oral surgery

The Risk of Future Extraction of Wisdom Teeth

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An interesting study titled “What is the Risk of Future Extraction of Asymptomatic Third Molars? A Systematic Review,” written by Gary F. Bouloux and et al., appears in the May 2015 issue of the Journal of Oral and Maxilofacial Surgery (vol. 73, issue 5). The study attempts to determine the annual and cumulative rate of when asymptomatic wisdom teeth become necessary to remove. The authors state that the management of asymptomatic wisdom teeth is controversial and unresolved. They performed a systematic review of past studies using PubMed, Google Scholar, and the Cochrane Central Register of Controlled Trials on retained wisdom teeth. The authors had several criteria necessary for the study to be included in their analysis. The studies were included if they were an English language publication, were a prospective study design, had more than 50 subjects, had recorded the … Read more

Care Guidelines for Wisdom Teeth: 2014 Finnish Guidelines

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An article titled Current Care Guidelines for Third Molar Teeth appears in the May 2015 issue of the Journal of Oral and Maxilofacial Surgery (vol. 73, issue 5), written by Irja Venta. The article describes the 2014 Finnish Care Guidelines on wisdom teeth removal. The guidelines were written in mind for the best possible care to the patient without weighing against the resources of the health system. The author states “The updated guidelines for the third molar are based on evidence, with an extensive review of 180 references…Because nerve injuries continue to be the most common reason for malpractice claims submitted to the Finnish Patient Insurance Center, this issue warrants attention. Another important issue is the controversy surrounding the preventive, prophylactic, early, or elective removal of third molars; 4 distinct groups are suggested as candidates for early removal.” The guidelines … Read more

Osteonecrosis of the Jaw As a Complication After Wisdom Teeth Removal

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Removing wisdom teeth or a wisdom tooth has risks and in some instances complications can occur. I have discussed numerous complications of wisdom teeth over at http://www.teethremoval.com/complications.html. One of the complications discussed is Bisphosphonate Related Osteonecrosis of the Jaw (BRONJ). What happens is that when a patient is on bisphosphonates and has a tooth extracted (any tooth a wisdom tooth or not) bone that is exposed can fail to heal. A case of this occurring is described at the Daily Mail titled “Grandmother in agony for FOUR YEARS after dentist removed wisdom tooth without checking her medical records,” by Steve Robinson, published on March 19, 2013. In this case a 72 year old woman had a problem where she kept catching her teeth with her cheek and noticed blood. She went to her general practitioner who performed a biopsy and … Read more

Association Between Partially Erupted Mandibular Third Molar and Caries in Distal Second Molar

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An interesting article titled “Association between the presence of a partially erupted mandibular third molar and the existence of caries in the distal of the second molars,” appears in the International Journal of Oral and Maxilofacial Surgery by S. G. M. Falci and et. al. (October 2012, pp. 1270-1274). The article mentions how previous studies have shown that caries on the mandibular second molar due to the presence of partially erupted third molars has varied between 7% and 32%. The article criticizes prior work where studies based their prevalence data on panoramic radiographs which is not as good as periapical radiographs when diagnosing caries. The authors state “The lack of sample characterization, the absence of sample calculation, the deficient or inadequate statistical analysis and the absence of a description of the eligibility criteria, discredits the scientific evidence of these previous … Read more

Propofol-Remifentanil Versus Propofol-Ketamine for Third Molar Surgery

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A study titled “Comparison of Propofol-Remifentanil Versus Propofol-Ketamine Deep Sedation for Third Molar Surgery” appears in the 2012 Anesthesia Progress journal. The authors of the study set out to better determine what anesthetic to provide during third molar (aka wisdom teeth) surgery. In the study, two drug combinations for use as deep sedation during oral surgery were evaluated. Patients in a control group received a continuous intravenous infusion of propofol-remifentanil,  and patients in an experimental group received a continuous intravenous infusion of propofol-ketamine. This study was double blind in that neither patients nor surgeons were aware of which treatment was given. In this study, 37 patients  were monitored while sedated for respiratory, heart rate, and blood pressure stability. Emergence from the effects of anesthesia and total recovery time were recorded. In addition, patients and surgeons were both asked to rate … Read more