title: Adjacent tooth trauma in complicated mandibular third molar surgery: Risk degree classification and digital surgical simulation.
abstract: Analysis of adjacent tooth resistance is essential in wisdom teeth extraction to prevent adjacent tooth trauma, however it lacks adequate attention nowadays. This study aims at suggesting special extraction methods based on adjacent tooth resistance analysis for prevention of adjacent tooth damage. In this study, 136 complicated mandibular third molars extracted using piezosurgery were reviewed and classified based on the adjacent teeth resistances shown in orthopantomogram (OPG) during their mesio-distal rotations: degree I refers to teeth with no adjacent teeth resistance; degree II refers to teeth with resistance released after mesial-half crown sectioning; degree III refers to teeth which still had resistance after mesial-half crown sectioning. With the use of surgical simulations using cone beam computerized tomography (CBCT) reconstruction, all teeth in degree I were designed to rotate mesio-distally; 86.36%(38/44) teeth in degree II were designed to rotate mesio-distally after mesio-half crown sectioning; 69.09%(36/55) teeth in degree III were designed to rotate bucco-lingually. All teeth were extracted successfully, and only one adjacent tooth was subluxated due to the incomplete bone removal. Our study suggested that in order to prevent adjacent teeth trauma, complete bone removal is of importance, and impacted teeth with higher adjacent teeth trauma risks should consider bucco-lingual rotations.
authors.affiliation: Shanghai Stomatological Hospital, Fudan University, Shanghai, People's Republic of China.
authors.forename: Zhou-Xi
authors.initials: ZX
authors.lastname: Ye
authors.affiliation: Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology, Shanghai, People's Republic of China.
authors.forename: Chi
authors.initials: C
authors.lastname: Yang
authors.affiliation: Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology, Shanghai, People's Republic of China.
authors.forename: Jing
authors.initials: J
authors.lastname: Ge
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008964:Molar, Third / Q000000981:diagnostic imaging / Q000601:surgery*; D059745:Piezosurgery / Q000379:methods*; D011862:Radiography, Panoramic; D012189:Retrospective Studies; D014081:Tooth Extraction / Q000379:methods*; D014095:Tooth, Impacted / Q000000981:diagnostic imaging / Q000601:surgery; D055815:Young Adult