A clinical study of the two-stage surgical approach combining coronectomy with microimplant anchorage traction for extraction of impacted mandibular third molars
10.3760/cma.j.cn112144-20240507-00184
- VernacularTitle:牙冠切除术结合支抗钉牵引分阶段拔除下颌阻生第三磨牙的临床研究
- Author:
Fei WANG
1
;
Ziyu YAN
;
Xiangliang XU
;
Shen LIN
;
Wei ZHANG
;
Nianhui CUI
Author Information
1. 北京大学口腔医学院·口腔医院口腔颌面外科 国家口腔医学中心 国家口腔疾病临床研究中心 口腔生物材料和数字诊疗装备国家工程研究中心 口腔数字医学北京市重点实验室，北京100081
- Keywords:
Tooth, impacted;
Inferior alveolar nerve;
Coronectomy;
Microimplant anchorage traction;
Traction angle
- From:
Chinese Journal of Stomatology
2024;59(8):791-797
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To establish a two-stage surgical procedure of impacted mandibular third molars (IMTM) extractions assisted by coronectomy and microimplant anchorage traction and to investigate the influencing factors of root movement and the effects of different traction angles on the clinical outcomes.Methods:Fifty-three IMTM in contact with inferior alveolar nerve (IAN) that underwent tooth extraction in the Department of Oral and Maxillofacial Surgery Peking University School of Stomatology from January 2022 to June 2023 were included, with coronectomy and microimplant anchorage implantation in the first stage of the surgery, root traction was achieved with orthodontic elastic and microimplant anchorages by about 5.886 N of force, when the IMTM root was detached from IAN, a second surgery was performed to extract the residual root. The basic information of patients and M3M, data on the microimplant anchorage implantation and traction, imaging measurements, and complications were recorded and analyzed.Results:The movement distance of the residual roots was (1.80±0.92) mm, and the duration of traction was (32.9±7.9) d. Multiple linear regression analysis showed that the residual root movement distance was significantly correlated with age, gender, number of roots, traction angle, and depth of the distal bone defect of the second molar ( P<0.05). The smaller the traction angle, the more significant the movement of the residual roots ( P=0.044). In one case, the patient experienced abnormal sensation in the lower lip 16 days after one IMTM (1.9%, 1/53) traction. Conclusions:The two-stage surgical method of combined coronectomy with rapid traction technique to extract the IMTM allows for rapid movement of the residual root and reduces the risk of IAN injury. The efficiency of root movement can be accelerated by appropriately reducing the traction angle during surgery. The traction effect can be predicted based on indicators such as age, gender, number of roots and depth of distal bone defects of second molar.
