Archive for the ‘ Oral Surgery ’ Category

SHOULD WE BONE GRAFT JAW CYSTS AT THE TIME OF REMOVAL?

We have treated extensive jaw cysts and tumors, some that involve an entire segment of the jaw. If you have an otherwise healthy individual without associated pathology (such as jaw fracture) cleaning out the cyst and maintaining the bone architecture as you can along with closing of the tissues gives the best result. The body […]

CAN SURGICAL MANAGEMENT IMPROVE RESOLUTION OF MEDICATION-RELATED OSTEONECROSIS OF THE JAW AT EARLY STAGES?

We are still seeing patients with medication-related osteonecrosis of the jaw (MRONJ) although it is becoming much less common as the dosage regimens for the use of antiresorptive and antiangiogenic drugs have improved dramatically over the past 20 years. (J Oral Maxillofac Surg 78: 1986-1999, 2020). We do, however still see these patients in our […]

USE OF PRF AND PRGF FOR THIRD MOLAR EXTRACTION SOCKETS

We have been using the PRF, L-PRF, and PRGF technologies now for many years. This technology uses concentrated platelets processed at the time of surgery, as a graft material either alone or in combination with bone graft material (autologous, allograph, and/or xenograft). A recent study looked at outcomes when this is used as a socket […]

ANTIBIOTIC PRESCRIBING PATTERNS. HOW MUCH IS TOO MUCH ANTIBIOTICS?

We routinely prescribe antibiotics following oral surgery procedures such as removal of wisdom teeth or placement of dental implants. (JADA 2017:148(12):878-886). The mouth is a naturally dirty place and it is not possible to “sterilize” it prior to treatment. In fact, it is common that the structures that we are treating are infected such as […]

CAN MICROSURGICAL REPAIR OF INFERIOR ALVEOLAR NERVE INJURIES IMPROVE SENSORY FUNCTION AND RELIEF OF PAIN?  

The nerve bundle that runs through the mandible provides sensory perception (feeling) to the lower lip and chin, the teeth and gums, and there is a branch that goes to the side of the tongue. The nerve enters the bone on the inside surface at the back of the jaw and then runs forward from […]

Is IV anesthesia needed and appropriate for my oral surgery treatment?

Sometimes we are questioned about the need for IV Anesthesia for treatment.  The typical concerns are for the appropriateness of care, risks of treatment, and cost of treatment.  This most often comes up when there is an urgent care need.  The patient is of course under some stress in that they have to see another […]

HOW SAFE IS OUTPATIENT SEDATION ADMINISTERED BY ORAL AND MAXILLOFACIAL SURGEONS?

The typical techniques used by Oral and Maxillofacial Surgeons (OMFS’s) have evolved over my years in practice, but the overall safety has remained the same. It is very safe. (J Oral Maxillofac Surg 79: 990-999, 2021). Anesthesia administered by OMFS’s has one of the highest safety records in medicine. There is a very good reason […]

Does a  Preoperative Dose of Ibuprofen Reduce the Pain Associated with Wisdom Tooth Removal?

 Should I take a dose of ibuprofen prior to my wisdom tooth treatment?  There have been many studies through the years showing that taking an NSAID, such as ibuprofen, prior to extraction of wisdom teeth reduces post-treatment pain and swelling.  (J Oral Maxillofac Surg 77:1990-1997, 2019).  I believe this is true for most dental procedures […]

Should I Try One of These Other Methods to Remove Wisdom Teeth?

I (Dr. Wagner) have been removing impacted wisdom teeth for over 30 years.  I regularly have to treat very difficult cases, including cases where there is a significant risk to the neurovascular bundle in the jaw (inferior alveolar nerve), jaw cysts (odontogenic cysts), infections, and complicated/difficult extractions.  I am an expert in this treatment and […]

Is it Okay to Get Dental Implants if I Have Diabetes?

Another way to phrase the question would be, “Does the presence of diabetes cause problems with dental implant care?”  The quick answer to the question is “no”.  (JADA 2021:152(3):189-201).  Over the years, we have looked at the presence of diseases and the effect of these diseases on dental implant care.  This can be looked at […]