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Localization of impacted canines with Status-X radiography.

There are, at present, a number of clinical and radiologic methods available to establish the buccopalatal relationship of an impacted maxillary canine. A new method, employing the Status-X x-ray machine, can now be used. This technique makes use of the fact that the anode of the Status-X machine is considered to have an almost point source of x-radiation. Applying the laws of central projection, an object closer to the focal point will produce a larger image on a film than that produced by an object of equal size but farther away from the focal point. In a recent series of twenty-eight canine transplant procedures, this method was used with great success to establish, preoperatively, the position of the impacted canines.

Cuspid↗

Follicular cysts of mandibular third molar teeth: radiological evaluation of enlargement.

To test the hypothesis that follicular (dentigerous) cyst enlargement arises from impeded tooth eruption, data from standardized Orthopantomographs of 30 uninfected, wholly intracortical cysts associated with mandibular third molar teeth were analysed. Cyst areas were measured with a computer-aided image analyser (Magiscan 2, Joyce Loebl, Gateshead, UK). Two size categories, small and large, each comprising 15 cases, were distinguished. These were correlated with the radiographic variables of cyst relationships to tooth crown, and angulation and nature of impaction of associated tooth. Cyst enlargement is most active in the third and fourth decades of life. Smaller cysts were associated with teeth impacted against adjacent tooth or bone, whereas larger cysts developed predominantly from horizontally angulated teeth intruded endosteally. These findings lend support to the haemodynamic concept of follicular cyst enlargement linked with dysfunctional eruptive forces.

Adult↗

Quality of life following third molar removal: a patient versus professional perspective.

AIMS: To identify the adverse effects of third molar surgery having the greatest impact on patients' perceived quality of life; and to compare the rankings between patients, dental practitioners (GDPs) and hospital consultants. METHOD: Seven adverse effects were identified after interviewing 20 patients. A questionnaire was sent to 120 patients whose third molars had been removed and 121 dental surgeons (100 GDPs and 21 consultants in oral and maxillofacial surgery). RESULTS: Response rates for patients, GDPs and consultants were 72.5%, 92% and 76.2% respectively. Patients ranked highest the effects on eating, while dental surgeons ranked 'pain' the highest. The mean rankings of consultants and patients generally showed a closer agreement, than with GDPs. However, no statistically significant differences were detected between the mean rankings of GDPs and consultants. CONCLUSIONS: Dental surgeons' perceptions of the impact of third molar surgery on their patients' quality of life show statistically significant differences from those of patients for four of the seven parameters assessed. Clinicians should consider mentioning the effects on ability to eat when obtaining informed consent, since patients would appear to rank this an important side effect.

Adult↗

Pell-Gregory classification is unreliable as a predictor of difficulty in extracting impacted lower third molars.

We present a study of 166 extractions of impacted lower third molars, all vertical and all extracted by the same surgeon. Each tooth was classified according to the Pell-Gregory scales of position for the occlusal plane (scale A-C) and the ascending ram us of the mandible (scale 1-3). The extraction was subsequently rated as 'easy' or 'difficult'.Taking Pell-Gregory class C as a predictor of a 'difficult' extraction, specificity was 88% but sensitivity was low at 15%. Taking Pell-Gregory class 3 as an indicator of 'difficult', sensitivity was somewhat better (50%), but at the expense of specificity (62%). Likelihood ratios for the individual classes also indicated that the scales are of little value for predicting a difficult extraction.

Forecasting↗

[Five cases referred to the First Department of Oral Surgery due to failure of impacted mandibular third molar extraction].

Of patients referred to our department over the post two years due to failure of tooth extraction 5 with impacated mandibular third molars were treated. We found that extraction had been hindered by the narrow operative field due to inadequate incision of the overlying mucosal tissue, insufficient bone resection and inadequate separation of the crown and root.

Humans↗