Management of impacted mandibular third molar /certified fixed orthodontic courses by Indian dental academy
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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats. Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics, Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call 0091-9248678078
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Management of impacted mandibular third molar /certified fixed orthodontic courses by Indian dental academy
- 1. MANAGEMENT OF IMPACTED MANDIBULAR THIRD MOLAR www.indiandentalacademy.com
- 2. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
- 3. • IMPACTED TOOTH – DEFINITION • CLASSIFICATIONS • CLINICAL EVALUATION • RADIOLOGICAL ASSESSMENT – WHARF’S ASSESSMENT – “WAR” LINES – PEDERSON’S INDEX • SURGICAL MANAGEMENT www.indiandentalacademy.com
- 4. IMPACTED TOOTH – DEFINITION • Impacted tooth is one that fails to erupt & will not eventually assume its anatomical arch relationship beyond the chronological eruption date. www.indiandentalacademy.com
- 5. PELL & GREGROY’S CLASSIFICATION • Relationship of teeth to Ramus • Relative depth • Long axis of the tooth www.indiandentalacademy.com
- 6. PELL & GREGROY’S CLASSIFICATION www.indiandentalacademy.com
- 7. Archer (1975) and Kruger (1984). www.indiandentalacademy.com
- 8. Quek et al. (2003) • • • • • Vertical impaction (10° to -10°), Mesioangular impaction (11° to 79°), Horizontal impaction (80° to 100°), Distoangular impaction ( -11° to -79°), Others (111° to -80°) www.indiandentalacademy.com
- 10. Int. J. Oral Maxillofac. www.indiandentalacademy.com Surg. 2003; 32: 548–552
- 11. CLINICAL EVALUATION • • • • • Restricted mouth opening Retrusive mandible Small oral commissure Pericoronitis Adjacent teeth www.indiandentalacademy.com
- 13. RADIOLOGICAL ASSESSMENT – WHARF’S ASSESSMENT – “WAR” LINES – PEDERSON’S INDEX www.indiandentalacademy.com
- 14. WHARF’S ASSESSMENT S. No Criteria Category Score 1 Winter’s Horizontal 2 classification Distoangular 2 Mesioangular 1 Vertical 0 1-30mm 0 31-34mm 1 35-39mm 2 Angulation of third 1-50 0 molar 60-69 1 70-79 2 80-89 3 90+ 4 2 3 4 Height of mandible 3 Normal 0 1 Enlarged 2 Space available 0 Distal cusps covered 1 Mesial cusps covered 2 Both covered Path of exit 2 Possibly enlarged 6 1 Unfavorable curvature Follicles Complex Favorable curvature 5 Root shape 3 www.indiandentalacademy.com
- 17. INFERIOR ALVEOLAR NERVE RELATION www.indiandentalacademy.com
- 20. SURGICAL MANAGEMENT • • • • • • • Anesthesia Incision & Mucoperiosteal flap Removal of Bone Tooth Removal Wound Debridement Arrest of hemorrhage Wound closure www.indiandentalacademy.com
- 31. WOUND DEBRIDEMENT & SUTURING www.indiandentalacademy.com
- 32. BONE & TOOTH REMOVAL TECHNIQUES • • • • Bur technique Chisel Technique Split Bone Technique Lateral Trephination Technique www.indiandentalacademy.com
- 33. CHISEL vs BUR CRITERIA Chances of fracture of bone CHISEL & MALLET Relatively High BUR Less Possibility Healing of Bone Good Delayed Post op Edema Less More Dry Socket Post op Infection Deeply buried tooth Incidence is less High Less More Difficult to Remove www.indiandentalacademy.com Relatively Easy
- 34. Split Bone Technique VERTICAL ‘STOP CUT’ AT ANTERIOR END HORIZONTAL CUT JUST ABOVE LOWER END OF ‘STOP CUT’ DISTO LINGUAL BONE FRACTURED WITH CHISEL AT AN ANGLE OF 45◦ PARALLEL TO E.O.R LINGUAL PLATE GRASPED BY HEMOSTAT TOOTH ELEVATED www.indiandentalacademy.com
- 35. Lateral Trephination Technique • S shaped incision from retromolar fossa across external oblique ridge • Bur used to trephine buccal cortical plate over 3rd molar crypt • Vertical cut anteriorly & posteriorly www.indiandentalacademy.com
- 36. Thank you www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com