The Effect of the COVID-19 Pandemic on the Decision-making Process of Mandibular Impacted Third Molar Extraction.

Objectives: In this study, we investigated the impact of the COVID-19 pandemic on the decision-making process for impacted mandibular third molar removal and related clinical teaching. Methods: From April 21 to April 28, 2020, we distributed a self-constructed survey via the Wenjuanxing software platform to oral clinicians engaged in the extraction of mandibular third molars. Results: We received 321 valid responses. Overall, 22.4% of clinicians were temporarily not performing tooth extractions in outpatient clinics and 50.2% of clinicians were temporarily not performing impacted tooth extractions. The main reason cited was that aerosol-generating high-speed handpieces were not recommended for use during the pandemic, opting instead for the surgical handpiece with copious saline irrigation as the main method for bone removal; the hammer-and-chisel method was considered to be too traumatic and posed too high of a risk for iatrogenic injury. Conclusions: The implementation of disease control measures during the COVID-19 pandemic significantly affected clinical decision-making regarding impacted mandibular third molar extractions; the main reason cited was the contraindication of using aerosol-generating high-speed handpieces. The hammer-and-chisel method may represent a valuable surgical application under the requirements for epidemic prevention and control. We provide a new idea for the extraction of interrupted permanent molars in the context of epidemic prevention and control is provided.

The Use of Chisels in the Extraction of Mandibular Third Molars: A Technique That May Prevent the Aerosolization of Severe Acute Respiratory Syndrome Coronavirus 2.

An aerosolizing reducing technique for the extraction of impacted mandibular third molars with the use of a bibevel chisel and mallet will be presented. Every oral and maxillofacial surgeon should have this technique in their armamentarium, especially with the current global pandemic with the severe acute respiratory syndrome coronavirus 2, the cause of coronavirus disease 2019. In this era, we must all consider ways to reduce the number of aerosols produced during the extraction of third molars. Prioritizing hand instrumentation with the use of chisels and mallets will reduce aerosolization as compared with the more traditional technique of using a surgical handpiece.