FEATURES OF REMOVAL OF RETAINED AND SEMI-RETAINED THIRD MOLAR TEETH
DOI:
https://doi.org/10.35220/2078-8916-2023-48-2.31Keywords:
removal, molar tooth, retained tooth, semiretained tooth, complicationsAbstract
The purpose of this article is to analyze and summarize the data of modern scientific literature regarding the features of removal of retained and semi-retained third molar teeth. The results. Teeth that are located in the bone tissue of the jaw and have not erupted are called retained teeth, which is a fairly common anomaly. Semi-erupted teeth are teeth that have partially erupted. Surgical removal of the third molar teeth of the upper and lower dental arch is one of the most common operations, including the preventive removal of asymptomatic retained third molars, as it is possible to prevent the development of such pathologies as caries and root resorption of adjacent teeth, pericoronitis, gingivitis, periodontosis, the development of cysts or tumors, as well as eliminate the cause of “crowding” of the tooth row. The operation to remove a retained and semiretained tooth is most often accompanied by postoperative pain, swelling and restriction of mouth opening. Less common complications are alveolar osteitis, damage to the branches of the trigeminal nerve, a fracture of the angle of the lower jaw, abscess, phlegmon, odontogenic sinusitis, postoperative bleeding, displacement of tooth fragments, fistula, subcutaneous emphysema, pneumomediastinum, pneumorrhagia, etc. The third molars of the lower jaw are located close to the mandibular canal, which contains the inferior alveolar nerve, artery and vein. This close relationship creates a risk of injury to the inferior alveolar nerve during extraction of the mandibular third molar. At the end of the operation, the patient may be offered the use of fibrin enriched with platelets from the patient's own plasma, which contributes to the rapid healing of the wound and the reduction of postoperative edema. Conclusion. Therefore, the removal of retained and semi-retained third molares is a multi-stage intervention that requires adequate diagnosis and preparation to prevent complications. The peculiarity of removal is that, following the accepted principles of the course of intervention, the approach to the operation is individual and depends on the position of the axis of the retained tooth in the jaw and relative to the axis of the neighboring teeth, the state of the alveolar part of bone, the age of the patients and their general somatic status.
References
Мельник В.С., Горзов Л.Ф., Білищук Л.М., Зомбор К.В., Гриненко Є.М. Частота поширеності ретинованих та дистопованих зубів у м. Ужгород. Вісник стоматології. 2020. № 2 (111), Т. 36. С. 84–88.
Rivera-Herrera R.S., Esparza-Villalpando V., Bermeo-Escalona J.R., Martinez-Rider R., Pozos-Guillen A. Agreement analysis of three mandibular third molar retention classifications. Gac Med Mex. 2020. Vol. 156, No 1. P. 22–26.
Fernandes I.A., Galvao E.L., Goncalves P.F., Falci S.G.M. Impact of the presence of partially erupted third molars on the local radiographic bone condition. Sci Re. 2022. Vol. 12, No 1. e8683. https://doi.org/10.1038/s41598-022-12729-w.
Duarte-Rodrigues L., Miranda E.F.P., Souza T.O., de Paiva H.N., Falci S.G.M., Galvao E.L. Third molar removal and its impact on quality of life: systematic review and metaanalysis. Quality Life Research. 2018. Vol. 10. P. 2477–2489.
Wadia R. Disease related to mesio-angular third molars. Br Dent J. 2019. Vol. 227, No 10. e885. https://doi.org/10.1038/s41415-019-1008-x.
Фліс П.С., Бродецька Л.О. Особливості діагностики і лікування ретенованих зубів. Український стоматологічний альманах. 2019. Вип. 3. С. 57–62.
Bailey E., Kashbour W., Shah N., Worthinghton H.V., Renton T.F., Coulthard P. Surgical techniques for the removal of mandibular wisdom teeth. Cochrane Database Syst Rev. 2020. Vol. 2020, No 7. CD004345. https://doi.org/10.1002/14651858.CD004345.pub3
Toedtling V., Forouzanfar T., Brand H.S. Parameters associated with radiographic distal surface caries in the mandibular second molar adjacent to an impacted third molar. BMC Oral Health. 2023. Vol. 23. e125. https://doi.org/10.1186/s12903-023-02766-w
Toedtling V., Devlin H., Tickle M., O’Malley L. Prevalence of distal surface caries in the second molar among referrals for assessment of third molars: a systematic review and meta-analysis. Br J Oral Maxillofac Surg. 2019. Vol. 57, No 6. P. 505–514.
Toedtling V., Forouzanfar T., Brand H. Historical aspects about third molar removal versus retention and distal surface caries in the second mandibular molar adjacent to impacted third molars. Br Dent J. 2023. Vol. 234. P. 268–273 https://doi.org/10.1038/s41415-023-5532-3.
Su N., Harroui S., Rozema F., Listl S., Lange J., Heijden G.J.M.G.V. What do we know about uncommon complications associated with third molar extractions? A scoping review of case reports and case series. J Korean Assoc Oral Maxillofac Surg. 2023. Vol. 49, No 1. P. 2–12. https://doi.org/10.5125/jkaoms.2023.49.1.2.
Nunn M.E., Fish M.D., Garcia R.I., Kaye E.K., Figueroa R., Gohel A., Ito M., Lee H.J., Williams D.E., Miyamoto T. Retained asymptomatic third molars and risk for second molar pathology. J Dent Res. 2013. Vol. 92, No 12. P. 1095–1099. https://doi.org/10.1177/0022034513509281.
Kang F., Huang C., Sah M.K., Jiang B. Effect of Eruption Status of the Mandibular Third Molar on Distal Caries in the Adjacent Second Molar. J Oral Maxillofac Surg. 2016. Vol. 74, No 4. P. 684–692. https://doi.org/10.1016/j.joms.2015.11.024.
Chen Y., Zheng J., Li D., Huang Z., Huang Z., Wang X., Whang X., Hu X. Three-dimensional position of mandibular third molars and its association with distal caries in mandibular second molars: a cone beam computed tomographic study. Clin Oral Investig. 2020. Vol. 24, No 9. P. 3265–3273. https://doi.org/10.1007/s00784-020-03203-w.
Kaye E., Heaton B., Aljoghaiman E.A., Singhal A., Sohn W., Garcia R.I. Third-Molar Status and Risk of Loss of Adjacent Second Molars. J Dent Res. 2021. Vol. 100, No 7. P. 700–705. https://doi.org/10.1177/0022034521990653.
Marques J., Montserrat-Bosch M., Figueiredo R., Vilchez-Perez M., Valmaseda-Castellon E., Gay-Escoda C. Impacted lower third molars and distal caries in the mandibular second molar. Is prophylactic removal of lower third molars justified? J Clin Exp Dent. 2017. Vol. 9, No 6. P. 794–798. https://doi.org/10.4317/jced.53919
Li D., Tao Y., Cui M., Zhang W., Zhang X., Hu X. External root resorption in maxillary and mandibular second molars associated with impacted third molars: a cone-beam computed tomographic study. Clin Oral Investig. 2019. Vol. 23, No 12. P. 4195–4203.
Loureiro R.M., Sumi D.V., Tames H.L.V.C., Ribeiro S.P.P., Soares C.R., Gomes R.L.E., Daniel M.M. Cross-Sectional Imaging of Third Molar-Related Abnormalities. AJNR Am J Neuroradiol. 2020. Vol. 41, No 11. P. 1966–1974. https://doi.org/10.3174/ajnr.A6747.
McArdle L.W., Andiappan M., Khan I., Jones J., McDonald F.. Diseases associated with mandibular third molar teeth. Br Dent J. 2018. Vol. 224, No 6. P. 434–440. https://doi.org/10.1038/sj.bdj.2018.216.
McArdle L.W., Jones J., McDonald F. Characteristics of disease related to mesio-angular mandibular third molar teeth. Br J Oral Maxillofac Surg. 2019. Vol. 57, No 4. P. 306–311. https://doi.org/10.1016/j.bjoms.2019.02.002.
Vranckx M., Fieuws S., Jacobs R., Politis C. Prophylactic vs. symptomatic third molar removal: effects on patient postoperative morbidity. Journal of Evidence Based Dental Practice. 2021. Vol. 21, No 3. e101582. https://doi.org/10.1016/j.jebdp.2021.101582.
Momin M., Albright T., Leikin J., Miloro M., Markiewicz M.R. Patient morbidity among residents extracting third molars: does experience matter? Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 2018. Vol. 125, No 5. P. 415–422. https://doi.org/10.1016/j.oooo.2017.12.006.
Henriksson C.H., Andersson M., Moystad A. Hypodontia and retention of third molars in Norwegian medieval skeletons: dental radiography in osteoarchaeology. Acta Odontol Scand. 2019. Vol. 77, No 4. P. 310–314.
Ouassime K., Rachid A., Amine K., Ousmane B., Faiçal S. The wisdom behind the third molars removal: A prospective study of 106 cases. Ann Med Surg (Lond). 2021. Vol. 68. e102639. https://doi.org/10.1016/j.amsu.2021.102639.
Sigron G.R., Pourmand P.P., Mache B., Stadlinger B., Locher M.C. The most common complications after wisdom-tooth removal: part 1: a retrospective study of 1,199 cases in the mandible. Swiss Dent J. 2014. Vol. 124, No 10. P. 1042–1056.
Lutz JC., Cazzato R., Le Roux, M.K., Bornert F. Retrieving a displaced third molar from the infratemporal fossa: case report of a minimally invasive procedure. BMC Oral Health. 2019. Vol. 19. e149 https://doi.org/10.1186/s12903-019-0852-z
Tay Y.B.E., Loh W.S. Extensive subcutaneous emphysema, pneumomediastinum, and pneumorrhachis following third molar surgery. Int J Oral Maxillofac Surg. 2018. Vol. 47, No 12. P. 1609–1612. https://doi.org/10.1016/j.ijom.2018.04.023.
Ghaeminia H., Nienhuijs M.E., Toedtling V., Perry J., Tummers M., Hoppenreijs T.J., Van der Sanden W.J.M., Mettes T.G. Surgical removal versus retention for the management of asymptomatic disease-free impacted wisdom teeth. Cochrane Database Syst Rev. 2020. Vol. 5. CD003879. https://doi.org/10.1002/14651858.CD003879.pub5
He Y., Chen J., Huang Y., Pan Q., Nie M. Local Application of Platelet-Rich Fibrin During Lower Third Molar Extraction Improves Treatment Outcomes. J Oral Maxillofac Surg. 2017. Vol. 75, No 12. P. 2497–2506. https://doi.org/10.1016/j.joms.2017.05.034.
Zhu J., Zhang S., Yuan X., He T., Liu H., Wang J., Xu B. Effect of platelet-rich fibrin on the control of alveolar osteitis, pain, trismus, soft tissue healing, and swelling following mandibular third molar surgery: an updated systematic review and meta-analysis. Int J Oral Maxillofac Surg. 2021. Vol. 50, No 3. P. 398–406. https://doi.org/10.1016/j.ijom.2020.08.014.
