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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]

Supernumerary teeth are commonly observed in the anterior region of the maxilla; however, reports of their occurrence in the molar region, particularly near the third molars, are rare. A 21-year-old man with no genetic disease visited our department for a third-molar extraction. Panoramic radiography and computed tomography revealed one and four supernumerary teeth in the right and left maxillary third-molar regions, respectively. The bilateral third molars and supernumerary teeth were extracted under general anesthesia. The supernumerary teeth were incompletely developed, and one tooth morphologically resembled a premolar. The patient's postoperative course was uneventful. [ABSTRACT FROM AUTHOR]

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.

Objective To explore the influence of extracting different types of mandibular mesially impacted third molars on the proximal contact strength(PCS) of adjacent teeth. Methods One hundred and ten cases of mandibular mesially impacted third molars were divided into high impacted group(40 cases), middle impacted group(40 cases) and low impacted group(30 cases). The PCS of the adjacent teeth of impacted teeth(between the mandibular second premolar L5 and the mandibular first molar L6, and between the mandibular first molar L6 and the mandibular second molar L7) were measured by high-precision dynamometer before and after operation, and the mean and standard deviation were statistically measured. The differences of PCS before and after extraction in each group were analyzed. Results Without considering the classification of mesial impacted teeth, extraction of mandibular third molars led to the decrease in PCS of L5/L6 and L6/L7. In the high-middle impacted groups, the extraction of mandibular third molars led to the decrease in PCS of L5/L6 and L6/L7, while in the low impacted group, there was no statistical difference between the changes in PCS of L5/L6 and L6/L7. Conclusion The extraction of high-middle mandibular mesially impacted third molars can significantly reduce the adjacent teeth’s PCS, but the extraction of low mandibular mesially impacted third molars has no significant effect on the adjacent teeth’s PCS.

Background: Impacted third molars can cause significant challenges for dental health. While many of these impacted teeth remain asymptomatic, they can lead to dental caries. Objective: To investigate the patterns of mandibular third molar impaction and its relationship with the occurrence of caries in the adjacent mandibular second molars. Materials and Methods: This study assessed the dental panoramic radiographs of 1591 participants who visited the Department of Oral and Maxillofacial Surgery at the Dental Teaching Hospital at Umm Al-Qura University between 2022 and 2024. The presence of distal caries in the adjacent mandibular second molars was assessed and compared across the different impaction patterns, considering both age and gender. Results: The results showed that 29.22 % of the patients had impacted mandibular third molars. The most common patterns of impacted mandibular third molar angulation were mesioangular in the females and horizontal in the males. The majority of these impacted third molars were level A and class I (as per the Pell and Gregory classification).One hundred and eighty-three (39.35 %) of the impacted mandibular third molars had associated carious lesions, with 89 showing distal caries in the adjacent mandibular second molar and 18 showing caries in the third molar itself. The carious lesions were most commonly found in cases of mesioangular, level A, and class I impaction patterns (p

One of the most commonly performed surgical interventions in dentistry is the third molar extraction. This procedure may be performed routinely, but it may also be associated with complications. Numerous variations in the postoperative course have been described. Our investigation aimed to examine the reliability of postoperative follow-up of surgical third molar extraction using the method of teledentistry via patients' smartphone devices. We performed a randomized experimental study. The follow-up examination undertaken a day after the surgical procedure consisted of two parts: a virtual one and an in-person one. Our digital examination involved photographs taken by the patients themselves and an electronic survey. The oral surgeon first evaluated the digital follow-up results before conducting the patient in-person examination. The results were processed and compared using Cohen's kappa coefficient, Z test and McNemar's χ² test for the statistical significance cut-off value of p = 0.05. In total, 40 follow-up examinations (100%) were performed. In 39 (98%) examinations, the results obtained with in-person and virtual approaches were identical. In 7 cases (25%), the indications for a change in therapy were presented by both methods. The actual number of therapy changes recommended was 10 (100%) for the in-person approach and 9 (100%) for the teledentistry method. The following agreement values were obtained: sensitivity: 0.9750; specificity: 0.9750; efficiency: 0.9750; and Cohen's Kappa: 0.9500. These values suggested an almost perfect agreement. The diagnostic differences between patient recovery follow-up using the virtual and in-person approaches after third molar surgical extraction were not statistically significant. In that regard, postoperative course follow-up may rely on contemporary digital communication technologies with a high degree of confidence. [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]

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]

Impacted third molars can cause significant challenges for dental health. While many of these impacted teeth remain asymptomatic, they can lead to dental caries. To investigate the patterns of mandibular third molar impaction and its relationship with the occurrence of caries in the adjacent mandibular second molars. This study assessed the dental panoramic radiographs of 1591 participants who visited the Department of Oral and Maxillofacial Surgery at the Dental Teaching Hospital at Umm Al-Qura University between 2022 and 2024. The presence of distal caries in the adjacent mandibular second molars was assessed and compared across the different impaction patterns, considering both age and gender. The results showed that 29.22 % of the patients had impacted mandibular third molars. The most common patterns of impacted mandibular third molar angulation were mesioangular in the females and horizontal in the males. The majority of these impacted third molars were level A and class I (as per the Pell and Gregory classification). One hundred and eighty-three (39.35 %) of the impacted mandibular third molars had associated carious lesions, with 89 showing distal caries in the adjacent mandibular second molar and 18 showing caries in the third molar itself. The carious lesions were most commonly found in cases of mesioangular, level A, and class I impaction patterns (p < 0.05). The findings of this study shed light to the high prevalence of carious lesions associated with impacted mandibular third molar, especially in cases of mesioangular, level A, and class I impaction patterns. These findings highlight the importance of careful monitoring of impacted third molars to prevent the development of caries in the adjacent teeth. [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]

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]

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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]

ABSTRACT Background/Aim Material and Methods Results Conclusions To evaluate the efficacy of the combined cone‐beam (CBCT)/3D‐replicas protocol on the clinical and radiographic outcomes of autotransplanted molars.Controlled clinical trial registered ISRCTN13563091 from August 2019 to September 2022. Patients aged 13–22 years requiring permanent premolar extraction and having at least one non‐erupted third molar were enrolled at the Institute of Stomatology, Stradins University, Riga, Latvia. Patients in the 3D‐replicas (n = 30) underwent maxillary CBCT scans and had 3D‐printed replicas of the third molar fabricated, while the control group (n = 28) did not. The clinical outcomes included tooth mobility, bleeding on probing, and periodontal pocket depth assessed at 3, 6, and 12 months. The radiographic outcomes included root development, obliteration, periapical status, and crown changes at 12 months.Of the 55 patients assigned to interventions, 46 completed the study. No significant differences in survival and radiographic outcomes were found between the control (n = 22) and 3D‐replica group (n = 24): root development (p = 0.3), root resorption (p = 0.057), periapical status (p = 0.7), and crown/root ratio change (p = 0.4). Logistic regression showed no significant associations between radiologic predictors (root resorption: p = 0.4; periapical status: p > 0.9; root development: p = 0.8). Significant clinical outcome predictors included total operative time (β = 0.0043, p = 0.049), Moorrees' stage (stage 4: β = −0.31, p < 0.001; stage 5: β = −0.39, p < 0.001), and four donor placement times (β = 0.93, p < 0.001), but group assignment was not a significant predictor.The CBCT/3D‐replica protocol showed no significant differences in the clinical or radiological outcomes. The high success rates in both groups suggest that the protocol is valuable primarily for optimizing surgical efficiency and as a training tool for clinicians. [ABSTRACT FROM AUTHOR]

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]

ABSTRACT Background Objective Methods Results Conclusion Trial Registration Trismus and subsequent restricted range of motion in the temporomandibular joint may impede vital activities of daily living.The primary purpose of the current study was to explore the impact of muscle energy techniques on the range of temporomandibular motions in individuals with trismus and restricted range of the temporomandibular motions after third molar extraction surgery.Eligible volunteers were randomly assigned to either the intervention or control group. Participants in the intervention group received muscle energy techniques over seven consecutive postoperative days, while those in the control group did not receive any intervention. Both groups adhered to the recommended postoperative healthcare protocol provided by a single dentist. The range of cardinal and linear intra‐articular motions of the temporomandibular joint was assessed on the first, second and seventh postoperative days in each group using a vernier calliper and an ultrasound machine, respectively.The range of linear intra‐articular motion (p‐value < 0.001) and cardinal motion (p‐value < 0.032) of the TMJ significantly increased within groups after the first postoperative week. The range of temporomandibular motions, except for the forward displacement of the mandibular condyle (p‐value = 0.193), and the range of mandibular retrusion (p‐value = 0.339) exhibited a significant difference between groups (p‐value < 0.017) after the first postoperative week.The current study revealed, for the first time, that muscle energy techniques increase the range of cardinal and linear intra‐articular motions in individuals with trismus and restricted range of the temporomandibular motions following third molar extraction surgery.Clinical Trials: IRCT20211016052783N1 [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the relationship between the precise three-dimensional location of the third molar (M3) and mandibular angle fracture (MAF) patterns and to assess the effect of the volume ratio occupied by M3 in the mandibular angle on fracture patterns. The location of M3 was assessed in 218 patients with MAF using computed tomography reconstruction. The bone volume of the mandibular angle and the bone volume occupied by M3 were measured to calculate the volume ratio of M3 to the mandibular angle (M3/MA). MAF patterns were categorized into simple fracture (Type I), displaced fracture (Type II), and comminuted fracture (Type III) based on fracture severity. The results showed that the location of M3 significantly influenced MAF patterns (vertical position: P =.001; horizontal position: P =.002; angulation: P =.027, respectively) and the volume ratio of M3/MA was significantly higher for Type III fracture than Types I and II (P <.001). Regression analysis showed that the horizontal position and angulation of M3 and the volume ratio of M3/MA were the main predictors for comminuted MAF. A larger volume ratio (odds ratio [OR], 1.201; 95% confidence interval [CI], 1.037–1.391; P <.014), Class III position (OR, 7.978; 95% CI, 1.275–49.910; P <.026), and horizontal angulation (OR, 7.212; 95% CI, 1.028–50.581; P <.047) of the M3 were more prone to comminuted MAF than simple fracture. Our findings indicate that the location of M3 significantly affects MAF patterns, and that M3 may weaken the mandibular angle by occupying more bone space, thereby increasing the risk of a comminuted fracture. [ABSTRACT FROM AUTHOR]

Lingual nerve injury (LNI) is a rare, serious complication and previous studies include limited numbers of cases. The aim of this retrospective study was to report the neurosensory outcomes for a large patient cohort with permanent LNI and correlate the mechanism of injury (surgical vs non-surgical) to neurosensory characteristics. Demographics, procedural parameters, mandibular third molar (M3) position, surgeon type, neurosensory test results, and symptoms were recorded for 228 patients and analysed. The majority were female (67.1%). Overall, 59.6% of LNIs were caused by M3 removal and 36.4% by local anaesthesia. Complete loss occurred more frequently in surgical LNIs (P = 0.013). The presence of pain did not differ significantly, however the burning type of pain was significantly more frequent in non-surgical LNIs (P = 0.008) along with altered gustation (P = 0.025). The most common M3 position related to LNI was distoangular (40.4%), class III (63.2%), level A (58.1%) (Winter/Pell and Gregory classifications). The majority of patients undergoing M3 removal were >24 years. A total of 71.7% showed no sign of recovery and 5.5% reported further impairment in their condition. Overall, nine patients underwent microsurgical repair. This study presents neurosensory characteristics potentially decisive for timely referral of operable LNIs. [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]

ABSTRACT Objective: Compare the effect of Diazepam versus Midazolam on hemodynamic changes in oral conscious sedation in lower third molar exodontias. Methods: A systematic review was conducted, with registration in the International Prospective Register of Systematic Reviews (protocol CRD42020162953), using the databases from PubMed/MEDLINE, Embase, Cochrane Library, BVS Regional Portal and Grey Literature (Clinical Trial and OpenGrey), and also manual searches in Bucomaxillofacial Surgery journals, concluding the collections on November 3, 2020, updated on September 20, 2024. Randomized clinical trials comparing Diazepam with Midazolam were included, excluding those with incomplete information, which did not assess blood pressure, heart rate and peripheral oxygen saturation, and those which texts were not located. A risk of bias analysis was performed using the RoB 2.0 Cochrane Handbook for Systematic Reviews of Interventions tool. Subsequently, a narrative synthesis was conducted to show the results. Results: From the 2,017 records found, only two were included, aggregating 210 patients. Midazolam showed better results in blood pressure and peripheral oxygen saturation, while Diazepam showed more favorable values in heart rate. Conclusion: Due to limitations such as absence of data and failures in randomization, the evidences were considered fragile, requiring further randomized clinical trials, with a better scientific design.

ABSTRACT Odontogenic cutaneous fistulas are abnormal connections between the oral cavity and skin, often mistaken for skin infections. They typically result from dental infections but may also arise from salivary gland issues, tumors, or congenital anomalies. Accurate diagnosis is essential to prevent complications like infection, osteomyelitis, and discomfort. A 26‐year‐old woman presented with bilateral facial lesions and itching for the past year. Her symptoms began 5 years earlier with cheek pain and swelling, initially treated with antibiotics. Examination revealed pericoronitis of the mandibular third molars, leading to bilateral orocutaneous fistulas. Surgical removal of the affected teeth and fistulas was performed. Orocutaneous fistulas commonly result from long‐standing dental infections. Their location depends on the perforation site of the cortical plate. Early diagnosis through clinical examination and imaging is vital to prevent severe complications like osteomyelitis. Treatment involves addressing the underlying cause, typically through root canal therapy or tooth extraction. This case highlights the importance of early, interdisciplinary management of orocutaneous fistulas to prevent misdiagnosis, reduce discomfort, and avoid complications. Timely treatment ensures better outcomes and minimizes cosmetic concerns.

Abstract 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

Aims: The current study aims to compare the impact of three different treatment approaches on the surface microhardness of the enamel of third molar teeth. Materials and Methods: An in vitro study was done on fifty extracted impacted third molars. All samples were immersed in solutions of pH cycle for 10 days (demineralizing solution for 3 hours, remineralizing solution for 20 hours, and artificial saliva for 30 minutes twice daily). Then the samples were divided randomly into 5 groups according to enamel surface treatment, group1: Colgate (containing Arginine) toothpaste, group2: GC (containing Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP)-tooth mousse, group 3: Sensodyne (containing NovaMin) toothpaste group 4: distilled water and group 5: pH cycle solutions. The microhardness numbers were calculated from the length of the indentation on the enamel surface, the indentation length was determined microscopically with 70X magnification. An ANOVA was constructed (value P ≤ 0.05) followed by Duncan’s post –hoc test for comparisons of mean values. Results: there were significant differences among the study groups with respect to Vickers microhardness (VMH) mean values of samples. The lowest value was for the control group after the pH cycle followed by the Colgate (containing Arginine) group and the highest value was for the control group before the pH cycle followed by the Sensodyne (containing NovaMin) group. Conclusions: Sensodyne (containing NovaMin) toothpaste is more effective in restoring the hardness of artificial WSLs when compared with GC (containing CPP-ACP) and Colgate (containing Arginine) toothpaste