mpacted teeth

Question 1

Which teeth normally are impacted?

Answer 1

U13 568

Question 2

What are signs to look out for?

Answer 2

RR
>6 MONTH DELAY IN ERUPTION OF PERMANENT TEETH

Question 3

What dental causes of impaction of teeth?

Answer 3

Delayed exfoliation of Deciduous teeth
Abnormal position of the tooth gem
- Ectopia
- supernumerray
Odontomes
Cyst
Trauma
Dilaceration
-ankylosis
Tumors
Systemic cause
Genetic

Question 4

What are the risk of impacted teeth?

Answer 4

• root resorption
• Cyst formation
• Poor aesthetics

Question 5

What do you look out for in CE?

Answer 5

• swelling in the buccal sulcus or palatal
• Angulation of lateral incisors
• Colour changes of deciduous teeth may indicate previous trauma or possible resorption from impacted tooth
• Palpation

Question 6

When should palpation be carried out?

Answer 6

8-10
- Check mobility of Deciduous canines
- Lateral incisors (Eruption 8-9)

Question 7

When would we take an OPG?

Answer 7

-Unerupted teeth
- Root morphology, position , shape , closure of the apex
- Developing dentition
- condyles
- Bone support levels

Pathology
- Cysts , supernumeraries, tumours , PA RLs

Question 8

what are the advantages of an OPG?

Answer 8

Shows full teeth and jaw
Objects close or further away from the beam will be magnified or dimineshed helping localise position

Question 9

What are the disadvantages of the OPG?

Answer 9

Poor quality at the midline
Narrow focal trough
Often require supplemental view to confirm details

Question 10

What are the advantages of lateral cephologram?

Answer 10

Profile view - loclalise tooth positioj on horizontal plane

degree of impaction

Question 11

What are the disadvantages of lateral ceph?

Answer 11

Exposes whole head and neck to radiation - even if low dose

Question 12

When would we take an Lateral CEPH?

Answer 12

Skeletal AP relationship
Trace landmarks and compare to average
Position of unerupted canines in ap plane and vertical plane

Question 13

What are the advantages of occlusal radiographs?

Answer 13

Good detail and low dosage
D: Needs complementary radiograohs to pinpoint tooth location

Question 14

What is the aetiology of unerupted maxillary central incisors?

Answer 14

• Supernumerary
• Cleft lip and palate
• Cleidocranial dystosis
  odontomas
  Gingival fibromatosis
  Trauma
  Early xla
  RR
  CYSTS
  endocrine abnormalities
  bone disease

Question 15

What is the management of unerupted Maxillary Central incisors?

Answer 15

Remove obstruction
- Primary and supernumerary
Make space
- URA
- sECTIONAL FIXED APPLIANCE
- Retainer
Exposure is indicated in failed erupt at 12 months
- erupt through attached ginigiva to minimise apical migration of the gingivae

Question 16

When do the canines erupt?

Answer 16

UPPER 11-12

LOWER 9-10

3s should be palpable bucally by 8-10

Question 17

What is the cause of impacted canines?

Answer 17

Long path of eruption - UR3 cLOSE TO ZYGOMATIC PROCESS
Develops earlier than 2s(8-9) in maxilla
Small or absent 2s
Guided erption by the 2s
Cs resistant ton resorption
Polygenic interfernace

Question 18

what do have to warn the patient anout in impacted teeth?

Answer 18

Root resorption of the 2s
Cyst formation

Question 19

What is interceptive Tx?

Answer 19

• XLA oF BOTH Cs to avoid centraline shift
• Creating or maintaning space
• Consider premolar xla
  Distalation?
  Orthodontic Traction
  NICE - EXPOSE AND BOND IN FAVOUR OF EXPOSE AND PACK

Question 20

When would you consider the surgical removal?

Answer 20

Consider if poorly positioned curved root or XLA needed as part of Orthodontic Tx
Uncrowded = Prostic replacement
Eliminated the ned for frequent radiographic monitoring

Question 21

When do you use autotransplanation/ surgical repositioning?

Answer 21

• Poor posiotn
• Open apex at THE AGE OF 13-14TO AVOID THE LOSS OF VITALITY
• Risk of ankylosis and root resorption
  May require endo
• Long term prognosis is variable
• age dependant
  can be removed autraumatically
  older patient
  Advantageous over RBB IMPLANT

Question 22

what are the risks of alligning impacted canines?

Answer 22

Root resorption of adjacent teeth
Loss of vitality
Poor tissue contour
Increased Pocket depths
Canine root resorption
Ankylosis
Torque Problems

Question 23

Causes and Tx of 5s?

Answer 23

• Likely due to premature loss of secondary primary molars
• accept
• Removal/ incorporate in orhto ext
• Expose and bond

Question 24

Causes and Tx of 6s?

Answer 24

• Blubouse E
• CROWDING
• mesial path of eruption
• primary Fialure of erption
• after 8 yrs
• extract e and disimpact