Displaying publications 21 - 40 of 42 in total

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  1. Kar May L, Mei Shian AY, Durward C, Jayaraman J
    Heliyon, 2020 Feb;6(2):e03476.
    PMID: 32140592 DOI: 10.1016/j.heliyon.2020.e03476
    A growing number of Cambodian children without legal documentary evidence of date of birth are vulnerable to exploitation. This study aimed to evaluate the applicability of southern Chinese reference dataset for dental age estimation on Cambodian children and young adults of different socioeconomic status. Dental panoramic tomographs (DPT) of 371 Cambodian children and young adults belonging to lower and higher socioeconomic status (SES) groups were analyzed. All the left maxillary and mandibular permanent teeth including the third molars were scored based on Demirjian's classification of tooth development stages. Chronological age (CA) was calculated from the date of birth and date of exposure of radiograph. The mean age of attainment for each stage of development was obtained from the southern Chinese reference dataset. Dental age (DA) was calculated by averaging the mean age scores for all the teeth. Paired t-test and correlation analysis were conducted to measure associations between the chronological age and the dental age for males and females in the lower and higher socio-economic status groups. Underestimation of age was observed in both SES groups using the southern Chinese reference dataset. For the higher SES group, the difference between the chronological and dental age (CA-DA) was 0.26 years for females and 0.11 years for males. The difference was statistically significant only in females (p < 0.05). In the low SES group, the results showed a difference of 0.07 years in females and 0.01 years in males; the differences were not statistically significant in both sexes (p > 0.05). A strong correlation was observed between the CA and DA in both sex and SES groups ranging from 0.969 to 0.988 (p < 0.05). The southern Chinese dental reference dataset can be used to estimate the age of undocumented Cambodian male and female children and young adults of both higher and lower SES.
    Matched MeSH terms: Molar, Third
  2. Azizah Ahmad Fauzi, Mohamed Ebrahim Parker, Norval E., Phrabhakaran N
    Sains Malaysiana, 2017;46:59-65.
    Cone-beam-computed-tomography (CBCT) has been useful in providing insights of relevant anatomy prior to surgical
    procedures, including the assessment of the proximity of impacted mandibular-third-molar to the inferior-alveolar-canal
    (IAC). It is important to understand the reliability of conventional panoramic-radiograph in the assessment of this criterion
    since it is more commonly used as first line radiographic approach due to its availability and lower radiation dose. This
    study aimed to investigate the reliability of conventional panoramic-radiograph in the evaluation of the proximity of
    impacted mandibular-third-molar root tip to the IAC by correlating the results with CBCT. A total of 65 root tips of impacted
    mandibular-third-molars that had both panoramic radiographs and CBCT images were included in this retrospective study.
    Two trained observers participated in all image evaluations. A prepared standard 1 cm ruler was used to measure the
    proximity of the third-molar root apices to the IACs. Measurements recorded in this study were categorized into positive
    (root apex above a roof of IAC), zero (root apex was superimposed on IAC) and negative (root apex below a roof of IAC).
    Data analysis was carried out using student t-test. In this study, both observers recorded statistically significant differences
    in the measurement between third-molars root apices and the IAC from panoramic radiographs and CBCT images. The low
    reliability of panoramic radiograph to assess the vertical proximity between these two anatomical structures suggests
    the importance of additional assessment with CBCT in cases where panoramic radiograph shows superimposition of the
    third molar root on the roof of the canal and presence of root below the roof of the IAC.
    Matched MeSH terms: Molar, Third
  3. Abdul Rahim AH, Davies JA, Liversidge HM
    Forensic Sci Int, 2023 May;346:111654.
    PMID: 37011430 DOI: 10.1016/j.forsciint.2023.111654
    Reliability, or repeatability, of permanent tooth staging techniques is usually expressed as Cohen's Kappa. This single value obscures information about the quantity and allocation of disagreements. In this study we assess and compare intra-observer reliability of permanent tooth staging techniques described by Nolla, Moorrees et al. and Demirjian et al. The sample was panoramic radiographs of healthy dental patients made up of 100 males and 100 females aged 6-15 years. All permanent teeth on the left side (excluding third molars) were scored twice. Weighted Kappa and percentage agreement were calculated. Results show Kappa values for all teeth combined as 0.918, 0.922 and 0.938 for Demirjian (number of teeth N = 2682), Nolla (N = 2698) and Moorrees (N = 2674) respectively. A comparison of Kappa values between upper and lower teeth showed marginally higher values for upper incisors and lower molar for all three scoring methods. Small differences in Kappa values were noted between tooth types with the upper first molar having smaller values than other teeth. Percentage agreement ranged from 81 % (Moorrees), 86 % (Nolla) to 87 % (Demirjian). Tooth stage differences between first and second assessments were not more than one stage. Our findings show that Demirjian scoring is marginally more reliable than Nolla or Moorrees. We suggest that (1) data for reliability are tabulated in full to show the quantity and allocation of disagreement between first and second readings, and (2) that the reliability sample is sufficiently large with a wide age range to include multiple different tooth stages.
    Matched MeSH terms: Molar, Third
  4. Ishak MH, Zhun OC, Shaari R, Rahman SA, Hasan MN, Alam MK
    Mymensingh Med J, 2014 Oct;23(4):781-6.
    PMID: 25481601
    This study evaluated the validity of panoramic radiography and cone beam computed tomography (CBCT) in the assessment of mandibular canal and impacted third molar. In this descriptive-analytical study, 58 mandibular third molars from 42 patients who showed a close relationship between impacted third molar and canal on panoramic radiographs were selected. They were then classified into seven radiographic markers in panoramic radiographs (superimposition, darkening of the root, interruption of the white lines, root narrowing, canal diversion, canal narrowing, and also closed distance in OPG <1mm). The groups of markers were further assessed with CBCT to see presence or absence of contact. The three most common markers seen in panoramic images are superimposition, interruption of white line and root darkening. In CBCT, superimposition marker always presented higher frequency of contact with canal compared to non-contact group. There are 31% of teeth presented with interruption of white lines and there are 29.3% of teeth presented with superimposition. About 55.6% and 35.3% of the impacted mandibular third molars which indicated interruption of white lines and superimposition also indicated contact in the CBCT respectively. Presence or absence of radiological sign in panoramic radiography was not properly predict a close relationship with third molar and it is suggested that in case of tooth-canal overlapping, the patient should be referred for CBCT assessment.
    Matched MeSH terms: Molar, Third/radiography*
  5. Ngeow WC, Lim D
    Adv Ther, 2016 Jul;33(7):1105-39.
    PMID: 27287853 DOI: 10.1007/s12325-016-0357-y
    INTRODUCTION: The use of corticosteroids to reduce the post-operative sequelae of lower third molar surgery, namely pain, swelling and trismus, has been well studied by many researchers over the past 6 decades. This study reviewed the reported outcome of corticosteroids used in controlling the above sequalae after third molar surgery.

    MATERIALS AND METHODS: A PubMed, Medline, EMBASE and Google search was undertaken of all controlled clinical trials on the effects of corticosteroids on pain, swelling and trismus after lower third molar surgery. The review was limited to studies published over the last 10 years (2006-2015).

    RESULTS: Of the 46 initially retrieved articles, 34 were finally included. Eleven studies compared the effect of 2 similar (but different dose) or different group of corticosteroids. Thirty-one studies reported the effects of corticosteroids on all sequale, 2 reported the outcome on swelling and trismus and another 1 on swelling and pain only. In 16 of the studies, corticosteroid use resulted in significant reductions in pain after third molar removal. Twenty-two out of 29 studies reported reduced swelling against negative control while 18 out of 25 studies reported improved mouth opening. Fourteen studies reported the benefit of corticosteroids on all 3 sequelae, with 71.4% resulted from the use of methylprednisolone.

    CONCLUSION: Although there are some conflicting effects, the results of this analysis shows in general the benefits derived from short-term use of corticosteroids in relation to pain, swelling and trismus following third molar surgical extraction, with no side effects observed.

    FUNDING: This work was supported by the University of Malaya's High Impact Research grant UM.C/625/1/HIR/MOHE/05.

    Matched MeSH terms: Molar, Third/surgery*
  6. Phrabhakaran N
    Malays J Pathol, 1995 Jun;17(1):31-4.
    PMID: 8907002
    Teeth are the most durable structures in the human body. The pattern of their development has been used as a credible technique of age determination of unidentified bodies. Dental age estimation is by comparison of the dental status of an individual with published dental surveys. The third molars are the last teeth to erupt and are regarded as the most variable in the dentition. Nevertheless, radiographs depicting their growth have been used to determine the chronological age. A case for actual need for age estimation using a developing third molar is presented here.
    Matched MeSH terms: Molar, Third/growth & development*
  7. Menon RK, Gopinath D, Li KY, Leung YY, Botelho MG
    Int J Oral Maxillofac Surg, 2019 Feb;48(2):263-273.
    PMID: 30145064 DOI: 10.1016/j.ijom.2018.08.002
    The objectives of this systematic review were to investigate the efficacy of amoxicillin/amoxicillin-clavulanic acid for reducing the risk of postoperative infection after third molar surgery and to evaluate the adverse outcomes in these patients, as well as in healthy volunteers. A systematic search of four databases was performed on May 26, 2017. Eleven studies qualified for the qualitative analysis and eight were found suitable for meta-analysis. The results suggest that both amoxicillin-clavulanic acid and amoxicillin significantly reduce the risk of infection after third molar extraction (overall relative risk (RR) 0.25, P<0.001). However, with the exclusion of randomized controlled trials with a split-mouth design (due to an inadequate crossover period after antibiotic treatment), only amoxicillin-clavulanic acid was found to be effective (RR 0.21, P<0.001). The risk of adverse effects was significantly higher in the amoxicillin-clavulanic acid group (RR=4.12, P=0.023) than in the amoxicillin group (RR 1.57, P=0.405). In conclusion, amoxicillin-clavulanic acid and amoxicillin may significantly reduce the risk of infection after third molar extraction. However, their use in third molar surgery should be viewed with caution, as recent clinical trials on healthy volunteers have shown evidence of the negative impact of amoxicillin use on bacterial diversity and antibiotic resistance.
    Matched MeSH terms: Molar, Third/surgery*
  8. Angelakopoulos N, Galić I, Balla SB, Kiş HC, Gómez Jiménez L, Zolotenkova G, et al.
    Int J Legal Med, 2021 Nov;135(6):2423-2436.
    PMID: 34228192 DOI: 10.1007/s00414-021-02656-2
    The diagnostic accuracy of the I3M to assess the legal age of 18 years has already been tested in several specific-population samples. The left lower third molar has been extensively used for discriminating between minors and adults. This research aimed to compare the usefulness of lower third molar maturity indexes, from both left and right side (I3ML and I3MR), in samples originating from four distinct continents in order to examine possible differences in their accuracy values. For this purpose, a sample of 10,181 orthopantomograms (OPGs), from Europe, Africa, Asia and America, was analysed and previously scored in other studies. The samples included healthy subjects with no systemic disorders with both third molars and clear depicted root apices. Wilcoxon Signed Rank test for left and right asymmetry did not show any significant differences. Data about sensitivity, specificity, predictive values, likelihood ratio and accuracy were pooled together and showed similar results for I3ML and I3MR, respectively. In addition, all these quantities were high when only the I3MR was considered to discriminate between adults and minors. The present referable database was the first to pool third molar measurements using panoramic radiographs of subjects coming from different continents. The results highlighted that both I3ML and I3MR are reliable indicators for assessing the legal age of 18 years old in those jurisdictions where this legal threshold has been set as the age of majority.
    Matched MeSH terms: Molar, Third/growth & development*
  9. Awang MN, Boon LC, Nor GM
    Indian J Med Sci, 1990 Aug;44(8):205-8.
    PMID: 2262207
    The results of the present investigation have shown the usefulness of suprofen in the control of pain following surgical removal of impacted wisdom tooth. The regime of 200 mg. q.d.s. orally, was shown to be satisfactory in the control of postoperative pain. Pain was rapidly controlled by the 1st hour after ingestion and subsequently maintained at a low profile until is was completely abolished by the 8th hour of the postoperative period.
    Matched MeSH terms: Molar, Third/surgery*
  10. Liversidge HM, Peariasamy K, Folayan MO, Adeniyi AO, Ngom PI, Mikami Y, et al.
    J Forensic Odontostomatol, 2017 Dec 01;35(2):97-108.
    PMID: 29384741
    BACKGROUND: The nature of differences in the timing of tooth formation between ethnic groups is important when estimating age.

    AIM: To calculate age of transition of the mandibular third (M3) molar tooth stages from archived dental radiographs from sub-Saharan Africa, Malaysia, Japan and two groups from London UK (Whites and Bangladeshi).

    MATERIALS AND METHODS: The number of radiographs was 4555 (2028 males, 2527 females) with an age range 10-25 years. The left M3 was staged into Moorrees stages. A probit model was fitted to calculate mean ages for transitions between stages for males and females and each ethnic group separately. The estimated age distributions given each M3 stage was calculated. To assess differences in timing of M3 between ethnic groups, three models were proposed: a separate model for each ethnic group, a joint model and a third model combining some aspects across groups. The best model fit was tested using Bayesian and Akaikes information criteria (BIC and AIC) and log likelihood ratio test.

    RESULTS: Differences in mean ages of M3 root stages were found between ethnic groups, however all groups showed large standard deviation values. The AIC and log likelihood ratio test indicated that a separate model for each ethnic group was best. Small differences were also noted between timing of M3 between males and females, with the exception of the Malaysian group. These findings suggests that features of a reference data set (wide age range and uniform age distribution) and a Bayesian statistical approach are more important than population specific convenience samples to estimate age of an individual using M3.

    CONCLUSION: Some group differences were evident in M3 timing, however, this has some impact on the confidence interval of estimated age in females and little impact in males because of the large variation in age.

    Matched MeSH terms: Molar, Third/growth & development*
  11. Nik NN, Abul Rahman R
    J Clin Pediatr Dent, 2003;27(4):371-5.
    PMID: 12924738
    This study was conducted to determine the prevalence of pre-eruptive intracoronal dentin defects from panoramic radiographs from a group of children and young adults aged 20 years and below. The radiolucent lesions were noted with regard to which teeth were affected, the location of the defects and the size of the defects relative to the width of dentin. Out of 1007 radiographs examined, 275 (27.3%) have pre-eruptive dentin defects. The prevalence of anomaly among males was 28.4% as compared to 26.2% among females. However, the difference between genders was not significant, thus subsequent results have been combined. Of 275 subjects with dentin radiolucencies, 243 subjects (88.7%) had only one affected tooth, 30 subjects (10.9%) had two teeth affected and 2 subjects (0.7%) had three affected teeth. The tooth prevalence of the anomaly was 2.1% and most of the lesions occurred as a single occurrence on the affected tooth. Within each tooth type, the highest tooth prevalence of intracoronal dentin defect was found in the upper first premolar (5.1%). More than half of the lesions extended less than 1/3 of the width of the dentin thickness. The high prevalence of the condition indicates the need for increased awareness and recognition of this during radiographic examination of teeth in the pediatric age group in early pre-eruptive stages so that early detection and diagnosis can be made and treatment can be done at the most appropriate time.
    Matched MeSH terms: Molar, Third/abnormalities; Molar, Third/radiography
  12. Ali R, Parthiban N, O'Dwyer T
    J Surg Tech Case Rep, 2014 Jan;6(1):21-5.
    PMID: 25013548 DOI: 10.4103/2006-8808.135144
    Desmoid fibromatosis is a benign yet locally aggressive tumor with a tendency to recur. It causes considerable morbidity particularly when it arises in a small area in the head and neck region. This tumor is extremely rare in the submandibular region. We report a case of desmoid tumor in the submandibular region in a 32-year-old male who presented with right submandibular swelling postextraction of right lower wisdom tooth. Excision biopsy was carried out initially following inconclusive fine needle aspiration and discussion at multidisciplinary meeting. The tumor recurred 4 months following initial excisional biopsy necessitating a more radical secondary approach involving segmental mandibulectomy. Intraoperatively we also noted that the tumor was originating from the site of previous wisdom tooth extraction, raising the question of surgical trauma as precursor of desmoid tumor. We achieved a negative resection margin and a complete remission for 24 months.
    Matched MeSH terms: Molar, Third
  13. Eva Tan Lee Yin, Kuck Peng Sim, Mohd Yusmiaidil Putera Mohd Yusof
    MyJurnal
    Introduction: Identification of remains recovered at advanced stages of decomposition can be problematic due to the lack of physical evidence. Nonetheless, human dentition is least susceptible to decomposition and as such carry a significant value in personal identification of decomposed remains. Demirjian’s method of age estimation was developed specifically for children with developing dentition. In this article, a method on adapting the Demirjian’s method for Malay ethnic-specific age estimation using the third molar development is presented. Methods: Orthop- antomograms of Malay subjects aged 18 to 25 were obtained from UiTM Sungai Buloh. Total of 318 samples were taken, comprising of 123 and 195 images from male and female subjects. Development of right and left mandibular third molar was classified according to the eight stages of development as illustrated in Demirjian’s method. Data obtained were subjected to statistical analysis such as descriptive statistics and analysis of variance. The intra- and inter-gender variation between left and right mandibular third molar was evaluated using independent student t-test and analysis of variance, respectively. Results: Intra-gender comparison analysis revealed a significant difference in the female and male with a p-value of 0.000 and 0.003, respectively. Regression equation to estimate age based on third molar development were formulated according to dental age and maturity score. Conclusion: The Demirjian’s method was successfully adapted for age estimation of individuals of Malay ethnicity. These findings can help with victim identification in cases of poor skeletal framework recovery and highly decomposed remains.
    Matched MeSH terms: Molar, Third
  14. Wong, Soo Yee, Roselinda Ab. Rahman, Haslina Taib
    MyJurnal
    The purpose of this study was to evaluate the periodontal status distal to the adjacent second molar following the extraction of a partially or fully impacted mandibular third molar at Klinik Pergigian Pakar Hospital Universiti Sains Malaysia (KPPHUSM) from April of 2008 until June of 2008.This was a prospective study which involved the clinical and radiological study of patients. In this study, convenience sampling method had been used. The sample size was 22 patients aged 18-32 years old with inclusion criteria. The outcomes measured in this study were periodontal pocket depth (PPD), clinical attachment level (CAL) and alveolar bone height (ABH). Subjects were examined at distal surface (disto-buccal, mid-distal and disto-lingual) of second molar for PPD and CAL before and 3 months after the impacted adjacent lower third molar extraction. OPG was taken each before and after the third molar removal. These data were analyzed using SPSS version 16 and Wilcoxon-signed-ranks test was used to compare the PPD, CAL and ABH pre and post operatively. All the results were not significant with p >0.05. For PPD, median = 3mm pre and post extraction. CAL median= 2mm pre and post operatively and ABH median of 3.10mm (before) and 2.8mm (after) the third molar removal. From our study, we concluded that there were no significant changes of PPD, CAL and ABH at distal side of second molar after 3 months of the adjacent impacted lower third molar removal.
    Study site: Dental clinics, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
    Matched MeSH terms: Molar, Third
  15. Rosfaima Othman Jaffar, Tin-Oo M.M.
    MyJurnal
    The aim of this study was to identify the position of impacted mandibular third molars based on the classifications of Pell & Gregory and Winter, the indications for extraction, and the relation of post-operative complications and position. Records of patients who attended Hospital Universiti Sains Malaysia between January and December 2007 for surgical removal of mandibular third molars were reviewed. The angulation type, width and depth of impaction were determined by reviewing the orthopantomograms. The indications of extraction and occurrence of any post- operative complications were recorded. A total of 238 impacted teeth were surgically extracted from 194 patients (97 males, 97 females). The reasons for extraction include recurrent pericoronitis (43.1%) followed by prophylactic purposes (33.5%). Mesioangular impactions accounted for 52.3% and Class IIA position of impaction accounted for 45.7% of extractions. The most common post-operative complication was persistent pain and swelling (14.7%) followed by trismus (4.1%) and dry socket (3.0%). There was no significant relationship between the angulation, width and depth of impaction and the occurrence of complication. Mesioangular type and Class IIA position of impaction were the most common impaction. Although the association was not significant, high frequency of post-operative complications was observed in mesioangular, horizontal, IIA and IIC positions.
    Matched MeSH terms: Molar, Third
  16. Keat, John Hon Chong, Ahmad Dzulfikar Samsudin, Mei, Siang Ma
    MyJurnal
    Surgical removal of impacted lower wisdom tooth has become increasingly costly to patient while still remains as the most common dental surgical procedure that is performed on outpatient basis. In the present study, a total of 23 patients with impacted lower wisdom tooth were surgically removed under local anaesthesia by using different irrigating solution namely, normal saline, distilled water and chlorhexidine. The samples underwent standard operating procedures and medication. Post operative complications in terms of pain, swelling, infection and delayed wound healing were assessed and compared on Day 1 and Day 7 after surgery. The result of this study showed that there is no significant difference between the three irrigating solution used in surgical removal of impacted lower wisdom tooth in terms of postoperative complication. A bigger scale of research with more samples is recommended to evaluate the most efficacy irrigating solution during surgical removal of impacted lower wisdom tooth.
    Study site: Oral surgery clinic, Universiti Sains Islam Malaysia (USIM), Kuala Lumpur, Malaysia
    Matched MeSH terms: Molar, Third
  17. Roslan AA, Rahman NA, Alam MK
    J Orthod Sci, 2018;7:16.
    PMID: 30271761 DOI: 10.4103/jos.JOS_37_18
    OBJECTIVE: This study was carried to study the prevalence of dental anomalies and treatment modalities/planning among the orthodontic patients.

    MATERIALS AND METHODS: A total of 370 orthodontic records including their pre-treatment orthopantomographs (OPG) and study models of orthodontic patients in permanent dentition who attended dental clinic were assessed for impaction, hypodontia, supernumerary, supraocclusion, infraocclusion, and any other anomalies excluding the third molars. The association of anomalies with gender status and racial status was analyzed using Pearson's Chi-square test. A P value of <0.05 is considered as significant. The confidence interval at 95% (CI) was set.

    RESULTS: Among the 370 subjects, 105 (28.4%) presented with at least one anomaly. Eighty-five (23%) demonstrated a single anomaly and 20 (5.4%) with more than one anomaly. The most prevalent anomaly was impaction (14.32%), followed by hypodontia (7.03%). The less common anomalies were microdontia (1.08%), dilacerations (0.27%), and generalised enamel hypoplasia (0.27%). Maxillary right lateral incisors and canines were the most common affected teeth and these are located on the maxillary right quadrant. It was evident that dental anomalies were statistically dependant on race (P = 0.025), but independent of gender. The most common treatment planned for these patients was fixed appliance.

    CONCLUSIONS: Impaction was predominant among 28.4% subjects observed with anomaly and most patients with anomaly are treated with fixed appliances (49%).

    CLINICAL RELEVANCE: These anomalies play a great role in occlusion and alignment in treatment planning and relapse for orthodontic treatment.

    Matched MeSH terms: Molar, Third
  18. Lim D, Ngeow WC
    J Oral Maxillofac Surg, 2017 Nov;75(11):2278-2286.
    PMID: 28666096 DOI: 10.1016/j.joms.2017.05.033
    PURPOSE: To compare the efficacy of preoperative submucosal injection of 4 mg of dexamethasone versus 40 mg of methylprednisolone in reducing postoperative sequelae after surgical removal of impacted mandibular third molars.

    PATIENTS AND METHODS: This prospective, randomized, double-blind study included 65 patients who required surgical removal of impacted mandibular third molars with Class II or position B impaction (Pell and Gregory classification). Patients were randomly assigned to 1 of 3 groups: dexamethasone, methylprednisolone, or placebo (control). Surgery was performed with patients under local anesthesia. Baseline measurements were obtained preoperatively, and subsequent assessments were made on postoperative day 1, 2, 5, and 7 to measure postoperative facial swelling by use of 2 linear measurements: interincisal mouth opening width and visual analog scale score for pain. The amount of analgesics consumed was recorded. Wound healing also was assessed on postoperative day 7. Descriptive and multivariate statistics were computed, and significance was set at P 

    Matched MeSH terms: Molar, Third/surgery*
  19. Rajaran JR, Nazimi AJ, Rajandram RK
    BMJ Case Rep, 2017 Sep 27;2017.
    PMID: 28954756 DOI: 10.1136/bcr-2017-221892
    Surgical removal of impacted mandibular third molar is a routine procedure in oral surgery. Various iatrogenic complications related to the procedure has been discussed well in the literatures before. Some of these complications are related to the wrong usage of instruments and techniques. Here we discuss a rare complication on a 42-year-old male, related to the use of high-speed handpiece drill in mandibular third molar removal in a general dental office setting. He was referred when a high speed tungsten carbide bur was accidentally broken and displaced into the mandibular bone during surgical procedure. It is not common to use a high-speed handpiece in impacted third molar removal. This iatrogenic complication could have been totally avoided with the use of proper equipment and technique; therefore raising awareness regarding wrong usage of instrument is vital to avoid similar incidents in the future.
    Matched MeSH terms: Molar, Third*
  20. Wang CY, Chiu CL, Har KO, Chan C, Rahman ZA
    Int J Oral Maxillofac Surg, 2002 Oct;31(5):506-10.
    PMID: 12418566
    This study compares the use of inhalation sedation using sevoflurane (group S) with inhalation sedation using nitrous oxide (group N) in patients undergoing bilateral extraction of third molar teeth under local anaesthesia. The study was designed as a cross-over study. Seventeen ASA I, day surgery patients were studied. Patients were randomly allocated to receive either 8 l/min 50% nitrous oxide in oxygen (group N) or same flow of 1% sevoflurane (group S) for the first procedure. Each patient then had the alternate method of sedation for the second procedure. There were no significant differences between the methods in patient co-operation and surgeon's satisfaction with sedation. Psychomotor tests were comparable in both groups. The patients were significantly more sedated in the group S compared to group N (P=0.004). Significantly more patients complained of an unpleasant odour group S (P<0.01) but none withdrew from the study for this reason. No adverse cardiorespiratory effects resulted from sevoflurane or nitrous oxide sedation. Both methods gave good amnesia during the procedure. There was high acceptance of both methods and the patients rated the technique as equally satisfactory. We conclude that inhalation sedation with sevoflurane is a suitable alternative method to nitrous oxide sedation.
    Matched MeSH terms: Molar, Third/surgery
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