Post on 16-Jul-2015
Tooth impaction Research Articles
Tooth impaction refers to the failure of teeth to erupt
into the mouth within the normal time, where the failure
of outburst appears to originate from mechanical blocking. Tooth impaction may result from a number of
local causal factors. These include arch length discrepancy, ectopic positioning of the teeth, presence
of supernumerary teeth, bony barriers, and retained deciduous teeth
Angulation of tooth Most commonly used
classification system with respect to treatment
planning. Depending on the angulation the tooth
might be classified as
Mesioangular
Horizontal
Vertical
Distoangular
Palatal
Buccal
Lingual
This type of classification is based on the amount of
impacted tooth that is covered with the mandibular ramus. It is known as the Pell and Gregory classification, classes
1, 2, and 3. [3]
Impacted wisdom teeth don't always cause symptoms.
However, when an impacted wisdom tooth becomes infected, damages other teeth or causes other dental
problems, you may experience some of these signs or symptoms:
Pain
Red or swollen gums
Tender or bleeding gums
Swelling around the jaw
Bad breath
An unpleasant taste in your mouth
Headache
Complications
Damage to other teeth. If the wisdom tooth pushes
against the second molar, it may damage the second molar or make it more vulnerable to infection. This
pressure can also cause problems with crowding of the other teeth or orthodontic treatments to straighten other
teeth.
Cysts. The wisdom tooth grows in a sac within the
jawbone. The sac can fill with fluid, forming a cyst that can damage the jawbone, teeth and nerves. Rarely, a
tumor — usually a noncancerous tumor — develops.
This complication may require removal of tissue and bone.
Decay. Partially impacted wisdom teeth appear to be
more vulnerable to tooth decay (caries) than other teeth.
This probably occurs because wisdom teeth are harder to clean and because food and bacteria get easily
trapped between the gum and a partially erupted tooth.
Gum disease. The difficulty of cleaning impacted,
partially erupted wisdom teeth also makes them a vulnerable site for the development of a painful,
inflammatory gum condition called pericoronitis (per-ih-kor-o-NI-tis)
Classification Winter's
The classification is based on the inclination of the
) to the long axis of the3rd molarimpacted wisdom tooth (
.2nd molar
The impacted tooth is tilted toward the . Angular-Mesio
direction mesial 2nd molar in a
The long axis of the 3rd molar is . Angular-Disto
l awayfrom the 2nd mola distally / posteriorlyangle
horizontal The long axis of the 3rd molar is . Horizontal
The long axis of the 3rd molar is parallel to the . Vertical
long axis of the 2nd molar.
the above, In combination with . Lingual Obliquity / Buccal
the tooth can be
(tilted lingually (tilted towards the cheek) or buccally
towards the tongue)
impacted.
This is where the tooth is in . Transverse
impacted but in a horizontally effect
tongue direction.-cheek
Classification Pell & Gregory's
This is based on the relationship between the impacted
lower wisdom tooth (3rd
(lower jaw) and the ramus of the mandible molar) to the
molar (based on the2nd
to the 2nd molar). distal space available
of the impacted tooth is at occlusal plane The . Class A
the same level as the
(The highest portion of of the 2nd molar. occlusal plane
impacted 3rd molar is on
).clusal planeoc a level with or above the
of the impacted tooth is occlusal plane The . Class B
occlusal plane between the
(The highest of the 2nd molar. cervical margin & the
portion of impacted 3rd
cervical but above the occlusal plane molar is below the
ar).of the of 2nd mol line
cervical The impacted tooth is below the . Class C
(The of the 2nd molar. margin
cervical highest portion of impacted 3rd molar is below the
of the of 2nd line
molar).
There is sufficient space available between . Class 1
theanterior border of the
aspect of the 2nd molar for distal & the ascending ramus
the eruption of the 3rd
molar.
anterior border The space available between the . Class 2
& the of the ramus
aspect of the of the 2nd molar is less than distal
of the distal width-mesio the
portion of distal It denotes that the crown of the 3rd molar.
the 3rd molar crown is
.ascending ramus covered by bone of the
The 3rd molar is totally embedded in the bone of . Class 3
anterior border of the
ack of because of the absolute l the ascending ramus
It is obvious that space.
teeth present more difficulty in removal as a Class 3
relatively large amount of
damaging bone has to be removed and there is a risk of
fracturing or the ID nerve
the mandible(or both).
Classification of Impacted Maxillary 3rd Molars
3rd molars is maxillary classification of impactedThe
similar to those used for
3rd molars. mandibular
Classification Gregory-Pell
of the impacted tooth is at occlusal plane The . Class A
the same level as the
(The lowest portion of of the 2nd molar. occlusal plane
impacted 3rd molar is on a
).occlusal plane level with or above the
of the impacted tooth is occlusal plane The . Class B
occlusal plane between the
(The lowest of the 2nd molar. cervical margin & the
f impacted 3rd molarportion o
of cervical line but above the occlusal plane is below the
the of 2nd molar).
cervical The impacted tooth is below the . Class C
(The of the 2nd molar. margin
cervical lowest portion of impacted 3rd molar is below the
of 2nd molar).of the line
Winter's Classification
Vertical Horizontal
Mesio-Angular Disto-Angular
Inverted Bucco-version
Linguo-version Transverse
These classifications have been revised / tweaked / conflated by Archer (1975) &
Kruger (1984).
Relationship of the Maxillary 3rd Molar to the Maxillary Sinus / Antrum
Sinus Approximation (SA):
No bone or thin partition of bone twixt the
impacted maxillary 3rd molar & the maxillary sinus / antr
> 2mm of bone twixt the impacted maxillary 3rd molar & the maxillary sinus /
antrum.
No Sinus Approximation (NSA):
> 2mm of bone twixt the impacted maxillary 3rd molar &
the maxillary sinus /
antrum.