PubMed · 14928134
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K H WOOD. 1952. Alveolectomy.. https://pubmed.ncbi.nlm.nih.gov/14928134/
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PURPOSE: Lingual nerve damage following lower third molar surgery remains a clinical problem. The traditional approach in the United States has been a buccal approach avoiding exposure or surgery on the lingual side of the crest of the ridge. An alternative technique is to deliberately expose the lingual tissues and retract the lingual nerve lingually before tooth removal. This study reports a trial of this technique. MATERIALS AND METHODS: Patients had removal of their lower third molars carried out using a technique that raises a lingual flap in addition to a buccal flap and places a specially designed lingual retractor to ensure that the lingual nerve is held out of the surgical field. This technique was used in cases where the crown of the tooth had to be sectioned or when distal bone needed to be removed. RESULTS: Two hundred fifty patients were treated by this method. There were 4 cases of transient lingual paresthesia, presumably caused by traction pressure from the retractor. Three of these cases were mild and resolved within 3 weeks. The fourth case had more profound paresthesia, but still resolved within 2 months. There were no cases of permanent nerve damage, and in many cases removal of the third molar was simplified by the superior access. CONCLUSION: Lingual retraction for third molar removal improves access to the surgical site and can simplify third molar removal. In this prospective study there were no cases of permanent lingual nerve injury.
A 45-year-old woman needing a Class V restoration in a mandibular molar without attached gingiva is presented. In an interdisciplinary intervention, transurgical restoration was accomplished, including flap surgery with a slight ostectomy and restoration with a bonding system and a resin composite. A 1-year clinical evaluation showed satisfactory marginal adaptation and restoration contour associated to gingival tissue health.
OBJECTIVE: To observe the results of surgical crown lengthening procedure and the factors which affected the success of the surgery. METHODS: Crown lengthening surgery was performed on 27 teeth. The distance between margin of tooth and bone crest (MT-B) was obtained greater than 4 mm during the surgeries on 10 teeth which were considered as satisfying group. The other 17 teeth were as temporized group with MT-B < or = 3 mm. The position of the tooth margin was evaluated before surgery, immediately after suturing, and at 4 - 6 weeks after surgery. The occlusal force and tooth mobility were measured immediately after restoration, at 3 and 6 months after surgery. RESULTS: MT-B was obtained > or = 4 mm and all margins and sites of the teeth were exposed in satisfying group (10/10). At least 1 site with MT-B < 3 mm in temporized group in which there still were 11 sites (16%) in 5 teeth (29%) with subgingival tooth margin at 4 - 6 weeks after surgery. There were more teeth showing increased mobility in temporized group (12/17) than in satisfying group (1/10) after surgery (P < 0.05). The occlusal force of the teeth after surgery and restoration in temporized group was significantly lower than that of their counterpart teeth (P < 0.01), but it was not the case in satisfying group (P > 0.05). CONCLUSIONS: It is suggested that ideal exposure of tooth margin could be obtained if 4 mm from tooth margin to alveolar crest could be created during the crown lengthening surgery. The teeth both with 4 - 5 mm subgingival margin sites and factors limiting surgical performance are not the suitable indications for the surgical crown lengthening.