Impacted Mandibular Third Molar to be Removed or Retained?

Mishra, Sandipan; Anandh, B.; Bhanumurthy, Lokesh; Parthiban, Jkbc; Kasthuri, Magesh

doi:10.13005/bpj/719

Cited by 1 publication

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“…The post-surgical complications after mandibular third molar extraction have been researched extensively and mainly comprise complications like inferior alveolar nerve paraesthesia and lingual nerve damage. 16 However, during the extraction of the maxillary third molar, the post-surgical complications are relatively lower as there are no major neurovascular bundles in proximity and less dense bone in the posterior maxilla. 17 OAC, broken, inaccessible root pieces, maxillary tuberosity fracture, and pterygoid plate fracture are some of the intra-operative complications that are generally encountered during surgical or non-surgical removal of maxillary third molar.…”

Section: Discussionmentioning

confidence: 99%

Role of CBCT in Prediction of Oro-antral Communication Post Third Molar Extraction: A Retrospective Study

et al. 2023

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Objective Oro-antral communication (OAC) is one of the most frequently encountered complications during third molar extraction. Various radiographic factors, like excessive maxillary sinus pneumatization, long periods of edentulism, periapical lesions, etc., have been considered high-risk factors for OAC. However, a panoramic radiograph has not proven to be accurate in predicting the chances of OAC. Through this retrospective study, we evaluated the efficacy of a CBCT in predicting the incidence of OAC after maxillary third molar extraction. Materials and Methods We conducted a retrospective study in our department, which included the patients who had undergone extraction of a maxillary third molar over five years with the presence of panoramic X-rays and/or CBCT scans prior to extraction. Primary outcomes assessed from the case files were intra-operative complications like OAC, root fracture, tuberosity fracture, pterygoid plate fracture, etc. The incidence of these complications was correlated with the presence or absence of CBCT before extraction. Results Out of 920 extracted maxillary third molar, only 148 teeth (16.1%) had a CBCT record before extraction. The most commonly encountered complication was broken inaccessible root piece/s (4.9%), followed by OAC (3.5%). An inter-group comparison showed that a significantly higher percentage of patients (p < 0.001) with CBCT records had an incidence of OAC (11.5%) as against the group of patients with no CBCT record (1.9%). Conclusion A CBCT scan prior to cases with high-risk factors for OAC can be a valuable tool in accurately predicting the chances of OAC after maxillary third molar extraction.

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Section: Discussionmentioning

confidence: 99%