Surgical techniques for the removal of mandibular wisdom teeth

Abstract

The thirty-five included trials looked at a range of different surgical techniques. The comparisons related to seven broad aspects of the surgical procedures for impacted mandibular third molars: type of surgical flap raised, use of retractors, techniques for bone removal, wound irrigation, wound closure, wound drainage, and complete/incomplete tooth removal. The quality of the body of evidence for each of these comparisons was very low to moderate due to the small number of trials and patients, and the majority of the trials being at high risk of bias (65%) with the remainder at unclear risk of bias.The evidence for making changes to surgical practice is therefore limited. However, it is useful to describe the state of the research evidence supporting practice so that surgeons can make an informed choice in adopting new techniques, or continuing with established techniques.

Wisdom tooth extraction causing lingual nerve and styloglossus muscle damage: a mimic of multiple cranial nerve palsies

“…The lingual nerve grooves the inner table of the mandible adjacent to the lower third molar. The lingual plate of the mandible at that site is very thin and fractures easily, either as a planned procedure to improve a path for extraction (a lingual split), in the process of mobilising the tooth or by pressure from a mandibular retractor 6. The proximity of the tiny styloglossus muscle puts it at risk from any of these insults.…”

A Review of Wound Closure Technique-Patient Morbidity Relationship After Wisdom Tooth Surgery

“…Facial swelling may also alarm patients and typically peaks at around one or two days before subsiding over the subsequent days. Trismus results from inflammation of the muscles that move the jaw and may persist for more than a few days causing concern and difficulty in eating for about two weeks or more (3) .…”

Terceiros molares: avaliação da presença de cárie, doença periodontal e qualidade de vida, e suas variações conforme posição dental

“…A exodontia traz benefícios como o alivio da dor. Para indicar exodontia devemos pesar benefícios versus o risco de complicações PO (Coulthard et al, 2014).…”

“…As indicações clássicas de exodontias de 3Ms são infecção, lesões cariosas não passíveis de restauração (Coulthard et al, 2014), cistos, tumores, destruição óssea na região (Polat et al, 2008), dor, progressão de Dp, pericoronarite (Chang et al, 2009), facilitação da manutenção de Dp, infecção crônica ou aguda, erupção ectópica, tamanho do dente, alterações patológicas Rafetto, 2012), episódios recorrentes de pericoronarite, reabsorções, perda óssea na região, cáries e Dp no 2M (Christensen et al, 2012).…”

“…Determinar qual risco aumenta com o passar do tempo ajuda na tomada de decisão das exodontias de 3Ms (Moss et al, 2007a). Riscos e benefícios de manter o 3M devem ser pesados (Coulthard et al, 2014), assim como a vontade do paciente (Knutson et al 1996;Adeyemo et al, 2008;Negreiros et al, 2012;Dodson, 2012). A exodontia de 3Ms só pode ser justificada quando a indicação certamente trará benéfico ao paciente, como o alivio da dor (Polat et al, 2008).…”