Wisdom Teeth

What is the Polo Mint Wisdom Tooth and How to Treat It

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An interesting article titled “Identifying the Polo® mint mandibular third molar: a case series” written by Chopra et al. appears in the 2019 edition of Oral Surgery (vol. 12, pp. 89-95). The article discusses lower wisdom teeth that have a perforation in the root where the inferior dental nerve passes through and resemble the classic perforation within the Polo Mint confectionary (the Polo mint is a breath mint with a hole in the middle). These type of wisdom teeth are described as being uncommon, occurring every 1 in 800 cases or less; however they present a high degree of inferior dental nerve injury if they are extracted. The authors state that surgeons may only seen one or two cases in their entire career. In the article the authors describe a study from 2010 to 2017 where they identified 22 cases … Read more

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