Wisdom Teeth Removal: Evaluating Risk Using Cone Beam Scanning

There are inherent risks with wisdom teeth removal. At Wagner Oral Surgery, we use advanced technology to predict the risk and prepare for surgery.

When removing third molar teeth, there is an increased risk of injury to the sensory nerve in the lower jaw, especially in the adult patient. The risk generally increases with age. A cone beam scan image of the wisdom teeth and nerve canal can provide a significant prediction of injury risk for the third molar tooth extraction.

The sensory nerve in the lower jaw provides feeling in the lower jaw bone. It does not control any muscle function. Injury to the nerve can result in a loss of feeling in the area. It does not cause any paralysis. Because this risk increases with age, it is better to perform this treatment on the younger patient. Twenty years old is better than thirty, thirty years old is better than forty, etc. In my hands, with the teenage patient, the risk is almost zero. As you age the risk goes up, but again in our experience the risk is still in the single digits – meaning less than one percent.

Advanced technology reduces risk associated with wisdom teeth removal

Having said that, if you have this complication it is significant. The x-ray appearance, and especially with the cone beam scan, can be a predictor for this. We now have the advanced technology of cone beam scanning and with this we can visualize the teeth and nerve much more accurately in three dimensions and this allows us to approach the tooth surgically with a greater accuracy and helps to reduce the risk when performing the wisdom teeth removal.

Cone beam scans and wisdom teeth removal at Wagner Oral Surgery

Cone beam scans are not yet a standard of care and there is increased cost with this technology, but it clearly is a great benefit, both to the patient (decreased risks) and to the surgeon (better visualization). I strongly recommend the cone beam scan if you are having your wisdom teeth (third molars) removed.  

(Ref: J Oral Maxillofac Surg 71:2012-2019, 2013)

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