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. 2016 Dec 15:6:39126.
doi: 10.1038/srep39126.

Adjacent tooth trauma in complicated mandibular third molar surgery: Risk degree classification and digital surgical simulation

Zhou-Xi Ye  1 , Chi Yang  2 , Jing Ge  2
Affiliations

Adjacent tooth trauma in complicated mandibular third molar surgery: Risk degree classification and digital surgical simulation

Zhou-Xi Ye et al. Sci Rep. .

Abstract

Analysis of adjacent tooth resistance is essential in wisdom teeth extraction to prevent adjacent tooth trauma, however it lacks adequate attention nowadays. This study aims at suggesting special extraction methods based on adjacent tooth resistance analysis for prevention of adjacent tooth damage. In this study, 136 complicated mandibular third molars extracted using piezosurgery were reviewed and classified based on the adjacent teeth resistances shown in orthopantomogram (OPG) during their mesio-distal rotations: degree I refers to teeth with no adjacent teeth resistance; degree II refers to teeth with resistance released after mesial-half crown sectioning; degree III refers to teeth which still had resistance after mesial-half crown sectioning. With the use of surgical simulations using cone beam computerized tomography (CBCT) reconstruction, all teeth in degree I were designed to rotate mesio-distally; 86.36%(38/44) teeth in degree II were designed to rotate mesio-distally after mesio-half crown sectioning; 69.09%(36/55) teeth in degree III were designed to rotate bucco-lingually. All teeth were extracted successfully, and only one adjacent tooth was subluxated due to the incomplete bone removal. Our study suggested that in order to prevent adjacent teeth trauma, complete bone removal is of importance, and impacted teeth with higher adjacent teeth trauma risks should consider bucco-lingual rotations.

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Figures

Figure 1
Figure 1. Teeth with risk degree I.
(A) the OPG shows 48 was in risk degree I. (B) the sketch shows 48 had no adjacent tooth resistance after the complete bone removal.
Figure 2
Figure 2. Teeth in risk degree II.
(A) the OPG shows 38 was in risk degree II; (B) the sketch shows 38 got adjacent tooth resistance released after the complete bone removal and half crown sectioning.
Figure 3
Figure 3. Teeth in risk degree III.
(A) OPG shows 48 was in risk degree III. (B) the sketch shows 48 had adjacent tooth resistance after the complete bone removal and half crown sectioning.
Figure 4
Figure 4. The extraction method of tooth in risk degree I.
(A–C) three-dimensional reconstruction of CT helps the surgical simulation, which shows 48 could rotate mesio-distally after occlusal bone removal. (D) the critical surgical procedure.
Figure 5
Figure 5. The extraction method of tooth in risk degree II.
(A,B) surgical simulation shows 38 could rotate mesio-distally after the complete bone removal and mesio-half crown sectioning. (C,D) the critical surgical procedures.
Figure 6
Figure 6. The extraction method of tooth in risk degree III.
(A–C) surgical simulation shows 48 could rotate bucco-lingually. (D) the critical surgical procedure.
See this image and copyright information in PMC

References

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