Degree of difficulty in lower third molar surgery
Keywords:
SURGERY, ORAL, COMPLICATIONS, OPERATIVE TIME.Abstract
Introduction: Third molar formation often occurs in a very limited space, there are several difficulty scales to determine the complexity in the surgery of retained molars that are key for planning and prediction.
Objective: to evaluate the difficulties and complications in lower third molar surgeries. Methods: retrospective, observational and descriptive, with a sample of 100 extractions of retained lower third molars in two different populations, the following variables were evaluated: spatial relationship, depth, relationship with the ramus or available space, integrity of the bone and mucosa, roots, follicle size, the data were recorded in a spreadsheet and the difficulty scale was obtained.
Results: the study evaluated 100 molars from patients of the CME oral surgery clinic in Mexico and Ecuador. In group 1 (CME), a relationship between sex and surgical difficulty was observed, with 18 % of women facing "difficult" difficulty and 6 % of men with "very difficult" difficulty. In group 2 (Ecuador), 18 % of men had a "difficult" difficulty and both sexes had a "very difficult" difficulty equally.
Conclusions: there are significant differences in surgical time according to age, complications according to the location of the third molar, and follicle size. Hence, the scale to be used may be crucial in planning extractions of retained third molars, as it allows for a reduction in surgical times and prevention of complications.
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1. González Espangler L, Mok Barceló P, de la Tejera Chillón A, George Valles Y, Leyva Lara ML. Caracterización de la formación y el desarrollo de los terceros molares. MEDISAN [Internet]. 2014 Ene [citado 25/11/2024]; 18(1): 34-44. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1029-30192014000100006&lng=es.
2. Armand Lorié M, Legrá Silot E, Ramos de la Cruz M, Matos Armand F. Terceros molares retenidos. Actualización. Rev Inf Cient [Internet]. 2015 [citado 25/11/2024]; 92(4): 995-1010. Disponible en: https://revinfcientifica.sld.cu/index.php/ric/article/view/217
3. Arias Estrada AR. Tecnica quirurgica en exodoncia de terceros molares inferiores impactados y semiretenidos. Universidad de Guayaquil. Facultad Piloto de Odontología. Biblioteca Virtual SEMISUD[Internet]; 2019 [citado 25/11/2024]. Disponible en: https://biblioteca.semisud.org/opac_css/index.php?lvl=notice_display&id=278083
4. Quezada Marquez MM, Beltrán Silva JA, Bernal Morales JB, Evangelista Alva , Del Castillo López CE. Relación entre la edad cronológica y la mineralización del tercer molar inferior según método de Demirjian. Rev Estomatol Herediana [Internet]. 2014 [citado 25/11/2024]; 24(2): 63-72. Disponible en: https://www.redalyc.org/pdf/4215/421539381002.pdf
5. Loureiro RM, Sumi DV, Tames HLVC, Ribeiro SPP, Soares CR, Gomes RLE, et al. Cross-Sectional Imaging of Third Molar-Related Abnormalities. AJNR Am J Neuroradiol [Internet]. 2020 Nov [citado 25/11/2024]; 41(11): 1966-1974. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32912872/
6. Campbell JH. Pathology associated with the third molar. Oral Maxillofac Surg Clin North Am [Internet]. 2013 Feb [citado 25/11/2024]; 25(1): 1-10. Disponible en: https://pubmed.ncbi.nlm.nih.gov/23273561/
7. Mateos Corral I, Hernández Flores F. Prevalencia de inclusión dental y patología asociada en pacientes de la clínica de la Facultad de Odontología Mexicali de la UABC. Rev Odont Mex [Internet]. 26 de agosto de 2022 [citado 25/11/2024]; 9(2). Disponible en: https://revistas.unam.mx/index.php/rom/article/view/16022
8. Bucal. Sedc. Diagnostico e indicaciones para la extraccion de los terceros molares [Internet]. SECIB; 2018 [citado 25/11/2024]: p. 45. Disponible en: https://portal.guiasalud.es/wp-content/uploads/2023/11/gpc_626_terceros_molares_secib_compl.pdf
9. Condado García CM. factores predictivos mas frecuentes para determinar la dificultad en cirugia de terceras molares inferiores no erupcionadas [Tesis]. Lima; 2018 [citado 25/11/2024]. Disponible en: https://www.academia.edu/89468261/Factores_predictivos_m%C3%A1s_frecuentes_para_determinar_la_dificultad_en_cirug%C3%ADa_de_terceras_molares_inferiores_no_erupcionadas?hb-sb-sw=107609571
10. Matzen LH, Schropp L, Spin-Neto R, Wenzel A. Radiographic signs of pathology determining removal of an impacted mandibular third molar assessed in a panoramic image or CBCT. Dentomaxillofac Radiol [Internet]. 2017 Jan [citado 25/11/2024]; 46(1): 20160330. Disponible en: https://pubmed.ncbi.nlm.nih.gov/27681861/
11. Marciani R. Third molar removal: an overview of indications, imaging, evaluation, and assessment of risk. Oral Maxillofac Surg Clin North Am [Internet]. 2007 Feb [citado 25/11/2024]; 19(1): 1-13. Disponible en: https://pubmed.ncbi.nlm.nih.gov/18088860/
12. Motts Jones J, Di Marco A, Ghedini T, Mazza F, Toselli. Examen clínico y radiológico de terceros molares incluidos. El dentista moderno [Internet]. 2016 [citado 25/11/2024]. Disponible en: https://www.researchgate.net/publication/309646478_ Examen_clinico_y_radiologico_de_los_terceros_molares_incluidos
13. Encinas A, Saez L, Cobo C, Meniz C. Coronectomía en terceros molares inferiores. Cient. Dent [Internet]. 2020 [citado 25/11/2024]; 17(3): 65-71. Disponible en: https://coem.org.es/pdf/publicaciones/cientifica/vol17num3/coronectomia.pdf
14. Sthorayca Retamozo FR. Frecuencia de terceros molares inferiores retenidos según las clasificaciones de Pell-Gregory y Winter. etvita [Internet]. 16 de julio de 2018 [citado 26/11/2024]; 12(2): 837 - 842. Disponible en: https://revistas.upt.edu.pe/ojs/index.php/etvita/article/view/49
15. Luo , Shi , Zhao , Zhao Y, Xu. Automatic Synthesis of Panoramic Radiographs from Dental Cone Beam Computed Tomography Data. PLOS ONE [Internet]. 2016 [citado 26/11/2024]; 11(6): e0156976. Disponible en: https://pubmed.ncbi.nlm.nih.gov/27300554/
16. Vasquez Vasquez ML. Factores predictivos de dificultad en relación con el tiempo de cirugía efectiva del tercer molar mandibular incluido [Tesis]. Lima ; 2009 [citado 26/11/2024]. Disponible en: https://cybertesis.unmsm.edu.pe/item/bd8489ad-23be-4d3b-9c10-54a674859d3d
17. Olguin Martínez TG, Amarillas Escobar ED. Morfologia radicular de los terceros molares Revista ADM [Internet]. 2017 [citado 26/11/2024]; 74(1): 17-24. Disponible en: https://www.medigraphic.com/pdfs/adm/od-2017/od171e.pdf
18. Romero Ruiz M, Gutierrez Perez J. En El tercer molar incluido. Sevilla: GSK; 2012. p. 280-285.
19. Vargas Madrid WA, González Bustamante AM, Zurita Minango PE. Factores predictivos para valorar la dificultad para extraer terceros molares inferiores retenidos. Univ Odontol [Internet]. 29 de diciembre de 2020 [citado 27/11/2024]; 39. Disponible en: https://revistas.javeriana.edu.co/index.php/revUnivOdontologica/article/view/32446
20. Castillo Alcoser C, Crespo Mora V, Castelo Reyna M, León Velastegui MA. Análisis ortopantomográfico en la determinación de la posición recurrente de terceros molares. Revista Eugenio Espejo [Internet]. 2020 [citado 27/11/2024]; 14(1): 8-17. Disponible en: https://www.redalyc.org/journal/5728/572863747014/html/
21. Acosta Rodríguez A, Morales Navarro D, Cárdenas Moya J. Grado de dificultad en terceros molares mandibulares retenidos / Degree of difficulty in mandibular impacted third molars. Arch Hosp Univ "Gen Calixto García” [Internet]. 2021 [citado 27/11/2024]; 9(1): 65-74. Disponible en: https://revcalixto.sld.cu/index.php/ahcg/article/view/614
22. Alvira-González J, Figueiredo R, Valmaseda-Castellón E, Quesada-Gómez C, Gay-Escoda C. Predictive factors of difficulty in lower third molar extraction: A prospective cohort study. Med Oral Patol Oral Cir Bucal [Internet]. 2017 Jan 1 [citado 27/11/2024]; 22(1): e108-e114. Disponible en: https://pubmed.ncbi.nlm.nih.gov/27918736/
23. Chaparro Avendaño AV, Pérez García S, Valmaseda Castellón E, Berini Aytés L, Gay Escoda C. Morbidity of third molar extraction in patients between 12 and 18 years of age. Med. oral patol. oral cir. bucal (Ed.impr.) [Internet]. 2005 Dic [citado 27/11/2024]; 10(5): 422-431. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1698-44472005000500007&lng=es
24. Hans Bachmann , Cáceres R, Muñoz C, Uribe S. Complicaciones en Cirugía de Terceros Molares entre los Años 2007¬2010, en un Hospital Urbano, Chile. Int. J. Odontostomat [Internet]. 2014 [citado 27/11/2024]; 8(1):107-112. Disponible en: https://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0718-381X2014000100014
25. Llerena García G, Arrascue Dulanto M. Tiempo de cirugía efectiva en la extracción de los terceros molares realizadas por un cirujano oral y maxilofacial con experiencia. Rev Estomatol Herediana [Internet]. 24 de septiembre de 2014 [citado 27/11/2024]; 16(1): 40. Disponible en: https://revistas.upch.edu.pe/index.php/REH/article/view/1930
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