The Bone Lid Technique for Surgical Management of Deeply Impacted Mandibular Molars Associated with Pathological Lesions: A Case Series

Sezai Çiftçi; Hadi Nasrollahi; Bahar Maide Kösen

doi:10.29228/erd.128

TR EN

Patolojik Lezyonlarla İlişkili Derin Gömülü Mandibular Molarların Cerrahi Yönetiminde Bone Lid Tekniği: Bir Olgu Serisi

Abstract

Amaç: Mevcut literatürde, bone lid yaklaşımının patolojik lezyonlarla ilişkili derin gömülü mandibular molar dişlerde kullanımına ilişkin klinik veriler sınırlıdır. Bu olgu serisinin amacı, bone lid yaklaşımının patolojik lezyonlarla ilişkili derin gömülü mandibular molar dişlerin cerrahi tedavisindeki klinik sonuçlarını değerlendirmektir. Gereç ve Yöntemler: Bu çalışmaya, konik ışınlı bilgisayarlı tomografi (CBCT) ile derin gömülü olduğu doğrulanan ve mandibular molar dişlerle ilişkili patolojik lezyon tespit edilen üç hasta dahil edildi. Tüm hastalardan yazılı bilgilendirilmiş onam alındı. Tüm olgularda cerrahi tedavi bone lid yaklaşımı ile gerçekleştirildi. Patolojik lezyonlar cerrahi olarak enükle edildi ve ilişkili gömülü dişler aynı seansta çekildi. Postoperatif dönemde tüm hastalara 5 gün süreyle Antibiyotik (amoksilin 875 mg + klavulanik asit 125 mg, 12 saatte bir), analjezik (İbuprofen 600 mg 8 saate bir) ve %0,12 klorheksidin içeren antiseptik ağız gargarası (günde iki kez) reçete edilmiştir. Lezyonların kesin tanıları histopatolojik inceleme ile doğrulandı. Hastalar postoperatif dönemde 1. gün, 1. hafta, 1 ay, 3. ay, 6. ayda klinik ve radyolojik olarak takip edildi. Bulgular: İki hasta ağrı şikayeti ile başvururken, bir hastada herhangi bir semptom olmaksızın lezyon radyolojik inceleme sırasında tesadüfen saptanmıştır. Histopatolojik incelemeler sonucunda iki olguda dentigeröz kist, bir hastada ise Fokal semento-osseöz displazi (FSOD) tanısı konuldu. Takip süresince hiçbir hastada inferior alveolar sinir (İAS) hasarı, enfeksiyon, bukkal segment nekrozu ya da lezyon nüksü izlenmedi. Sonuç: Bone lid yaklaşımı, derin gömülü dişlerin ve ilişkili patolojik lezyonların tedavisinde yeterli cerrahi erişim sağlayan, kemik bütünlüğünü koruyan cerrahi bir seçenek olarak değerlendirilebilir.

Keywords

Ethical Statement

Bu çalışma, üç hastayı içeren bir vaka raporu niteliğindedir. Çalışmaya dahil edilen tüm hastalardan, bilimsel yayın amacıyla verilerinin kullanılmasına yönelik yazılı bilgilendirilmiş onam alınmıştır. Bu nedenle çalışma için etik kurul onayı gerekmemektedir.

The Bone Lid Technique for Surgical Management of Deeply Impacted Mandibular Molars Associated with Pathological Lesions: A Case Series

Abstract

Objective: In the current literature, clinical data regarding the use of the bone lid approach for deeply impacted mandibular molars associated with pathological lesions are limited. The aim of this case series is to evaluate the clinical outcomes of the bone lid approach in the surgical management of deeply impacted mandibular molars associated with pathological lesions. Materials and Methods: Three patients with deeply impacted mandibular molars confirmed by cone-beam computed tomography (CBCT) and associated pathological lesions were included in this study. Written informed consent was obtained from all patients. In all cases, surgical treatment was performed using the bone lid approach. The pathological lesions were surgically enucleated, and the associated impacted teeth were extracted during the same session. In the postoperative period, all patients were prescribed antibiotics (amoxicillin 875 mg + clavulanic acid 125 mg, twice daily for 5 days), analgesics (ibuprofen 600 mg every 8 hours), and an antiseptic mouthwash containing 0.12% chlorhexidine (twice daily). Definitive diagnoses of the lesions were confirmed by histopathological examination. Patients were followed clinically and radiologically on postoperative day 1, week 1, and at 1, 3, and 6 months. Results: Two patients presented with pain, whereas in one patient the lesion was incidentally detected during radiological examination without any symptoms. Histopathological evaluation revealed dentigerous cysts in two cases and focal cemento-osseous dysplasia (FCOD) in one case. During the follow-up period, no inferior alveolar nerve (IAN) injury, infection, buccal segment necrosis, or lesion recurrence was observed in any patient. Conclusion: The bone lid approach can be considered a surgical option that provides adequate access while preserving bone integrity in the management of deeply impacted teeth and associated pathological lesions.

Keywords

Ethical Statement

This study is a case report involving three patients. Written informed consent was obtained from all patients for the use of their clinical data for scientific publication purposes. Therefore, ethics committee approval was not required.

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Details

Primary Language

English

Subjects

Oral and Maxillofacial Surgery

Journal Section

Case Report

Authors

Sezai Çiftçi
0009-0000-7872-8956
Türkiye

Hadi Nasrollahi
0009-0001-1242-1967
Türkiye

Bahar Maide Kösen ^*
0009-0004-8936-0367
Türkiye

Publication Date

August 13, 2026

Submission Date

February 6, 2026

Acceptance Date

May 22, 2026

Published in Issue

Year 2026 Volume: 10 Number: 1

DOI

https://doi.org/10.29228/erd.128

IZ

https://izlik.org/JA93HF86EL

Cite

RIS / Bibtex

APA

Çiftçi, S., Nasrollahi, H., & Kösen, B. M. (2026). The Bone Lid Technique for Surgical Management of Deeply Impacted Mandibular Molars Associated with Pathological Lesions: A Case Series. European Journal of Research in Dentistry, 10(1), 43-49. https://doi.org/10.29228/erd.128

AMA

1.Çiftçi S, Nasrollahi H, Kösen BM. The Bone Lid Technique for Surgical Management of Deeply Impacted Mandibular Molars Associated with Pathological Lesions: A Case Series. Eur. J. res. Dent. (ERD). 2026;10(1):43-49. doi:10.29228/erd.128

Chicago

Çiftçi, Sezai, Hadi Nasrollahi, and Bahar Maide Kösen. 2026. “The Bone Lid Technique for Surgical Management of Deeply Impacted Mandibular Molars Associated With Pathological Lesions: A Case Series”. European Journal of Research in Dentistry 10 (1): 43-49. https://doi.org/10.29228/erd.128.

EndNote

Çiftçi S, Nasrollahi H, Kösen BM (August 1, 2026) The Bone Lid Technique for Surgical Management of Deeply Impacted Mandibular Molars Associated with Pathological Lesions: A Case Series. European Journal of Research in Dentistry 10 1 43–49.

IEEE

[1]S. Çiftçi, H. Nasrollahi, and B. M. Kösen, “The Bone Lid Technique for Surgical Management of Deeply Impacted Mandibular Molars Associated with Pathological Lesions: A Case Series”, Eur. J. res. Dent. (ERD), vol. 10, no. 1, pp. 43–49, Aug. 2026, doi: 10.29228/erd.128.

ISNAD

Çiftçi, Sezai - Nasrollahi, Hadi - Kösen, Bahar Maide. “The Bone Lid Technique for Surgical Management of Deeply Impacted Mandibular Molars Associated With Pathological Lesions: A Case Series”. European Journal of Research in Dentistry 10/1 (August 1, 2026): 43-49. https://doi.org/10.29228/erd.128.

JAMA

1.Çiftçi S, Nasrollahi H, Kösen BM. The Bone Lid Technique for Surgical Management of Deeply Impacted Mandibular Molars Associated with Pathological Lesions: A Case Series. Eur. J. res. Dent. (ERD). 2026;10:43–49.

MLA

Çiftçi, Sezai, et al. “The Bone Lid Technique for Surgical Management of Deeply Impacted Mandibular Molars Associated With Pathological Lesions: A Case Series”. European Journal of Research in Dentistry, vol. 10, no. 1, Aug. 2026, pp. 43-49, doi:10.29228/erd.128.

Vancouver

1.Sezai Çiftçi, Hadi Nasrollahi, Bahar Maide Kösen. The Bone Lid Technique for Surgical Management of Deeply Impacted Mandibular Molars Associated with Pathological Lesions: A Case Series. Eur. J. res. Dent. (ERD). 2026 Aug. 1;10(1):43-9. doi:10.29228/erd.128

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Open Access Policy
An old tradition and a new technology have converged to make possible an unprecedented public good. The old tradition is the willingness of scientists and scholars to publish the fruits of their research in scholarly journals without payment, for the sake of inquiry and knowledge. The new technology is the Internet. The public good they make possible is the worldwide electronic distribution of the peer-reviewed journal literature and completely free and unrestricted access to it by all scientists, scholars, teachers, students, and other curious minds. Removing access barriers to this literature will accelerate research, enrich education, share the learning of the rich with the poor and the poor with the rich, make this literature as useful as it can be, and lay the foundation for uniting humanity in a common intellectual conversation and quest for knowledge.

For various reasons, this kind of free and unrestricted online availability, which we will call open access, has so far been limited to small portions of the journal literature. But even in these limited collections, many different initiatives have shown that open access is economically feasible, that it gives readers extraordinary power to find and make use of relevant literature, and that it gives authors and their works vast, readership and impact. To secure these benefits for all, we call on all interested institutions and individuals to help open up access to the rest of this literature and remove the barriers, especially the price barriers that stand in the way. The more who join the effort to advance this cause, the sooner we will all enjoy the benefits of open access.

The literature that should be freely accessible online is that which scholars give to the world without expectation of payment. Primarily, this category encompasses their peer-reviewed journal articles, but it also includes any unreview preprints that they might wish to put online for comment or to alert colleagues to important research findings. There are many degrees and kinds of wider and easier access to this literature. By "open access" to this literature, we mean its free availability on the public internet, permitting any users to read, download, copy, distribute, print, search, or link to the full texts of these articles, crawl them for indexing, pass them as data to software, or use them for any other lawful purpose, without financial, legal, or technical barriers other than those inseparable from gaining access to the internet itself. The only constraint on reproduction and distribution, and the only role for copyright in this domain, should be to give authors control over the integrity of their work and the right to be properly acknowledged and cited.

While the peer-reviewed journal literature should be accessible online without cost to readers, it is not costless to produce. However, experiments show that the overall costs of providing open access to this literature are far lower than the costs of traditional forms of dissemination. With such an opportunity to save money and expand the scope of dissemination at the same time, there is today a strong incentive for professional associations, universities, libraries, foundations, and others to embrace open access as a means of advancing their missions. Achieving open access will require new cost recovery models and financing mechanisms, but the significantly lower overall cost of dissemination is a reason to be confident that the goal is attainable and not merely preferable or utopian.

To achieve open access to scholarly journal literature, we recommend two complementary strategies.
I. Self-Archiving: First, scholars need the tools and assistance to deposit their refereed journal articles in open electronic archives, a practice commonly called, self-archiving. When these archives conform to standards created by the Open Archives Initiative, then search engines and other tools can treat the separate archives as one. Users then need not know which archives exist or where they are located in order to find and make use of their contents.

II. Open-access Journals: Second, scholars need the means to launch a new generation of journals committed to open access, and to help existing journals that elect to make the transition to open access. Because journal articles should be disseminated as widely as possible, these new journals will no longer invoke copyright to restrict access to and use of the material they publish. Instead they will use copyright and other tools to ensure permanent open access to all the articles they publish. Because price is a barrier to access, these new journals will not charge subscription or access fees, and will turn to other methods for covering their expenses. There are many alternative sources of funds for this purpose, including the foundations and governments that fund research, the universities and laboratories that employ researchers, endowments set up by discipline or institution, friends of the cause of open access, profits from the sale of add-ons to the basic texts, funds freed up by the demise or cancellation of journals charging traditional subscription or access fees, or even contributions from the researchers themselves. There is no need to favor one of these solutions over the others for all disciplines or nations, and no need to stop looking for other.

Open access to peer-reviewed journal literature is the goal. Self-archiving (I.) and a new generation of open-access journals (II.) are the ways to attain this goal. They are not only direct and effective means to this end, they are within the reach of scholars themselves, immediately, and need not wait on changes brought about by markets or legislation. While we endorse the two strategies just outlined, we also encourage experimentation with further ways to make the transition from the present methods of dissemination to open access. Flexibility, experimentation, and adaptation to local circumstances are the best ways to assure that progress in diverse settings will be rapid, secure, and long-lived.

The Open Society Institute is committed to providing initial help and funding to realize this goal. It will use its resources and influence to extend and promote institutional self-archiving, to launch new open-access journals, and to help an open-access journal system become economically self-sustaining. While the Open Society Institute's commitment and resources are substantial, this initiative is very much in need of other organizations to lend their effort and resources.

We invite governments, universities, libraries, journal editors, publishers, foundations, learned societies, professional associations, and individual scholars who share our vision to join us in the task of removing the barriers to open access and building a future in which research and education in every part of the world are that much more free to flourish. Submitting a paper to ERD is free of charges. In addition, ERD has not have article processing charges.