Application of digital positioning guide plates for the surgical extraction of multiple impacted supernumerary teeth: A case report and review of literature

Feasibility study of a novel digital template-guided flapless extraction for maxillary palatal impacted teeth

OBJECTIVE

With the increasing maturity of 3D printing technology, the application of digital guide template in the extraction of impacted teeth has become more sophisticated. However, for maxillary palatal deeply impacted teeth, there still exist significant clinical challenges. This experiment introduces a novel digital guide template and innovatively employs a flapless technique to explore a minimally invasive approach for the extraction of palatal deeply impacted teeth.

METHODS

This experiment included 40 patients diagnosed with palatal completely impacted teeth, randomly divided into an experimental group and a control group. The experimental group used the new digital guide template for flapless extraction, while the control group employed the traditional freehand flap technique.

RESULTS

The experimental group can significantly reduce the localization time of palatally impacted teeth (P < 0.001), with total surgery times of 18.15 ± 4.88 min and 22.00 ± 7.71 min for the experimental and control groups, respectively (P = 0.067). Although there were no significant statistical differences between the two groups in terms of intraoperative bleeding, adjacent tooth damage, infection, or damage to nearby important anatomical structures, the experimental group showed significant improvements in postoperative pain (P < 0.05), swelling (P < 0.001), and patient satisfaction (P < 0.001) compared to the control group.

CONCLUSION

Compared to traditional freehand flap surgery, flapless extraction of palatally impacted teeth guided by digital templates significantly reduces the localization time of impacted teeth and demonstrates notable advantages in some postoperative complications. Future studies with larger sample sizes are needed to substantiate the feasibility of this technique.

A New Surgical Assistance Aid for Mesiodens Extraction Based on the Ideal Approach

BACKGROUND

To date, the classification of mesiodens has been based on the location, crown orientation, and morphology; however, there is no assistance aid focusing on choosing surgical approach.

PURPOSE

This study aimed to introduce and evaluate a new surgical assistance aid for mesiodens extraction based on surgical approach.

STUDY DESIGN, SETTING, SAMPLE

For the retrospective trial part of this study, case data from mesiodens patients who had surgery at the Affiliated Stomatological Hospital was collected, and a new surgical assistance aid was developed. A prospective randomized controlled trial was conducted on mesiodens patients who were seen in our department (patients with one mesiodens were included).

PREDICTOR VARIABLE

The predictor variable was surgical approach either with or without the surgical assistance aid. Subjects were randomized to one of the two study groups. For subjects assigned to the group using the surgical assistance guide, the approach was selected according to the aid detailed in this study. For subjects assigned to the group without the surgical assistant aid, 2 residents chose an approach based on their judgment and review of relevant imaging and physical examination.

MAIN OUTCOME VARIABLES

The preoperative evaluation time, operative time, and complications associated with surgery were recorded separately for the two groups.

COVARIATES

The age and sex were also recorded.

ANALYSES

Variables were analyzed using the independent t-test and χ2 test. The level of statistical significance is P < .05.

RESULTS

In the retrospective trial part, a new surgical assistance aid for mesiodens extraction was developed based on the ideal surgical approach. In the prospective randomized controlled trial, the experimental group (n = 50) was statistically significant in preoperative evaluation time (4.51 ± 0.34 mins vs 5.43 ± 0.34 mins) and operative time (31.87 ± 5.57 mins vs 36.32 ± 5.28 mins) compared to the control group (n = 50) (P < .001). There was no significant intergroup difference in complications associated with surgery (P > .05).

CONCLUSION AND RELEVANCE

The new surgical assistance aid developed in this study guides surgeons to ease the selection of surgical approaches and shorten the operative time.

Development of a minimally invasive surgical guide template for flapless extraction of deeply impacted premolars: A technical note and case report

The emergence of digital surgical guide templates in alveolar surgery has rapidly increased in the past decade, coinciding with the advancements in 3D printing technology. In contrast to conventional freehand procedures, the utilization of digital templates serves as a 'bridge' that facilitates the extraction of impacted teeth with expedited and accurate intraoperative localization, resulting in a notable reduction in surgical duration, minimized trauma, and lowered risk. However, there is significant scope for enhancements in surgical techniques and refinement of surgical guide templates. The purpose of our study was to employ an innovative surgical guide template founded on computer-aided design for the purpose of executing flapless extraction of deeply impacted teeth and investigating a surgical approach that is more effective, secure, and less invasive.