3rd Molars Flashcards
When does eruption of 3rd molar occur?
18-24years
When does crown calcification begin
7-10years and completed by 18yrs
When does root calcification begin
18-25yrs
Agenesis
organ failed to develop - 3rd molar not developed - if mssing at age 14 on radiograph then almost always fail tp erupt
What nerves are at risk with 3molars
IAN
Lingual nerve
Mylohyoid nerve
Long buccal
What guidelines are available for 3rd molars
NICE - XLA of wisdom teeth
SIGN - managment of unerupted impacted 3rd molar
Indications for removal of 3rd molar
Caries, periocornititis
Cysts
Tumours
High risk of disease - horizontally impacted
Tumours
external resoprtion of 7/8
Accessibility
Autotraonsplantation
Medical coniditions - imunnocompromised
Surgical indications - orthgnathic surgery
What is periocorontitis
inflamation around the crown of a partial erupted tooth
Bacteria involved in pericorontits
streptocci
actinomyces
fusobacterium
signs and symptoms of periocorntits
pain
swelling
bad taste
pus discharge
evidence of cheeck biting
occlusal trauma to operculum
limited mouth opening
dysphagia
pyrexia
malaise
regional lymphadenopathy
Tx for periocoronitis
incision of localised pericoronal abscess if required
IDB depend on pain
irrigation with warm saline or chx mw
patient instructed on frequent warm saline
advise analgesia
soft diet and keep fluid levels up
only prescribe antibiotics if systemically unwell
Signs of wisdom tooth close to IDC
deflection of roots
interuption of white lines/lamina dura in canal
darkening of root when crossed by canal
diversion/deflection of IDC
narrowing of root
dark and bifid roots
narrowing of IDC
juxta apical area - radiolucent region lateral to 3rd molar
Depth of impaction of tooth
suerpificial = crown of 8 related to crown of 7
moderate = crown of 8 related to crown and root of 7
deep = crown of 8 related to root of 7
