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Piezosurgery for the Lingual Split Technique in Lingual Positioned Impacted Mandibular Third Molar Removal

View Article: PubMed Central - PubMed

ABSTRACT

The aim of this study was to evaluate the effect and safety of lingual split technique using piezosurgery for the extraction of lingual positioned impacted mandibular 3rd molars with the goal of proposing a more minimally invasive choice for this common surgery.

Eighty-nine consecutive patients with 110 lingual positioned impacted mandibular 3rd molars requiring extraction were performed the lingual split technique using piezosurgery. One sagittal osteotomy line and 2 transverse osteotomy line were designed for lingual and occlusal bone removal. The success rate, operative time, postoperative outcome, and major complications (including nerve injury, mandible fracture, severe hematoma or edema, and severe pyogenic infection) were documented and analyzed.

All impacted mandibular 3rd molars were successfully removed (110/110). The average time of operation was 14.6 minutes (ranged from 7 to 28 minutes). One hundred and seven extraction sites (97.3%) were primary healing. Pain, mouth opening, swelling, and PoSSe scores on postoperative 7-day were 0.34 ± 0.63, 3.88 ± 0.66(cm), 2.4 ± 0.2(cm), and 23.7 ± 5.9, respectively. There were 6 cases (5.5%) had lingual nerve disturbance and 3 cases (2.7%) developed inferior alveolar nerve impairment, and achieved full recovery within 2 months by neurotrophic drug treatment.

Our study suggested piezosurgery for lingual split technique provided an effective way for the extraction of lingual positioned and deeply impacted mandibular 3rd molar.

No MeSH data available.


Related in: MedlinePlus

3D reconstruction occlusal view showed the osteotomy line for lingual split technique. (A) There was 1 sagittal osteotomy line and 2 transverse osteotomy line. (B) Full exposure of the third molar after removal of the alveolar bone.
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Figure 4: 3D reconstruction occlusal view showed the osteotomy line for lingual split technique. (A) There was 1 sagittal osteotomy line and 2 transverse osteotomy line. (B) Full exposure of the third molar after removal of the alveolar bone.

Mentions: The osteotomy line was designed in the following pattern: 1 oblique sagittal line was made just parallel with the lateral side of the 3rd molar, stretching from the molar's mesial point to distal point (Figure 4); 2 transverse lines, including the mesial one and the distal one, were made from the oblique sagittal line to the lingual plate (Figure 5). There is no sagittal osteotomy line on the lingual plate in this technique, the lingual plate would break at its weakest point where the 3rd molar is nearest to the lingual cortex bone. During the procedure, gentle irrigation within the osteotomy permitted visualization of the lingual nerve (Figure 6).


Piezosurgery for the Lingual Split Technique in Lingual Positioned Impacted Mandibular Third Molar Removal
3D reconstruction occlusal view showed the osteotomy line for lingual split technique. (A) There was 1 sagittal osteotomy line and 2 transverse osteotomy line. (B) Full exposure of the third molar after removal of the alveolar bone.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998409&req=5

Figure 4: 3D reconstruction occlusal view showed the osteotomy line for lingual split technique. (A) There was 1 sagittal osteotomy line and 2 transverse osteotomy line. (B) Full exposure of the third molar after removal of the alveolar bone.
Mentions: The osteotomy line was designed in the following pattern: 1 oblique sagittal line was made just parallel with the lateral side of the 3rd molar, stretching from the molar's mesial point to distal point (Figure 4); 2 transverse lines, including the mesial one and the distal one, were made from the oblique sagittal line to the lingual plate (Figure 5). There is no sagittal osteotomy line on the lingual plate in this technique, the lingual plate would break at its weakest point where the 3rd molar is nearest to the lingual cortex bone. During the procedure, gentle irrigation within the osteotomy permitted visualization of the lingual nerve (Figure 6).

View Article: PubMed Central - PubMed

ABSTRACT

The aim of this study was to evaluate the effect and safety of lingual split technique using piezosurgery for the extraction of lingual positioned impacted mandibular 3rd molars with the goal of proposing a more minimally invasive choice for this common surgery.

Eighty-nine consecutive patients with 110 lingual positioned impacted mandibular 3rd molars requiring extraction were performed the lingual split technique using piezosurgery. One sagittal osteotomy line and 2 transverse osteotomy line were designed for lingual and occlusal bone removal. The success rate, operative time, postoperative outcome, and major complications (including nerve injury, mandible fracture, severe hematoma or edema, and severe pyogenic infection) were documented and analyzed.

All impacted mandibular 3rd molars were successfully removed (110/110). The average time of operation was 14.6 minutes (ranged from 7 to 28 minutes). One hundred and seven extraction sites (97.3%) were primary healing. Pain, mouth opening, swelling, and PoSSe scores on postoperative 7-day were 0.34 ± 0.63, 3.88 ± 0.66(cm), 2.4 ± 0.2(cm), and 23.7 ± 5.9, respectively. There were 6 cases (5.5%) had lingual nerve disturbance and 3 cases (2.7%) developed inferior alveolar nerve impairment, and achieved full recovery within 2 months by neurotrophic drug treatment.

Our study suggested piezosurgery for lingual split technique provided an effective way for the extraction of lingual positioned and deeply impacted mandibular 3rd molar.

No MeSH data available.


Related in: MedlinePlus