Health Condition 1: K011- Impacted teeth
Conditions
Interventions
Intervention1: Group A -
Coronectomy with MTA Pulpotomy
: Group A Coronectomy without MTA Pulpotomy
A standard coronectomy will be performed under local anesthesia. The crown will be sectioned a
Sponsors
All India Institute of Medical Sciences
Eligibility
Inclusion criteria
Inclusion criteria: 1. Patients aged 18 to 50 years, classified as ASA I according to the American Society of Anesthesiologists classification, with indications for extraction of impacted mandibular third molars due to dental caries, caries in adjoining mandibular second molar or history of recurrent pericoronitis or periodontal disease. 2. Radiographic markers on panoramic X-rays: Radiographic assessment revealed one or more high-risk indicators as defined by Rood and Shehab, including increased radiolucency at the root apex, root narrowing, or disruption of the radiopaque border of the inferior alveolar nerve canal (IANC), indicating close proximity to the inferior alveolar nerve. 3. Cone-Beam Computed Tomography (CBCT) confirmation demonstrated direct contact between the root and the mandibular canal, with the absence of intervening cortical bone.
Exclusion criteria
Exclusion criteria: Exclusion Criteria: 1. Patients with systemic conditions (uncontrolled diabetes, bleeding disorders etc ) , history of radiotherapy contraindicating surgical procedures. 2. Infection or periapical pathology involving the Impacted third molar region. 3. Pre-existing IAN injury or neurological deficits. 4. Non-vital teeth, caries extending to the root, periapical infection and immature root apex. 5. Mobility of root during coronectomy. 6. Patients not willing to provide informed consent. 7. Patients with a history of tobacco use in any form, including smoking and smokeless tobacco (e.g., pan, gutka).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Primary Outcomes: 1. Postoperative Pain: Measured using the Visual Analog Scale (VAS) at 6, 12, 24, and 48 hours, comparing pain reduction and total analgesic consumption between the MTA pulpotomy and coronectomy groups. 2. Postoperative Swelling: Assessed using facial measurements on Days 1, 3, and 7 post-surgery. Quantified using facial measurements (tragus-commissure and tragus-pogonion distance), comparing preoperative and postoperative values. 3. Inferior Alveolar Nerve (IAN) Injury: Assessed clinically for signs of paresthesia or dysesthesia in the area of the IAN/ mental nerve distibution, evaluated during follow-up visits day 1 and at 1 week using von frey monofilament fibres. Timepoint: Primary Outcomes: 1. Postoperative Pain: Measured using the Visual Analog Scale (VAS) at 6, 12, 24, and 48 hours, comparing pain reduction and total analgesic consumption between the MTA pulpotomy and coronectomy groups. 2. Postoperative Swelling: Assessed using facial measurements on Days 1, 3, and 7 post-surgery. Quantified using facial measurements (tragus-commissure and tragus-pogonion distance), comparing preoperative and postoperative values. 3. Inferior Alveolar Nerve (IAN) Injury: Assessed clinically for signs of paresthesia or dysesthesia in the area of the IAN/ mental nerve distibution, evaluated during follow-up visits day 1 using von frey monofilament fibres. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Healing and Infection: Assess secondary intention healing and the incidence of postoperative infection (pus). 2. Post-operative Root Migration: Changes in the position of the retained root relative to anatomical landmarks on follow-up radiographs (OPG or CBCT) at 3, 6, and 12 months. 3. Patient-Reported Satisfaction and Quality of Life: Assessed using a custom 5-point Likert scale for satisfaction, ease of recovery, and willingness to undergo the procedure again if needed Timepoint: Healing and infection- 1 Week 3 week Postoperative root migration- 3, 6 and 12 months Patient reported satisfaction and quality of life - 1 week postoperatively | — |
Countries
India
Contacts
Public ContactVijay Yadav
All India Institute Of Medical Sciences (AIIMS)
Outcome results
None listed