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Oral Surgery > Surgical Removal of Impacted Teeth > Flashcards

Surgical Removal of Impacted Teeth Flashcards

1
Q

Definition of Impacted teeth

A

an impacted tooth is one that fails to erupt into the dental arch within the expected time.

the eruption has been impeded by adjacent teeth, dense bone, or excessive soft tissue

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2
Q

most common impacted? why?

A

3rd molars – becauwe lase to erupt

then canine – maxillary - because later in eruption as well

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3
Q

general rule about impacted teeth

A

should be removed unless removal is contra-indicated

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4
Q

ideal time for 3rd molar removal

A

when the roots of the teeth are on-third formed and before they are 2/3 formed

usually between the ages of 17 and 20

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5
Q

indications for removal of impacted teeth (long list)

A
  1. prevention of perio disease
  2. prevent caries
  3. prevent pericornitis
  4. prevention of root resorption
  5. impacted teeth under a dental prosthesis
  6. prevention of odontogenic cysts and tumors
  7. tx of pain of unexplained origin
  8. prevention of jaw fracture
  9. facilitation of orthodontic treatment
  10. optimal periodontal healing
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6
Q

main reason to remove the 3rd molars

A

Periodontal disease prevention

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7
Q

study regarding the dominant hand *

A

no difference

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8
Q

pericorinitis

definition and describe

A

seen in partially erupted teeth with large amounts of soft tissue over the occlusal surface

it is an infection of the soft tissue around the crown

caused by noraml oral flora

host defense maintain balance

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9
Q

pericorinitis secondary to

A

to minor trauma from the maxillary third molar - traumatizes the operculum over the partially erupted mandibular 3rd molar

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10
Q

take out opposing third molar to diminish pericorinitis

A

yes – could be harmful to the tooth having pericorinitis

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11
Q

pericorinitis caused by

A

streptococci and anaerobic bacteria

can be mild to severe

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12
Q

tx for periorintis

mild?
moderate?
severe?

A

mild – irrigation

moderate – tx with antibiotics

severe – facial space infections - trismus, temp greater than 101 F, mailaise, facial swelling, pain – need referral and possible hospital admit.

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13
Q

tx for periorintis

mild?
moderate?
severe?

A

mild – irrigation

moderate – tx with antibiotics

severe – facial space infections - trismus, temp greater than 101 F, mailaise, facial swelling, pain – need referral and possible hospital admit.

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14
Q

operculectomy?

A

usually does not work to cure the pericoriniits – tends to recur

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15
Q

risk factors for external root resoprtion of second molars associated with impacted third molars?

A

increased with age and with mesioangular and horizontal inclincations

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16
Q

impacted tooth removal before other tx?

A

yes - should be removed before prosthesis is constructed - because if the impacted tooth must be removed after construction, the alveolar ridge may be so altered by the extraction that the prosthesis becomes unaatractive and less functional

17
Q

operculum is?

A

soft tissue covering an impacted / partially erupted tooth

18
Q

odontogenic cysts and tumors association

A

it is recommended that impacted teeth be removed to prevent the occurence of cysts and tumors

19
Q

diagnosis of a dentigerous cyst is reasonable when?

A

if the follicular space around the crown of the tooth is greater than 3mm, the diagnosis of a dentigerous cyst is reasonable

20
Q

most common odontgenic tumor

A

ameloblastoma in the third molar region

21
Q

relative contraindications for removal of impacted teeth

A
  1. over age 40

2.

22
Q

over age 40 details

A
  1. highly calcified brittle bone
  2. prolonged healing time
  3. anesthesia considerations
23
Q

impacted teeth classification

A
  1. angulation
24
Q

impacted teeth classification

A
  1. angulation
25
Q

impacted teeth classification in terms of angulation

A
  1. angulation
    - mesio-angular
    - horizontal
    - vertical
    - distoangular
26
Q

mesioangular impaction details

A

*generally acknowledged as the least difficult to remove in the mandible

tilted toward the second molar in a mesial direction

approx. 43% of all impacted mandibular third molars

27
Q

horizontal impaction

A

approx 3% (based on info we have) of mandibular impactions

second ‘ easiest

28
Q

classification (3 caegories)

A
  1. angulation
  2. relationship to the anterior border of the ramus
  3. relationship to the occlusal plane
29
Q

relative contraindications to removal of impacted teeth

A
  1. probable damaeg to adjacent structures
    - nerves
    - major blood vessels
    - teeth
    - prostheses
  2. long standing asymptomatic tooth
30
Q

age when relative contraindications to removal of impacted teeth

A

over 40

  • highly calcified brittle bone
  • prolonged healing time
  • anesthesia considerations

Medical status
- ASA classification

31
Q

vertical impaction

A

long axis of the tooth runs in the same direction as the long axis of the second molar

approx. 38%

the third most difficult to remove

32
Q

*distoangular impaction details

A

the MOST difficult angulation for removal of mandibular impacted tooth

long axis of the third molar is distally or posteriorly angled AWAY from the second molar

its path of withdrawl runs into the mandibular ramus *

approx. 6% of mandibular third molars

33
Q

PG / Pell and Gregoy classsification

A
  1. Relationship to the anterior border of the ramus

1,2,3

  1. Relationship to the occlusal plane
    A,B, and C
34
Q

PG classification 1

A

the mesiodistal diameter of the crown is completley anterior to the anterior border of the ramus

35
Q

PG classification 2

A

approx. half the crown is covered by the anterior border of the ramus

36
Q

PG classification 3

A

the crown is covered entirely by the anterior border of the ramus

37
Q

normal development of the lower third molars sequence

A

starts at disto-angular – changes to mesio-angular – then to vertical

38
Q

usual time of eruption of the 3rd molars

A

20 – can continue to erupt into the age of 25

Oral Surgery (26 decks)

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