Management of impacted teeth
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Transcript of Management of impacted teeth
Principles of management of impacted teeth
Dr.Mohamed Rahil (( Maxillofacial surgeon ))
Tikrit dentistry college 2015 – 2016
impaction An impacted tooth is any tooth that is prevented from reaching its normal position in the mouth by tissue, bone, or another tooth.
Indications for Extraction
• Localized or Generalized Neuralgias • Pericoronitis• Production of Caries• Destruction of Adjacent Teeth Due to
Resorption of Roots• Participation in the Development of
Various Pathological condition• Restrict the Placement of a Partial or
Complete Denture. • Restrict the Normal Eruption of
Permanent Teeth• Provoking or Aggravating
Orthodontic Problems
Timing
most suitable time is when the patient is young due to :
younger patients generally well tolerate surgical procedure and stress .
faster postsurgical wound healing compared with older patients.
Bone removal more easy in young than older patient.
Steps of Surgical Procedure1. Incision and reflection of the mucoperiosteal flap
2. Removal of bone to expose the impacted tooth
3. Luxation of the tooth
4. Care of the postsurgical socket and suturing of the wound
Impacted Third Molar Classifications• Mesioangular• Distoangular• Vertical• Horizontal• Buccoangular• linguoangular• Inverted
• Class A: The occlusal surface of the impacted tooth is at the same level as, or a little below that of, the second molar
• Class B: The occlusal surface of the impacted tooth is at the middle of the crown of the second molar or at the same level as the cervical line
• Class C: The occlusal surface of the impacted tooth is below the cervical line of the second molar
Class 1: The distance between the second molar and the anterior border of the ramus is greater than themesiodistal diameter of the crown of the impacted tooth
Class 2: The distance is less and the existing space is less than the mesiodistal diameter of the crown of the impacted tooth
Class 3: There is no room between the second molar and the anterior border of
the ramus, so that the entire impacted tooth or part of it is embedded in the ramus
Types of Flaps
Triangular flap:• The incision for this type of flap
begins at the anterior border of the ramus (external oblique ridge) with special care for the lingual nerve and extends as far as the distal aspect of the second molar,
• while the vertical releasing incision is made obliquely downwards and forward, ending in the vestibular fold .
Types of Flaps
Horizontal (envelope) flap:• The incision for the flap also
begins at the anterior border of the ramus and extends as far as the distal aspect of the second molar, continuing along the cervical lines of the last two teeth, and ending at the mesial aspect of the first molar.
• This type of flap is usually used in cases where impaction is relatively superficial.
Types of Flaps
Removal of Bud of Impacted Mandibular Third Molar
Extraction of Impacted Third Molarin Horizontal Position
Extraction of Third Molar with Mesioangular Impaction
Extraction of Third Molarwith Distoangular Impaction
Extraction of Impacted Third Molarin Edentulous Patient
Impacted Premolar
Impacted Canine
Extraction of Impacted Maxillary Teeth
Impacted Third Molar
Impacted Canines
Extraction Using Labial Approach
Extraction Using Palatal Approach
Ectopic Impacted Canine
Exposure of Impacted Teethfor Orthodontic Treatment
Impacted Mandibular Caninewith Labial Position
Thank you for listening