Trigeminal Nerve Surgery for Neuropathic Pain

An interesting article titled “Factors Determining Outcome After Trigeminal Nerve Surgery for Neuropathic Pain” appears in the July 2016 issue of Journal of Oral and Maxillofacial Surgery written by John R. Zuniga and David M. Yates. It is known that the inferior alveolar and lingual nerves which are part of the trigeminal nerves can be damaged after wisdom teeth surgery. Additional surgery can be performed to repair the trigeminal nerve but in some cases this injury remains and is only partially resolved. The others set out to better explore why neuropathic pain can persist after trigeminal nerve surgery. The study included 28 patients who underwent trigeminal nerve repair in Texas between 2006 and 2014. The patients were grouped into three different cohorts: 1) those who had no recurrence (NR) were any neuropathic pain went away, 2) those who had complete recurrence (CR) were the … Read more

Can you Use Low Level Laser Therapy After Wisdom Teeth Removal to Reduce Pain?

An interesting article titled “Is Low-Level Laser Therapy Effective in the Management of Pain and Swelling After Mandibular Third Molar Surgery?” appears in the July, 2016, issue of Journal of Oral and Maxillofacial Surgery and written by Majid Eshghpour, Farzaneh Ahrari, and Mohammad Takallu. The article seeks to explore if using low-level laser therapy after removing impacted wisdom teeth can reduce pain and swelling. In the study 40 patients included had lower impacted wisdom teeth on both sides. One side was subjected to lower level laser therapy and the other side just placebo. After removing wisdom teeth patients often experience pain, swelling, and tristmus for several days. Pain usually reaches a peak 3 to 5 hours after surgery while swelling peaks around 12 to 48 hours later. The trauma that occurs during surgery leads to inflammation which causes these other symptoms. Surgeons typically prescribe … Read more

Computer Assisted Retrieval of Accidentally Displaced Wisdom Teeth

An article titled “Use of Computer-Assisted Navigation in the Retrieval of Accidentally Displaced Third Molars,” appears in the 2016 Journal of Oral and Maxilofacial Surgery, written by Yi Guo and et al., vol. 74, pp. 889-894. The article describes using a computer to retrieve accidentally displaced mandibular third molars. A total of 12 patients in the study successfully had their roots retrieved. They all healed successfully without complications. In rare cases when performing wisdom teeth surgery, a tooth or a tooth root can be displaced. When they are displaced into difficult to access areas surgery retrieving the displaced molars should be performed by conventional methods which include extending the original operative exposure or planning a new operative approach and then finding and removing the tooth. This surgery can cause severe tissue injury or complications. The paper discusses computer-assisted navigation in … Read more

Comparing Complications from Anesthesia with Wisdom Teeth Extractions

An article titled “Anesthesia Complications of Diazepam Use for Adolescents Receiving Extraction of Third Molars,” appears in the 2016 Journal of Oral and Maxilofacial Surgery by Gino Inverso and et. al, vol. 74, pp. 1140-1144. The article seeks to evaluate the safety of midazolam and diazepam for adolescents during wisdom teeth extraction and whether any differences in complications exist when using the 2 benzodiazepines alone or in combination. Compared with diazepam, midazolam has a faster onset of action, greater incidence of amnesia, and shorter recovery time. The authors hypothesized that diazepam, when used as an intravenous sedative agent for third molar extraction, would be associated with a higher rate of anesthetic complication than midazolam. The study included patients enrolled in the OMSOS from January 2001 through December 2010. To be included, patients had to be adolescents (<21 yr old) who … Read more

Quality Measures Need Measures of Quality

An article titled “Quality Measures Need Measures of Quality” appears in the 2016 Journal of Oral and Maxillofacial Surgery, issue 74, pp. 1101-1102, and written by Thomas Dodson. The article discusses how nowadays doctors have a lot more access to information thanks to the information technology revolution. He discusses HIPAA and electronic medical records (EMRs). The author states “EMRs were introduced—we were promised—to make patient information portable and to improve communication between providers, thus improving patient safety and quality of care. In truth, these were secondary intentions, the first and overriding being Medicare’s (now CMS’) need to provide comparable data across institutions in order to control costs and monitor utilization.” In the article he talks about compliance with data capture and automation and how with quality measures oral surgeons are not much farther now than in 1984. Measures of quality, … Read more