Impacted Wisdom Teeth Research Articles

Maxillary sinus involvement of maxillary third molars: An OPG study conducted at Dow International Dental College, Karachi.

Objective: This study aims to evaluate the angulation, position, and impaction of the maxillary third molar and its proximity and relationship to the maxillary sinus assessed through dental OPGs. Study Design: Cross-sectional Analytical study. Setting: Department of Oral Surgery, Dow International Dental College, Dow University of Health Sciences. Period: November 2019 to February 2020. Material & Methods: Through convenience sampling, 1684 Orthopantograms were collected. Out of which 864 OPGs were selected and included in this study. From these OPGs, 1228 maxillary third molars were evaluated for their proximity to the floor of the maxillary sinus. Results: Most common relation of the maxillary sinus with third molar roots was in class II which is 0-2mm bone presenting between the root and the sinus unanimously between both genders. Most of the roots of maxillary third molars present within the maxillary sinus were found within the second and third decade of life in both genders. Conclusion: Dental OPGs present a cost-effective viable alternative to CBCT in the treatment planning of impacted maxillary upper incisors in combination with other radiographs. The findings of this study further strengthen the proposal of using dental OPGs in the diagnostic repertoire of impacted wisdom teeth in low resource settings.

Prevalence of Developmental Dental Anomalies in A Sample of Adult Libyan Patients: Orthopantomographic Study

Objectives: This research was aimed to investigate the prevalence of dental anomalies among a selected adult Libyan sample using panoramic radiographs.
 Materials and Methods: Retrospective study of digital panoramic radiographs of (412) Libyan adult patients of both sexes (males and females). The data was collected from different Clinics in Benghazi district over six months period of time. The radiographs were studied on a computer screen to find out the developmental dental anomalies. Descriptive statistics and bivariate analysis by age and gender were conducted using SPSS software.
 Results: A total of 412 panorama radiographs were used in the data analysis. The majority were females (273, 66%), aged between 18 and 70 years old. The most common type of dental anomalies was dilaceration (130,31.6%), followed by impaction of wisdom teeth (66, 16%) and impaction of other teeth (23, 5.6%). A few cases of other anomalies were reported; these included one case of odontome, ectopic eruption of left upper 8 and one mesiodens. 
 Conclusions: Dilaceration and impaction were the most common types of developmental dental anomalies among study population, with rare cases of supernumerary teeth and odontome. Multiple anomalies are common in the present study, suggestion genetic origin. The study showed that the prevalence of dental anomalies increases with the age of participants.

Photobiomodulation after Surgical Extraction of the Lower Third Molars: A Narrative Review

The surgical extraction of the lower third molar is widely practiced in oral surgery. Inflammatory complications such as pain, swelling, and trismus can cause discomfort to the patients after third molar extraction. Several methods have been used to reduce these postoperative sequelae, including the use of corticosteroids, nonsteroidal anti-inflammatory drugs, analgesics, antibiotics, less traumatic surgical methods, and the use of photobiomodulation. This narrative review summarizes the current evidence on the effect of photobiomodulation on pain, facial swelling and trismus after third molar surgery. A literature search using MEDLINE (NCBI PubMed and PMC), EMBASE, Scopus, Cochrane library, Web of Science, and Google Scholar was undertaken up to October 2021. Forty-one articles met the inclusion criteria. Photobiomodulation can be considered an alternative and useful method for controlling pain following impacted wisdom tooth surgery. The effectiveness of PBM in reducing swelling and trismus is still controversial. This review highlights the lack of consensus in the literature on protocols used in PBM therapy.

Expert System to Diagnose Dental Impaction Disease using Certainty Factor Method

The impaction of a tooth or pent-up tooth is the condition of a tooth trapped inside the gums. In most case, dental impact occurs in the wisdom teeth of adults. Dental impaction makes a person more susceptible to tooth decay and gum disease But the number of people who are lay about dental impaction disease, it is necessary to have a system that can be accessed online to help patients or the public to be able to consult independently. This expert system is designed using the PHP Programming Language and MySQL Databse.

Intra-socket application of Hyaluronic acid reduces pain and swelling following wisdom teeth removal

Background:Hyaluronic acid (HA) has the potential to promote wound healing. Pain and swelling with trismus are common sequalae post wisdom teeth removal. This study aims to investigate the effectiveness of intra-socket HA solution to reduce these uncomfortable post-operative events.Materials and methods:30 patients underwent bilateral extractions of mandibular wisdom teeth for this study. Intra-socket application of 0.7 ml 20 mg/2 ml HA solution (Hyalgun) with Gel foam as a scaffold in study site versus Gel foam only on control site was conducted via a split mouth study design. Data collection of five facial reference points for swelling and maximum mouth opening was recorded during the pre-operative period and post-operative 2nd and 7th day. The VAS pain score at post-op 1st, 2nd and 3rd day and the number of analgesics for the 7-day post-operative duration were evaluated.Results:The HA group demonstrated statistically significant less swelling, trismus and analgesia consumption on the 2 and 7 days after surgery. VAS scores on day 1, 2 and 3 after surgery (P = 0.05) were significantly less in the HA group compared to the control group.Conclusion:The application of intra-socket HA has a positive effect for reducing postoperative pain and swelling with trismus after the lower third molar intervention (LTMI).

Translation and Validation of the Dental Impact Daily Living Oral Health-related Quality of Life Questionnaire in Indonesia.

ABSTRACTObjective:The need to assess oral health-related quality of life (OHRQoL) has grown increasingly in the healthcare sector over the past few decades. The Dental Impact on Daily Living (DIDL) assessment is a tool created to measure OHRQoL. The aim of this study was to complete a cross-cultural adaptation of the DIDL to yield a valid and reliable Indonesian version for use as an official instrument to assist in further OHRQoL research in Indonesia.Materials and Methods:The original English version of the DIDL was translated and validated. Content validity and face validity were considered. Psychometric testing for test–retest reliability was analyzed among 32 subjects, while internal consistency using Cronbach’s alpha and clinical oral health status using the DMF-T index to obtain convergent validity of the questionnaire were checked among 278 subjects.Results:The study subjects showed a good understanding of how to complete the Indonesian language version of the DIDL questionnaire, and conceptual and semantic equivalence (content and face validity) were noted. Further, test–retest reliability was noted (intraclass correlation coefficient range: 0.975–1 and Cronbach’s alpha: 0.942), whereas convergent validity suggested a correlation between DMF-T and DIDL questionnaire of −0.502 with significance at alpha of 5% (P = 0.00), which means that decreasing the DMF-T outcome will increase the satisfaction using the DIDL among research subjects.Conclusion:Cross-cultural adaptation of the DIDL yielded a valid and reliable Indonesian version. The DIDL questionnaire is a promising questionnaire that can be applied to measure OHRQoL in Indonesians.

Validation of Early Childhood Dental Anxiety Impact Scale among 3-5 Year Old Preschool Children in Chennai City

Background: The early childhood dental anxiety impact scale (EC-DAIS) has been developed for assessing dental anxiety related quality of life ( DAR-QoL ) in pre-school children, which is then validated in the English language to confirm with their geographic locations.Aim: The present study was undertaken to assess the validity of the English version among 3-5 year old pre-school children of Chennai city.Methodology: The English version of EC-DAIS was developed. It was tested for validity and reliability among 469 parents and children after obtaining informed consent and assent. Statistical Analysis : Construct validity was assessed by correlating EC-DAIS with FBRS-Frankl’s Behavior Rating Scale. Internal consistency or reliability was determined by Cronbach’s alpha. Testretest reliability by ICC assessment was done and outcomes were measured.Results: Construct validity was r=0.298.Reliability using Cronbach’s alpha was 0.873. Test-retest reliability by Intra Class Correlation assessment was 0.91.Conclusion: The English version of EC-DAIS is a valid instrument for assessing Dental Anxiety Related-Quality of Life (DAR-QoL) in pre-school children.

Potentially harmful materials in the feces of wild ring-tailed coatis (Nasua nasua) and health implications

ABSTRACT: In ecological parks, the proximity to tourist activities facilitates the exploration of garbage by coatis, with possible serious consequences for the animals health . We described the contents of wild coatis feces from three ecological parks. After analyzing 62 samples, fragments of plants and animals were identified in all feces. In the feces of two parks, seeds were present between 36.4% and 48.6% of the samples. Arthropod fragments were identified in 100% of the samples from two parks, but only 87.3% in a third park. Scales, bones or bird feathers were present in some samples. Undigested material of industrial origin was detected in 34.3% to 54.5% of the samples, such as fragments of paper, string, plastic, aluminum, latex and glass. Results are in line with other studies on the diet of wild coatis, but the intake of foreign bodies, potentially harmful to health, is described for the first time. Clinical problems resulting from ingesting waste can be dental fractures, mucosal erosions, intestinal perforation, peritonitis, impaction, diarrhea, weight loss, intoxication and infections. Coatis in the three parks are at risk of health, and actions are needed to avoid clinical and potentially fatal problems. Four actions are recommended to avoid ingesting foreign bodies: increasing the environmental education of visitors; improving the storage of waste generated in parks; periodically monitor the health of coatis, in order to make interventions when possible; make a permanent program to study the ecology of species in the three parks.

Evaluation of alkaline phosphatase as a biomarker in the healing progression following tooth extraction

Objective: The progression of a healing socket following an extraction is usually analysed through clinicalexamination and radiographic investigation. Whilst soft tissue healing is usually maintained well, healingprogression of hard tissue is more challenging to predict and manage, with issues such as a dry socket or malunionof the underlying bone. Serum biomarkers for bone healing progression, such as alkaline phosphatase(ALP), could prove helpful as a diagnostic tool for early intervention. Material and Methods: Twenty healthy18-30-year-old individuals who were to extract lower impacted wisdom teeth were included. 2ml of blood wascollected before treatment, 48 hours after then following samples were collected 1 month, 2 months and 3 monthsafter the procedure. Intra-oral radiographs were taken at the end of the three months. Results: There was asignificant correlation elicited with the healing and ALP levels at 1,2 & 3 months’ time intervals (p<0.05), where17 patients who had a substantial increase in the levels of ALP also had satisfactory healing after three months.Three individuals who did not show any increase in ALP level did not have satisfactory healing. Conclusion:ALP is a useful supplementary biomarker for bone healing. KEYWORDSAlkaline phosphatase; Tooth extraction; Bone healing; Oral surgery.

Tek Doz Preemptif İntravenöz Deksketoprofen Trometamol ve İbuprofen'in Üçüncü Molar Cerrahisi Sonrası Ağrı ve Ödem Kontrolü Üzerine Etkileri: Prospektif, Randomize, Çift Kör ve Klinik Bir Çalışma

Objective: This comparative study aims to investigate the single-dose preemptive effects of intravenous (IV) dexketoprofen trometamol, ibuprofen for pain and edema control in mandibular wisdom teeth surgery. Material and Methods: In this study, 75 patients were randomly divided into 3 groups. Group 1 received IV ibuprofen 60 min before surgery; Group 2 received IV dexketoprofen trometamol 60 min before surgery; Group 3 received IV placebo (100 cc saline) 60 min before surgery. The pain and facial swelling were evaluated. Postoperative pain was recorded with a Visual Analog Scale (VAS) during 24 h. The total recovery acetaminophen intake dose was recorded in the first 24 h. Also, a 3D surface imaging device was used in the evaluation of swelling. Results: There was no statistically significant difference in the pain between the ibuprofen and dexketoprofen groups. There was a statistically significant difference in the edema on the 2nd day (T1) between the ibuprofen and dexketoprofen group (p=0.010). On the 2nd day edema, the amount of edema observed in the ibuprofen group was recorded as the least. Postoperative edema and pain were higher in the placebo group than in the other groups (p<0.05). Conclusion: The findings obtained in this study suggest that the preemptive application of IV ibuprofen and dexketoprofen is effective in the control of edema and pain compared to the placebo group after third molar surgery.

Practical lessons from a general dentist of more than 50 years private practice plus 2 years of United States Air Force practice

Having practiced over 54 years the art and science of general dentistry, many changes in philosophy and performance have occurred. Some are minor while others very major. This series of observations will treat some in detail while others very briefly. The physical locations have been in the Dallas, Texas area of the USA. Definitions of terms set the stage for discussion of the basis of dentistry. Support for the scientific as well as evidence-based approaches is laid forth. Filling materials have transitioned from amalgam to composite being most prevalent. Fluoride added to local water supplies has decreased the number of decayed/sensitive teeth, the timing of initial decay, and the prognosis for remediation. pH is a major player in the deterioration of tooth structure. New understandings of tooth brushing and oral hygiene have significantly improved the future for continuing dental health. Absence of fluoride in bottled water has taken a front-center stage for helping/hurting chances of keeping teeth free of decay. Fluoride varnishes have widespread acceptance in America. Failure to seek routine dental care has influenced the outcomes for many younger patients, especially those who have graduated high school, gone off to college or into the workforce. Such lack of routine preventive influence raises the costs of care when it is received, often leading to complaints from patients about the high costs of repair. The alternative is prevention with ongoing consistent 6-month recalls/repairs when problems initiate, rather than allowing problems of long duration. The USA dental insurance industry adverse impact on practicing dentists is a vital monologue. Revealing the dental insurance industry as a number one concern of many surveys of practicing dentists is a way of preparing international countries for learning from the flawed USA models. Recent Congressional law, HR 1418, the Competitive Health Insurance Reform Act, will address some of the most critical wrongs by placing the dental insurance industry into antitrust restraints. Current concerns about digital X-ray’s diagnostic potential are revealed. Conservative dentistry is promoted. Results of conservative practice from nearly 50 years are documented with photos and X-rays. Bonded bridge technology is highlighted for its valued impact.

A review: Inferior alveolar nerve injury related to the impacted wisdom tooth

AbstractExtraction of the impacted wisdom teeth, especially the difficult ones, might lead to postoperative complications, such as pain, swelling, alveolar osteitis, and inferior alveolar nerve injury. Injury of the inferior alveolar nerve is a relatively severe symptom, which could impact patients’ life. It could cause emotional problems, socialising problems, even legal action. Hence, there is very important to assess the therapeutic process with multi‐perspective views. This article systematically reviews the anatomic and iatrogenic factors related to the inferior alveolar nerve injury, introduces the outcomes and treatments, and proposes problem‐solving methods and prospects.

Nasolacrimal duct disease secondary to an unerupted tooth in a dog

AbstractA 5‐year‐old male neutered Lurcher was evaluated for left‐sided epiphora of 4 months’ duration and persistence following topical treatment and nasolacrimal duct irrigation. Physical examination revealed a missing left maxillary canine tooth, and CT dacryocystorhinography showed extrinsic compression of the left lacrimal duct and adjacent nasal turbinates caused by an impacted maxillary canine tooth. Further irrigation was successful in clearing debris from the nasolacrimal duct and temporarily relieving the patient of epiphora; however, surgical extraction of the tooth and radiographic monitoring was declined by the owner. Ophthalmic disorders may be secondary to overlooked dental conditions. This case describes the importance of inspecting the oral cavity as part of a general physical examination when presented with ocular signs, as well as assessing impacted teeth for evidence of pathology, and being aware of sequelae to dental impaction when advising clients on case management.

New bone conservation technology of impacted teeth extraction

AbstractObjectTo introduce an impacted wisdom tooth extraction method based on the new concept of bone preservation.MethodsAbout 60 cases with impacted mandibular third molars in our clinic were reviewed from January to March 2021. Two senior attending doctors were selected to perform the extraction operations. Two different techniques were used to extract the impacted third molar. The duration of the operation time, the postoperative swelling scaling and the pain scaling were reviewed.Research resultsThere was no significant difference between the two groups in operation time, the postoperative swelling scaling and the pain scaling. Both methods can remove wisdom teeth, and clinicians should choose less invasive methods.ConclusionThe extraction of impacted teeth should be improved with more precision and less trauma.

Management of third molars—Impacted wisdom tooth indications, complications and new evolution

Management of third molars—Impacted wisdom tooth indications, complications and new evolution

Prosthetic aftercare, mastication, and quality of life in mandibular overdenture wearers with narrow implants: A 3-year cohort study

ObjectivesThis cohort study investigated clinical, functional, and quality of life outcomes, along with prosthetic maintenance events in mandibular overdenture (MO) wearers for 3 years. MethodsThirty MO wearers with narrow diameter implants (NDIs) and locking taper stud abutments (Facility-Equator system) were annually monitored by registering the visible plaque index (VPI), peri‑implant inflammation (PI), calculus presence (CP), probing depth (PD), bleeding on probing (BOP), secondary implant stability (ISQ), marginal bone loss (MBL), masticatory performance and dental impact in daily life (DIDL) questionnaire domains. Multilevel mixed-effects linear regression was performed to analyse changes over time. Chi-square tests were performed to analyse the relationship between the appearance of prosthetic complications and maintenance occurrences. The survival rate of patients with NDIs was calculated using the Kaplan–Meier test. ResultsTwenty-six individuals attended all follow-ups, the survival rate of 83.3% in the first year was maintained, and no one implant was lost over the 3-year period. There were significant differences for PD between 1 and 3 years (p ≤ 0.01) and between 2 and 3 years for PI (p ≤ 0.01), GI (p ≤ 0.01), ISQ (p = 0.02), and MBL (p ≤ 0.01). All masticatory performance outcomes showed significant differences (p ≤.01). Prosthetic maintenance events decreased significantly over time. Appearance, general performance, and eating and chewing domains presented high effect sizes. ConclusionContinued changes were observed in the clinical parameters of MO users over the 3-year period. In addition, most functional parameters, except for particle homogenization, improved significantly over time. The positive impact on quality of life is likely related to the significant reduction in prosthetic maintenance events. Clinical significancePeriodic returns to assess peri‑implant tissues and MO maintenance should be performed to ensure the success of rehabilitation to assure improvements in masticatory function and oral health-related quality of life.

Risk indicators of operculitis.

The aim of this study was to illustrate the features of tooth number 38 and 48 having acute operculitis employing clinical parameters and radiological distinctiveness. Fifty subjects of both genders in the age range of 19-36 years with a diagnosis of acute operculitis comprised the group for study. After thorough clinical examination, uniform orthopantomograms (Rotograph 230 eur, Villa Sistemi Medicali, Buccinasco, Milan, Italy) for each of the individual subject participating in the study was made. Four parameters were evaluated as plausible prognostic factors for the progression of acute operculitis. The χ2 test was used to foretell the role of individual factors studied in the progression of acute operculitis. Significance was set at P less than 0.05. For all statistical analysis, the SPSS (version 16; SPSS Inc., Chicago, IL, USA) software was used. Based on the assessment of the parameters investigated in this study, most likely to be among the essential determinants of acute pericoronitis are vertical angulations, part (50%) encapsulation, eruption point underneath the occlusal plane and existence of an encroaching opposing 28 and 18. Prophylactic extractions may thus be recommended in such cases, as a delay may result in grave complications. All patients with impacted wisdom teeth should be evaluated and the treatment planned must be based on their individual presentation.

Salivary Alpha-Amylase and Calcium levels Evaluation as a Biomarker in Stress Patients Undergoing Surgical Wisdom Tooth Extraction

The salivary enzyme alpha-amylase has been proposed as a biomarker for stress-induced activity of the sympathetic nervous system. In the growing field of amylase research, recent studies have underscored the usefulness of salivary alpha-amylase in this regard. Calcium is the major component of bones and teeth, and it is not surprising that disturbances in calcium metabolism have been implicated in most of the major chronic diseases, including renal disease, osteoporosis; and periodontal tissues.Twenty healthy Iraqi male undergo wisdom tooth extraction from undergraduates dental students were considered in this study with age mean of 22 years old, 2 ml samples of stimulated saliva were collected prior ten mints of surgical wisdom tooth removal, and recollected after one week fromsurgery from these students, the samples were analyzed to assess changes in ∝-amylase and calcium ion concentration under controlled conditions. The collected data predicted elevation of amylase level from ((7652.965 ±34.0410) to (7674.710 ± 68.8958) IU/L) with a significant change. And also increase in the calcium ion concentration level from (0.1465 ± 0.048) to reach level (0.1975± 0.100) mmol/L. Positive correlation were recorded between alpha amylase and calcium concentration when plotted the correlations values of stress and no stress individual's. In a conclusion. Acute stresscaused by wisdom tooth removal will elevate level of amylase in saliva significantly, howeverSignificant increasing in calcium concentration was observed in the stimulated saliva in comparison with the non-stimulated saliva with significant mean changes. However, our result predicted elevated levels of calcium concentration of the stimulated saliva than the non-stimulated (after extraction).

Effect of Intraoral Drainage after Impacted Mandibular Third Molar Extraction on Non-Infectious Postoperative Complications.

Surgical removal of mandibular third molars is associated with non-infectious postoperative complications, including pain, swelling, trismus. Intraoral drains are noteworthy because of their ease of application, availability, and effectiveness. This study aimed to evaluate the use of latex and calcium–sodium alginate mouth flat drains on the severity of postoperative complications such as pain, trismus, and edema after surgical removal of mandibular third molars. Ninety patients who underwent surgical removal of wisdom teeth were studied. The patients were divided into three groups. Group A—with a latex flat drain, group B—with a sodium–calcium alginate (Kaltostat) flat drain, and group C—with a wound closed with knotted sutures. Patients were assessed for pain on a VAS scale every day from surgery to postoperative day 7. Before the procedure and on postoperative days 1, 2, and 7, the pain level, edema, and trismus were measured, respectively. Intraoral drainage with a flat drain after mandibular third molar removal does not significantly reduce pain, as measured by the VAS scale, or postoperative swelling, as measured by lines between craniometric points. Intraoral drainage with a latex drain after mandibular third molar removal does not significantly reduce trismus, while intraoral drainage with a calcium–sodium alginate drainage bag significantly increases trismus.

270 A Retrospective Analysis of The Impaction Status of Mandibular Third Molars as A Risk Factor for Fractures of Angle or Condylar Region of The Mandible

Abstract Background the position and angulation of mandibular third molars have both been found to influence the angle and condylar fractures. Objective: To identify whether there is an association between the depth and angulation of third molar impaction and the relative risk of fracture of the mandibular angle and condyle. Method Four-hundred and eighty-two panoramic dental radiographs were assessed for the period from January 2012 to June 2020. The study variables included the presence of mandibular third molars, position and angulation. The outcome variables were angle and condylar fractures. Results the mean age was 28.5 years (range 15-89) and 93.2% (n = 499) were male. Angle fractures were significantly more frequent with an impacted wisdom tooth (M3) ( p = 0.023) whereas condylar fractures were more commonly associated with a fully erupted M3. The highest incidence of angle fractures was observed with wisdom teeth classified as class II ( p = 0.026) and position B ( p = 0.05). In contrast, class I wisdom molars were more frequently associated with condylar fractures. With regards to the angulation of wisdom teeth, angles between 80 o – 100 o were highly correlated with angle fractures ( p = 0.020) whereas M3 angulations of 60 o – 80 o were related to condylar injuries (p = 0.025). Conclusions fractures of the mandibular angle were significantly associated with Class II and position B wisdom teeth whereas class I third molars were associated with fracture of the condyles. The likelihood of angle and condylar fractures almost doubled when M3 angulations were (80-100) and (60-80) respectively.