Wisdom Teeth

Reducing Opioids in Oral and Maxillofacial Surgery

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An interesting article titled “Opioid Prescribing Can Be Reduced in Oral and Maxillofacial Surgery Practice,” written by Tatch appears in the 2019 edition of the Journal of Oral and Maxillofacial Surgery. In the article the author discusses the results of implementing an office protocol for pain management to reduce opioid use in oral and maxillofacial surgery during a three year time period. Results from a similar study were presented previously in a post titled Oral and Maxillofacial Surgeons Current Perspectives on Opioid Prescribing. In the article the author discusses how a risk of opioids is dependence which can develop after just one week of using. The author came up with a 3-year retrospective study to measure changes in opioid use after the introduction of an office protocol which was designed to offer alternatives to pain relief. In the study a … Read more

Osteomyelitis after Wisdom Teeth Removal can Lead to Multiple Reconstructive Surgeries

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Wisdom teeth removal is not without risks and complications such as osteomyelitits can occur. Osteomyelitits is an inflammation and infection of bone cortex and marrow that develops in the jaw. Some symptoms that can occur with osteomyelitits include high body temperature, increased pain, and neck swelling. In some cases emergency treatment is required to prevent death. In a case in 2012, a 24 year old man woman had an upper left and a lower right wisdom tooth extracted by an oral and maxillofacial surgeon. Five days after surgery the woman returned to the oral surgeon’s office where he discoveredmild swelling near the lower right wisdom tooth site, without pus, and a large amount of food debris. He irrigated the area, placed gel foam packing, and gave the woman a prescription for penicillin. Ten days after surgery the woman returned to … Read more

Does Keeping Wisdom Teeth Lead to More Lower Jaw Fractures?

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An interesting article titled “Does an Association Exist Between the Presence of Lower Third Molar and Mandibular Angle Fractures?: A Meta-Analysis” written by Ruela et al. appears in the 2018 edition of the Journal of Oral and Maxillofacial Surgery (vol. 76, pp. 34-45). The article seeks to explore if having wisdom teeth can lead to more lower jaw fractures and specifically mandibular angle fractures. In the article the authors argue how in the past some have argued for the prophylactic (preventative) removal of wisdom teeth to prevent mandibular angle fractures. This is because the mandibular angle occupies an area that should be filled with bone and by having teeth in this area it is susceptible to be 2 to 3 times or likely to fracture. To investigate this the authors performed a systematic review and meta-analysis to look at studies … Read more

Preventing Lingual Nerve Damage After Wisdom Teeth Extraction

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An interesting article titled “Prevention of Lingual Nerve Injury in Third Molar Surgery: Literature Review” written by Pippi et al. appears in the 2017 edition of the Journal of Oral and Maxillofacial Surgery (vol. 75, pp. 890-900). The article discusses attempting to identify any factors that could influence if a patient suffers lingual nerve damage after wisdom teeth removal. In the study the authors reviewed previous literature published up until February 2016 that pertained to lingual nerve injuries after wisdom teeth surgery. From the literature review the authors analyzed three different surgical techniques used for wisdom teeth removal: 1) buccal approach, 2) lingual split technique, and 3) buccal approach plus lingual flap retraction in order to determine if their were any differences on lingual nerve injuries. The authors also evaluated the association between nerve damage and tooth sectioning or ostectomy. … Read more

Is there a Difference in Complications following Wisdom Teeth Removal when using Local Anesthesia versus General Anesthesia?

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An interesting article titled “Retrospective multivariable comparison for complications of third molar surgery performed under general versus local anaesthesia” written by Beteramia et al. appears in Oral Surgery in 2019 (vol. 12, pp. 96-103). The article seeks to explore if there is a difference in the amount of complications that occur during or after wisdom teeth surgery when using local anesthesia or when using general anesthesia. In the article the authors discuss complications that can happen during wisdom teeth removal including excessive bleeding, injury to the inferior alveolar and lingual nerves, damage to the adjacent second molar, alveolar bone fracture, and displacement of tooth fragments into fascial spaces and complications that can happen after wisdom teeth removal including alveolar osteitis (dry socket), a secondary infection, and hemorrhage. These complications are discussed more over at http://www.teethremoval.com/complications.html. The authors further discuss how … Read more