Welcome to Francis Academic Press

International Journal of Frontiers in Medicine, 2024, 6(3); doi: 10.25236/IJFM.2024.060306.

Skills and methods for the extraction of mandibular embedded wisdom teeth: Research progress

Author(s)

Dilihumaer Kuerban1,2, Gu Li1,2, Wang Ling1,2

Corresponding Author:
Wang Ling
Affiliation(s)

1Oral Surgery Clinic, The First Affiliated Hospital of Xinjiang Medical University (Affiliated Stomatological Hospital), Urumqi, Xinjiang, 830000, China

2Xinjiang Uygur Autonomous Region Institute of Stomatology, Urumqi, Xinjiang, 830000, China

Abstract

Mandibular embedded wisdom teeth refer to the mandibular third molars that are completely embedded in the bone tissue and cannot erupt normally. Mandibular embedded wisdom teeth usually cause a series of complications such as deep periodontal pocket in the distal end, infection, distal bone loss, external root resorption of adjacent teeth, osteomyelitis, and cysts. Therefore, it is suggested that such mandibular third molars should be extracted as soon as possible by experts. At present, the operation of extracting mandibular embedded third molars is difficult, risky, with a high incidence of complications, and poor bone healing after surgery, which even aggravates the degree of some complications. More minimally invasive extraction methods are being studied by some scholars to better guide the healing of bone tissue, and modified flap methods, windowing methods, bone removal, and tooth separation methods have been proposed. This article takes the extraction of mandibular embedded third molars as an example, summarizes a series of modified extraction methods, and writes a review to provide a reference for clinical work.

Keywords

Mandibular embedded third molar; adjacent teeth; flap; window; suture

Cite This Paper

Dilihumaer Kuerban, Gu Li, Wang Ling. Skills and methods for the extraction of mandibular embedded wisdom teeth: Research progress. International Journal of Frontiers in Medicine (2024), Vol. 6, Issue 3: 33-38. https://doi.org/10.25236/IJFM.2024.060306.

References

[1] Camps-Font, O., Caro-Bonfill, C., Sánchez-Garcés, M.À. and Gay-Escoda, C. (2018) Periodontal Regenerative Therapy for Preventing Bone Defects Distal to Mandibular Second Molars after Surgical Re-moval of Impacted Third Molars: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Journal of Oral and Maxillofacial Surgery, 76, 2482-2514. 

[2] Candotto, V., Oberti, L., Gabrione, F., Scarano, A., Rossi, D., & Romano, M. (2019). Complication in third molar extractions. Journal of biological regulators and homeostatic agents, 33(3 Suppl. 1).

[3] Kugelberg, C. (1990) Impacted Lower Third Molars and Periodontal Health. Anepidemiological, Methodological, Retrospective and Prospective Clinical Study. Swedish Dental Journal, 68, 1-52. 

[4] Montero, J. and Mazzaglia, G. (2011) Effect of Removing an Impacted Mandibular Third Molar on the Periodontal Status of the Mandibular Second Molar. Journal of Oral and Maxillofacial Surgery, 69, 2691-2697. 

[5] Passarelli, P., Lajolo, C., Pasquantonio, G., et al. (2019) Influence of Mandibular Third Molar Surgical Extraction on the Periodontal Status of Adjacent Second Molars. Journal of Periodontology, 90, 847-855. 

[6] Kugelberg, C.F. (1990) Periodontal Healing Two and Four Years after Impacted Lower Third Molar Surgery. A Comparative Retrospective Study. International Journal of Oral and Maxillofacial Surgery, 19, 341-345.

[7] Kungu Daming, Wen Yu, Gu Yihao.Retrospective analysis of 2749 impacted third molar lesions [J].Modern medical and health care, 2022, 38(7): 1209-1212

[8] Leung, W.K., Corbet, E.F., Kan, K.W., et al. (2005) A Regimen of Systematic Periodontal Care after Removal of Impacted Mandibular Third Molars Manages Periodontal Pockets Associated with the Mandibular Second Molars. Journal of Clinical Periodontology, 32, 725-731.

[9] Li Yuan, Zhang Wuyang, Deng Tiange. New technique of tooth extraction [J].Chinese Journal of Practical Stomatology.2021,14(6):650-654. DOI:10.19538/j.kq.2021.06.003.

[10] Korkmaz, Y., Mollaoglu, N. and Ozmeriç, N. (2015) Does Laterally Rotated Flap Design Influence the Short-Term Periodontal Status of Second Molars and Postoperative Discomfort after Partially Impacted Third Molar Surgery? Journal of Oral and Maxillofacial Surgery, 73, 1031-1041. 

[11] Ahmad, M., Khan, Z., Khan, T., et al. (2021) Influence of Surgical Flap Design (Envelope and Szmyd) for Removal of Impacted Mandibular Third Molars on Clinical Periodontal Parameters: A Clinical Trial. International Journal of Environmental Research and Public Health, 18, 4465.

[12] Kirtiloğlu, T., Bulut, E., Sümer, M. and Cengiz, I. (2007) Comparison of 2 Flap Designs in the Periodontal Healing of Second Molars after Fully Impacted Mandibular Third Molar Extractions. Journal of Oral and Maxillofacial Surgery,65, 2206-2210. 

[13] Ahmad, M., Khan, Z. A., Khan, T. U., Alqutub, M. N., Mokeem, S. A., AlMubarak, A. M., Haider, M., Al-Askar, M., Ahmed, N., Aldahiyan, N., Vohra, F., & Abduljabbar, T. (2021). Influence of Surgical Flap Design (Envelope and Szmyd) for Removal of Impacted Mandibular Third Molars on Clinical Periodontal Parameters: A Clinical Trial. International journal of environmental research and public health, 18(9), 4465. https://doi.org/10.3390/ijerph18094465.

[14] Alqahtani, N. A., Khaleelahmed, S., & Desai, F. (2017). Evaluation of two flap designs on the mandibular second molar after third molar extractions. Journal of oral and maxillofacial pathology: JOMFP, 21(2), 317–318. https://doi.org/10.4103/jomfp.JOMFP_75_17.

[15] Scolozzi P. (2022). Buccal corticotomy using piezosurgery as a surgical approach for removal of deeply impacted mandibular teeth: An alternative procedure to avoid pitfalls associated with the conventional technique. Journal of stomatology, oral and maxillofacial surgery, 123(2), 142–146. https://doi.org/10.1016/j.jormas.2021.04.012.

[16] Suarez-Cunqueiro, M. M., Gutwald, R., Reichman, J., Otero-Cepeda, X. L., & Schmelzeisen, R. (2003). Marginal flap versus paramarginal flap in impacted third molar surgery: a prospective study. Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics, 95(4), 403–408. https://doi.org/10.1067/moe.2003.84.

[17] Kirtiloğlu, T., Bulut, E., Sümer, M., & Cengiz, I. (2007). Comparison of 2 flap designs in the periodontal healing of second molars after fully impacted mandibular third molar extractions. Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons, 65(11), 2206–2210. https://doi.org/10.1016/j.joms.2006.11.029.

[18] Karaca, I., Simşek, S., Uğar, D., & Bozkaya, S. (2007). Review of flap design influence on the health of the periodontium after mandibular third molar surgery. Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics, 104(1), 18–23. https://doi.org/10.1016/j. tripleo. 2006. 11.049.

[19] Yuan Chunyu.A randomized controlled trial of the effect of lingual basal flap on the prognosis of impacted mandibular third molar extraction [D]. [Master 's thesis].Shandong University,2021.

[20] Menziletoglu, D., Guler, A. Y., Basturk, F., Isik, B. K., & Erdur, E. A. (2020). Comparison of two different flap designs for bilateral impacted mandibular third molar surgery. Journal of stomatology, oral and maxillofacial surgery, 121(4), 368–372. https://doi.org/10.1016/j.jormas.2019.08.006

[21] Yolcu, Ü., & Acar, A. H. (2015). Comparison of a new flap design with the routinely used triangular flap design in third molar surgery. International journal of oral and maxillofacial surgery, 44(11), 1390–1397. https://doi.org/10.1016/j.ijom.2015.07.007

[22] Motamedi M. H. (1999). Preventing periodontal pocket formation after removal of an impacted mandibular third molar. Journal of the American Dental Association (1939), 130(10), 1482–1484. https://doi.org/10.14219/jada.archive.1999.0060

[23] Scolozzi P. (2022). Buccal corticotomy using piezosurgery as a surgical approach for removal of deeply impacted mandibular teeth: An alternative procedure to avoid pitfalls associated with the conventional technique. Journal of stomatology, oral and maxillofacial surgery, 123(2), 142–146. https://doi.org/10.1016/j.jormas.2021.04.012

[24] Zhou Yangyifan, Zhang Xueming, Hou Guangyu. Ultrasonic bone knife buccal window method to remove the lower mandibular bone impacted third molar [J].Journal of Oral and Maxillofacial Surgery, 2019, 29(1)30‐33.

[25] Yang Huina, Wu Jing, Du Xinya, Li Xiaoyu.Clinical analysis of buccal fenestration in extraction of lower impacted mandibular wisdom teeth [J].Journal of Oral and Maxillofacial Surgery, 2023, 33(3): 173-177.

[26] Hasegawa, T., Ri, S., Shigeta, T., Akashi, M., Imai, Y., Kakei, Y., Shibuya, Y., & Komori, T. (2013). Risk factors associated with inferior alveolar nerve injury after extraction of the mandibular third molar--a comparative study of preoperative images by panoramic radiography and computed tomography. International journal of oral and maxillofacial surgery, 42(7), 843–851. https://doi.org/10. 1016/j.ijom.2013.01.023.

[27] Umar, G., Obisesan, O., Bryant, C., & Rood, J. P. (2013). Elimination of permanent injuries to the inferior alveolar nerve following surgical intervention of the "high risk" third molar. The British journal of oral & maxillofacial surgery, 51(4), 353–357. https://doi.org/10.1016/j.bjoms.2012.08.006

[28] Patel V, Sproata C, Kwok J, et al. Histological evaluation of mandibular third molar roots retrieved after coronectomy [J]. Br J Oral Maxillofac Surg, 2014, 52(5): 415-419. 

[29] Sivolella S, Berengo M, Bressan E, et al. Osteotomy for lower third molar germectomy: randomized prospective crossover clinical study comparing piezosurgery and conventional rotatory osteotomy [J]. J Oral Maxillofac Surg, 2011, 69(6): 15-23.

[30] Cortes AR, No-Cortes J, Cavalcanti MG, et al. An alternative approach to extruding a vertically impacted lower third molar using an orthodontic miniscrew: a case report with cone-beam CT follow-up [J]. Imaging Sci Dent, 2014, 44(2): 171-175. 

[31] Wang Y, He DM, Yang C, et al. An easy way to apply orthodontic extraction for impacted lower third molar compressing to the inferior alveolar nerve [J]. J Craniomaxillofac Surg, 2012, 40(3): 234-237.

[32] Matzen LH, Villefrance JS, Nφrholt SE, et al. Cone beam CT and treatment decision of mandibular third molars: removal vs coronectomy-a 3-year audit [J]. Dentomaxillofac Radiol, 2020, 49 (3): 20190250.  

[33] Pitros P, Jackson I, O'Connor N. Coronectomy: a retrospective outcome study[J]. Oral Maxillofac Surg, 2019, 23(6): 453-458. 

[34] Kang FW, Xue ZX, Zhou XK. Coronectomy: A useful approach inminimizing nerve injury compared with traditional extraction of deeply impacted mandibular third molars [J]. J Oral Maxillofac Surg, 2019, 77(11): 2221.e1-2221.e14.

[35] Dalle Carbonare, M., Zavattini, A., Duncan, M., Williams, M., & Moody, A. (2017). Injury to the inferior alveolar and lingual nerves in successful and failed coronectomies: systematic review. The British journal of oral & maxillofacial surgery, 55(9), 892–898. https://doi.org/10.1016/j. bjoms. 2017. 09.006.

[36] Mohammad I Al-Obaida, Mehdiya Haider, Rawan Hashim, et al.Comparison of perceived pain and patients' satisfaction with traditional local anesthesia and single tooth anesthesia: A randomized clinical trial. World Journal of Clinical Cases, 2019, 7(19): 2986-2994. 

[37] Pan Jian, Yang Tengyu, Su Naichuan. New progress in oral local anesthesia. Chinese Journal of Practical Stomatology, 2012, 5(7): 387-390.