Analysis of the use of open technique in Eruptioned Third Molars / Análise do uso da técnica aberta em Terceiros Molares em Erupção

Samuel Rocha França, Josfran da Silva Ferreira Filho, Marcelo Bonifácio da Silva Sampieri, Dandara Rodrigues de Vasconcelos, Gislayne Nunes de Siqueira, Marcelo Ferraro Bezerra, Rodrygo Nunes Tavares, Nara Juliana Custódio de Sena


Purpose: To describe the clinical situations in which the open technique was used after the attempt to use the closed technique in surgical procedures for extraction of lower third molars of 1A classification. Methodology: Lower third molar extractions were performed at the University Department of Sobral Oral and Maxillofacial Surgery and Traumatology from September 2016 to May 2019. Seventy-three patients aged 18 to 38 years, ASA I and II, with indications for extraction of fully erupted vertical IA classification third molars were selected for research. Results: The sample consisted of 73 patients, in which 90 lower 1A vertical molar extractions were performed. Regarding the outline of the surgical technique, of the 90 surgeries performed, only 22 followed the previous planning. Of the 69 surgeries that had alterations in the technique, 64 had failures regarding dislocation and removal of the tooth via the socket and 4 presented trans-surgical accidents such as corono-radicular fractures, leading the surgeon to transalveolar extraction. Conclusion: Root anatomy, previously evaluated by imaging exams, may directly influence the type of technique to be recommended for removal of lower third molars of vertical IA classification, it is necessary to evaluate and question the classification of root types to assist in the preoperative planning of this type of tooth, optimizing the surgical time.


Panoramic Radiography, Third Molar, Unerupted Tooth, Tooth Extraction.

Full Text:



Badenoch-Jones EK, Lynham AJ, Loessner D. Consent for third molar tooth extractions in Australia and New Zealand: a review of current practice. Aus Dent Journal 2016; 61: 203–207.

Barbosa-Rebellato NL, Thomé AC, Costa-Maciel C, Oliveira J, Scariot R. Factors associated with complications of removal of third molars: a transversal study. Med Oral Patol Oral Cir Bucal 2010;16 (3):376-80

Baqain ZH, Karaky AA, Sawair F, Khraisat A, Duaibis R, Rajab LD. Frequency estimates and risk factors for postoperative morbidity after third molar removal: a prospective cohort study. J Oral Maxillofac Surg 2008; 66:2276-83.

Carter K. Worthington S. Predictors of third molar impaction: a systematic review and meta-analysis. J Dent Research 2016; 95(3):267–76.

Chuang SK, Perrott DH, Susarla SM, Dodson TB. Risk factors for inflammatory complications following third molar surgery in adults. J Oral Maxillofac Surg. 2008; 66: 2213-8.

Lee CTY, Shinan Z, Yiu YL, Li KYS, Cissy CT, Chun-Hung C. Patients’ satisfaction and prevalence of complications on surgical extraction of third molar. Patient Prefer Adherence 2015; 9:257–263.

Winter GB. Impacted mandibular third molar. St. Louis: American Medical Book; 1926

Johnson TM, Badovinac R, Shaefer, J. Teaching alternatives to the standard inferior alveolar nerve block in dental education: outcomes in clinical practice. J Dent Educ. 2008; 71:1145–52.

Ellis E 3rd, Hupp JR, Tucker MR. Contemporary Oral and Maxillofacial Surgery. 6ª ed.Guanabara Koogan: Rio de Janeiro; 2016.

Sampieri MBS, Viana FLP, Cardoso CL, Vasconcelos MF, Vasconcelos MHF, Gonçales ES. Radiographic study of mandibular third molars: evaluation of the position and root anatomy in Brazilian population. Oral Maxillofac Surg 2018; 22(2):163–8

Juodzbalys G, Daugela P. Mandibular third molar impaction: review of literature and a proposal of a classification. J Oral Maxillofac Res 2013;4:e1.

Ruga E, Gallesio C, Boffano P. Mandibular Alveolar Neurovascular Bundle Injury Associated with Impacted Third Molar Surgery. The Journal of Craniofacial Surgery 2010; 21(4): 1175-7

Komerik N, Muglali M, Tas B, Selcuk U. Difftculty of Impacted Mandibular Third Molar Tooth Removal: Predictive Ability of Senior Surgeons and Residents. J Oral Maxillofac Surg 2014; 72:1062. e1-1062.e6.

Osunde OD, Saheed BD. Effect of Age, Sex and Level of Surgical Difficulty on Inflammatory Complications After Third Molar Surgery. J. Maxillofac. Oral Surg 2015; 14(1):7–12.

Patel S, Mansuri S, Shaikh F, Shah T. Impacted Mandibular Third Molars: A Retrospective Study of 1198 Cases to Assess Indications for Surgical Removal, and Correlation with Age, Sex and Type of Impaction—A Single Institutional Experience. J. Maxillofac. Oral Surg 2017; 16(1):79–84.

Ghaeminia H, Meijer GJ, Soehardi A, Borstlap WA, Mulder J, Bergé SJ. Position of the impacted third molar in relation to the mandibular canal. Diagnostic accuracy of cone beam computed tomography compared with panoramic radiography. Int J Oral Maxillofac. Surg 2009; 38: 964–71.

Hasegawa T, Ri S, Shigeta T, Akashi M, Imai Y, Kakei Y, et al. Risk factors associated with inferior alveolar nerve injury after extraction of the mandibular third molar—a comparative study of preoperative images by panoramic radiography and computed tomography. Int J Oral Maxillofac Surg 2013; 42:843–51.

Barreiro-Torres J, Diniz-Freitas M, Lago-Méndez L, Gude-Sampedro F, Gándara-Rey JM, García-García A. Evaluation of the surgical difficulty in lower third molar extraction. Med Oral Patol Oral Cir Bucal. 2010 1;15 (6):e869-74.

Uribe S. Radiographic prediction of inferior alveolar nerve injury in third molar surgery. Evid Based Dent 2017; 18(3):88-89.

Peker I, Sarikir C, Alkurt MT, Zor ZF. Panoramic radiography and cone-beam computed tomography findings in preoperative examination of impacted mandibular third molars. BMC Oral Health 2014,14(3) :71.

Maruthingal S, Mohan D, Maroli RK. A comparative evaluation of 4% articaine and 2% lidocaine in mandibular buccal infiltration anaesthesia: A clinical study. J Int Soc Prev Commun Dent 2015;5(6): 463–9.

Maria, L. et al. Brazilian Journal of health Review Complicated coronorradicular fracture : Brazilian Journal of health Review. n. 21, p. 2231–2242, 2020.



  • There are currently no refbacks.