Surgical Tip of the Week #3

How To Avoid IAN Injury - Notching

A quality panoramic x-ray is sufficient when assessing possible IAN injury while removing third molars. Nine panoramic radiographic markers can reliably predict IAN injury. A CT is recommended when injury is likely.

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NOTCHING

Notching, like grooving, is caused by the developing tooth contacting the inferior alveolar canal. In this case, the tooth root develops directly above the canal. This is seen on a radiograph as a radiolucent third molar apex and loss of the top white line as the canal passes over the root. The dark apex may also indicate an open apex for young patients whose third molar roots are still developing. Notching increases the possibility of IAN paresthesia.

Notching

  • Flap
  • Trough
  • Section
  • Split
  • Remove
  • Debride & Irrigate
  • Close

Surgical Tip of the Week #14 – 7 Steps for Predictable Removal of Mandibular Third Molar Impactions

STEP 1 FLAP Many flap designs will work. The two most popular flaps for impacted third molars are the triangular and envelope. Western Surgical and Sedation recommends a large envelope flap starting distal to the second premolar (including papilla) and ending 1-1.5 cm...

Surgical Tip of the Week #13 – “S” Flap

"S" FLAP There are many flap designs recommended for the removal of impacted third molars. Western Surgical and Sedation’s STOW will discuss four different flap designs: envelope, triangle, modified triangle, and “S” flap. The most commonly recommended flaps are the...

Surgical Tip of the Week #12 – Modified Triangle Flap

MODIFIED TRIANGLE FLAP There are many flap designs recommended for the removal of impacted third molars. Western Surgical and Sedation’s STOW will discuss four different flap designs: envelope, triangle, modified triangle, and “S” flap. The most commonly recommended...

Surgical Tip of the Week #11 – Triangular Flap

TRIANGULAR FLAP There are many flap designs recommended for the removal of impacted third molars. Western Surgical and Sedation’s STOW will discuss four different flap designs: envelope, triangle, modified triangle, and “S” flap. The most commonly recommended flaps...