the Relationship Between Various Clinical Variables and Surgical Difficulty of Patients Have Impacted Lower Third Molar

NCT ID: NCT05320744

Last Updated: 2022-04-11

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

50 participants

Study Classification

OBSERVATIONAL

Study Start Date

2022-01-03

Study Completion Date

2023-02-28

Brief Summary

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This study is to evaluate the effect of angle of impaction, impaction depth, and bone density on surgical difficulty of impacted lower third molar, by measuring the angle of impaction, the depth of impaction (Winter's Red line), and bone density (gonial, and antegonial indices) preoperatively by using panoramic radiograph and to correlate the angle, the depth of impaction, and bone density with the surgical difficulty by operation time and surgical technique.

Detailed Description

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* All patients will provide detailed medical history and will sign a written informed consent. Oral hygiene instruction, scaling, and root planing.
* Panoramic radiograph will be taken for every patient, It will be used for measuring the angle of impaction along the lamina dura of the lower second and third molar and measuring impaction depth (Winter's Red line) by using software (planmeca romexis). The same software will be used to measure gonial index and antegonial angle as indices of bone density.
* All patients will have mouth rinsing with 0.2% chlorhexidine digluconate for 1 minute.

Surgical Procedure

* After administration of local anesthesia, full thickness enveloped or triangular flap incision according to the surgical principles.
* Flap reflection with periosteal elevator and retraction.
* Bone removal (if required) by using a slow speed, high torque surgical handpiece with sharp bur with copious normal saline irrigation.
* Tooth sectioning (if required) by using sharp diamond bur with saline irrigation.
* Tooth extraction by using appropriate elevator. .The operative difficulty will be determined by the surgical techniques of the extraction and the duration of extraction. With respect to the surgical technique the degree of difficulty is considered low when the extraction is performed by elevator alone, moderate when bone removal (ostectomy) is required, and high when ostectomy and tooth sectioning is required for tooth extraction.

For the duration of surgery, the difficulty is considered low when the duration of surgical extraction is less than 15 minutes, moderate when the duration is 15-30 minutes, and high when the duration is more than 30 minutes.

* Irrigation and cleaning of surgical site and removing remaining follicle if present.
* Bone smoothing with bone file and irrigation with saline.
* Flap Suturing with black silk suture 3/0.
* Ask the patient to bite on wet gauze.
* Instruction and medication (analgesic and antibiotic if required).

Conditions

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Impacted Third Molar Tooth

Study Design

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Observational Model Type

OTHER

Study Time Perspective

PROSPECTIVE

Interventions

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surgical extraction of impacted lower third molar

surgical removal of impacted third molar under local anesthesia.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. Healthy patients over 18 years old of either gender.
2. Patients who have mesioangular or horizontal impacted mandibular third molar.
3. Presence of mandibular second molar.
4. Ability to tolerate surgical procedure.

Exclusion Criteria

2\. Patients with uncontrolled systemic diseases. 3. Patients with history of chemotherapy or radiotherapy therapy to the head and neck region.

4\. Acute infection at the surgical site at time of operation. 5. The presence of cysts or tumors associated with the impacted teeth.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Baghdad

OTHER

Sponsor Role lead

Responsible Party

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Mohammed Ahmed

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Salwan Y. Bede, F.I.B.M.S

Role: STUDY_CHAIR

Baghdad college of dentistry/ Department of oral and maxillofacial surgery

Locations

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university of Baghdad/ Baghdad college of dentistry

Baghdad, , Iraq

Site Status RECRUITING

Countries

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Iraq

Central Contacts

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Mohammed A. Muter, B.D.S.

Role: CONTACT

07700661160

Facility Contacts

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mohammed A muter, BDS

Role: primary

07700661160

References

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de Carvalho RWF, Vasconcelos BC. Pernambuco index: predictability of the complexity of surgery for impacted lower third molars. Int J Oral Maxillofac Surg. 2018 Feb;47(2):234-240. doi: 10.1016/j.ijom.2017.07.013. Epub 2017 Aug 14.

Reference Type RESULT
PMID: 28818641 (View on PubMed)

Zhang X, Wang L, Gao Z, Li J, Shan Z. Development of a New Index to Assess the Difficulty Level of Surgical Removal of Impacted Mandibular Third Molars in an Asian Population. J Oral Maxillofac Surg. 2019 Jul;77(7):1358.e1-1358.e8. doi: 10.1016/j.joms.2019.03.005. Epub 2019 Mar 14.

Reference Type RESULT
PMID: 30959010 (View on PubMed)

Other Identifiers

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impacted lower third molar

Identifier Type: -

Identifier Source: org_study_id

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