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SP15 Oral Surgery > Impacted Teeth > Flashcards

Impacted Teeth Flashcards

(49 cards)

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1
Q

This is the failure of the tooth to fully erupt within the expected developmental time period

A

impacted tooth

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2
Q

This is when the tooth has not perforated the oral mucosa

A

unerupted tooth

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3
Q

True or False

Not all unerupted teeth are impacted

A

True

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4
Q

What is the age of 3rd molar crown formation

A

14 years

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5
Q

What is the age of 3rd molar root formation

A

approximately 50% by 16 years

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6
Q

What is the average age of formation of 3rds

A

20 years and as late as 24

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7
Q

Position of 3rd does not change substantially after what age

A

25

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8
Q

What are the four theories of impacted 3rds

A

differential root growth between mesial and distal
inadequate arch space
dental development lags skeletal development
obstruction secondary to cyst, tumor, supernumeray teeth

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9
Q

This winters classification of mandibular 3rd contains 43% of cases and are generally the easiest to extract

A

mesioangular

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10
Q

This winters classification of mandibular 3rds contains 6% of cases and are the most difficult to extract

A

distoangular

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11
Q

This winters classification of mandibular 3rds contains 3% of case and are difficult to extract

A

horizontal

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12
Q

This winters classification of mandibular 3rds contains 38% of cases and are generally easy to extract

A

vertical

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13
Q

This winters classification of maxillary 3rd is 63% of cases

A

vertical

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14
Q

This winters classification of maxillary 3rds is 25% of cases

A

distoangular

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15
Q

This winters classification of maxillary 3rds is 12% of cases

A

mesioangular

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16
Q

This winters classification of maxillary 3rds is rarely seen (<1%)

A

horizontal

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17
Q

What are the three different codings regarding the removal of 3rds

A

soft tissue
partial bony
full bony impaction

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18
Q

What are four things to consider regarding the roots when extracting 3rds

A

length
fused vs. separate and distinct
curvature
PDL space

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19
Q

An increase of this facilitates delivery

A

follicle size

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20
Q

What are 5 considerations before extracting 3rds

Study These Flashcards
A 
acute infection
history of pericornitis
ANUG
herpes labialis
sinusitis
21
Q

What are 5 tolerance factors regarding the patient to be taken into consideration

Study These Flashcards
A 
age
psychological factors
prior experiences
difficulty of impaction
degree of opening (ROM)
22
Q

This indication for removal is to treat a currently active process/disease

23
Q

This indication for removal is to prevent future disease or other problems

24
Q

What are some therapeutic indications for removal

Study These Flashcards
A 
pericoronitis
caries
pathological resorption
pathology
eruption pain
crowding
post-orthodontics
orthognathic surgery
in the line of a mandible fracture
periodontal disease
lack of attached gingiva
crowding
25
What four things are important to document when removing 3rd
probing depths detailed clinical and radiographic findings patient education CONSENT
26
What is the idea patient for 3rds removal
``` 2/3rd of root formation 18-25 year old healthy no psychological contraindications no job restriction to "numb lip" ```
27
What are the age contraindications of 3rd molars
young age; mandible may grow to accommodate 3rds | old age; most common contraindications for removal
28
What is it about "old age (>40) bone" that is contraindicative for 3rds removal
highly calcified bone less flexible bone recuperate more slowly
29
There is an increased tendency towards these regarding 3rd removal in old age
increased tendency toward mandibular fractures increased tendency toward non-resolving fracture increased tendency toward infection - osteomyelitis
30
How should you monitor an old age patient regarding extractions
with a panoramic x-ray every 1-2 years
31
How much overlying bone would be a contraindication for removal in >40 years
4mm
32
This is a major contraindication for 3rds removal
compromised medical status
33
What are four adjacent anatomic structures that could be damaged from removal of 3rds
IAN adjacent teeth/restorations periodontal injury to adjacent teeth sinus communication
34
What four things make up the assessment and planning of the patient initial exam
document the video watched document all risks, benefits, and indications questions answered NPO and anesthesia plan reviewed
35
What anesthesia is typically used for extractions
2% lidocaine with 1:100k epi 0.5% maracaine with 1:200k epi V2 and V3 blocks long buccal
36
What is the incision/flap design for maxillary 3rds
crestal incision - sulcular | 1-2 adjacent
37
What is the addition to the incision/flap design for really highly impacted maxillary 3rds
vertical release
38
What four things are important regarding the "socket toilet"
remove follicle gentle curette of socket irrigate with copious amounts of saline don't drown the patient
39
If there is no path of withdrawal when removing roots, do this
remove more bone or section the tooth
40
What could be done to ensure that all of the tooth structures have been extracted
"puzzle" them back together
41
If you hear this, its indicative of a root that has failed until proved otherwise
a snap or crack
42
This is your responsibility upon finishing the extraction
inspect and verify no debris have been retained in the socket or under the flap; smooth any prominent, rough, or unsupported areas of bone
43
What are the four characteristics of suturing
use 3-0 chromic keep it simple not too many - many lead to excessive swelling reapproximate passively with minimal tension
44
This tooth is also typically impacted due to crowding from adjacent teeth and difficult route to erupt
maxillary canine
45
It is important to know this about an impacted maxillary canine
whether it is located buccal or palatal
46
What type of incision is used for maxillary canine impacted extraction
sulcular
47
What is an open flap design involving the maxillary canine
apically repositioned flap best for labial impacted teeth do not remove bone beyond the CEJ
48
In an open flap, the flap is sutured apically to allow what
the attached tissue to erupt with the crown of tooth
49
What is a closed flap design involving maxillary canine
full thickness flap best for palatal impacted teeth do not remove bone beyond CEJ suture flap over tooth

SP15 Oral Surgery (7 decks)

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