Impacted teeth Flashcards
Winter Lines
White line – occlusal surfaces of erupted mandibular molars and extended over the 3rd molar posteriorly
indicates the difference in occlusal levels
Amber line – surface of the bone on the distal aspect of the 3rd molar to the crest of the inter-dental septum between 1st and 2nd molars. Denotes the margin of the alveolar bone covering the 3rd molar and give indication of the amount of bone that will need to be removed.
Red line – line drawn perpendicular from the amber line to the point of application. Cemento-enamel junction on the mesial aspect of tooth
Signs that the IDN is close to the tooth
Deviation of the nerve
narrowing of the nerve
loss of tram lines
change in radiodensity of the tooth
tx options
surgical removal
coronectomy
operculectomy
remove opposing tooth
surgical exposure
monitoring
indications for removal of impacted 3rd molars
pericoronitis 2+
unrestorable caries
non-treatable pulpal disease
internal/external resorption of tooth
periodontal disease
fracture of tooth
disease of follicles eg cyst/tumour
tooth impeding surgery
tooth involved in field of tumour resection
indications not to remove an impacted 3rd molar
no symptoms
minimal symptoms
lower incisor crowding
contralateral tooth
clinical assessment for ectopic canines
bulge palpable buccally/labially
proclination of upper incisors
vitality of upper lateral incisors
mobility of lateral upper incisors
retention of deciduous canines
Parallax
IOPAs x 2
IOPA and Ant occ
OPT and Ant occ
Tx options for ectopic canines
leave and monitor
exposure (open and closed)
surgical removal
risks involved in the management of impacted canines
leave and monitor –> risk of movement which can cause damage eg root of lateral incisor/cyst formation
surgical removal –> orthodontists may do this if the tooth does not come down into the arch within a reasonable time period
