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.

Coronectomy of the wisdom teeth: the dental extraction alternative

Background. Coronectomy of the wisdom teeth is an alternative surgical procedure to tooth extraction, which aims to preserve the roots of the wisdom teeth in the dental socket after surgical separation of the crown, in order to avoid the injury of the inferior alveolar vascular-nervous bundle. Purpose. Minimizing the damage to the inferior alveolar nerve when extracting lower third molars caused by the intimate relationship between the nerve and the roots of the teeth, by using the technique of coronectomy, or intentional root retention. Material and Methods. Patients who reported to University Dental clinic during the period 2020–2021 for surgical removal of impacted L3M were screened for nerve–root relationship with OPG or CBCT. 15 patients underwent coronectomy as a procedure to remove the crown and upper third of the roots of a lower third molar to reduce the risk of damage to the inferior alveolar nerve. Results. 15 patients were enrolled in this study, with a total of 17 lower third molars. Sixteen sites healed primarily, but in 1 case the sockets on both sides opened and failed to close secondarily. In this case, the root fragments were later removed and found to be mobile. Conclusion. Coronectomies are safer to perform than complete extractions in situations in which the third molar is in close proximity to the mandibular canal. The technique appears to be associated with a low incidence of complications and the removal of remaining roots is required in around 6-7% of cases due to the mesial migration of the fragment and not any symptoms or reinfection.

Estimation of time utilized in suturing of oral flaps post-surgical wisdom teeth removal using Negus knot pusher instrument (a comparative study)

Wisdom teeth were the most common teeth affected among the rest of the teeth, these teeth need accurate evaluation and diagnosis, surgical removal of impacted wisdom needs time for incision, bone removal and suture, so the use of any instrument helps to reduce this time is essential. Objective The objectives of this study were to estimate the time needed for the suture of oral flaps post-surgical removal of the lower wisdom teeth by using Negus knot pusher and compare it with the time used for stitching in conventional manual holding single stitching. Material and Methods: Data had been collected from thirty patients through history, clinical examination and radiographic assessment, followed by classical surgical removal performed on the same principles for all patients, at the suture level patients divided arbitrarily into two groups, control group 15 patients and 15 patients Negus pusher group, using Negus knot pusher, which is usually used to hold the stitch and stop bleeding post tonsillectomy operations by ligation, time elapsed for suturing with knot tying is calculated for both groups. Results: Among the 30 patients incorporated in the clinical study, control group mean was (1 minutes and 11 seconds and 70 milliseconds) while for the pusher group was (1 minutes and 32 seconds and 57 milliseconds), the comparison by means of T-test was not significant with the (0.424) value. Conclusion: the Negus pusher instrument can be used for the knotting stiches post wisdom teeth removal as an auxiliary tool and the time can be shortened by the use of a modified handling technique and more satisfaction for patients. Keywords Time; Suturing; Wisdom teeth; Negus knot pusher.

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

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.

Assessment of Electrosensitivity of the Pulp of the Mandibular Second Molar after Surgical Removal of an Impacted Mandibular Third Molar

Despite the frequent discussion of complications associated with surgical removal of wisdom teeth in the scientific literature, increased mobility of the second molar, which can affect the clinical status of the pulp, is often downplayed or overlooked. This study aimed to evaluate surgical removal of an impacted third molar on the change in the electrosensitivity of the pulp of the mandibular second molar. Sixty patients consecutively presenting to the Department of Oral Surgery to remove an impacted mandibular third molar were included in the study. Clinical examinations of pulp sensitivity of second molars in both the study and control groups were evaluated before the procedure, seven days after the procedure, and eight weeks after the procedure. The surgical removal of an impacted mandibular third molar significantly affected the pulp sensitivity of the second molar.

EVALUATION OF LOWER WISDOM TEETH SURGERY RESULTS AT THAI BINH MEDICAL UNIVERSITY HOSPITAL

Objective: Evaluation of lower wisdom teeth surgery results at Thai Binh Medical University Hospital.Subjects and methods: Progressive study on 143 subjects with lower wisdom teeth surgery at Thai Binh Medical University Hospital from November 2019 to June 2020.Results: Parant type II surgery accounted for the highest rate 44.76%. Surgery time from 30-60 minutes accounts for the majority of 48.25%. In the process of surgery, the most common accident isfracture/rupture of the bone in the lower wisdom teeth accounting for 57.34%, root fracture accounts for 11.89%, a case of mild late anesthetic allergy is recorded. Long-term bleeding complicationsaccounted for 11.19%; dry alveolar acupressure and wet alveolar acupressure accounted for 8.39% and 7.69% respectively.Conclusions: According to Parant dividing lower wisdom teeth surgery into 4 types, the rate of type II surgery, ie tooth extraction needs to open a part of the alveolar bone and cut the neck of the teethfor the majority.

Influence of the microbial factor in acute pericoronitis occurrence

Pericoronitis is an inflammatory disease that occurs after the eruption of the lower wisdom teeth and affects the surrounding tissues, with a complex microbial and traumatic etiology, manifested by an erythematous swelling and gum hyperemia in the retromolar area. The main goal was to determine the etiological spectrum of the microorganisms involved in acute pericoronitis and to evaluate the antibiotics, antiinflammatory drugs effect on pericoronitis treatment. The study included 30 patients (18 male, 12 female), aged between 18-45 years (27,8±8,2 years) with acute pericoronitis of the lower wisdom tooth. The study determined the severity of infection related to subjective and objective clinical symptoms (pain, swelling, congestion), the incidence of various streptococci; antibiotics resistance analysis was performed for in order to determine the sensibility and the rate between monomicrobial and polymicrobial cultures. 14 references, 4 figures.