Aim: The aim of our study is to demonstrate that the presence of upper wisdom teeth must be evaluated before and during Le Fort I osteotomy because attention must be focused to the disadvantages or facilitations of surgery depending on molar presence.
Materials of study: Our study has analyzed two groups, each one including 20 patients, 10 males and 10 females, with an age between 16-30 years. The first group was treated with le Fort I osteotomy leaving in situ the wisdom upper third molars. The second group was treated with Le Fort I osteotomy after the extraction of the wisdom upper third molars.
Results: Group A: upper third molar avulsion, necessary in 5 cases, was the main reason for prolongation of surgical time. However, in group A, increased bleeding occurred in 3 cases, bone irregularities and bone interferences occurred in 2 cases, neurological injuries occurred in 2 cases, any complications occurred in 8 cases. Group B: the management of the hemorrhage resulting from the vascular injuries, occurred in 7 cases, was the main reason for prolongation of surgical time. However, in group B, bone irregularities and bone interferences occurred in 4 cases, neurological injuries occurred in 3 cases, any complication occurred in 6 cases.
Discussion: In literature is actually discussed the risks related to the presence of lower third molars during mandibular osteotomies.
Conclusions: Our study is designed to be helpful to the beginner surgeons during them first time approach to this kind of surgery.
Key words: Retained third molar, Le Fort I osteotomy, Wisdom teeth extraction.
L’avulsione del terzo molare superiore nei paziente sottoposti a chirurgia mascellare nell’ambito della chirurgia ortognatica deve essere valutata di volta in volta in base allo specifico caso clinico dal momento che può comportare vantaggi e svantaggi. Nel nostro studio abbiamo preso in considerazione due gruppi entrambi composti da 20 pazienti, 10 maschi e 10 femmine di età compresa tra i 16 e i 30 anni, sottoposti ad osteotomia di Le Fort tipo I. Nel primo gruppo il terzo molare superiore è stato lasciato in situ, nel secondo gruppo si è proceduto ad avulsione dello stesso. I parametri che abbiamo valutato sono stati: tempo chirurgico, danno vascolare, danno alle strutture nervose, irregolarità ossee residue. La comparazione dei risultati, alla luce dei parametri sopracitati non ha portato a differenze significative, ecco perché la conclusione del nostro lavoro è stata quella di valutare di volta in volta, in base al plannig chirurgico, l’eventuale o meno avulsione preoperatoria del terzo molare superiore.