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Summary 

The three classification systems discussed so far are used in conjunction to determine the difficulty of an extraction. For example, a mesioangular impaction with a class 1 ramus and a class A depth is easy to remove and is
essentially the extraction of an erupted tooth (Fig. 9-26): . However, as the ramus relationship changes to a class 2 and the depth of the impaction increases to a class B, the degree of difficulty becomes greater. A horizontal
impaction with a class 2 ramus relationship and a class B depth is a moderately difficult extraction and one that most general practitioners do not” want to attempt (Fig. 9-27). Finally, the most difficult of all impactions is a distoangular impaction with a class 3 ramus relationship at a class C depth. Even specialists view removing this tooth as a surgical challenge (Fig. 9-28). FIG. 9-24

FIG. 9-24

FIG. 9-24 Pell and Gregory class B’ impaction. Occlusal plane of impacted tooth is between occlusal plane and cervical line of second molar.
FIG. 9-25 Pel! and Gregory class C impaction. Impacted tooth is below cervical line of second molar. FIG. 9-25

FIG. 9-25

Pel! and Gregory class C impaction. Impacted tooth is below cervical line of second molar. FIG. 9-26'

FIG. 9-26′

FIG. 9-26′ Mesioangular impaction with class 1 ramus r,elationship and class A depth. AI! three classifications make it easiest type of impaction to remove. F!c,. 9· 27

F!c,. 9· 27

Horizontal impaction with class’ 2 ramus relationship
and class B depth makes it moderately difficult to extract

FIG. 9-28

FIG. 9-28

 

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