Approaches to surgical access for impacted tooth removal in the mandible: clinical case reports
https://doi.org/10.33925/1683-3031-2024-845
Abstract
Relevance. Delayed eruption of mandibular canines and premolars is a frequent concern in pediatric dentistry, commonly linked to tooth retention or impaction. Several treatment strategies are available to address this issue, including surgical-orthodontic repositioning into the dental arch or extraction of the affected teeth. Given the anatomical positioning of impacted teeth in the mandible, surgical procedures are often performed via a vestibular approach, which can lead to substantial bone defects and an elevated risk of microtrauma to the vascular-nerve bundle.
Description of clinical case. In the first case, during the removal of the impacted tooth 3.3 and a follicular cyst in the left mandibular region, a portable nasopharyngolaryngoscope was used to ensure sufficient visibility. The surgical intervention involved a selective method of minimally invasive osteotomy performed with a surgical hand-piece, which allowed for a reduction in the size of the bony wound and the prevention of trauma to the vascular- nerve bundle. In the second case, during the removal of the impacted tooth 3.5, a selective method of minimally invasive osteotomy was also applied, utilizing a dual vestibular approach. This technique reduced the size of the bone defect and minimized the risk of injury to the mental nerve.
Conclusion. When a tooth is positioned in proximity to the mandibular canal or mental foramen, it is essential to adjust the surgical access approach accordingly. This article provides an overview of clinical cases involving the removal of impacted teeth, highlighting the application of different surgical techniques.
About the Authors
K. K. Gasparyan
«Аuthor's dentistry Dr. Gasparyan K»
Russian Federation
Russian Federation
Karen K. Gasparyan, director, dentist
Krasnodar
S. O. Mostovoy
V. I. Vernadsky Crimean Federal University
Russian Federation
Russian Federation
Semen O. Mostovoy, DMD, PhD, Associate Professor, Department of Dentistry and Orthodontics, Medical Institute named after S. I. Georgievsky
Simferopol
V. V. Volobuev
Kuban State Medical University
Russian Federation
Russian Federation
Vladimir V. Volobuev, DMD, PhD, Associate Professor, Department of Pediatric Dentistry, Orthodontics and Maxillofacial Surgery
4 Mitrofan Sedin Str., Krasnodar, 350053
A. G. Uvarova
Kuban State Medical University
Russian Federation
Russian Federation
Anna G. Uvarova, DMD, PhD, Associate Professor, Department of the Dental and Maxillofacial Surgery
Krasnodar
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For citations:
Gasparyan K.K., Mostovoy S.O., Volobuev V.V., Uvarova A.G. Approaches to surgical access for impacted tooth removal in the mandible: clinical case reports. Pediatric dentistry and dental prophylaxis. 2024;24(4):399-406. (In Russ.) https://doi.org/10.33925/1683-3031-2024-845
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