extraction

Should you use Sutures when having Wisdom Teeth Out?

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A study titled “A comparative study of the effect of suture-less and multiple suture techniques on inflammatory complications following third molar surgery” appears in the 2012 (in press) International Journal of Oral and Maxillofacial Surgry by O.D. Osunde, R.A. Adebola, and B. D. Saheeb. The study in Nigeria included 80 patients between the ages of 18 and 30 who had a mandibular third molar extracted. These patients were randomized into 2 treatment groups A: (suture-less – no sitches) and B: multiple sutures. The operation time was found to be roughly 3 minutes longer in the sutures group (statistically significant). In addition, the suture-less group experienced less pain, swelling, and trismus on post-operative days 1 and 2 (statistically significant). In the article the authors state: “The suture-less technique is cheap, saves operative time, minimizes manipulation of soft tissue and hence causes … Read more

Avoiding Nerve Injuries with Lower Wisdom Teeth

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A study (in press) appears in the International Journal of Oral and Maxillofacial Surgery (2012) titled “Early extraction: a silver bullet to avoid nerve injury in lower third molar removal?” by Q. B. Zhang and Z. Q. Zhang. At the beginning of the article the authors discuss how lower third molars show the highest incidence of impaction and are responsible for pathology such as pericoronitis, periodontitis, pain, cysts, tumors, and second molar-tooth crown resorption. I have discussed the risks of keeping wisdom teeth in over here http://www.teethremoval.com/risks_of_keeping_wisdom_teeth.html The authors also discuss the complications associated with removal of third molars which I have elaborated on in great detail here http://www.teethremoval.com/complications.html. In this study two groups of patients from China were grouped: A) those less than 23 and with immature teeth, and B) those greater than 23 and with mature teeth. Group … Read more

Third Molars (aka Wisdom Teeth): Kandasamy vs White and Proffit

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Like usual there are often heated exchanges over the management of wisdom teeth (third molars). Back in November 2011, in the American Journal of Orthodontics and Dentofacial Orthopedics (vol. 140, issue 5)  there was an exchange regarding two previous articles that had appeared and consequent exchange (White RP Jr, Proffit WR. Evaluation and management of asymptomatic third molars: lack of symptoms does not equate to lack of pathology. Am J Orthod Dentofacial Orthop 2011;140:10-6; and Kandasamy S. Evaluation and management of asymptomatic third molars: watchful monitoring is a low-risk alternative to extraction. Am J Orthod Dentofacial Orthop 2011;140:11-7) The articles in question I am referring to here are “Third molars” by Raymond P. White, Jr, and William R. Proffit in the American Journal of Orthodontics and Dentofacial Orthopedics (vol. 140, issue 5, pages 600-601) and Author’s response by Sanjivan Kandasamy … Read more

Management of Wisdom Teeth without Symptoms

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An article by Raymond P. White and William R. Proffit titled “Evaluation and management of asymptomatic third molars: Lack of symptoms does not equate to lack of pathology” appeared in the July 2011 issue of the American Journal of Orthodontics and Dentofacial Orthopedics (Vol 140, Issue 1). The article states “Some patients have third molars that are “symptom free and pathology free.” More often, however, third molars are “symptom free, and pathology exists,” requiring a clinical or radiographic examination for confirmation.” The authors state that a recent report suggests that limited periodontal examination in the United States in the National Health and Nutrition Estimates Survey…”underestimated the prevalence of periodontal disease.” A study carried out at the University of North Carolina and the University of Kentucky is mentioned which included 409 healthy young adults who averaged 25 years old and had … Read more

The Evidence Base for Third Molar (Wisdom Teeth) Decisions

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An excellent editorial appears in the Journal of Oral and Maxillofacial Surgery in the August 2012 edition titled “Those Who Ignore the Evidence Are Doomed to Misuse It” by Dr. Thomas B. Dodson (70, pages 1765-1767). Dr. Dodson explains how the debate regarding whether or not to either 1) remove asymptomatic, disease-free third molars, or 2) retain asymptomatic, disease-free third molars has become highly controversial. He argues that there are an assortment of viewpoints that play a role here. A) Payer-based clinical decision making: “The payer is the invisible hand in the operatory, influencing the treatment plan with a bold line that determines whether a service is covered or not. With PBCD, there is little regard or sympathy for what the OMS perceives about the individual patients and their circumstances. Thus, PBCD risks moral hazard by pre-empting services that the … Read more