Impacted Mesioangular Mandibular Third Molars Extracted Without Raising of Mucoperiosteal Flap: Is It Possible?

Abstract

Objective: This study compared surgical outcome and quality of life of patients who had extraction of impacted mandibular third molars using standard technique and a less invasive approach.

Methods: All consecutive patients who had their symptomatic impacted mandibular third molar extracted via the transalveolar or a less invasive technique, at the Oral Surgery Clinic of our institution, were prospectively studied over a 3-year period. Oral quality of life score was assessed using the United Kingdom Oral Health Related Quality of Life (UK-OHQoL) questionnaire.

Results: The demographic data, indications for extractions, as well as preoperative QoL scores in both the experimental and study groups were comparable. All the teeth were of the mesioangular impaction type.  The duration of extractions was significantly (P=0.001) longer in the transalveolar (29.2 ± 2.13) than the routine extraction group (16.6 ± 2.44). Of the three fractured teeth in the flapless technique, only one of them required raising of a mucoperiosteal flap and a transalveolar approach to extract the apical remnant, giving a success rate of 96.7% for the less invasive treatment approach for extraction of impacted mandibular third molar. The mean Oral health quality of life scores were significantly higher for patients in the routine extraction group compared to those in transalveolar group up to first 3days after surgery (P<0.001). At days 7 and 14 there no differences between the mean domain scores in both study populations.

Conclusion: Routine extraction of mesioangular impacted mandibular third molar is possible for selected cases. This will avoid the potential morbidities associated with surgical extractions of impacted third molars, and thus giving better QoL in patients undergoing third molar surgery.

Keywords: Impacted third molar, minimal invasive technique, quality of life