OD23

Question 1

What are the most commonly impacted teeth?

Answer 1

8 > upper 3 > upper 1 > lower 4 > lower 5 > supernumerary [83145$]

Question 2

What are some potential complications of impacted teeth?

Answer 2

• Pericoronitis
• Resorption = unerupted teeth accelerate resorption of overlying primary teeth
• Cystic change = overlying halo, leading to destruction of bone in local area – if perforates buccal cortex get infection there also
• Food trap
• Mandibular fracture – if tooth is in the line of the fracture remove it as it decreases healing by leaving tooth present

Question 3

Some indications to remove wisdom teeth?

Answer 3

o Caries, pulpal, periapical pathology, cellulitis, abscess, osteomyelitis, resorption, tooth fracture, disease of the follicle
o Repeated pericoronitis
o One severe bout pericoronitis

Question 4

Exceptions where pathology is not necessary for removal of wisdom teeth?

Answer 4

Orthognathic surgery = usually extracted ~1 year before surgery

Question 5

Some symptoms of an impacted tooth?

Answer 5

•	Retention of deciduous tooth
•	Tooth missing
•	Swelling
•	Mobility of adjacent tooth
•	Tilting of adjacent tooth – especially upper 
        anteriors
•	Loss of vitality of adjacent tooth
•	Pericoronitis

Question 6

Factors to examine on a radiograph for impacted teeth?

Answer 6

Depth
Angulation
Crown Features
Root morphology
Texture bone – difficult to do
Relationship to vital structures (mental, and inferior alveolar nerve, maxillary sinus)
Adjacent teeth

Question 7

What are some red flags that root morphology is close to the inferior alveolar canal?

Answer 7

Darkening of the root
Diversion of the canal
Interruption of the cortical outline

Question 8

What radiograph would you request if you suspected involvement of the IAC?

Answer 8

CBCT

Parallax views – 2 radiographs with a tube shift inbetween
2 Periapicals (CLARK’S METHOD)
Occlusal and DPT

Question 9

What are some surgical problems to warn the patient of?

Answer 9

Vital structures (IAN 2.2%, LING 0.3%)
Root displaced into maxillary antrum

Don’t speak in jargon