nach oben

Clinical Oral Investigations

Erschienen in:

30.04.2020 | Original Article

Risk factors for lingual plate fracture during mandibular third molar extraction

verfasst von: Cheng Huang, Chun Zhou, Minhua Xu, Derong Zou

Erschienen in: Clinical Oral Investigations | Ausgabe 11/2020

Einloggen, um Zugang zu erhalten

Abstract

Objective

The aim of this study was to predict the risk of lingual plate fracture during mandibular third molar (M3) extraction.

Materials and methods

Cone beam computed tomography (CBCT) data from 264 mandibular M3s (erupted and impacted) from 264 patients (104 males and 160 females; age range, 17–75 years) were retrospectively analyzed. Lingual plate thicknesses at the levels of the mid-root and root apex of the M3s were measured and defined as “thicker” (bone thicker than 1 mm), “thinner” (bone thinner than 1 mm), or “perforated” (bone perforated by the M3 root). These measurements were correlated with potential risk factors for thinner and perforated lingual plates: tooth position of the mandibular M3, morphology of the lingual plate, and patient characteristics (age and sex).

Results

The mean thickness of the lingual plate was 1.49 ± 1.38 mm at the mid-root of the M3s, and 2.35 ± 2.03 mm at the root apex. Multivariate regression analyses revealed that mesioangularly and horizontally impacted M3s were significantly associated with thinner and perforated lingual plates at the mid-root (P < 0.001), whereas the M3s in infra-occlusion positions (in infra-occlusion when compared with the adjacent second molar) had thinner lingual bone at the root apex (P = 0.022 and P = 0.027, depending on the level of impaction). Female patients were less likely to have lingual plate perforation (P = 0.036).

Conclusions

Mesioangulation, infra-occlusion, and male sex were risk factors for lingual plate fracture.

Clinical relevance

When the risk of lingual plate fracture is high, a sufficiently large flap, osteotomy, and tooth section by bur or piezosurgery are recommended to create a good operative field and avoid excessive pressure on the lingual plate.

Boffano P, Ferretti F, Giunta G, Gallesio C (2012) Surgical removal of a third molar at risk for mandibular pathologic fracture: case report and clinical considerations. Oral Surg Oral Med Oral Pathol Oral Radiol 114(6):e1–e4. https://doi.org/10.1016/j.oooo.2011.09.025CrossRefPubMed

Aznar-Arasa L, Figueiredo R, Gay-Escoda C (2012) Iatrogenic displacement of lower third molar roots into the sublingual space: report of 6 cases. J Oral Maxillofac Surg 70(2):e107–e115. https://doi.org/10.1016/j.joms.2011.09.039CrossRefPubMed

Figueiredo R, Valmaseda-Castellon E, Formoso-Senande MF, Berini-Aytés L, Gay-Escoda C (2012) Delayed-onset infections after impacted lower third molar extraction: involved bacteria and sensitivity profiles to commonly used antibiotics. Oral Surg Oral Med Oral Pathol Oral Radiol 114(1):43–48. https://doi.org/10.1016/j.tripleo.2011.06.022CrossRefPubMed

Kose I, Koparal M, Günes N, Atalay Y, Yaman F, Atilgan S, Kaya G (2014) Displaced lower third molar tooth into the submandibular space: two case reports. J Nat Sci Biol Med 5(2):482–484. https://doi.org/10.4103/0976-9668.136274CrossRefPubMedPubMedCentral

Zhao S, Huang Z, Geng T, Huang L (2015) Intraoral management of iatrogenically displaced lower third molar roots in the sublingual space: a report of 2 cases. Int J Clin Exp Med 8(10):19591–19595PubMedPubMedCentral

Figueiredo R, Valmaseda-Castellon E, Laskin DM, Berini-Aytes L, Gay-Escoda C (2008) Treatment of delayed-onset infections after impacted lower third molar extraction. J Oral Maxillofac Surg 66(5):943–947. https://doi.org/10.1016/j.joms.2008.01.045CrossRefPubMed

Charan Babu HS, Reddy PB, Pattathan RK, Desai R, Shubha AB (2013) Factors influencing lingual nerve paraesthesia following third molar surgery: a prospective clinical study. J Maxillofac Oral Surg 12(2):168–172. https://doi.org/10.1007/s12663-012-0391-5CrossRefPubMed

Jerjes W, Upile T, Shah P, Nhembe F, Gudka D, Kafas P, McCarthy E, Abbas S, Patel S, Hamdoon Z, Abiola J, Vourvachis M, Kalkani M, Al-Khawalde M, Leeson R, Banu B, Rob J, El-Maaytah M, Hopper C (2010) Risk factors associated with injury to the inferior alveolar and lingual nerves following third molarsurgery-revisited. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 109(3):335–345. https://doi.org/10.1016/j.tripleo.2009.10.010CrossRefPubMed

Bataineh AB (2001) Sensory nerve impairment following mandibular third molar surgery. J Oral Maxillofac Surg 59(9):1012–1017. https://doi.org/10.1053/joms.2001.25827CrossRefPubMed

10.

Ge J, Zheng JW, Yang C, Qian WT (2016) Variations in the buccal-lingual alveolar bone thickness of impacted mandibular third molar: our classification and treatment perspectives. Sci Rep 6:16375. https://doi.org/10.1038/srep16375CrossRefPubMedPubMedCentral

11.

Wang D, He X, Wang Y, Zhou G, Sun C, Yang L, Bai J, Gao J, Wu Y, Cheng J (2016) Topographic relationship between root apex of mesially and horizontally impacted mandibular third molar and lingual plate cross-sectional analysis using CBCT. Sci Rep 6:39268. https://doi.org/10.1038/srep39268CrossRefPubMedPubMedCentral

12.

Emes Y, Oncu B, Aybar B, Al-Badri N, Işsever H, Atalay B, Yalçın S (2015) Measurement of the lingual position of the lower third molar roots using cone-beam computed tomography. J Oral Maxillofac Surg 73(1):13–17. https://doi.org/10.1016/j.joms.2014.06.460CrossRefPubMed

13.

Pell GJ, Gregory GT (1933) Impacted mandibular third molars: classification and modified technique for removal. Dent Dig 39(9):e330–e338

14.

Winter GB (1926) Principles of exodontia as applied to the impacted third molar. American Medical Books, St Louis

15.

Yilmaz S, Adisen MZ, Misirlioglu M, Yorubulut S (2016) Assessment of third molar impaction pattern and associated clinical symptoms in a central Anatolian Turkish population. Med Princ Pract 25(2):169–175. https://doi.org/10.1159/000442416CrossRefPubMed

16.

Tolstunov L, Brickeen M, Kamanin V, Susarla SM, Selvi F (2016) Is the angulation of mandibular third molars associated with the thickness of lingual bone? Br J Oral Maxillofac Surg 54(8):914–919. https://doi.org/10.1016/j.bjoms.2016.06.005CrossRefPubMed

17.

Chan HL, Brooks SL, Fu JH, Yeh CY, Rudek I, Wang HL (2011) Cross-sectional analysis of the mandibular lingual concavity using cone beam computed tomography. Clin Oral Implants Res 22(2):201–206. https://doi.org/10.1111/j.1600-0501.2010.02018.xCrossRefPubMed

18.

Momin MA, Matsumoto K, Ejima K, Asaumi R, Kawai T, Arai Y, Honda K, Yosue T (2013) Correlation of mandibular impacted tooth and bone morphology determined by cone beam computed topography on a premise of third molar operation. Surg Radiol Anat 35(4):311–318. https://doi.org/10.1007/s00276-012-1031-yCrossRefPubMed

19.

Xavier CB, Gonçalves FR, Batista SH, Veras Filho Rde O, Vogt BF (2011) Spontaneous migration of third molar following displacement to pterygomandibular fossa. J Oral Maxillofac Surg 69(4):1004–1007. https://doi.org/10.1016/j.joms.2010.05.052CrossRefPubMed

20.

Huang IY, Wu CW, Worthington P (2007) The displaced lower third molar: a literature review and suggestions for management. J Oral Maxillofac Surg 65(6):1186–1190. https://doi.org/10.1016/j.joms.2006.11.031CrossRefPubMed

21.

Araki K, Maki K, Seki K, Sakamaki K, Harata Y, Sakaino R, Okano T, Seo K (2004) Characteristics of a newly developed dentomaxillofacial X-ray cone beam CT scanner (CB MercuRay): system configuration and physical properties. Dentomaxillofac Radiol 33(1):51–99. https://doi.org/10.1259/dmfr/54013049CrossRefPubMed

22.

Hashimoto K, Kawashima S, Kameoka S, Akiyama Y, Honjoya T, Ejima K, Sawada K (2007) Comparison of image validity between cone beam computed tomography for dental use and multidetector row helical computed tomography. Dentomaxillofac Radiol 36(8):465–471. https://doi.org/10.1259/dmfr/22818643CrossRefPubMed

23.

Loubele M, Guerrero ME, Jacobs R, Suetens P, van Steenberghe D (2007) A comparison of jaw dimensional and quality assessments of bone characteristics with cone-beam CT, spiral tomography, and multi-slice spiral CT. Int J Oral Maxillofac Implants 22(3):446–454PubMed

24.

Pauwels R, Araki K, Siewerdsen JH, Thongvigitmanee SS (2015) Technical aspects of dental CBCT: state of the art. Dentomaxillofac Radiol 44(1):20140224. https://doi.org/10.1259/dmfr.20140224CrossRefPubMed

25.

Aksoy U, Orhan K (2018) Risk factor in endodontic treatment: topographic evaluation of mandibular posterior teeth and lingual cortical plate using cone beam computed tomography (CT). Med Sci Monit 21(24):7508–7516. https://doi.org/10.12659/MSM.908970CrossRef

26.

Menziletoglu D, Tassoker M, Kubilay-Isik B, Esen A (2019) The assessment of relationship between the angulation of impacted mandibular third molar teeth and the thickness of lingual bone: a prospective clinical study. Med Oral Patol Oral Cir Bucal 24(1):e130–e135. https://doi.org/10.4317/medoral.22596CrossRefPubMed

27.

Mallick A, Vidya KC, Waran A, Rout SK (2017) Measurement of lingual cortical plate thickness and lingual position of lower third molar roots using cone beam computed tomography. J Int Soc Prev Community Dent 7(Suppl 1):S8–S12. https://doi.org/10.4103/jispcd.JISPCD_106_17CrossRefPubMedPubMedCentral

28.

Aoki C, Nara T, Kageyama I (2011) Relative position of the mylohyoid line on dentulous and edentulous mandibles. Okajimas Folia Anat Jpn 87(4):171–176. https://doi.org/10.2535/ofaj.87.171CrossRefPubMed

29.

Huang RY, Cochran DL, Cheng WC, Lin MH, Fan WH, Sung CE, Mau LP, Huang PH, Shieh YS (2015) Risk of lingual plate perforation for virtual immediate implant placement in the posterior mandible: a computer simulation study. J Am Dent Assoc 146(10):735–742. https://doi.org/10.1016/j.adaj.2015.04.027CrossRefPubMed

30.

Wolsan M, Suzuki S, Asahara M, Motokawa M (2015) Tooth size variation in pinniped dentitions. PLoS One 10(8):e0137100. https://doi.org/10.1371/journal.pone.0137100CrossRefPubMedPubMedCentral

31.

Watanabe H, Mohammad Abdul M, Kurabayashi T, Aoki H (2010) Mandible size and morphology determined with CT on a premise of dental implant operation. Surg Radiol Anat 32(4):343–349. https://doi.org/10.1007/s00276-009-0570-3CrossRefPubMed

Titel: Risk factors for lingual plate fracture during mandibular third molar extraction
verfasst von: Cheng Huang
Chun Zhou
Minhua Xu
Derong Zou
Publikationsdatum: 30.04.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Oral Investigations / Ausgabe 11/2020
Print ISSN: 1432-6981
Elektronische ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-020-03286-5

Update Zahnmedizin

Bestellen Sie unseren kostenlosen Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.

Newsletter bestellen

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Risk factors for lingual plate fracture during mandibular third molar extraction

Abstract

Objective

Materials and methods

Results

Conclusions

Clinical relevance

Neu im Fachgebiet Zahnmedizin

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

Klinikreform soll zehntausende Menschenleben retten

Darf man die Behandlung eines Neonazis ablehnen?

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

Update Zahnmedizin

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

Objective

Materials and methods

Results

Conclusions

Clinical relevance

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 11/2020

Epidemiological trends, predictive factors, and projection of tooth loss in Germany 1997–2030: part II. Edentulism in seniors

Spontaneous eruption of impacted maxillary incisors after surgical extraction of supernumerary teeth: a systematic review and meta-analysis

Characterization and effect of nanocomplexed fluoride solutions on the inhibition of enamel demineralization created by a multispecies cariogenic biofilm model

Effect of treatment with a full-occlusion biofeedback splint on sleep bruxism and TMD pain: a randomized controlled clinical trial

Diabetes mellitus and poor glycemic control increase the occurrence of coronal and root caries: a systematic review and meta-analysis

Development and validation of a screening model for diabetes mellitus in patients with periodontitis in dental settings

Neu im Fachgebiet Zahnmedizin

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

Klinikreform soll zehntausende Menschenleben retten

Darf man die Behandlung eines Neonazis ablehnen?

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

Update Zahnmedizin