dental (odontogenic) cysts

ROUTINE SCREENING ORTHOPANTOMOGRAPHY (OPG)
&
MANDIBULAR JAW CYSTS

Oral & Maxillofacial Surgeons are specifically trained to deal with all pathological lesions of the mouth, face & jaws. Surgical care begins with diagnosis. This in turn allows for surgical planning towards pathology eradication & later reconstruction of the surgical defect.

ROUTINE OPG X-RAY SCREENING OF JAWS

We recommend routine OPG (orthopantomogram) screening for all people at age 9, 13, 17, & 21 years & thereafter at least every decade. This advice can differ aqccording to both personal opinion, and professional grouping.

OPG's are jaw or "dental" x-rays which can assess simultaneously for jaw joint (TMJ), wisdom teeth, standing teeth, developing teeth, jaw, & (maxillary) sinus diseases.

Jaw x-ray screening, particularly during development, allows for the exclusion of developmental lesions before they lead to major pathological problems. Such lesions include jaws cysts & tumours.

Wisdom teeth in particular are a major source of developmental lesions of the jaws, particularly if they become impacted, & may lead to jaw-angle fracture following minor knocks or trauma.

Of the entire population, very few people will retain their wisdom teeth over their lifetime. Wisdom teeth are a major source of morbidity & jaw disease, & specialist surgeons & orthodontists will recommend their prophylactic removal before they become a problem.

OPG x-ray films when read & interpreted by qualified specialist oral & maxillofacial surgeons (or by maxillofacial radiologists) are an ideal screening tool for an enormous variety of conditions that can occur throughout the jaws. Modern OPG machines are digitally based, & have extremely low radiation when compared with film based devices.

Routine OPG screening should only be conducted by surgical or radiological specialists using only digital OPG machines. OPGs are Medicare rebate items when performed by Medicare-approved specialist surgeons or radiologists.

Good general dental practice includes routine (6-12 monthly) dental caries assessment with clinical examination & dental bitewing films. Periodically, your general dentist or specialist orthodontist should advise for routine OPG screening of your jaws (by a maxillofacial surgeon or radiologist) for hidden jaw disease; before you present with symptoms.

JAW CYSTS

In synchrony, many cell & tissue types develop teeth & bone; together they allow for normal tooth & jaw growth. Once teeth & bone have formed, residual cells & tissues have the potential to form a range of hidden cysts & tumours which typically arise during growth, but which present throughout the adult years.

The routine use of screening OPGs allows your dentist, orthodontist, or maxillofacial surgeon to catch jaw cyst & jaw tumour development at an early & treatable stage. Excessive growth of cysts & tumours can destroy teeth, & in some instances lead to extensive jaw loss.

When referred by your medical GP, screening OPGs by our specialist Maxillofacial Surgeon are bulk billed under Medicare, & are free to the patient. Screening OPGs are only useful when interpreted by specialists trained in OPG interpretation.

ADVICE FOR PATIENTS SEEKING OPG SCREENING

Wisdom Teeth Australia advises that all patients should be offered screening OPGs at ages 9, 13, 17 & 21 years & thereafter every decade.

1. During growth, the screening OPG assesses for impacting teeth, & for the presence of developmental lesions of the jaws,
2. Throughout life, jaw lesions may arise de novo, & screening OPGs of the jaws are an effective, low radiation screening tool. They are effective for screening of...
   1. Dental disease such as caries & periodontal disease,
   2. Impacted teeth,
   3. Developmental lesions of the jaws,
   4. Maxillary sinus disease,
   5. Bony changes of the TM joints.
3. Even if you have had previous disease (or impacted teeth) identified or removed, the practice still recommends for screening OPGs once each decade,
4. Screening OPGs performed by Wisdom Teeth Australia are bulk-billed.

ADVICE FOR PATIENTS SEEKING 3rd MOLAR SCREENING

1. Wisdom teeth either cause problems due to their impactions, or because of their partial eruptions through early to late adulthood,
2. Normally most developing or developed wisdom teeth may be advised for removal before they become a problem, but only following on from a formal consultation and assessment with your specialist surgeon
3. Impacted wisdom teeth may lead to jaw fractures, tumour or cyst development, orthodontic crowding (but there may be other causes for this also), local & regional swelling, neck infections, & destruction of the backside surface (distal) of the forward second molar tooth,
4. We recommend prophylactic wisdom teeth removal by wisdom teeth specialists in order to maximally minimise exposure to and expression of surgical complications that you may have increased risk for.