SURGICAL OUTCOMES OF PARANT II IMPACTED MANDIBULAR THIRD MOLAR REMOVAL USING A VERTICAL CORONECTOMY TECHNIQUE WITH A 45-DEGREE HANDPIECE
Nội dung chính của bài viết
Tóm tắt
Objectives: To evaluate the surgical outcomes of mandibular third molar (MTM) removal with Parant II impaction using the vertical tooth sectioning technique assisted by a 45° angled handpiece.
Methods: A prospective interventional clinical study was conducted on 95 patients treated at Bach Mai Hospital and Hai Phong University of Medicine and Pharmacy Hospital, employing a pre- and post-intervention design without a control group.
Results: The mean surgical duration was 25.3 ± 7.1 minutes; patients over 25 years of age required significantly longer procedures (28.0 minutes) compared to those aged 16–25 years (23.0 minutes) (p = 0.01). Pain, swelling, and trismus peaked at 48 hours postoperatively and markedly subsided after 7 days. The complication rate was low, including infection (5.3%), postoperative bleeding (3.2%), and transient neurosensory disturbance (1.1%), despite 40% of the teeth being in proximity to the inferior alveolar canal. Overall outcomes were classified as Good in 67%, Fair in 24%, and Poor in 9% of cases. Predictors of poorer outcomes included age > 25 years (aOR = 1.9), history of pericoronitis (aOR = 2.4), impaction depth C (aOR = 3.8), and prolonged surgical duration (aOR = 1.25).
Conclusion: The vertical tooth sectioning technique using a 45° angled handpiece is a safe and effective approach for Parant II mandibular third molar extractions, providing good postoperative recovery and minimizing complications, particularly inferior alveolar nerve injury.
Chi tiết bài viết
Từ khóa
Mandibular third molar, Parant II, Vertical coronectomy, 45-degree handpiece, Surgical outcome.
Tài liệu tham khảo
2.Thang NP. (2023). Oral Surgery II. Vietnam Education Publishing House.
3.Tuong LV, Hieu PD. (2024). Surgical results of removing Parant II and III impacted mandibular third molars at the Institute of Air Force Medicine. Journal of Community Medicine, 65.
4.Tan LN. (2019). A study of clinical, X-ray characteristics and evaluation of treatment outcomes for patients with impacted mandibular third molars using the vertical tooth sectioning technique... Can Tho Journal of Medicine and Pharmacy.
5.Duc TM. (2023). Surgical outcomes of Parant II mandibular third molars using a laterally based triangular flap at Hai Phong University of Medicine and Pharmacy Hospital. Level II Specialist Thesis, Hai Phong University of Medicine and Pharmacy.
6.Anighoro E, Gbotolorun O, Adewole R, et al. (2013). Assessment of the effect of wound closure technique on postoperative sequaele and complications after impacted mandibular third molar extraction. Open Journal of Stomatology, 03:527-532.
7.Gay-Escoda C, Sánchez-Torres A, Borrás-Ferreres J, et al. (2022). Third molar surgical difficulty scales: systematic review and preoperative assessment form. Medicina oral, patologia oral y cirugia bucal, 27(1):e68-e76.
8.Jeyashree T, Kumar MPS (2022). Evaluation of difficulty index of impacted mandibular third molar extractions. Journal of advanced pharmaceutical technology & research, 13(Suppl 1):S98-s101.
9.de Toledo Telles-Araújo G, Peralta-Mamani M, Caminha RDG, et al. (2020). CBCT does not reduce neurosensory disturbances after third molar removal compared to panoramic radiography: a systematic review and meta-analysis. Clinical oral investigations, 24(3):1137-1149.
10.Di Spirito F, Di Lorenzo P, Rizki I, et al. (2025). Impacted Mandibular Third Molar: Approaches and Current Perspectives in Surgical Therapy. Medicina (Kaunas, Lithuania), 61(9).
11.Zhang L, Li L (2024). The effect of primary closure versus secondary closure techniques on postoperative wound pain in patients undergoing mandibular surgery: A meta-analysis. International wound journal, 21(4):e14753.
12.de Abreu JM, Cerqueira É, Quitério A, et al. (2024). Assessment of complications in third molar surgery performed by resident surgeons: A comprehensive analysis. Surgery in practice and science, 18:100256.