Difficulty index in extraction of impacted mandibular third molars and their post-operative complications

Khanal, Pranaya; Dixit, Siddharth; Singh, Rajendra; Dixit, Punam Basnet

doi:10.3126/jkmc.v3i1.10918

Cited by 15 publications

(21 citation statements)

References 11 publications

(17 reference statements)

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“…In this study, higher incidence of mandibular third molar impaction was found in females (54.2%) which is corroborated by studies done by Upadhyaya et al 18 and Khanal et al 19 This can be attributed to differences in growth pattern between males and females. Females have less incremental and a shortened duration for growth of mandible compared to males.…”

Section: Discussionsupporting

confidence: 90%

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A Comparative Study on Efficacy of Amoxicillin and Azithromycin in Prevention of Postoperative Sequelae Following Third Molar Surgery

Gurung¹,

Bimb²,

Shrestha³

2019

Nep. Med. Coll. J.

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Amoxicillin is the commonly prescribed antimicrobial for prevention of post-operative complications following surgical extraction of mandibular third molar. However recently, the use of macrolideantibiotics had been encouraged in dentistry. The aim of this study was to compare the efficacy of Amoxicillin and Azithromycin in preventing post-operative sequelae following third molar surgery. An open- labeled randomized controlled study was carried out in Department of Oraland Maxillofacial surgery, college of Dental Sciences and Hospital, Nepal Medical College (CODSHNMC), Attarkhel, Kathmandu, Nepal from May 2018 to June 2019. One hundred and twenty patients undergoing surgical extraction of impacted mandibular third molar were randomized by lottery method into two groups: Group A received Amoxicillin and Group B received Azithromycin. Both the groups were assessed postoperatively on 1st, 3rd and 7th days for post-operative complications- pain, swelling, trismus and pus discharge. The present study revealed no significant differences between the efficacy of Amoxicillin and Azithromycin in preventing postoperative sequelae following surgical extraction of impacted third molar. Amoxicillin and Azithromycin were therefore found to be equally effective. Thus, Azithromycin can be used as an alternative drug to Amoxicillin in case of resistance and intolerance to Amoxicillin.

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Section: Discussionsupporting

confidence: 90%

“…Several authors have mentioned similar observation. 18,19 Pus discharge was found statistically insignificant between the two study groups. Data from this study showed the incidence of infection at 5% in POD 1 and 1.7% in POD 3 for Amoxicillin group and nil for Azithromycin group.…”

Section: Discussionmentioning

confidence: 67%

A Comparative Study on Efficacy of Amoxicillin and Azithromycin in Prevention of Postoperative Sequelae Following Third Molar Surgery

Gurung¹,

Bimb²,

Shrestha³

2019

Nep. Med. Coll. J.

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“…Studies found that the difficulty in L3M extraction is directly associated with vertical and horizontal tooth position [3,17,18], and with bulbous roots [3,18].…”

Section: Discussionmentioning

confidence: 99%

“…When tooth angulation take in account, more postoperative complication were associated with distoangular, vertical [17,19], and mesioangular impaction [20]. The position of the L3M relative to the inferior alveolar nerve was also associated with an increased risk for complications [20].…”

Section: Discussionmentioning

confidence: 99%

Third Molar Assessment: Examiners Agreement about the Radiographically Determined Anatomical Parameters

Samman¹

2017

Austin J Dent

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Objective: This study aimed to evaluate the reproducibility of the radiographically determined anatomical parameters related to the lower third molar (L3M) by analyzing the results of examiners agreement degree.Study Design: An observational study of 50 L3M was made from twentyfive digital panoramic radiographs, which analyzed by four examiner groups (oral and maxillofacial surgeons, dental specialists, general dental practitioners (GDP), and post-rotation dentists) through the evaluation of the position and angulation of L3M along with the root forms and their relation to the inferior dental nerve (IDN). Intra and interexaminer agreement were determined by descriptive analysis and variance test.Results: Only evaluation of tooth angulation showed both intra and inter-group agreement among examiners (82.3%, P= 0.128), whereas mean agreement about tooth position was 80.7% for intragroup analysis with statistical significant difference to position variable in intergroup analysis.Root form and tooth-IDN relation variables revealed lowest intragroup mean of agreement with lack of inter-group reproducibility with greater disagreement to the GDP and specialist group (P< .05). Conclusion:The intra and interexaminer reproducibility of subjective L3M evaluation was only associated to tooth angulation. These results suggest the need for using an objective measurement method to minimize the error introduced by observer interpretation.

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“…8 The difficulty index consist of three components; Angulation (in relation to long axis of second molar [mesioangular, distoangular, horizontal], Depth (in relation to occlusal plane [Class A,B,C]) and position (in relation to vertical ascending ramus [Class I,II & III]). 9 The occurrence of these indices are associated with several factors which include age, gender, and general health of patient, the smoking status, use of oral contraceptive (in case of females), and surgical technique used along with the preferred flap design. 10 The aim of this study is to evaluate the less aggressive technique Ward's versus Modified Ward's flap with respect to less post-operative complications in removal of lower third molar.…”

Section: Introductionmentioning

confidence: 99%

Flap design: Comparison of ward’s flap versus modified ward’s flap in surgical extraction of impacted mandibular third molar.

Kumar

Memon

Panjabi

et al. 2019

TPMJ

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To compare the Ward’s Flap Versus Modified Ward’s flap in relation to access, healing & postoperative complications in surgical extraction of mandibular third molar impaction. Study Design: Comparative Cross Sectional. Setting: Department of Oral & Maxillofacial Surgery LUMHS Jamshoro/Hyderabad: Period: March 2017 to November 2017. Materials and Methods: The history, clinical examination and radiographs (OPG and periapical) had done by team of researchers and recorded on proforma. After selection of patient into either group (Group A=Wards Flap, Group B Modified Wards), the surgical extraction was carried out under local anesthesia. For group A, a standard full thickness mucoperiosteal flap (ward’s flap) was raised. The incision was given mesial to the impacted lower third molar. For group B, a standard full thickness mucoperiosteal flap (Modified ward’s flap) was given mesial to second molar. At the end of the surgery, the flap design used for the extraction of impacted lower third molar tooth and the duration of each operation (from the first extraction maneuver to the completion of the last suture), Pain, Swelling and Trismus13 were recorded on the proforma. Every patient was called for follow up on the 3rd day and 7th day. Results: Mean age was found 27.93 years, with range of minimum 20 years and maximum 35 years. Male were found in the majority 72.3%. Majority of the cases 51.5% were found with class B, in class A 37.5% and 10.9% were found with class C. According to the impaction position 50% cases were in class I, and 50% cases were in class II. Preoperative pain measurement was done according VAS, 71.9% patients were found with mild pain, 9.4% were with moderate pain while 18.8% patients were without pain. Modified Wards flap showed good efficacy regarding duration of third molar extraction as compare to Ward’s flap P-value 0.018. Modified ward’s flap had showed less postoperative pain as compare to ward’s flap p-value 0.022. No significant difference was found between both groups on 3rd and 7th postoperative day in Mouth opening. Conclusion: This study concluded that both ward’s flap and modified ward’s flaps showed good efficacy, while duration of surgery and postoperative pain were significantly less in the modified ward’s flaps as compare to ward’s flap. More large sample size studies are required to evaluate more accurate findings.

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Difficulty index in extraction of impacted mandibular third molars and their post-operative complications

Cited by 15 publications

References 11 publications

A Comparative Study on Efficacy of Amoxicillin and Azithromycin in Prevention of Postoperative Sequelae Following Third Molar Surgery

A Comparative Study on Efficacy of Amoxicillin and Azithromycin in Prevention of Postoperative Sequelae Following Third Molar Surgery

Third Molar Assessment: Examiners Agreement about the Radiographically Determined Anatomical Parameters

Flap design: Comparison of ward’s flap versus modified ward’s flap in surgical extraction of impacted mandibular third molar.

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