Third Molars Flashcards
give 2 causes of lack of space in dental arch - causing impaction.
evolutionary changes & lack of an abrasive diet
what are the top 5 most commonly impacted teeth?
- lower 8s
- upper 3s
- lower 3s, 4s and 5s
- upper 1s and 2s
- upper 8s
why are lower 8s the most commonly impacted?
they erupt the latest
what causes malpositioning of ectopic and displaced teeth?
ectopic - congenital factors
displaced - nearby pathology
what happens to teeth at the level of a jaw fracture?
they are rendered non vital
when is it not necessary to XLA impacted lower 8s?
asymptomatic, pt has no complaints, XLA risks nerve damage
what is pericorinitis?
inflammation of tissues around crown of partially erupted or impacted tooth
symptoms of pericorinitis & when to refer
pain, swelling, dysphagia, bad taste, malaise, may lead to cellulitis - if 2 or more cases then refer
is operculotomy recomended?
no as will just re-grow
list local measures for pericoronitis
irrigate w/ saline, OH measures, remove trauma
what can be done if indentations/trauma seen on operculum?
XLA or grind down cusps of opposing 8
when should pt be given antibiotics for pericorinitis? (3) what antibiotic & dose?
is systemically unwell
immunocompromised
if cannot drain locally - trismus, pt uncompliant
metranidazole 400mg 3x daily for 3 days
what microbes are involves in pericoronitis?
what 2 bacteria are involved in increased pocket depths between 2nd & 3rd molars?
anaerobic
prevotella intermedia & campylobacter rectus associated w/ inc pocket depths of 2nd and 3rd molars
list tx options for impacted lower 8s
do nothing, XLA, coronectomy
what radiograph is used to assess lower 8s?
half/whole DPT - PA is 2nd choice