Background: Although the removal of impacted mandibular third molars is a common minor oral surgical procedure, the extraction of these teeth can present with certain post-operative complications. Koerner KR proposed a Diffi culty Index Scale for removal of these teeth on the basis of local anatomy and radiographs, which were helpful in predicting the diffi culty that would be encountered intra-operatively, as well as the post-operative complications. Objective: To study the different post-operative complications in the removal of impacted mandibular third molars calculating their diffi culty index value. Method: A total of 119 patients, 79 females and 40 males who underwent extraction of their impacted third molars were selected over a one year period. Data were collected prospectively, according to the angulation, depth and position of the impacted mandibular third molars and their diffi culty index calculated. This was further correlated with the postoperative complications encountered. Results: Mesio-angular impaction (43.7%), with level A (66.4%) and Class I (70.6%) impaction were the major type of impaction seen. The diffi culty index showed that majority were in the moderately diffi cult category (51.2%), with swelling and trismus seen to increase as the diffi culty index value increased. Females were affected more than males, with swelling (Odds ratio 2.206) and trismus (Odds ratio 2.570) seen to be signifi cantly more. Conclusion: Surgical removal of impacted mandibular third molars causes post-operative complications and special care is required in their removal, especially in females. The Diffi culty Index, as described by Koerner KR can be used as a tool for predicting the frequency of the post-operative complications, especially swelling and trismus.
Introduction: The positional relationship between the mandibularcanal with impacted mandibular third molar is the main factor of inferior alveolar nerve injury. The purpose of this study wasto classify the anatomical three dimensional relationship between the proximity of impacted mandibular third molars to the inferior alveolar canal. Methods: The descriptive cross-sectional study was conducted inthe Department of Oral and Maxillofacial Surgery of a tertiary care hospital from July 2020 to August 2020 after obtaining ethical approval from the Institutional Review Committee (Reference number 2506202001). Cone-beam computed tomography images of 200 patients’ mandibular third molars were used. A convenient sampling method was used. Data were analyzed using Statistical package for the Social Sciences. Results: Mandibular canal relative to the roots of the mandibular third molar was observed on the apical side in 104 (52.0%) and 173 (86.5%) third molars had direct contact with the mandibular canal. About 36 (97.3%) lingually placed mandibular third molars had contact with the mandibular canal. Conclusions: The findings of the study conclude that most of the mandibular third molars situated lingually had a higher occurrence of mandibular nerve involvement. The anatomic structures of the mandibular third molar and the mandibular canal may be helpful to draw upon the adequate surgical plan to avoidor reduce nerve involvement.
Introduction: Third molar impaction is a common patient complaint in dentistry. Common symptoms are localized pain, swelling, bleeding, and difficulty in mouth opening. Since dental students deal with patients early in their education, for better skill, they should have knowledge of various teeth impactions. Hence, the objective was to find out the knowledge of impacted teeth among undergraduate dental students of a medical college. Methods: A descriptive cross-sectional study was conducted among bachelor in dental surgery students of a medical college from November 30, 2020 to April 3, 2021. Data collection was done by convenience sampling after receiving ethical clearance from Institutional Review Committee (Reference 1208202006). A structured questionnaire in Google Forms was sent to 221 participants via Viber. Out of 213 responses received, 144 were analyzed in Excel after discarding for duplication and other errors. Descriptive statistics such as mean, standard deviation, frequency, and percentage were analyzed. Results: Out of the total of 144 participants, only 81 (56.3%) (47.89-91.4 at 95% Confidence Interval) had known about the term ‘impacted teeth’ before joining Bachelor in Dental Surgery course. The source of information was mostly the internet 27 (18.8%) followed by dentist 23 (16%). Most students 116 (80.6%) were familiar with third molar impactions, 62 (43.1%) knew about types of impacted teeth/impaction, and 100 (69.4%) were aware of the complications of not removing impacted teeth. Conclusions: Dental students should be provided with appropriate ‘impacted teeth’ education supported by practical experience. More detailed information regarding impacted teeth should be included in the curriculum for better understanding.
Background: Mental foramen is an important landmark to be considered when operating in the anterior mandible. It is mandatory to identify the location of the foramen to prevent injury to mental nerve and subsequent paresthesia. Objectives: The objective of this study was to identify the position of the mental foramen in relation to the mandibular premolars and first molar in patients visiting Kathmandu Medical College, Department of Oral Surgery, Duwakot using the Orthopantomogram. Methodology: A total of 200 digital panoramic radiographs of 92 males and 108 females in the age range of 20-50 years were collected. Consequently, 184 mental foraminain males and 216 mental foraminain females were evaluated. The outline of the mandible along with canine, first premolar, second premolar, and first molar was traced. The mental foramen opening was also traced and the position wasevaluated in relation to the first, second premolars and first molar. Results: Out of 400 foramina, 217 (54.2%) were located between the first and second premolar, i.e. position 3. The second most commonlocationof 152 (38%) foramina was in line with the second premolar, i.e. position 4. Position 2, i.e. in line with the first premolar was seen in 4% and position 5, i.e. between the second premolar and first molar was seen in 3.5%. The left side (29.2%) had a higher occurrence of position 3 as compared to the right side (25%). Conclusion: The location of mental foramen should be identified in all surgeries involving the anterior mandible as this will help us prevent injury to the mental nerve.In our population, position 3 was the most common location of the mental foramen.
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