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PubMed1977

Lingual exposure during mandibular third molar surgery.

The necessity for surgical exposure of the lingual aspect of mandibular third molars will vary according to the severity of the impaction and the surgical technique adopted. A retractor is described for use in those cases when major lingual retraction is required. The retractor provides optimum access to the mandibular third molar area with adequate protection for the lingual nerve, tongue retraction and enhanced illumination by light reflection. It can be used under both local and general anaesthesia.

Dental Instruments↗
PubMed1978

The palatally impacted canine: a new approach to treatment.

A method for the application of traction to misplaced maxillary canines in the palate is described. The treatment approach is from the palatal side, with initial traction applied in a lingually downward direction to prevent interference with the neighboring teeth. Emphasis is placed on the suitability of the method as an adjunct to almost any of the established techniques. In this way improving their efficiency in treating the over-all orthodontic problem.

Child↗
PubMed1995

Imaging of unerupted and displaced teeth by cross-sectional CT scans.

Thirty-six impacted and displaced teeth in 29 patients were examined radiographically by using orthopantomography (OPG) and computed tomography (CT). CT scans were obtained by using both a conventional program and a dental CT software program. The radiographic images obtained were compared for visualization of the internal position, inclination of unerupted teeth, and diagnosis of contact and doubtful or clearly visible resorption of adjacent roots. Both CT methods were superior to OPG. As far as the internal position and inclination of the impacted teeth, direct contact, and clearly visible resorption are concerned, the conventional CT program yielded the same information as the dental CT program. However, the exact proportional cross-sectional views obtained by dental CT yielded significantly (P < 0.01) better information about doubtful root resorption in adjacent teeth than did conventional CT.

Adolescent↗
PubMed2003

Personal computer-based three-dimensional computed tomographic images of the teeth for evaluating supernumerary or ectopically impacted teeth.

This study describes the use of personal computer (PC)-based three-dimensional computed tomographic (3D CT) images in the evaluation of supernumerary and ectopically impacted teeth. Three selected cases were presented as examples of the more complex cases in which 3D CT imaging added information not readily available from periapical, occlusal, or panoramic radiographs. Patients were CT scanned from the occlusal plane to the periapical region of the impacted teeth. Digital Image and Communications in Medicine CT data were transferred to a personal laptop computer using a network line. 3D volume rendering was performed using PC-based volumetric analysis software. 3D CT-reformatted imaging of the teeth is a useful way to investigate and localize supernumerary or impacted teeth. Newer software that enables this investigation using a PC provides a relatively inexpensive way to carry out such investigations, making it easier for dental practitioners to request such investigations and to view the results in real time in their own offices.

Adolescent↗
PubMed1984

Root resorption of upper permanent incisor caused by impacted canine. An analysis of 23 cases.

Unusual root resorption of 12 central and 11 lateral upper permanent incisors in 11 patients is described. The degree of resorption ranged from loss of the apical 1/4 to almost complete loss of root structure. Excepting 1 case, permanent canines were partially or completely impacted and their crowns were in close apposition to the resorbed surfaces of the incisors. The roots of the canines were either in the process of formation or completely formed. The findings suggest that the pressure from the canine which persists in moving downward despite the lack of space to permit normal eruption could cause root resorption of adjacent incisors even in the absence of systemic factors. Of 14 extracted incisors, 10 were replaced orthodontically by the impacted canines, whereas the spaces of the extracted incisors were restored by prosthetic means in the 4 other cases. 6 incisors were preserved without any treatment and 2 with the aid of a sapphire dento-osseous anchor pin. Since the resorbed incisors were mostly free of pain, early detection by radiographic examination is essential to establish a proper diagnosis.

Adolescent↗
PubMed2001

Accuracy of the Third Molar Eruption Predictor in predicting eruption.

OBJECTIVE: To evaluate the possibility of applying the Third Molar Eruption Predictor to all panoramic radiographs. STUDY DESIGN: Panoramic radiographs were retrospectively analyzed from a 4-year follow-up study of third molars carried out at the University of Copenhagen, Denmark. The radiographs, taken at a mean age of 20.6 years, included 45 unerupted or partially erupted mandibular third molars in 28 subjects. Because the device was calibrated both with simple proportions and by use of the methods of Bayes' Decision Theory, the separation point of the device was therefore adjusted at 12 mm from the distal surface of the second molar. RESULTS: The predictions of future eruption or impaction made with the calibrated device and the actual clinical outcome 4 years later were in conformity for 80% of the mandibular third molars. CONCLUSION: The Third Molar Eruption Predictor may be applied to all panoramic radiographs, but it seems to require calibration before use.

Adult↗
PubMed1999

Bilateral dentigerous cysts--report of an unusual case and review of the literature.

Dentigerous cysts are the most common developmental cysts of the jaws, most frequently associated with impacted mandibular third molar teeth. Bilateral dentigerous cysts are rare and occur typically in association with a developmental syndrome. The reported occurrence of bilateral dentigerous cysts in the absence of a syndrome is rare and, to date, only 11 cases have been described. Here, we report a case of bilateral nonsyndromic, dentigerous cysts and review the literature for this unusual finding.

Adult↗
PubMed1990

[Experience with surgical-orthodontic management of impacted and retained upper canines].

On basis of experiences obtained in the course of the surgical orthodontic treatment of 26 upper impacted and retained, respectively, incisors it has been established that, at given conditions, positioning the incisor into occlusion should be tried, even if the axis position approaches 90 degrees. The lesion is discovered relatively lately, many do not risk the treatment and the number of interrupted treatments is high as well. There is possibility to avoid possible complications, interruption of joining to force system, loss of anchorage, pulpa necrosis, root resorption, cysta follicularis.

Child↗
PubMedDate not supplied

Impacted mandibular third molars in a hospital.

A 6-month clinical and radiographical survey was done on 210 patients consulting the hospital for management of impacted third molars. A majority (37%) consulted for pain secondary to a carious lesion but waited 1 week (21%) from the onset of symptoms until consultation. Ninety-one percent of third molars were partially erupted, while 9% were unerupted. Two hundred thirty third molars from 166 patients were included in the radiographic survey showing the highest occurrence of the Class 2 position A (49%) and the mesioangular orientation (48%).

Adolescent↗
PubMed1999

Factors influencing the selection of panoramic radiography in general dental practice.

OBJECTIVES: To identify factors influencing dentists' decisions to take panoramic radiographs and to determine dentists' perceptions of the value of panoramic radiographs in the diagnosis of common dental pathologies. METHODS: Questionnaire of dentists with access to panoramic radiography equipment in 22 randomly selected Family Health Service Authorities in England and Wales. Dentists were asked to score 17 factors for their influence upon panoramic use, compare the relative diagnostic value of panoramic and intraoral radiographs for diagnosis of common dental pathologies and state their principal reasons for taking panoramic radiographs. RESULTS: The response rate to the questionnaire was 73.3%. The factors most likely to influence dentists to take a panoramic radiograph were 'planning oral surgery', 'facial trauma', 'periodontal disease', 'heavily restored dentition' and 'patient first attendance'. Dentists' opinions on the diagnostic usefulness of panoramic radiographs were in broad agreement with those in the scientific literature. The main reasons for taking panoramic radiographs were as a 'general screen' and as a 'view for unerupted or impacted teeth'. CONCLUSIONS: There are areas where dentists' prescription of panoramic radiographs is in disagreement with recent guidelines. Successful implementation of these guidelines would be likely to lead to a substantial reduction in the numbers of panoramic radiographs taken by GDPs.

Adult↗
PubMed1975

Case 11, Part 2. Angiokeratoma corporis diffusum (Fabry's disease).

A case of Fabry's disease is reported. The patient had multiple supernumerary, impacted, and unerupted teeth and other developmental abnormalities of the facial skeleton. The patient tolerated surgical removal of impacted and unerupted teeth without complications. However, this did not relieve the facial pain. The expected prognosis of this patient will be a continued vascular and renal degeneration with death probable before the age of 50 years if the disease is untreated. Currently, the patient is being considered as a possible candidate for renal transplantation.

Diagnosis, Differential↗
PubMed1983

Impacted supernumerary teeth: a survey of 50 cases.

Supernumerary teeth are considered one of the most significant dental anomalies during the primary and early mixed dentition stages. A total of 50 patients, ranging in age from 16 months to 17 years, were studied before, during, and after the surgical removal of their supernumerary teeth. Early removal of such teeth is recommended if they impede the eruption of adjacent permanent teeth, appear inverted or rudimentary, or if they are associated with certain pathological conditions. Complications associated with early removal are infrequent and seem minor in nature.

Adolescent↗
PubMed2001

[Rare earth magnets in conjunction with fixed orthodontics. An "attractive" solution for the positioning of impacted teeth].

Two rare earth permanent magnets are used to align impacted teeth: one is bonded on the crown of the ectopic tooth, the other, intraoral, guides the impacted tooth to the desired place by its attractive power. The intraoral magnet is fixed to an edgewise arch. The adjustments allowed by fixed appliance create better final tooth position than with removable appliance. Our experience depicts an improvement of stability in results and a diminution of periodontal breakdown.

Boron↗
PubMed2004

Management of unerupted maxillary canines where no orthodontic treatment is planned; a survey of UK consultant opinion.

OBJECTIVE: To assess current consultant opinion on the management of impacted maxillary canines in patients for whom no orthodontic treatment is planned. DESIGN: Questionnaire survey. METHOD: Questionnaires were sent to all UK consultant orthodontists identified from the Consultant Orthodontists Group database. Follow-up questionnaires were sent to those who had not replied within 6 weeks. An overall response rate of 76% was achieved. RESULTS: Most consultants were in favor of intervention, with removal of the unerupted canine, although a significant minority suggested a conservative approach. Of the latter group, nearly all recommended radiographic monitoring, but there was little agreement regarding the frequency and duration of this. The risk of root resorption was stated to be the most important factor justifying monitoring. CONCLUSIONS: Significant variation was found amongst UK consultant orthodontists with regard to the management of impacted canines, where orthodontic treatment was not planned. The clinical and radiographic features, which the respondents stated would influence their decision to remove or leave the canine, were not those that existing research suggests as being the primary risk factors. It is suggested that, once the patient has passed the peak age for initiation of resorption, a more conservative approach may be appropriate.

Attitude of Health Personnel↗
PubMed1991

Assessing the eruption of lower third molars on the basis of radiographic features.

To determine radiographic features by which one could estimate whether lower third molars are likely to erupt after the age of 20 years, university students with a total of 84 unerupted or partially erupted lower third molars were followed up. Five radiographic features of each third molar were measured from the panoramic tomogram taken at age 20 years, and the status of third molars was examined for a second time at age 26 years. The results showed that the lower third molars that did erupt after the age of 20 years were initially: 1) root formation complete; 2) impacted in soft tissue; 3) vertical; 4) placed at the same occlusal level as the neighbouring second molar; 5) showed sufficient space between the ramus and the second molar. In contrast, the teeth that remained impacted at the age of 26 years showed such initial features as: 1) incomplete root formation; 2) embedding in bone; 3) mesioangularity; 4) situated at the cervical level of the neighbouring second molar. It was concluded that a panoramic tomogram taken at age 20 years revealed radiographic features on which an estimation of future eruption of mandibular third molars could be based.

Adult↗
PubMed1991

Eruption disturbances of permanent molars: a review.

Eruption disturbances of permanent molars may become clinically and radiographically manifest as impaction, primary retention or secondary retention. This may result in clinical problems such as malocclusion and loss of neighboring teeth due to caries and periodontal disease. Which of these disorders will develop, depends primarily on the eruptive stage. Factors that may interfere with the eruptive stages (i.e. follicular growth, pre-emergent eruptive spurt, postemergent eruptive spurt, juvenile occlusal equilibrium, circumpubertal occlusal eruptive spurt, adult occlusal equilibrium) and the clinical consequences of that interference are reviewed. Treatment recommendations are given.

Humans↗
PubMed1993

General practitioners' and dental students' decisions on third-molar diagnoses, treatment, and referrals.

A questionnaire on third-molar problems was mailed to a systematic random sample of 200 Norwegian general dental practitioners in November 1991. The return rate was 88%. Similar questions were given to 59 5th-year dental students, with a return rate of 83%. Ten third-molar cases were presented by means of copies of radiographs and written information. The following conclusions were drawn: Apart from a terminology problem consisting of lack of discrimination between the terms retention and impaction, overall good diagnostic abilities were shown by both practitioners and students. Receiver operating characteristic analysis of treatment decisions indicated that students were more radical than practitioners. The students had an increased referral rate for third-molar surgery, whereas the practitioners indicated a more selective practice of referring advanced cases.

Adult↗
PubMed1994

Perception of the need for removal of impacted third molars by general dentists and oral and maxillofacial surgeons.

This prospective study investigated the influence of professional training and method of payment on how dental practitioners planned extraction of impacted third molars. The subjects were four groups of dental practitioners in metropolitan Chicago: 1) general dentists in traditional fee-for-service practice; 2) general dentists who were members of a preferred provider organization; 3) general dentists who were members of an Independent Practice Association model of a capitation system; and 4) oral and maxillofacial surgeons, all of whom were in fee-for-service practice. A carefully selected and trained professional actress, in good health, with four unerupted, impacted, and asymptomatic third molars, brought her recently taken full mouth periapical and panoramic radiographs to randomly selected dentists for a consultation. The number of planned extractions (no treatment was ever done) was compared. Data showed that oral and maxillofacial surgeons suggested significantly more extractions than capitation dentists and the average of all general dentists, combined.

Adult↗