Modified maxillary vestibular approach with subperiostal intranasal dissection for surgical extractions of mesiodentes impacted in the floor of the nasal cavity
| Autor: | Daniel Hrusak, L. Hosticka, Lukas Hauer, Petr Posta, Jan Jambura, P. Andrle, Jiri Gencur |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Nasal cavity Adolescent Dentistry Orthodontics Corrective 03 medical and health sciences 0302 clinical medicine Maxilla medicine Nasal septum Humans Supernumerary Prospective Studies Child Nose business.industry Dissection Tooth Impacted Surgical wound 030206 dentistry Neurovascular bundle Incisor medicine.anatomical_structure Tooth Supernumerary Otorhinolaryngology 030220 oncology & carcinogenesis Tooth Extraction Female Surgery Nasal Cavity Oral Surgery business Malocclusion |
| Zdroj: | Journal of Cranio-Maxillofacial Surgery. 47:1-5 |
| ISSN: | 1010-5182 |
| Popis: | Introduction Impacted mesiodentes in the inverted position may interfere with the base of the nasal cavity or the nasal septum. They can rarely erupt into the nose as well. Traditionally they are extracted via intraoral approaches (transpalatal or vestibular). Also, an endoscopically assisted transnasal approach can be used. In this paper, the authors are the first to present a group of patients suffering from impacted mesiodentes who have been surgically treated using a modified maxillary vestibular approach with subperiostal intranasal dissection. Material and Method The prospective study was completed in the time period 12/2013–6/2017. The inclusion criteria were: 1. Mesiodens impacted in the inverted position extending to the base of the nasal cavity or into the nasal septum without concomitant pathological lesion and without eruption into the nasal cavity. 2. Localization of the mesiodens at the level of or dorsally to the roots of the upper middle incisors in the sagittal plane or ventrally to the roots of these teeth, but with the crown extending significantly posteriorly to the base of the nasal cavity.3. Indication for extraction because of clinical or orthodontic reasons. Results In total, 9 patients were enrolled into the group. In these patients, surgical extractions of 9 mesiodentes were performed using the alternative approach described above. All extractions were done according to a uniform surgical protocol. The mean age of the patients was 11.7 ± 3.1 years (age range 7–17 years). The crown's most cranial point exceeded the bone of the nasal cavity on average by2.0 ± 1.4 mm (in the range 0–5 mm). 8 mesiodentes were conical, 1 was tuberculate. Surgical procedure and postoperative healing were always without any complications. Conclusion For the removal of midline supernumerary teeth, the modified maxillary vestibular approach with subperiostal intranasal dissection in comparison to the intraoral palatal approach provides less postoperative morbidity and a lower risk of complications (smaller surgical wound, minimal exposure of maxilla, minimal bone loss, reduced risk of damage to the roots of the upper incisors, lower risk of damage to the nasopalatine neurovascular bundle, good visibility in the surgical field, easier surgery, and finally no need of postoperative palatal splint). For oral and maxillofacial surgeons the presented technique represents a more traditional way of surgical tooth extraction than the endoscopically assisted transnasal approach. |
| Databáze: | OpenAIRE |
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