Application of a surgical guide in the extraction of impacted mesiodentes: a randomized controlled trial
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ORIGINAL ARTICLE
Application of a surgical guide in the extraction of impacted mesiodentes: a randomized controlled trial Xianghuai Zheng 1 & Jianjiang Zhao 1 & Shuguang Liu 1 & Zhiping Wang 1 & Bo Jia 1 & Xi Lin 2 Received: 15 July 2020 / Accepted: 1 October 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objective To explore and evaluate the application of a surgical guide in the extraction of impacted mesiodentes. Materials and methods Patients with impacted mesiodentes approachable from the labial side of the maxilla were randomly divided into three groups. The surgical guide for group I was made using cone beam computed tomography (CBCT) and dental cast, whereas the surgical guide for group II was only made using CBCT data. Group I and group II were first evaluated to determine whether guide use could accurately locate the cementoenamel junction (CEJ) of the mesiodentes, and the impacted mesiodentes were extracted with the help of the surgical guide. Group III underwent an operation without a guide. For all patients, the preoperative design time, tooth searching time, operation time, complications, and costs were measured. Results The guides for group I and group II could locate the CEJ of the mesiodentes accurately, with good application effect during the operation. Group I and group II required additional preoperative design time compared with group III. However, the tooth searching time and operation time in groups I and II were significantly reduced compared with those in group III. Group I and group II showed no intraoperative complications, and two cases in group III showed imprecision during localization. The overall cost for group III was higher than that of group I or group II. But group I and group II required extra visits and costs. Conclusions Despite some limitations, the surgical guide assisted with mesiodentes extraction and can improve the quality of the operation quality as well as reducing its economic burden, difficulty, and duration. Through proper design, we can create a highquality surgical guide using only CBCT data. Clinical relevance The surgical guide can be used as an important assistive tool in alveolar surgery. Keywords CAD/CAM . Surgical guide . Mesiodens . Supernumerary teeth . Minimally invasive
Introduction Supernumerary teeth are an uncommon occurrence that have the ability to arise anywhere in the dental arch [1, 2]. A mesiodens is a supernumerary tooth present in the premaxilla, usually in the area of the midline between the two central
incisors [3, 4], with a prevalence of approximately 0.15 to 1.9% [5, 6]. Mesiodentes may occur as single, multiple, unilateral, or bilateral. Mesiodentes can be either erupted or impacted in alveolar bone, and they can be oriented vertically, horizontally, or in an inverted manner [7, 8]. Complications associated with mesiodentes include impaction of permanent
* Xi Lin [email protected] Xianghuai Zheng [email protected]
Bo Jia [email protected] 1
Department of Oral and Maxillofacial Surgery, Stomatologic
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