short-term postoperatively.

Immunological Study for Interleukin-5 and GM-CSF for Complications Post-Wisdom Teeth Extraction

Abstract Background: Wisdom teeth extraction is one of the most common operations conducted in dental clinics and the most common duty performed in oral and maxillofacial surgery clinics. Complications from this treatment are common, including dry socket, postoperative discomfort, delayed healing, postoperative infection, hematoma, edema, and trismus. Objectives: The purpose of this study is to quantify the proinflammatory interleukin-5 (IL-5) and granulocyte-macrophage colony-stimulating factor before extraction in saliva by ELIZA technique from patients who visit the clinic to extract wisdom tooth to study its impact on problems following extraction. Materials and Methods: A total of 100 saliva study samples (50 cases and 50 control), 44 males and 56 females, aged 19–65 years, were referred to the surgical clinic, College of Dentistry, University of Babylon specialized dentistry centers, and private clinics in Hillah city, Iraq, to determine the levels of preoperative IL-5 and GM-CSF by ELIZA technique. Results: There were no major differences between females and males in both groups, according to the findings of this study. In comparison to the healthy subjects, however, patients showed higher significant differences in measuring (IL-5) and (GM-CSF) concentrations (366.81 ± 17.8, 12.26 ± 1.3) (P ≤ 0.05) by using the ROC test IL-5 and GM-CSF showed (cutoff 146.42, sensitivity 90%, specificity 82%), (cutoff 4.04, sensitivity 84%, specificity 72%). Conclusion: proinflammatory IL-5 and GM-CSF were shown to be higher in patients with complications following wisdom teeth extraction than it was in control; highly level of IL-5 and GM-CSF may Predict complications following extraction.

Limosilactobacillus reuteri DSM 17938 Inhibition of Biofilm Formation by Prevotella intermedia and Fusobacterium nucleatum Across Salivary pH: An In Vitro Study

Abstract Objectives This study aims to investigate Limosilactobacillus reuteri DSM 17938's antibiofilm effects on Prevotella intermedia and Fusobacterium nucleatum, common causes of alveolar osteitis. It seeks topical alternatives to prevent this condition posttooth extraction. The secondary objective is to assess these effects under different pH conditions (pH 4.5 and pH 7), mimicking oral cavity saliva pH dynamics. Materials and Methods Ethical approval was secured for the saliva collection process involving five healthy adult participants who had undergone wisdom tooth extraction. Saliva samples were diligently collected on the 7th day post-surgery. The unstimulated saliva underwent a series of treatments, including the addition of phenylmethylsulfonyl fluoride (PMSF), pH adjustments, centrifugation, and filtration. The pH levels were re-measured, and subsequent adjustments were made to achieve pH values of 4.5 or 7. Limosilactobacillus reuteri DSM 17938, with a concentration of 1×108 colony-forming units (CFU) per 5 drops, was utilized in the study. Biofilm testing involved incubating saliva samples with varying pH (4.5 or 7) alongside bacterial suspensions (Prevotella intermedia, Fusobacterium nucleatum, or a mixed species). The Interlac suspension was introduced, and plates were anaerobically incubated for 24 hours. Biofilm results were obtained using a spectrometer. The test is conducted in triplicate. Statistical Analysis To scrutinize the impact of pH on biofilm development, the acquired data underwent a two-way ANOVA test in SPSS as part of the statistical analysis. A significance level of p&lt;0.05 was used to determine statistical significance. Results Limosilactobacillus reuteri DSM 17938 significantly reduced biofilm formation across bacterial strains (p = 0.000). Statistical analysis indicated a significant impact of pH on biofilm development (p = 0.000) compared to no saliva samples, with higher formation observed under acidic conditions (pH 4.5). However, the pH levels of 4.5 and 7 did not result in significantly different bacterial biofilm formation (p = 0.529). Conclusion This research highlights Limosilactobacillus reuteri DSM 17938's potency in inhibiting biofilm formation of Prevotella intermedia and Fusobacterium nucleatum. Salivary pH variations significantly influence biofilm development, emphasizing the need to consider pH when assessing probiotic effectiveness. Despite limitations in saliva sample sterilization, this study provides valuable insights into alternative approaches for preventing alveolar osteitis. Further research should explore clinical applications and refine sterilization methods for more accurate results.

Evaluation of a New Simplified Approach for Upper Superficial Impacted Third Molar Extraction-A Retrospective Split-Mouth Study.

A new access technique was developed to reduce postoperative adverse events after the extraction of impacted maxillary wisdom teeth. Hence, this study aimed to assess the occurrence of adverse events after the extraction of maxillary impacted wisdom teeth using a traditional access (TA) or a new technique (NT). Two different surgical incision designs were used for bilateral wisdom tooth extractions in 30 patients. The traditional incision was performed distal to the second molar in the center of the tuberosity, followed by a buccal releasing incision. After the tooth extraction, the wound was secured by sutures. The new technique consists of an oblique incision from the distal palatal aspect of the tuberosity towards the buccal aspect of the second molar. After the tooth extraction, cyanoacrylate glue was used on the wound. Lower pain was reported by patients at the site treated with the new technique (p < 0.01). Edema, postsurgical bleeding, and hematoma were similar in both groups. The surgical time was shorter for the new technique (p < 0.01). The new technique applied for the extraction of impacted maxillary wisdom teeth reduced postsurgical pain and the duration of surgery.

Comparative Analysis of Surgical Techniques for Wisdom Tooth Extraction.

Wisdom tooth extraction often requires various surgical techniques due to differences in tooth position, root morphology, and patient characteristics. This research aims to compare traditional surgical extraction with minimally invasive techniques such as piezo surgery and laser-assisted extraction, as well as extraction with the aid of 3D imaging and navigation systems. Patients requiring wisdom tooth extraction were randomly assigned to one of the surgical technique groups. Preoperative imaging assessed tooth position and root morphology. Intraoperative variables and postoperative outcomes were recorded, including pain levels, swelling, and healing time. Patient-reported outcomes were assessed using standardized questionnaires. Piezo surgery, 3D imaging, and navigation-guided extraction techniques demonstrated a shorter mean duration of surgery and lower incidence of intraoperative complications compared to traditional extraction and laser-assisted extraction. Postoperative outcomes were superior in the 3D imaging and navigation-guided extraction group, with lower pain scores, reduced swelling, and faster healing time. Advanced imaging-guided techniques, particularly 3D imaging and navigation-guided extraction, offer significant benefits for patients undergoing wisdom tooth extraction by improving surgical precision, minimizing complications, and enhancing postoperative outcomes. Incorporating these technologies into routine practice can optimize patient care and outcomes in oral surgery.

Legal Protection of Dentists After Removing Wisdom Teeth Causes Death of Patients in Ngawi East Java

The development of dentistry to serve patients to get comfort and elegant appearance. Wisdom tooth extraction caused death in patients who were talked about in the mass media. The purpose of this study is to provide protection to dentists for handling patients and are protected by a code of medical ethics so that health services can be fulfilled properly. The method used is normative juridical by more specifically reviewing the legal case of wisdom tooth extraction against patients who cause death, analyzing based on legal standards of applicable laws and regulations. Using primary, secondary and tertiary legal data and legal products related to this study. The results of the study explained that the authority of dentists to take action on patients' teeth is part of professional, tidying, reducing the risk of respiratory tract infections and gum disease. Based on article 6 of Law No. 29 of 2004 concerning Medical Practice, it is explained that the Indonesian Medical Council has the role of regulating, ratifying, determining, and coaching doctors and dentists who practice medicine, in order to improve the quality of medical services in accordance with the code of medical ethics and free from accusations of malpractice.

Profile and Prevalence of Oral and Maxillofacial Diseases Among Armed Forces Personnel and Their Families in Military Dental Centre, Cumilla

Background: Oral and maxillofacial diseases encompass a wide range of conditions in and around oral cavity and in maxillofacial region. It includes maxillofacial trauma, cyst and tumour of jaw bones, conditions involving impacted wisdom teeth, oral premalignant and malignant lesions, fascial space infection around maxillofacial region, temporomandibular joint disorder, dental implantology, salivary gland disorder and congenital defects of jaw bones. Maxillofacial region is more vulnerable to sustain injuries in the battlefield. In peace time, various maxillofacial diseases reduce the overall performances of the troops. The aim of this study is to delineate rank wise distribution of armed forces personnel reported with maxillofacial diseases, gender distribution, types of maxillofacial diseases, different types of surgical procedures performed and types of anesthesia used. Methods: A descriptive cross-sectional study was conducted to assess the prevalence of maxillofacial diseases among the armed forces personnel and their entitled family members during the period of 1st January 2019 to 31st December 2019 in Military Dental Centre, Cumilla. Purposive sampling technique and semi structured questionnaire was used to include the patients in this study.Data were analyzed by using Statistical Packages for Social Sciences (SPSS) version 25. Results: A total of 170 cases were evaluated and treated. Male patients were 110(65%) and female were 60(35%). Among the military personnel numbers of sainik (privates) were highest 32(35%). Impacted wisdom teeth cases were mostly found 80(47%). In case of impacted teeth mesio angular impactions were most 35(35%). In case of maxillofacial pathological conditions cystic lesions were most in number 22(39%) (n=56). Maxillofacial soft tissue laceration cases were highest 05(29%) (n=17) among all trauma patients. Surgical extraction of wisdom teeth were mostly performed surgery 80(59%) (n=138). In regards to administration of anesthesia, 128(93%) cases were performed under local anesthesia and 10(7%) were under general anesthesia. Conclusion: The present study imparts valuable perception about the types and prevalence of maxillofacial diseases and the treatment modalities among the armed forces personnel and their families in Cumilla area. Bangladesh Armed Forces Med J Vol 56 No (2) December 2023, pp 24-30

Systematic Analysis of Lower Second Molar Periodontal Health after Autogenous Dentine Graft from Wisdom Tooth Extraction

Introduction: Postoperative complications stemming from lower wisdom tooth extractions are often overshadowed by the immediate need to address pain and existing disease. Nevertheless, an emerging body of evidence suggests the importance of preventing potential periodontal damage to the adjacent second molar resulting from the extraction surgery. To avert periodontal complications involves promoting bone formation within the extracted socket defect. Allogenic and artificial bone, as well as the patient’s bone, have conventionally filled the osseous void post-surgery. These approaches are costly and may extend the patient’s recovery. An Autogenous Dentine Graft (ADG), derived from the recently extracted wisdom tooth, presents, as a particulate with osteoconductive and osteoinductive properties, is ideal for preserving bone integrity. This review assesses the available evidence supporting the use of ADG in safeguarding against periodontal morbidity resulting from the surgical extraction of a lower third molar. Materials and methods: A systematic review of the literature was conducted, focusing on the periodontal health of the second molar and the bone height of the osseous defect postwisdom tooth extraction. Out of 76 identified articles, four studies were selected for the review. Results: Three months post-surgery, the mean periodontal probing depth distal to the second molar was 4.7mm in control sites and 2.83mm in sites treated with ADG. Over 12 months, the mean bone height exhibited a negative loss of 1.25mm in control sites and a positive gain of 0.9mm in sites treated with ADG. Conclusion: Presently, there is insufficient evidence to unequivocally support the use of an autogenous dentine graft following the surgical extraction of a wisdom tooth. However, early results are promising, and given the biocompatibility of a material derived from the patient, ADG is considered a safe option for patients at high risk of an osseous defect. Further research is needed to substantiate these findings and guide clinical decision-making.

Impact of three types of music on patients during dental implant surgery and wisdom tooth extractions

Relevance. Many patients suffer from anxiety when planning a surgical procedure, which leads them to either postpone it or go through it with all those negative feelings that may affect the course of the surgical work or even its outcomes. Modern medicine aims to find non-pharmaceutical ways, such as music, to put these emotions under control so that the patient feels a sense of calm and tranquility throughout the surgical operation and comes out with less negative feelings and good memories, which prevents the formation of any psychological trauma. Our investigation aims to study the effect of three types of music, on the psychological state of the patient during surgery, by evaluating the data of systolic and diastolic pressure, pulse, and oxygen level in the blood. Materials and Methods . 36 patients who visited the Medical Center of the RUDN University on a daily basis for dental implants and wisdom tooth extractions were randomly selected to undergo the experiment. They were divided into four groups, the first was the control group which was not exposed to music, the second was exposed to classical music, the third was exposed to Buddhism music, and the fourth was exposed to music generated by Artificial Intelligence. Pressure, pulse, and oxygen level were recorded in three phases and changes assessed using Student’s t-test and Mann-Whitney U analyses. Results and Discussion. The final results obtained did not show any significant changes in the values of pressure, pulse, and blood oxygenation during the period of exposure to music when compared with control group. Conclusion. Exposing to music didn’t show any positive effect on stress levels during dental implantation and extraction.

Infective endocarditis following wisdom tooth extraction in a pro-fessional basketball player with bicuspid aortic valve

Infective endocarditis following wisdom tooth extraction in a pro-fessional basketball player with bicuspid aortic valve

Evaluation of Different Drugs for Prevention of Dry Socket after Extraction of Lower Wisdom Teeth

Dry socket is one of the most common complications of tooth extraction especially after lower wisdom tooth removal. Many drugs have been used to decrease the incidence of this complication. The purpose of this study was to evaluate different drugs in prevention of dry socket. In this study 150 patients needs removal of lower wisdom tooth were included. The patients divided into five equal groups were and each group received different type of drug postoperatively. The patients were evaluated for the presence of dry socket in the 2nd, 5th, and 7th day after tooth extraction. The females were affected more than males in this study with 2.1: 1 rat io. The incidence of dry socket in the total number of the patients was 17.3%. The analysis of the data showed no significant relations between the five groups as the P value was &gt; 0.05.The use of different drugs postoperative in this study showed no differences in the incidence of dry socket which high lighten the use of preventive measures to decrease the occurrences of such condition.

Effectiveness of virtual reality in relieving anxiety and controlling hemodynamics during oral surgery under local anesthesia: A prospective randomized comparative study

It was the aim of the study to evaluate the contribution of a relaxing immersive experience with virtual reality (VR) goggles in reducing patient anxiety related to wisdom tooth extraction under local anesthesia.A prospective randomized comparative study in consecutive patients scheduled for bilateral wisdom tooth extraction under local anesthesia was carried out between March and December 2022. Both sides were operated upon in the same surgery, but on one side VR goggles were applied (VR), while on the other they were not (noVR). Anxiety was evaluated both subjectively (State-Trait Anxiety Inventory [STAI] and visual analogue scale [VAS]) and objectively (measuring heart rate, blood pressure [BP] and blood oxygen saturation) before (T1) and after each surgical step (T2VR and T2noVR).The study sample consisted of 27 patients: 9 men and 18 women, with an average age of 25.8 ± 6.5 years (range: 18–43). Anxiety as assessed by the STAI and VAS decreased from T1 to T2 (p < 0.001 and p < 0.001, respectively), although to a similar degree regardless of whether VR was used or not. Heart rate showed significant differences influenced by RV exposure (p = 0.013): it increased +2.5 ± 8.8 bpm in the control group and decreased −2.22 ± 7.55 bpm with VR (p = 0.013). Both minimum and maximum BP after surgery were significantly higher in the noVR group (p = 0.002 and p = 0.040, respectively). Regarding minimum BP, VR proved more effective among male patients (p = 0.057) and on starting the procedure using VR (p = 0.055).The results provided evidence of meaningful control of the hemodynamic variables, but less predictable performance in the subjective evaluation of anxiety.

Autologous blood concentrates application for post-extractional wound healing after impacted inferior wisdom tooth removal

Wisdom teeth extraction is the most common OMF surgical intervention. After the surgery, there might emerge some complications that persist even if all the indications recommended by the doctor were followed. Purpose: To settle, based on a prospective case–control research, the performance of platelet–rich fibrin, introduced as A–PRF into the socket, on clinical development after wisdom teeth removal. Materials and methods: 24 patients aged between 22 and 46 years old, with an mean age of 28,38±7,06, participated in this research. All of them had their impacted lower wisdom teeth extracted, assessed according to the Modified Parent Scale with extraction difficulty index III. The patients were divided into two groups, each with 12 patients: Case — patients who had A–PRF plugs introduced into the socket and Control — patients undergoing conventional treatment. The patients were examined after the surgery on day 1, 3, 7, 10 where three variables were analyzed — pain, based on the Numerical Pain Rating Scale, edema, according to the Laskin method and regeneration with the Landry index. Results and discussion: Patients in the experimental group presented a lower pain index, none of which reported severe pain. In the control group, one patient reported severe pain on the first postoperative day. Regeneration of the oral mucosa clinically was faster and without complications, compared to the control group, in which 2 patients presented post–extraction bleeding on the next day of the surgery. No significant differences were observed between the groups in the clinical appearance of facial edema. Conclusions: Fibrin clots introduced into the socket reduced the risk of post–extractional bleeding with positive signs of faster surgical wound healing, with less pain for patients in the experimental group compared to those in the control group, but studies in larger groups of patients are necessary due to the relatively small number of patients included in this study.

Analysis of the anatomical relationship between the roots of three lower molars with the lingual bone plate and the mandibular canal using cone beam computed tomography

Odontectomy of the inferior wisdom teeth is considered to be one of the most frequently performed dental surgeries. It is certain that in order to prevent possible complications, the oral surgeon must have extensive knowledge regarding the anatomy of the region, possible intra– and postoperative risks, as well as treatment methods that would minimize the occurrence of complications. Of course, a key aspect in choosing the treatment technique and method is represented by the paraclinical investigations, and currently CBCT is considered to be the “golden” standard in visualizing the relationship of the third inferior molars to the neighboring anatomical structures, a fact that significantly contributes to the optimization the provision of dental surgical assistance. The purpose of this study was to reveal the role of the CBCT paraclinical radiological examination in the pre–surgical evaluation of the anatomical relationships of the roots of the lower third molars with the neighboring anatomical elements for the prophylaxis of postextractional complications. Material and methods. The prospective clinical study was based on the visualization of tomographic sections of 116 CBCTs, with a total of 160 inferior wisdom teeth, analyzing various study variables such as the relationship of the inferior wisdom teeth roots to the mandibular canal, to the lingual bony plate, root morphology, etc., with their subsequent statistical analysis. Results and discussion. The extraction of the lower wisdom teeth can be associated with the occurrence of various complications such as the association of postoperative infection, dislodging the teeth into the neighboring spaces, nerve damage. It is important to use preoperatively both the predictability scale of the difficulty of extraction of inferior third molar and the three–dimensional paraclinical investigations in order to plan a treatment plan involving low risks of intra– and postoperative complications. Conclusions. The use of three–dimensional paraclinical investigations such as CBCT are absolutely necessary both for visualizing the relationship between anatomical structures and for planning complex clinical cases.