Lingual flap retraction for third molar removal

Pogrel, M. Anthony; Goldman, Kim E.

doi:10.1016/j.joms.2004.04.013

Cited by 61 publications

(48 citation statements)

References 46 publications

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“…Kugelberg et al, found that deeper periodontal pocket depth after third molar surgery was 3 times more frequent in people who were older than 25 years of age. They showed that the process of periodontal healing after the surgery was correlated with age [15][16][17][18].…”

Section: Resultsmentioning

confidence: 99%

To Compare Standard Incision and Comma Shaped Incision and Its Influence on Post–Operative Complications in Surgical Removal of Impacted Third Molars

Sarumathi²,

Veerabahu³

et al. 2013

JCDR

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Objectives: To compare standard incision and comma shaped incision and its influence on post operative complications in surgical removal of impacted third molar.Methods: This was a cross-over trial. Twenty subjects with bilateral impacted mandibular third molars were recruited for the study. A standard incision was made on one side of the lower jaw and a comma incision was made on the other side to reflect the mucoperiosteal flap, after which the common steps for removal of impacted third molars were followed. The postoperative parameters were recorded immediately on the post -operative days 1, 3 and 7 respectively. Results:The pain scores which were recorded on days 1, 3 and 7 in the surgical area with comma incisions were found to be significantly lower as compared to the pain scores in the area where standard incisions were made. Similarly, swelling was lesser with comma incisions than with standard incisions. There was a significant difference in mouth opening between the two incisions on day 1, but no significance was seen on days 3 and 7. All these findings showed significant statistical differences. Conclusion:The results of the study showed that the new incision design was preferable over the conventional method, considering the lesser degree of post-operative complications. The cross-over design of the study greatly enhanced its statistical power and validity. InTROduCTIOnThird molars are present in 90% of the population with 33% having at least one impacted third molar. Thus, surgical removal of impacted third molar is the most frequently performed procedure [1]. Impacted lower third molar extraction produces a series of side effects, which include pain, inflammation, and trismus [2].Flap design is one important factor which influences the severity of these complications [3]. Flap design is important, not only for allowing optimal visibility and access to the impacted tooth, but also for subsequent healing of the surgically created defect. With so many objectives, the actual design of a flap sometimes becomes a compromise between peri-and post-operative considerations [4].The aim of this study was to compare two different flap designs in extraction of impacted mandibular third molars, by assessing their post-operative complications. In this study, pain, swelling, mouth opening and pocket depth were selected as parameters for comparing the two flap designs. MATeRIAl And MeThOdSThis study was a hospital based, experimental study with a "cross-over" design, which was done on thirty patients. Patients with bilateral, completely impacted, mandibular third molars or partially erupted third molars, without any symptoms of pain or swelling, who had good oral hygiene, were included in the study. Dentistry SectionPatients who were on any medications, lady patients who were pregnant, patients with severe pericoronitis, patients with soft tissue impaction and patients who were medically compromised were excluded from study.Thirty patients who satisfied the inclusion criteria were enrolled in the study aft...

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Section: Resultsmentioning

confidence: 99%

To Compare Standard Incision and Comma Shaped Incision and Its Influence on Post–Operative Complications in Surgical Removal of Impacted Third Molars

Sarumathi²,

Veerabahu³

et al. 2013

JCDR

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“…Lingual flap retraction for lower molar removal improves the accessibility and simplifies the procedure [22]. But adjacent to lower third molar lingual nerve is covered with only a thin layer of soft tissue and mucosa increasing the chances of injury [8,23].…”

Section: Discussionmentioning

confidence: 99%

“…Significantly higher LNI occurred in cases where lingual flap was retracted in the present study. Several studies have shown that raising and retraction of a lingual mucoperiosteal flap is associated with an increased frequency of lingual nerve damage [10,[21][22][23][24]. Few recent studies and a systematic review have concluded that retraction of lingual periosteal flap is not necessary and can be avoided during third molar surgery [25,26].…”

Section: Discussionmentioning

confidence: 99%

Factors Influencing Lingual Nerve Paraesthesia Following Third Molar Surgery: A Prospective Clinical Study

Babu

Reddy²,

Pattathan

et al. 2012

J. Maxillofac. Oral Surg.

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Background and Objectives The purpose of this prospective study was to evaluate the incidence and various risk factors influencing the sensory deficit in case of lingual nerve injury (LNI) in individuals whose impacted mandibular third molars are surgically removed under local anesthesia. Materials and Methods The study was based on the data collected prospectively from a random group of 100 patients who underwent surgical removal of bony impacted lower third molar in a dental hospital. Details of the patient, reason for extraction, type of impaction, method of surgery and signs and symptoms of nerve injury are recorded. Neurosensory testing was done to evaluate the LNI at 1 week, 1 months, 3 months and 6 months interval.Comparison was carried out using Chi square test. For all tests a P \ 0.05 was considered significant. Results The incidence of LNI was 4 % and of temporary in nature which recovered well within 6 months postoperatively. The age of the patient above 26 years, lingual flap retraction, depth of impaction (red line C10 mm) and duration of surgery above 30 min were the significant factors for causing LNI. Conclusions The age of the patient, depth of impaction, lingual flap retraction and longer duration of surgery are significant risk factors for LNI during mandibular third molar surgery. Greater care should be taken to avoid the morbidity and patients should be informed well ahead about the probable complications.

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“…Sensory impairment following this surgery is probably the most significant morbidity [2] , but this is largely preventable if the potential risk is anticipated and the surgical procedure adapted accordingly. Despite numerous publications and suggested recommendations, there is no significant decrease in the number of cases of permanent LN involvement [5,7,8,[14][15][16] . The prevalence of postoperative lingual sensory impairment in our study compares favorably with other data from previous studies [6,7,15,17] .…”

Section: Discussionmentioning

confidence: 99%

“…A Howarth periosteal elevator [5,8] was carefully inserted at the lingual rim of the retromolar trigone and was not pushed deep down along the lingual aspect. The socket was then inspected, curetted and irrigated with normal saline, the flap repositioned and sutured with a resorbable suture on a reverse cutting needle.…”

Section: Surgical Proceduresmentioning

confidence: 99%

Lingual Nerve Morbidity and Mandibular Third Molar Surgery: A Prospective Study

Baqain¹,

Karaky²,

Hassoneh³

2009

Med Princ Pract

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Objective: The objective of this study was to estimate the frequency of postoperative lingual nerve (LN) impairment after the surgical removal of mandibular third molars (M3) and to identify potential risk indicators. Subjects and Methods: A prospective cohort study involving 321 subjects who had 443 mandibular M3 surgically extracted at the University Hospital, Amman, Jordan. Predictor variables were categorized as patient-, anatomy- and operation-specific. The outcome variable was the presence or absence of LN impairment. Bivariate and multivariate analyses were performed to identify independent predictors. Results: The prevalence of temporary LN hypoesthesia was 2.5% and all 11 cases resolved within 6 months. Factors that predicted LN injury by univariate analysis were horizontal and mesioangular tooth angulation, bone removal, tooth sectioning, longer operations, lingual flap retraction and bleeding into the socket. In the multivariate logistic regression model, lingual flap retraction (p = 0.002, OR = 26.790) and bleeding into the socket (p = 0.044, OR = 4.918) were the independent predictors. Conclusion: Operative variables were the main predictors of temporary LN damage.

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Lingual flap retraction for third molar removal

Cited by 61 publications

References 46 publications

To Compare Standard Incision and Comma Shaped Incision and Its Influence on Post–Operative Complications in Surgical Removal of Impacted Third Molars

To Compare Standard Incision and Comma Shaped Incision and Its Influence on Post–Operative Complications in Surgical Removal of Impacted Third Molars

Factors Influencing Lingual Nerve Paraesthesia Following Third Molar Surgery: A Prospective Clinical Study

Lingual Nerve Morbidity and Mandibular Third Molar Surgery: A Prospective Study

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