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The most common location of dry socket: in the socket of an extracted mandibular third molar (wisdom tooth). Since alveolar osteitis is not primarily an infection, there is not usually any pyrexia (fever) or cervical lymphadenitis (swollen glands in the neck), and only minimal edema (swelling) and erythema (redness) is present in the soft tissues surrounding the socket.
General anesthesia drugs such as midazolam, ketamine, propofol and fentanyl are used to put a person in a twilight state or render them completely unconscious and unaware of pain. Dentists who have completed a training program in anesthesiology may also administer general IV and inhalation anesthetic agents.
The lower teeth, and in particular the lower wisdom teeth, can therefore be in close proximity to this nerve. Damage to the inferior alveolar nerve is a risk of lower wisdom tooth removal (and other surgical procedures in the mandible). [20]
Impacted wisdom teeth are classified by the direction and depth of impaction, the amount of available space for tooth eruption and the amount of soft tissue or bone that covers them. The classification structure allows clinicians to estimate the probabilities of impaction, infections and complications associated with wisdom teeth removal. [31]
A treatment controversy exists about the need for and timing of the removal of disease-free impacted wisdom teeth. Supporters of early removal cite the increasing risks for extraction over time and the costs of monitoring the wisdom teeth. Supporters for retaining wisdom teeth cite the risk and cost of unnecessary surgery.
When extracting lower wisdom teeth, coronectomy is a treatment option involving removing the crown of the lower wisdom tooth, whilst keeping the roots in place in healthy patients. This option is given to patients as an alternative to extraction when the wisdom teeth are in close association with the inferior alveolar nerve , and so used to ...
Alveolar osteitis is a complication of tooth extraction (especially lower wisdom teeth) in which the blood clot is not formed or is lost, leaving the socket where the tooth used to be empty, and bare bone is exposed to the mouth. [29] The pain is moderate to severe, and dull, aching, and throbbing in character.
Most often, the cause of impaction is inadequate arch length and space in which to erupt. That is the total length of the alveolar arch is smaller than the tooth arch (the combined mesiodistal width of each tooth). The wisdom teeth (third molars) are frequently impacted because they are the last teeth to erupt in the oral cavity.