Outcome Analysis and Unexpected Scenario Prediction in Two-Stage Orthodontic Lower Third Molar Extraction

Publication date: Available online 16 October 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Tze-Ta Huang., Chen-Jung Chang, Ken-Chung Chen, Jen-Bang Lo, Meng-Yen Chen, Jehn-Shyun Huang
PurposeWe propose a two-stage orthodontic lower third molar extraction procedure to reduce iatrogenic inferior alveolar nerve injury. We tested our hypothesis that there are factors that can predict both dislodgement of the root portion and limited traction distances.Patients and MethodsFifteen patients (mean: 25.7 y/o, 17∼65 y/o) with 20 lower third molars were enrolled. Panoramic films and cone-beam computed tomography were analyzed. Dislodgement of the root portion, traction distance, duration of the orthodontic phase, and post-operative complications were documented. The predictive factors were analyzed and discussed.ResultsThree teeth had dislodgements of the root portion. Mean traction was 59.2 days (range: 33∼77 days), and the mean traction distance was 2.60mm (range: 0.27∼5.20 mm). Root apex cortical bone indentation and root curvature were significantly associated with traction distance. Pulpitis symptoms were documented in one tooth, and no post-operative nerve disturbances occurred.ConclusionOur proposed two-stage orthodontic lower third molar extraction procedure reduced iatrogenic inferior alveolar nerve injury. Cortical bone indentation and root curvature predicted dislodgement of the root portion and limited traction distances.



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