Surgical extraction of the third molar is the most commonly performed surgical procedure in the clinical practice of oral surgery.Third molar surgery is warranted when there is inadequate space for eruption,malpositio...Surgical extraction of the third molar is the most commonly performed surgical procedure in the clinical practice of oral surgery.Third molar surgery is warranted when there is inadequate space for eruption,malpositioning,or risk for cyst or odontogenic tumor formation.Preoperative assessment should include a detailed morphologic analysis of the third molar and its relationship to adjacent structures and surrounding tissues.Due to developments in medical engineering technology,computed tomography(CT)now plays a critical role in providing the clear images required for adequate assessment prior to third molar surgery.Removal of the maxillary third molar is associated with a risk for maxillary sinus perforation,whereas removal of the mandibular third molar can put patients at risk for a neurosensory deficit from damage to the lingual nerve or inferior alveolar nerve.Multiple factors,including demographic,anatomic,and treatment-related factors,influence the incidence of nerve injury during or following removal of the third molar.CT assessment of the third molar prior to surgery can identify some of these risk factors,such as the absence of cortication between themandibular third molar and the inferior alveolar canal,prior to surgery to reduce the risk for nerve damage.This topic highlight presents an overview of the clinical significance of CT assessment in third molar surgery.展开更多
Large oro-antral communication, associated with total maxillectomy, may lead speech and/or swallowing dysfunction. These surgical defects are packed with obuturator or prosthesis following surgery;however, achieving r...Large oro-antral communication, associated with total maxillectomy, may lead speech and/or swallowing dysfunction. These surgical defects are packed with obuturator or prosthesis following surgery;however, achieving retention and stability is dependent on anatomical conditions. A 68-year-old Japanese female with large oro-antral communication arising because of bilateral total maxillectomy was referred for evaluating application of obturator. The temporary obturator was constructed as underlying 3 mm thick and covereing 1.5 - 2 mm thick ethylene vinyl acetate sheet (EVA). These two sheets formed the flexible hollow bulb portion, which aided retention and stability by engaging the undercut portion of the surgical defect. For the patients who have difficulty anatomical features for conventional prosthesis, this type of temporary obturator made with EVA sheets could be an effective solution in the early postoperative period.展开更多
文摘Surgical extraction of the third molar is the most commonly performed surgical procedure in the clinical practice of oral surgery.Third molar surgery is warranted when there is inadequate space for eruption,malpositioning,or risk for cyst or odontogenic tumor formation.Preoperative assessment should include a detailed morphologic analysis of the third molar and its relationship to adjacent structures and surrounding tissues.Due to developments in medical engineering technology,computed tomography(CT)now plays a critical role in providing the clear images required for adequate assessment prior to third molar surgery.Removal of the maxillary third molar is associated with a risk for maxillary sinus perforation,whereas removal of the mandibular third molar can put patients at risk for a neurosensory deficit from damage to the lingual nerve or inferior alveolar nerve.Multiple factors,including demographic,anatomic,and treatment-related factors,influence the incidence of nerve injury during or following removal of the third molar.CT assessment of the third molar prior to surgery can identify some of these risk factors,such as the absence of cortication between themandibular third molar and the inferior alveolar canal,prior to surgery to reduce the risk for nerve damage.This topic highlight presents an overview of the clinical significance of CT assessment in third molar surgery.
文摘Large oro-antral communication, associated with total maxillectomy, may lead speech and/or swallowing dysfunction. These surgical defects are packed with obuturator or prosthesis following surgery;however, achieving retention and stability is dependent on anatomical conditions. A 68-year-old Japanese female with large oro-antral communication arising because of bilateral total maxillectomy was referred for evaluating application of obturator. The temporary obturator was constructed as underlying 3 mm thick and covereing 1.5 - 2 mm thick ethylene vinyl acetate sheet (EVA). These two sheets formed the flexible hollow bulb portion, which aided retention and stability by engaging the undercut portion of the surgical defect. For the patients who have difficulty anatomical features for conventional prosthesis, this type of temporary obturator made with EVA sheets could be an effective solution in the early postoperative period.
