7 - Third molars 2 Flashcards

1
Q

What HPC is required for the assessment of third molars?

A
  • how long?
  • how many episodes?
  • how often?
  • severity?
  • antibiotics?
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2
Q

Describe the EO exam for third molars.

A
  • TMJ
  • limited mouth opening
  • lymphadenopathy
  • facial asymmetry
  • MOM
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3
Q

Describe the IO exam for third molars.

A
  • STE
  • condition of dentition
  • M2M prognosis and working space
  • eruption status of M3M
  • occlusion +/- operculum
  • OH
  • caries and perio status
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4
Q

When is an OPT appropriate for third molar assessment?

A

Only when surgical removal is being considered

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5
Q

What should be assessed on an OPT for third molar surgery?

A
  • presence/absence of disease
  • anatomy of third molar
  • depth of impaction
  • orientation of impaction
  • working distance
  • follicular width
  • perio status
  • proximity of upper third molars to sinus
  • proximity of lower third molars to ID canal
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6
Q

What does follicular width on an OPT indicate?

A
  • radiolucency around third molar
  • if larger than 2.5-3mm then indicative of a cyst
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7
Q

What third molar anatomy can be observed on an OPT?

A
  • crown size
  • shape
  • condition
  • root formation
  • crown to root ratio
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8
Q

What is the working distance?

A

Distal of lower 7 to ramus of mandible

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9
Q

What are the different ways that the M3M can be related to the ID canal radiographically?

A
  • interruption of white lines of canal
  • darkening of root where crossed by canal
  • diversion/deflection of ID canal
  • deflection of root
  • narrowing of ID canal
  • narrowing of root
  • dark and bifid root
  • juxta apical area
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10
Q

Which radiographic signs are associated with increased risk of nerve injury during third molar surgery?

A
  • diversion fo ID canal
  • darkening of root where crossed by canal
  • interruption of white lines of canal
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11
Q

What is meant by a bifid root?

A

Root appears to spilt or divide around ID canal

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12
Q

What is a juxta apical area?

A
  • well defined radiolucent area lateral to root
  • corticated margin
  • lamina dura still intact
  • not pathological
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13
Q

When is further imaging indicated?

A
  • close relationship of M3M to ID canal, CBCT may be beneficial
  • caries, PA may benefit
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14
Q

Define a transverse third molar.

A

Roots are placed buccal or lingual

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15
Q

Define an abberant third molar.

A

In unusual place ie lower border or mandible or half way up ramus

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16
Q

How is the angulation of third molars measured?

A

Against the curve of spee

17
Q

Define superficial impaction.

A

Crown of 8 related to crown of 7

18
Q

Define moderate impaction.

A

Crown of 8 related to crown and root of 7

19
Q

Define deep impaction.

A

Crown of 8 related to root of 7

20
Q

What are the different angulations of impactions of third molars?

A
  • vertical
  • mesial
  • distal
  • horizontal
  • transverse
  • aberrant