Managment Of Impacted Teeth

Question 1

The tooth that has failed to erupt partially or completely to its correct position in the dental arch and its eruption potential has been lost

Answer 1

Impacted tooth

Question 2

Most common impacted teeth

Answer 2

Maxillary canines

Question 3

Impacted max canine- how much of population?

Answer 3

~2%

Question 4

Maxillary canines - most common in male or female and most common cause

Answer 4

Female
Inadequate arch length

Question 5

Eruption in abnormal position

Answer 5

Ectopia

Question 6

Palatally impacted canines

Answer 6

2/3
85% had sufficient space

Question 7

Labially impacted canines

Answer 7

1/3
17% had sufficient space

Question 8

A canine can be ______ impacted because of genetic predisposition

Answer 8

Palatally

Question 9

Arch length discrepancy primary etiologic factor

Answer 9

Labially impacted canine

Question 10

Causes of canine impaction

Answer 10

Genetic or ethnic
Retained deciduous
Space deficiency
Short lateral roots
Abnormal eruption sequence
Trauma to primary tooth bud
Premature root closure
Eruption into cleft

Question 11

What are labial impactions usually

Answer 11

Vertical
Due to loss of space

Question 12

What are palatal impactions usually

Answer 12

Horizontal

Question 13

Root resorption of _____ teeth

Answer 13

Root resorption

Question 14

Dentigerous _____ and ameloblastoma

Answer 14

Cyst

Question 15

When is there first evidence of calcification of permanent canine

Answer 15

4-5 months

Question 16

Crown formation of permanent canine

Answer 16

5-6 years

Question 17

Eruption permanent canine

Answer 17

11-12 years

Question 18

Root completed permanent canine

Answer 18

13-15 years

Question 19

Clinical signs of impacted canine

Answer 19

Delayed eruption of canine (failure by 14 to erupt)
Prolonged retention of primary canine
Elevation of soft tissue either labially or Palatally
Distal migration of lateral incisors

Question 20

Determine _____ before initiating treatment

Answer 20

Location

Question 21

What diagnostic information is needed

Answer 21

X-rays
Photos
Palapation

Question 22

SLOB/Clark’s Rule

Answer 22

Same lingual opposite buccal

Question 23

If impacted tooth moves in the same direction as the second PA the tooth is _____

Answer 23

Lingual or palatal

Question 24

Impactions in the palate will generally appear larger and more blurry than the Contralateral canine

Answer 24

Panorex

Question 25

Buccal (facial) impactions appear vertical and coronal to the apices of the anterior teeth Palatal impactions appear horizontal and apical to the anterior teeth

Answer 25

Lateral ceph

Question 26

Facial permanent canine eruption

Answer 26

Arch length deficiency (crowding) Detected earlier than palatal Easier to manage May be transposed

Question 27

Palatal permanent canine eruption

Answer 27

No arch length deficiency Watch for 6 month difference from Contralateral canine Treat early

Question 28

Tx choices of impacted canine

Answer 28

Exposure and natural eruption Exposure and ortho Extraction and premolar substation Reimplantation

Question 29

When facial canine, usually need just simple ________ and ___________ mechanics, __________ preservation is chief concern

Answer 29

Uprighting Extrusive Anchorage

Question 30

Soft tissue considerations - facial

Answer 30

Flap design

Question 31

Flap design facial

Answer 31

Preserve attached gingiva Closed eruption of apically repositioned flaps Adequate exposure for bonding

Question 32

Palatal — ________ arch and make space (TPA, heavy arch wires), expose

Answer 32

Stabilize

Question 33

Soft tissue considerations (palatal)

Answer 33

Full thickness flap Good hemostasis Bone removal if necessary

Question 34

Full thickness flap

Answer 34

Open or closed eruption

Question 35

Attachment to cuspids

Answer 35

Important utilize proper bonding techniques Ensure bond is to crown not root Usually placed by periodontist/OS

Question 36

Clinical hints

Answer 36

Identify impactions early - X-rays, clinical exam Extract primary canine - facilitate eruption

Question 37

Palatal impactions usually require __________ surgery

Answer 37

Exposure

Question 38

What do you want to determine the prognosis of before extracting primary teeth

Answer 38

Prognosis of impaction

Question 39

You want to establish good ______ and space for the impacted tooth before bringing into the arch

Answer 39

Anchorage

Question 40

You want to apply ______ to the tooth immediately following exposure (no later than 2-4 weeks)

Answer 40

Traction

Question 41

The removal of the deciduous canine before the age of 11 years will _____ the position of the ectopically erupting permanent canines in ____ % of the cases if the canine is ______ to the midline of the lateral incisor

Answer 41

Normalize, 91%, distal

Question 42

The success rate is only ___% if the canine crown is _____ to the midling of the lateral incisor

Answer 42

64% Mesial