1. In vitro resistance to fracture of two nickel-titanium rotary instruments made with different thermal treatments
- Author
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Susanna Annibali, Rita Giardino, Maria Paola Cristalli, Gerardo La Monaca, Iole Vozza, and Nicola Pranno
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Mandibular canal ,030206 dentistry ,General Medicine ,Inferior alveolar nerve ,Submandibular space ,Mucoperiosteal Flap ,Surgery ,Retractor ,stomatognathic diseases ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,stomatognathic system ,Suture (anatomy) ,030220 oncology & carcinogenesis ,medicine ,Ostectomy ,business ,Lingual nerve - Abstract
Surgery to the mandibular third molar is common, and injuries to the inferior alveolar nerve and the lingual nerve are well-recognized complications of this procedure. The aim of these technical notes is to describe operative measures for reducing neurological complications during mandibular third molar surgery. The following procedure should be used to prevent damage to the inferior alveolar nerve: a well-designed mucoperiosteal flap, to obtain appropriate access to the surgical area; a conservative ostectomy on the distal and distal-lingual side; tooth sectioning, to facilitate its removal by decreasing the retention zones; tooth dislocation in the path of withdrawal imposed by the curvature of the root apex; and careful socket debridement, when the roots of the extracted tooth are in intimate contact with the mandibular canal. To prevent injury to the lingual nerve, it is important (I) to assess the integrity of the mandibular inner cortex and exclude the presence of fenestration, which could cause the dislocation of the tooth or its fragment into the sublingual or submandibular space; (II) to avoid inappropriate or excessive dislocation proceedings, in order to prevent lingual cortex fracture; (III) to perform horizontal mesial-distal crown sectioning of the lingually inclined tooth; (IV) to protect the lingual flap with a retractor showing the cortical ridge; and (V) to pass the suture not too apically and from the inner side in a buccal-lingual direction in the retromolar area.
- Published
- 2017
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