Tooth section technique and pain upon elevation in third molar removal

Arakeri, Gururaj; Arali, Veena

doi:10.1016/j.ijom.2009.10.007

Cited by 6 publications

(5 citation statements)

References 2 publications

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“…8 Arakeri proposed a three-piece technique, for mesioangularly impacted third molar where he sectioned the tooth into two halves, upper half did not show any resistance to elevation but the lower half which was locked under the maximum convexity of distal surface of second molar strongly resisted elevation. 10 Elevation of lower segment may result in hinging of root over the neurovascular canal. Study by Cherian et al in their "Modified Furcation to Crown tooth sectioning technique" for removing mesioangularly impacted mandibular third molars reported that duration of the procedure as well as neurosensory deficits are relatively less with modified furcation to crown tooth sectioning.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of post-operative outcomes of longitudinal and cross-sectional odontectomy in surgical removal of mesioangular impacted mandibular third molars – A prospective study

E K,

Poorna T

et al. 2021

JOOO

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Surgical removal of the mandibular third molar is a routine procedure done in dental office. It is associated with various intra operative and post-operative complications. The purpose of the prospective study was to compare the longitudinal and cross-sectional methods of odontectomy in the surgical removal of mesioangular impacted mandibular third molars and to evaluate the difference in duration of surgery and post-operative complications between the two techniques.This prospective study was conducted over a period of 18 months after institutional ethical clearance was obtained.Fifty patients with mesioangular impacted mandibular third molars were selected and treated with cross-sectional tooth sectioning (n= 25) and longitudinal tooth sectioning (n=25) by random allocation. Clinical parameters such as pre and post-operative maximal mouth opening, post-operative edema, time taken for the procedure to be completed and post-operative pain were used to compare and evaluate the outcomes of both the techniques in our study. The significance of difference between qualitative variables and quantitative variables were assessed using chi square test and unpaired t test respectively.Longitudinal tooth sectioning consumed significantly less time than cross sectional tooth cutting (P<0.05). Edema (P<0.05) was found to be significantly less amongst the group that underwent longitudinal sectioning of the tooth. In disimpaction of mesioangular impacted mandibular third molars, longitudinal sectioning of the tooth was associated with less incidence of edema and consumed less duration than cross-sectional odontectomy.Longitudinal tooth sectioning of impacted mandibular third molars provide better results compared to the cross-sectional tooth sectioning as it is relatively quick and yields favorable post-operative outcome, hence being adoptable by any dental practitioner for disimpaction.

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Section: Discussionmentioning

confidence: 99%

Evaluation of post-operative outcomes of longitudinal and cross-sectional odontectomy in surgical removal of mesioangular impacted mandibular third molars – A prospective study

E K,

Poorna T

et al. 2021

JOOO

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“…[1] Recently, a concern was raised regarding the incidence of pain upon the elevation of an impacted third molar. [2,3] The pain typically manifested during elevation of the tooth and even during curettage of the extraction socket at the apical region. This pain was thought to be an alert for the proximity of root apices to the inferior alveolar canal.…”

Section: Introductionmentioning

confidence: 99%

“…[2] However, the pain was absent during soft tissue retraction, bone guttering, and tooth section procedures. [3] The purpose of the present article was to postulate a theory which explains the EPP while elevation or curettage steps of third molar surgery based on a systematic literature search.…”

Section: Introductionmentioning

confidence: 99%

Neurovascular plexus theory for "escape pain phenomenon" in lower third molar surgery

Arakeri¹,

Sagoo²,

Brennan³

2015

Plast Aesthet Res

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Pain during extraction of impacted mandibular third molars which can occur despite adequate local anesthesia is termed as "escape pain phenomenon". Recently, it was described during elevation of a mesioangular impacted mandibular third molar and also while curetting an extracted third molar socket. This phenomenon has been overlooked, as it was previously considered secondary to pressure effect on the inferior alveolar neurovascular bundle (IANB). However, it is unlikely that the pain impulses originate from direct pressure on the IANB, as the nerve is blocked more proximally at its entry into the mandible. The authors speculated that the occasional presence of a neurovascular plexus (NVP) independent of the IANB causes the escape of a pain impulse upon stimulation by root pressure or instrumentation. To validate the presence of such a plexus, a meticulous literature search and review were performed. The search revealed evidence of the occasional presence of a NVP consisting of auriculotemporal and/or retromolar neural filaments. The plexus may be present around the inferior alveolar artery or embedded within the IANB, and does not innervate the tooth. This plexus likely propagates pain impulses only upon stimulation by compression or instrumentation in the apical area of the tooth socket. This theory explains the absence of pain during tooth sectioning and bone guttering in the presence of a complete inferior alveolar nerve block.

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“…Recently a shift in paradigms can be observed towards atraumatic surgical techniques in third molar surgery like odontosection (Genu et al, 2008;Arakeri et al, 2010;Ngeow, 2008), and partial removal of third molar crowns ( Landi et al, 2010). This also applies to tooth removal in the anterior aesthetic zone, where buccal bone loss has a very high impact on implant treatment outcome (Al Harbi, 2011).…”

Section: Introductionmentioning

confidence: 99%

Endoscopically Assisted Root Splitting (EARS): Method and First Results

Engelke

Beltrán

Fuentes

et al. 2012

Int. J. Odontostomat.

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ABSTRACT:The trauma of surrounding bone structures during exodontia represents a mayor clinical shortcoming of conventional oral surgery. An alternative minimal invasive technique is presented to support aesthetic rehabilitation by conservation of alveolar bone walls. Endoscopically assisted root splitting (EARS) is a new technique for root removal wothout ostectomy. EARS consists of enlargment of the root canal, longitudinal root splitting, inward mobilisation and removal of the fragments under endoscopic control. In 24 patients (11 m, 13 f), aged 18-66 years, 8 central incisors, 6 lateral incisor, 5 canines and 5 bicuspids were removed using EARS. Endoscopic observation revealed complete maintenance of the buccal wall at it`s preoperative level, control radiographs showed no apical root remnants. EARS has revealed to be a valuable tool to avoid alveolar crest trauma during exodontia

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Tooth section technique and pain upon elevation in third molar removal

Cited by 6 publications

References 2 publications

Evaluation of post-operative outcomes of longitudinal and cross-sectional odontectomy in surgical removal of mesioangular impacted mandibular third molars – A prospective study

Evaluation of post-operative outcomes of longitudinal and cross-sectional odontectomy in surgical removal of mesioangular impacted mandibular third molars – A prospective study

Neurovascular plexus theory for "escape pain phenomenon" in lower third molar surgery

Endoscopically Assisted Root Splitting (EARS): Method and First Results

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