Tag Archives | Wisdom Teeth

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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Trigeminal Nerve Surgery for Neuropathic Pain

An interesting article titled “Factors Determining Outcome After Trigeminal Nerve Surgery for Neuropathic Pain” appears in the July 2016 issue of Journal of Oral and Maxillofacial Surgery written by John R. Zuniga and David M. Yates. It is known that the inferior alveolar and lingual nerves which are part of the trigeminal nerves can be damaged after wisdom teeth surgery. Additional surgery can be performed to repair the trigeminal nerve but in some cases this injury remains and is only partially resolved. The others set out to better explore why neuropathic pain can persist after trigeminal nerve surgery. The study included 28 patients who underwent trigeminal nerve repair in Texas between 2006 and 2014. The patients were grouped into three different cohorts: 1) those who had no recurrence (NR) were any neuropathic pain went away, 2) those who had complete recurrence (CR) were the pain level of any neuropathic pain was the same postoperatively, and 3) those who had incomplete recurrence (ICR) were the pain intensity was below the pain intensity prior to surgery.  Seven patients were in the NR cohort (25%), ten were in the CR cohort (36%), and eleven were in the ICR cohort (39%). There were statistically significant differences found among groups at 3 months, […]

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Can you Use Low Level Laser Therapy After Wisdom Teeth Removal to Reduce Pain?

An interesting article titled “Is Low-Level Laser Therapy Effective in the Management of Pain and Swelling After Mandibular Third Molar Surgery?” appears in the July, 2016, issue of Journal of Oral and Maxillofacial Surgery and written by Majid Eshghpour, Farzaneh Ahrari, and Mohammad Takallu. The article seeks to explore if using low-level laser therapy after removing impacted wisdom teeth can reduce pain and swelling. In the study 40 patients included had lower impacted wisdom teeth on both sides. One side was subjected to lower level laser therapy and the other side just placebo. After removing wisdom teeth patients often experience pain, swelling, and tristmus for several days. Pain usually reaches a peak 3 to 5 hours after surgery while swelling peaks around 12 to 48 hours later. The trauma that occurs during surgery leads to inflammation which causes these other symptoms. Surgeons typically prescribe medications to help alleviate these concerns but these have side effects. Treatments like low level laser therapy are believed to be without side effects. The study took place in Iran and to be included the patients had to have lower wisdom teeth on each side similar in position and inclination. Patients with certain diseases were excluded from the study. It […]

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Computer Assisted Retrieval of Accidentally Displaced Wisdom Teeth

An article titled “Use of Computer-Assisted Navigation in the Retrieval of Accidentally Displaced Third Molars,” appears in the 2016 Journal of Oral and Maxilofacial Surgery, written by Yi Guo and et al., vol. 74, pp. 889-894. The article describes using a computer to retrieve accidentally displaced mandibular third molars. A total of 12 patients in the study successfully had their roots retrieved. They all healed successfully without complications. In rare cases when performing wisdom teeth surgery, a tooth or a tooth root can be displaced. When they are displaced into difficult to access areas surgery retrieving the displaced molars should be performed by conventional methods which include extending the original operative exposure or planning a new operative approach and then finding and removing the tooth. This surgery can cause severe tissue injury or complications. The paper discusses computer-assisted navigation in the retrieval of displaced mandibular third molars and to evaluate the effectiveness of this method. The criterion for using this technique of computer-assisted navigation involved teeth or tooth fragments that were displaced into difficult-to-access areas (sublingual space, pterygomandibular space, lateral pharyngeal space, submandibular space, and lateral cervical space). To localize the displaced mandibular third molar or root fragment computed tomographic […]

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Comparing Complications from Anesthesia with Wisdom Teeth Extractions

An article titled “Anesthesia Complications of Diazepam Use for Adolescents Receiving Extraction of Third Molars,” appears in the 2016 Journal of Oral and Maxilofacial Surgery by Gino Inverso and et. al, vol. 74, pp. 1140-1144. The article seeks to evaluate the safety of midazolam and diazepam for adolescents during wisdom teeth extraction and whether any differences in complications exist when using the 2 benzodiazepines alone or in combination. Compared with diazepam, midazolam has a faster onset of action, greater incidence of amnesia, and shorter recovery time. The authors hypothesized that diazepam, when used as an intravenous sedative agent for third molar extraction, would be associated with a higher rate of anesthetic complication than midazolam. The study included patients enrolled in the OMSOS from January 2001 through December 2010. To be included, patients had to be adolescents (<21 yr old) who underwent at least 1 third molar extraction by an oral and maxillofacial surgeon in the ambulatory setting. The study cohort was divided into 3 groups: patients who received diazepam as the only parenteral benzodiazepine, patients who received midazolam as the only parenteral benzodiazepine, and patients who received a combination of diazepam and midazolam. The primary outcome was perioperative anesthetic complications. Complications […]

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