Liu H, Wang F, Tang YL, Yan X. Asymmetric outcomes in bilateral maxillary impacted tooth extractions: A case report. World J Radiol 2024; 16(10): 608-615 [PMID: 39494141 DOI: 10.4329/wjr.v16.i10.608]
Corresponding Author of This Article
Xing Yan, MD, Chief Physician, Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, Xicheng District, Beijing 100050, China. happytooth@yeah.net
Research Domain of This Article
Dentistry, Oral Surgery & Medicine
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Radiol. Oct 28, 2024; 16(10): 608-615 Published online Oct 28, 2024. doi: 10.4329/wjr.v16.i10.608
Asymmetric outcomes in bilateral maxillary impacted tooth extractions: A case report
Han Liu, Fang Wang, Yan-Li Tang, Xing Yan
Han Liu, Fang Wang, Yan-Li Tang, Xing Yan, Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
Author contributions: Liu H drafted the manuscript; Liu H and Yan X conducted the research; Wang F and Tang YL revised the language. All authors reviewed and edited the entire manuscript.
Informed consent statement: All involved persons gave their informed consent prior to study inclusion.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest concerning this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xing Yan, MD, Chief Physician, Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, Xicheng District, Beijing 100050, China. happytooth@yeah.net
Received: May 28, 2024 Revised: September 19, 2024 Accepted: October 15, 2024 Published online: October 28, 2024 Processing time: 152 Days and 14.5 Hours
Abstract
BACKGROUND
The extraction of maxillary impacted teeth is a common procedure in oral surgery, frequently complicated by oroantral communications. For less-experienced clinicians, accurately assessing the difficulty and associated risks of maxillary third molar extractions remain a significant challenge.
CASE SUMMARY
We present a case involving disparate outcomes following bilateral extraction of maxillary third molars. Using cone-beam computed tomography and three-dimensional software, we conducted a digital assessment of the factors contributing to extraction difficulty and risk, controlling for potential confounders. Key variables analyzed included alveolar bone volume, bone quality, crown-root angulation, and maxillary sinus mucosal thickness. Additionally, we introduce the novel concept of "tegmen bone" to quantitatively evaluate the bone mass between the teeth and the maxillary sinus. This unique case, with differing outcomes on opposite sides of the same patient, provided an opportunity to minimize extraneous variables and focus on the local anatomical factors influencing the procedures, thereby improving the precision of our analysis.
CONCLUSION
This case highlights the potential utility of predictive analysis in guiding the management of complex tooth extractions.
Core Tip: This case report presents unexpected findings in bilateral maxillary third molar extractions. Using cone-beam computed tomography (CBCT) and three-dimensional software, we digitally evaluated factors influencing extraction difficulty and risk, accounting for potential confounders. Key variables analyzed included alveolar bone volume, bone quality, crown-root angulation, and maxillary sinus mucosal thickness. Notably, variations in "tegmen bone" volume between the tooth and maxillary sinus emerged as a critical determinant. We propose a simplified CBCT-based measurement method to enhance risk assessment and extraction planning of impacted tooth.
