Tooth multi-sectioning with the use of magnification, for extraction of a deeply impacted lower second molar with entrapment of the inferior alveolar nerve: Report of a case

Tilaveridis, Ioannis; Dalambiras, Stilianos; Λαζαρίδου, Μαρία; Zouloumis, Lambros

doi:10.1515/bjdm-2016-0008

Cited by 2 publications

(1 citation statement)

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“…When surgery is embarked upon, there is no approved management technique; however, the use of a rotary handpiece is a common approach and aims to make elective surgical cuts for favourable fractures within the tooth to allow the opportunity to free the IDN and then remove the tooth. Tilaveridis et al . reports on a case surgically removing a PM8 of a 19‐year‐old male under magnification (5X) in which the root around the IDN was fractured into four pieces and removed.…”

Section: Managementmentioning

confidence: 99%

Identifying the Polo^® mint mandibular third molar: a case series

et al. 2018

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Aim: Perforation of mandibular third molars (MTMs) by the inferior dental nerve (IDN) is an uncommon finding. Such cases are thought to carry the highest risk for IDN injury (IDNI) due the entrapment of the nerve within the tooth. This case series aims to highlight the lack of consistency through varying radiographic signs, a perforated MTM may present on 2D imaging. Methods: In this series, 22 cases of perforated MTMs were identified prospectively by cone beam CT. The plain film radiographic images for these cases were retrospectively analysed to determine if any of the 2D radiographic features could help to identify a perforated MTM. Results: In 86% (19/22) of the cases at least three IDNI 'at risk' radiographic signs were present, 91% (20/22) of the cases superimposition of the IDN canal was seen and in 86% (19/22) of the cases banding of the root was evident. Deviation and narrowing of the canal was only identified in 59% (13/22) of the cases. Conclusion: In this study no single or repeated multiple 2D 'at risk' sign was predictive of perforation of the tooth by the IDN. Most cases show multiple 'at risk' signs but there remains no consistency even within these signs. Clinical relevanceScientific rationale for study Inferior dental nerve injury remains the most important complication associated with mandibular third molars (MTM). Surgical intervention requires assessment via 2D imaging. This study highlights perforated MTM, which carry the highest risk of nerve injury, and their varying radiographic appearances on basic imaging. Principal findingsPerforated third molars present with a mixture of radiographic presentation and there appears to be no exclusive sign or signs that can help identify such cases. Practical implicationsCone beam CT has been shown to be superior for anatomy and therefore would remain the only imaging technique that can identify perforated MTM predictably. Such imaging should be considered in these 'high-risk' cases for surgical planning when it provides a clinical advantage.Oral Surgery 12 (2019) 89--95.

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Section: Managementmentioning

confidence: 99%