Pathological Changes in Radiographically Normal Dental Follicule: A CBCT Study

Introduction: Dental follicle arises from odontogenicmesenchyme which result in tooth formation. Study aimed toestimate pathological alteration in follicle of impacted thirdmolar(ITM) in cone beam computer tomography (CBCT)and correlation with patient’s age, gender, site and angularposition.Material and Methods: Dental follicle (DF) from 80 ITMwere collected from 68 patients with follicular space ≤ 1.5 mmas measured from the CBCT. dental follicle associated withimpacted teeth were extracted and sent for histopatholicalexamination. statistical analysis was performed.Results: In 80 follicles which were evaluated for patholocalchanges were taken from patients ranging from age of 18to 50 years with a mean age of 37.5 years out if which 21were females and 19 were males. Pathological alterationwere found associated with 10 (35%) follicles which wasstatistically significant (p < 0.001). Incidence of pathologywas slightly more in females and in mandibular jaw. Lesionswere most commonly seen in jaws which were distoangularlyand horizontally impacted.Conclusion: it was concluded that radiographically normalappearing impacted teeth may be associated with variouspathology. So histopatholoic evaluation of all impacted teethis mandatory

Inward fragmentation and socket preservation in complex mandibular third molar surgery - a case report

Open extraction sockets following inward fragmentation of partially erupted mandibular third molars may compromise the hard tissue regeneration and lead to postoperative complications. in the case report, we present socket preservation to seal the open alveolous without flap displacement. a female patient aged 22, presented for removal of a partially erupted M3M was operated on via occlusal inward fragmentation under magnifying endoscopic vision. critical nerve structures were identified and protected before socket preservation with resorbable in situ hardening TCP particles was performed. the alveolar bone site healed uneventful, panoramic and cross-sectional conebeam reformats confirmed an complete hard tissue maintanence. endoscopically assisted inward fragmentation combined with socket preservation leads to the maintenance of adjacent hard tissues without need for flap transposition in complex anatomical sites.

Prophylactic Extraction of Third Molars: Evidence-Based Dentistry

his new perspective article was performed to investigate the evidence from published dental literature about the prophylactic extraction of asymptomatic (or disease-free) impacted third molars (ITM) in adolescents and young adults. This clinical procedure is common until today and has been the origin of controversy among the dental community worldwide. However, evidence-based data from wellconducted clinical studies and systematic reviews are not sufficient to justify the routine prophylactic extraction of ITM. Active surveillance at regular intervals has been proposed as a better management strategy. As a conclusion, surgical removal of ITM is only justified in the presence of specific pathosis, independently of the patient's age.

l presente artículo se realizó para investigar la evidencia en literatura dental publicada sobre la extracción profiláctica de terceros molares impactados asintomáticos (o libres de enfermedad) (TMI) en adolescentes y adultos jóvenes. Este procedimiento clínico es común y ha sido el origen de la controversia entre la comunidad dental en todo el mundo. Sin embargo, los datos basados en evidencia de estudios clínicos y revisiones sistemáticas no son suficientes para justificar la extracción profiláctica rutinaria de TMI. La vigilancia activa a intervalos regulares se ha propuesto como una mejor estrategia de manejo. Como conclusión, la remoción quirúrgica de TMI sólo se justifica en presencia de patología específica, independientemente de la edad del paciente.

Impacted mandibular third molars among patients attending Hospital Universiti Sains Malaysia

The aim of this study was to identify the position of impacted mandibular third molars based on the classifications of Pell & Gregory and Winter, the indications for extraction, and the relation of post-operative complications and position. Records of patients who attended Hospital Universiti Sains Malaysia between January and December 2007 for surgical removal of mandibular third molars were reviewed. The angulation type, width and depth of impaction were determined by reviewing the orthopantomograms. The indications of extraction and occurrence of any post- operative complications were recorded. A total of 238 impacted teeth were surgically extracted from 194 patients (97 males, 97 females). The reasons for extraction include recurrent pericoronitis (43.1%) followed by prophylactic purposes (33.5%). Mesioangular impactions accounted for 52.3% and Class IIA position of impaction accounted for 45.7% of extractions. The most common post-operative complication was persistent pain and swelling (14.7%) followed by trismus (4.1%) and dry socket (3.0%). There was no significant relationship between the angulation, width and depth of impaction and the occurrence of complication. Mesioangular type and Class IIA position of impaction were the most common impaction. Although the association was not significant, high frequency of post-operative complications was observed in mesioangular, horizontal, IIA and IIC positions.