Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

xD2 Oral Surgery Final > Management of Impacted Teeth > Flashcards

Management of Impacted Teeth Flashcards

1
Q

What is the term for a tooth ooth that fails to erupt into the dental arch within the expected time? (Another definition is a tooth that has not completely erupted into the oral cavity and can no longer reasonably be expected to do so)

A

Impacted tooth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are 4 reasons teeth become impacted?

A
  1. Adjacent teeth
  2. Dense overlying bone
  3. Excess soft tissue
  4. Genetic abnormality
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the most common reason teeth become impacted?

A

inadequate dental arch length and space in which to erupt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the most common impacted teeth?

A

Max & Mand 3rd Molars > Max Canines > Mand PM> Mand Canines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the general rule for the treatment of impacted teeth?

A

Remove unless surgery is contraindicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are 6 indications for the removal of an impacted tooth?

A
  1. Pericornitis
  2. Caries
  3. Perio disease
  4. Resorption/caries in adjacent tooth
  5. Cysts/ tumors
  6. Ortho
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Within what demographic is the removal of impacted teeth optimally indicated?

A

Young patients because they olerate surgery better, recover quicker, and experience less interference in daily life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Erupted teeth adjacent to impacted teeth are susceptible to what?

A

Periodontal disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the term for the infection of the soft tissue around the crown of a partially impacted tooth and is usually caused by normal oral flora? (It can also be caused by trauma from an opposing fully erupted third molar occluding on the overlying tissue)

A

Pericornitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Because the impacted third molar occupies space normally occupied by bone, what is the patient at more risk for?

A

Jaw fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the 2 most important factors concerning periodontal healing following impacted third molar extraction?

A
  1. The extent of preoperative infrabony defect on distal of 2nd molar
  2. The patient’s age at time of surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Contraindications for removal of impacted teeth primarily involve what?

A

The patient’s physical status

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Most common contraindication for removal of impacted teeth?

A

Advanced age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the Ideal time for removal of impacted third molars?

A

When roots are 1/3 formed and before they are 2/3 formed. Approximately late teenage between 17-20 yrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the average age for complete 3rd molar eruption?

A

20

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the average age for third molar eruption in males?

A

Erupt after 20 and are fully in place by 25

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

The majority of impaction classification schemes are based on what?

A

Radiographic analysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which radiograph shows the most accurate picture of the total anatomy of the region and is the radiograph of choice for planning the removal of impacted third molars?

A

Panoramic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the most commonly used impaction classification system based upon?

A

Angulation of the long axis of impacted thirds w/ respect to long axis of adjacent 2nd molar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the 4 angulation classifications?

A
  1. Mesially
  2. Horizontally
  3. Vertically
  4. Distally
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which angulation class is considered least difficult to manage?

A

Mesioangular, partially impacted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the most common impaction seen, comprising 43% of all impactions?

A

Mesioangular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the 2nd most frequent impaction angle of 3rd molars, comprising 38% of all impactions?

A

Vertical impaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the most difficult angulation for removal?

A

Distoangular, because withdrawal pathway that runs into mandibular ramus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the classification for an impacted tooth is tilted toward the second molar in a mesial direction?

A

Mesioangular impaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the impaction classification when the long axis of the third molar is perpendicular to the second molar?

A

Horizontal impaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the impaction classification when the long axis runs parallel to the long axis of the second molar

A

Vertical impaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the impaction classification when the long axis is distally or posteriorly angled away from the second molar?

A

Distoangular impaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is a method used to classify impacted mandibular 3rd molars that is covered with the bone of the mandibular ramus? (According to Dr Lam, this is not a clinically useful criteria, but is more research-related)

A

Pell and Gregory Classification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the classification for when the mesiodistal diameter of the crown is completely anterior to the anterior border of the mandibular ramus? (This classification carries a good prognosis for complete eruption)

A

Pell and Gregory Class 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the classification for when the tooth is positioned posteriorly so that approximately one half is covered by the ramus? (Tooth cannot erupt completely free from bone over the crown and a small shelf of bone overlies distal portion of tooth)

A

Pell and Gregory Class 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the classification for when the tooth is located completely within the mandibular ramus? (Provides least accessibility and greatest difficulty for extraction)

A

Pell and Gregory Class 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are the Pell and Gregory classifications that compare the depth of the impacted tooth with the height of the adjacent second molar?

A

Pell and Gregory Class A, B, C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is the term for when an impacted tooth is level or nearly level with the occlusal plane of the second molar?

A

Pell and Gregory Class A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the term for when an impacted tooth with an occlusal surface between the occlusal plane and the cervical line of the second molar?

A

Pell and Gregory Class B

36
Q

What is the classification for an impacted tooth with the occlusal surface of the impacted tooth below the cervical line of the second molar?

A

Pell and Gregory Class C

37
Q

What are 6 factors for determining surgical difficulty?

A
  1. Tooth position
  2. Patient Age
  3. Bone Density
  4. Position of tooth in relation to other anatomic structures (IAN, Max sinus)
  5. Cooperation of patient
  6. Surgeon experience
38
Q

What are 5 root-associated considerations for determining extraction difficulty?

A
  1. Root length (Optimum to EXT = 1/3 formed)
  2. Root curvature
  3. Root curve direction (could be helpful, e.g. distal curved root with mesioangular angled impacted tooth)
  4. Root width PDL space
39
Q

What are the 5 basic steps for removing impacted teeth?

A
  1. Reflect adequate flaps for accessibility 2. Remove overlying bone
  2. Section the tooth
  3. Deliver sectioned tooth with elevator
  4. Prepare for wound closure (recontour bone and irrigate)
40
Q

How far should you remove the bone on the occlusal, buccal, and distal aspects of the impacted bone?

A

Down to the cervical line

41
Q

Should bone be removed on the lingual aspect of the impacted tooth and why?

A

No, due to the likelihood of lingual nerve damage

42
Q

With respect to follicle size when considering difficulty of impaction extraction, what is the best follicle size and why?

A

Follicle around tooth is wide/ almost cystic. Because much less bone must be removed

43
Q

What is the best way to determine patient’s bone density?

A

Best to determine by age. Patients who are 18 and younger have the most favorable bone density for extraction

44
Q

Patients above what age have much denser bone and decreased flexibility and ability to expand for impacted tooth extraction?

A

Over 35 yrs old

45
Q

Where does the IAN usually go in relation to the impacted third molar, though it is superimposed on the radiograph?

A

IAN buccal to mandinbular 3rd

46
Q

What are some common symptoms associated with mandibular 3rd molar extractions with respect to IAN?

A

Paresthesia or anesthesia of lower lip and chin lasting few days to weeks, rarely permanent

47
Q

What are 8 complications associated with Impacted tooth extraction?

A
  1. Soft tissue injuries
  2. Complications w/ tooth being extracted
  3. Injuries to adjacent teeth
  4. Injuries to Osseous Structures
  5. Injuries to adjacent Structures
  6. Oroantral communications
  7. Postoperative bleeding
  8. Delayed healing and infection
48
Q

What is associated with an inadequately sized flap retracted beyond the tissue’s ability to stretch? (E.g short envelope flap when area of surgery is at the apex)

A

Tearing mucosal flap/soft tissue injury

49
Q

How can you prevent tearing the mucosal flap?

A
  1. Adequate flap size

2. Gentle retraction

50
Q

How manage a torn mucosal flap?

A

Reposition and suture. If there are jagged edges, trim before suturing.

51
Q

What is caused by instrument slippage and how can it be prevented?

A

A puncture wound of soft tissue. Prevent by controlling force.

52
Q

How do you manage a puncture wound of soft tissue?

A

Suturing to prevent infection and allow healing to occur

53
Q

What is a soft tissue injury caused by bur shank or retractor and how is it prevented?

A

Stretch or abrasion injury. Prevent by being careful.

54
Q

What is the management for stretch and abrasion injury to soft tissues?

A

Keep it moist (ointment)

It will heal within 5-10 days

55
Q

What occurs when tooth being extracted has long, curved, divergent roots, or by excessive force during extraction?

A

Root fracture

56
Q

How are root fractures prevented?

A

Proper exposure and bone removal

57
Q

What are 4 places an impacted root can be displaced into?

A
  1. Mandibular canal
  2. Lingual pouch
  3. Infratemporal space
  4. Maxillary sinus
58
Q

What are 2 injuries that can occur on the adjacent teeth during impacted tooth extraction

A
  1. Luxation of Adjacent teeth

2. Fracture of adjacent restoration

59
Q

What is the least common impaction? (Making up about 3% of molar angulation)

A

Horizontal impaction

60
Q

What is the cause of luxation of adjacent teeth or fracture of adjacent restoration?

A

Carelessness. Prevented by judicious use of elevators

61
Q

What causes the fracture of the buccal or lingual cortex of alveolar bone and how is it prevented?

A

Caused by inadequate exposure and excessive force. Prevented by adequate bone removal and exposure.

62
Q

What is the cause of maxillary tuberosity fractures?

A

Excessive force. Prevented by proper support and controlled force

63
Q

What is the management of Maxillary tuberosity fracture?

A

If still attached, dissect and remove tooth. If detached, smooth bone edges and suture

64
Q

What is the cause of Mandible fracture and how do you prevent it?

A

Caused by excessive force. Prevented by proper bone removal and controlled force

65
Q

Excessive extraction force on teeth with curved roots or sectioning the tooth all the way inferiorly can cause what

A

Injury to Inferior alveolar nerve

66
Q

What are 3 ways to prevent injury to the inferior alveolar nerve?

A
  1. Proper exposure and bone removal
  2. Controlled force
  3. Careful sectioning, leave a shell of tooth
67
Q

What injury can be caused by placement of retromolar incision far lingually, or sectioning the tooth all the way to the lingual cortex?

A

Lingual nerve injury

68
Q

What are 3 keys to preventing lingual nerve injury

A

Proper incision, careful sectioning, leaving a shell of tooth

69
Q

What is an injury caused by inadequate support of the mandible during extraction and can be prevented by the use of a bite block?

A

Injury to TMJ

70
Q

How do you manage an injury to the TMJ?

A

Reduction

71
Q

What is the term for remedying a dislocation or fracture by returning the affected part of the body to its normal position?

A

Reduction

72
Q

What injury occurs in the maxilla during extraction of impacted maxillary canines caused by excessive bone removal or failure to locate the tooth?

A

Oroantral communication

73
Q

What are 3 preventative measures for oroantral communication?

A
  1. Proper preoperative radiographic evalulation
  2. Proper bone removal
  3. Controlled force
74
Q

What are 3 causes of postoperative bleeding?

A
  1. Bleeding at wound margins
  2. Bleeding at bony foramen within socket
  3. Medical problem
75
Q

What are 4 preventative measures to avoid postoperative bleeding?

A
  1. Good medical history
  2. Atraumatic surgical extraction
  3. Obtain good hemostasis at surgery
  4. Postoperative instructions
76
Q

What are 4 things to do for atraumatic surgical extraction?

A
  1. Clean incisions
  2. Gentle management of soft tissues
  3. Smoothen bony specules
  4. Curette granulation tissue
77
Q

What are 5 local measures to control postoperative bleeding?

A
  1. Pressure packs
  2. Suturing
  3. Ligate bleeding vessels
  4. Burnish bone
  5. Apply material to aid hemostasis
78
Q

Debris left under the flap causes what and how can it be prevented?

A

Causes infection. Can be prevented with irrigation.

79
Q

What is the management for post-extraction infection caused by debris left under flap?

A

Debridement and drainage

80
Q

What is the term for lysis of a fully formed blood clot before the clot is replaced with granulation tissue?

A

Dry Socket/Alveolar Ostitis

81
Q

What are 2 demographics that have higher incidence of dry socket/alveolar ostitis

A
  1. Smokers

2. Patient taking oral contraceptives

82
Q

What are 2 preventative measures against post-extraction dry socket/ alveolar ostitis?

A
  1. Presurgical irrigation w/ antimicrobial (e.g. Chlorhexidine)
  2. Intraoperative irrigation with saline
83
Q

What is the management protocol for dry socket/alveolar ostitis?

A 
Irrigate with warm saline 
Remove old clots 
Place sedative dressing 
Prescribe mild analgesics 
Reassess after 24-48 hrs
84
Q

Does the presence of 3rd molars mean there will be anterior crowding?

A

No

85
Q

Are 3rd molars removed for solely prophylactic purposes?

A

No

86
Q

What are the size differences between a follicular sac and follicular cyst?

A

Follicular sac up to 1.5 cm

Follicular cyst >1.5cm

xD2 Oral Surgery Final (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions