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The Buccal Lid Approach for Removal of Impacted Mandibular molars—When, How and Why?

Open Journal of Stomatology 2017年第1期7卷 81-90页

作者： Fares Kablan Victoria Yaffe Imad Abu El-Naaj Department of Oral and Maxillofacial Surgery Baruch Padeh Medical Center Poriya Israel Department of Oral and Maxillofacial Surgery Baruch Padeh Medical Center Affiliated to the Faculty of Medicine of Bar-Ilan University in the Galilee Poriya Israel

Background: The surgical removal of impacted mandibular molars represents one of the most prevalent procedures carried out by the oral and maxillofacial surgeon. Despite its prevalence, unusual impaction location of mandibular molars necessitates alternative extraction approaches. One of the methods described for extraction of deeply impacted molars is the bony lid approach which was first presented for surgical endodontic treatment of mandibular molars. The aim of this study was to evaluate the outcome of the bony lid approach in extracting mandibular molars. In addition, critical clinical key points, new aspects while performing this procedure, indications and contraindications are discussed. Materials and Methods: 9 patients were treated with the bony lid technique. A retrospective analysis of medical charts was conducted to evaluate the results of surgery. Results: The operative technique described in the article was successfully carried out in 12 cases of impacted mandibular molars. No incidence of permanent sensory deficit was recorded. In one patient, an infection mandated the removal of the bony lids. In all other cases the healing process was uneventful. Conclusion: The bony lid technique has many advantages over alternative extraction methods and should be considered as a treatment option in cases of critical proximity between an impacted tooth and the inferior alveolar nerve.

关键词： Buccal Lid Mandibular molars Extraction

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Ultrasonic piezotome surgery: is it a benefit for our patients and does it extend surgery time? A retrospective comparative study on the removal of 100 impacted mandibular 3rd molars

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Open Journal of Stomatology 2011年第4期1卷 179-184页

作者： Angelo Troedhan Andreas Kurrek Marcel Wainwright 不详

Aim of the study was to evaluate if there is a constant and significant reduction in traumaticity when mas- sively traumatic oral surgical procedures such as the removal of third molars are conducted with only ul- trasonic surgical devices (Piezotomes) expressed in a reduction of postsurgical pain and swelling on the patient’s side since such clinical experiences by the authors suggested this. Since oral surgeons criticize a higher time consumption for surgeries with Piezoto- mes also the objective time consumption was evalu- ated and compared to the traditional methods. Mate- rial and Methods: 56 female and male patients were selected that already underwent a removal of an im- pacted third mandibular molar on one side with rota- ry instruments by bone destructive burring with a still persisting comparable third mandibular molar on the contralateral side complaining about recur- rent pain episodes and were already documented for pain and swelling before. The ultrasonic surgical re- moval with the Piezotome was conducted with a buc- cal osteotomy of the compacta lateral to the impacted third molar, preservation of the resected compacta in saline solution, removal of the third molar by single or multiple dentotomy and full anatomical restitution of the surgical site with the preserved buccal com- pacta. The swelling was documented by kephalome- try 24/48/72 hours and 1 week post surgery, the pain index by the total consumption of ibuprofen-400 mg—tablets. Lesions of the mandible nerve were documented. Netto surgery time was taken from the first incision to the last suture of the procedure. Re-sults: 6 patients had to be excluded from evaluation due to incomplete post surgical follow up. A signify-cant (***, p > 0.999) decrease in pain and swelling of 50% was detected both for the parameters swelling and pain with Piezotome-surgery. No lesions of the mandible nerve were detected with Piezotome sur- gery whereas surgery with rotary instruments re- sulted in 16% hypesthe

关键词： Ultrasonic Surgery Piezotome Rotating Instruments Post Surgical Swelling Post Surgical Pain Impacted Mandibular Third molars Osteotomy

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