Wisdom Teeth

Management for an Ectopic Wisdom Tooth

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One of the medically necessary valid reasons that the American Association of Oral and Maxillofacial Surgeons gives for removal of a wisdom tooth is if it is in an ectopic position. So the question is what exactly is the ectopic wisdom tooth and what should one do about it? In the article titled “Removal of ectopic mandibular third molar teeth: literature review and a report of three cases” written by Ahmed and Speculand appearing in Oral Surgery in 2012 (vol. 5, pp. 39-44) discussion is made of a literature review of ectopic wisdom tooth along with three cases of lower ectopic wisdom teeth. In the article titled “Ectopic wisdom tooth in the condyle area” written by Mourouzis et al. appearing in Oral Surgery in 2011 (vol. 4, pp. 194–196) discussion is made of an upper ectopic wisdom tooth in a … Read more

The Predictive Value of using Panoramic X-Rays for Wisdom Teeth Surgery Complications

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An interesting article titled “Predictive Value of Panoramic Radiography for Injury of Inferior Alveolar Nerve After Mandibular Third Molar Surgery,” appears in the 2017 edition of the Journal of Oral and Maxillofacial Surgery (vol. 75, pp. 663-679) written by Su et al. The article sought to explore if panoramic x-rays taken before wisdom teeth removal can predict possible injury of the inferior alveolar nerve. In the article the authors discuss how inferior alveolar nerve injury is the third most common complication following wisdom teeth removal. When inferior alveolar nerve injury occurs numbness of the lip or chin can occur along with difficulty speaking and chewing food. Current studies have shown inferior alveolar nerve injury occurs about 8% of the time after wisdom teeth removal with less than 1% expected to be permanent. Current practice has shown that panoramic x-rays can … Read more

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