Tag Archives | wisdom teeth extraction

Pneumomediastinum After Coronectomy

An interesting article titled “Surgical emphysema and pneumomediastinum after coronectomy” appears in the 2015 British Journal of Oral and Maxillofacial Surgery and written by C. Wong and et al. (vol. 53, pp. 763-764). The article describes a case of emphysema and pneumomediastinum occuring in an otherwise healthy 48 year old women after coronectomy of a lower wisdom tooth. This was determined by a chest x-ray after she presented with swelling and impaired eye opening. No surgery was necessary and after staying in the hospital several hours she was discharged. Around a week later the swelling had resolved. The authors say they do not know of any other cases of pneumomediastinum occuring after coronectomy; however, it is known to occur after wisdom teeth removal. See http://www.teethremoval.com/complications.html where a discussion of this occurs. It appears that an air turbine drill was used in this women’s case and introduced air into the mediastinum through the parapharyngealand retropharyngeal spaces. The authors state “Although pneumomediastinum usually resolves spontaneously in 3 to 10 days, potential complications include mediastinitis, cardiac tamponade, obstruction of the airway, simple or tension pneumothorax, and pneumoperitoneum.” The women appears to have recovered without any problems. In the article a picture of the women is provided shortly after coronectomy and then again 1 week after […]

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Exploring Mandibular Wisdom Teeth Roots after Coronectomy

Coronectomy involves the removal of part of the mandibular wisdom teeth but retention of the root. It is believed to cause less risk to the inferior alveolar nerve than extraction. An article on this topic titled “Histological evaluation of mandibular third molars roots retrieved after coronectomy,” appears in the 2015 British Journal of Oral and Maxilofacial Surgery and written by Vinod Patel and et. al (vol. 52, pp. 415-419). In the article the authors sought to find out the pulpal and periradicular status of retained roots of mandibular wisdom teeth and histologically evaluated coronectomy roots that were removed because of persistent symptoms. It is possible the roots had become infected. A total of 21 patients (with 26 roots) were included in their study with persistent symptoms after the roots had been retrieved. Of the 26 symptomatic roots, radiographic assessments showed coronectomy had been sufficient in twenty, but a shard of enamel had been retained on the root fragment in six. All roots were retrieved with no complications except for 1 which had persistent dsyfunction of the nerve. In their discussion the authors sate “This report is seminal as it shows that all the roots retrieved had a vital vascularised pulp, and in all cases the […]

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Painkiller Overdose in Michigan: Are Wisdom Teeth Extractions Contributing?

Before on this blog I have talked about how oral surgeons prescribe powerful painkillers for use after wisdom teeth removal. It is possible some of these painkillers are instead used for non-medical use. See the posts http://blog.teethremoval.com/comparing-narcotic-prescribing-habits-for-oral-surgeons-in-the-u-s-and-canada/ and http://blog.teethremoval.com/do-oral-surgeons-prescribe-too-many-narcotics-for-use-after-wisdom-teeth-removal/. An interesting article titled “Synder officials take on painkiller overdose ‘epidemic’” located at  http://www.detroitnews.com/story/life/wellness/2015/10/12/prescriptions/73798342/ and written by Gary Heinlein and Joel Kurth, discusses a surge in overdose deaths in Michigan linked to the abuse of pain and anxiety medications (Oct. 12, 2015). One of the cases describe how a man’s addiction to painkillers was aided by a 30-day prescription for Vicodin after his wisdom teeth extraction. The article states “The state’s health department has said overdose deaths linked to opioids were increasing at a faster rate than for illegal drugs such as heroin — also on the rise — and cocaine. A state report also noted that another class of medications called benzodiazepines — prescribed for anxiety — accounted for about 9 percent of deaths.” The governor of Michigan Rick Snyder has created a task force to explore the issue of painkiller overdose deaths. The drugs included those such as fentanyl, codeine and hydrocodone, or brand names such as OxyContin, Demerol and Vicodin. The article later says “According […]

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Wisdom Teeth Surgery: A Patient’s View

Many who come to this blog and website are of course interested in learning more about wisdom teeth removal. In the past I have posted some successful and positive wisdom teeth extraction experiences see http://blog.teethremoval.com/successful-and-positive-wisdom-teeth-removal-experiences/. Even so this site has more negative experiences. For those who want a more detailed positive experience from the surgery an article by Laura Pacey in the May 2014, British Dental Journal titled “Third Molar Surgery” is helpful (vol. 216, issue 9, pp. 490). The article is written by the assistant editor of the British Dental Journal and describes her experience with having three wisdom teeth extracted. As someone who works in the dental field of course she may be more knowledgeable than the average patient. She describes how she feared that she would become another ill-fated statistic concerning complications following wisdom teeth removal. Prior to surgery, she had a CBCT scan performed which revealed that the roots of her lower right wisdom teeth were connected to the nerve below and her lower left wisdom tooth was close to the inferior alveolar nerve. As such she had her upper right wisdom tooth extracted and coronectomy performed on both lower wisdom teeth. She also describes having […]

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A Study of 185 Coronectomy Procedures of Wisdom Teeth

An interesting article titled “Coronectomy of the Mandibular Third Molar: A Retrospective Study of 185 Procedures and the Decision to Repeat the Coronectomy in Cases of Failure,” appears in the April 2015 issue of the Journal of Oral and Maxillofacial Surgery written by Boaz Frenkel and et. al. (vol. 73, issue 4). The article seeks to evaluate the success rate of coronectomy and if failure occurs, retreatment. Coronectomy is an alternative extraction technique of wisdom teeth to prevent inferior alveolar nerve (IAN) injury in cases of root proximity to the IAN or complicated root anatomy of the mandibular wisdom teeth. The technique seeks to extract the crown of the mandibular wisdom teeth and leave the roots intact. Coronectomy is not without risks and complications and things such as infection, dry socket, and pain can occur in addition to healing that doesn’t fully resolve and root eruption. Coronectomy failure can be treated with reoperation (removal of the residual roots) or in some cases repeat coronectomy can occur. The study included 173 patients undergoing 185 coronectomy procedures between December, 2008, and October,  2012, at Sheba Medical Center in Israel.  Coronectomy was performed when orthopantographic imaging indicated close proximity of the roots of […]

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