Clinical evaluation of two-stage mandibular wisdom tooth extraction method to avoid mental nerve paresthesia

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  • NOZOE Etsuro
    Department of Oral and Maxillofacial Surgery, Field of Oral and Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medical and Dental Sciences
  • NAKAMURA Yasunori
    Department of Oral and Maxillofacial Surgery, Field of Oral and Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medical and Dental Sciences
  • OKAWACHI Takako
    Department of Oral and Maxillofacial Surgery, Field of Oral and Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medical and Dental Sciences
  • ISHIHATA Kiyohide
    Department of Oral and Maxillofacial Surgery, Field of Oral and Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medical and Dental Sciences
  • SHINNAKASU Mana
    Department of Oral and Maxillofacial Surgery, Field of Oral and Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medical and Dental Sciences
  • NAKAMURA Norifumi
    Department of Oral and Maxillofacial Surgery, Field of Oral and Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medical and Dental Sciences

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Other Title
  • オトガイ神経知覚異常回避のための下顎智歯2回法抜歯の臨床的検討
  • オトガイ シンケイ チカク イジョウ カイヒ ノ タメ ノ カガク チシ 2カイホウ バッシ ノ リンショウテキ ケントウ

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Abstract

Clinical courses following two-stage mandibular wisdom tooth extraction (TMWTE) carried out for preventing postoperative mental nerve paresthesia (MNP) were analyzed. When panoramic X-ray showed 1) overlapping of wisdom tooth root on the superior 1/2 or more of the mandibular canal, 2) interruption of the white line of the superior wall of the canal, or 3) diversion of the canal, CT examination was facilitated. In cases where contact between the tooth root and canal was demonstrated in CT examination, TMWTE was then selected after gaining the patient's consent. TMWTE consisted of removing more than a half of the tooth crown and tooth root extraction at the second step after 2-3 months. The clinical features of wisdom teeth extracted and postoperative courses including tooth movement and occurrence of MNP during two-stage MWTE were evaluated.<br>TMWTE was carried out for 40 teeth among 811 wisdom teeth (4.9%) that were extracted from 2007 to 2009. Among them, complete procedures were accomplished in 39 teeth, and crown removal was performed insufficiently at the first-stage operation in one tooth. Tooth movement was detected in 37 of 40 cases (92.5%). No postoperative MNP was observed in cases in which complete two-stage MWTE was carried out, but one case with insufficient crown removal was complicated by postoperative MNP. Seven mild complications (dehiscence, cold sensitivity, etc.) were noted after the first-stage operation.<br>Therefore, we conclude that TMWTE for high-risk cases assessed by X-ray findings is useful to avoid MNP after MWTE.

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