Permanent damage to inferior alveolar and lingual nerves during the removal of impacted mandibular third molars. Comparison of two methods of bone removal

Rood, J.P.

doi:10.1038/sj.bdj.4807777

Cited by 111 publications

(51 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This was also the case when labial and lingual nerve damage was considered separately. This is perhaps surprising, though previous studies [2][3][4][5] have found that nerve damage reflected surgical technique more than anatomical position of the tooth.…”

Section: Discussioncontrasting

confidence: 40%

Factors influencing nerve damage during lower third molar surgery

1999

View full text Add to dashboard Cite

RESEARCHoral surgery in predicting future pathology. 12,13 The most frequently cited criteria for the removal of lower third molars are those developed at the 1979 conference of the American National Institutes of Health (NIH). 8 Decision analyses of the risks and benefits of prophylactic removal have concluded that prophylactic surgical extraction is not in patients' best interests. 13 Nerve damage resulting in lingual and/or labial paraesthesia or anaesthesia is perceived as particularly debilitating by patients. 14 From such studies the surgical outcomes considered to reduce health to the greatest degree included nerve damage causing permanent anaesthesia of the lip, tongue, or both lip and tongue. Decision analyses have also shown that prophylactic lower third molar removal is unwarranted both on the basis of patient derived utilities and those derived from oral surgeons. 15 A great deal of research has been undertaken in relation to the incidence of nerve injury during lower third molar surgery, but little is known about the factors affecting the rate of damage. Surgical technique is one area that has been examined in this context. A randomised comparison of the lingual split procedure and removal using surgical burs did not find significant differences 16 though there is now strong evidence that lingual nerve damage is substantially less likely if a lingual flap is not raised. 17 A number of studies point to the elevation of the lingual flap as the most important surgical factor causing lingual nerve damage. 2,18 The study reported here was designed to investigate the importance of factors (pathology, eruption status, age and anaesthetic modality) that might influence the rate of nerve damage during third molar surgery. MethodsData were collected in relation to all patients selected for surgery from a series of 500 consecutive patients referred to consultant oral and maxillofacial surgeons for lower third molar assessment. These patients were recruited over an 11-month period. Patients were unselected on the basis of age, gender, or social class. 19 All patients seeking an opinion regarding their third molars were included though cases where this was not the primary focus of referral were excluded. For example a patient attended with a fractured lower jaw and, inter alia, was considered for removal of third molars.Patients were examined by one of four consultants or their designated deputies and treatment was planned in the standard manner. Immediately following this consultation the patients were examined and interviewed by a research hygienist in the same clinical area (though not in the presence of other clinical staff). This worker was appointed specifically to undertake this project and had wide experience of clinical assessment. The hygienist collected data on a standard proforma and recorded demographic information, clinical history and medical history. Maximum mouth opening, extra oral swelling, degree of eruption of each lower third molar, evidence of current pericoronitis, presence and site of ca...

show abstract

Section: Discussioncontrasting

confidence: 40%

Factors influencing nerve damage during lower third molar surgery

1999

View full text Add to dashboard Cite

show abstract

“…(7)(8)(9)(10) Bu çalışmada amaç gömülü 3. molar diş cerrahisinde anksiyete düzeyini düşürmek için uygulanan midazolam ile kombine edilen fentanil ve tramadolün anksiyete ve postoperatif ağrı üzerine etkilerinin karşılaştırılmasıdır.…”

Section: Discussionunclassified

Comparing the Effects of Tramadol and Fentanyl on Anxiety and Postoperaıve Pain in Impacted Third Molar Surgery

Göktay¹,

Satilmis²,

Garip³

et al. 2011

J Turk Anaesth Int Care

View full text Add to dashboard Cite

ÖZETAmaç: Gömülü 3. molar diş çekimi operasyonu endikasyonu bulunan ve korkan hastalarda anksiyete düzeyini dü-şürmek amacıyla uygulanan sedasyon işlemlerinde midazolam ile kombine edilen fentanil ve tramadolün anksiyete ve postoperatif ağrı üzerine etkisini araştırmaktır.Gereç ve Yöntem: İleriye dönük, randomize, çift kör ve plasebo kontrollü çalışmaya, horizontal gömülü 3. molar diş cerrahi çekimi gerçekleşecek APAIS verileri 10'un üzerinde olan 60 ASA I-II hasta dahil edilmiştir. Hastalar, 0,03 mg kg -1 iv midazolam bolus dozunun uygulanmasını takiben rasgele üç gruba ayrılıp, Grup A'ya yalnızca midazolam, Grup B'ye midazolam ve 1 μg kg -1 fentanil, Grup C'ye midazolam ve tramadol 1 mg kg -1 uygulanmıştır. Tüm vital bulgular, intraoperatif parmak ucu ter indeksi (PSI) verileri kaydedilmiş; hastalar postoperatif ağrı, yan etkiler açısından değer-lendirilmiştir.Bulgular: PSI verilerinde gruplar arası fark saptanmamıştır. Postoperatif ilk 1 saat içinde Grup C'deki VAS değerlerinin diğer iki gruptan anlamlı düzeyde daha düşük olduğu tespit edilmiştir (p<0.05). Gruplar ilk ilaç alım zamanı açısından değerlendirildiğinde A, B, C gruplarının ilk ilaç alım zamanı sırasıyla 3, 3,5, 5 saat olarak tespit edilmiş olup, Grup C'deki hastaların ilk ilaç alım zamanlarının diğer iki gruptan anlamlı şekilde daha uzun olduğu saptanmıştır (p<0.01).Sonuç: Tramadolün 3. molar diş cerrahi çekim ağrısında fentanile ve plaseboya göre daha etkin bir analjezi sağladığı gözlenmiştir.Anahtar kelimeler: Anksiyete, bilinçli sedasyon, oral cerrahi SUMMARY Comparing the Effects of Tramadol and Fentanyl on Anxiety and Postoperaıve Pain in Impacted Third Molar SurgeryAim: This study aims to evaluate and compare the effects of fentanyl and tramadol, used in combination with midazolam in the sedation procedures in dentistry so as to alleviate anxiety and postoperative pain associated with surgical third molar extraction in scared patients. Materials and Methods:This prospective randomized double-blind, placebo-controlled study enrolled 60 ASA I-II patients who had horizontal third molar extraction operation indication with APAIS scores above 10 points. All the paients were firstly given 0.03 mg kg -1 bolus midazolam and then they were randomized into three groups as Group A, only midazolam, Group B midazolam -fentanyl (1 μg kg -1 ), Group C, midazolam -tramadol (1 mg kg -1 ) combinations, respectively. All vital signs and intraoperative phalanx sweat index (PSI) data were recorded. Patients were assessed as for postoperative pain, and adverse effects.Results: No difference was found in PSI scores between the groups. During postoperative pain assessments, VAS scores of patients in Group C were lower than the other two groups at the postoperative 1st hour (p<0.05). Time to the need of the first rescue analgesic in Groups A, B, C were reported as 3, 3.5, and 5 hours respectively, while the time interval was comparatively prolonged in Group C (p<0.01).Conclusion: Tramadol has observedly provided more effective analgesia in third molar surgery than f...

show abstract

“…Algunos autores han mostrado un 13% de parestesia en pacientes intervenidos para extracción de terceros molares con uso de retractores, aunque esta parestesia no fue permanente (18). En aquellos casos en los que no se emplearon retractores para apartar el nervio, mostraron un 3,2% de incidencia de daño del nervio, siendo un 2% permanente.…”

Section: Región Posterior De La Mandíbulaunclassified

“…En aquellos casos en los que no se emplearon retractores para apartar el nervio, mostraron un 3,2% de incidencia de daño del nervio, siendo un 2% permanente. Todos los casos de daño permanente o irreversible del nervio estaban asociados con el uso de fresas en la tabla lingual (18). Otros estudios han mostrado que a pesar del daño transitorio que pueden causar los retractores linguales durante la cirugía de terceros molares, se sugiere su uso de manera rutinaria para la cirugía de extracción de terceros molares, ya que no se va visto afectación de manera permanente.…”

Section: Región Posterior De La Mandíbulaunclassified

Consideraciones anatómicas durante la cirugía periodontal

Mendoza

Martínez

2014

Avances en Periodoncia

View full text Add to dashboard Cite

RESUMENEn el presente trabajo hemos realizado una revisión bibliográfica de la literatura con el objetivo de esclarecer las consideraciones anatómicas que deben tenerse en cuenta a la hora de realizar cirugía periodontal, que posibles estructuras anatómicas podemos encontrarnos al elevar un colgajo y cómo podemos evitar la lesión de las mismas. También aportamos un breve repaso sobre conceptos y referencias anatómicas que los especialistas debemos tener presentes durante el manejo de los tejidos blandos y duros. PALABRAS CLAVE:Cirugía, lesión y estructuras anatómicas. SUMMARYFor the present work, we have made a revision through the literature with the objective to clarify the anatomic considerations that should be considered during periodontal surgery, which anatomic structures we could find when raising a flap and how could we avoid injury. Also we have made a short review of the concepts and anatomic references that the specialists should take into consideration during the management of soft and hard tissues. KEY WORDS:Surgery, injury and anatomic structures. INTRODUCCIÓNLa elevación de colgajos es parte fundamental de la cirugía periodontal, que tiene como objetivo adquirir una mejor visibilidad y acceso de la zona a tratar, ya que el tratamiento periodontal básico, basado principalmente en el raspado y alisado radicular no permite una total eliminación del cálculo subgingival.Estos colgajos también son empleados en el caso de la cirugía mucogingival para el recubrimiento de raí-ces, aumento en grosor o altura de tejido gingival y cirugías de regeneración entre otros. Por ello resulta de suma importancia el conocimiento de las estructuras existentes en la cavidad oral, sus límites y relación con estructuras vecinas así como vasos y nervios que no deben de ser traumatizados durante el acto quirúr-gico. PRINCIPALES ESTRUCTURAS PRESENTES EN LA CAVIDAD ORALLa cavidad oral se divide fundamente en dos partes: vestíbulo y la cavidad oral verdadera. La parte exterior del vestíbulo la conforman: los labios y mejillas y

show abstract

Permanent damage to inferior alveolar and lingual nerves during the removal of impacted mandibular third molars. Comparison of two methods of bone removal

Cited by 111 publications

References 0 publications

Factors influencing nerve damage during lower third molar surgery

Factors influencing nerve damage during lower third molar surgery

Comparing the Effects of Tramadol and Fentanyl on Anxiety and Postoperaıve Pain in Impacted Third Molar Surgery

Consideraciones anatómicas durante la cirugía periodontal

Contact Info

Product

Resources

About