Evaluation of cone beam computed tomography and piezosurgery for the diagnosis and treatment of impacted teeth

Hala Mokhtar Abdel-Alim

Abstract


Surgical extraction impacted third molar requires precise anatomical localization.  CBCT is superior to plain films and CT in accurate identification of the area.  Surgical complications of osteotomy performed with conventional rotary instruments are compared with outcomes while using Piezoelectric surgery..

Materials and methods: 30 patients with bilateral impacted mandibular third molars were allocated to 2 groups according to the osteotomy device used, Group 1 conventional rotary while Group 2 a piezoelectric device. Postoperative evaluation of nerve injury, pain, edema and trismus was carried out.  Results: CBCT proved to be an important tool for precise estimation of the amount of bone to be removed and the relation to the neighboring soft tissue.  Piezosurgery was superior to conventional cutting devices since decreased bleeding ensured a clear field; and  with better quality of life including no symptoms of nerve injuries, and less pain, edema and trismus. However, time of surgery was longer with piezosurgery than with conventional surgery. Conclusion:  Accurate assessment using CBCT and the use of piezosurgery in removing impacted teeth specially in anatomical areas with approximation to vital soft tissue structures are important tools in decreasing morbidity while removing impacted teeth.

 

Key words: CBCT Impaction, edema, piezosurgery, pain, trismus

 


References


The references:

Leung YY, Cheung LK. Safety of coronectomy versus excision of wisdom teeth: A randomized controlled trial. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 108:821–7.

Yusof WZ. Non-syndromal multiple supernumerary teeth: literature review. J Can Dent Assoc. 1990; 56:147–9.

Tantanapornkul W, Okochi K, Bhakdinaronk A, Ohbayashi N, Kurabayashi T. Correlation of darkening of impacted mandibular third molar root on digital panoramic images with cone beam computed tomography findings. Dentomaxillofac Radiol. 2009; 38:11–6.

Tyndall DA, Rathore S, Cone beam CT diagnostic applications:caries, periodontal bone assessment, and endodontic applications. Dent Clin North Am 2008; 52(4):825-41.

Monaco G, Montevecchi M, Bonetti GA, Gatto MRA, Checchi L. Reliability of panoramic radiography in evaluating the topographic relationship between the mandibular canal and impacted third molars. J Am Dent Assoc 2004; 135:312-8.

Öhman A, Kivijärvi K, Blombäck U, Flygare L. Preoperative radiographic evaluation of lower third molars with computed tomography. Dentomaxillofac Radiol 2006; 35:30-5.

NeugebauerJ,ShiraniR,MischkowskiRA,RitterL,ScheerM, Keeve E et al. Comparison of cone-beam volumetric imaging and combined plain radiographs for localization of the mandibular canal before removal of impacted lower third molars. Oral Surg Oral Med Oral Pathol Oral Radiol Endod.2008; 105:633–42.

Tamimi D and ElSaid K. Cone Beam Computed Tomography in the Assessment of Dental Impactions. Seminars in Orthodontics, 2009; 15 No 1:57-62.

Becker A, Chaushu S, Casap-Caspi N. Cone-beam computed tomography and the orthosurgical management of impacted teeth. JADA 2010; 141:14-8.

Dalili Z, Mahjoub P, Sigaroudi A K. Comparison between cone beam computed tomography and panoramic radiography in the assessment of the relationship between the mandibular canal and impacted class C mandibular third molars. Dent Res J. 2011; 8 (4): 203-10

Jung Y, Nah K, Cho B. Correlation of panoramic radiographs and cone beam computed tomography in the assessment of a superimposed relationship between the mandibular canal and impacted third molars. Imaging Sci Dent. 2012 ;42 (3):121-7

Ruta DA, Bissias E, Ogston S, Ogden GR: Assessing health outcomes after extraction of third molars: the postoperative symptoms severity (PoSSe) scale. Br J Oral Maxillofac Surg 2000, 38:480-487.

Bello SA, Wasiu L Adeyemo2†, Babatunde O Bamgbos, V Obi1 E and Adeyinka A A. Effect of age, impaction types and operative time on inflammatory tissue reactions following lower third molar surgery. Head & Face Medicine 2011, 7:2-8

Vercellotti T. Technological characteristics and clinical indications of piezoelectric bone surgery. Minerva Stomatol. 2004; 53:207-14

Beziat J-L, T. Vercellotti, Gleizal A. (What is Piezosurgery®, Two-year experience in craniomaxillofacial surgery). Revue de Stomatologie et Chir Maxillofaciale. 2007; 108(2):101-7.

Geha H, Gleizal A, Nimeskern N, Beziat J.L. Sensitivity of the Inferior Lip and Chin following Mandibular Bilateral Sagittal Split Osteotomy Using Piezosurgery. Plast. Reconstr.Surg. 2006; 118(7):1598-607

Killey HCand Kay LW 1975: The impacted wisdom tooth. 2nd ed. Edinburgh: Churchill Livingstone. New York, London 7-70.

Wong DL, Hackenberry-Eaton M, Wilson D, Winkelstein ML, Schwartz P Wong-Baker FACES Rating Scale: From: Wong’s Essentials of Pediatric Nursing, 6/e, St. Louis, 2001, P. 1301. Copyrighted by Mosby, Inc. Reprinted with permission.

Saglam AA: Effect of tube drain with primary closure technique on postoperative trismus and swelling after removal of fully impacted mandibular third molars. Quintessence Int 2003; 34:143-7.

Santana-Santos T d, de Souza-Santos JAS, Martins-Filho PRS, da Silva LCF, de Oliveira e Silva ED, Gomes, ACA. Prediction of postoperative facial swelling, pain and trismus following third molar surgery based on preoperative variables. 2013; Med Oral Patol Oral Cir Bucal. Jan 1; 18 (1): 65-70.

Susarla, S.M., Dodson, T.B. Preoperative computed tomography imaging in the management of impacted mandibular third molars. J Oral Maxillofac Surg, 2007; 65: 83-8.

Labanca, M., Azzola, F., Vinci, R., Rodella, L.F. Piezoelectric surgery: Twenty years of use. 2008; Br J Oral Maxillofac Surg. 46: 265-69.

Eggers, G., Klein.J, Blank, J., Hassfeld, S.. Piezosurgery: an ultrasound device for cutting bone and its use and limitations in maxillofacial surgery. 2004; Br J Oral Maxillofac Surg. 42: 451-53.

Bartuli FN,1 Luciani F,Caddeo F, De Chiara L, Di Dio M, Piva P, Ottria L, and Arcuri C. Piezosurgery vs High Speed Rotary Handpiece: a comparison between the two techniques in the impacted third molar surgery. 2013; 6(1): 5–10.

Walsh LJ. Piezosurgery: an increasing role in dental hard tissue surgery. Australasian Dental Practice. 2007; 18: 52-56.

Sortino, F., Pedulla, E., Masoli, V. The piezoelectric and rotary osteotomy technique in impacted third molar surgery: comparison of postoperative recovery. J Oral Maxillofac Surg. 2008; 66: 2444-48.

Khan A, khitab U, Khan MT. Impacted mandibular third molars: pattern of presentation and postoperative complications. Pakistan Oral & Dental J. 2010; 30: 307-12.

Jaffar RO, Tin-Oo. Impacted mandibular third molars among patients attending Hospital Universiti Sains Malaysia. Archives of Orofacial Sciences 2009; 4: 7-12.

Goval M, Marva K, Jhamba A, Chawla S, Sonoo PR, Singh V, Aqqarwal A. Comparative evaluation of surgical outcome after removal of impacted mandibular third molars using a Piezotome or a conventional handpiece: a prospective study. Brit J Oral Maxillofac Surg. 2012; 50(6): 556-61.

Barone A, Marconcini S, Giacomelli L, Rispoli L, Calvo JL, Covani. A randomized clinical evaluation of ultrasound bone surgery versustraditional rotary instruments in lowerthird molar extraction. J Oral Maxillofac Surg 2010; 68:330-36.

Grossi GB, Maiorana C, Garramone RA, et al: Assessing postoperative discomfort after third molar surgery: A prospective study. J Oral Maxillofac Surg 2007; 65:901-7.

Pedersen A: Interrelations of complaints after removal of impacted mandibular third molars. Int J Oral Maxillofac Surg 1985; 14:241-8.

Oikarinen K: Postoperative pain after mandibular third molar surgery. Acta Odontol Scand 1991; 49:7-13.


پاراگلایدر Full Text: PDF

Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution 3.0 License.

ISSN : 2251-1563