third molars - assessment Flashcards
Describe the components of the history assessment for removing third molars
General appearance
Presenting complaint
HPC
Pain history
Medical history
Dental history
Social history
What are some aspects of the clinical assessment for removing third molars?
Extra-oral examination (TMJ, lymphadenopathy, facial asymmetry)
Intra-oral examination (soft tissue examination, dentition, eruption status, occlusion, oral hygiene, caries status, periodontal status).
When is radiographic assessment necessary for removing third molars?
If surgical intervention is being considered.
What information can be obtained from a radiographic assessment of third molars?
The presence or absence of disease
Anatomy of the third molar
Depth and orientation of impaction
Crown:root ratio
Working distance
Follicular width
Periodontal status
Any associated pathology.
How can a high-risk third molar be identified on a radiograph?
Proximity to the maxillary antrum or inferior dental canal
Presence of associated pathology
Unfavorable crown root ratio
What are the signs associated with a significantly increased risk of nerve injury during third molar surgery?
Diversion of the inferior dental canal
Darkening of the root where crossed by the canal
Interruption of the white lines of the canal
When should cone beam computed tomography (CBCT) be used in relation to the third molar and inferior dental canal?
If conventional imaging shows a close relationship between the third molar and inferior dental canal
What type of radiograph can be used for caries detection?
Periapicals
Describe the angulation of third molars
Vertical (30-38% of cases)
Mesial (40%)
Distal (6-15%)
Horizontal (3-15%)
Transverse or aberrant (quite rare).
What makes distally impacted third molars difficult to remove?
The roots are close to the roots of the second molars, making it hard to get a good application point for extraction
Define transverse angulation of third molars
When the crown is buccally placed and the roots are lingually placed, or vice versa
What does aberrant mean in relation to third molars?
Tooth positioned in an odd place, such as midway up the ramus of the mandible or lower border of the mandible
How is the angulation/orientation of third molars measured?
Against the curve of Spee
What does depth indicate in relation to third molars?
It gives an indication of the amount of bone removal required
What is a superficial third molar?
Crown of the 8 related to crown of the 7
