REMOVAL OF IMPACTED SUPERNUMERARY TEETH USING A DYNAMIC SURGICAL NAVIGATION SYSTEM

There are systems available for computer guided techniques to approach difficult-to-visualize structures such as dental implant sites, the temporomandibular joint (TMJ), and impacted teeth such as supernumerary teeth. (J Oral Maxillofac Surg 77:1130-1134, 2019)  I have had the opportunity to train in and try these techniques and use this equipment. In most cases, as it relates to oral and maxillofacial surgery, it is a technique looking for an application. What I mean by this is that, in my opinion, having this technology is really neat, but unnecessary.

We use cone beam imaging to view and treatment plan our difficult procedures such as approaching impacted supernumerary teeth. With this technology we are able to “do the surgery virtually” and then approach the actual patient with a high degree of accuracy and certainty. Adding on the guided technique has three concerns. First it is very expensive and adds a level of cost to the procedure. Second the technology as it exists today is not exacting and to me I trust my own skill, artistry, and experience more in the operating situation as opposed to a technology with tolerances that are questionable. Third is that we perform hundreds of these procedures and, although challenging, we do not have problems.

I will continue to monitor the developments with all of the related technologies. Surgeons love new devices and techniques. But, especially when providing the best care for your patients, and trying to provide it at a reasonable expense, you need to use the procedures and instruments consistent with that outcome. That is the best outcome.