EVALUATION OF MODIFIED PEDERSON INDEX FOR PREDICTING DIFFICULTY OF LOWER THIRD MOLAR SURGICAL EXTRACTION USING OSTEOTOMY AT SCHOOL OF DENTISTRY, HANOI MEDICAL UNIVERSITY IN 2023-2024

Mạnh Nguyên Trương, Kim Loan Hoàng, Hữu Khánh Nguyễn

Main Article Content

Abstract

Objective: Analysis of the difficulty in extracting lower wisdom teeth with bone exposure indicated at School of Dentistry, Hanoi Medical University in 2023-2024. Subjects and methods: Descriptive study based on case  serie. Patients with impacted or partially or fully erupted lower wisdom teeth, indicated for extraction with bone exposure, were assessed through clinical examination and Cone Beam CT. Evaluation criteria included wisdom tooth position (angulation, degree of impaction, type), root morphology (number, shape), the angle between the second molar and the lower wisdom tooth, bone width distal to the second molar, mesiodistal dimensions of the lower wisdom tooth, extent of bone resorption (if present) on the distal aspect of the second molar, relation of the inferior alveolar nerve canal to the wisdom tooth roots, and the bone density around the lower wisdom tooth roots. Results: The average age of patients was 19.9. The highest proportion of lower wisdom teeth were in a near-vertical position, at 51.5%. The most common root morphology was the tapered two-root type, at 56.2%. The majority of wisdom teeth were classified as type A2 in depth, at 65.6%. The most common horizontal classification was type II, at 56.2%. Most lower wisdom tooth roots did not contact the inferior alveolar nerve canal, at 62.5%. Bone density was predominantly type DI, at 87.6%. Most lower wisdom teeth had a widened periapical radiolucency, at 59.4%. In terms of extraction difficulty, 71.9% were of moderate difficulty and 28.1% were very difficult. Conclusion: Lower wisdom teeth are classified as moderately difficult in 71.9% of cases, 28.1% are considered very difficult.

Article Details

References

1. Lê Nguyên Lâm, Võ Văn Biết. Đặc điểm lâm sàng, X-quang phân loại răng khôn theo Pell và Gregory tại Bệnh viện Đa khoa Cái Nước. VMJ. 2023;522(1). doi:10.51298/vmj.v522i1.4293
2. Hà Ngọc Chiều, Nguyễn Đình Phúc, Nguyễn Mạnh Cường và cộng sự. Đặc điểm lâm sàng và cận lâm sàng răng khôn hàm dưới mọc lệch ngầm. VMJ. 2023; 526(2). doi:10.51298/ vmj.v526i2.5584
3. Nguyễn Mạnh Phú, Nguyễn Thị Phương Thảo, Đinh Thị Thái và cộng sự. Đặc điểm lâm sàng, cận lâm sàng răng khôn hàm dưới mọc lệch theo Parant II-III. VMJ. 2023;525(1B). doi:10.51298/vmj.v525i1B.5098
4. Santos KK, Lages FS, Maciel CAB, et al. Prevalence of Mandibular Third Molars According to the Pell & Gregory and Winter Classifications. J Maxillofac Oral Surg. 2022;21(2):627-633. doi:10.1007/s12663-020-01473-1
5. Vũ Minh Hoàng, Vũ Anh Dũng. Đánh giá kết quả phẫu thuật răng 8 hàm dưới mọc lệch, mọc ngầm sử dụng tay khoan phẫu thuật chếch góc tại Bệnh viện Đại học Y Thái Bình. Tạp chí Y dược Thái Bình. 2021(01):64-68.
6. Kim JY, Yong HS, Park KH, et al. Modified difficult index adding extremely difficult for fully impacted mandibular third molar extraction. J Korean Assoc Oral Maxillofac Surg. 2019;45(6): 309-315. doi:10.5125/jkaoms.2019.45.6.309
7. Renton T, Smeeton N, McGurk M. Factors predictive of difficulty of mandibular third molar surgery. Br Dent J. 2001;190(11):607-610. doi:10.1038/sj.bdj.4801052
8. Carvalho RWF, do Egito Vasconcelos BC. Assessment of Factors Associated With Surgical Difficulty During Removal of Impacted Lower Third Molars. Journal of Oral and Maxillofacial Surgery. 2011;69(11): 2714-2721. doi:10.1016/ j.joms.2011.02.097