Computer-Aided Design/Computer-Aided Manufacturing Cutting Guides for Odontectomy of Deeply Impacted Mandibular Third Molars

Mamdouhh Ahmed; Mariam Kamel Salah; Nesrine Khairy

doi:10.3889/oamjms.2018.371

Authors

Mamdouhh Ahmed Faculty of Dentistry, Cairo University, Oral and Maxillofacial Department 11 Al Saraya, Al Manial, Giza Governorate 11553, Egypt
Mariam Kamel Salah Faculty of Dentistry, Cairo University, Oral and Maxillofacial Department 11 Al Saraya, Al Manial, Giza Governorate 11553, Egypt
Nesrine Khairy Faculty of Dentistry, Cairo University, Oral and Maxillofacial Department 11 Al Saraya, Al Manial, Giza Governorate 11553, Egypt

DOI:

https://doi.org/10.3889/oamjms.2018.371

Keywords:

Deeply impacted mandibular third molar (DIMTM), Inferior alveolar nerve (IAN) injury, Computer guided cutting guide, External oblique ridge

Abstract

AIM: To evaluate a new technique for surgical removal of deeply impacted mandibular third molars (DIMTM), using computer-guided cutting guide to maintain inferior alveolar nerve (IAN) integrity and the covering buccal bone.

PATIENTS AND METHODS: Eighteen cases indicated for removal of DIMTM. Cone-beam Computed Tomography (CBCTs) used to determine the toothâ€™s relation to the IAN. Computer-guided software used for fabrication of surgical cutting guide stent to expose the impacted tooth and repositioning of bone after odontectomy without fixation. Clinical assessment included a neurosensory deficit of IAN, pain using a visual analogue scale (VAS), facial swelling, and maximal mouth opening (MMO). CBCTs were taken immediately and six months postoperatively to evaluate position and healing of bone.

RESULTS: None of the patients showed a permanent neurological deficit of IAN while all patients showed normal parameters of pain, facial swelling and MMO.

CONCLUSION: this technique has shown the accurate determination of the bony window cuts with subsequent preservation of IAN and external oblique ridge.

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