Objectives: The innate fragility of lingual plate (LP) is assumed to be the main reason leading to injuries of lingual neurovascular bundles and surrounding fascial spaces during mandibular third molar (MTM) surgery. The aim of this study was to assess the LP and lingual cortical plate (LCP) thickness of mesioangular impacted MTM. Methods: A total of 130 cone beam computed topography images were collected and studied. The related landmarks of MTM roots and LP were identified for measurements. At three positions of each root, including middle third, apical third and apex, the integrity of LP together with thickness of LP and LCP were evaluated. Results: The results showed that mean values of LP and LCP thickness of the most lingual root at apical third were 0.89 and 0.57 mm respectively. The average values of LP and LCP thickness surrounding mesial root were significantly smaller than those of distal root at all examined positions, except LP thickness at the apex. Moreover, the thickness of LP presumably increased together with the horizontal and vertical impacted levels according to Pell-Gregory classification. The percentage of losing LP integrity was determined as 89.5%, 93.4% and 77.4% at middle third, apical third and apex, respectively. Conclusion: In conclusion, LP surrounding the mesioangular impacted MTM is considerably thin, which can be the reason of lingual neurovascular bundles traumas and fascial spaces damages, especially at the apical third of the mesial root and in class A MTM. Clinical relevance Scientific rationale for studyThe width of lingual plate (LP) is one of the most vital factors associated with lingual nerve trauma and tooth displacement to submandibular spaces in third molars extraction. Principle findingsLingual plate surrounding mesioangular impacted third molars is particularly thin in the majority of cases. LP of mesioangular impacted tooth is more vulnerable than that of distoangular one. The thickness of LP is also correlated to vertical and horizontal levels of impaction by Pell-Gregory classification.
A633 cost, drugs cost accounted for the highest proportion with 44.52%; the lower is the clinical test cost with 21.67% (3,376,153.70 and 1,643,644.83 VND; respectively). The influential factors on costs of treatment included the place of residence, the number of days in hospital, the stage and the complications of cirrhosis. ConClusions: With the rising trend of liver cirrhosis in Vietnam and the high cost of treatment, national health policies and medical programs should be considered.
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