Nature of Overlying Tissue Medical Assignment Help

Nature of Overlying Tissue

The preceding-systems all classify factors that make third molar extraction easier or more difficult. The classification  system discussed in this section does not fit into this category. However, it is the system used by most dental
insurance ‘companies and the one by which the surgeon charges for his

f-I~. ? 35 A, Radioqrephic view of mandibuiar th!rd molar suggests that It ISsurrounding or adjacent to inferior alveolar neurovascular canal. B, Hole and indentation in two joots of mandibular third molar indicate position of roots of this tooth to Interior alveolar canal. When this tooth was removed, inferior alveolar neurovascular bundle was severed (not same tooth as shown in A).

f-I~. ? 35 A, Radioqrephic view of mandibuiar th!rd molar suggests that It ISsurrounding or adjacent
to inferior alveolar neurovascular canal. B, Hole and indentation in two joots of mandibular third molar
indicate position of roots of this tooth to Interior alveolar canal. When this tooth was removed, inferior
alveolar neurovascular bundle was severed (not same tooth as shown in A).

 

 

According to this scheme, the three types of impactions  are (1) soft tissue impaction, (2) partial bony impaction, and (3) full bony impaction. An impaction is defined as a soft tissue impaction when the height of the tooth’s contour is above the level of the alveolar. bone, and the superficial portion of the tooth is covered only by soft. tissue (Fig. 9-36). To remove the soft tissue  impaction, the surgeon must incise the soft tissue andreflect a small soft tissue flap to obtain access to the tooth to elevate it from its socket. The soft tissue impaction is  usually the easiest of the three extractions.The partial bone impaction occurs when the superficial portion of the tooth is covered by soft tissue, but the  height of the tooth’s contour is below the level of the surroundingalveolar bone (Fig. 9-37). To remove the tooth,
the surgeon must incise the sof t tissue, reflect a soft tissueflap, and remove the bone above the height of the’ contour. The surgeon may need to divide the tooth in addtion  to removing bone.The complete bone tmpactton is an impacted tooth  that is completely encased in bone so that, when the surgeon  reflects the soft tissue trap, no tooth is visible (Fig.9-38). To remove the tooth, extensive amounts of bone must be removed and the tooth almost always must be sectioned. The complete bony impaction is often the most difficult to remove. Although this classification is extensively used, it frequently has no relationship to the difficulty of the extraction  (Boxes 9-1 and 9-2). The parameters of angulation,

BOX 9_1

Factors that MakeImpaction Surgery Less Difficult

1. Mesioangular
position
2. Class 1 ramus
3. Class A depth
4. Roots one third to
two thirds formed”
5.1=used conic roots
6. Wide periodontal
ligament”
7. Large follicle”
8. Elastic bone”
, 9¥ Separated from second
‘molar ‘
10. Separated from. inferior
alveolar nerve”
11. Soft tissue impaction

BOX 9-2

Factors that Make Impaction Surgery More Difficult
1. Distoanqular
2. Class 3 ramus
3. Class C depth
4. Long, thin roots”
5. Divergent curved
roots
6: Narrow periodontal
ligament”
7. Thin follicle”
8. Dense, inelastic bone”
9. Contact with second
molar
10. Close to inferior alveolar
canal
11. Complete bony impaction
“Present in older patients.

Posted by: brianna

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