SCIENTIFIC ARTICLES & PUBLICATIONS

Complications remain a concern with any dental procedure. When the procedure involves the removal of wisdom teeth, any complication deteriorates the experience of the patient and may end up in a lawsuit. The reason for this increased risk of legal proceedings lies in the debate over whether asymptomatic disease-free teeth should be touched. When complications arise in this situation, dental professionals must take the proper steps to prevent further action on the part of the patient.

Possible Complications

One concern when removing wisdom teeth revolves around the risk of accidentally displacing a maxillary third molar. Most large prospective studies overlook this complication, particularly when it comes to displacement into the infratemporal fossa or ITF. A distal retractor significantly reduces the risk of this complication, but it does happen, even when the patient visits a surgeon with significant experience in wisdom tooth removal.

Retrieval techniques remain available but come with their own risks. Nevertheless, the surgeon must quickly retrieve the third molar to avoid further deterioration of the patient experience. With the help of CT scan assisted interventional radiology, this retrieval can be completed safely and swiftly.

What is Interventional Radiology?

Interventional radiology involves the diagnosis and treatment of diseases using small tools. The radiologist benefits from x-ray and imaging techniques when carrying out procedures, and its use allows individuals to avoid surgery for the treatment of many conditions. In addition, patients might find they won't need hospitalization following the procedures. Individuals may learn more about this medical subspeciality by visiting https://www.webmd.com/cancer/what-is-interventional-radiology.

Case Presentation: Retrieving a Displaced Third Molar from the Infratemporal Fossa

A 17-year old girl benefited from interventional radiology after her right upper third molar was displaced in the ITF and couldn't be reached. An interventional radiologist placed a bone trocar above the molar with the help of a CT scan. Her recovery following this procedure was uneventful.

During surgery to remove her wisdom teeth, the dental professional unintentionally pushed the upper right third molar into the ITF. They immediately attempted to retrieve the tooth with no success. This led to the patient being referred to interventional radiology.

Upon completion of a CBCT scan, the medical professionals learned the tooth was sitting horizontally in the ITF with the crown in a posterior position. A second CBCT scan was carried out three weeks later, at which time the doctors learned the tooth had turned again and was now vertical. The crown was facing down and had moved down in the jawbone.

The Procedure

The tooth lacked cranial support, which meant the tooth could be displaced again during any retrieval attempts. This led to the medical team deciding to use interventional radiology. Fortunately, the patient wasn't experiencing any pain, so there was no rush to complete the procedure.

Surgeons first inserted a bone trocar with the help of CT guidance. They positioned the trocar so it would provide the needed cranial support. They were then able to successfully retrieve the tooth, and the entire procedure took less than 30 minutes.

The patient experienced no significant complications or side effects following the retrieval. She only needed outpatient care after the procedure and was satisfied with the outcome. Follow-up visits at three weeks and one year showed she was recovering with no complications.

Medical and dental professionals benefit greatly from CT scan-assisted interventional radiology. It allows for the real-time assessment of a displaced tooth's location thanks to image refreshment. This allows for the steady stabilization of the molar and safe and non-traumatic retrieval. Inconspicuous scarring serves as one benefit of using this technique, and patients appreciate not needing a hospital stay after its use.

Periodontal disease is highly prevalent among people over the age of forty, but it can occur at any age. Periodontitis is a gum condition that causes inflammation and swelling of the gum tissue. In cases of periodontitis, individuals can also experience gum shrinkage. If left untreated, this condition may lead to tooth loosening and eventual loss. With nonsurgical periodontal debridement, individuals can find relief from their discomfort and protect the health of their gum tissue and teeth.

Periodontal Treatments Are Sometimes Hindered By Furcation Areas

When someone has periodontal disease, they often require a deep cleaning, which involves scaling and root planing. Sometimes, the patient is put to sleep for deep cleaning, but usually, this treatment is carried out with the aid of a local anesthetic.

The dentist will clean the roots' surfaces to remove biofilm and plaque during the procedure. On teeth with multiple roots, this process can be challenging. The furcation areas, which are where the root splits, are sometimes ineffectively cleaned. Without a full cleaning, teeth with multiple roots can end up causing ongoing issues with periodontitis. An experimental study may have answers to how this issue can be overcome.

Results: Experimental Study Aims to Improve Subgingival Cleaning in the Furcation Area

In the study, trained operators used powered scalers and ultrasonic scalers against air polishers using non-abrasive powder. The operators used 3D-printed replicas of molars. They used four 3-rooted teeth and two 2-rooted teeth. The sonic scalers and ultrasonic scalers were used in the control group, and the air polishers with non-abrasive powder were used in the test group.

The results showed traditional mechanical nonsurgical periodontal debridement was most effective at removing the simulated biofilm on the 3D-printed teeth. In the furcation areas of 3-root teeth, there was a reduction in cleaning versus the 2-root teeth.

Overall, the study found mechanical debridement using powered scalers was the most beneficial in scaling and root planing. Although the powered scalers took longer to clean the furcation areas, they were more effective than the air polishers and powder method.

The study concludes that periodontitis is an inflammatory disease of the gum tissue, which progressively destroys the periodontium. The destruction of the periodontium leads to gum shrinkage, tooth loosening, and eventual tooth loss.

To successfully treat periodontal disease, individuals must regularly see their dentists and receive mechanical biofilm removal using traditional powered scalers. With these treatments and improved oral hygiene at home, individuals with periodontitis can better manage their disease and protect the health of their teeth and gums.

See Your Dentist Today

Periodontitis is a serious gum condition that requires treatment from the dentist. Early intervention helps to protect against gum shrinkage and tooth loosening, so teeth are not lost. If you have noticed redness and swelling in your gums, see the dentist right away. Gingivitis is the precursor to periodontitis. At this stage, the condition can be reversed entirely using improved oral hygiene habits and medicated mouth rinse. However, once the condition progresses, invasive treatments are necessary. Call your dentist today to schedule an appointment.