3rd Molar Assess

Question 1

What hx would want regarding wisdom teeth?

Answer 1

PC - episodes of infection, previous tx, PMH

Question 2

How examine wisdom tooth?

Answer 2

Caries/ pathology inc adjacent teeth
Degree impaction
Food packing
Opposing wisdom tooth

Question 3

What are indications for XLA 8s?

Answer 3

Unrestorable pathology
Cellulits/ abscess
Recurent or severe episodes pericoronitis
Resoprtion inc adjacent teeth
Fracture
Involved in tumour resection

Question 4

What special tests can be used to assess wisdom tooth?

Answer 4

Perio pocket - deep pockets (area for debris to accumulate)
PA - technically difficult in lower 8s
OPT - ideal radiographic assessment inc IAN

Question 10

When is CBCT used?

Answer 10

Close proximity IAN
Associated w/ cyst
Unusual root anatomy/ angulation

Question 11

What is a fun bony impaction?

Answer 11

Tooth fully enclosed in bony cavity

Question 12

Issues w/ PE teeth?

Answer 12

Plaque retention and higher risk of pericoronitis

Question 13

How can angulation of wisdom tooth be classified?

Answer 13

Horizontal, distoangular, mesioangular and vertical

Question 14

What indicates close proximity to IAN?

Answer 14

Dark band over root, narrowing IAN, bifid roots
Interruption of white line of canal, diversion of canal, narrowing IAN

Question 15

When should CBCT be carried out?

Answer 15

No clear guidance inUK
Suggested if 1+ sign of close proximity and CBCT will change tx or tx outcomes

Question 16

Is pre-op CBCT associated w/ reduced IAN damage?

Answer 16

No

Question 17

What are options for repeated pericoronitis and high chance IAN damage

Answer 17

Do nothing
Smoothing opposing tooth
Operculecomty
Coronectomy

Question 18

What are risks for XLA?

Answer 18

Pain, swelling, bleeding, infection
Altered sensation lower lip, chin and tongue, teeth - temp or permanent, damage to adjacent teeth, retained roots which may require further surgery