Archive for the ‘ Blog ’ Category

THE REMOVAL OF HORIZONALLY IMPACTED MANDIBULAR THRID MOLARS

Difficult wisdom teeth are the regular practice for an oral and maxillofacial surgeon (OMS). We are expert in removing third molar teeth (wisdom teeth) and we know how to evaluate and treat all of  them – even when they are associated with difficult anatomy and/or pathology such as cysts and tumors. (J Oral Maxillofac Surg […]

DOES LEUKOCYTE AND PLATELET-RICH FIBRIN WORK?

There is a big difference between leukocyte and platelet-rich fibrin (LPRF) and platelets rich in growth factors (PRGF) in results and efficacy. LPRF came out as an alternative to PRGF because the technique for collecting and processing the material was easier and took less time. A recent article came out showing that LPRF was no […]

CAN DENTAL INFECTION SPREAD TO THE HEAD OR BRAIN?

The anatomy of the head and facial blood vessels allows for blood to flow in either direction as there are no valves in these vessels. This design helps to keep the brain alive in case of head/face trauma and/or head/face vessel blockage (such as a blood clot or a lesion). The point is, that the […]

DOES ORTHOGNATHIC SURGERY AFFECT BREATHING?

The technical question would be “does orthognathic surgery affect the upper airways?” There is a favorable effect of orthognathic surgery in the upper airways regardless of the surgical approach. Bimaxillary (upper and lower jaws together) advancement and counterclockwise rotation of the mandibular occlusal plane are the most significant contributors. (J Oral Maxillofac Surg 79:450-462, 2021). […]

IS SOFT TISSUE GRAFTING (ATTACHED MUCOSAL GRAFTING) NEEDED AROUND DENTAL IMPLANTS?

IS SOFT TISSUE GRAFTING (ATTACHED MUCOSAL GRAFTING) NEEDED AROUND DENTAL IMPLANTS? Yes. This is true of any site, but especially true in compromised sites such as patients who have undergone treatments including radiation therapy or major jaw reconstruction (J Oral Maxillofac Surg 79:560-574, 2021). Around our healthy teeth there is a band of tissue that […]

CAN JAW SURGERY INCREASE THE RISK OF OBSTRUCTIVE SLEEP APNEA (OSA)?

If you have a growth abnormality with your jaws such as a protrusive lower jaw, and you have breathing concerns, studies have shown that having the jaw surgery could increase your risk of obstructive sleep apnea (OSA). (J Oral Maxillofac Surg 78:2061-2069, 2020). This concern and this question would mainly bring up issues if we […]

DOES RETAINING THIRD MOLARS RESULT IN THE DEVELOPMENT OF PATHOLOGY OVER TIME?

To me, this seems like a silly question because I have had over 35 years of experience treating patients of all ages with wisdom tooth problems and absolutely the types of problems, severity of problems, and the risks of treatment increase with age – and transversely are much less in the younger patient. I have […]

ANXIETY DURING THIRD MOLAR EXTRACTION

In our practice, removal of third molar teeth (wisdom teeth) is most commonly performed under IV anesthesia. This is appropriate and I feel necessary for this treatment to be a positive experience for most patients. With intravenous anesthesia you are completely relaxed, you have no anxieties and your jaw muscles are relaxed – it makes […]

DO POSTOPERATIVE ANTIBIOTICS DECREASE THE FREQUENCY OF INFLAMMATORY COMPLICATIONS FOLLOWING THRID MOLAR REMOVAL

I was pleased to see this article in the JOMS looking at post-op antibiotic use for third molar treatment on a meaningful group of patients. (J Oral Maxillofac Surg 76:700-708, 2018) There is a big push by national and world medical authorities to try to get clinicians to prescribe less or no antibiotics for routine […]

DOES THE CONE BEAM SCAN (CONE BEAM COMPUTED TOMOGRAPHY) CHANGE THE TREATMENT DECISION TO REMOVE IMPACTED THIRD MOLAR TEETH?

The main reasons why I recommend a cone beam scan (CBCT) for third molar extractions is when there is significant risk to the nerve in the lower jaw (inferior alveolar nerve) or when there are significant lesions (typically cysts or tumors) associated with the jaw and/or teeth. For me, the cone beam scan has never […]