Month: May 2017

Using Dexmedetomidine For Wisdom Teeth Surgery

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An interesting article titled “Sedation Protocol Using Dexmedetomidine for Third Molar Extraction” appears in the 2016 Journal of Oral and Maxilofacial Surgery written by Dae-Seung Ryu and et. al. (vol. 74, pp. 926.e1-926.e7). The article seems to determine a sedation protocol for dexmedetomidine. The authors state that IV sedation is often given in cases of wisdom teeth surgery with midazolam being a medication commonly used. When midazolam is combined with opioids it can cause respiratory depression. Dexmedetomidine is an alpa2-agonist acting on adrenoceptors in many tissues, including those in the nervous, cardiovascular, and respiratory systems. Compared with midazolam, the major advantage of dexmedetomidine is its minimal effect on the respiratory system. It also produces an analgesic effect which can help alleviate the sensation of pain after tooth extraction. The authors set out to study the pain, patient satisfaction, sedation depth, and adverse effects after wisdom teeth extraction using dexmedetomidine and to compare IV and intranasal (IN) routes of administration. The … Read more

Retrieving a Broken Dental Needle Using a Minimally Invasive Technique

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An interesting article titled “Use of Intraoperative Navigation for Minimally Invasive Retrieval of a Broken Dental Needle” appears in the 2015 Journal of Oral and Maxillofacial Surgery and written by Kyle M. Stein (vol. 73, pp. 1911-1916). The article describes retrieving a broken dental needle using a Medtronic StealthStation S7 surgical navigation system. The use of disposable needles in dentistry has rendered the occurrence of needle breakage an extremely rare event. However, this complication continues to occur, and can be caused by improper technique, inappropriate armamentarium, and unexpected patient movement. I have described a few cases of this occuring on the wisdom teeth complications page at http://www.teethremoval.com/complications.html. In almost every case, needle breakage occurs when an inferior alveolar nerve block is administered with 30-gauge short needles. In the article a case of a 13 year old female had a broken dental … Read more

Do Mesial Angled Wisdom Teeth Cause Problems to Adjacent Second Molars

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An interesting article titled “Mesial Inclination of Impacted Third Molars and Its Propensity to Stimulate External Root Resorption in Second Molars—A Cone-Beam Computed Tomographic Evaluation” written by Anne Caroline Costa Oenning and et al. appears in the 2015 Journal of Oral and Maxillofacial Surgery (vol. 73, pp. 379-386). The authors explore cone-beam computed tomography (CBCT) scans to look at the teeth in the mouth. They look at the  presence of external root resorption (ERR) in second molars adjacent to horizontally and mesioangular impacted mandibular wisdom teeth. Unlike cavities, ERR is usually asymptomatic and aseptic, unless the pulp cavity has been involved or the lesion has been secondarily infected. Literature attributes the occurrence of this resorption to pressure from an adjacent impacted tooth. This pressure can activate clastic cells responsible for triggering resorption. Studies of periapical and panoramic radiographs have looked … Read more

Extraction of High Risk Impacted Upper Wisdom Teeth

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An interesting article titled “Orthodontic Extraction of High-Risk Impacted Mandibular Third Molars in Close Proximity to the Mandibular Canal: A Systematic Review,” written by Mahmood Reza Kalantar Motamedi and et al. appears in the 2015 Journal of Oral and Maxilofacial Surgery (issue 73, pp. 1672-1685). The article describes extraction of lower wisdom teeth in close proximity to the mandibular canal which is high risk and called orthodontic extraction. The authors searched for case reports, case series, retrospective analyses, and clinical trials that reported orthodontic extraction of wisdom teeth with high risk of inferior alveolar nerve injury. The study population included patients scheduled for elective surgical removal of impacted mandibular wisdom teeth in close proximity to the mandibular canal as visualized by radiographic examination. Various databases were searched. The selected studies consisted of publications from August 1996 to March 2014 and the number of impacted mandibular wisdom teeth ranged … Read more