Influence of two different surgical techniques on the difficulty of impacted lower third molar extraction and their post-operative complications

Abstract

Background: Post-operative complications of various degrees of severity are commonly observed in third molar impaction surgery. For this reason, a surgical procedure that decreases the trauma of bone and soft tissues should be a priority for surgeons. In the present study, we compare the efficacy and the post-operative complications of patients to whom two different surgical techniques were applied for impacted lower third molar extraction.

Material and methods: Patients of the first group underwent the classical bur technique, while patients of the second group underwent another technique, in which an elevator was placed on the buccal surface of the impacted molar in order to luxate the alveolar socket more easily.

Results: Comparing the two techniques, we observed a statistically significant decrease in the duration of the procedure and in the need for tooth sectioning when applying the second surgical technique, while the post-operative complications were similar in the two groups. We also found a statistically significant lower incidence of lingual nerve lesions and only a slightly higher frequency of sharp mandibular bone irregularities in the second group, which however was not statistically significant.

Conclusions: The results of our study indicate that the surgical technique using an elevator on the buccal surface of the tooth seems to be a reliable method to extract impacted third molars safely, easily, quickly and with the minimum trauma to the surrounding tissues.

Figure 1

Schematic representation of the application of the straight elevator in the buccal surface of the tooth. Soft tissues are not depicted in order to display in detail the exact location where the elevator is positioned.

Figure 2

Schematic representation of the cryer elevator applied in the buccal surface of the tooth. Soft tissues are not depicted in order to display with accuracy the exact location where the elevator is positioned.