Impactions

Question 1

Indications for removal of impactions

Answer 1

• Infection/inflammation
• Caries of impacted tooth
• Facial pain
• Pressure on adjacent teeth
• Pathology
• Orthodontic treatment

Question 2

Complications during/after surgery to remove impacted 3rd molars

Answer 2

Crown or root fracture
Fracture of bone
Displacement of tooth into the submandibular or infratemporal area
asipiration of tooth
Soft tissue laceration
Post op bleeding, pain, swelling

Question 3

Describe the Pell and gregory Impacted 3rd molar classification

Answer 3

Class
Position
Angulation
Relationship to inferior Alveolar Nerve

Question 4

Describe Pederson difficulty Index

Answer 4

• Angulation

Mesioangular 1
Horizontal 2
Vertical 3
DistoAngular 4

• Depth
  A 1
  B 2
  C 3
• Ramus relationship
  class 1 2 3

Difficulty index
- very D 7-10
- Mod D 5-7
- Min D 3-4

Question 5

How can we determine the inferior alveolar involvement of a 3rd molar on a radiograph

Answer 5

Root Darkening ( loss of root density )
Root Deflection ( deviation of roots )
Root Narrowing ( Narrowing of the tooth roots where the canal crosses )
The presence of a dark and bifid root apex
Interruption of the white lines of IAC

Question 6

Post OP care and instructions for impactions

Answer 6

Pressure pack to control bleeding
Ice pack to control swelling
If local anaesthetic was used avoid eating and drinking until anaesthetic wears off
Prescription for control of Pain and swelling and infection
Soft Diet for 1-2 days

Question 7

Treatment of Pericoronitis

Answer 7

Hydrogen peroxide mouth wash
AntiBiotic and Pain
Determine occlusal trauma
Trismus present?

Question 8

What is the prescription for hydrogen peroxide

Answer 8

For pericoronitis specifically -
20 vol (6%) H2O2
100ml dilute 10ml 1:1 with water and use as mouthwash q8h