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Background: It has been outlined that LTM (Lower third molar) extracted from patients in which grinding, cleaning, sterilization & demineralization prove to be highly effective as graft material for filling the alveolar socket of the very same patient. These investigations aim to assess the efficiency of ADDM (Autogenous Demineralized Dentin Matrix) graft in third molar extraction sockets. Purpose: To check the effectiveness of ADDM as graft material in extraction socket by evaluating pain, swelling, trismus, PD (Probing Depth) and bone density. Study design, setting, sample: A prospective, randomized control trial was conducted at our institute. The patients were haphazardly, non-blindly alienated into two groups. Group A (45 patients) on the test side after LTM impaction surgery will receive ADDM graft material with bio-collagen membrane and Group B (45 patients) on the control side underwent LTM removal, with the alveolus left to heal conventionally by forming a blood clot. Results: Swelling showed significant difference between CG (Control Group) and TG (Test Group), the intergroup comparison of change in the swelling scores at seventh post-operative day (from pre-op level) was significantly higher in the TG (117.35) as compared to the CGs (115.92) (p = 0.001). A statistically significant difference in probing depth was also noted between the two groups, CG 4.46 ± 1.252 & TG 2.52 ± 0.641 in the post-operative examination at three months. In our study radiographical evaluation revealed progressive increase in bone density in TG (135.81 ± 8.73) when compared to CG (121.59 ± 13.83) over a period of three months. Pain and trismus evaluation did not reveal any significant difference between TG & CG. Conclusion: The clinical results of the ADDM graft procedure demonstrate satisfactory outcomes in extraction sockets. The findings of this study highlight the importance of preservation methods in maintaining the periodontal pocket depth distal to the second molar and the remaining alveolar ridge following extraction. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the effect of low-level laser therapy (LLLT) applied before mandibular third molar extractions on postoperative pain, swelling, and trismus. Materials and methods: The study included 28 patients aged 18–45 years with bilaterally impacted mandibular third molars in similar positions, indicated for extraction based on clinical and radiographic examinations. Patients were divided into two groups: Group 1 received LLLT 10 min before surgery, while Group 2 (control group) underwent routine impacted tooth extraction after applying blue LED light. Measurements were taken preoperatively and at 24 h (T0), 48 h (T1), and 7 days (T2) postoperatively to assess the effects of LLLT on pain, swelling, and trismus. Statistical analysis was performed using the Jamovi 2.2.5 software. Due to the non-normal data distribution, the Friedman test was used for repeated measures within groups, while the Mann-Whitney U test was employed to compare the laser and control groups. Results: The study included 23 female (82.14%) and 5 male (17.86%) patients, with a mean age of 21.34 ± 4.37 years. No statistically significant differences were observed between the laser and control groups concerning pain, trismus, and swelling at T0, T1, and T2 (p > 0.05). Conclusion: Within the limitations of this study, preoperative LLLT showed clinically acceptable effects on postoperative pain, swelling, and trismus. Further clinical studies are needed to evaluate the long-term success of LLLT. [ABSTRACT FROM AUTHOR]

Background: Untreated impacted wisdom teeth can lead to complications, including delayed healing and inferior alveolar nerve damage. Delayed management is further complicated by age-related comorbidities. Aim: This study aimed to evaluate the management of impacted wisdom teeth in a teaching dental hospital and identify challenges faced by dental care providers. Materials and Methods: A retrospective radiographic study was conducted using data from electronic medical records and panoramic radiographs of patients. Independent variables included demographics and clinical details of wisdom teeth, such as type and presence of impaction, associated pathology, nerve proximity, second molar resorption, and extraction difficulty. The study assessed the evaluation of dental care provider practices in managing impacted wisdom teeth. Chi-square tests analyzed relationships between management type, provider level, and extraction difficulty. Results: Data from 270 panoramic radiographs and dental records were analyzed. Most cases were not managed (n = 216, 80%), irrespective of extraction difficulty or care provider level (undergraduate vs. graduate). There was no significant association between care provider levels and the type of management or between impaction difficulty and management type (p > 0.05). Conclusions: The findings highlight a lack of proper evaluation and management of impacted wisdom teeth, regardless of the provider's experience. In hospital settings, all care providers should ensure the timely evaluation and management of impacted wisdom teeth to prevent complications. [ABSTRACT FROM AUTHOR]

Objectives: The primary objective of this systematic review was to analyze the overall prevalence of distal caries in mandibular second molars (MSMs) associated with the presence of impacted mandibular third molars (IMTMs). Secondary objectives were to determine how IMTM position and level of impaction influence the occurrence of distal caries. Materials and methods: PRISMA guidelines were followed. An automated search was conducted as well as a manual search for relevant clinical articles. The review included studies reporting IMTM and adjacent MSM presenting distal caries published in the last ten years. The quality of evidence was evaluated using the Newcastle-Ottawa Quality Assessment Scale. Results: Thirteen studies met the inclusion criteria and underwent analysis; they included a total of 13,788 patients. The overall prevalence of caries in MSMs adjacent to IMTMs was 29.89% (CI 95%: 21.05 − 38.74%; p < 0.001). Following Winter’s classification, the mesioangular position was the most frequently associated with caries with 43.37% (CI 95%: 33.03 − 53.70%; p < 0.001). Following Pell & Gregory classification, position A was the most frequently associated with caries with 33.97% (CI 95%: 24.06 − 43.89%; p < 0.001). Conclusions: IMTMs in mesioangulated positions, especially if accompanied by level A impaction, present the highest risk of MSM distal caries. Clinical relevance: Knowing which positions and level of IMTMs are most frequently associated with distal caries in MSMs is crucial to implementing preventive measures. Review registration: This systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO). Reg. number: CRD42023393143. [ABSTRACT FROM AUTHOR]

Objectives: This study evaluates the selective outcome reporting (SOR) in clinical trials on antibiotic use in third molar surgeries. It explores how SOR may bias results and affect systematic reviews, potentially leading to misinterpretations of intervention efficacy. Materials and methods: A search was conducted on “ClinicalTrials.gov”, “Brazilian Registry of Clinical Trials”, “International Clinical Trials Registry Platform” and “European Union Clinical Trials Register” using the terms “third molar” and “antibiotics” up to December 2024. Two independent researchers selected eligible clinical trials. Data were extracted from registered protocols and corresponding publications. Discrepancies were analyzed using established criteria, and the risk of bias of published articles was assessed with Risk of Bias2. Results: Discrepancies between protocols and publications were found in 87.5% of cases, affecting outcomes in 68.7% of studies. SOR significantly influenced results in studies with one or more discrepancies. 75% of studies assess pain post-antibiotic therapy; of those, 50% found significant results. Only 31,25% of studies showed significant reductions in trismus or edema with antibiotic use. The risk of bias varied significantly across studies. Conclusions: The high rate of selective reporting stresses the need for transparent studies to clarify the role of antibiotics in the perioperative period. Researchers should adhere to best clinical practices, including protocol registration, accurate sample size calculations, and precision in reporting. Journals and reviewers must prioritize transparency to reduce bias and improve research quality. Clinical relevance: This study emphasizes the impact of SOR in clinical trials using antibiotics in third molar surgery. Clinicians should be more cautious in reading evidence based on randomized clinical trials with SORs. [ABSTRACT FROM AUTHOR]

The autotransplant of third molars to replace missing teeth is gaining attention. This study aimed to analyze factors influencing the success, survival, and inflammatory root resorption (IRR) of autotransplanted third molars with completely formed roots. A total of 160 patients who underwent autotransplant of third molars with completely formed roots were evaluated retrospectively, involving 168 teeth. Preoperative, intraoperative, and postoperative variables were assessed to identify prognostic factors for success, survival, and IRR. The average (SD) follow-up was 5.21 (1.99) years. The success, survival, and IRR rates were 75.0%, 91.1%, and 17.3%, respectively. Cox proportional hazards regression analysis revealed that both apical resection and retrofilling (ARR) (P <.001) and donor tooth replicas (P <.001 for success and IRR; P =.013 for survival) were associated significantly with success, survival, and IRR. Furthermore, root canal treatment timing and patient age significantly affected success and survival, respectively (P =.006 and P =.036). The use of donor tooth replicas significantly reduced both the surgical time (P <.001) and extraoral time of the donor tooth (P <.001), whereas ARR increased the extraoral time of the donor tooth (P =.002). The use of a single root donor tooth was associated with a reduced surgical time (P =.003). Using donor tooth replicas and avoiding ARR contributed to increased success and survival rates and prevented IRR. Third molars with completely formed roots are suitable donors for replacing missing teeth, provided that appropriate preoperative, intraoperative, and postoperative indications are considered. [ABSTRACT FROM AUTHOR]

Background/Objectives: Photobiomodulation therapy (PBM) creates a biostimulatory or modulatory effect, promoting tissue regeneration and improving patients' health-related quality of life (HRQoL). PBM has shown promise as an effective treatment and management strategy for peripheral nerve injuries, including inferior alveolar nerve (IAN) damage. This study aims to assess the impact of PBM on HRQoL in patients with iatrogenic IAN injuries. Methods: A prospective study was implemented to investigate the research question. PBM treatments were administered weekly, with patient discharge contingent upon either complete recovery or stabilization of associated signs and symptoms. HRQoL was assessed using the EQ-5D-5L questionnaire at the initial and final appointments. Results: The study included 71 participants, divided into 3 groups based on etiology: inferior third molar surgery, mandibular orthognathic surgery, and dental implant surgery. The results showed a widespread reduction of symptoms along with a statistically significant improvement (p < 0.001) across four of the five dimensions of the EQ-5D-5L questionnaire, as well as in patients' perceived health levels in both Groups I and II. Group III patients also demonstrated a notable improvement; however, due to the small sample size, statistical analysis was not conducted for this group. Conclusions: PBM demonstrated a comparable ability to enhance HRQoL and alleviate symptoms in patients with IAN injuries within different etiologies. These findings underscore the effectiveness of the protocol used in this study and highlight potential avenues for expanding research in this field. [ABSTRACT FROM AUTHOR]

The analgesic efficacy and safety of liposomal bupivacaine (LB) in third molar extraction was evaluated in this phase 3, double-blind, placebo-controlled study of subjects undergoing bilateral third molar extraction. Subjects were randomized 2: 1 to infiltration with LB (133 mg/10 mL) or placebo, and received opioid rescue medication as needed. Primary efficacy measure was cumulative area under the curve (AUC) of numeric rating scale (NRS) pain severity scores through 48 hours (AUC of NRS0–48) postsurgery. Other measures included AUC of NRS0–24, AUC of NRS0–72, and AUC of NRS0–96, and incidence of adverse events. There were 150 subjects in the primary efficacy population (n = 99 LB, n = 51 placebo) and 89 in the per-protocol population (n = 59 LB, n = 30 placebo). Least-squares mean for AUC of NRS0–48 was 172.3 LB versus 194.7 placebo (P =.227) in the primary efficacy population and 120.8 LB versus 183.3 placebo (P =.023) in the per-protocol population. At all time points, between-group differences in AUC of NRS scores were significant in the per-protocol population (LB lower than placebo, P <.05) but not in the primary efficacy population. The adverse event profile was similar between groups. LB produced significantly lower cumulative pain scores versus placebo at all time points in the per-protocol analysis but not in the primary efficacy analysis because of protocol violations. This study indicates significant improvement in pain scores in the third molar model, but because of extensive protocol violations additional studies are warranted to demonstrate effectiveness. [ABSTRACT FROM AUTHOR]

Background: Anesthetic irrigation is an effective treatment for postoperative pain suppression in patients after molar extraction, but exerts a short period of extraction. The study aimed to evaluate the effect of lidocaine with epinephrine irrigation on acute pain relief in healthy volunteers with inferior alveolar nerve block (IANB) injection for the surgical removal of mesioangular (MA)-impacted third molars. Methods: A total of 28 patients (56 samples) with bilateral MA-impacted third molars were recruited. This study was a split-mouth, double-blind, randomized clinical trial. Surgical procedures were conducted over two separate appointments. Each patient randomly received 2% lidocaine with 1:100,000 epinephrine for the irrigation of the extraction site after surgery on one side of the mouth and normal saline solution on the other side. The postoperative visual analog scale (VAS) as a pain indicator was recorded and statistically analyzed for both treatments. Results: The VAS levels at 3 and 4 h after surgery in the lidocaine group were significantly lower than those of the normal saline group. Increases in pain scores were recorded five hours after surgery in both groups. No complications were recorded during this study. Conclusions: Continuous local anesthetic irrigation appears to be effective in reducing acute postoperative pain in patients with IANB for MA-impacted third molar surgery. Clinical Trial Registry: Reference number ISRCTN13866362, Date: 1 October 2024. [ABSTRACT FROM AUTHOR]

Purpose: This study proposes a novel intraoral approach combined with sub-sigmoid osteotomy to effectively and safely remove of ectopic third molar teeth without complications. Methods: The procedure included a sub-sigmoid osteotomy to expose and remove the ectopic tooth, followed by fixation of the osteotomized coronoid with titanium plates. Preoperative cone beam computed tomography (CBCT) was used for precise tooth localization. Results: The ectopic third molar was successfully removed with minimal bone removal. One intraoperative complication, a bad split of the anterior ramus, was observed but managed effectively. Postoperative healing was uneventful, with no nerve injury, infection, or reduced mouth opening. Conclusion: The transoral sub-sigmoid osteotomy technique is a reproducible, effective method for ectopic third molar removal, avoiding extraoral scars, nerve damage, and extensive dissection. Preoperative planning using CBCT is essential to prevent complications, making this technique a valuable alternative to traditional approaches. [ABSTRACT FROM AUTHOR]

The life-altering effects of criminal trials necessitate providing reliable methods to distinguish adults (=18) from minors (< 18). The present study aims to evaluate the accuracy of the third molar maturity index (I3M) introduced by Cameriere et al. (2008) in distinguishing adults from minors in the Iranian population. Panoramic radiographs of 800 Iranian individuals (400 males and 400 females) aged 14-23 were evaluated. The cut-off value of I3M=0.08 was analysed to determine whether the individual is younger or older than 18. All male or female subjects with I3M above 0.7 were below 18 years old. The cutoff value of 0.08 showed a sensitivity of 80.83% and 63.33% and a specificity of 88.12% and 93.12%, respectively, in males and females. The positive predictive values were 91.08% and 93.25%, and the negative predictive values were 75.40% and 62.87%, respectively, for males and females. The Bayes' posttest probability was 94% for females and 92% for males. 83.75% of males and 75.25% of females correctly classified as adults or minors. The most remarkable error rate occurred at 18 years old (67.5 % in females and 57.5% in males). By ROC curve analysis, the population-specific cut-off values of I3M 0.097 for males, 0.116 for females, and 0.099 regardless of sex, were acquired, which improved the sensitivity of discrimination between adults and minors (86.3%, 73.8%, and 78.1 %, respectively). The results showed that I3M is a reliable method for distinguishing between minors and adults in the Iranian population. This method provides a higher accuracy level in identifying individuals under 18 years old. Population-specific I3M cut-off values increased accuracy, sensitivity, and NPV, especially for females. The I3M method produced better results in diagnosing adult males than adult females and a higher accuracy level in identifying individuals under 18. [ABSTRACT FROM AUTHOR]

Background: This systematic review aimed to determine whether cone-beam computed tomography (CBCT) and panoramic radiography (PR) yield consistent results in determining the degree of impacted lower third molar teeth based on existing classification parameters. Methods: A comprehensive literature search was conducted of PubMed, Embase, Cochrane, and PLOS One, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Additionally, a manual search was also carried out. There were no restrictions on publication dates, allowing a broader scope of literature. Only articles published in English were eligible for inclusion. Furthermore, all studies that compared the outcomes of CBCT and panoramic images concerning the position of impacted teeth, according to the Winter and the Pell & Gregory classifications, were included. Results: Four studies met the inclusion criteria. One study used the Pell & Gregory classification to assess differences, finding a significant result (p< 0.001). Two studies used both the Winter and the Pell & Gregory classifications. In these assessments, one study found no significant differences in the Winter classification (p= 1.000) or the Pell & Gregory assessment (p= 0.500). However, another study identified significant differences using both the winter and the Pell & Gregory classifications (p< 0.001). One study conducted an assessment using only Winter classification and found no significant differences between PR and CBCT (p> 0.05). Conclusion: There are inter-modality differences in the agreement concerning the degree of impaction of the third molar when using CBCT compared with panoramic imaging across various classification levels. Improved assessment methods are necessary to determine the most appropriate imaging modality for therapeutic management. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study is to estimate the effect of Platelet Rich Fibrin (PRF) on the control of post-operative sequalae i.e. Pain, Trismus, Swelling and Incidence of Alveolar Osteitis (AO) following mandibular third molar surgery. Material and Methods: 26 patients are divided into two groups. Group I gets PRF after extraction of the third molar while Group II does not get any PRF. Post-surgical Pain, Swelling, Trismus, Incidence of AO are evaluated. Results: It is found that Group II has greater pain scores than Group I assessed by VAS, with statistically significant greater score after 2 hours (P=0.0014) and 12 hours (P=0.0063). In case of swelling, Site II shows statistically significant difference on the 7th day (P=0.007) and the 14th day (P=0.04), Site III shows statistically significant difference on the 3rd day (P=0.005) and the 7th day (P=0.03), and Site IV shows statistically significant difference only on the 3rd day (P=0.004). Interincisal distance is higher for Group I than Group II, statistically significant on the 7th day (P=0.0069) and the 14th day (P=0.0008). This study does not find any incidence of AO in both groups. Conclusions: PRF appears to be beneficial and effective in lowering postoperative sequalae in mandibular third molar surgery. PRF effectively decreases Pain, Swelling and Trismus when compared with case and control group. However, this study cannot comment on effectiveness of PRF on incidence of alveolar osteitis. [ABSTRACT FROM AUTHOR]

Background: The infratemporal fossa is a space located along the lateral skull into which an upper wisdom tooth can be displaced during the extraction of a maxillary third molar. Although this complication is rare, many patients remain at risk even during a routine outpatient visit with an experienced oral and maxillofacial surgeon. To retrieve the displaced wisdom tooth localized inferior and medial to the ipsilateral zygomatic arch, surgical exploration of this space can be done using a variety of techniques described in the literature and in this case. Case Description: This article presents a case in which a right upper wisdom tooth was apically displaced into the infratemporal fossa. Cone-beam computed tomography aided in verifying the exact position of the third molar and subsequent surgical planning. In this case, an immediate approach was used with minimal intraoral dissection into the posterior maxillary vestibule. In doing so, sufficient access and visibility were established for successful retrieval of the tooth in the same visit by extending the original incision site and without the need for any additional procedures thereafter. This article also offers an overview of potential retrieval options as described by the literature. Continuing Education Credit Available: The practice worksheet is available online in the supplemental material tab for this article. A CDA Continuing Education quiz is online for this article: . [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: This study aims to compare the outcomes of suture-less and multiple suture closure methods on postoperative pain, swelling, and trismus, and associated complications. Materials and methods: This prospective, randomized clinical trial was conducted at the Department of Oral & Maxillofacial Surgery, Goa Dental College & Hospital. Inclusion criteria encompassed subjects aged between 17 and 55 years, classified as American Society of Anaesthesiologists (ASA) I, with asymptomatic impacted third molars falling within the moderately difficult impaction range (Pederson's difficulty index: 5–7). Study excluded individuals classified as ASA II, III, or IV, those with known or suspected allergies to the anaesthetic solution, immunocompromised patients, and individuals taking medications that could affect healing. Pregnant or lactating females and those with a history of bleeding disorders were also excluded. Wound closure methods were compared: Group A underwent primary closure with silk sutures, while Group B had suture-less closure. Subjects were allocated to the specific groups using a simple randomization method. This involved using a lottery-based random sequence to assign each participant to either Group A or Group B. Pain intensity, facial swelling, and trismus were key outcomes. Secondary outcomes included lingual nerve sensation and postoperative complications. Demographics factors, surgical details, radiographic and perioperative data, and physiological parameters were considered. Non-parametric tests and parametric test (repeated measure ANOVA) were employed. Statistical significance was set at P < 0.05. Results: Among 101 participants, both closure techniques exhibited similar outcomes in pain, swelling, and lingual nerve function. However, suture-less closure resulted in significantly less trismus and fewer cases of delayed wound healing. Conclusions: Suture-less method after surgical removal of third molar may reduce trismus compared to multiple sutures. While pain, swelling, and lingual nerve function management were comparable. [ABSTRACT FROM AUTHOR]

Background: Protocols are currently being studied in preventing postoperative complications after exodontia. Purpose: This systematic review and meta-analysis aims to evaluate whether the application of intra-alveolar honey reduces inflammatory complications after the extraction of mandibular third molars (CRD 42.023.467.041). Methods: Searches were carried out in six electronic databases. Clinical trials comparing intra-alveolar honey administration with non-intervention or placebo after mandibular third molar extraction were selected to assess their impact on postoperative inflammatory parameters. The Cochrane ROB 2 tool was used to assess the bias risk in included studies, Stata software to conduct a meta-analysis for quantitative synthesis, and the GRADE system to evaluate the certainty of the evidence. Results: This systematic review included 5 studies with 330 participants, and two studies were included in the meta-analysis. The results of the meta-analysis demonstrated that postoperative pain on the second day [MD: − 1.05; 95% CI − 2 to − 0.1] and fifth day [MD: − 0.97; 95% CI − 1.97 to − 0.03] was lower in the honey group compared to the control group. Total analgesic consumption [MD: − 4.77; 95% CI − 6.73 to − 2.81] was also lower in patients in the intervention group. The descriptive results indicated that honey appears to be beneficial in controlling edema, reducing trismus, and improving healing after extraction of third molars. Alveolar osteitis showed inconclusive results. Conclusions: The use of intra-alveolar honey after extraction of mandibular third molars seem to be associated with pain reduction. For the other outcomes, the results remain uncertain. [ABSTRACT FROM AUTHOR]

Copyright of Acta Medica Medianae is the property of Acta Medica Medianae and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Dental age assessment based on evaluating dental mineralization status is one of the most common methods used in forensic practice. The aim of this study is to enhance the accuracy of age diagnostics and provide reference data from the Syrian population for forensic application. After several selection steps, a total of 280 orthopantomograms (OPGs) from 140 males and 140 females from the Syrian population divided into 14 age groups between 12 and 25 years were analysed. Based on Demirjian's classification system, the mineralization stages of third molars (18, 28, 38 and 48) as well as lower second molars (37 and 47) were evaluated. Statistical investigations and evaluations were carried out to estimate the marginal probabilities of the subjects having attained ages 14 and 18 by generalized estimating equation models. Our results show that no significant differences can be revealed in the mineralization status with respect to jaw side and sex. In the Syrian population, third molars showing mineralization stage G provide evidence of reaching the age of 14 years with the highest standard of proof ("beyond reasonable doubt"). A completed mineralization in lower second molars (stage H) provides very high marginal probabilities (more than 90%) of the subjects having attained age 14 years. Nevertheless, this cannot exclude an age under 14 years. For the age threshold of 18 years, third molars showing incomplete root development (G dental stage or lower) are associated with a low probability (less than 40%) of the subject having reached 18 years of age. A person's probability of having attained 18 years of age is very high (82– 95%) when the roots of third molars are fully developed (stage H). Nevertheless, third molars at stage H do not conclusively exclude an age under 18 years. [ABSTRACT FROM AUTHOR]

Background/Objectives: The extraction of impacted mandibular third molars (M3Ms) carries significant risks, especially regarding the inferior alveolar nerve (IAN). This study aimed to evaluate the effectiveness of a 3D-planned inward fragmentation technique (3Dp-IFT) to improve surgical outcomes, reduce complications, and preserve bone structure in cases involving complex M3M impactions. Methods: Twenty-three patients aged between 18 and 36 years requiring M3M removal were included. Preoperative planning involved the use of cone–beam computed tomography (CBCT) for precise localization of the furcation area, followed by the creation of a 3D navigation template using PlastyCAD software version 1.7. The surgical procedure was performed under local anesthesia, with meticulous endoscopic assistance to ensure accurate access and minimize trauma. Postoperative outcomes, such as bone loss, pain, swelling, and mouth opening range, were carefully measured. The data were systematically organized and analyzed descriptively using Microsoft Excel. Results: No disturbances to the IAN or lingual nerve were observed. The mean buccal bone loss was 2.2 mm, with a standard deviation of 1.2 mm. Postoperative pain and swelling were generally low, with significant reductions within the first week. The use of the 3D navigation template significantly improved surgical access, enhancing safety and minimizing complications. Conclusions: The 3Dp-IFT technique represents a significant advancement in the minimally invasive removal of M3M by allowing precise access to critical anatomical areas while minimizing bone loss and postoperative complications. This approach is particularly beneficial for complex cases involving M3M near the IAN, thereby improving surgical safety and patient outcomes. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Dental Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background. Platelet-rich fibrin (PRF) enhances tissue healing by releasing essential growth factors. Surgical extraction of deeply impacted mandibular third molars poses a common challenge, often leading to significant defects at the distal root of the second molar. This study explored the role of PRF in soft and hard tissue healing after surgical extraction. Methods. This triple-blind, split-mouth, randomized controlled trial involved patients with bilateral impacted mandibular third molars. Single-stage surgical extraction was performed, and PRF was applied at one site while the other served as the control. Plaque index (PI), sulcus bleeding index (SBI), clinical attachment levels (CALs), postoperative pain, edema, tenderness, sensitivity, and bone level were assessed on day 1, day 3, first week, and first, third, and sixth months. Results. Sixty-four (34 males and 30 females) patients were found eligible for assessment. The test group exhibited a significant decrease in mean pain scores compared to controls (P<0.001), notably resolving by one month. Edema scores were significantly lower in the test group at all intervals up to one month (P=0.045). Tenderness showed a significant difference at one week (P=0.001), resolving by three months. No significant hard tissue changes were noted (P=0.825). Conclusion. Significant benefits over postoperative pain, bleeding, tenderness, and initial sensitivity underscored the importance of PRF in soft tissue healing following impacted mandibular third molar extraction. However, no improvement in bone height outlined its limited potential in hard tissue regeneration over exposed root surfaces of the mandibular second molar. [ABSTRACT FROM AUTHOR]

The prevalence of teeth impaction varies substantially between different populations, and the impaction of third molars is the most commonly recorded. This study aimed to explore the prevalence and pattern of the third molars impactions among Yemeni population. This was a retrospective radiographic study conducted in Yemen between 2022 and 2023. The digital panoramic radiographs were collected from two major X-ray centers in Yemen. The angular position and depth of the impacted third molars were assessed according to the classifications of Winter and of Pell and Gregory, respectively. All radiographs were evaluated twice by one investigator in a two-week interval, and Kappa test was used for intra-rater reliability. Gender-wise differences, differences between both sides, and differences between maxilla and mandible were analyzed using Chi-squared tes with odds ratio (OR) for the risk of impaction. A P-value < 0.05 was considered significant. Panoramic radiographs of 6338 individuals were included. Their mean age was 35.1 ± 13.3 years andand 63.9% were females. A total of 25,352 sites (quadrants) were screened for the presence of thirds molars. Among which, 14,003 third molars (55.3%) were present in one or more sites. There were 1440 individuals (23%) with a total of 2828 impacted third molars (20% of the existing third molars). Females were less likely to have third molar impaction (OR = 0.46, CI95% = 0.4–0.52). Impaction of the mandibular third molars was significantly more frequent than the maxillary ones (OR = 1.15, CI95% = 1.04–1.26; P = 0.005). Horizontal and mesioangular impactions were statistically more frequent in the lower molars compared to the upper ones (P < 0.001 each). Contrastingly, vertical (P = 0.015), distoangular, and other impactions (P < 0.001 each)were statistically more frequent in the maxilla. Levels A and B were more frequent in the lower third molars, while level C was predominating in the upper molars (P < 0.001 each). The prevalence of third molars impaction is more frequent in males and mandibular arch. The angulation and level of impaction seem to be more complicated in the maxillary arch. [ABSTRACT FROM AUTHOR]

Objectives: This study addresses the limited body of literature concerning the impact of photobiomodulation on complications following mandibular third molar extractions. Methods: A systematic literature review and meta-analysis of clinical studies that reported the use of photobiomodulation after mandibular third molar surgery was conducted based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) recommendations. The formulation of research questions followed the PICO model, and comprehensive strategies for record search and study selection were devised. The protocol was registered on PROSPERO (The Prospective Register of Systematic Reviews; no CRD42024511892). Two independent reviewers consulted four databases during the literature search: MEDLINE/PubMed, Google Scholar, Clinicaltrial.gov, and Cochrane Library databases without imposing any date restrictions. A search on the grey literature was carried out too (OpenGrey). Duplicate articles were eliminated. Results: After the initial screening, 18 studies were retained to be screened by the reviewers. The full texts of the identified studies were scrutinized for original data, and their related references were manually retrieved and checked for additional relevant studies. The available studies exhibit considerable heterogeneity, exploring various factors related to postoperative outcomes. Our meta-analysis primarily focuses on three key aspects: the incidence of alveolar osteitis (AO), mucosa repair/alveolar pocket healing, and bone repair. The resultant CI of the VAS scale was 98 to 99%. Conclusions: This meta-analysis underscores the need for further research in this domain, highlighting the existing heterogeneity among studies and the importance of a nuanced understanding of photobiomodulation's multifaceted effects on postoperative complications. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to conduct a thorough analysis, both quantitative and qualitative, of bibliometric parameters related to preemptive analgesia (PA) in oral surgical procedures (OSP). Methods: Research trends on PA in OSP using ibuprofen were reviewed through bibliometric analysis of 68 journal articles published from 1991 to 2022 in the Web of Science database. Bibliometric indicators were applied to analyze the journal article data, including the annual distribution of publications and literature growth, document types, citation indicators to measure qualitative research performance, and keyword mapping to identify research trends. The results were imported into RStudio, and the Bibliometrix package was used to prepare and analyze the metadata. Results: The 68 included articles received a total of 900 citations, ranging from 1 source to 72 citations with some fluctuations. The papers on PA in OSP using ibuprofen had an average of 16.85 citations per paper. These publications were originated from 25 countries, with the highest contributions from Brazil (n = 17), the USA (n = 13), and Turkey (n = 8). The top five major contributing journals were the International Journal of Oral and Maxillofacial Surgery, Journal of Oral and Maxillofacial Surgery, Journal of Cranio-Maxillo-Facial Surgery, Journal of Periodontology, and Acta Odontologica Scandinavica, representing more than half of all selected papers. Conclusion: Papers focused on PA in OSP received numerous citations. The citation per article correlated with the number of publications at the affiliation, author, country, and journal levels. However, there is still a scarcity of studies in this field. [ABSTRACT FROM AUTHOR]

This study aimed to systematically review the literature to evaluate the effectiveness of virtual reality in reducing anxiety and pain in patients undergoing third molar surgeries. Clinical trials evaluating patients who used virtual reality (VR) compared with no VR in the management of pain or anxiety after third molar extractions were included. A literature search was conducted in five electronic databases to identify relevant articles: Medline (PubMed interface), Web of Science, Virtual Health Library, Embase, and Scopus. There were no restrictions on the time or language of publication. The risk of bias was assessed using the Cochrane Risk of Bias Tool for Randomised Trials (RoB 2.0). A total of six studies were included in the qualitative analysis and three in the quantitative analysis. The results of the meta-analyses on anxiety revealed that patients in the intervention group before VR already showed less anxiety compared to those in the control group (-0.28 [-0.44 to -0.13, 95%CI] I²=24.51%. In the post-intervention evaluation, the group that received VR remained with a lower level of anxiety and a slight reduction compared to the pre-intervention. (-0.34 [-0.49 to -0.19, 95%CI] I²=36.61%. Virtual reality can be a clinical resource in dental care because it seems to cause a small reduction in anxiety, and with still uncertain results in the reduction of postoperative pain in extractions of third molars. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to assess success rates and to report complications of coronectomy of mandibular third molars (M3M), including intra-operative failure, pain, infection, dry socket, inferior dental alveolar (IAN) and lingual nerve (LN) injuries and re-operation rates. Methods: Retrospective analysis of 167 coronectomies completed between January 2017 to December 2022 was undertaken. Results: The success of coronectomy was 93%. Intra-operative failure was reported to be 3.6% (n = 8). Complications accounted for pain (15%, n = 24), infection (9%, n = 15) and dry socket (3.6%, n = 6). Three patients required removal of M3M root at 3 months (n = 2) and 24 months (n = 1), accounting for 1.8% re-operation rate. A total of number of patients who suffered a nerve injury was 12; three of these were permanent (LN – 1.2%, n = 2; IAN – 0.6%, n = 1), nine were temporary (IAN – 1.2%; n = 2, LN – 2.4%; n = 4; site not specified – 1.8%, n = 3). No patients with intra-operative failure and re-operation suffered IAN or LN injury post-operatively. Conclusion: Coronectomy offers a successful strategy for management of high risk M3M. The treatment outcomes can be improved with careful case selection and adjusting surgical technique, including assessment of root morphology, incomplete crown sectioning technique and avoidance of lingual retraction. Reporting of coronectomy success as a factor of surgical outcome, presence or absence of permanent IAN injury, persistent symptoms or any other long-standing complications (such as LN injury), and the need for re-operation accounting for root migration status may be a useful tool to measure coronectomy outcomes. [ABSTRACT FROM AUTHOR]

Objective: To determine the influence of the presence/absence of third molars and intact/loss of cortical plate of the maxillary tuberosity on the amount of distal movement of the maxillary first permanent molar during distal movement of the maxillary dentition with mini-implants. Materials and methods: Thirty six maxillary tuberosity sites were evaluated in eighteen young adult patients. The distal movement of the entire maxillary dentition was performed with mini-implants with 200 g of distalising force applied from the mini-implant placed in the maxillary posterior buccal region to attachments placed on the arch wire between the maxillary lateral incisor and canine bilaterally. The distal movement of the maxillary first permanent molars was measured on lateral cephalograms. The maxillary tuberosity sites with intact cortical plate due to congenitally missing third molars or atraumatic extraction of third molars (G1), partial loss of cortical plate due to surgical removal of third molars (G2), fully erupted third molars (G4), third molars located at (G3), and below the cementoenamel junction (G5) were evaluated with cone beam computed tomography. One way Anova and Fisher LSD test was done. Results: The order of greater to lesser amount of distal movement of the maxillary first permanent molar depending on the integrity of maxillary of tuberosity was partial loss of cortical plate, third molars at the cementoenamel junction, third molars below the cementoenamel junction, intact cortical plate and fully erupted third molars. Conclusion: The integrity of the cortical plate and the relative position of the maxillary third molar to the second molar influence the amount of distal movement of the maxillary first permanent molar during distal movement of the maxillary teeth with TADS. Clinical relevance: The amount of distal movement of the maxillary dentition appears to depend on the presence or absence of the third molars and the condition of the cortical plate in the region of the maxillary tuberosity and thereby greatly influence the outcome of treatment. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Society of Forensic Science Journal is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A dentigerous cyst is a developmental odontogenic cyst frequently associated with lower third molars, upper canines, and lower second premolars. In most cases, dentigerous cysts are present asymptomatically. The growth is gradual and when it reaches a significant size, it may affect anatomical structures and adjacent teeth. The majority of these cysts are detected during regular radiographic examination. They are induced by the degeneration of the enamel organ's stellate reticulum, which results in fluid accumulation between the crown and the reduced enamel epithelium. In the presented case, we report the progression of a dentigerous cyst associated with an impacted left mandibular third molar. The cyst behavior, differential diagnosis, and management are discussed. [ABSTRACT FROM AUTHOR]

Background/Objectives: Glucocorticoids are drugs that are increasingly used in oral surgery to reduce trismus, inflammation, and postoperative pain, three frequent complications after the surgical extraction of impacted lower third molars. The aim of this study was to compare the effect of 8 mg dexamethasone versus 40 mg methylprednisolone in the prevention of postoperative complications after third molar surgery. Methods: A randomized double-blind clinical trial was conducted following CONSORT guidelines. In detail, 84 patients were included in the study, who randomly received a single preoperative submucosal dose of dexamethasone (8 mg) or methylprednisolone (40 mg). The variables analyzed, as primary outcomes, were trismus, inflammation, and postoperative pain. The measurements were performed at baseline (0 h), 3 h, 7 h, 24 h, 48 h, and 7 th day using a Visual Analog Scale (VAS), Verbal Rating Scale (VRS), and the Gabka–Matsumara method. Results: Dexamethasone reduced trismus, inflammation, and postoperative pain significantly better than methylprednisolone. Conclusions: Preoperative submucosal administration of 8 mg dexamethasone is effective and safe in reducing the severity of postoperative complications following surgical extraction of impacted lower third molars. [ABSTRACT FROM AUTHOR]

Objectives: The study aimed to examine the authenticity of the often-mentioned statement that the third molar is the most frequently extracted tooth. This finding has not been shown previously in a large population-based sample. Materials and methods: Data comprised a nationally representative sample of 6082 panoramic radiographs taken from adults in the cross-sectional Health 2000 Survey. From the radiographs, all missing teeth were recorded. Information on congenital agenesis of individual teeth was retrieved from two published meta-analyses. Primary outcome was the frequency of missing teeth by tooth type. Explanatory variables were age, sex, and the jaw (maxilla/mandible). Statistical analyses included χ2 test and binomial logistic regression. Results: Mean age of participants (46% men, 54% women) was 53 years (SD 14.6; range 30‒97 years). Missing teeth occurred more often in women than in men (P < 0.001). The third molar was most frequently missing and the canine least frequently. In the maxilla and mandible, the third molar was missing more often than each of the other tooth types up to the age of 80 years (P < 0.01). Conclusions: When considering the rates of congenital agenesis of individual teeth, it is concluded that the third molar remained the most common tooth extracted up till the age of 80 years. Clinical relevance: The third molar is the most common target for extraction, but also the most common tooth associated with malpractice claims, and therefore, calls for skills, adequate equipment, and other resources for a successful extraction. [ABSTRACT FROM AUTHOR]

Background: The study evaluates the feasibility of employing the radiographic visibility of the root pulp and periodontal ligament in mandibular molars for age estimation, particularly focusing on the 18 years of age threshold. This study additionally investigates the potential of root canal width reduction in mandibular molars, as a reliable method for forensic age estimation in living individuals. Materials and methods: A cross-sectional study was conducted to assess the radiographic visibility of the root pulp (RPV) and the root canal width (RCW) of mandibular first, second, and third molars along with the radiographic visibility of the periodontal ligament (PLV) of mandibular third molars, in a sample of 403 individuals aged 16-25 years (220 males and 183 females). Data regarding age for different stages of RPV and PLV and various types of RCW were recorded and observed for sex-based differences. Results obtained were tabulated and descriptive statistics were applied to summarise the findings. Results: Individuals over 18 years old were classified with higher accuracy using stage 3 of the RPV scoring system in all mandibular molars (first, second, and third) compared to stage 2, which was also effective for the second and third molars. This result held regardless of sex and side examined. Additional l y, root canal width (RCW) a ssessment demonstrated that individuals with RCW types A, B, and C were more likely to be under 18 years old in both sexes. Conversely, individuals with RCW type U on the right side for males and the left side for females exhibited a higher likelihood of being above 18 years old. Conclusion: The study suggests that the assessment of mandibular molars could potentially serve as an auxiliary tool in age estimation methods, particularly for approximating individuals around the 18 years of age threshold. Further investigation is warranted to explore the potential application of root canal width measurements in forensic age estimation. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of RSBO: Revista Sul-Brasileira de Odontologia is the property of UNIVILLE and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: There is little evidence regarding risk prediction for surgical site infection (SSI) after lower third molar (L3M) surgery. Methods: We conducted a nested case–control study to develop a multivariable logistic model for predicting the risk of SSI after L3M surgery. Data were obtained from Hokkaido University Hospital from April 2013 to March 2020. Multiple imputation was applied for the missing values. We conducted decision tree (DT) analysis to evaluate the combinations of factors affecting SSI risk. Results: We identified 648 patients. The final model retained the available distal space (Pell & Gregory II [p = 0.05], Pell & Gregory III [p < 0.01]), depth (Pell & Gregory B [p < 0.01], Pell & Gregory C [p < 0.01]), surgeon's experience (3–10 years [p = 0.25], <3 years [p < 0.01]), and simultaneous extraction of both L3M [p < 0.01]; the concordance‐statistic was 0.72. The DT analysis demonstrated that patients with Pell and Gregory B or C and simultaneous extraction of both L3M had the highest risk of SSI. Conclusions: We developed a model for predicting SSI after L3M surgery with adequate predictive metrics in a single center. This model will make the SSI risk prediction more accessible. [ABSTRACT FROM AUTHOR]

An impacted third molar is one of the most common abnormalities of the tooth position, impacting patients and their quality of life. Based on the impact and the invasive removal procedure, this study aimed to evaluate the characteristics of impacted third molars based on their radiographic features as well as their association with demographic characteristics. Outpatient dental records of the oral and maxillofacial surgery department of Hasan Sadikin Hospital, Bandung, Indonesia, from 1 January 2018 to 31 December 2019, were sorted, and relevant clinical and demographic data and panoramic radiographic examination results were extracted from these records. All data were then tabulated and analyzed by using SPSS version 29. As many as 3019 impacted third molars were identified. Our findings suggested the association between age to the occurrence of impacted third molars where patients aged between 17 and 29 years old showed high occurrences of impacted third molars. Male patients with impacted third molars are more likely to have multiple impacted third molars, while this risk decreases in females. Radiographic examination showed that the mesioangular position is the most common position for mandibular third molars. The variation in high occurrences of the impacted third molar is associated with several demographic factors. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Dental Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Impacted and semi-impacted third molar surgery can lead to considerable distress and discomfort in patients. Aims: The present study aimed to assess the changes in salivary levels of malondialdehyde (MDA) and total antioxidant capacity (TAC) after third molar surgery. Materials and Methods: In this study, 210 patients scheduled for third molar surgery were selected. Unstimulated whole saliva samples were collected from patients preoperatively and one week after the surgery, via the 'spitting method'. The collected samples were immediately centrifuged and the supernatants were stored at −20°C until testing. The levels of MDA and TAC were measured with a spectrophotometer. Results: The results were presented as mean ± standard deviation and paired t -test was used to statistically analyse the changes in pre-operative and post-operative values of MDA and TAC. A decrease of mean salivary TAC (P = 0.031) and an increase of mean salivary MDA (P = 0.034) were detected postoperatively. Discussion: Following third molar surgery, the increase of mean salivary MDA and the decrease of mean salivary TAC were detected; however, these changes were not statistically significant. [ABSTRACT FROM AUTHOR]

Objectives: This cross-sectional study aimed to measure the distance between the buccal and lingual cortical bones and its relation with the mandibular canal roof of third molars classified as III-C position according to Winter, Pell and Gregory classifications in cone-beam computed tomography. Material and Methods: A total of 140 lower third molars were classified according to Winter, Pell and Gregory. The distance between the buccal external cortex and the lingual external cortex was measured at 25%, 50% and 75% of the distance to the roof of the mandibular canal in parasagittal sections of teeth classified in horizontal III-C position. The presence or absence of lesions associated with the elements in this position was observed. Descriptive statistical analysis was performed and the intraexaminer agreement was calculated using the Bland-Altman and t-test methods (0.88 and 0.91, respectively). The significance level used was 5% (P = 0.05). Results: Seventy patients (29.4 [SD 8.8] years, 54% women and 46% men) were included. Fourteen (10%) third molars were classified in horizontal III-C position. The average measurements taken were 1.78, 1.1 and 1.53 mm for the distances between the buccal external cortex and lingual external cortex, at 25%, 50% and 75% of the distance to the roof of the mandibular canal, respectively. No pathological conditions associated with the included elements were observed. Conclusions: Analysis of cone-beam computed tomography parasagittal sections of third molars classified in horizontal III-C position, revealed proximity of impacted teeth to the mandibular canal roof, mainly in the midline between the buccal and lingual external cortices. [ABSTRACT FROM AUTHOR]

Aim: This study aims to determine the accuracy of the Mincer method for estimating dental age (DA) using digital panoramic radiographs (PR) in a Honduran population aged 14–22 years. Materials and Methods: This observational, cross-sectional, retrospective study was applied in a sample of 134 digital PR from a private dental center in Comayagua (72 females and 62 males; mean age 18 ± 3 years). A calibrated observer (kappa ≥0.83) analyzed DA with the Demirjian and Mincer method in all third molars (3M) from stage D (complete crown) to H (apex closure) differentiating by sex. The decimal DA of each individual was calculated from the average of the four 3M. Estimation of chronological age (CA) according to the Mincer method was obtained with linear regression formulas. Results: The results revealed that the mean and standard error of the difference between CA and DA was 0.58 ± 0.13 years (male 0.5 ± 0.19 and female 0.65 ± 0.19). Age groups showed higher overestimation (>1.1) from 14 to 17 years (50%–100%), agreement (±1.1 years) at 18 years (66.7%–70%), and underestimation (<–1.1) from 21 and 22 years (42.9%–100%; P = 0.000). The prediction equations of CA according to DA were statistically significant (P = 0.000) explaining 66.5% of the total sample (error = 1.465), 84.5% in males (error = 1.367), and 79.3% in females (error = 1.548). Conclusion: This study concludes that the Mincer method obtained a reasonable prediction to estimate the age of the majority with improvement in the adjustments with the age estimation formula in a specific population in Comayagua, Honduras. [ABSTRACT FROM AUTHOR]

Various staging scales have been proposed for the assessment of the visibility of the periodontal ligament space of mandibular third molars on dental panoramic radiographs (PANs) for forensic age assessment in living individuals. However, up to now, there has been no systematic comparison between these staging scales available. We directly compared the 2010 staging scale proposed by Olze et al. with the 2017 staging by Lucas et al. and the 2020 staging by Guo et al. in a German study population. We evaluated 233 PANs from 115 females and 118 males aged 20.0 to 40.9 years using three independent examiners, with one examiner conducting two assessments. We examined the correlation between age and stage, as well as the inter- and intra-rater reliabilities. While the point estimates for the correlation coefficient and the reliability measures were lowest for the Guo scale and highest for the Olze scale, confidence intervals showed a large overlap, particularly for the scales of Olze et al. and Lucas et al. The correlation coefficients between stage and age were consistently lower in females than in males across all methods. In summary, we showed that the staging scales of Olze et al. and Lucas et al. were very similar. The Olze method showed higher point estimates across all analyses, and because there are more reference data available for this method, we argue that it should be preferred as the method of choice for further studies in the field. However, Guo method could be considered for instances, in which the inter-radicular periodontal ligament is not evaluable. [ABSTRACT FROM AUTHOR]

Introduction: The aim of the study was to assess and compare the efficacy of autotransplantation of molars with complete and incomplete root formation, by checking the viability of the procedure to replace non‑restorable molar teeth in the extraction sockets. Materials and Methods: Twenty patients with non‑restorable molars were included in this study. They were divided into two groups with complete and incomplete root‑formed third molars, which needed to be transplanted in place of non‑restorable molars. A routine surgical procedure was performed to remove infected molars. Atraumatic removal of the third molar was performed and reimplanted in the socket of previously extracted infected molars. Results: Results were evaluated based on clinical observation and radiographic analysis of the transplanted tooth. Out of 20 transplants, one transplant, despite good initial stability, was extracted after one month because of abnormal horizontal and axial mobility; this was the single failure case (5%). Of the rest, 19/20 (95%) transplants were followed up for 6 months and showed no failure. Conclusion: This study clearly indicated that the benefits of autotransplantation over other treatment options are numerous, and the results are not affected by whether the root of the transplanted tooth is complete or incompletely formed. [ABSTRACT FROM AUTHOR]

Background: The management of the surgical wound of partially impacted mandibular third molar surgery has a great impact on recovery as well as on food impact retention. The present study used clinical parameters and health-related quality of life (HRQL) to compare outcomes of cyanoacrylate application versus traditional suture of third molar impaction surgery. Methods: This was a retrospective observational study of subjects scheduled for outpatient third molar surgery. Each participant signed an informed consent agreement. Inclusion criteria were as follows: presence of at least one partially impacted mandibular third molar, confirmed with a preoperative panoramic radiograph. Exclusion criteria were the following: smoking, diagnosed diabetes mellitus. Between June 2020 and September 2023, a total of 78 patients of mean age 31.14 years old (range 21–40 years, standard deviation 9.14), were included in this study—38 patients were male, 40 patients were female. A group of patients received traditional silk suture (G1 = 41 patients), while the second group (G2 = 37 patients) received hemostasis performed with fibrin sponge and, after complete soaking of the sponge, the application of cyanoacrylate gel on the blood clot and suture with one 2/0 stitch in order for recovery for secondary closure. The following parameters were measured: HRQL, average pain (AP), maximum pain (MP), complication score (CS), facial swelling (FS), and erythema. Results: For HRQL parameters, oral disability was found to be significantly higher in G1 while AP was significantly higher in G2 (p < 0.05). AP was higher in G2 (p = 0.0098), as well as MP (p = 0.001). No differences were found with regards to CS (p = 0.0759). FS and erythema were higher in G1 (p < 0.0001 for facial swelling, and p = 0.0001 for erythema). Conclusions: on the basis of this study, the use of cyanoacrylate after mandibular third molar surgery appears to be useful in order to reduce postoperative oral disability, facial swelling, and erythema after tooth extraction, with increased average and medium pain: clinicians may consider its use in selected cases. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the efficacy of pregabalin and dexamethasone coadministration in preemptive analgesia and anxiety control in lower third molar surgery. Materials and methods: A triple-blind, split-mouth clinical trial conducted with patients divided into two groups: control group, receiving placebo and dexamethasone, and test group, receiving pregabalin and dexamethasone preoperatively. The evaluated variables were pain, measured by the Visual Analog Scale (VAS), anxiety assessed through the State-Trait Anxiety Inventory (STAI) questionnaires, hemodynamic parameters [Blood Pressure (BP), Heart Rate (HR), Oxygen Saturation (SpO2)], and sedation assessed by the Ramsay scale. Results: A total of 31 patients were included. The test group exhibited a significant reduction in pain at 2,4,6,8,12,16,24, and 48 h after surgery and in the consumption of rescue analgesics. Anxiety, evaluated by STAI and VAS, showed a significant decrease in the test group (p < 0.001). Additionally, there was a significant decrease in BP at most of the assessed time points (p < 0.05) and a significant reduction in HR at two different time intervals (p = 0.003 and p = 0.009), indicating a positive effect in the test group. There was no significant difference in SpO2 between the groups. Sedation assessment revealed a significant difference at all time points favoring the test group (p < 0.05). There were no significant postoperative adverse effects. Conclusions: Pregabalin coadministered with dexamethasone demonstrated significant efficacy in controlling postoperative pain and anxiety, as well as a sedative effect. Clinical relevance: The coadministration of pregabalin with dexamethasone may presents potential advantages in both pain modulation and psychological well-being of individuals undergoing third molar surgeries. Trial registration: Brazilian Clinical Trials Registry (REBEC), No. RBR-378h6t6. [ABSTRACT FROM AUTHOR]

Background: Surgical removal of the mandibular third molar requires reflection of the mucoperiosteal flap. Several studies have suggested different varieties and innovative designs for flap reflection. We have designed a randomized controlled trial (RCT) to check the feasibility of two flap designs: lingual-based triangular flap (LBTF) and buccal-based triangular flap (BBTF) by calculating the duration of surgery and evaluating postoperative complications such as pain, swelling, and trismus. Materials and Method: It was a non-inferiority parallel-group RCT. The trial was registered in the Control Trial Register of India (CTRI/2021/10/037182) and was performed according to Consolidated Standards of Registered Trial (CONSORT) guidelines. Intraoperative surgery time and postoperative pain, swelling, and trismus were measured and analyzed by a two-sample t test. The Chi-square test was used to measure gender distribution in the study. Result: Of the total of 88 required subjects, gender distribution and performed surgical time were statistically insignificant with a p-value of 0.76 and 0.48, respectively. The pain was significantly higher in the LBTF group in the 5th and 7th postoperative days with a p-value of 0.02 and 0.028. The swelling was statistically higher during all the follow-ups except for the 28th day in the LBTF group with values of 0.006, 0.002 and 0.003, respectively. There was no significant difference in inter-incisional distance (IID) between the groups during postoperative check-ups. Conclusion: LBTF shows no edge over BBTF during mandibular third molar disimpaction. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to compare the analgesic efficacy of 4% articaine associated with epinephrine (1:100,000), and 2% lidocaine associated with epinephrine (1:100,000) in third molar extraction surgery. Methods: Sixty patients who underwent surgeries to extract upper and lower third molars were included in this split-mouth, double-blind, randomized, controlled trial. The groups in this study were divided according to the anesthetic solution used to provide local anesthesia during extraction of upper and lower third molars: (1) 4% articaine associated with epinephrine (1:100,000); (2) 2% lidocaine associated with epinephrine (1:100,000). The time to the beginning and end of the sensation of analgesia, pain sensation according to the VAS scale, and number of anesthetic tubes necessary for supplementation were analyzed. Results: It was found that the onset time for analgesia was shorter on the side anesthetized with articaine compared to the side anesthetized with lidocaine (122.1 ± 52.90 s vs. 144.5 ± 68.85 s) (p < 0.05). In addition, the number of tubes used for anesthetic supplementation was also reduced on the articaine side compared to the lidocaine side (0.26 ± 0.48 vs. 0.50 ± 0.75) (p < 0.05). There were no differences between the anesthetic solutions in the other evaluated parameters. Conclusion: It can be concluded that the use of 4% articaine associated with epinephrine (1:100,000) reduced the time of onset of analgesia and the necessity for anesthetic supplementation in third molar extraction surgeries compared to the use of 2% lidocaine associated with epinephrine (1:100,000). [ABSTRACT FROM AUTHOR]

Purpose: To assess the efficacy and safety of perioperative parenteral administration or submucosal infiltration of tramadol for perioperative pain control on the basis of pain intensity or analgesics consumption and perioperative outcomes in mandibular third molar surgery. Material-methods: An electronic database search was conducted up to 10 November 2022 to retrieve all randomized controlled trials (RCTs), assessing the analgesic efficacy of parenteral use of tramadol implemented as an adjunct to local anesthesia or intraoperative sedation/general anesthesia, in surgical extraction of mandibular third molars. Modified Jadad scale and Cochrane bias tool were used for the qualitative appraisal. Results: Nineteen RCTs were selected for qualitative analysis. Nine studies involved intravenous, and 5 intramuscular administration of tramadol, while 5 evaluated submucosal infiltration with tramadol. Intravenous or intramuscular tramadol provided a weaker analgesic effect compared with non-steroidal anti-inflammatory drugs (NSAIDs), while intravenous tramadol induced an enhanced analgesic effect than oral tramadol. Parenteral administration of tramadol improved the quality of postoperative analgesia versus placebo. No notable adverse effects were recorded. Conclusions: Parenteral or submucosal infiltration of tramadol constitutes an effective and safe alternative analgesic approach in surgical extraction of mandibular third molars, yet the nociceptive effect of this analgesic modality could not supersede that of NSAIDs. Trial registration: PROSPERO No CRD42021227574. [ABSTRACT FROM AUTHOR]