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SP15 Oral Surgery > Impacted Teeth > Flashcards

Impacted Teeth Flashcards

1
Q

This is the failure of the tooth to fully erupt within the expected developmental time period

A

impacted tooth

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2
Q

This is when the tooth has not perforated the oral mucosa

A

unerupted tooth

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3
Q

True or False

Not all unerupted teeth are impacted

A

True

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4
Q

What is the age of 3rd molar crown formation

A

14 years

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5
Q

What is the age of 3rd molar root formation

A

approximately 50% by 16 years

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6
Q

What is the average age of formation of 3rds

A

20 years and as late as 24

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7
Q

Position of 3rd does not change substantially after what age

A

25

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8
Q

What are the four theories of impacted 3rds

A

differential root growth between mesial and distal
inadequate arch space
dental development lags skeletal development
obstruction secondary to cyst, tumor, supernumeray teeth

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9
Q

This winters classification of mandibular 3rd contains 43% of cases and are generally the easiest to extract

A

mesioangular

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10
Q

This winters classification of mandibular 3rds contains 6% of cases and are the most difficult to extract

A

distoangular

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11
Q

This winters classification of mandibular 3rds contains 3% of case and are difficult to extract

A

horizontal

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12
Q

This winters classification of mandibular 3rds contains 38% of cases and are generally easy to extract

A

vertical

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13
Q

This winters classification of maxillary 3rd is 63% of cases

A

vertical

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14
Q

This winters classification of maxillary 3rds is 25% of cases

A

distoangular

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15
Q

This winters classification of maxillary 3rds is 12% of cases

A

mesioangular

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16
Q

This winters classification of maxillary 3rds is rarely seen (<1%)

A

horizontal

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17
Q

What are the three different codings regarding the removal of 3rds

A

soft tissue
partial bony
full bony impaction

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18
Q

What are four things to consider regarding the roots when extracting 3rds

A

length
fused vs. separate and distinct
curvature
PDL space

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19
Q

An increase of this facilitates delivery

A

follicle size

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20
Q

What are 5 considerations before extracting 3rds

A 
acute infection
history of pericornitis
ANUG
herpes labialis
sinusitis
21
Q

What are 5 tolerance factors regarding the patient to be taken into consideration

A 
age
psychological factors
prior experiences
difficulty of impaction
degree of opening (ROM)
22
Q

This indication for removal is to treat a currently active process/disease

A

therapeutic

23
Q

This indication for removal is to prevent future disease or other problems

A

prophylactic

24
Q

What are some therapeutic indications for removal

A 
pericoronitis
caries
pathological resorption
pathology
eruption pain
crowding
post-orthodontics
orthognathic surgery
in the line of a mandible fracture
periodontal disease
lack of attached gingiva
crowding
25
Q

What four things are important to document when removing 3rd

A

probing depths
detailed clinical and radiographic findings
patient education
CONSENT

26
Q

What is the idea patient for 3rds removal

A 
2/3rd of root formation
18-25 year old
healthy
no psychological contraindications
no job restriction to "numb lip"
27
Q

What are the age contraindications of 3rd molars

A

young age; mandible may grow to accommodate 3rds

old age; most common contraindications for removal

28
Q

What is it about “old age (>40) bone” that is contraindicative for 3rds removal

A

highly calcified bone
less flexible bone
recuperate more slowly

29
Q

There is an increased tendency towards these regarding 3rd removal in old age

A

increased tendency toward mandibular fractures
increased tendency toward non-resolving fracture
increased tendency toward infection - osteomyelitis

30
Q

How should you monitor an old age patient regarding extractions

A

with a panoramic x-ray every 1-2 years

31
Q

How much overlying bone would be a contraindication for removal in >40 years

A

4mm

32
Q

This is a major contraindication for 3rds removal

A

compromised medical status

33
Q

What are four adjacent anatomic structures that could be damaged from removal of 3rds

A

IAN
adjacent teeth/restorations
periodontal injury to adjacent teeth
sinus communication

34
Q

What four things make up the assessment and planning of the patient initial exam

A

document the video watched
document all risks, benefits, and indications
questions answered
NPO and anesthesia plan reviewed

35
Q

What anesthesia is typically used for extractions

A

2% lidocaine with 1:100k epi
0.5% maracaine with 1:200k epi
V2 and V3 blocks
long buccal

36
Q

What is the incision/flap design for maxillary 3rds

A

crestal incision - sulcular

1-2 adjacent

37
Q

What is the addition to the incision/flap design for really highly impacted maxillary 3rds

A

vertical release

38
Q

What four things are important regarding the “socket toilet”

A

remove follicle
gentle curette of socket
irrigate with copious amounts of saline
don’t drown the patient

39
Q

If there is no path of withdrawal when removing roots, do this

A

remove more bone or section the tooth

40
Q

What could be done to ensure that all of the tooth structures have been extracted

A

“puzzle” them back together

41
Q

If you hear this, its indicative of a root that has failed until proved otherwise

A

a snap or crack

42
Q

This is your responsibility upon finishing the extraction

A

inspect and verify no debris have been retained in the socket or under the flap; smooth any prominent, rough, or unsupported areas of bone

43
Q

What are the four characteristics of suturing

A

use 3-0 chromic
keep it simple
not too many - many lead to excessive swelling
reapproximate passively with minimal tension

44
Q

This tooth is also typically impacted due to crowding from adjacent teeth and difficult route to erupt

A

maxillary canine

45
Q

It is important to know this about an impacted maxillary canine

A

whether it is located buccal or palatal

46
Q

What type of incision is used for maxillary canine impacted extraction

A

sulcular

47
Q

What is an open flap design involving the maxillary canine

A

apically repositioned flap
best for labial impacted teeth
do not remove bone beyond the CEJ

48
Q

In an open flap, the flap is sutured apically to allow what

A

the attached tissue to erupt with the crown of tooth

49
Q

What is a closed flap design involving maxillary canine

A

full thickness flap
best for palatal impacted teeth
do not remove bone beyond CEJ
suture flap over tooth

SP15 Oral Surgery (7 decks)

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