Removal of Impacted Molars With Lingual Split Technique

NCT05946317 | Completed DMC

• 1 other identifier: TishreenU - Maxillofacial surg
• Study Type: interventional
• Target: 20
• Locations: 1 country
• Sites: 1

Brief Summary

This research assesses removal of mandibular third molars by the lingual split technique with using Walter's lingual retractor for retracting lingual flap, and evaluates the lingual nerve injury that may result after applying this technique. The research sample included 20 patients and their age under 25 years where the grain is clear. The lingual nerve is assessed by sensory neurological tests on a graphic map that divides the tongue into sextants.

Conditions

Lingual Nerve Injuries

Keywords

Impacted third molar; lingual nerve; lingual flap retractor

Outcome Measures

Primary Outcomes (3)

• Lingual nerve injury location

  The location of the disorder on the tongue is determined on a graphic map that divides the tongue into six sextants in each side: middle apical, lateral apical, middle, lateral, middle posterior and lateral posterior.

  6 hours after the surgical procedure of removal of impacted mandibular third molar.

• Nerve discrepancy

  0 : No sensational impairment 1. : Mild loss of sensation 2. : Moderate loss of sensation 3. : Severe loss of sensation

  6 hours after the surgical procedure of removal of impacted mandibular third molar.

• Taste function

  Taste function is assessed by Taste sensation tests of sweetness, saltiness, acidity and bitterness.

  6 hours after the surgical procedure of removal of impacted mandibular third molar.

Secondary Outcomes (6)

• Healing time

  Two weeks after the surgical procedure.

• Healing time

  Four weeks after the surgical procedure.

• Healing time

  Six weeks after the surgical procedure.

• Healing time

  Two months after the surgical procedure.

• Healing time

  Four months after the surgical procedure.

Study Arms (1)

Lingual nerve function assessed after removal of Impacted mandibular third molar

EXPERIMENTAL

20 patients who had have an impacted mandibular third molar indicated for extraction by lingual split technique with using Walter's lingual retractor for retracting lingual flap. The neurological function of the lingual nerve was assessed after the demise of local anesthesia, then the location of the disorder and taste function and healing time are determined by sensory neurological tests on a graphic map that divides the tongue into sextants.

Procedure: Lingual nerve function assessed after removal of mandibular third molar with lingual split technique

Interventions

Lingual nerve function assessed after removal of mandibular third molar with lingual split technique PROCEDURE

The lingual split technique is based on using chisel and hammer in bone removing. After the buccal and lingual flaps are raised and retracted. Two buccal bone cutting with horizontal cutting up between them are performed, The disto-lingual bone fragment is fractured inward by placing the cutting edge of the chisel at 45 degrees with the surface of the bone and directed towards the lower second premolar of the opposite side. By maintaining the cutting edge of the chisel parallel to the external oblique ridge, a few light taps with the mallet will separate the lingual plate from the rest of the alveolar bone. And it released from soft tissues, buccally force is applied to roll the whole tooth lingually. The neurological function of the lingual nerve was assessed after the demise of local anesthesia, then the location of the disorder and taste function and healing time are determined by sensory neurological tests on a graphic map that divides the tongue into sextants.

Lingual nerve function assessed after removal of Impacted mandibular third molar

Eligibility Criteria

• Age: 19 Years - 24 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Patients who have impacted mandibular third molar indicated for removal.
• Patients are healthy and have no systemic diseases (ASA1 ASA2).
• Patient's age is less than 25 years where the bone grain is still present and the use of the chisel and hammer is permitted.

You may not qualify if:

• A deep impacted mandibular third molar which is close proximately to the neuro-vascular package, deep horizontal impaction, extreme disto-angular impaction.
• Patient's age is over 25 years.
• The lingual plate is thick.

Sponsors & Collaborators

• Tishreen University: lead

Study Sites (1)

Alaa Alaji

Latakia, Syria

Location

Related Publications (6)

• Rud J. Reevaluation of the lingual split-bone technique for removal of impacted mandibular third molars. J Oral Maxillofac Surg. 1984 Feb;42(2):114-7. doi: 10.1016/0278-2391(84)90323-9. No abstract available.

  PMID: 6582236 BACKGROUND

• Farish SE, Bouloux GF. General technique of third molar removal. Oral Maxillofac Surg Clin North Am. 2007 Feb;19(1):23-43, v-vi. doi: 10.1016/j.coms.2006.11.012.

  PMID: 18088862 BACKGROUND

• Pippi R, Spota A, Santoro M. Prevention of Lingual Nerve Injury in Third Molar Surgery: Literature Review. J Oral Maxillofac Surg. 2017 May;75(5):890-900. doi: 10.1016/j.joms.2016.12.040. Epub 2017 Jan 4.

  PMID: 28142010 BACKGROUND

• Pogrel MA, Goldman KE. Lingual flap retraction for third molar removal. J Oral Maxillofac Surg. 2004 Sep;62(9):1125-30. doi: 10.1016/j.joms.2004.04.013.

  PMID: 15346365 BACKGROUND

• Steel B. Lingual split versus surgical bur technique in the extraction of impacted mandibular third molars: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012 Sep;114(3):294-302. doi: 10.1016/j.tripleo.2011.07.028. Epub 2012 Jan 27.

  PMID: 22883979 BACKGROUND

• Smith MH, Lung KE. Nerve injuries after dental injection: a review of the literature. J Can Dent Assoc. 2006 Jul-Aug;72(6):559-64.

  PMID: 16884649 BACKGROUND

MeSH Terms

Conditions

Lingual Nerve Injuries

Condition Hierarchy (Ancestors)

Trigeminal Nerve Injuries; Trigeminal Nerve Diseases; Facial Neuralgia; Facial Nerve Diseases; Mouth Diseases; Stomatognathic Diseases; Cranial Nerve Injuries; Cranial Nerve Diseases; Nervous System Diseases; Craniocerebral Trauma; Trauma, Nervous System; Wounds and Injuries

Study Officials

• Abdul Karim Khalil, PHD

  Tishreen University

  STUDY CHAIR

• Alaa Alaji, Master

  Tishreen University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: The research sample included 20 patients from the Faculty of Dentistry in Tishreen University and maxillofacial surgery department in Tishreen Hospital who had have an impacted mandibular third molar indicated for extraction and their age under 25 years.

Study Record Dates

• First Submitted: June 12, 2023
• First Posted: July 14, 2023
• Study Start: December 1, 2021
• Primary Completion: November 28, 2022
• Study Completion: December 5, 2022
• Last Updated: July 18, 2023

Record last verified: 2023-06

Locations

SY (1)