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Ectopic third mandibular molar: evaluation of surgical practices and meta-analysis
Julia Caillet1,2,3, Bruno Pereira4, Romain Courtot1,2,3
1Oral and Maxillofacial Department, Estaing Hospital, CHU Clermont Ferrand, 1 Place Lucie Aubrac, 63003, Clermont Ferrand Cedex 1, France.
Clinical Oral Investigations
|June 17, 2021
Summary
The preferred surgical approach for ectopic third mandibular molars (ETMM) is intra-oral, unless the molar is condylar or a cutaneous fistula is present, necessitating an extra-oral approach. Grafting or osteosynthesis is indicated for condylar ETMM.
Area of Science:
- Oral and Maxillofacial Surgery
- Dental Implantology
- Surgical Oncology
Background:
- Ectopic third mandibular molars (ETMM) present unique surgical challenges.
- Determining the optimal surgical approach and reconstructive techniques for ETMM is crucial for patient outcomes.
Purpose of the Study:
- To identify the preferred surgical approach (intra-oral vs. extra-oral) for ETMM removal based on location and associated pathology.
- To determine indications for bone grafting or osteosynthesis in ETMM management.
Main Methods:
- A surgical practice questionnaire was distributed to oral and maxillofacial surgeons.
- A systematic literature review and meta-analysis were conducted using major databases (PubMed, Cochrane, Embase, ScienceDirect).
- Keywords included "Ectopic teeth", "Third molar", and "Mandibular".
Main Results:
- Intra-oral approach is preferred unless the ETMM is condylar (extra-oral preferred).
- Extra-oral approach is indicated for cutaneous fistulas (90% vs. 35.9%).
- Cysts did not influence the surgical approach, but condylar location and cutaneous fistulas impacted the need for grafts or osteosynthesis.
Conclusions:
- The preferential surgical approach for ETMM is intra-oral, with exceptions for condylar locations or cutaneous fistulas.
- Osteosynthesis or grafts are more likely indicated for condylar ETMM.
- This study provides guidance for surgeons managing ETMM treatment.
