Trans-alveolar extraction: a spectacular oral surgical approach
DOI:
https://doi.org/10.18203/2320-6012.ijrms20261003Keywords:
Complicated, Exodontia, Surgical, Hypercementosis, Incisions, 2D gammaAbstract
Dental caries’ has significantly become a widespread disease, raising a serious global concern. In certain cases, when caries or other oral symptoms like root resorption, tooth ankylosis seem to happen beyond care; ‘dental extraction’ becomes inevitable. But, in various cases like retained roots; hypercementosis; impaction; bony sclerosis; where simple extraction is unable to eradicate the distress; “complicated exodontia” or “trans alveolar extraction” ranges the highest accord. A ‘trans alveolar extraction is a surgical approach’ to successful tooth removal necessary; when a tooth or root cannot be extracted with standard forceps methods, often, because of fracture or other difficulties. The particular "open" or "surgical" technique involves making incisions and exposing the tooth and the underlying jawbone; with the purpose of removing the tooth fragment. It may also owe to alarming post-operative complications, and over-time, studies have evaluated its incidence and management, while effective research highlighting patient demographics, the diagnostic tools like indices for surgical difficulty, and post-operative care with agents like topical ozone therapy is still in progress. This paper chiefly imparts special mention to ‘complicated exodontia’-the otherwise typically established oral surgical procedure.
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References
Malik N. Textbook of oral and Maxillofacial surgery. 2014. Available at: https://www.jaypeebrothers.com/. Accessed on 21 October 2025.
Howe GL. Minor Oral surgery. Available at: https://www.examplepublisher.com/minor-oral-surgery. Accessed on 21 October 2025.
Peterson LJ, Hupp JR. Contemporary Oral and maxillofacial Surgery. South East Asia publications. 2018;220-60.
Ozdemir-Ozenen D, Guler N, Sungurtekin-Ekci E, Sandalli N. Transalveolar repositioning of an impacted immature permanent mandibular canine. J Dent Child (Chic). 2014;81(3):156-60.
Plakwicz P, Kapuścińska A, Kukuła K, Czochrowska EM. Pulp revascularization after repositioning of impacted incisor with a dilacerated root and a detached apex. J Endod. 2015;41(6):974-9. DOI: https://doi.org/10.1016/j.joen.2015.01.034
Grisar K, Chaabouni D, Romero LPG, Vandendriessche T, Politis C, Jacobs R. Autogenous transalveolar transplantation of maxillary canines: a systematic review and meta-analysis. Eur J Orthod. 2018;40(6):608-16. DOI: https://doi.org/10.1093/ejo/cjy026
Kokich VG. Surgical and orthodontic management of impacted maxillary canines. Am J Orthod Dentofacial Orthop. 2004;126:278-83. DOI: https://doi.org/10.1016/j.ajodo.2004.06.009
Grover PS, Lorton L. The incidence of unerupted permanent teeth and related clinical cases. Oral Surg Oral Med Oral Pathol. 1985;59:420-5. DOI: https://doi.org/10.1016/0030-4220(85)90070-2
Bishara SE. Impacted maxillary canines: a review. Am J Orthod Dentofacial Orthop. 1992;101:159-71. DOI: https://doi.org/10.1016/0889-5406(92)70008-X
Alqerban A, Jacobs R, Lambrechts P, Loozen G, Willems G. Root resorption of the maxillary lateral incisor caused by impacted canine: a literature review. Clin Oral Investig. 2009;13:247-55. DOI: https://doi.org/10.1007/s00784-009-0262-8
Becker A, Chaushu S. Etiology of maxillary canine impaction: a review. Am J Orthod Dentofacial Orthop. 2015;148:557-67. DOI: https://doi.org/10.1016/j.ajodo.2015.06.013
Schatz JP, Joho JP. Indications of autotransplantation of teeth in orthodontic problem cases. Am J Orthod Dentofacial Orthop. 1994;106:351-57. DOI: https://doi.org/10.1016/S0889-5406(94)70055-9
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009;62:e1-34. DOI: https://doi.org/10.1016/j.jclinepi.2009.06.006
Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. The Cochrane Collaboration, Table 7.7.a: Formulae for combining groups. Wiley Blackwell. 2011. Available at: https://training.cochrane.org/handbook. Accessed on 21 October 2025.
Ahlberg K, Bystedt H, Eliasson S, Odenrick L. Long-term evaluation of autotransplanted maxillary canines with completed root formation. Acta Odontol Scand. 1983;41:23-31. DOI: https://doi.org/10.3109/00016358309162300
Arikan F, Nizam N, Sonmez S. 5-year longitudinal study of survival rate and periodontal parameter changes at sites of maxillary canine autotransplantation. J Periodontol. 2008;79:595-602. DOI: https://doi.org/10.1902/jop.2008.070409
Kvint S, Lindsten R, Magnusson A, Nilsson P, Bjerklin K. Autotransplantation of teeth in 215 patients. A follow-up study. Angle Orthod. 2010;80: 446-51. DOI: https://doi.org/10.2319/062509-354.1
Lownie JF, Cleaton-Jones PE, Fatti P, Lownie MA. Autotransplantation of maxillary canine teeth. A follow-up of 35 cases up to 4 years. Int J Oral Maxillofac Surg. 1986;15:282-7. DOI: https://doi.org/10.1016/S0300-9785(86)80086-2
Patel S, Fanshawe T, Bister D, Cobourne MT. Survival and success of maxillary canine autotransplantation: a retrospective investigation. Eur J Orthod. 2011;33:298-304. DOI: https://doi.org/10.1093/ejo/cjq071
Sagne S, Lennartsson B, Thilander B. Transalveolar transplantation of maxillary canines. An alternative to orthodontic treatment in adult patients. Am J Orthod Dentofacial Orthop. 1986;90:149-57. DOI: https://doi.org/10.1016/0889-5406(86)90047-8
Sagne S, Thilander B. Transalveolar transplantation of maxillary canines. A critical evaluation of a clinical procedure. Acta Odontol Scand. 1997;55:1-8. DOI: https://doi.org/10.3109/00016359709091932
Schatz JP, Joho JP. A clinical and radiologic study of autotransplanted impacted canines. Int J Oral Maxillofac Surg. 1993;22:342-6. DOI: https://doi.org/10.1016/S0901-5027(05)80663-0
Pogrel MA. Evaluation of over 400 autogenous tooth transplants. J Oral Maxillofac Surg. 1987;45:205-11. DOI: https://doi.org/10.1016/0278-2391(87)90116-9
Hall GM, Reade PC. Root resorption associated with autotransplanted maxillary canine teeth. Br J Oral Surg. 1983;21:179-91. DOI: https://doi.org/10.1016/0007-117X(83)90040-9
Andreasen JO, Paulsen HU, Yu Z, Ahlquist R, Bayer T, Schwartz OA. A long-term study of 370 autotransplanted premolars. Part I. Surgical procedures and standardized techniques for monitoring healing. Eur J Orthod. 1990;12:3-13. DOI: https://doi.org/10.1093/ejo/12.1.3
Hammarström L, Blomlöf L, Lindskog S. Dynamics of dentoalveolar ankylosis and associated root resorption. Endod Dent Traumatol. 1989;5:163-75. DOI: https://doi.org/10.1111/j.1600-9657.1989.tb00354.x
Schätzle M, Tanner SD, Bosshardt DD. Progressive, generalized, apical idiopathic root resorption and hypercementosis. J Periodontol. 2005;76:2002-11. DOI: https://doi.org/10.1902/jop.2005.76.11.2002
Hunter ML, Hunter B, Dhir AP, Shah B. General anaesthesia for exodontia in children: experience of a dental teaching hospital in relation to changes in national guidance. Int J Paediatr Dent. 2002 ;12(4):260-6. DOI: https://doi.org/10.1046/j.1365-263X.2002.00358.x
O'Brien M. Children's dental health in the United Kingdom 1993. London: HMSO. 1994. Available at: https://www.gov.uk/government/publications. Accessed on 21 October 2025.
Department of Health. General anaesthesia sedation and resuscitation in dentistry. Report of an expert working party. London: Department of Health. 1990.
Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/216247/dh_108193.pdf. Accessed on 21 October 2025.
Clinical Standards Advisory Group. Dental General Anaesthesia. London: HMSO. 1995. Available at: https://www.gov.uk/government/publications. Accessed on 21 October 2025.
Holt RD, Rule DC, Davenport ES, Fung DE. The use of general anaesthesia for tooth extraction in children in London: a multi-centre study. Br Dent J. 1992;173:333-9. DOI: https://doi.org/10.1038/sj.bdj.4808048
General Dental Council. General Dental Council: Maintaining Standards, Guidance to Dentists on Professional and Personal Conduct. London: General Dental Council. 1998. Available at: https://www.gdc‑uk.org/docs/default‑source/guidance‑documents/guidance‑on‑professional‑conduct‑personal‑behaviour.pdf. Accessed on 21 October 2025.
Department of Health. A Conscious Decision. A Review of the Use of General Anaesthesia and Conscious Sedation in Primary Dental Care. London: Department of Health. 2000. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/216291/dh_4002.pdf. Accessed on 21 October 2025.
Department of Health. The New Contract: an Operating Manual for Dentists. London: Department of Health. 1990. Available at: https://www.gov.uk/government/publications. Accessed on 21 October 2025.
Coventry P, Holloway PJ, Lennon MA, Worthington HV. A trial of a capitation system of payment for the treatment of children in the General Dental Service. Final Report. Community Dent Health. 1989;6(1).
Holt RD, Al Lamki S, Bedi R, Dowey JA, Gilthorpe M. Provision of dental general anaesthesia for extractions in child patients at two centres. Br Dent J. 1999;187:498-501. DOI: https://doi.org/10.1038/sj.bdj.4800314a
Verweij JP, Jongkees FA, Anssari Moin D, Wismeijer D, van Merkesteyn JPR. Autotransplantation of teeth using computer-aided rapid prototyping of a three-dimensional replica of the donor tooth: a systematic literature review. Int J Oral Maxillofac Surg. 2017;46:1466-74. DOI: https://doi.org/10.1016/j.ijom.2017.04.008
Shah A, Orchard K, Shakib K. Analysis of performed paediatric oral and maxillofacial procedures under general anaesthesia over a two-year period in a North London NHS Trust. Br J Oral Maxillofac Surg. 2021;59(8):912-20. DOI: https://doi.org/10.1016/j.bjoms.2020.09.039
Albadri SS, Lee S, Lee GT, Llewelyn R, Blinkhorn AS, Mackie IC. The use of general anaesthesia for the extraction of children’s teeth. Results from two UK Dental Hospitals. Eur Arch Paediatr Dent. 2023;1(2):112-7. DOI: https://doi.org/10.1007/BF03320825
Nagaven NB, Umashankara KV. Radix entomolaris and paramolaris in children: a review of the literature. J Indian Soc Pedod Prev Dent. 2012;30(2):94-102. DOI: https://doi.org/10.4103/0970-4388.99978
Hamza B, Papageorgiou SN, Patcas R, Schätzle M. Spontaneous space closure after extraction of permanent first molars in children and adolescents: a systematic review and meta-analysis. Eur J Orthod. 2024;46(6):cjae054. DOI: https://doi.org/10.1093/ejo/cjae054
Odai CD, Azodo CC, Ezeja EB, Obuekwe ON. Reasons for exodontia in rural Nigerian children. Odontostomatol Trop. 2010;33(132):19-24.
Conner ER, Musser ED, Colpitts KM, Laochamroonvorapongse DL, Koh JL. Perioperative opioid administration in children with and without developmental delay undergoing outpatient dental surgery. J Clin Anesth. 2017;37:92-6. DOI: https://doi.org/10.1016/j.jclinane.2016.12.006
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