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A Review of In-Office Dynamic Image Navigation for Extraction of Complex Mandibular Third Molars.

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Citation: Journal of Oral & Maxillofacial Surgery. , 2017 Mar 25Journal of Oral & Maxillofacial Surgery. 75(8):1591-1600, 2017 AugPMID: 28419843Institution: MedStar Washington Hospital CenterDepartment: Medicine/Oral and Maxillofacial SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Ambulatory Surgical Procedures/is [Instrumentation] | *Ambulatory Surgical Procedures/mt [Methods] | *Molar, Third/su [Surgery] | *Surgery, Computer-Assisted/is [Instrumentation] | *Surgery, Computer-Assisted/mt [Methods] | *Tooth Extraction/is [Instrumentation] | *Tooth Extraction/mt [Methods] | Adult | Aged | Cone-Beam Computed Tomography | Dental High-Speed Equipment | Dental Models | Equipment Design | Female | Humans | Imaging, Three-Dimensional | Male | Middle Aged | Molar, Third/dg [Diagnostic Imaging] | Postoperative Complications/et [Etiology] | Printing, Three-DimensionalYear: 2017 Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007ISSN:

0278-2391

Abstract: CONCLUSIONS: We present results using a new technology, the DINS, for removal of complex mandibular third molars. Potential advantages are 1) improved visualization and localization of anatomic structures such as the inferior alveolar nerve, lingual cortical plate, and adjacent roots; 2) improved control during osteotomy; 3) decreased surgical access requirements and reduction in overall bone removal; 4) ability to perform complex procedures successfully in an in-office setting; 5) decreased surgical time resulting from improved visualization; and 6) potential use as a teaching tool. Possible limitations of the use of an in-office DINS include increased cost, increased time attributed to presurgical planning, initial learning curve, and optical array interference by the surgeon or assistants during surgery.Copyright � 2017. Published by Elsevier Inc.MATERIALS AND METHODS: A retrospective review was conducted of cases completed from 2010 to 2014 by a single oral and maxillofacial surgeon. The average age of the patients was 47 years (range, 27 to 72 years). Extraction complexity was classified with Juodzbalys and Daugela's classification system. The included study cases had complexity scores of 9 or greater. Each patient received custom intraoral splints to secure the tracking array and underwent cone beam computed tomography image acquisition. All surgical procedures were performed with a precalibrated tracking straight handpiece under dynamic navigation.PURPOSE: We performed a retrospective review of in-office removal of complex mandibular third molars with a dynamic image navigation system (DINS).RESULTS: All 25 cases were treated successfully with the use of the DINS. Twelve of these cases were associated with pathologic lesions. Three patients were noted to have inferior alveolar nerve paresthesia. One patient sustained a pathologic fracture at week 2. Postoperative infections were noted in 7 cases, 2 of which had a pre-existing infection. One patient reported temporary limitation of mouth opening. A coronectomy was performed in 1 case.All authors: Agarwal R, Emery RW, Korj OFiscal year: FY2017Digital Object Identifier:

https://dx.doi.org/10.1016/j.joms.2017.03.031

Date added to catalog: 2017-05-06

Holdings ( 1 )
Title notes ( 7 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	28419843	Available		28419843

Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007

CONCLUSIONS: We present results using a new technology, the DINS, for removal of complex mandibular third molars. Potential advantages are 1) improved visualization and localization of anatomic structures such as the inferior alveolar nerve, lingual cortical plate, and adjacent roots; 2) improved control during osteotomy; 3) decreased surgical access requirements and reduction in overall bone removal; 4) ability to perform complex procedures successfully in an in-office setting; 5) decreased surgical time resulting from improved visualization; and 6) potential use as a teaching tool. Possible limitations of the use of an in-office DINS include increased cost, increased time attributed to presurgical planning, initial learning curve, and optical array interference by the surgeon or assistants during surgery.

MATERIALS AND METHODS: A retrospective review was conducted of cases completed from 2010 to 2014 by a single oral and maxillofacial surgeon. The average age of the patients was 47 years (range, 27 to 72 years). Extraction complexity was classified with Juodzbalys and Daugela's classification system. The included study cases had complexity scores of 9 or greater. Each patient received custom intraoral splints to secure the tracking array and underwent cone beam computed tomography image acquisition. All surgical procedures were performed with a precalibrated tracking straight handpiece under dynamic navigation.

PURPOSE: We performed a retrospective review of in-office removal of complex mandibular third molars with a dynamic image navigation system (DINS).

RESULTS: All 25 cases were treated successfully with the use of the DINS. Twelve of these cases were associated with pathologic lesions. Three patients were noted to have inferior alveolar nerve paresthesia. One patient sustained a pathologic fracture at week 2. Postoperative infections were noted in 7 cases, 2 of which had a pre-existing infection. One patient reported temporary limitation of mouth opening. A coronectomy was performed in 1 case.

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