Tag Archives | wisdom teeth risks

Management of Wisdom Teeth 2016 AAOMS Updates

The American Association of Oral and Maxilofacial Surgeons (AAOMS) has some additional information they appear to have added more recently to their third molar research news section. For those considering how to best manage their wisdom teeth they should take a look at http://www.aaoms.org/docs/govt_affairs/advocacy_white_papers/management_third_molar_white_paper.pdf and http://www.aaoms.org/images/uploads/pdfs/management_third_molar_supporting_information.pdf. The first document describes what many different oral surgeons groups including AAOMS currently suggest for managing wisdom teeth. The article says “There are a variety of recognized management choices for third molars, including removal, partial removal (coronectomy), retention with active clinical and radiographic surveillance, surgical exposure, tooth repositioning, transplantation, surgical periodontics, and marsupialization of associated soft tissue pathology with observation and possible secondary treatment.” The article says that a decision to remove or retain healthy asymptomatic wisdom teeth should be made before a patient is 30. The position statement is said “Predicated on the best evidence-based data, third molar teeth that are associated with disease, or are at high risk of developing disease, should be surgically managed. In the absence of disease or significant risk of disease, active clinical and radiographic surveillance is indicated.” When wisdom teeth have no disease and no symptoms the surgeon should review the likelihood of pathology developing in the […]

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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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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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Does Not Treating Asymptomatic Wisdom Teeth Cause Harm?

An interesting article appears in the July 2015, British Dental Journal, titled “Revolution vs status quo? Non-intervention strategy of asymptomatic third molars causes harm” written by V. Toedtling and J. M. Yates (vol. 219, no. 1, pp. 11-12.) The article addresses how the Faculty of Dental Surgery of the Royal College of Surgeons of England has asked the National Institute for Health Care Excellence (NICE) to re-assess their guidance on wisdom teeth extractions. This is because the group and doctors feel that there is an increasing amount of distal-cervical caries (cavities) in lower second molar teeth (teeth right next to wisdom teeth) when associated with asymptomatic partially erupted mesial or horizontally impacted lower wisdom teeth (mandibular third molars). The authors say that NICE has been reluctant to re-appraise their 2000 guidance and guidelines on wisdom teeth removal. The authors point out that these guidelines were based partially off of a report which refers to research that is 3 decades old (at the time of the guidance). This report showed that there is a very low rate of distal cervical caries in lower second molars (1 to 4.5% incidence). The authors say because so many wisdom teeth were prophylactically extracted during […]

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Measuring Lingual Position of Lower Wisdom Teeth

An interesting study titled “Measurement of the Lingual Position of the Lower Third Molar Roots Using Cone-Beam Computed Tomography,” appears in the January 2015 issue of the Journal of Oral and Maxilofacial Surgery (vol. 73, issue 1) and written by Yusuf Emes and et al. The authors set out to use Cone-beam computed tomography (CBCT) to evaluate the proximity of lower wisdom teeth roots to the lingual cortex, which can be used to determine the potential risk of root displacement during lower wisdom teeth removal. The study used CBCT images of 32 impacted lower wisdom teeth of 31 patients (5 men and 26 women). The images were collected for reasons not related to surgery including impacted teeth, dental implants, and cysts of the jaws. An evaluation was performed independently by 2 trained oral and maxillofacial surgeons who were experienced in the radiographic evaluation of maxillofacial anatomy. The teeth were grouped according to their positions on the orthopantomogram as vertical, mesioangular, horizontal, and distoangular. Two measurements were performed for each tooth. If 1 tooth had more than 1 root, the root in the most lingual position was considered: 1) the distance from the root apex of the tooth, which is in […]

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