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The goal of this clinical trial is to investigate the usage of maxillary miniscrew and cross-arch elastics for the orthodontic traction of the impacted mandibular third molar in close proximity to the inferior alveolar nerve to decrease the chance of nerve injury
To investigate the traction of the impacted mandibular third molar away from the inferior alveolar nerve by using the orthodontic miniscrew in the maxillary bone and cross-arch elastic power chain as a temporary anchorage device before extraction to avoid injury of the nerve and neurosensory complications.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Participants | Experimental | Patients with impacted mandibular third molar in close proximity to the inferior alveolar nerve |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Orthodontic extrusion of the impacted mandibular third molar by using the maxillary miniscrew and cross arch elastic power chain as a temporary anchorage device before extraction | Procedure | Orthodontic extrusion of the impacted mandibular third molar of high-risk for nerve injury using maxillary TAD. |
| Measure | Description | Time Frame |
|---|---|---|
| Radiographically | By measuring the amount of extrusion of the impacted tooth gained in millimetres Using CBCT | 6months |
| Measure | Description | Time Frame |
|---|---|---|
| Clinical neurosensory assessment | By using pinprick test in which ;A sharp dental probe was applied to the skin over chin region, lip and mucosa in a quick pricking movement and pain perception of the patient was assessed. Each area was tested three times bilaterally.the scale ranged from 0-2, where 0= no sensation, 1= decreased sensation and 2= normal sensation. | 6months |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Saeeda Osman, Professor Dr | Alexandria University | Study Chair |
| Tarek Nasreldin, Ass.prof. | Alexandria University | Study Director |
| Tasneem Amer, Lecturer | Alexandria University | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Alexandria university | Alexandria | Egypt | ||||
| Faculty of Dentistry, Alexandria University |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33667345 | Background | Jung S, Lee JH, Huh J, Park W. Orthodontic Extrusion of Mandibular Third Molar With a Miniscrew and Cross-Arch Elastic. J Oral Maxillofac Surg. 2021 Jul;79(7):1422.e1-1422.e8. doi: 10.1016/j.joms.2021.01.036. Epub 2021 Feb 7. | |
| 22901857 | Background | Kim JW, Cha IH, Kim SJ, Kim MR. Which risk factors are associated with neurosensory deficits of inferior alveolar nerve after mandibular third molar extraction? J Oral Maxillofac Surg. 2012 Nov;70(11):2508-14. doi: 10.1016/j.joms.2012.06.004. Epub 2012 Aug 15. |
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Patients with impacted mandibular third molar in close proximity to the inferior alveolar nerve requiring orthodontic extrusion of the impacted teeth before extraction
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|
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| clinical brush stroke directional test | using a micro brush tip which was moved in horizontal and/or vertical directions on the chin area ten times and asked the patient to reproduce the movements the scale ranged from 0-2, where 0= no sensation, 1= decreased sensation and 2= normal sensation. | 6months |
| Clinical Two-point discrimination test | By using probes of caliper device which were drawn across the skin at constant pressure and patient was asked whether one or two points were felt, the minimum separation distance was felt by the patient was termed two point discrimination threshold.scoring from 0-2 in which; 0=>15mm, 1=8-15, 2= <8 . | 6months |
| Alexandria |
| Egypt |
| Faculty of Dentistry | Alexandria | Egypt |
| 18486807 | Background | Ramaraj PN. Orthodontic extraction: the riskless extraction of the impacted lower third molars close to the mandibular canal. J Oral Maxillofac Surg. 2008 Jun;66(6):1317; author reply 1317. doi: 10.1016/j.joms.2008.02.008. No abstract available. |
| 25882437 | Background | Kalantar Motamedi MR, Heidarpour M, Siadat S, Kalantar Motamedi A, Bahreman AA. Orthodontic Extraction of High-Risk Impacted Mandibular Third Molars in Close Proximity to the Mandibular Canal: A Systematic Review. J Oral Maxillofac Surg. 2015 Sep;73(9):1672-85. doi: 10.1016/j.joms.2015.03.031. Epub 2015 Mar 24. |
| 18022488 | Background | Alessandri Bonetti G, Bendandi M, Laino L, Checchi V, Checchi L. Orthodontic extraction: riskless extraction of impacted lower third molars close to the mandibular canal. J Oral Maxillofac Surg. 2007 Dec;65(12):2580-6. doi: 10.1016/j.joms.2007.06.686. No abstract available. |
| 37326659 | Result | Zhao S, Wang Y, Yang X, Zhou X, Wang Z, Zhang K, Yang X. Extraction of impacted mandibular third molars in close proximity to the inferior alveolar canal with coronectomy-miniscrew traction to avoid nerve injury. Clin Oral Investig. 2023 Aug;27(8):4279-4288. doi: 10.1007/s00784-023-05044-9. Epub 2023 Jun 16. |
| ID | Term |
|---|---|
| D000080902 | Mandibular Nerve Injuries |
| ID | Term |
|---|---|
| D061221 | Trigeminal Nerve Injuries |
| D020433 | Trigeminal Nerve Diseases |
| D005156 | Facial Neuralgia |
| D005155 | Facial Nerve Diseases |
| D009059 | Mouth Diseases |
| D009057 | Stomatognathic Diseases |
| D020209 | Cranial Nerve Injuries |
| D003389 | Cranial Nerve Diseases |
| D009422 | Nervous System Diseases |
| D006259 | Craniocerebral Trauma |
| D020196 | Trauma, Nervous System |
| D014947 | Wounds and Injuries |
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