Wisdom Teeth

What to do with an Inverted (Upside Down) Impacted Wisdom Tooth?

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An interesting article titled “An unusual case of an inverted and impacted maxillary third molar,” written by Rammal and Alfonso appears in Oral Surgery in 2014 (vol. 7, pp. 109–111). The article discusses a case of an inverted and impacted upper wisdom tooth. In the article the authors discuss how there are seven possible positions that a tooth can be classified into and one of these is the inverted position where the the root apex faces the alveolar crest and the crown faces the maxillary sinus. In such a presentation the tooth appears as if it is growing into the maxillary sinus and the tooth clearly has no use for chewing in the mouth. The authors state: While inverted impacted third molars [wisdom teeth] remain dormant without significant manifestation, removal presents difficulty because of the need to remove large amounts … Read more

An Index to Assess Surgical Difficulty of Impacted Wisdom Teeth

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An interesting article titled “Development of a New Index to Assess the Difficulty Level of Surgical Removal of Impacted Mandibular Third Molars in an Asian Population,” written by Zhang et al. appears in the 2019 edition of the Journal of Oral and Maxillofacial Surgery. The article discusses development of an index to determine the surgical difficulty of impacted lower wisdom teeth. The authors discuss how historically the Pell and Gregory classification and the Winter classification provide a simple judgment on the difficulty level of tooth extraction. They also discuss the Pederson scoring system which assesses the difficulty of extracting impacted wisdom teeth using three factors using the position of the wisdom tooth, the relative depth, and the relation with the ramus. The Pederson scoring system calculates a score from 3 to 10 based on these three factors and then assigns … Read more

Reoperation in Wisdom Teeth Having Coronectomy

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An interesting article titled “What Are the Parameters for Reoperation in Mandibular Third Molars Submitted to Coronectomy? A Systematic Review,” appears in the 2019 edition of the Journal of Oral and Maxillofacial Surgery written by Barcellos et al. The article seeks to identify factors that are associated with needing a reoperation after having a lower wisdom tooth coronectomy. Coronectomy is often suggested to treat wisdom teeth where their is a belief their is a high chance of damage to the inferior alveolar nerve with their removal see for example Do People Know about Coronectomy For Management of Wisdom Teeth? and Coronectomy Five Year Follow Up. Typically such risk is assessed using panoramic radiography and cone-beam computed tomography. In the article the authors implemented a systematic review exploring articles on wisdom teeth coronectomy up until June 2018. A total of 362 studies … Read more

Do People Know about Coronectomy For Management of Wisdom Teeth?

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An interesting article titled “Coronectomy: a recognised procedure?” appears in the 2018 edition of Oral Surgery written by Dhanrajani and Smith (vol. 11, pp. 273-281). The article discusses a review of the literature on coronectomy to treat wisdom teeth along with a retrospective study. Coronectomy is often suggested to treat wisdom teeth when there is a high risk of nerve damage and is associated with a low rate of complications, see for example the past posts Care Guidelines for Wisdom Teeth: 2014 Finnish Guidelines, A Study of 185 Coronectomy Procedures of Wisdom Teeth, and Complications Associated with Coronectomy. In the article by Dhanrajani and Smith the authors discuss how the inferior alveolar nerve or lingual nerve can be damaged during wisdom teeth removal and that patients seek to avoid such a complication. Coronectomy is a procedure that removes only the … Read more

Does Intravenous Ibuprofen Reduce Pain After Wisdom Teeth Surgery?

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An interesting article titled “Does Single-Dose Preemptive Intravenous Ibuprofen Reduce Postoperative Pain After Third Molar Surgery? A Prospective, Randomized, Double-Blind Clinical Study” appears in the 2019 edition of the Journal of Oral and Maxillofacial Surgery. The article explores if intravenous ibuprofen given either shortly before or after wisdom teeth surgery has any any effect on pain experienced in the subsequent 24 hours. In the article a study is conducted using 75 patients who presented at Erciyes University in Turkey over the time period from March to October 2018 for removal of impacted lower wisdom teeth. The 75 patients were randomly divided into 3 groups with 25 patients in each. The first group of patients received 800 mg of intravenous ibuprofen 60 minutes before surgery and intravenous placebo 60 minutes after surgery, the second group of patients received intravenous placebo 60 … Read more