Comparison of two incision designs for surgical removal of impacted mandibular third molar: A randomized comparative clinical study

Desai, Adarsh; Patel, Rushit; Desai, Kiran; Vachhani, Nirav Bharatbhai; Shah, Kruti A; Sureja, Raj

doi:10.4103/0976-237x.132308

Cited by 17 publications

(5 citation statements)

References 10 publications

(9 reference statements)

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“…In a study conducted by Desai et al .,[ 30 ] statistically significant difference was observed in postoperative hematoma, wound gaping and distal pocket in adjacent tooth, which was significant in triangular incision group in comparison to envelope incision group. The results of this study are contradictory to the findings of our study.…”

Section: Discussionmentioning

confidence: 94%

Evaluation of two flap designs on the mandibular second molar after third molar extractions

AlQahtani

Khaleelahmed

Desai

2017

J Oral Maxillofac Pathol

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Background:The extraction of third molars is associated with some clinical outcomes and periodontal problems. It is imperative to note that the type of incision used in the surgery for the removal of the impacted third molar is critical. The design of the flap influences the healing of the surgically created defect and damage to the distal periodontal area of the adjacent second molar. However, till date, there have been conflicting reports on the influence of different flap designs used for the surgical removal of impacted third molars.Aim:The present study aimed to comparatively evaluate the clinical outcomes and periodontal status of the adjacent second molar, when two different flap designs, namely, the envelope and the modified triangular flap designs were used.Materials and Methods:Sixty female patients with bilateral impacted third molars completed the study with envelope flap on one side and modified triangular flap design on the other side of the mandible for third molar removal. Clinical parameters including pain, dehiscence and swelling were assessed postoperatively and periodontal probing depth (PPD) on the distal aspect of adjacent second molar were assessed both pre- and post-operatively.Results:The results were assessed on 1, 3 and 8 days for pain using visual analog scale. The subjective perception of swelling was evaluated on 3, 7 and 15 days postoperatively in a similar manner. The results of the periodontal parameters were evaluated both preoperatively and 3 months postoperatively, with cautious exploration using a University of North Carolina (UNC)-15 periodontal probe. The statistically significant results for swelling and PPD were noted for the two flap groups using the Chi-square test (P < 0.05).Conclusion:The study revealed that the modified triangular flap had lesser postoperative PPDs and dehiscence. The envelope flap was better when swelling was analyzed. The pain scores, though slightly higher for the modified triangular flap group, were not statistically significant.

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Section: Discussionmentioning

confidence: 94%

Evaluation of two flap designs on the mandibular second molar after third molar extractions

AlQahtani

Khaleelahmed

Desai

2017

J Oral Maxillofac Pathol

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“…[ 31 ] Longer surgical time also correlates significantly with other postoperative complications, such as swelling and clenching of the teeth due to prolonged injuries to tissues, while shorter surgical time is associated with reduced analgesic consumption. [ 32 ]…”

Section: Discussionmentioning

confidence: 99%

Associations between dental anxiety and postoperative pain following extraction of horizontally impacted wisdom teeth

Wang¹,

Wu²,

Tseng

et al. 2017

Medicine

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The aim of the study is to identify associations between dental anxiety and postoperative pain in patients undergoing extraction of horizontally impacted wisdom teeth.A total of 119 volunteers provided demographic data, and completed questionnaires, the State-Trait Anxiety Inventory (STAI), Chinese Index of Dental Anxiety and Fear (C-IDAF)-4C, and the Numeric Rating Scale (NRS) for pain.Mean SAI, TAI, and C-IDAF-4C scores were 42.5 ± 8.7, 46.4 ± 10.9, and 16.9 ± 7.2, respectively. Mean postoperative pain level score was 3.0 ± 1.8 (range: 0.3–8.4). SAI scores increased as preoperative pain levels increased (β = 1.30, 95% confidence interval [CI]: 0.62–1.98, P < .001); females had higher SAI scores than males (5.34; 95% CI: 1.74–8.95, P = .004). Multivariable analysis revealed that females, bad exodontic experience, and higher predicted pain levels were associated with higher IDAF-4C scores. SAI scores (γ = 0.611, P < .001) and TAI scores (γ = 0.305, P < .001) increased as C-IDAF-4C scores increased. Higher C-IDAF-4C scores and longer operative time were significantly associated with higher levels of postoperative pain.Specific factors are associated with anxiety and stress, and postoperative pain in patients undergoing wisdom teeth extraction. Addressing these factors preoperatively may reduce stress and anxiety, and lead to more favorable treatment outcomes.

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“…It is believed that as human being evolved, a refined diet may lead to less migration of teeth, causing higher incidence of impacted third teeth 1 . Ninety percent of the general population have mandibular third molars, with 33% of them have at least one impacted molar 2 , 3 . Many reasons are suggested to removed the third molar such as caries, periodontal problems of adjacent molar, germination disorders, orthodontic problems 2 , 4 .…”

Section: Introductionmentioning

confidence: 99%

Piezosurgery vs conventional rotary instrument in the third molar surgery: A systematic review and meta-analysis of randomized controlled trials

Liu¹,

Hua²,

Pan³

et al. 2018

Journal of Dental Sciences

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Background/purpose The surgical removal of mandibular third molars is frequently accompanied by significant postsurgical sequelae. Different instruments such as piezosurgery and conventional rotary handpiece have been used to decrease such adverse events. There are controversial results from randomized controlled trials evaluating the effects of Piezosurgery in the mandibular third molar extraction, compared with conventional rotary instrument. This study was performed to determine the impact of piezosurgery versus conventional rotary instrument on postoperative reactions after extraction. Materials and methods A systematic review and meta-analysis was performed to combine relevant RCTs results. Results Five RCTs were eligible for this study, enrolling a total of 402 patients. Compared with conventional rotary instrument, pain score at 6 or 7 days and mouth opening at 1 day after surgery was significantly lower in Piezosurgery group (SMD -0.33, 95% CI: −0.56 to −0.10, P = 0.005), as well as swelling score at 7 days after surgery (SMD -1.95, 95% CI: −3.22 to −0.67, P = 0.003). Furthermore, mouth opening at 1 day after surgery was significantly better in patients treated with Piezosurgery (SMD 0.84, 95% CI: 0.19 to 1.49, P = 0.01). However, more operation time will be required for Piezosurgery (MD 6.23, 95% CI: 3.32 to 9.14, P < 0.0001). With regard to analgesic dosage, pooled results from two RCTs suggested there were no significant differences between Piezosurgery and conventional rotary instrument (SMD -1.45, 95% CI: −4.39 to 1.49, P = 0.33). Conclusion There might be some advantages on third mandibular molar extraction with piezosurgery compared to conventional rotary instrument. More multi-centre trials are required to get more conclusive results.

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Comparison of two incision designs for surgical removal of impacted mandibular third molar: A randomized comparative clinical study

Cited by 17 publications

References 10 publications

Evaluation of two flap designs on the mandibular second molar after third molar extractions

Evaluation of two flap designs on the mandibular second molar after third molar extractions

Associations between dental anxiety and postoperative pain following extraction of horizontally impacted wisdom teeth

Piezosurgery vs conventional rotary instrument in the third molar surgery: A systematic review and meta-analysis of randomized controlled trials

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