Impaction

Question 1

What is Hypodontia?

Answer 1

The developmental absence of one or more teeth excluding the third molars.

Question 2

What is the most common dental anomalies and has a negative impact on both esthetic and function?

Answer 2

Hypodontia

Question 3

What is Oligodontia?

Answer 3

More than 6 teeth missing

Question 4

What is Anodontia?

Answer 4

No teeth at all

Question 5

What to do if pt is present with Hypodontia, Oligodontia, or anodontia?

Answer 5

Accept the missing tooth/teeth - use ortho to close gaps
Plan to replace missing tooth/teeth with proths
Investigate any syndromic origin and address them by medical referral.

Question 6

What is Hyperdontia (Supernumerary tooth)?

Answer 6

is the condition of having teeth that appear in addition to the regular number of teeth (32 in the average adult).

Question 7

Where can supernumerary tooth?

Answer 7

anywhere in the dental arch

Question 8

Supernumerary tooth which appears in the maxillary midline is called a ________

Answer 8

Mesiodens

Question 9

Supernumerary teeth were present in ___ of primary dentition and in ___ of permanent dentition

Answer 9

0.8%
2.1%

Question 10

Most supernumerary teeth are found where?

Answer 10

Maxillary anterior

Question 11

Supernumerary teeth may cause what?

Answer 11

Delayed eruption of adjacent teeth
Significant crowding
Development of cysts or tumors.

Question 12

Supernumerary teeth may be encountered by the general dental practitioner as a chance finding on a radiograph or as the cause of an impacted central incisor.

Question 13

Detection of supernumerary teeth is best achieved by

Answer 13

Thorough clinical.
Radiographic examination.

Question 14

What do you do if you find a supernumerary tooth?

Answer 14

Treatment depends on the type and position of the supernumerary tooth and on its effect on adjacent teeth.

As a majority of supernumerary teeth cause clinical problems, treatment generally consists of removal of the teeth when possible.

Question 15

What is ectopic eruption? 1st molar

Answer 15

A local eruption disturbance characterized by the abnormal eruptive pathway of FPM causing the permanent tooth to be locked under the distal undercut of the second primary molar and failure to erupt into normal occlusal plane.

Question 16

How to dx ectopic eruption?

Answer 16

Clinical eval
Pts age
X-ray

Question 17

If the ectopic eruption received no treatment it may cause

Answer 17

1. Space loss for the erupting permanent premolar
2. Malocclusion
3. Decreased arch length.

Question 18

What to do if pt presents with ectopic eruption of `1st molar?

Answer 18

1. move the ectopically erupting tooth away from the tooth it is resorbing
2. allow it to erupt
3. retain primary second molar

Question 19

What do you use if FPM is partially erupted?

Answer 19

use brass wire or separator elastic.

Question 20

When tooth is less erupted and can not get under the contact point, what do you do?

Answer 20

• Band second primary molar and apply a distal force to the permanent molar via * Helical spring
• Elastomer
• Occlusal surface of the permanent molar must be visible.
• A small ledge of resin/metal button bonded to the occlusal surface. * Occlusal surface serves as the point of force application.
• End of spring can be bonded directly to the impacted tooth.
• Appliance evaluated every two weeks.
• Occasionally need to remove primary molar because of extensive root resorption caused by the permanent molar.
• Loss of arch length is certain.
• Need to plan treatment for impending space loss.

Question 21

What is over-retained primary tooth & ankylosis? aka Sub x ray?ergence or infra-occ

Answer 21

This is a condition where teeth are found with their occlusal surface below the adjacent teeth, long after they should have reached occlusion.
- Not all the over-retained primary teeth are ankylosed

Question 22

How to dx an over-retained primary or ankylosis tooth?xrays

Answer 22

X rays - obliteration of PDL and/or roots become less distinguished

Question 23

How to dx over-retained primary or ankylosis tooth clinically?

Answer 23

Tooth remains below occlusal level
Ankylosed teeth give out a sharp solid sound on a percussion test in comparison to a cushion sound heard in the normal teeth.

Question 24

What do you do if you have an over-retained or ankylosis tooth?

Answer 24

Majority of the time teeth with exfoliate on time - A six-month delay in exfoliation considered acceptable.
First decision to be taken is to determine the time of onset.

Question 25

Late onset? Early onset?

Answer 25

Late onset cases usually are in slight infra-occlusion. * The treatment objectives are focused on the exfoliation of the ankylosed primary tooth. Early onset cases could cause some issues such as: tipped adjacent teeth, supra- eruption of the antagonist. * The treatment objectives are focused on some orthodontic intervention followed by extraction.

Question 26

What do you do when you have over-retained or ankylosis tooth that does NOT have a successor?

Answer 26

- It may be left in the dental arch and used as a natural space maintainer to preserve arch length and the alveolar bone height. - Occlusal disturbances, can be prevented by amplifying the coronal height and proximal contacts with bonded materials. - After an assessment of root resorption and adjacent periodontal support loss, extraction might be needed, then orthodontic intervention could help to close the gap

Question 27

what is canine eruption time?

Answer 27

btw 11-12 years

Question 28

What is the most common impacted tooth?

Answer 28

3rd molars then Canines

Question 29

Maxillary canine impaction occurs in approximately __ of the population and is twice as common in females as it is in males

Answer 29

2%

Question 30

The incidence of canine impaction in the _____ is more than twice that in the ______

Answer 30

Maxilla Mandible

Question 31

What is the % of canines having a bilateral impaction?

Answer 31

8%

Question 32

Approximately _______ of impacted maxillary canines are located labially and _______ are located palatally.

Answer 32

1/3 2/3

Question 33

What is the main reason for palatal impaction of canines?

Answer 33

genetics

Question 34

How to clinically dx canine impaction?

Answer 34

1. Delayed eruption of the permanent canine or prolonged retention of the deciduous canine beyond 14–15 years of age. 2. Absence of a normal labial canine bulge. 3. Presence of a palatal bulge. 4. Delayed eruption, distal tipping, or migration of the lateral incisor.

Question 35

Williams thoughts on what to do with canine impaction?

Answer 35

Selective extraction of the deciduous canines as early as 8 or 9 years of age has been suggested by Williams as an interceptive approach to canine impaction in Class I uncrowded cases.

Question 36

Ericson and Kurol thoughts on what to do with canine impaction?

Answer 36

Ericson and Kurol suggested that removal of the deciduous canine before the age of 11 years will normalize the position of the ectopically erupting permanent canines in: * 91% of the cases if the canine crown is distal to the midline of the lateral incisor. * 64% if the canine crown is mesial to the midline of the lateral incisor

Question 37

Most common methods to fix canine impaction?

Answer 37

The most common methods used to bring palatally impacted canines into occlusion are: 1. Surgically exposing the teeth 2. Placing a bonded attachment.(if traction needed) 3. Allowing them to erupt naturally during early or late mixed dentition. 4. Using orthodontic forces (ballista Spring) to bring the teeth into the arch.