Speaker: Mariana Velazquez , DDS
Mariana Velazquez was born and raised in Caracas, Venezuela. After graduating with honors from high school, she pursued the same career path as her mother, her oldest brother and 21 other family members. She went to dental school at the Universidad Central de Venezuela, where she graduated at the top of her class.
Dr. Velazquez then moved to Boston, Massachusetts, where she completed her Oral and Maxillofacial Surgery internships and residency at Boston University. During her training, she attended Boston Medical Center, Beth Israel Medical Center, the Veterans Affairs Hospitals and Lemuel Shattuck Hospital. She also served one year of General Surgery and had extensive training in Anesthesiology.
Dr. Velazquez belongs to several professional organizations including the American Association of Oral and Maxillofacial Surgeons, the Florida Society of Oral and Maxillofacial Surgeons, the American Dental Association, the Florida Dental Association and the South Florida District Dental Association. She also currently serves as President of the Miami Dade Dental Society.
Dr. Velazquez is a Diplomate of the American Board of Oral and Maxillofacial Surgeons.
She also has hospital affiliations with Baptist Hospital, South Miami Hospital, Doctors Hospital and Nicklaus Children’s Hospital.
Dr. Velazquez areas of interest are dentoalveolar surgery, implantology, anesthesia, pathology and facial trauma and reconstruction. She believes in high-quality care and good communication with patients and colleagues.
Topic: Coronectomy: An alternate method for high risk third molar surgery.
Iatrogenic damage to the Inferior Alveolar Nerve (IAN) is a significant risk factor following prophylactic or therapeutic removal of impacted mandibular third molar. The risk to IAN injury increases many fold, when the third molar root overlaps the nerve canal as identified by the radiographic imaging.
The common risk factors for the IAN damage includes advanced age and difficult impaction but the most important one is the proximity of the root to the IAN canal. The incidence of IAN injury following mandibular third molar extraction is 0.41% to 8.1% for temporary altered sensation and 0.014% to 3.6% for permanent nerve damage. But the incidence increases up to 20% to 36% in high risk cases as defined by radiographic signs described by various authors which includes alteration in the root structure (darkening, narrowing, root deflection, bifid apex or overlapping over the nerve canal) or alteration in the inferior alveolar canal features (obliteration of radio opaque line, deflection or narrowing of the inferior alveolar canal). In these cases the nerve injury may occur either due to the instrumentation or due to crushing and tearing of the nerve by the root during tooth elevation.
The coronectomy procedure is a technique that reduces morbidity of the Inferior Alveolar Nerve (IAN) after removal of high-risk mandibular third molars. The success of coronectomy relies on the retained root fragment having vital, non-inflamed pulpal tissue and normal surrounding bone.
The patient’s age is important in treatment planning, in that conceptually coronectomy is believed to be more appropriate for older patients, who in general do not tolerate nerve
damage as well as young patients.
Coronectomy significantly reduces inferior alveolar nerve injury even in high risk cases, with reduced morbidity and other associated complications in contrast to conventional technique.