Surgical extraction of wisdom teeth
The wisdom tooth shows the greatest atypia in its morphology compared to any other tooth of the jaw and the highest percentage of impaction in the jaw. These in combination with its posterior position in the dental arch make the extraction of wisdom tooth a dental procedure, the degree of difficulty of which can turn out to be quite high.
Surgical wisdom tooth extraction is one of the most common surgical dental procedures.
Wisdom tooth extraction indications can be varied:
- Wisdom tooth caries to a degree untreatable.
- Frequent and repeated cases of pericoronitis (dentitio difficile), inflammation that develops in the soft tissues surrounding the wisdom tooth.
- Caries of the second molar at the contact point with the wisdom tooth.
- Periodontal damage to the second molar.
- Cyst due to wisdom tooth.
- For orthodontic or for prosthetic reasons.
A wisdom tooth may have erupted normally in the dental arch, be partially or completely covered by gums or bone, thus being semi-impacted or impacted. For its radiographic imaging, a good quality panoramic X-ray is necessary, from which important information is derived in relation to its angle,
the degree of its impaction,
the morphology of its roots and thus a preoperative assessment of the degree of difficulty of its extraction can be made. In some cases it is necessary to perform an additional X-ray, the so-called digital volume tomography (DVT), or cone-beam computed tomography (CBCT), which depicts in great detail in three dimensions the position of the wisdom tooth in the jaw bone and its relationship with important anatomical elements, that is, the relationship of the lower wisdom tooth with the nerve of the lower jaw, the lower alveolar nerve and the relationship of the upper wisdom tooth with the sinus.
After the extraction of the wisdom tooth, suturing of the wound is performed, the appropriate medication (painkillers / anti-inflammatories, antibiotics, antiseptic mouthwash) and postoperative instructions are given, and an appointment is arranged for re-examination of the patient and removal of sutures after 7-10 days.
