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Module 6 - Oral Surgery > Maxillary Incisors and Premolars > Flashcards

Maxillary Incisors and Premolars Flashcards

1
Q

3 incidences where delayed eruption of maxillary incisors requires investigation/ monitoring?

A
  1. Contralateral tooth erupted for 6 months.
  2. Both upper centrals missing 1 year after lower centrals erupted.
  3. Deviation from normal sequence of eruption (ex. laterals before centrals).
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2
Q

What is the most common cause of delayed maxillary incisor eruption?

A

TRAUMA.

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3
Q

7 hereditary causes of delayed incisor eruption?

A
  • Supernumeraries.
  • Cleft lip and palate.
  • Cleidocranial disostosis.
  • Odontomes.
  • Abnormal tooth/tissue ratio.
  • Gingival fibromatosis
  • Generalized retarded eruption.
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4
Q

6 environmental causes of delayed incisor eruption?

A
  • Trauma (root dilaceration).
  • Early loss or extraction of deciduous tooth.
  • Retained deciduous tooth.
  • Cyst formation.
  • Endocrine abnormalities.
  • Bone disease.
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5
Q

4 things to look for during examination pf delayed incisor eruption?

A
  • Retained deciduous teeth.
  • Palpable mass palatally/buccally.
  • Lack of space.
  • Erupted mesiodens/supernumeraries
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6
Q

What is the radiographic assessment for the delayed eruption of maxillary incisors?

A

HORIZONTAL PARALLAX - 2PAs.

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7
Q

5 potential management methods for incisor impaction

A
  • Conservative.
  • Interceptive.
  • Exposure.
  • Removal.
  • Transplantation
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8
Q

What is the interceptive technique? Success rate?

A
  • Take out the deciduous tooth and expect the permanent successor to erupt spontaneously.
  • When create and maintain space, 75% ERUPT SPONTANEOUSLY, 55% ALIGN SPONTANEOUSLY.
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9
Q

Success rate of interceptive technique?

A

When creating and maintaining space:
- 75% ERUPT SPONTANEOUSLY
- 55% ALIGN SPONTANEOUSLY.

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10
Q

What is the exposure technique? Success rate?

A
  • Remove other obstruction (ex. supernumeraries) and expose tooth surgically.
  • May require BRACKETS to align.
  • 50-75% ERUPT in 16 MONTHS
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11
Q

Success rate of exposure technique?

A
  • 50-75% ERUPT in 16 MONTHS
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12
Q

What type of incisors have no hope other than to be removed?

A

Severely dilacerated.

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13
Q

2 effects of supernumeraries on tooth positioning?

A
  • Can impede eruption.
  • Can impact alignment.
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14
Q

What kind of flap is cut for the surgical exposure of maxillary incisors?

A

Apically repositioned 3 sided flap.

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15
Q

What is the open technique for the surgical exposure of maxillary incisors (3)?

A
  • APICALLY REPOSITIONED 3-SIDED FLAP.
    1. Flap raised taking as much attached gingivae as possible.
    2. Removal of bone/ fibrous tissue to expose the MAXIMUM CONVEXITY of the tooth.
    3. Repositioned apically and packed, leaving thr CROWN EXPOSED.
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16
Q

What is the open technique for the surgical exposure of maxillary incisors (3)?

A
  • APICALLY REPOSITIONED 3-SIDED FLAP.
    1. Flap raised taking as much attached gingivae as possible.
    2. Removal of bone/ fibrous tissue to expose the MAXIMUM CONVEXITY of the tooth.
    3. Tooth is dried, etched and an ORTHODONTIC BRACKET with a GOLD CHAIN is bonded to its surface.
    4. Repositioned back to original place, CROWN CANNOT BE SEEN..
17
Q

What is an open technique suitable?

A

When the tooth is a SMALL DISTANCE FROM WHERE IT SHOULD ERUPT.

18
Q

When is an open technique contraindicated? Why?

A
  • NOT indicated for teeth that are HIGHLY IMPACTED.
  • Can lead to POOR GINGIVAL AESTHETICS, ROOT SENSITIVITY AND TSL.
19
Q

When is a closed technique indicated? What is an advantage of this technique?

A
  • When the incisor is IMPACTED AT A HIGH POSITION
  • BETTER GINGIVAL AESTHETICS.
20
Q

When is incisor removal indicated?

A

Severely dilacerated incisor that cannot be aligned.

21
Q

5 causes for mandibular premolar impaction?

A
  • Crowding.
  • Pathology.
  • Ankylosed deciduous tooth.
  • Supernumeraries
  • Genetic disorders.
22
Q

Where are premolars typically impacted?

A

LINGUAL/ PALATAL DISPLACEMENT!! Buccal displacement rare.

23
Q

What is the incidence of impacted mandibular premolars? Mandible + maxilla?

A
  • 0.2-0.3%.
  • 0.5% overall.
24
Q

What flap design is used to expose the mandibular premolars?

A

2 sided MP flap.
- Mesial relieving incision: ensure far away from mental foramen.
- Pericoronal incision.

25
Q

Do you use open or closed technique when surgically exposing the mandibular premolar?

A

Can use EITHER depending on the position of the premolar.

26
Q

What are supplemental supernumeraries? Where are they common?

A
  • Healthy teeth that look exactly like the teeth they are replacing.
  • Common in the MAXILLA in the PREMOLAR/THIRD MOLAR region.
27
Q

What are conical supernumeraries? Where are they common?

A
  • Peg shaped teeth.
  • Commonly erupt in the MAXILLARY CENTRAL INCISOR POSITION.
  • When a conical supernumerary erupts between the centrals it is termed MESIODENS.
28
Q

How are mesiodens removed?

A

With LA and an elevator as roots are very small.

29
Q

What is a mesiodens?

A

A conical supernumerary tooth that has erupted between the centrals.

30
Q

What are tuberculate supernumeraries? Where are they common?

A
  • Do not resemble a tooth/ MALFORMED TEETH.
  • Often FAIL TO ERUPT
31
Q

A condition that is associated with supernumerary teeth?

A

Cleidocranial disostosis

32
Q

3 complications of odontomes?

A
  • Can impede eruption of teeth (need to be surgically removed)
  • Can erupt into the mouth (hygiene problematic - can become carious and have to be removed).
  • Can develop pathology.
33
Q

What are the two types of odontomes?

A
  • Compound: proliferation of the dental lamina, thus consist of a number of denticles. CAN SEE INDIVIDUAL TEETH.
  • Complex: do not resemble tooth (disordered aggregation of enamel, dentine, cementum and pulp).
34
Q

Where are odontomes common?

A
  • Complex: POSTERIORLY.
  • Compound: ANTERIORLY.
35
Q

What are odontomes? What else are they called?

A
  • Genetic malformations called HEMARTOMA.
  • Account for 22% of odontogenic tumors but are entirely BENIGN.

Module 6 - Oral Surgery (11 decks)

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