Inward fragmentation and socket preservation in complex mandibular third molar surgery - a case report.

  • Víctor Beltrán Universidad de La Frontera, Dental School, Clinical Investigation and Dental Innovation Center (CIDIC), Temuco, Chile
  • Wilfried Engelke Georg-August-University Hospital, Depart-ment Oral and Maxillofacial Surgery, Göttingen, Germany.

Abstract

Open extraction sockets following inward fragmentation of partially erupted mandibular third molars may compromise the hard tissue regeneration and lead to postoperative complications. In the case report, we present socket preservation to seal the open alveolous without flap displacement.  A female patient  aged 22,  presented for removal of a partially erupted M3M was operated on via occlusal inward fragmentation under magnifying endoscopic vision. Critical nerve structures were identified and protected before socket preservation with resorbable in situ hardening TCP particles was performed. The  alveolar bone site  healed uneventful, panoramic and cross-sectional  conebeam reformats confirmed an complete hard tissue maintanence. Endoscopically assisted inward fragmentation combined with  socket preservation leads to the maintenance of adjacent hard tissues without need for flap transposition in complex anatomical sites.

References

1. Renton T, Hankins M, Sproate C, McGurk M. A randomised controlled clinical trial to compare the incidence of injury to the inferior alveolar nerve as a result of coronectomy and removal of mandibular third molars. Br J Oral Maxillofac Surg. 2005;43(1):7–12.
2. Manor Y, Bader A, Chaushu G, Haim D, Manor A, Gultekin A, Mijiritsky E. How Patients Percept Their Recovery Following Impacted Mandibular Third Molar Coronectomy. J Craniofac Surg. 2016;27(3):671–4.
3. Engelke W, Fuentes R, Beltrán V. Endoscopically assisted removal of a lingually displaced third molar adjacent to the inferior alveolar nerve. J Craniofac Surg. 2013;24(6):2171–4.
4. Engelke W, Beltrán V, Cantín M, Choi EJ, Navarro P, Fuentes R. Removal of impacted mandibular third molars using an inward fragmentation technique (IFT) - Method and first results. J Craniomaxillofac Surg. 2014;42(3):213–9.
5. Delgado-Ruiz R, Romanos GE, Alexandre Gerhke S, Gomez-Moreno G, Maté-Sánchez de Val JE, Calvo-Guirado JL. Biological effects of compressive forces exerted on particulate bone grafts during socket preservation: animal study. Clin Oral Implants Res. 2016;2:[Epub ahead of print].
6. Corinaldesi G, Lizio G, Badiali G, Morselli-Labate AM, Marchetti C. Treatment of intrabony defects after impacted mandibular third molar removal with bioabsorbable and non-resorbable membranes. J Periodontol. 2011;82(10):1404–13.
7. Engelke W, Streit D, Hornung F. Die geführte Exodontie unter endoskopischer Visualisierung. digital dentistry Fachbeitrag. 2017;3:12–7.
8. Kouwenberg AJ, Stroy LP, Rijt ED, Mensink G, Gooris PJ. Coronectomy of the mandibular third molar: Respect for the inferior alveolar nerve. J Craniomaxillofac Surg. 2016;44(5):616–21.
9. Tabrizi R, Khorshidi H, Shahidi S, Gholami M, Kalbasi S, Khayati A. Use of lincomycin-impregnated demineralized freeze-dried bone allograft in the periodontal defect after third molar surgery. J Oral Maxillofac Surg. 2014;72(5):850–7.
Published
2018-07-19
How to Cite
BELTRÁN, Víctor; ENGELKE, Wilfried. Inward fragmentation and socket preservation in complex mandibular third molar surgery - a case report.. Journal of Oral Research, [S.l.], v. 7, n. 6, p. 260-262, july 2018. ISSN 0719-2479. Available at: <http://www.joralres.com/index.php/JOR/article/view/joralres.2018.059>. Date accessed: 13 july 2020. doi: https://doi.org/10.17126/joralres.2018.059.
Section
Cases

Keywords

mandibular impacted third molars; endoscope; inward fragmentation; socket preservation; CBCT.