Oral Surgery/Cyst in jaw

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Question
The cyst
The cyst  
Dear Dr Ryan,

I just recently, two weeks ago, discovered that I had a wisdom tooth on the lower left. More than that the x ray showed a big cyst below the next tooth, and around the wisdom. I am considering the surgery to remove the wisdom tooth #17, and the cyst in the bone. But I am worried about the risk of damaged nerves and losing feelings permanently own the left side of the face,  tongue and more.  Would it be okay to think to have the wisdom teeth pulled first. I have  the root canal done the day the wisdom tooth and the cyst was diagnosed.  Can i monitor the csyt for a while and come back to have it removed later. The cyst is pretty big.

The wisdom tooth is impacted. To make it complicated, the tooth next to it has a bridge for #15. I'm afraid I am going to loss this tooth and the bridge,  then I would be missing two teeth on the lower left side.

After the removal of the cyst, would an implant be possible.  

Thank you for your time and answers.

Regards

Answer
Hui, Thank you for your question. The cyst in the left jaw appears to be associated with the wisdom tooth. To take out the wisdom tooth and leave the cyst would be considered malpractice and I do  not think you would find anyone who would just take out the tooth without an attempt of removing the cyst. The cyst needs to be biopsied and if it can be removed easily at the time of wisdom tooth removal, then it should. The risk of injury to the nerves is a possibility but the alternatives of leaving the cyst can be devastating. The cyst will not resolve on its own and monitoring it will provide absolutely no benefit and is discouraged. Hui, have the tooth and the lesion removed/biopsied to see if further treatment is required. Make sure that your oral surgeon is board certified in the process of becoming board certified by ABOMS and has hospital privileges so if urgent care is needed they can take you to the hospital and admit you themselves without having to call someone else to take care of you. Once the cyst is removed, you would most likely be a candidate for implants at site #18 or 19. This is a discussion to have with your surgeon. Good Luck.  

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James M. Ryan. DDS, MS; Board Certified Oral and Maxillofacial Surgeon

Expertise

Dr. Ryan's expertise is in the field of Oral and Maxillofacial Surgery. Specifically, Dr. Ryan is an expert in Orthognathic Surgery. He holds uniques experience as the former Assistant Program Director of the Oral and Maxillofacial Surgery Residency Training Program at Washington Hospital Center where he trained residents to perform these complicated surgical procedures. Additionally, Dr. Ryan also has a tremendous amount of experience in reconstruction of the maxillofacial skeleton related to trauma and tooth loss. Dr. Ryan is an expert in 3 dimensional treatment planning for Orthognathic Surgery, Dental Implant Surgery and Wisdom Teeth removal. To learn more about Dr. Ryan, his full profile can be seen at www.eosdds.com

Experience

Diplomate of the American Board of Oral and Maxillofacial Surgery with current hospital affiliations at: Washington Hospital Center Holy Cross Germantown Hospital National Institute of Health/NIDCR

Organizations
American Dental Association. American Association of Oral and Maxillofacial Surgeons. District of Columbia Society of Oral and Maxillofacial Surgeons. District of Columbia Dental Society. American Board of Oral and Maxillofacial Surgeons. Health Volunteers Overseas.

Publications
Journal of Oral and Maxillofacial Surgery Journal of The American Dental Association

Education/Credentials
S.U.N.Y @ Stony Brook- B.S. in Biochemistry, Stony Brook, NY. Northeastern University- M.S. in Perfusion Technology, Boston, MA. D.D.S.- New York University College of Dentistry, New York, NY. Certificate and Chief Resident- Washington Hospital Center, Washington, DC. Clinical Fellow- The Johns Hopkins Hospital, Baltimore, MD.

Awards and Honors
Dr. Ryan has received numerous awards including: 2006 American Association of Oral and Maxillofacial Surgeons Dental Student Award, Washington Hospital Center 2008 Nurses' Choice Physician Collaboration Award, 2009 Resident Research Summit Scholarship Award, and the 2011 Outstanding Surgical Attending in the Department of Oral & Maxillofacial Surgery at Washington Hospital Center. He has also authored/coauthored and published several journal articles and held several teaching positions,including assistant professor, while at NYUCD.

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