基于CBCT的上颌第三磨牙拔除术与上颌窦穿孔的相关性分析

目的 调查分析拔除上颌第三磨牙患者的临床因素及局部多种解剖学因素对上颌窦穿孔的影响.方法 选取2017年6月—2021年9月在新疆医科大学第一附属医院接受上颌第三磨牙拔除术的患者,所有患者术前均拍摄CBCT,共有1350例.分别从年龄、性别、术前症状、阻生情况、位置、牙齿倾斜度、牙根发育度、RS分类、垂直关系、水平关系...     

上颌第三磨牙对第一磨牙近中移动影响的研究

目的探讨萌出中的上颌第三磨牙是否会使上颌第一磨牙向近中移动。方法选择18～24岁正畸患者18例,均拔除4颗第一前磨牙矫治,且随机拔除一侧上颌第三磨牙,两侧其余治疗条件保持一致。治疗3个月后观察两侧上颌第一磨牙近中移动量是否存在差异。结果1)拔除上颌第三磨牙的一侧,其上颌第一磨牙在治疗3个月后未发生明显的近中移动;2)未拔除上颌第三磨牙的一侧,其上颌第一磨牙在治疗3个月后的近中移动量为1mm;3)治疗3个月后,未拔除上颌第三磨牙侧的第一磨牙近中移动量大于拔除第三磨牙侧的第一磨牙的近中移动量,其差异有统计学意义(P<0.01)。结论在正畸治疗的初始阶段,若上颌第三磨牙的萌出间隙不足,其萌出会对其近中的上颌第一磨牙产生影响,导致其近中移动而丧失支抗。     

Actinomyces parotid infection after mandibular third molar extraction

Actinomycosis is currently an uncommonly diagnosed human disease. The disease is a chronic suppurative infection caused by micro-organism from the Actinomyces group, most often Israelii. A patient with cervicofacial actinomycosis generally reports a history of recent dental treatment which, usually, involves extraction of a mandibular molar. The common initial signs and symptoms of infection (such as sudden onset of cervicofacial pain, swelling, erythema, edema and suppuration) can be absent. In this case report a 29-year-old man presented a mass in his left parotid area, 1 week after mandibular molar extraction. Echography and CT scans revealed a parotid abscess area. The needle-biopsy of swelling revealed infection due to Actinomyces. Therapy was started with intravenous cefazolin (fl 1g X 2 in 100 s.s. i.v.) and methylprednisolone (25 mg tablet, 1/die) for 9 days; 14 days after treatment suspension the lesion reappeared with a fistula and a new therapy was given (ceftriaxone 1 g/die and gentamicin 80 mg/i.m. for 3 weeks). To prevent a relapse, the patient received cefalexin 1 gx2/die per os for 4 weeks. After a follow-up of 1 year, the patient was still asymptomatic.     

Influence of unilateral maxillary first molar extraction treatment on second and third molar inclination in Class II subdivision patients

Objective:To assess the maxillary second molar (M2) and third molar (M3) inclination following orthodontic treatment of Class II subdivision malocclusion with unilateral maxillary first molar (M1) extraction.Materials and Methods:Panoramic radiographs of 21 Class II subdivision adolescents (eight boys, 13 girls; mean age, 12.8 years; standard deviation, 1.7 years) before treatment, after treatment with extraction of one maxillary first molar and Begg appliances and after at least 1.8 years in retention were retrospectively collected from a private practice. M2 and M3 inclination angles (M2/ITP, M2/IOP, M3/ITP, M3/IOP), constructed by intertuberosity (ITP) and interorbital planes (IOP), were calculated for the extracted and nonextracted segments. Random effects regression analysis was performed to evaluate the effect on the molar angulation of extraction, time, and gender after adjusting for baseline measurements.Results:Time and extraction status were significant predictors for M2 angulation. M2/ITP and M2/IOP decreased by 4.04 (95% confidence interval [CI]: −6.93, 1.16; P  =  .001) and 3.67 (95% CI: −6.76, −0.58; P  =  .020) in the extraction group compared to the nonextraction group after adjusting for time and gender. The adjusted analysis showed that extraction was the only predictor for M3 angulation that reached statistical significance. M3 mesial inclination increased by 7.38° (95% CI: −11.2, −3.54; P < .001) and 7.33° (95% CI: −11.48, −3.19; P  =  .001).Conclusions:M2 and M3 uprighting significantly improved in the extraction side after orthodontic treatment with unilateral maxillary M1 extraction. There was a significant increase in mesial tipping of maxillary second molar crowns over time.     

Localization of maxillary third molar immobilized within an infected maxillary sinus

Because a condition of this type could not be detected with intraoral radiographs, the panoramic radiograph was the logical choice for further diagnostic information without resorting to the specialized extraoral radiographs of the maxillary sinus (Waters' view or anteroposterior extraoral radiograph, for example). As the panoramic radiograph is a fast, simple, and relatively inexpensive procedure, all dentists should make use of this technique when a patient with these symptoms is involved.     

Autotransplantation of a maxillary third molar to replace a maxillary premolar with vertical root fracture

Aim To report the successful autotransplantation of a fully developed third molar that required nonsurgical and surgical interventions for tooth adaptation. Summary This case report describes the autotransplantation of a third molar with complete root development after the loss of a fractured premolar in a 47-year-old male. To allow better adaptation of the donor tooth, the buccal roots of the third molar were removed using a diamond bur and the canal entrances were filled. Recall examination 6 years after completion of root-canal treatment showed normal periodontal healing with absence of infection, ankylosis or progressive resorption. The transplantation of a third molar is seen as a promising method to replace a lost permanent tooth, and to restore aesthetics and function. Key learning points

• • Autotransplantation is a viable option for the treatment of a missing tooth or for replacement of traumatized tooth when there is a donor tooth available.
• • Fully developed third molars are potentially reliable candidates in the absence of other suitable donor teeth.

     

Incidence and evolution of inferior alveolar nerve lesions following lower third molar extraction

OBJECTIVES: To calculate the incidence of inferior alveolar nerve (IAN) damage due to lower third molar extraction and to describe the evolution of IAN sensitivity and the prognosis of IAN damage based on preoperative data. STUDY DESIGN: A retrospective study of 4995 lower third molar extractions in 3513 outpatients. RESULTS: Fifty-five extractions (1.1%) resulted in IAN impairment. Cox regression analysis showed age to be a risk factor for the persistence of IAN injury due to lower third molar extraction. The sensation recovery rate was higher in the first 3 months. Fifty percent of the patients showed full recovery after 6 months. CONCLUSIONS: Most cases of IAN impairment following lower third molar extraction recover within 6 months, though in some cases recovery takes more than 1 year. Older patients are at an increased risk of incomplete recovery of chin and lip sensibility after third molar extraction.     

Frequency and evolution of lingual nerve lesions following lower third molar extraction.

PURPOSE: To calculate the frequency of lingual nerve (LN) damage caused by lower third molar extraction and describe the evolution of LN sensitivity as well as the prognosis of LN damage based on preoperative data. PATIENTS AND METHODS: A retrospective study of 4,995 lower third molar extractions performed in 3,513 outpatients of the Department of Oral and Maxillofacial Surgery (University of Barcelona, Spain) between January 1998 and September 2001. RESULTS: Twenty-four extractions (0.5%) resulted in LN impairment. All involved ostectomy, with tooth sectioning in 20 cases. Cox regression analysis showed no risk factors for the persistence of LN injury during lower third molar extraction. The sensitivity recovery rate was greater in the first 3 months and then gradually decreased. CONCLUSION: LN impairment usually recovers, the recovery rate being faster in the first months. LN damage is generally associated with ostectomy and tooth sectioning.     

Necrotizing soft tissue infection following routine third molar extraction: report of two cases and review of the literature

Necrotizing cellulitis, necrotizing fasciitis, and necrotizing myositis are a constellation of severe soft tissue infections characterized by rapid progression, dusky soft tissue changes, and edema and induration expanding beyond the clinical wound edges. The cases of two female patients with type II necrotizing soft tissue infections occurring after routine third molar extraction are reported here. The patients were treated for the infections at the University of North Carolina Hospitals in 2016. Both were previously healthy. Of particular interest, recent inoculation of group A Streptococcus appears to have contributed to the infection in both cases.     

Gustatory function after third molar extraction

OBJECTIVE: The purpose of this study was to determine the severity and time course of taste changes after extraction of all 4 third molars. STUDY DESIGN: Taste function in 17 patients was measured before third molar surgery and at 1 month and 6 months after surgery. Two tests were administered: a whole-mouth, above-threshold test in which subjects sipped, expectorated, and then rated the intensities and identified the taste qualities of various solutions, and a localized test in which subjects rated and identified solutions painted with cotton swabs on different oral sites. RESULTS: Intensity ratings for solutions in the whole-mouth test were reduced by approximately 14% for NaCl, citric acid, and quinine hydrochloride at 1 month after surgery and had not recovered by 6 months after surgery for citric acid (P<.02). The taste quality of NaCl was identified correctly less frequently after third molar extraction. Perceived taste intensity on discrete areas of the tongue was significantly reduced after surgery (P<.05). Patients with the most severely impacted molars gave the lowest taste intensity ratings to whole-mouth test solutions at 6 months after surgery (P<.02). In contrast, taste function in a group of subjects who received only local dental anesthesia was not affected. CONCLUSIONS: Gustatory deficits occur after third molar extraction, persist for as long as 6 months after surgery, and appear to be associated with depth of impaction.     

Accidental displacement of impacted maxillary third molar: a case report

An unusual case of an impacted right maxillary third molar that was accidentally displaced into the maxillary sinus during exodontia and was surgically retrieved almost 2 years later is described. The tooth was removed under general anesthesia, after maxillary sinus exposure through Caldwell-Luc approach. Postoperative recovery was uneventful. Six months after the retrieval surgery, the maxillary sinus was completely healed and the patient did not present any complaint.     

Intraosseous lipoma in the periapical region of a maxillary third molar

Introduction

Images of oral lesions can look so exceptionally similar that a diagnosis hypothesis could be difficult. Lesions mimicking apical periodontitis must be considered when making a differential diagnosis. Intraosseous lipoma is a rare benign tumor of low incidence among all bone tumors, and therefore few cases have been reported in the literature.

Methods and Results

A case of intraosseous lipoma associated with the distobuccal root of tooth #1 in a 39-year-old woman is described. The dental general practitioner did not perceive anything of note in terms of the radiographic aspect, so consequently the periapical lesion went unnoticed. However, after tooth extraction, a different feature was noticed in the surgical specimen. The lesion associated to the roots of tooth #1 was surrounded by soft tissue forming a fibrous capsule (10 mm in diameter). A histopathologic examination showed an area of bone of lamellar aspect surrounding a central area of fat tissue diagnosed as intraosseous lipoma. This type of lesion is asymptomatic, and its etiology is unclear.

Conclusions

Intraosseous lipoma should be considered in the differential diagnosis of other jaw lesions. A histologic examination is mandatory for the diagnosis, because this lesion is characterized by bone of lamellar aspect surrounding a central area of fat tissue. The treatment chosen in this case was surgical excision, and the outcome was favorable.