Orthodontic extrusion with followed surgical extraction of high-risk lower third molar

Albena Gencheva; Tihomir Georgiev; Hristina Arnautska; Gergana Ivanova; Kamen Nogalchev

doi:10.14748/ssmd.v2i2.1814

Orthodontic extrusion with followed surgical extraction of high-risk lower third molar

Albena Gencheva, Tihomir Georgiev, Hristina Arnautska, Gergana Ivanova, Kamen Nogalchev

Abstract

lower third molar with sings that indicates high risk of postoperative complications. Materials and methods: We represent an orthodontic extrusion followed by surgical extraction of lower third molar. For precise diagnostics and approach to suitable method of treatment we used standard panoramic radiograph and CBCT. As a method of surgical treatment we chose assisted orthodontic extraction with individually manufactured ring with soldered bar, fixed to tooth 47. Results: In our clinical case we achieved traction of the impacted lower third molar to safe distance from the mandibular canal. On the second stage of the treatment we performed a classic odontectomy without affect or damaging the IAN. Conclusion: The classic odontectomy is surgical method with high risk of damaging the IAN when the impacted tooth is very close to the mandibular canal. The orthodontic extraction like an alternative surgical method of high-risk lower third molars is preventive method, by which there is minimal risk of damaging the nerve during the surgery. The orthodontic extrusion makes the following surgical extraction a safe and secure method for the patient.

Keywords

retention, impacted lower third molar, alternative method, orthodontic extrusion, CBCT

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References

Wang Y, He D, Yang C, Wang B, Qian W. An easy way to apply orthodontic extraction for impacted lower third molar compressing to the inferior alveolar nerve. J CraniomaxillofacSurg 2012; 40: 234-7.

HATTAB FN, ALHAIJA ES. Radiographic evaluation of mandibular third molar eruption space. Oral Surg Oral Med Oral Pathol Oral Radiol & Endodontics. 1999 ; 88 :285-91.

Juodzbalys G, Daugela P. Mandibular Third Molar Impaction: Review of Literature and a Proposal ofa Classification.J Oral Maxillofac Res 2013;4(2):e1

Richardson, M.: Late third molar genesis: Its significance in orthodontic treatment. Angle Orthod. 50: 121-128, 1980

Liedholm R. (2005) Mandibular third molar removal. Patient preferences, assessments of oral surgeons and patient flows. Doctoral thesis, University of Malmo

O`Riordan B. Uneasy lies the head that wears the crown. Br J Oral Maxillofac Surg1997; 35: 209.

Frenkel B, Givol N, Shoshani Y: Coronectomy of the mandibular third molar: a retrospective study of 185 procedures and the decision to repeat the coronectomy in cases of failure. J Oral Maxillofac Surg. 2015 Apr;73(4):587-94

Leung YY, Cheung LK: Risk factors of neurosensory deficits in lower third molar surgery: an literature review of prospective studies. Int J Oral Maxillofac Surg. 2011 Jan;40(1)

Bonetti GA, Parenti SI, Checchi L. Orthodontic extraction of mandibular third molar to avoid nerve injury and promote periodontal healing. J Clin Periodontol 2008;35(8):719-23

Hirsch A, Shteiman S, Boyan BD, Schwartz Z. Use of orthodontic treatment as an aid to third molar extraction: a method for prevention of mandibular nerve injury and improved periodontal status. J Periodontol 2003;74(6):887-92.

Chen YJ, Chang HH, Huang CY, Hung HC, Lai EH, Yao CC. A retrospective analysis of the failure rate of three different orthodontic skeletal anchorage systems. Clin Oral Implants Res 2007;18(6):768-75.

Wonse Park, DDS, MSD,a Joon-Soo Park, DDS,b Yun-Mi Kim, DDS,b Hyung-Seog Yu, DDS, MSD, PhD,c and Kee-Deog Kim, DDS, MSD, PhD,d Seoul, KoreaYONSEI UNIVERSITY)

Rossouw PE, Buschang PH. Temporary orthodontic anchorage devices for improving occlusion. Orthod Craniofac Res 2009; 12(3):195-205

Schatzle M, Mannchen R, Zwahlen M, Lang NP. Survival and failure rates of orthodontic temporary anchorage devices: a systematic review. Clin Oral Implants Res 2009;20(12):1351-9.

Cornelis MA, Scheffler NR, De Clerck HJ, Tulloch JF, Behets CN. Systematic review of the experimental use of temporary skeletal anchorage devices in orthodontics. Am J Orthod Dentofacial Orthop 2007;131(4 Suppl):S52-8.

Kravitz ND, Kusnoto B. Risks and complications of orthodontic miniscrews. Am J Orthod Dentofacial Orthop 2007;131(4 Suppl):S43-51.0

Papadopoulos MA, Tarawneh F. The use of miniscrew implants for temporary skeletal anchorage in orthodontics: a comprehensive review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;103(5):e6-15.

Bonetti Al., Bendandi M., Checchi V., Orthodontic extraction: Riskless extraction of impacted lower third molars close to the mandibular canal. J Oral Maxillofac Surg 65:2580-2586, 2007

Chen YJ, Chang HH, Huang CY, Hung HC, Lai EH, Yao CC. A retrospective analysis of the failure rate of three different orthodontic skeletal anchorage systems. Clin Oral Implants Res 2007;18(6):768-75.

Park W, Park JS, Kim YM, Yu HS, Kim KD. Orthodontic extrusion of the lower third molar with an orthodontic mini implant. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 110: e1-6.

DOI: http://dx.doi.org/10.14748/ssmd.v2i2.1814