Impacted Incisors & Premolars

Question 1

what 2 reasons are there to investigate unerupted maxillary incisors?

Answer 1

if contralateral incisor has been erupted for 6 months
if both lower centrals erupted for 1 year and still no upper centrals

Question 2

list inherited causes of delayed eruption

Answer 2

supernumaries
cleft lip/palate
CC dysostosis
odontomes
abnormal tooth/tissue ratio
gingival fibromatosis - gingivae too thick

Question 3

where are incisors usually displaced? what flap required?

Answer 3

labially - so buccal flap

Question 4

explain open technique - where is flap repositioned? only when is it used? negative consequences?

Answer 4

flap repositioned apically - bone and fibrous tissue removed to expose max bulbosity of tooth
only used when tooth small distance from where it is meant to be
can cause root exposure and hypersensitivity, poor aesthetics, tooth loss

Question 5

explain closed technique - benefits?

Answer 5

flap raised, chain bonded to tooth, mucosa sutured back to original position, gold chain attached to ortho bracket
better gingival health and aesthetics

Question 6

mandibular premolars - where are they usually placed? what flap? (position and deisgn)

Answer 6

mandibular - lingually
maxillary - buccally
raise buccal flap
2 sided for mandibular premolars - mesial reliving incision should avoid mental bundle

Question 7

name 3 classes of supernumaries

Answer 7

supplemental - look normal
conical - cone shape
tuberculate - barrel shaped w/ several cusps
mesiodens - conical between centrals

Question 8

what condition is associated w/ unerupted supernumaries?

Answer 8

CC dysostosis

Question 9

name 2 types of odontomes - what does each look like?

Answer 9

complex = disordered aggregation of dental tissues, cannot make out teeth
compound = bag of teeth, number of denticles
can impede eruption - surgical removal required