Lingual Tooth Section Technique In Removal Of The Impacted Mandibular Third Molars

Objective: With the advances of the tooth removal techniques,especial the wide application of the Surgical Impact Air Handpiece,removal of the impacted mandibular third molars has become less invasive.However,the dental surgeon is still in a dilemma that the current large incision and bone removal do not meet the principles of minimally invasive surgery.In this study,Lingual Tooth Section Technique was adopted and compared with routine techniques in the aspect of operating time,size of trauma,postoperative reaction and other postoperative complications.The less invasive of Lingual Tooth Section Technique technique was explored.Methods:1 Clinical Data A prospective,randomized clinical trial was conducted in 120 patients with the mesioangular and horizontal impactioted mandibular third molar,who visited department of stomatology of Bethune International Peace Hospital of PLA from December 2015 to August 2016.There were 41 cases of male and79 cases female,and 82 cases of the mesially inclined and 38 cases of horizontal third molars in the study.Degree of surgical difficulty were evaluated with the impacted mandibular third molars removal of comprehensive quantitative analysis scale[1].2 Removal Method2.1 Experimental group Lingual Tooth Section Technique in Extraction of Impacted Mandibular Third Molar: The half of the tooth occlusion was exposed with the occlusal mini-flap and bone removal.After the mesio-distal section,the lingual section could be elevated.The height of buccal bone should be preserved and the amount of bone removal should be reduced to a minimum.The wound was closed without suture.2.2 Control group Standard Operation Of Clinical Practice In The Oral Surgery:the incision and bone removal was done to expose the tooth diameter.The tooth were sectioned in buccal-lingual direction,the medial section was elevated,and the wound was closured partially.3 Postoperative Treatment and Observation Postoperative routine was administrated.The pain degree was recorded12 h after operation.The swelling and trims were recorded 3d,7d after operation.The others complications including bleeding,trismus and dry socket were also recorded.4 Statistical analysis: Data were analyzed via IBM SPSS Statistics version21.0.Data for the degree of surgical difficulty and pain scores were initially tested for normal distribution using the two–samples test.It was tested through the Wilcoxon test for non-normally distributed variables(surgery time,swelling).Data for the trismus and bone loss scores were tested by the Wilcoxon test.The c2 test was used to examine differences of the bleeding,dry socket,subcutaneous emphysema,lip numbness,and intraoperative complications between groups.Results:1 Degree of Surgical Difficulty The degree of surgical difficulty in experimental group was 10.77±1.94,and the degree of surgical difficulty in control group was 10.97±1.88.There was no statistical significance in degree of surgical difficulty between two groups(P>0.05),so the two groups had comparability.2 Bone Loss Scores Mean rank of the experimental group was 42.05,and the sum of ranks were 2523;Mean rank of the control group was 78.95,and the sum of ranks were 4737.It was obvious that the experimental group saves more bone tissue(P < 0.05).3 Surgery TimeMedian of the experimental group was 11.5min,while interquartile range was 11min;Median of the control group was 10 min,while interquartile range was 8min.There was no statistical significance in the removal molars of time between two groups(P>0.05).4 Postoperative Pain The pain(3.87±0.81)in experimental group was shorter than that(6.91±1.21)in control group at 12 h postoperatively(P<0.05).5 Trismus The trismus in experimental group was shorter than that in control group at 3d postoperatively(P<0.05).There was no statistical significance in the trismus between two groups at 7d postoperatively(P>0.05).6 Swelling There were both no statistical significance in the swelling between two groups at 3d and 7d postoperatively(P>0.05).7 Others There was no statistical significance in the bleeding,dry socket,subcutaneous emphysema,lip numbness,and intraoperative complications between two groups(P>0.05).Conclusion:1 Lingual Tooth Section Technique in Removal of Impacted Mandibular Third Molars without the tooth diameter exposure,Less flaps and bone removal.2 A fairy good surgical vision can be achieved,even if mini-incision and less bone removal is done in the lingual sectioning of the tooth.With the removal of lingual and mesial resistance,the remaining tooth can be easily elevated and dislocated in mesial,occlusal and mesial directions with less resistance.3 Less trismus and swelling:Lingual Tooth Section Technique in Removal of Impacted Mandibular Third Molars has the characters of less injuries,which improves the life quality of the patients.