Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons · 2026
Clinical Efficacy and Neurosensory Safety of a Standardized Management Protocol for Retrieval of Fractured Burs in Mandibular Third Molar Surgery: A Retrospective Cohort Analysis.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Nguyen Thuc Xuan, Pham Hai Thanh, Nguyen Loc Huu, Cao Nguyen Ngan My, Nguyen Tinh Trong
Аннотация
BACKGROUND: Iatrogenic surgical bur fracture is a rare, clinically significant complication in third molar surgery. A standardized management approach may prevent fragment migration and permanent neurosensory injury.
PURPOSE: This study evaluated the clinical efficacy and neurosensory safety of a standardized clinical management protocol for mandibular fractured bur retrieval.
STUDY DESIGN, SETTING, AND SAMPLE: A retrospective cohort study was conducted at the Artdentist Dental Clinic, with institutional affiliation and ethical approval from the Hai Phong Medical University Hospital. The sample included consecutive subjects with cone beam computed tomography-confirmed mandibular bur fragments (types 1 to 3) referred from 2023 to 2025. Exclusions comprised nonbur foreign bodies and incomplete records.
PREDICTOR VARIABLE: The primary predictor was anatomic localization of the fractured bur fragment: type 1 (intrabony fragment), type 2 (subperiosteal fragment), or type 3 (lingual soft tissue fragment).
MAIN OUTCOME VARIABLE(S): Clinical efficacy was defined by retrieval success (complete radiographic removal) and operative duration (minutes). Neurosensory safety was measured using objective and subjective neurosensory testing and complications.
COVARIATES: Variables included demographic (age and sex), radiographic, anatomic, and operative (operator experience and surgical approach) categories.
ANALYSES: Descriptive statistics and the Kruskal-Wallis test were used to compare operative duration across localization types. Statistical significance was set at P < .05.
RESULTS: The sample comprised 15 subjects (median age, 24.0 years; interquartile range [IQR], 21.0 to 30.0). Retrieval success was 100%. Fragment localization was statistically significantly associated with operative duration (P = .016). Type 3 retrievals using a lingual flap were fastest (median, 21.0 minutes; IQR, 15.5 to 23.5), compared to type 1 (median, 37.0 minutes; IQR, 31.0 to 48.5) and type 2 (median, 41.5 minutes; range, 31.0 to 52.0). Furthermore, fractures during tooth sectioning required longer retrieval times than those during bone removal (median, 46.0 minutes; IQR, 32.0 to 52.0 vs 27.0 minutes; IQR, 20.5 to 34.0; P = .009). No postoperative neurosensory deficits or complications occurred (n = 0/15).
CONCLUSIONS AND RELEVANCE: Guided by the cone beam computed tomography classification, this standardized protocol is highly effective for retrieving fractured burs. It achieved complete success, efficient operative durations, and neurosensory preservation.
PURPOSE: This study evaluated the clinical efficacy and neurosensory safety of a standardized clinical management protocol for mandibular fractured bur retrieval.
STUDY DESIGN, SETTING, AND SAMPLE: A retrospective cohort study was conducted at the Artdentist Dental Clinic, with institutional affiliation and ethical approval from the Hai Phong Medical University Hospital. The sample included consecutive subjects with cone beam computed tomography-confirmed mandibular bur fragments (types 1 to 3) referred from 2023 to 2025. Exclusions comprised nonbur foreign bodies and incomplete records.
PREDICTOR VARIABLE: The primary predictor was anatomic localization of the fractured bur fragment: type 1 (intrabony fragment), type 2 (subperiosteal fragment), or type 3 (lingual soft tissue fragment).
MAIN OUTCOME VARIABLE(S): Clinical efficacy was defined by retrieval success (complete radiographic removal) and operative duration (minutes). Neurosensory safety was measured using objective and subjective neurosensory testing and complications.
COVARIATES: Variables included demographic (age and sex), radiographic, anatomic, and operative (operator experience and surgical approach) categories.
ANALYSES: Descriptive statistics and the Kruskal-Wallis test were used to compare operative duration across localization types. Statistical significance was set at P < .05.
RESULTS: The sample comprised 15 subjects (median age, 24.0 years; interquartile range [IQR], 21.0 to 30.0). Retrieval success was 100%. Fragment localization was statistically significantly associated with operative duration (P = .016). Type 3 retrievals using a lingual flap were fastest (median, 21.0 minutes; IQR, 15.5 to 23.5), compared to type 1 (median, 37.0 minutes; IQR, 31.0 to 48.5) and type 2 (median, 41.5 minutes; range, 31.0 to 52.0). Furthermore, fractures during tooth sectioning required longer retrieval times than those during bone removal (median, 46.0 minutes; IQR, 32.0 to 52.0 vs 27.0 minutes; IQR, 20.5 to 34.0; P = .009). No postoperative neurosensory deficits or complications occurred (n = 0/15).
CONCLUSIONS AND RELEVANCE: Guided by the cone beam computed tomography classification, this standardized protocol is highly effective for retrieving fractured burs. It achieved complete success, efficient operative durations, and neurosensory preservation.