Retained Third Molars Removal in a Severely Resorbed Edentulous Mandible. A Case Report

Abstract

The presence of asymptomatic third molars can represent a potential problem in the mandible when these teeth are retained and the patient has lost all normally erupted teeth. Once the mandibular first and second molars are removed, the mandibular body becomes weaker with time, increasing the complexity, morbidity and incidence of complication in the surgical procedure to remove the retained third molar. This paper reports a case where the mandibular third molars retained in a severely resorbed mandible were removed in a 54-year-old female patient. The treatment plan was based on the safe surgical removal of the teeth and prosthetic rehabilitation with an implant-supported milled bar overdenture and a bone-mucous-supported complete denture in the mandibular and maxillary arch, respectively. If the removal of a retained third molar is indicated in a severely resorbed edentulous mandible, the treatment plan must involve not only preventive measures in order to avoid mandible fracture during or after tooth removal, but also alternatives that allow an adequate mandibular rehabilitation.

The ability of orthodontists and oral/maxillofacial surgeons to predict eruption of lower third molar

“…The retrospective nature of this study increases the possibility of bias. A prospective follow-up study including different impaction severity and treatment outcomes should be considered, not only on an orthodontic perspective but also examining surgical complications after third molar removal [ 28 ].…”

Management of an Imminent Pathological Fracture of a Fibular Neomandible Via a Minimally Invasive Approach—A Case Report

“…Classical management in removal of a deeply impacted tooth or implant where pathological fracture is anticipated, would be to pre-emptively apply rigid fixation to the two anticipated segments. 17 In this case, this would have involved placement of a new reconstruction plate to the facial aspect of the fibula. The bone immediately adjacent to the anticipated fracture line contains multiple dental implants, and they might have blocked the usage of most screw holes of the reconstruction plate in these key regions.…”

“…Classical management in removal of a deeply impacted tooth or implant where pathological fracture is anticipated, would be to pre‐emptively apply rigid fixation to the two anticipated segments 17 . In this case, this would have involved placement of a new reconstruction plate to the facial aspect of the fibula.…”

Considerations for the Prophylactic Extraction of Asymptomatic Unerupted Third Molars

“…En caso de indicar la remoción, la potencial fractura deberá ser prevenida con la colocación de placas quirúrgicas y una planificación protésica adecuada buscando rehabilitaciones estables y biocompatibles. Si se opta por un control y seguimiento de rutina, deberá informarse al paciente de que esta opción terapéutica involucrará numerosas citas y exámenes, no descartando con ello que deba someterse eventualmente al procedimiento quirúrgico (Sverzut et al, 2013).…”