Tag Archives | surgery

Controversy Over Spinal Fusion

Debate over spinal fusion surgery continues to occur. A recent article tiled “Spinal fusions serve as a case study for debate over when certain surgeries are necessary,” appears in the Washington Post written by Peter Whoriskey and Dan Keating and published on October 27, 2013. (Note I have previously mentioned some of the controversy over spinal fusion in the post Tips to Prevent Medical Errors – AHRQ) The article mentions that spinal fusions being performed in the U.S. has risen over the years and that around half of the surgeries they reviewed don’t meet expert consensus on when the surgery should be performed. This article discusses a surgeon at a Florida hospital who was earning well over a million a year performing spinal fusions on patients. Auditors at the hospital began to wonder if all the cases were necessary and […]

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Active Surveillance For Managing Retained Wisdom Teeth

An interesting expert opinion by Thomas B. Dodson appears in the Journal of Oral and Maxillofacial Surgery vol. 70, issue 9, supplement 1, pages 20-24, 2012, titled ” Surveillance as a Management Strategy for Retained Third Molars: Is It Desirable?”  The author opens by describing in the third paragraph that the treatment of symptomatic disease-free wisdom teeth can be challenging. The author states in the third paragraph “Absent good evidence, management decisions should incorporate the clinician’s experience and expertise, and after a careful, balanced review of the risks and benefits of both treatment options, weigh heavily the patient’s wishes and desires regarding extraction versus retention. The opinions in this chapter reflect the author’s personal decision-making process based on a careful literature review and clinical experience/expertise.” The author opens by describing his clinical classification of wisdom teeth rationale. He states that […]

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Looking at the Timing of Removal of Wisdom Teeth and It’s Effect on Complications

An interesting study by M. Anthony Pogrel titled “What Is the Effect of Timing of Removal on the Incidence and Severity of Complications?” appears in the Journal of Oral and Maxillofacial Surgery, vol. 70, issue 9, supplement 1, pages S37-S40, 2012. The author sets out to explore if younger patients (less than 25 years) have a decreased risk for postoperative complications than older patients.  The author begins by describing three studies in the literature that have shown that complications associated with wisdom teeth removal increase after 25 years of age. I have also mentioned several of these studies over at http://www.teethremoval.com/wisdomteeth.html. The author then goes on to discuss that recovery for patients of wisdom teeth surgery older than 21 may be delayed after extraction (by two studies). The author then discusses that mandibular fracture and tuberosity fracture may occur after […]

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Removing Wisdom Teeth May Improve The Periodontal Health of Remaining Teeth

An interesting article titled “Removal of Symptomatic Third Molars May Improve Periodontal Status of Remaining Dentition,” by Carolyn Dicus-Brookes and et al. appears in the Journal of Oral and Maxillofacial Surgery (vol. 71, pp. 1639-1646, 2013). The article seeks to explore the impact of removing wisdom teeth on the periodontal status of adjacent second molars and other teeth located in the mouth specifically for patients who have mild symptoms of pericoronitis. As discussed recently over at Upcoming Changes to JOMS and AAOMS in 2014, select articles in JOMS will have press releases written by AAOMS staff to accompany them. This is one of those articles so that feature appears to have already been rolled out. To get an idea of what the press release entails I will briefly describe it. It is very short (less than 10 sentences) and fits […]

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Wisdom Teeth Caries Experience and Periodontal Pathology in Young Patients

An interesting article explored the prevalence of caries experience and periodontal pathology on asymptomatic wisdom teeth in young adults appears in a 2012 issue of the Journal of Oral and Maxillofacial Surgery by Rachel N. Garaas and et al. titled “Prevalence of third molars with caries or periodontal pathology in young adults” (J Oral Maxillofac Surg. vol. 70, pages 507-513, 2012). The article seeks to help inform young adults who are seeking advice about the extraction or retention of wisdom teeth about if these teeth can remain symptom free or not. The study includes 409 patients with an average age of 25. The authors define a periodontal probing depth of at least 4 mm as indicative of periodontal inflammatory disease. The authors found that a periodontal probing depth of at least 4 mm was detected more often on a mandibular […]

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