Transalveolar Extraction of the Mandibular Third Molars

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This practical manual provides details on the clinical and radiographic evaluation, classification, principles of suturing and flaps, intricacies of the transalveolar surgery, newer advances in mandibular third molar surgery and complications that may be encountered during mandibular third molar exodontia. It presents vital surgical skills for the mandibular third molar exodontia in a concise and to-the-point manner. This book is a user-friendly resource for students of dentistry and maxillofacial surgery, as it brings together information from various reputable resources to one single platform for easier understanding and application. Key Features Addresses the necessary gap in the literature with a concise yet comprehensive approach. Overhauls and updates the content to provide an exam-oriented text for students of oral and maxillofacial surgery, and professionals.

Author(s): Darpan Bhargava
Publisher: CRC Press
Year: 2022

Language: English
Pages: 238
City: Boca Raton

Cover
Half Title
Title Page
Copyright Page
Dedication
Table of Contents
Foreword
Preface
Acknowledgements
About the Book
Editor
Contributors
1 Prologue to "Transalveolar extraction of the mandibular third molars"
References
2 Antiquity and introduction to the third molar or the "wisdom" tooth
Role of genetics in relevance to third molar tooth
Current trends
References
3 Applied surgical anatomy for transalveolar extraction of the mandibular third molar
Mucosa and mucoperiosteum
Skeletal anatomy
Adjacent muscles and ligaments
Regional blood vessels
Adjacent nerves and innervation
Adjacent teeth and periodontium
Buccal fat pad
Spaces involved with the mandibular third molars
References
4 Indications and contraindications for surgical extraction of the mandibular third molars
Definition
Causes for third molar impaction
Theories of tooth impaction
Indications for extraction of mandibular third molars
Contraindications for extraction for mandibular third molars
References
5 Classification for impacted mandibular third molars
Introduction
Classification systems for impacted mandibular third molar
Difficulty index
References
6 Basics of radiology for impacted mandibular third molars
Introduction
Conventional intraoral periapical radiograph
Tube shift intraoral radiographic technique
Panoramic radiographs
Cone-beam computed tomography
Magnetic resonance imaging
Conclusion
References
7 Clinical and radiographic assessment for impacted mandibular third molars
Clinical assessment
Radiographic assessment
Summary of difficulty assessment indices
References
8 Armamentarium for transalveolar extraction of third molars
Introduction
Classification of instruments
Instruments for diagnosis
Instruments for preparation of the surgical site
Instruments used to maintain mouth opening
Instruments for administration of local anaesthesia
Instruments for clear surgical site
Instruments for placing incision
Instruments for reflection
Instruments for retraction
Instruments for bone removal and odontotomy
Instruments for tooth delivery
Instruments for socket management
Instruments and materials for haemostasis and wound closure
Instruments and materials for post-operative dressing
Instruments for sterilization and storage
Advances
Acknowledgement
References
9 Principles and flaps for mandibular third molar surgery
Introduction
Principles of tooth extraction
Use of dental elevators for third molar surgery
Flaps for the mandibular third molar extraction
Principles of suturing
Ergonomics
References
10 Surgical techniques for transalveolar extraction of the mandibular third molars
Asepsis and patient preparation
Local anaesthesia
Incision and mucoperiosteal flap
Bone removal
Alternative techniques for special scenarios
Tooth division and removal of the tooth (odontectomy)
Socket toilet
Suturing
Post-operative care and follow-up
Conclusion
Transplantation of mandibular third molars
References
11 Periodontal considerations for impacted mandibular third molars
Introduction
Impaction as a risk factor for periodontal tissues distal to second molar
Effects on periodontium with various impaction type
Treatment
Periodontal risk predictors
Preoperative and intraoperative considerations
Post-operative management of the periodontal defects
Conclusion
References
12 Complications with impacted mandibular third molar surgery
Preoperative complications
Intraoperative complications
Post-operative complications
References
13 Healing after mandibular third molar extraction
Introduction
Healing of an extraction socket
Healing following mandibular third molar extraction
Assessment of wound healing after mandibular third molar extraction
Complications in healing of extraction socket
Advanced biologic approaches to enhance wound healing after mandibular third molar extraction
References
14 Advances in surgical extraction of the mandibular third molars
Surgical flaps for mandibular third molar removal
Lingual nerve protection during third molar removal surgery
Inferior alveolar nerve preservation during third molar removal surgery
Lasers in mandibular third molar surgery
Piezosurgery for mandibular third molar removal
Current perspectives in decision making for the asymptomatic mandibular third molar
References
15 Medico-legal considerations and informed consent for mandibular third molar extractions
Introduction
Does surgical removal of third molars need informed consent?
What are material risks that need to be disclosed?
The informed consent document should include
Some common benefits and risks of mandibular third molars
Validity of informed consent
Negligence related to non-disclosure
Conclusion
References
Prototype consent format
Consent form for wisdom tooth removal/impacted third molar surgery
Declaration
16 Pharmacology relevant to mandibular third molar surgery
Introduction
Local anaesthesia
Inhalational sedation
Anxiolytics and sedatives
Antibiotics
Analgesics
Corticosteroids (to supress post-surgical oedema, pain and for neuropraxic nerve injury)
Enzyme preparations
Topical oral agents
Styptics
Obtundents
Surgical irrigant
Gaba analogues
References
17 Case history: transalveolar extraction of the mandibular third molars
Prototype case history format
18 Appendix of clinical cases: transalveolar extraction of the mandibular third molars
Index