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Objective: This study aimed to provide a comprehensive case analysis from a single center, with the objective of clarifying the optimal timing and recommendations for a preferred treatment strategy customized to the specific presentation of each type of supernumerary tooth identified in the research. Method and materials: A retrospective study was conducted on patients who presented with a supernumerary tooth and were treated interdisciplinarily at the clinic. Results: In total, 55 patients with 81 supernumerary teeth of the permanent dentition were analyzed, 30 males and 25 females. The dentition status of the patients was as follows: 31 patients with mixed dentition, no patients with primary dentition, and 24 patients with permanent dentition. The diagnosis of supernumerary tooth was primarily made by general or pediatric dental practitioners and/or orthodontists. Patients were then referred to maxillofacial surgeons for treatment decision. The timing of treatment was mainly determined by the oral surgeon, based on the recommendations of the other specialists involved. Cases involving maleruption or malalignment of permanent teeth required both surgical and orthodontic treatment. Patients over 9 years old were treated either under local anesthesia or sedation, whereas those under 9 years old were treated under deep sedation or general anesthesia. A comprehensive investigation of cases involved the utilization of CBCT at the supernumerary tooth site to facilitate treatment planning. There was a significant correlation between younger age and the preference for treatment under sedation or general anesthesia (P = .01, t test). Similarly, a strong association was found between younger age and the need for additional orthodontic treatment (P = .016, t test). Cases of surgical removal of a supernumerary tooth at a young age typically did not require orthodontic traction of the permanent tooth, in contrast to cases of late surgical intervention (patients over 11 years old), which often did necessitate such traction. There was a strong tendency for treating supernumerary teeth in the maxilla. The proximity of supernumerary teeth to vital anatomical landmarks significantly influenced treatment decisions. Patients with supernumerary teeth near the mental foramen or the inferior dental canal in the premolar area were exclusively placed under follow-up care (P = .002, Pearson chi-square test). However, in the maxilla, the proximity of supernumerary teeth to vital structures such as the floor of the nose and the incisive nerve did not affect the treatment approach, and those supernumerary teeth were mostly removed. Conclusions: A team approach for managing supernumerary teeth is recommended. The timing of treatment should carefully consider the advantages and disadvantages of early versus late intervention. Early surgical treatment in cases where eruption is disturbed might result in spontaneous eruption, eliminating the need for orthodontic traction of the permanent teeth. [ABSTRACT FROM AUTHOR]

Background: This 20-year retrospective study aimed to evaluate the treatment methods used in patients with impacted maxillary permanent canines and to determine the occurrence of ankylotic and resorptive processes and their association with potential risk factors. Methods: The cohort consisted of 351 consecutive Caucasian patients (120 males and 231 females, mean age 18.4 and 19.9 years, respectively) with 420 impacted maxillary permanent canines. CT and CBCT findings were subsequently confirmed during surgery. Statistical analyses were performed by the generalized linear models, Pearson x2 and Fisher exact tests using the statistical programs R and Statistica v. 14. Results: A total of 273 (65.0%) impacted canines were aligned in the dental arch by orthodontic traction after surgical exposure, this treatment was predominant in patients under 20 years of age. Surgical extraction was performed in 115 (27.2%) impacted canines and was more common in older patients. Ankylotic changes were recorded in 61 (14.5%) impacted canines. The probability of ankylosis increased with age, particularly after the patient's 20th year of life (p < 0.001). Patients were 1.2% likely to develop ankylosis at age 15 years, 4.3% at age 20 years, 14.1% at age 25 years, and 96.8% at age 45 years. Invasive cervical root resorption (ICRR) was found in 8 (1.9%) canines. In 4 canines (1.0%), root ankylosis in addition to ICRR was observed. In contrast to ankylosis, whose frequency of occurrence increased with age, the occurrence of ICRR resulting from PDL damage during surgery was more typical in younger patients. Canines in a high position above the root apices of the adjacent teeth, with a horizontal inclination of the longitudinal axis, with the crown located deep in the center of the alveolar bone and with labiopalatal position, should be considered critically impacted canines with a high risk to failure of orthodontic traction. Conclusion: In conclusion, the treatment of impacted canines depends mainly on the age of the patient, and the position and inclination of the longitudinal axis of the impacted tooth. To select an adequate treatment method, we recommend CBCT examination, which allows a precise analysis of the position of impacted canines. [ABSTRACT FROM AUTHOR]

Background and Objectives: The role of surgical extraction of the third molar in patients' sleep quality remains unclear, although it is one of the most common oral surgical procedures. The aim of this study is to assess the changes in patient-reported sleep health outcomes after third molar surgery and to investigate any associations between sleep parameters and post-extraction pain. Materials and Methods: Young adults without known comorbidities who were in need of mandibular third molar surgical extraction were included. All participants completed a sleep diary, the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI) and Athens Insomnia Scale (AIS) questionnaires, which were used to assess sleep habits, daytime sleepiness, sleep quality and insomnia severity one week before and after extraction. In addition, a visual analog scale was completed postoperatively to assess the perception of pain. Results: Out of 75 patients who completed the study protocol, 32 (42.7%) were males and 43 (57.3%) were females, with a mean age of 24.01 (±3.43) years. Postoperatively, statistically significant higher scores were observed for PSQI [4.85 (±2.32) before vs. 5.39 (±2.75) after, p = 0.041], AIS [5.56 (±3.23) before vs. 6.91 (±4.06) after, p < 0.001] and average weekly number of nocturnal awakenings [2.01 (±3.72) before vs. 4.19 (±5.20) after, p < 0.001] but not for ESS, average weekly sleep duration and average weekly sleep onset latency. Pain perception was increased in patients who slept worse on almost all seven postoperative days, although this did not reach statistical significance. Conclusions: Third molar surgery impacts sleep quality and insomnia severity in the first week after extraction, while there is no effect on daytime sleepiness. The worsening of subjective sleep symptoms after extraction may be associated with an increased perception of pain. [ABSTRACT FROM AUTHOR]

This study aims to evaluate the impact of a single session of intraoral and extraoral photobiomodulation (PBM) on controlling pain and improving a patient's daily activities following surgical extraction of the impacted mandibular third molar, using combined three wavelengths: "445 nm, 660 nm, and 970 nm". A pilot study was conducted on 22 patients undergoing extraction of an impacted mandibular third molar. The patients were randomly divided into two groups: (1) The Test Group consisted of patients subjected to immediate postoperative PBM. The extraoral PBM parameters were power = 550 mW and spot area = 5 cm2, while the intraoral parameters were power = 200 mW and spot area = 2 cm2. (2) The Control Group consisted of the patients not subjected to PBM. For all the patients, the pain was evaluated via a Numeric Rating Scale (NRS) on day 0, day 1, day 3, and day 7 after surgical intervention. The patient's daily activities were evaluated on day 7 via a custom-made questionnaire. A statistically significant difference was observed between groups in the pain NRS scores on day 0 (p = 0.022), day 1 (p = 0.047), and day 7 (p = 0.028). No significant difference was found on day 3 (p = 0.153). A marginal statistical significance was observed with the number of painkillers taken (p = 0.054). No significant difference was observed with the questionnaire score (p = 0.206). This pilot study showed a significant reduction in postoperative pain on days 0, 1, and 7 with a single session of intraoral and extraoral PBM. However, the number of painkillers taken and the scores of the daily activities questionnaire did not show statistical significance despite the observed better results in patients subjected to PBM. [ABSTRACT FROM AUTHOR]

The treatment of facial abscesses of dental origin is difficult as jaw osteomyelitis in rabbits is mainly associated with a thick caseous pus that is particularly difficult to drain. Precise identification of the teeth involved in the infected site with the use of cone beam computed tomography (CBCT) was expected to ensure a favorable surgical treatment plan without a long-term local antibiotic strategy or local marsupialization. The first part of the study compared multi-planar reconstruction (MPR) and 3D reconstruction complemented by a maximum intensity projection filter (MIP). The surgical part of the study included rabbits with documentation of the treatment outcome for a period greater than one month after surgery and having had at least one post-operative CBCT demonstrating the achievement of surgical extraction. MPR is significantly more efficient than MIP techniques for alveolar bone (P < 10−7), spongious bone (P < 10−10) and apical elongation (P < 10−5) parameters. Nineteen of 20 surgical sites gave radiological confirmation of the success of the surgical plan. Eighteen of 20 of the abscess sites were clinically healed within one month. Seven out of 20 of the abscess sites presented evidence of one dental structure regrowth following the CBCT recheck. Two out of these seven cases presented with a concomitant persistent chronic facial fistula. Both cases healed after second-stage surgery to extract the tooth structure. The mean number of teeth extracted was 2.85, and seven of the 20 procedures included one incisor. [ABSTRACT FROM AUTHOR]

Objective: To determine the anxiety and hemodynamic changes in surgical removal of lower third molar under local anesthesia. Study Design: Comparative Cross-sectional study. Setting: Department of Oral and Maxillofacial Surgery, Institute of Dentistry of Liaquat University of Medical Health Sciences, Jamshoro. Period: January 2021 to December 2021. Material & Methods: Three hundred and fourteen patients were selected by non-probability convenience sampling technique. Patient having age between 18 to 50 years with either gender presented with third molar surgical extraction, first experience of tooth extraction and partial bony impaction were included in study. The demographic and clinical parameters like age, gender, level of anxiety and hemodynamic changes were identified. Hemodynamic parameters were recorded on before starting the surgical procedure (T1), after 5 minutes of injecting local anesthesia (T2) and after completion of surgery (T3). Results: Out of 314 patients, male patients were 156 (49.7%) and female patients were 158 (50.3%) with mean age of 31.0 ± 9.2 (18-50). In third molar extraction significant difference was observed for hemodynamic parameters at T1, T2 and T3 intervals. Conclusion: Surgical removal of lower third molar under local anesthesia significantly increases the anxiety, blood pressure and heart rate after injecting local anesthesia. [ABSTRACT FROM AUTHOR]

Background and Objectives: The role of surgical extraction of the third molar in patients’ sleep quality remains unclear, although it is one of the most common oral surgical procedures. The aim of this study is to assess the changes in patient-reported sleep health outcomes after third molar surgery and to investigate any associations between sleep parameters and post-extraction pain. Materials and Methods: Young adults without known comorbidities who were in need of mandibular third molar surgical extraction were included. All participants completed a sleep diary, the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI) and Athens Insomnia Scale (AIS) questionnaires, which were used to assess sleep habits, daytime sleepiness, sleep quality and insomnia severity one week before and after extraction. In addition, a visual analog scale was completed postoperatively to assess the perception of pain. Results: Out of 75 patients who completed the study protocol, 32 (42.7%) were males and 43 (57.3%) were females, with a mean age of 24.01 (±3.43) years. Postoperatively, statistically significant higher scores were observed for PSQI [4.85 (±2.32) before vs. 5.39 (±2.75) after, p = 0.041], AIS [5.56 (±3.23) before vs. 6.91 (±4.06) after, p < 0.001] and average weekly number of nocturnal awakenings [2.01 (±3.72) before vs. 4.19 (±5.20) after, p < 0.001] but not for ESS, average weekly sleep duration and average weekly sleep onset latency. Pain perception was increased in patients who slept worse on almost all seven postoperative days, although this did not reach statistical significance. Conclusions: Third molar surgery impacts sleep quality and insomnia severity in the first week after extraction, while there is no effect on daytime sleepiness. The worsening of subjective sleep symptoms after extraction may be associated with an increased perception of pain.

This study aims to evaluate the impact of a single session of intraoral and extraoral photobiomodulation (PBM) on controlling pain and improving a patient’s daily activities following surgical extraction of the impacted mandibular third molar, using combined three wavelengths: “445 nm, 660 nm, and 970 nm”. A pilot study was conducted on 22 patients undergoing extraction of an impacted mandibular third molar. The patients were randomly divided into two groups: (1) The Test Group consisted of patients subjected to immediate postoperative PBM. The extraoral PBM parameters were power = 550 mW and spot area = 5 cm2, while the intraoral parameters were power = 200 mW and spot area = 2 cm2. (2) The Control Group consisted of the patients not subjected to PBM. For all the patients, the pain was evaluated via a Numeric Rating Scale (NRS) on day 0, day 1, day 3, and day 7 after surgical intervention. The patient’s daily activities were evaluated on day 7 via a custom-made questionnaire. A statistically significant difference was observed between groups in the pain NRS scores on day 0 (p = 0.022), day 1 (p = 0.047), and day 7 (p = 0.028). No significant difference was found on day 3 (p = 0.153). A marginal statistical significance was observed with the number of painkillers taken (p = 0.054). No significant difference was observed with the questionnaire score (p = 0.206). This pilot study showed a significant reduction in postoperative pain on days 0, 1, and 7 with a single session of intraoral and extraoral PBM. However, the number of painkillers taken and the scores of the daily activities questionnaire did not show statistical significance despite the observed better results in patients subjected to PBM.

Background: Removal of impacted third molars is associated with postoperative complications such as pain, swelling, ecchymosis, trismus, infection, and hematoma. Thus, contemporary surgery aims to reduce complications by applying collagen or hyaluronic acid in the socket after extracting the impacted mandibular third molars. This study aimed to study the efficacy of hyaluronic acid (HA) addition to collagen, compared to collagen application alone, on the magnitude of swelling and trismus following impacted mandibular third molar surgery. Methods and materials: A total of 40 impacted molars of 20 participants who had completely bilateral impacted lower third molars were enrolled in this split-mouth, randomized, clinical trial. Randomization was carried out by two opaque envelops; two materials were applied topically in the socket collagen alone or with hyaluronic. The postoperative mouth-opening limitation and swelling rate were assessed on the third and seventh days after the extraction. Results: The mean age was 22.7 ± 3.079 years (75% female and 25% male). Regarding the rate of trismus, the test sides had less values than the control sides on 3rd days (44.03 ± 12.8 vs. 52.14 ± 13.7) and 7th days (19.22 ± 12.8 vs. 32.45 ± 15.3) postoperatively but the difference is only significant on the seventh day (P = 0.005). The swelling scores of the hyaluronic acid addition group were significantly lesser than those of the collagen alone group on the third and the seventh day (P < 0.05) except for the lateral canthus to the angulus mandibulae on the third day (P = 0.133). Conclusion: Adding hyaluronic acid to collagen could effectively reduce the severity of facial swelling and trismus following surgical extraction of impacted lower third molars. Statement of clinical relevance : Swelling and trismus are the most sequela following impacted third molar surgical extraction. This study showed that applying hyaluronic acid with collagen can reduce the severity of facial swelling and trismus which could be useful in surgeons' daily practice. We should mention that this original article has a preprint edition (44). [ABSTRACT FROM AUTHOR]

Abstract Objective This study aimed to investigate the effect of inflammatory states following impacted lower third molar (ILTM) surgery regarding postoperative bleeding and wound healing. Methods The study included patients who underwent extraction of ILTMs associated with or without inflammatory conditions. Post-extraction bleeding and wound healing were assessed. In addition, mean grey values (MGVs) of alveolar bone and bone height using an orthopantomography radiograph were analyzed. Results A total of 376 patients were enrolled; 171 pericoronitis, 51 pulpitis, 44 chronic periapical periodontitis, 36 chronic periodontitis, and 74 control. The bleeding score in the control group was significantly lower than in the periapical periodontitis and periodontitis groups. Excellent wound healing for control, pericoronitis, pulpitis, periapical periodontitis, and periodontitis groups was (78.38%, 35.67%, 70.59%, 70.45%, and 33.33%, respectively). Patients with pericoronitis and periodontitis had significantly poorer wound healing (P

Objective: This study aimed to investigate the effect of inflammatory states following impacted lower third molar (ILTM) surgery regarding postoperative bleeding and wound healing. Methods: The study included patients who underwent extraction of ILTMs associated with or without inflammatory conditions. Post-extraction bleeding and wound healing were assessed. In addition, mean grey values (MGVs) of alveolar bone and bone height using an orthopantomography radiograph were analyzed. Results: A total of 376 patients were enrolled; 171 pericoronitis, 51 pulpitis, 44 chronic periapical periodontitis, 36 chronic periodontitis, and 74 control. The bleeding score in the control group was significantly lower than in the periapical periodontitis and periodontitis groups. Excellent wound healing for control, pericoronitis, pulpitis, periapical periodontitis, and periodontitis groups was (78.38%, 35.67%, 70.59%, 70.45%, and 33.33%, respectively). Patients with pericoronitis and periodontitis had significantly poorer wound healing (P < 0.01). The MGV in periapical periodontitis and periodontitis was considerably lower than in the control group. Conclusions: The inflammatory conditions associated with ILTMs increase the risk of bleeding. So suturing with the placement of local hemostatic agents over a pressure pack alone is recommended. The poorest wound healing was in localized gingival inflammation. Furthermore, MGV was affected by age and was lower with periapical periodontitis. [ABSTRACT FROM AUTHOR]

Objective: To know the distal caries in mandibular second molars due to impacted mandibular third molars and their association with the type of impaction of patients who visited a tertiary care dental centre in Lahore, Pakistan. Study Design: Cross-sectional study. Place and Duration of Study: 28 Military Dental Centre, Combined Military Hospital, Lahore Pakistan from Dec 2020 to Nov 2021. Methodology: The dental records of 378 patients reported at 28 Military Dental Centres were retrieved from the data bank, then decoded and analysed. Results: Out of 378 patients, 242(64%) males and 136(36%) females were referred to Oral and Maxillofacial clinics of 28 MDC to undergo surgical extraction of mandibular third molar teeth. Mesio-angular 242(64%), depth Class-B 281(74.3%), and Ramal relationship I 224(59.3) were the most common impactions referred for surgical removal. 289(76.5%) impactions of all categories were unilateral. 178(73.6%) mesioangular impactions had neighbouring second molar distal caries on Orthopentomogram while none of the transverse impactions had neighbouring second molar caries. A significant association between angulation of impaction and neighbouring second molar caries has been noted (p<0.001). Conclusion: Increased mandibular second molar distal caries were noted adjacent to Mesioangular, depth B, Class 1 Ramal relationship mandibular wisdom tooth impaction. [ABSTRACT FROM AUTHOR]

Aim: Comparison of therapeutic effects of 8 mg Dexamethasone Intramuscular Administered Pre-operatively vs. Post Operatively after the Surgical Extraction of Impacted Mandibular Third Molars. Materials & methods: 100 outpatients who underwent surgical removal of lower third molar were included and were broadly divided into two study groups: Group A: Administration of Pre-operatively Intramuscular 8 mg Dexamethasone, and Group B: Administration of Post-operatively Intramuscular 8 mg Dexamethasone. Patients were subjected to complete history taking including medical and dental examination as per proforma. Maximum interincisal opening was measured pre-operatively, 1st and 3rd day. Visual analogue scale was used to analyse the intensity of the pain (0-10). The results of the two groups were compared using t-test. Results: Among the patients of group A, mean mouth opening during preoperative period, postoperative 1st day and postoperative 3rd day was 48.1 mm, 35.3 mm and 46.5 mm respectively. Among the patients of group B, mean mouth opening during preoperative period, postoperative 1st day and postoperative 3rd day was 48.6 mm, 31.7 mm and 39.4 mm respectively. Significant better results were obtained in terms of mouth opening among patients of group A. Mean VAS among the patients of group A at preoperative time, postoperative 1st day and postoperative 3rd day was 0, 4.3 and 2.4 respectively. Mean VAS among the patients of group B at preoperative time, postoperative 1st day and postoperative 3rd day was 0, 4.1 and 2.1 respectively. Non-significant results were obtained while comparing the mean VAS at different time intervals. Conclusion: It was concluded from the study that superior post-operativetherapeutic effects are achieved by pre-emptive administration of 8 mg intramuscular injection of dexamethasone [ABSTRACT FROM AUTHOR]

Objective: To know the distal caries in mandibular second molars due to impacted mandibular third molars and their association with the type of impaction of patients who visited a tertiary care dental centre in Lahore, Pakistan. Study Design: Cross-sectional study. Place and Duration of Study: 28 Military Dental Centre, Combined Military Hospital, Lahore Pakistan from Dec 2020 to Nov 2021. Methodology: The dental records of 378 patients reported at 28 Military Dental Centres were retrieved from the data bank,then decoded and analysed. Results: Out of 378 patients, 242(64%) males and 136(36%) females were referred to Oral and Maxillofacial clinics of 28 MDC to undergo surgical extraction of mandibular third molar teeth. Mesio-angular 242(64%), depth Class-B 281(74.3%), and Ramal relationship I 224(59.3) were the most common impactions referred for surgical removal. 289(76.5%) impactions of all categories were unilateral. 178(73.6%) mesioangular impactions had neighbouring second molar distal caries on Orthopentomogram while none of the transverse impactions had neighbouring second molar caries. A significant association between angulation of impaction and neighbouring second molar caries has been noted (p

The mesiodens is an extra tooth that is situated in the middle of the two central incisors. It is the most prevalent supernumerary teeth. Whereas genetic factors and dental lamina proliferation have been linked to mesiodens, its exact etiology is still unknown. Often, it causes cyst development, misaligned teeth, food entrapment, poor aesthetics, and other oral health problems. Therefore, to avoid these pathologic and orthodontic issues, early diagnosis and treatment are advised. This essay examines recent research on the causes, prevalence, diagnoses, and treatments of this concern. [ABSTRACT FROM AUTHOR]

The extraction of teeth carries a risk of associated complications, some of which may be predicted, providing an opportunity for them to be prevented or their effects minimised. Prior to embarking on any extraction, the dentist must be confident that they are able to deal with any complication that may arise. This paper provides an overview of the complications of dental extraction which are commonly encountered, considers the factors which predispose to them arising, suggests how the risk of them occurring can be reduced, and describes how they should be managed. [ABSTRACT FROM AUTHOR]

Mesiodens is the supernumerary tooth that occurs in the maxilla, between the central incisors. Mesiodens can be either paired or single, unerupted or impacted which can be unaesthetic and most of the time associated with complications like midline diastema, displacement, disturbance in eruption of the regular teeth and root resorption and cyst formation. A proper diagnosis and management will reduce such complications. In addition, alveolar ridge deformity result from tooth extractions might lead to aesthetic and functional compromises. The deformity that exists in the ridge is directly related to the volume of root structure and associated bone loss. Hence, prosthetic rehabilitation of an edentulous space in the pre-maxilla is critical. Ridge augmentation procedures should be preceded by careful surgical-prosthetic treatment planning in order to attain an optimal aesthetic result. This paper describes a case of palatally placed, inverted, and impacted mesiodentes which were detected on a radiographic examination for some other problem. In the present cases, mesiodentes were found in the anterior maxilla, both unerupted and one inverted and causing resorption of root of permanent central incisor. These mesiodentes are extracted to prevent its adverse effects followed by connective tissue augmentation and fixed partial denture. [ABSTRACT FROM AUTHOR]

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Objective: To monitor wound healing following surgical extraction of wisdom teeth using the novel Inflammatory Proliferative Remodeling (IPR) Scale. Methods: A prospective study design was used. Participants included 94 otherwise healthy adult patients undergoing surgical extraction of a wisdom tooth at a tertiary medical centre from June 2018 to June 2019. The IPR Scale was completed by two resident surgeons in oral and maxillofacial surgery at three time points after the procedure, corresponding to the three phases of wound healing. Mean subscale and total scores were calculated. Patients graded their preoperative anxiety, intraoperative pain, and pain during follow-up on a 10 cm visual analog scale, and the findings were correlated with the IPR Scale scores. Results: Mean IPR total score (range 0–16) was excellent (14.43 ± 1.45). Mean scores by healing phase were as follows: inflammatory 6.35 ± 1.34 (range 0–8); proliferation, 4.56 ± 0.8 (range 0–5); remodeling, 2.83 ± 0.51 (range 0–3). There was a positive correlation between mean preoperative anxiety level (5.9 ± 3.6) and intraoperative pain perception (2.4 ± 2.4; P = 0.65) and a negative correlation between mean preoperative anxiety level and IPR Scale scores for each healing phase. Two cases were complicated by abscesses which resolved with treatment. Conclusion: The IPR Scale is a promising tool for the effective evaluation of the wound healing process following wisdom tooth extractions. Relaxation methods and behavioural adaptation might help to lower patient anxiety and thereby improve oral wound healing.

BACKGROUND & OBJECTIVE: Tooth extraction is the most common procedure performed at the dental office. A very well recognized and recurrent post tooth extraction complication that dental surgeons face is Dry Socket (DO) also introduced as alveolar osteitis, localized osteitis, or simply alveolitis. The objective of this study is to ascertain the frequency of dry socket among patients undergoing dental extraction at Ayub Teaching Hospital. METHODOLOGY: This descriptive cross-sectional study was performed in the department of Oral and Maxillofacial Surgery, Ayub Teaching Hospital, Abbottabad for six months. A sample size of 203 patients was predetermined using WHO a calculator. Patients of either gender from 18 to 65 years were selected. Following the standard extraction technique, detailed postoperative instructions were given. The patients were educated about the symptoms of dry socket and were requested to report immediately if he/she felt any of the said symptoms. Those patients that reported dry socket, were identified, and their data was noted on structured proforma. Statistical Package for Social sciences (SPSS) version 21 was used to analyze the data obtained. RESULTS: The Mean age recorded in present study was 35±12.00. Gender distribution showed that 155 (76.35%) patients were male and 48 (23.64%) patients were female. Mean number of days elapsed for dry socket was 5+0.57 Frequency of dry socket recorded was 12 (05.91%) patients. No statistical association found among the variables. CONLCUSION: In this study, the results collected were found to be statistically insignificant on the accounts of trends such as female preponderance and dry socket distribution posteriorly in the mandible. Our study was in accordance with the studies in literature. [ABSTRACT FROM AUTHOR]

Endoscopic video capsule (ECV) is the first-line examination for small bowel exploration. We report on a 54-year-old patient who had undergone a laparotomy cholecystectomy ten years previously, and in whom a VCE scan was indicated for the assessment of unlabelled GI bleeding (normal fibroscopy and colonoscopy). Four weeks after ingestion, the patient had still not cleared the ECV and the abdominal CT scan showed retention of the videocapsule at the level of an ileal loop, with upstream intestinal obstruction. Surgical exploration revealed a multi-adherent abdomen and the encasement of the videocapsule in a magma of adherent ileal coves at 1.50 m from the Treitz angle. The videocapsule was extracted by enterotomy, followed by resection of the adherent magma of small intestines, with a terminal greco-celiac anastomosis. Post-operative follow-up was straightforward. The use of ECV requires a good knowledge of the limitations of this examination, in particular capsule retentions upstream of intestinal stenosis. Patients at risk of intestinal stenosis should be screened by careful questioning and clinical examination and by radiological examinations prior to exploration by ECV. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to assess the various indications of impacted mandibular third molar removal and pathologies associated with it. Methods: A retrospective cross-sectional study was conducted in the Department of Oral Surgery, Gandaki Medical College. The clinical case records from September 2016 to August 2019 were retrieved, reviewed, and analyzed. Surgically removed impacted mandibular third molars for which orthopantomogram were available and the lesions verified histologically were included in the study. Orthopantomograms were studied to determine the angular position of the impacted mandibular third molars and associated pathology. The data was entered in SPSS 20 and descriptive statistics was applied. Results: A total of 1344 impacted mandibular third molars (Male-709, 52.8%; Female - 635, 47.2%) were surgically extracted during the three-year period. The majority of patients (36.5%) were in the age groups of 25 - 34 years with a higher incidence of mesioangular impaction (33%). Recurrent pericoronitis (62.9%) was the most common indication followed by caries (11.7%). The radiographically detectable lesion was seen in 471 (35%) cases out of which 304 (64.5%) were symptomatic at the time of extraction. Among137 histopathologically diagnosed cases, chronic inflammatory lesion (76, 55.9%) was the most common finding. Conclusion: Awareness of the indications for removal of impacted mandibular third molars helps in proper management and prevention of future complications associated with retention and delayed extraction of such teeth. So, regular and periodic clinical and radiographic examination is required for patients with impacted mandibular third molars.

BACKGROUND & OBJECTIVE: Tooth extraction is the most common procedure performed at the dental office. A very well recognized and recurrent post tooth extraction complication that dental surgeons face is Dry Socket (DO) also introduced as alveolar osteitis, localized osteitis, or simply alveolitis. The objective of this study is to ascertain the frequency of dry socket among patients undergoing dental extraction at Ayub Teaching Hospital. METHODOLOGY: This descriptive cross-sectional study was performed in the department of Oral and Maxillofacial Surgery, Ayub Teaching Hospital, Abbottabad for six months. A sample size of 203 patients was predetermined using WHO a calculator. Patients of either gender from 18 to 65 years were selected. Following the standard extraction technique, detailed postoperative instructions were given. The patients were educated about the symptoms of dry socket and were requested to report immediately if he/she felt any of the said symptoms. Those patients that reported dry socket, were identified, and their data was noted on structured proforma. Statistical Package for Social sciences (SPSS) version 21 was used to analyze the data obtained. RESULTS: The Mean age recorded in present study was 35±12.00. Gender distribution showed that 155 (76.35%) patients were male and 48 (23.64%) patients were female. Mean number of days elapsed for dry socket was 5+0.57 Frequency of dry socket recorded was 12 (05.91%) patients. CONLCUSION: In this study, the results collected were found to be statistically insignificant on the accounts of trends such as female preponderance and dry socket distribution posteriorly in the mandible. Our study was in accordance with the studies in literature.

Background: Influence of over-erupted/buccally erupted maxillary third molar and distal surface caries (DSC) of mandibular second molar on oral health-related quality of life (OHRQoL) is not found in the literature. Materials and Methods: This prospective study was to evaluate the influence of associated pathology on OHRQoL after impacted mandibular third molar (IMTM) surgery. Demographics, indication for seeking IMTM removal, and presence of DSC and over-erupted/buccally erupted maxillary third molar were recorded. The Numeric Pain Scale and Arabic version of UK-OHRQoL instruments were used to evaluate pain and QoL after IMTM surgery. Analysis of variance was used statistically. Results: A total of 90 (41 [45.6%] males and 49 [54.4%] females) patients were recruited. The mean age was 31.3 ± 6.7 years. Patients with no associated pathology had lesser pain and better QoL scores. The domain scores became significant at: symptom level, body function level, and personal level on postoperative day (POD) 5; symptom level, body function level, personal level, and social level on POD 7; and at social level only on POD 14. Mean overall QoL was significant on POD 5 and 7. Conclusion: An over-erupted/buccally erupted maxillary third molar and mandibular second molar with DSC negatively affected pain perception and overall OHRQoL after surgical removal of IMTMs. [ABSTRACT FROM AUTHOR]

Introduction and aim: Healthcare information is becoming more readily available and searched for online, particularly on websites such as YouTube™. The accuracy and content of these websites is often questionable. We aimed to evaluate the quality of information available on surgical extraction of wisdom teeth on YouTube™. Materials and methods: We searched for the terms 'wisdom teeth', 'third molar', and 'wisdom tooth extraction' on YouTube™. The first 3 pages of results for each search term were assessed for inclusion and were independently rated by two assessors. Three separate scales to rate the quality of online information were used—DICSERN (range 0–5), HONcode (range 0–8) and the Global Quality Scale (GQS)(range 1-5). Cohen's kappa test was used to assess inter-rater reliability. Results: The searches returned 179 videos, but 114 were excluded (37 duplicates, 3 unrelated, 57 non-surgical, 13 <10k views, 4 non-English). Of the 65 videos included, the average length was 6 minutes and 34 seconds, and the average percentage positivity was 89%. The mean DISCERN score was 1.47 (SD 1.13), and the mean score for GQS was 2.15 (SD 0.6). No video met all HONcode criteria with the mean score being 2.96 (SD 0.9). There was good inter-rater reliability for the DISCERN score (kappa= 0.744) and HONcode score (kappa =0.866) but less reliability for GQS (kappa = 0.204). Conclusion: The standard of information on YouTube™ on surgical extraction of wisdom teeth varies, but is of poor quality overall. Patients should be advised to be cautious of such sources for information on this topic. [ABSTRACT FROM AUTHOR]

Abstract Background The purpose of this study was to compare the effectiveness of absorbable collagen sponge insertion in tooth extraction sites for socket healing of the impacted mandibular third molar. Methods Thirty-six patients with bilateral mandibular impacted third molars based on Pell-Gregory and Winter classification were included in this study. This study was a randomized clinical trial utilizing a split-mouth design with one side assigned as collagen sponge insertion and the other side assigned as the control. Post-operative clinical complications, periodontal integrities, and radiographic outcomes were assessed at 1, 2, and 14-weeks post operatively. Results Five patients were excluded during the follow-up period due to loss of follow-up. The study was conducted on 31 patients in total. The mean VAS score of collagen sponge insertion side at 1 week post operation was 1.42 ± 1.26, which was significantly lower than the control side (P

Objective: The goal of this study is to validate the psychometric properties of the Modified Dental Anxiety Scale (MDAS) and the Dental Fear Scale (DFS) at three different times: seven days before, immediately after, and seven days after watching a video of surgical extraction of a lower third molar in a sample with four strata: anxiety disorder, adjustment disorder, mixed anxiety-depressive disorder, and no mental disorder ages 18-70 in a psychiatric clinic in Malaga. Methods: The Research Ethics Committee of the Virgen Macarena-Virgen del Rocío Hospitals approved the study. After being interviewed by a psychiatrist and subsequently completing the Hamilton Rating Scales for Anxiety and Depression, the participants were divided into 4 strata (60 persons in each). The influence of education level was then analyzed. Results: The scales demonstrated good psychometric properties, with higher MDAS and DFS scores for lower levels of education and mixed anxiety-depressive disorder. Conclusions: Patients who show higher levels of dental anxiety and dental fear will be those with lower education levels, as well as those who suffer from mixed anxiety-depressive disorder.

Impaction of first, second and third molars at once comprise a rare clinical scenario with diverse therapeutic approaches and possess a great challenge for the dentist. Early detection of the eruption disturbances helps to manage and produce optimal outcomes. Here, the author reported a case of 17 years old male patient who reported with the chief complaint of pain in his lower left back tooth region with difficulty in mouth opening and chewing that revealed impacted mandibular left first, second and third molar on radiographic investigation. A proper decision making is required to satisfy the patient and also get an effective result. As the patient had severe pain in the left-side of the jaw near the angle of the mandible, surgical removal of the impacted molars was planned and performed using extra oral submandibular approach. Following the removal of the teeth, implants were placed in the extracted site supported by bone graft material and fixed orthodontic appliance therapy was carried out to correct the supraerupted upper molars on the left-side and arch expansion screw with upper Hawley's appliance was given to expand the maxillary arch to aid in appropriate occlusion. Restoration of the implant was done after one year of orthodontic treatment using ceramic crowns. The combined surgical, orthodontic and periodontal inter-disciplinary approach helped the patient to gain proper occlusion and satisfactory masticatory function. [ABSTRACT FROM AUTHOR]

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Impaction of first, second and third molars at once comprise a rare clinical scenario with diverse therapeutic approaches and possess a great challenge for the dentist. Early detection of the eruption disturbances helps to manage and produce optimal outcomes. Here, the authors reported a case of 17-year-old male patient who reported with the chief complaint of pain in his lower left back tooth region with difficulty in mouth opening and chewing that revealed impacted mandibular left first, second and third molar on radiographic investigation. A proper decision making is required to satisfy the patient and also get an effective result. As the patient had severe pain in the left side of the jaw near the angle of the mandible, surgical removal of the impacted molars was planned and performed using extra oral submandibular approach. Following the removal of the teeth, implants were placed in the extracted site supported by bone graft material and fixed orthodontic appliance therapy was carried out to correct the supraerupted upper molars on the left side and arch expansion screw with upper Hawley’s appliance was given to expand the maxillary arch to aid in appropriate occlusion. Restoration of the implant was done after one year of orthodontic treatment using ceramic crowns. The combined surgical, orthodontic and periodontal interdisciplinary approach helped the patient to gain proper occlusion and satisfactory masticatory function.

Objectives: To compare the clinical efficacy and the safety profiles of parenteral penicillin G vs. amoxicillin-clavulanate for the treatment of dentoalveolar abscess (DA) in hospitalized pediatric patients.Methods: A retrospective cohort study that was conducted at the Schneider Children's Medical Center in Israel.Results: Seventy-one patients that were included, 25 received parenteral penicillin G and 46 amoxicillin-clavulanate. There were no significant differences in the baseline clinical features except for higher rate of females in the amoxicillin-clavulanate group. Patients that were treated with penicillin G had shorter duration of fever, swelling and total length-of-stay (4.16 vs. 5 days in the penicillin G vs. amoxicillin-clavulanate groups, respectively, p = 0.007) and lower need for surgical intervention. Side effect were minor in both groups. In multivariate analysis, antimicrobial regimen was the only significant factor related with the total length-of-stay (p < 0.001).Conclusions: In pediatric patients hospitalized for DA, parenteral penicillin G was associated with better outcome compared with amoxicillin-clavulanate.

The extraction of mandibular third molars is a traumatic procedure accompanied by marked clinical symptoms in the postoperative period. The aim of the present study was to determine the effects of the removal of a partially impacted mandibular third molar on the masticatory efficiency in patients in the early postoperative period.

Objective: The purpose of this study was to evaluate the change in periodontal status of the adjacent second molar of the impacted mandibular third molar after surgical extraction and its association with the third molar condition in the presurgical stages, including position, eruption level, and local complications. Materials and Methods: The study was based on a 6-month follow-up of 38 patients (19 males and 19 females; Mean age: 21.89 ± 2.74) recruited consecutively after surgical extraction of an impacted lower third molar. The third molar's presurgical position, eruption level, and local complications were examined. Periodontal status, including Plaque Index (PI), Gingival Index (GI), and gingival bleeding on probing (BOP), of the teeth in the adjacent sextant was clinically evaluated. The pocket depth (PD) and the distance between the epithelial attachment and the adjacent second molar's occlusal surface were clinically measured; and the distance between the alveolar bone crest and cementoenamel junction (AC–CEJ) of the adjacent second molar was evaluated by the periapical film. All measures were recorded at the time of surgery and 1, 3, and 6 months after surgery. Results: The values of PI, GI, BOP, PD, and EA–OS were significantly reduced after 1, 3, and 6 months compared to baseline data. The AC–CEJ was decreased after 1 month but significantly increased after 3 and 6 months. Presurgical local complications of the impacted third molar mostly were significantly associated with the periodontal status of the adjacent sextant. Conclusion: There was a significant improvement of periodontal conditions of the second molar and adjacent sextant after impacted third molar surgery.

Objective To evaluate the clinical effect of the surgical extraction of traumatized permanent teeth with complicated crown⁃root fractures. Methods Among the dental trauma patients diagnosed in the Emergency Depart⁃ ment of Beijing Stomatological Hospital, Capital Medical University, from January 2011 to January 2016, a total of 17 permanent teeth with complicated crown⁃root fractures were included in this retrospective study. According to the Inter⁃ national Association of Dental Traumatology guidelines, the roots were surgically extruded to a more coronal position and stabilized with splints to reconstruct the biologic width. The follow⁃up period was 6 months to 7 years. Results All 17 teeth with complicated crown⁃root fractures survived during follow⁃up. The most common complications were surface resorption (5 teeth), marginal bone loss (2 teeth) and tooth mobility (1 tooth). No periapical lesion or root resorption was found in surgically extruded teeth. Conclusion Surgical extraction is a safe and rapid treatment option in the manage⁃ ment of complicated crown⁃root fractures in permanent anterior teeth.

Background: Third molar surgical extraction is one of the commonest surgical procedures in oral surgery and it is associated with postoperative complications. However, some of these complications are commoner than others and they have variable impacts on the quality of life of the patients. Objective: To review the common and uncommon complications of third molar surgery as reported in the literature. Methods: PubMed, ScienceDirect databases, AJOL, and Google scholar literature search was done to identify related articles on complications of mandibular third molar surgical extractions. Other online materials were also reviewed. The search words used were mandibular, third molar, lower jaw, surgical extraction, common, uncommon, and complications Results: Common complications of third molar surgery identified include; postoperative pain, swelling, trismus, infection, dry socket, inferior alveolar and lingual nerve damage, injury to the adjacent tooth, with their attendant impact on the patient’s quality of life. Conclusion: Third molar surgical extractions are associated with certain complications and some of them are unavoidable. Therefore, adequate patients’ education and psychological preparation for the procedure and its sequelae are necessary.

Impaction of teeth is a well‐documented phenomenon, and multiple cases have been reported in various sites in the oral and perioral structures. However, to our best knowledge, no single case has been reported of an impacted premolar with its crown lying in trifurcation of the roots of the neighbouring molar and its root projecting into the maxillary sinus. This unique case was managed by a transantral surgical extraction. This article aims to describe, by means of case report and review of the literature, the characteristics and occurrence of ectopic retention of the maxillary premolars. Different diagnostic procedures and surgical approaches for the removal of such impacted teeth are discussed. This case report and review emphasise the importance of using the cone‐beam computed tomography in the diagnosis and planning of management strategy for impacted teeth in close proximity to the roots of the surrounding teeth and other structures. [ABSTRACT FROM AUTHOR]

Objective: To compare the post surgical effects of two different concentrations’ i.e. 4mg (milligram) and 8mg of sub mucosal dexamethasone to decrease trismus by comparing the mean decrease in interincisal distance in patients undergoing impacted mandibular third molar surgery. Study Design: Randomized controlled clinical trial. Place and Duration of Study: Outpatient department of oral and maxillofacial surgery unit, Mayo Hospital, Lahore. The study was completed in 6 months, from Jan 2012 to Jul 2012. Material and Methods: This randomized controlled clinical trial was conducted on 150 patients. Patients were divided into two groups A and B. Mean interincisal distance of all patients was recorded pre operatively and post operatively. All patients were advised to use a mouthwash clorhexidine 0.2% before surgery. Group A received 4 mg dexamethasone and group B received 8 mg dexamethasone in the buccal vestibular tissues. Standard surgical procedure was performed by the same operator under same conditions. Postoperative mean interincisal distance of all patients was recorded on day 2 (after 48 hours of surgery). Results: Average age of patients was 32.62 ± 7.86 years with minimum and maximum ages of 20 and 50 years respectively. Gender distribution was almost equal. Average “maximum interincisal” mouth opening distance was significantly higher in group B as compared to group A i.e. (36 ± 3.928 mm (millimeter) versus 26.04 ± 3.097 mm) with p-value=0.000. Conclusion: Eight mg dose of dexamethasone was statistically more significant in reducing the trismus as compare to 4mg (p-value=0.000).

Background: Cleidocranial dysplasia (CCD) is a rare, autosomal dominant skeletal dysplasia with a prevalence of one per million births. The main causes of CCD are mutations in the core-binding factor alpha-1 (CBFA1) or runt-related transcription factor-2 (RUNX2), located at the 6p21 chromosomal region. RUNX2 plays important roles in osteoblast differentiation, chondrocyte proliferation and differentiation, and tooth formation. The disease is characterized by clavicular aplasia or hypoplasia, Wormian bones, delayed closure of cranial suture, brachycephalic head, maxillary deficiency, retention of primary teeth, inclusion of permanent teeth, and multiple supernumerary teeth. Materials and Methods: A 22-year-old girl suffering from cleidocranial dysplasia with short stature, narrow shoulders, craniofacial manifestations (short face, broad forehead, etc.) and dental anomalies (different lower dental elements under eruption, supernumerary and impacted multiple teeth, etc.) was examined at our service (Complex Operative Unit of Odontostomatology of Policlinico of Bari). RX Orthopantomography (OPG) and cone beam computed tomography (CBCT) were requested to better assess the position of the supernumerary teeth and their relationships with others and to evaluate the bone tissue. Results: Under eruption was probably caused by dental interferences with supernumerary teeth; hence, extractions of supernumerary upper canines and lower premolars were performed under general anaesthesia. Surgery outcome was excellent with good tissue healing and improvements in the therapeutic possibilities with future orthodontics. Conclusions: The objective of this article is to give an update about radiological, clinical, and molecular features of CCD and to alert the health team about the importance of establishing an early diagnosis and an appropriate treatment in these patients to prevent impacted teeth complications and to offer them a better quality of life.

The article presents a case study of a 10-year-old male child with missing upper anterior tooth since four years after the fall of the primary tooth. Topics include intraoral clinical examination revealing healthy mixed dentition with well formed labial mucosa and missing tooth number; and surgical extraction under general anaesthesia being planned considering the age and cooperativeness of the patient.

Objectives: To evaluate the efficacy of 0.2% chlorhexidine gel placed intra alveolar in the prevention of alveolar osteitis after the surgical extraction of mandibular third molar. Study Design: Randomized Control trial. Setting: Department of Oral and Maxillofacial Surgery, LUMHS, Jamshoro/Hyderabad. Period: January 2016 to July 2016. Material & Methods: This study consisted of 40 patients in control group A and 40 patients of Chlorohexidine gel group B used after surgical extraction. A single dose of 0.2% bio-adhesive gel was introduced in group B while the control group A was left alone. Postoperative complications like pain, swelling, limited mouth opening, and dry socket were seen. Frequency and percentages were calculated. Mean +/- SD were calculated for quantitative variables. Results: On 3rd day patients reported with pain in group A were 24 and in group B were 15. Pain was seen in 4 patients (10%) on 15th day in group A while in group B no patient came with pain. 19 patients reported with dry socket on day 3 in group A and 4 patients in group B, While none of the patient encountered with Dry socket on 15th day in group in both groups. Conclusion: The data presented indicates that the bio-adhesive gel containing 0.2% chlorohexidine, applied post-extraction produced a better patient recovery. [ABSTRACT FROM AUTHOR]

Coronectomy is an alternative surgical technique for the management of high-risk third molars. It involves the removal of the crown of a tooth and the deliberate retention of the roots, thereby avoiding injury to the inferior alveolar nerve (IAN). Previous studies have suggested that it reduces the risk of nerve injury when compared with surgical extraction. The purpose of this study was to systematically review the incidence of complications following coronectomy such as IAN injury, pain, dry socket, infection, root migration, and need for re-operation. A comparative cost analysis of coronectomy and surgical extraction was done based on the results of the review. This provides an insight into the economic implications of the two procedures. A search through the MEDLINE database via Ovid, PubMed, Scopus, EMBASE via Ovid, and Web of Science, was carried out to extract randomised and non-randomised controlled trials. Four studies fulfilled the inclusion criteria. A meta-analysis was conducted to measure the overall effect of each outcome. The pooled odds ratio (OR) for IAN injury was 0.16 (95% CI 0.01 to 0.39). Coronectomy reduced this risk by 84%. Dry socket may occur less frequently following coronectomy whereas infection did not show a higher incidence with either intervention. Root migration was found to occur in 13%–85% of cases and the average incidence of re-operation was 2.2%. The ratio of the average costs was 1.12 favouring coronectomy if cone-beam computed tomography (CBCT) was not done prior to the procedure. If a scan was taken routinely for coronectomy, the cost ratio marginally favoured extraction. Coronectomy reduced the risk of nerve injury in high-risk third molars. Definitive conclusions, however, cannot be made for outcomes such as the need for re-operation, which may alter the cost ratio of coronectomy:extraction, as higher quality studies with longer follow-up are needed. [ABSTRACT FROM AUTHOR]

Transmigration of mandibular canine is a rare phenomenon. Transmigration and impaction appear to be more common. Most of the patients do not have any symptoms, and these canines are often discovered at the radiological examination before orthodontic treatment. The aetiology is obscure, the treatment of impacted transmigrated canine is very complicated if it is diagnosed at a later stage. Early diagnosis of impacted canines is mandatory for timely treatment to ensure facial harmony and improved function. Here we present one such rare case of impacted mandibular canine which has transmigrated to opposite side and was accidentally found on radiological examination before orthodontic treatment and its surgical management. [ABSTRACT FROM AUTHOR]

Objectives: To assess the nerve injury (inferior alveolar nerve) after surgical removal of mandibular third molars under local anesthesia. Study Design: Observational study. Setting: Oral & Maxillofacial Surgery Department LUMHS Jamshoro/Hyderabad. Period: From 11th November 2015 to 10th May 2016. Material & Methods: This study consisted of one hundred patients. Inclusion criteria's were patients with impacted mandibular third molar, patient's age from 18 to 45years and irrespective of gender. Exclusion criteria were patients younger than 18yrs of age of above 45 years, patients having neurological disorders, medically compromised patients, patients receiving radiotherapy or chemotherapy, patients with known allergy to local anesthesia, patients having pathology due to mandibular third molars, patients radiographicaly root is very near to inferior dental canal. Results: Out of 100 patients incorporated in this research 66 were male (66%) and 34 female (34%). The mean age was 29+3.20 years. Common indication of extraction were recurrent pericoronitis 52(52%) cases followed by deep caries/ pulpitis in 28(28%) cases, orthodontic reason in 11(11%) cases and caries to adjacent tooth in 9(9%) cases. Third molar impaction according to winter's classification were Mesioangular in 54(54%) cases followed by Horizontal in 26(26%) cases and Vertical in 11(11%). Radiographic showed Narrowing of root in 21% cases and narrowing of inferior dental (ID) canal 20% cases, followed by diversion of ID canal in 16 % cases, deflection of root 14 % cases and darkening of root in 11% cases. After surgical removal of mandibular third molar, the inferior alveolar nerve injury was observed in 6(6%) cases. Conclusion: We conclude that inferior alveolar nerve paresthesia occurs in 6% after surgical removal of mandibular third molars. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to compare the effectiveness of absorbable collagen sponge insertion in tooth extraction sites for socket healing of the impacted mandibular third molar. Methods: Thirty-six patients with bilateral mandibular impacted third molars based on Pell-Gregory and Winter classification were included in this study. This study was a randomized clinical trial utilizing a split-mouth design with one side assigned as collagen sponge insertion and the other side assigned as the control. Post-operative clinical complications, periodontal integrities, and radiographic outcomes were assessed at 1, 2, and 14-weeks post operatively. Results: Five patients were excluded during the follow-up period due to loss of follow-up. The study was conducted on 31 patients in total. The mean VAS score of collagen sponge insertion side at 1 week post operation was 1.42 ± 1.26, which was significantly lower than the control side (P < 0.05). The mean probing depth of collagen sponge insertion side at 2-week post operation was 5.55 ± 2.28 mm, which was significantly lower than the control side (7.13 ± 1.86; P < 0.05). Other various measurements including radiographic outcomes showed no significant group differences. Conclusions: Placement of collagen sponge after extraction of mandibular impacted third molar reduced early stage post-operative complications and enhanced initial healing of soft tissues and periodontal defects. Trial registration: This study was retrospectively registered at the WHO ICTRP platform and Clinical Research Information Service, KCT0003363. Registered 21 Sep 2018. [ABSTRACT FROM AUTHOR]

Purpose: Inferior alveolar nerve (IAN) injury is reported as a complication following surgical removal of lower third molars. In cases where the IAN is intimately related to the roots of the tooth, coronectomy may be performed as an alternative. The objectives of this study were to record operative indications for coronectomy and assess the short- and long-term post-operative outcomes following coronectomy. Methods: This retrospective study included patients (19–95 years old) that had coronectomies carried out in the Edinburgh Dental Institute and Chalmers Dental Centre within the last 10 years. The patients were invited by letter to attend a review appointment. High-risk radiographic signs and short- (≤ 3 months) and long-term complications (> 3 months) were recorded. Results: A total of 124 patients were invited to participate and a total 28 patients returned for review. From the rest of the patients, data was extracted from their dental records. IAN injury was reported in 5 cases (4.3%) as a short-term complication and in 2 cases (3.5%) as a long-term complication. One patient presented with eruption of roots at the review appointment 7 years following surgery. In this study, 'very' long-term complications were recorded as the 28 patients that returned for a review, were seen on an average of 4.8 years post-operation. Conclusions: Coronectomy is a relatively safe technique for preservation of the IAN. However, prospective large scale research is needed to more accurately report on the prevalence of short- and long-term complications. [ABSTRACT FROM AUTHOR]

Background The surgical removal of mandibular third molars is one of the most common procedures in dentistry. Researchers have extensively studied the treatment of postoperative sequelae such as pain, edema, trismus, and alveolar osteitis throughout the past six decades. Many approaches have been used to address clinical difficulties after third molar surgery, including various flap designs and irrigating solutions. The aim of this study was to compare the effects of three irrigating solutions, hydrocortisone, povidone-iodine, and normal saline, on pain, trismus, and edema following surgical removal of the impacted mandibular third molar. Methodology The study involved 105 participants who required surgical extraction of mandibular third molars. The patients' ages ranged from 18 to 40 years, and they fulfilled the inclusion criteria. Using a simple random sampling technique, they were divided into three groups (group 1: hydrocortisone, group 2: povidone-iodine, group 3: normal saline). The parameters evaluated were edema, pain, and trismus on the second and seventh postoperative days. All data were input into Microsoft Excel (Microsoft ® Corp., Redmond, USA) worksheets and analyzed using Stata 17.0 (StataCorp LLC, College Station, USA). The visual analog scale (VAS) score was used to measure postoperative pain, and postoperative swelling was measured using linear measurements from four fixed anatomical points and compared to preoperative values. To assess trismus, the inter-incisal distance was measured in millimeters with a caliper. A p-value of <0.01 was considered statistically significant. Results The mean VAS score for pain in group 1 was lower than the other two groups. The effect of group 1 was significant on the second postoperative day but insignificant on the seventh postoperative day for swelling. The effect of all three groups on trismus was significant on the second and seventh days. Conclusions Hydrocortisone as an irrigating solution showed promising results in managing postoperative swelling in the first 48 hours, but its effect gradually declined by the seventh postoperative day. Additionally, it was effective in controlling postoperative pain and trismus. This suggests that utilizing hydrocortisone as an irrigating solution, compared to povidone-iodine, has been proven to be a significantly effective option in reducing postoperative pain, edema, and trismus resulting from the surgical removal of impacted teeth., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Ahmed et al.)