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An alternative approach to extruding a vertically impacted lower third molar using an orthodontic miniscrew: A case report with cone-beam CT follow-up.

Cortes AR, No-Cortes J, Cavalcanti MG, Arita ES - Imaging Sci Dent (2014)

Bottom Line: The present report discusses a case of a vertically impacted LTM associated with a dentigerous cyst.An intimate contact between the LTM roots and the mandibular canal was observed on a panoramic radiograph and confirmed with cone-beam computed tomographic (CBCT) cross-sectional cuts.CBCT imaging follow-up confirmed the success of the LTM orthodontic extrusion.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral Radiology, School of Dentistry, University of São Paulo, São Paulo, Brazil.

ABSTRACT
One of the most common oral surgical procedures is the extraction of the lower third molar (LTM). Postoperative complications such as paresthesia due to inferior alveolar nerve (IAN) injury are commonly observed in cases of horizontal and vertical impaction. The present report discusses a case of a vertically impacted LTM associated with a dentigerous cyst. An intimate contact between the LTM roots and the mandibular canal was observed on a panoramic radiograph and confirmed with cone-beam computed tomographic (CBCT) cross-sectional cuts. An orthodontic miniscrew was then used to extrude the LTM prior to its surgical removal in order to avoid the risk of inferior alveolar nerve injury. CBCT imaging follow-up confirmed the success of the LTM orthodontic extrusion.

No MeSH data available.


Related in: MedlinePlus

Initial cross-sectional cone-beam computed tomographic (CBCT) images of the site show the contact between the mandibular canal and the curvatures of the mesial (A) and distal (B) roots, depicted in different CBCT cuts.
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Figure 1: Initial cross-sectional cone-beam computed tomographic (CBCT) images of the site show the contact between the mandibular canal and the curvatures of the mesial (A) and distal (B) roots, depicted in different CBCT cuts.

Mentions: On these preoperative CBCT images, the vertical impaction of the left LTM was confirmed and classified as level B(LTM partially buried in the bone), according to Pell and Gregory's classification.7 Additionally, a cyst-like lesion was found associated with its crown. Cross-sectional CBCT images showed that the mandibular canal came into contact with a root curvature and the lingual plate (Fig. 1). Because of its intimate contact with the mandibular canal, it could be foreseen that LTM surgical extraction would increase the risk of IAN injury. Therefore, we decided to use an orthodontic miniscrew to extrude the LTM prior to its surgical removal. The risks and benefits of the available treatment options were explained to the patient, and he decided in favor of using the miniscrew to extrude the LTM and provided informed consent.


An alternative approach to extruding a vertically impacted lower third molar using an orthodontic miniscrew: A case report with cone-beam CT follow-up.

Cortes AR, No-Cortes J, Cavalcanti MG, Arita ES - Imaging Sci Dent (2014)

Initial cross-sectional cone-beam computed tomographic (CBCT) images of the site show the contact between the mandibular canal and the curvatures of the mesial (A) and distal (B) roots, depicted in different CBCT cuts.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4061303&req=5

Figure 1: Initial cross-sectional cone-beam computed tomographic (CBCT) images of the site show the contact between the mandibular canal and the curvatures of the mesial (A) and distal (B) roots, depicted in different CBCT cuts.
Mentions: On these preoperative CBCT images, the vertical impaction of the left LTM was confirmed and classified as level B(LTM partially buried in the bone), according to Pell and Gregory's classification.7 Additionally, a cyst-like lesion was found associated with its crown. Cross-sectional CBCT images showed that the mandibular canal came into contact with a root curvature and the lingual plate (Fig. 1). Because of its intimate contact with the mandibular canal, it could be foreseen that LTM surgical extraction would increase the risk of IAN injury. Therefore, we decided to use an orthodontic miniscrew to extrude the LTM prior to its surgical removal. The risks and benefits of the available treatment options were explained to the patient, and he decided in favor of using the miniscrew to extrude the LTM and provided informed consent.

Bottom Line: The present report discusses a case of a vertically impacted LTM associated with a dentigerous cyst.An intimate contact between the LTM roots and the mandibular canal was observed on a panoramic radiograph and confirmed with cone-beam computed tomographic (CBCT) cross-sectional cuts.CBCT imaging follow-up confirmed the success of the LTM orthodontic extrusion.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral Radiology, School of Dentistry, University of São Paulo, São Paulo, Brazil.

ABSTRACT
One of the most common oral surgical procedures is the extraction of the lower third molar (LTM). Postoperative complications such as paresthesia due to inferior alveolar nerve (IAN) injury are commonly observed in cases of horizontal and vertical impaction. The present report discusses a case of a vertically impacted LTM associated with a dentigerous cyst. An intimate contact between the LTM roots and the mandibular canal was observed on a panoramic radiograph and confirmed with cone-beam computed tomographic (CBCT) cross-sectional cuts. An orthodontic miniscrew was then used to extrude the LTM prior to its surgical removal in order to avoid the risk of inferior alveolar nerve injury. CBCT imaging follow-up confirmed the success of the LTM orthodontic extrusion.

No MeSH data available.


Related in: MedlinePlus