Prophylaxis of impacted teeth using MRI and focal ultra-sound ablation?… a feasible hypothesis.
Teeth start as bi-layered epithelial soft tissue follicles within bony jaws. Follicles grow into teeth and erupt. Early third molar follicles are detectable 8-9 years (±9 months). Intra-oral dental arches of jaws have finite space accommodating formed crowns. The last teeth to erupt are third molars. When the space needed by all the teeth exceeds the total arch space available, wisdom teeth may become impacted in bone. Lower impactions are more prevalent due to the mandible shape, and impaction associated pathologies with erupting partially or totally impacted teeth are common. Impacted third molars are universally prevalent from 17 to 23 years. Third molar impactions are sources of infection, pain, cyst formation and contribute to malocclusions and other pathologies. Surgical removal of third molars is traumatic, invasive and painful and may produce complicating morbidities. Magnetic resonance imaging (MRI) is used to locate lesions with clear definition and accurate targeting, both in soft and hard tissue organs. Focused ultrasound (FUS) is used to ablate hard and soft tissue structures and stops growth of targeted pathologies. For example, FUS is used to ablate CNS brain tumours, cell causing Parkinson's disease, prostatic growths and thrombolysis in strokes.


OBJECTIVE
Modern imaging techniques, like MRI, can accurately locate third molar follicles at age 9, before wisdom teeth form and grow. MRI in combination with FUS could be used to ablate follicles of third molars, stop tooth growth (both crown and root) and so avoid later impactions.
McGill Faculty of Dentistry, Montreal, PQ, Canada. louis.touyz@mcgill.ca
Louis Z G
LZ
Touyz
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Dent
D005240:Feasibility Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D014095:Tooth, Impacted / Q000517:prevention & control*; D014463:Ultrasonography / Q000379:methods*