Tag Archives | Wisdom Teeth

Avoiding Amoxicillin During Wisdom Teeth: What are the Possible Problems

An interesting article titled “Dental Care Professionals Should Avoid the Administration of Amoxicillin in Healthy Patients During Third Molar Surgery: Is Antibiotic Resistence the Only Problem?” appears in the 2016 Journal of Oral and Maxilofacial Surgery written by Othoniel H. Aragon-Martinez and et al. (vol. 74, pp. 1512-1513). The authors attempt to explain why amoxicillin should not be used during wisdom teeth surgery. Amoxicillin is commonly used to prevent infections. Information from high quality clinical trials has shown that amoxicillin is not effective to reduce the risk of wound infections when it is received both preoperatively and postoperatively.  Recent evidence has shown that the administration of 250 mg of amoxicillin in healthy volunteers every 8 hours for 7 days produces  antibiotic resistance. The authors also discuss the topic of dysbiosis. Dysbiosis is a detrimental modification in the composition of the microbiome alongside altered microflora functions, which can be produced by antibiotic exposure, type of diet, lifestyle habits, and other factors. Amoxicillin causes marked alterations in fecal microbiota during the treatment course. Dysbiosis in can produce harmful changes in health, including the accumulation of antimicrobial resistances, increased susceptibility to infectious diseases, altered immune homeostasis, and deregulated metabolism. This could contribute to a delayed onset of local infection of wisdom tooth extraction. The author states “The present information suggests that intestinal and oral […]

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Are There Differences in Complications After Wisdom Teeth Surgery Depending on the Sedation Received?

An interesting article titled “Complications of Moderate Sedation Versus Deep Sedation/General Anesthesia for Adolescent Patients Undergoing Third Molar Extraction” appears in the 2016 Journal of Oral and Maxilofacial Surgery written by Gino Inverso and et al. (vol. 74, pp. 474-479).  The authors set out to determine if there is any difference in complications occurring after wisdom teeth surgery when patients are given either moderate sedation or deep sedation. For patients undergoing wisdom teeth surgery they may have some say in what level of sedation they receive and it may also be based on the desires of the surgeon. Specifically the authors examined the complications resulting from moderate sedation versus deep sedation/general anesthesia for adolescent patients undergoing wisdom teeth extraction. They sought to determine if any differences in complication risk exist between the two levels of sedation. The authors explored a database commissioned by the the American Association of Oral and Maxillofacial Surgeons (AAOMS) which is known as the Oral and Maxillofacial Surgery Outcomes System (OMSOS). A total of 79 surgeons in 58 sites across the 6 AAOMS districts participated in the data collection. The patients had data entered into the OMSOS from January 2001 to December 2010. The patients included in the present study had to be less than or equal to 21 and had wisdom teeth extracted in an ambulatory […]

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Do Mesial Angled Wisdom Teeth Cause Problems to Adjacent Second Molars

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 at the presence of ERR in second molars adjacent to impacted wisdom teeth. Most of these studies have reported a low prevalence of ERR in second molars ranging from 0.3% to 7%. Even so  cone-beam computed tomographic images have been compared with with panoramic images and the detection of ERR on second molars was found to 4.3 times greater with […]

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Extraction of High Risk Impacted Upper Wisdom Teeth

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 from 1 to 64, with a total of 143 cases of mandibular impactions. Of these, 123 underwent orthodontic extraction and only 2 patients developed temporary paresthesia. A panoramic radiograph was the primary diagnostic predictor in all the included studies. If the wisdom teeth was deemed to be in close proximity to the mandibular canal, then a CBCT or CT scan was ordered for […]

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AAOMS Wisdom Teeth Removal Benchmark Study

An interesting article titled “American Association of Oral and Maxillofacial Surgeons’ Anesthesia and Third Molar Extraction Benchmark Study: Rationale, Methods, and Initial Findings” written by Thomas B. Dodson and Martin L. Gonzalez appears in the 2016 Journal of Oral and Maxilofacial Surgery (vol. 74, pp. 903-910). In 2007 the American Association of Oral and Maxillofacial Surgeons (AAOMS) Board requested a benchmarking study to assess practice patterns and outcomes of oral and maxiofacial surgeons (OMS). The study period was 12 months and began June 1, 2011 and ended May 31, 2012. The study was designed to enroll 300 OMSs randomly selected from a list of all active private practice AAOMS members. The first sample included OMSs who had enrolled as practice-based research collaborative (P-BRC) participants. The second sample included patients treated by the OMSs participating in the P-BRC. To be eligible for inclusion in the P-BRC, the OMSs were required 1) to be in private practice, full or part-time; 2) to be delivering anesthesia services in the office-based ambulatory setting; 3) to be current AAOMS members; 4) to have Internet access; and 5) to have agreed to participate. To develop a P-BRC composed of randomly selected OMSs, a list of active […]

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