wisdom teeth complications

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

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

Reconsideration of decision making for third molar extraction

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An article recently appeared in the Journal of the Korean Association of Oral and Maxillofacial Surgery titled “Reconsideration of decision making for third molar extraction, “(vol. 37, pages  343-348, 2011) by Wonse Park and et al. I am unable to read the article since it is in Korean but the abstract is in English. The introduction of the article states “Third molar extraction is one of the most common procedures in oral and maxillofacial surgery. The impacted third molar causes many pathological conditions, such as pericoronitis, caries, periodontitis, resorption of adjacent teeth, and cyst or tumors associated with impacted teeth. Extraction is often considered the treatment of choice for impacted lower third molars. On the other hand, imprudent extraction of deeply impacted third molars can cause permanent complications, such as inferior alveolar nerve damage. Therefore, guidelines for the extraction of … Read more

The Body Fights Gum Disease Better When You Are Not Fat

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An interesting study was conducted by researchers at Case Western Reserve University School of Dental Medicine. The study included 31 obese people with gum disease. Half of those in the group with an average BMI of 39 had gastric bypass surgery and had had fat cells from the abdomen removed. This half did better than a control group of people with an average BMI of 35 who did not have gastric bypass surgery or had fat removed. It was stated that “All study participants underwent nonsurgical periodontal treatments of scaling/root planing and oral hygiene instructions for home care. While both groups showed improvement, the surgery group did even better on the measures for periodontal attachment, bleeding, probing depths and plaque levels.” Periodontal disease is a potential risk of keeping wisdom teeth and is discussed in more detail over at http://www.teethremoval.com/risks_of_keeping_wisdom_teeth.html. Periodontal disease has … Read more

Alveolar Expansion Technique for Extraction of Third Molars (Wisdom Teeth)

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An interesting study titled “Comparison of an alveolar expansion technique and buccal guttering technique in the extraction of mandibular third molar. A pilot study,” appeared in the Open Journal of Stomatology (vol 1, pages 103-108, 2011) written by Babatunde O. Akinbami and Lukcy I. Ofomala from Nigeria. As stated in the abstract the background for this study was “The over-ambitious use of surgical drills for almost every case of third molar impaction is on the increase in most established oral surgery centers. The purpose of this study was to assess and compare the severity of post operative symptoms of swelling and pain that accompany the use of surgical drill in the buccal guttering technique and the non application of drill in an alveolar expansion technique.” The authors open in the introduction by discussion how bone around impacted third molar teeth … Read more