الضرس الثالث: معلومات وحقائق

Impacted Teeth

• Impacted teeth are teeth that have not erupted through the gum line.
• Several factors can cause tooth impaction, including:
  • Developmental issues.
  • Bone placement.
  • Cysts or tumors.
  • Infection.
  • Fusion.
  • Hereditary traits.
  • Vitamin deficiencies (A and D).
• Third molar embryology:
  • Tooth bud formation: 4-5 years old
  • Calcification: 9-10 years old
  • Full crown completion: 12-15 years old
  • Eruption: 17-21 years old
  • Root formation: 18-25 years old
• Third molars often have a mesial and lingual orientation.
• Changes in angulation typically occur between 14-16 years old.
• Indications for extraction:
  • Hypertrophy, cyst, or tumor development of the follicle.
  • Repeated pericoronitis episodes.
  • Irreversible carious lesions.
  • Distal periodontal defect or caries on the second molar in relation to the third molar.
  • Prophylactic extraction.
• Measurements can be used for impacted teeth extraction. Examples include:24.9 mm and 33.5 mm.
• Possible surgical interventions include: Operculectomy.

Operculectomy

• A procedure to remove a covering of gum tissue that is interfering with tooth eruption.
• Performed "How and When" is a question.

Winter's Classification

• A system for classifying the position and orientation of impacted third molars. Includes these characteristics:
  • Mesioangular
  • Horizontal
  • Vertical
  • Distoangular
  • Inverted

Pell and Gregory's Classification

• Used to identify the different types of impacted third molars. Subdivided into classes

Prophylactic Third Molar Extraction

• Indicates the reasons why third molars might be extracted preemptively.
• These include: Reducing neighbouring teeth damage
• Improving oral health in younger patients.
• Or, as part of orthodontic treatment.

Golden Time for Extraction

• The ideal time to extract impacted teeth to avoid complications.
• This is after the roots are approximately one-third to two-thirds formed.
• Ideally not performed before 16 years of age for optimal root development.

Surgical Odontectomy of Impacted Teeth

• A surgical procedure to remove impacted teeth.
• It involves several defined steps.

Systemic Evaluation for Impacted Teeth

• History taking includes evaluating age, diabetes, heart conditions, allergies, kidney issues, lung problems, pregnancy, hypertension and details
• Evaluation of systemic diseases needing to be controlled.
• Before the treatment, pre-medication is mandatory, including antibiotics, corticosteroids and sedatives.

Intra-oral Evaluation

• Key factors for intra-oral evaluation include
  • The shape of the impacted tooth.
  • Tooth axis orientation.
  • Relationship between impacted tooth and other structures, like the tooth ramus, second and third molars.
  • Depth of the impaction itself.
• Minor evaluative factors include
  • Oral hygiene condition.
  • Caries status.
  • Periodontal health.

Radiographic Evaluation

• Six essential radiological criteria:
  • Identifying the classification of the impaction.
  • Assessing the impacted tooth's relation to the second molar.
  • Distal bone level evaluation.
  • Root evaluation of the impacted wisdom tooth.
  • Evaluating the inferior alveolar canal position.
  • Determining density of surrounding bone.

Post-operative Complications

• Potential post-operative complications include: infection, swelling, pain, trismus, and paresthesia.
  • Swelling may include complications from edema, sterile or septic conditions, emphysema or hematoma formations.

Assessment of Degree of Difficulty

• Impacted tooth-related factors.

• Patient-related factors.

• Surgeon-related factors.

• Impacted tooth-related factors include:

  • Classification, of impacted tooth,
  • Nature of impaction,
  • Crown condition, and
  • Root condition.

• Patient-related factors include:

  • Patient's age.
  • Sex/Gender.
  • Patient medical and psychological status.
  • Patient motivation and cooperation.

• Surgeon-related factors. include:

  • Surgeon's skill,
  • Surgical facilities,
  • Access availability,
  • And, surgeon's training & development level.

Impacted Maxillary Canine

• Archer's classification for classifying maxillary canines, including:

  • Class I: Palatally impacted canine (horizontal, vertical, semivertical)
  • Class II: Buccally impacted canine (horizontal, vertical, semivertical)
  • Class III: Impacted canines in palatal and/or labial surfaces.
  • Class IV: Impacted canines in the alveolar process.
  • Class V: Impacted canines in an edentulous maxilla.

• Treatment might involve buccal impaction and unilateral or bilateral palatal impactions.

اختبر معلوماتك عن شكل وتكوين الضرس الثالث. يتناول هذا الاختبار موضوعات مثل العمر الذي يبدأ فيه تشكيل الأسنان وأسباب استخراج الضرس الثالث. تعرف على الأدلة والمعايير المتعلقة بالعناية بصحة الفم.