Online ISSN: 2515-8260

Keywords : Third molar

Use of CBCT scan for introducing a radiological classification of impacted third molar

Dr. Saurabh Jain, Dr. Narendra Singh Bansal, Dr. Naiem Ahmed, Dr. Lokendra Kumar Goyal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 985-992

Background: The impaction rate is much higher for third molars as compared to other teeth. While impacted third molars may remain asymptomatic for an indefinite period, it can cause various delinquents, such as pericoronitis, swelling with pain, distal caries, bone loss, root resorption of adjacent teeth, odontogenic cysts, and tumors. That’s why the most frequent surgical procedure in dentistry is third molar tooth extraction.
Objective: The aim is to propose a new classification for impacted mandibular third molars on CBCT images which cover all aspects of the anatomical situation
Methodology: A total of 143 images of molar teeth was collected and classified according to a relationship with the IAN canal and molar tooth. For statistical calculation, SPSS software was used.
Results: Classes 0-7 were planned and in which classes 1-6 were sectioned into two subtypes (subtypes A-B). The distribution of the classes presented an occurrence of buccal or apical course of the mandibular canal tailed by lingual position and inter-radicular one. Results emphasized that a close relationship of molar roots with the lingual side of IAN was more in female versus male other than it no anatomic differences occur in terms of IAN relationships between males and females. Younger patients displayed an increased rate of direct contact with a reduced calibre of the canal and/or without corticalization. This increases the chances of IAN damage, especially in the young woman (age range 25-30 years) with a lingual course of the mandibular canal.
Conclusion: The use of this classification is appreciated to get an equal definition of the impacted tooth on CBCT images worldwide.

A comparative study of tramadol versus ketorolac in pain management following third molar surgery

Dr. DeepaliJagdish Birla; DrPrashant Shriram; Dr. Hemant gadge; Dr.Priyanka Satpute; Dr.Nilesh Patil; Dr.Vaibhav Jain

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 7, Pages 5269-5273

Background: The present study was conducted to compare tramadol versus ketorolac in pain management following third molar surgery.
Materials & Methods: 56 cases of impacted mandibular third molar were divided into 2 groups of 28 each. Group I patients were given tramadol 50 mg intravenously before the surgery and group II patients were given ketorolac 30 mg intravenously before the surgery.
Results: The amount of local anesthetic used was 5.8 in group I and 5.2 in group II, mean operating time was 18.2 minutes in group I and 17.1 minutes in group II, mean VAS was 21.0 mm in group I and 15.4 mm in group II, total analgesic consumption was 6.5 tablets in group I and 4.2 tablets in group II and mean global assessment scores was 2.7 in group I and 3.4 in group II. The difference was significant (P< 0.05).
Conclusion: Tramadol is a suitable and safe analgesic for the relief of post-extraction pain following mandibular third molar extraction surgery as compared to Ketorolac.


Abhinaya LM; Muthukrishnan Arvind; Deepika Rajendran

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 1776-1785

Impaction denotes a tooth failing to attain its normal position to reach the occlusal table with third molars impaction being common in the mandible. The conventional radiographic views such as peri-apical, panoramic radiograph are two dimensional representations of three dimensional structure. Absence of information on relation of vital anatomical structures to impacted teeth, bone quality is a drawback for the operating surgeon which could lead to pre or post operative complications. CBCT imaging fills the lacunae of two dimensional imaging and holds a key role in impaction assessment.A retrospective analysis of 45 patients who underwent CBCT imaging prior to extraction of impacted third molars were included in the study and the data was analysed using SPSS.Among the 45 patients, 20 were males (44.4%) and 25 were females (55.5%) and the age group commonly affected with impaction was between 25-30 years (35.5%).The frequency of impacted third molars was more in mandible (80.0%) compared to maxilla (20%).There was significant correlation between nerve involvement and angulation of impacted third molars.CBCT imaging modality provides a three dimensional view to help in better treatment planning, anticipating possible complications post surgery. CBCT must be recommended as the only imaging modality in impaction assessment.


Trishala A; M.P.Santhosh Kumar; Arthi B

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 1987-1995

Impaction of the third molars has been established as a factor with the potential to damage temporomandibular joints. Furthermore, the trauma resulting from the surgery of third molars has been reported to be a predisposing factor in the progression of temporomandibular joint disorders (TMD) symptoms. The high frequency of third molar surgery can result in an increased number of patients who suffer from chronic oral and facial pains. Thus, it is important to identify those patients who have pre‐existing pain or any signs of dysfunction in their temporomandibular joints and masticatory structures, prior to third molar surgery. The aim of this study was to evaluate the association between impacted teeth and temporomandibular joint disorders. A retrospective study was conducted by reviewing the case records of patients who underwent treatment in Saveetha Dental College and Hospital from June 2019 - March 2020. The study population included 96 patients diagnosed with temporomandibular joint disorders and 98 patients without TMD. Thus the sample size included a total of 194 patients who were evaluated for the presence of impacted teeth. Data was collected and statistical analysis was performed. Microsoft Excel 2016 (Microsoft office 10) data spreadsheet was used to collect data and later exported to SPSS IBM (version 23.0). Descriptive statistics and chi square test were employed with a level of significance set at p<0.05. The most prevalent age group among the patients was 21 - 30 years (34.39%), followed by 31 - 40 years (29.29%). 60.8% were male patients and 39.2% were females. TMD was predominantly present (29.38%) in patients with impacted teeth than in patients without impacted teeth (20.1%) and the results were statistically significant (p=0.003). Within the limits of this study, there is a significant association between the presence of impacted teeth and temporomandibular joint disorders. Therefore, it is important to include an assessment of the temporomandibular apparatus in the pre‐operative evaluation of patients with impacted third molars.