Management of impacted teeth:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
2007
|
| Schriftenreihe: | Oral and maxillofacial surgery clinics of North America
19,1 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | VIII, 140 S. Ill., graph. Darst. |
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| 245 | 1 | 0 | |a Management of impacted teeth |c Vincent J. Perciaccante, guest ed. |
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| 650 | 4 | |a Perioperative Care | |
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| adam_text | MANAGEMENT OF IMPACTED TEETH
CONTENTS
Preface xi
Vincent J. Perciaccante
Third Molar Removal: An Overview of Indications, Imaging, Evaluation,
and Assessment of Risk 1
Robert D. Marciani
Asymptomatic third molars may have associated periodontal pathology that may not be
limited to the third molar region and have a negative impact on systemic health. Third
molars should be considered for removal when there is clinical, radiographic, or labora¬
tory evidence of acute or chronic periodontitis, caries, pericoronitis, deleterious effects on
second molars, or pathology. Radiographic findings of extreme locations of impacted
teeth, dense bone, dilacerated roots, large radiolucent lesions associated with impac
tions, and lower third molar apices in cortical inferior border bone are predictive of more
complex surgery. Certain demographic and oral health conditions available to the sur¬
geon before surgery and intraoperative circumstances are predictive of delayed recovery
for health related quality of outcomes and delayed clinical outcomes after third molar
surgery
Extraction Versus Nonextraction Management of Third Molars 15
Shahrokh C. Bagheri and Husain AH Khan
Surgical removal of impacted third molars is the most commonly performed procedure
by oral and maxillofacial surgeons. The removal of diseased or symptomatic third mo¬
lars has not been an issue of controversy. The risk of surgery and associated complica¬
tions are justified and uniformly accepted by most surgeons when the teeth are
associated with chronic or acute pathologic processes, including caries, nonrestorable
teeth, fractured roots, resorption, associated pathologic conditions (cysts, tumors), peri
apical abscesses, odontogenic infections, osteomyelitis, removal before reconstructive or
ablative surgery, and radiation therapy.
General Technique of Third Molar Removal 23
Sam E. Farish and Gary F. Bouloux
The most commonly performed surgical procedure in most oral and maxillofacial sur¬
gery practices is the removal of impacted third molars. Extensive training, skill, and ex¬
perience allow this procedure to be performed in an atraumatic fashion with local
anesthesia, sedation, or general anesthesia. The decision to remove symptomatic third
VOLUME 19 • NUMBER 1 • FEBRUARY 2007 v
molars is not usually difficult, but the decision to remove asymptomatic third molars is
sometimes less clear and requires clinical experience. A wide body of literature (dis¬
cussed elsewhere in this issue) attempts to establish clinical practice guidelines for deal¬
ing with impacted teeth. Data is beginning to accumulate from third molar studies,
which hopefully will provide surgeons and their patients with evidence based guide¬
lines regarding elective third molar surgery.
Office based Anesthesia 45
Trevor Treasure and Jeffrey Bennett
The practice of office based oral and maxillofacial surgery is continuously expanding
and involves the management of a diverse population in regards to the surgical proce¬
dures performed within the office and the age and medical health of the patients treated
within the office. Comfort, cooperation, and hemodynamic stability are critical to satis¬
factorily accomplishing the surgical procedure. Various anesthetic techniques are used,
including local anesthesia, anxiolysis, analgesia and sedation, and general anesthesia.
The topic is vast and too extensive to be fully discussed in this article. The intent of this
article is to provide a discussion of some fundamental concepts that can optimize anes¬
thetic safety and care.
Management of the Impacted Canine and Second Molar 59
Pamela L. Alberto
The clinical management of impacted canine and second molars can be challenging and
frustrating. Successful management requires a team approach with the orthodontist and
general dentist. It is recommended to try to preserve these teeth. Proper orthodontic me¬
chanics are necessary for long term stability. The appropriate treatment plan results in a
predictable, stable, and aesthetic result.
Therapeutic Agents in Perioperative Third Molar Surgical Procedures 69
Mehran Mehrabi, John M. Allen, and Steven M. Roser
Surgical extraction of third molars is one of the most common of all surgical procedures.
The outcome of third molar surgery includes pain, trismus, edema, nausea, infection,
and alveolar osteitis. The intent of this article is to provide a literature review and ana¬
lysis of the various chemotherapeutic agents used to control, minimize, or eliminate
these outcomes. Unfortunately, comparison of the published studies represents a tremen¬
dous challenge because of the variability in parameters and methods used for each
study. A trend does exist among many of the current researchers, who realize that ran¬
domized, controlled, evidence based research rather than personal experience is neces¬
sary to develop appropriate guidelines for using chemotherapeutic agents.
Partial Odontectomy 85
M. Anthony Pogrel
The problem of inferior alveolar nerve involvement during the removal of lower third
molars is a clinical and medicolegal issue. Because the results of damage to the inferior
alveolar nerve are unpredictable in that many cases do recover but some do not, it is pre¬
ferable to carry out a technique that may reduce the possibility of this involvement. The
technique of coronectomy, partial odontectomy, or deliberate root retention is one such
technique to protect the inferior alveolar nerve that has been studied in the past but does
not currently enjoy a strong body of support. The technique of coronectomy is worthy of
consideration in cases in which panorex radiograph and cone beam CT scanning show
vi CONTENTS
an intimate relationship between the roots of the mandibular third molar and the inferior
alveolar nerve.
Risk of Periodontal Defects After Third Molar Surgery:
An Exercise in Evidence based Clinical Decision making 93
Thomas B. Dodson and Daniel T. Richardson
This article s purpose is to apply evidence based principles to answer the question: What
is the risk of having persistent or new periodontal defects on the distal aspect of the man¬
dibular second molar after third molar removal? Commonly, the second molar period¬
ontal health either remains unchanged or improves after third molar removal.
Eighteen weeks or more after third molar removal, 52% to 100% of subjects had no
change or improvement in attachment levels or probing depths. For subjects with
healthy second molar periodontium preoperatively, the indication for third molar re¬
moval should be evaluated carefully because these patients have an increased risk for
worsening of probing depths or attachment levels after third molar removal.
Is There a Role for Reconstructive Techniques to Prevent Periodontal
Defects After Third Molar Surgery? 99
Thomas B. Dodson
The purpose of this article is to address the following clinical question: Among subjects
undergoing mandibular third molar (M3) removal, does an intervention at the time of
tooth removal, when compared with no intervention, improve the long term periodontal
health on the distal aspect of the adjacent second molar (M2)? Routine application of in¬
terventions to improve the periodontal parameters on the distal of the M2 at the time of
M3 removal is not indicated for most subjects. There seems to be a subpopulation of sub¬
jects having M3s removed who are at increased risk for periodontal defects after M3 re¬
moval, pre existing periodontal defects, and a horizontal or mesioangular impaction. In
the clinical setting of all three risk factors being present, there seems to be a predictable
benefit to treating the dentoalveolar defect at the time of extraction.
Nerve Injuries After Third Molar Removal 105
Vincent B. Ziccardi and John R. Zuniga
Trigeminal nerve injuries are a known complication of third molar surgery. This article
reviews the diagnosis, assessment, classification, microsurgical management, and out¬
come assessment of trigeminal nerve injuries that result from third molar removal.
Complications of Third Molar Surgery 117
Gary F. Bouloux, Martin B. Steed, and Vincent J. Perciaccante
This article addresses the incidence of specific complications and, where possible, offers
a preventive or management strategy. Injuries of the inferior alveolar and lingual nerves
are significant issues that are discussed separately in this text. Surgical removal of third
molars is often associated with postoperative pain, swelling, and trismus. Factors
thought to influence the incidence of complications after third molar removal include
age, gender, medical history, oral contraceptives, presence of pericoronitis, poor oral hy¬
giene, smoking, type of impaction, relationship of third molar to the inferior alveolar
nerve, surgical time, surgical technique, surgeon experience, use of perioperative antibio¬
tics, use of topical antiseptics, use of intra socket medications, and anesthetic technique.
Complications that are discussed further include alveolar osteitis, postoperative
infection, hemorrhage, oro antral communication, damage to adjacent teeth, displaced
teeth, and fractures.
CONTENTS vii
Legal Implications of Third Molar Removal 129
James R. Hupp
This article focuses on legal ramifications inherent in the management of impacted teeth.
The initial section explores the potential problems associated with the care of impacted
teeth that makes such treatment clinically challenging and legally risky. The next section
discusses means of preventing or mitigating the injuries that can occur during or after
impaction surgery. The final sections cover various strategies to consider should a pro¬
blem occur or legal action seem imminent.
Index 137
viii CONTENTS
|
| adam_txt |
MANAGEMENT OF IMPACTED TEETH
CONTENTS
Preface xi
Vincent J. Perciaccante
Third Molar Removal: An Overview of Indications, Imaging, Evaluation,
and Assessment of Risk 1
Robert D. Marciani
Asymptomatic third molars may have associated periodontal pathology that may not be
limited to the third molar region and have a negative impact on systemic health. Third
molars should be considered for removal when there is clinical, radiographic, or labora¬
tory evidence of acute or chronic periodontitis, caries, pericoronitis, deleterious effects on
second molars, or pathology. Radiographic findings of extreme locations of impacted
teeth, dense bone, dilacerated roots, large radiolucent lesions associated with impac
tions, and lower third molar apices in cortical inferior border bone are predictive of more
complex surgery. Certain demographic and oral health conditions available to the sur¬
geon before surgery and intraoperative circumstances are predictive of delayed recovery
for health related quality of outcomes and delayed clinical outcomes after third molar
surgery
Extraction Versus Nonextraction Management of Third Molars 15
Shahrokh C. Bagheri and Husain AH Khan
Surgical removal of impacted third molars is the most commonly performed procedure
by oral and maxillofacial surgeons. The removal of diseased or symptomatic third mo¬
lars has not been an issue of controversy. The risk of surgery and associated complica¬
tions are justified and uniformly accepted by most surgeons when the teeth are
associated with chronic or acute pathologic processes, including caries, nonrestorable
teeth, fractured roots, resorption, associated pathologic conditions (cysts, tumors), peri
apical abscesses, odontogenic infections, osteomyelitis, removal before reconstructive or
ablative surgery, and radiation therapy.
General Technique of Third Molar Removal 23
Sam E. Farish and Gary F. Bouloux
The most commonly performed surgical procedure in most oral and maxillofacial sur¬
gery practices is the removal of impacted third molars. Extensive training, skill, and ex¬
perience allow this procedure to be performed in an atraumatic fashion with local
anesthesia, sedation, or general anesthesia. The decision to remove symptomatic third
VOLUME 19 • NUMBER 1 • FEBRUARY 2007 v
molars is not usually difficult, but the decision to remove asymptomatic third molars is
sometimes less clear and requires clinical experience. A wide body of literature (dis¬
cussed elsewhere in this issue) attempts to establish clinical practice guidelines for deal¬
ing with impacted teeth. Data is beginning to accumulate from third molar studies,
which hopefully will provide surgeons and their patients with evidence based guide¬
lines regarding elective third molar surgery.
Office based Anesthesia 45
Trevor Treasure and Jeffrey Bennett
The practice of office based oral and maxillofacial surgery is continuously expanding
and involves the management of a diverse population in regards to the surgical proce¬
dures performed within the office and the age and medical health of the patients treated
within the office. Comfort, cooperation, and hemodynamic stability are critical to satis¬
factorily accomplishing the surgical procedure. Various anesthetic techniques are used,
including local anesthesia, anxiolysis, analgesia and sedation, and general anesthesia.
The topic is vast and too extensive to be fully discussed in this article. The intent of this
article is to provide a discussion of some fundamental concepts that can optimize anes¬
thetic safety and care.
Management of the Impacted Canine and Second Molar 59
Pamela L. Alberto
The clinical management of impacted canine and second molars can be challenging and
frustrating. Successful management requires a team approach with the orthodontist and
general dentist. It is recommended to try to preserve these teeth. Proper orthodontic me¬
chanics are necessary for long term stability. The appropriate treatment plan results in a
predictable, stable, and aesthetic result.
Therapeutic Agents in Perioperative Third Molar Surgical Procedures 69
Mehran Mehrabi, John M. Allen, and Steven M. Roser
Surgical extraction of third molars is one of the most common of all surgical procedures.
The outcome of third molar surgery includes pain, trismus, edema, nausea, infection,
and alveolar osteitis. The intent of this article is to provide a literature review and ana¬
lysis of the various chemotherapeutic agents used to control, minimize, or eliminate
these outcomes. Unfortunately, comparison of the published studies represents a tremen¬
dous challenge because of the variability in parameters and methods used for each
study. A trend does exist among many of the current researchers, who realize that ran¬
domized, controlled, evidence based research rather than personal experience is neces¬
sary to develop appropriate guidelines for using chemotherapeutic agents.
Partial Odontectomy 85
M. Anthony Pogrel
The problem of inferior alveolar nerve involvement during the removal of lower third
molars is a clinical and medicolegal issue. Because the results of damage to the inferior
alveolar nerve are unpredictable in that many cases do recover but some do not, it is pre¬
ferable to carry out a technique that may reduce the possibility of this involvement. The
technique of coronectomy, partial odontectomy, or deliberate root retention is one such
technique to protect the inferior alveolar nerve that has been studied in the past but does
not currently enjoy a strong body of support. The technique of coronectomy is worthy of
consideration in cases in which panorex radiograph and cone beam CT scanning show
vi CONTENTS
an intimate relationship between the roots of the mandibular third molar and the inferior
alveolar nerve.
Risk of Periodontal Defects After Third Molar Surgery:
An Exercise in Evidence based Clinical Decision making 93
Thomas B. Dodson and Daniel T. Richardson
This article's purpose is to apply evidence based principles to answer the question: What
is the risk of having persistent or new periodontal defects on the distal aspect of the man¬
dibular second molar after third molar removal? Commonly, the second molar period¬
ontal health either remains unchanged or improves after third molar removal.
Eighteen weeks or more after third molar removal, 52% to 100% of subjects had no
change or improvement in attachment levels or probing depths. For subjects with
healthy second molar periodontium preoperatively, the indication for third molar re¬
moval should be evaluated carefully because these patients have an increased risk for
worsening of probing depths or attachment levels after third molar removal.
Is There a Role for Reconstructive Techniques to Prevent Periodontal
Defects After Third Molar Surgery? 99
Thomas B. Dodson
The purpose of this article is to address the following clinical question: Among subjects
undergoing mandibular third molar (M3) removal, does an intervention at the time of
tooth removal, when compared with no intervention, improve the long term periodontal
health on the distal aspect of the adjacent second molar (M2)? Routine application of in¬
terventions to improve the periodontal parameters on the distal of the M2 at the time of
M3 removal is not indicated for most subjects. There seems to be a subpopulation of sub¬
jects having M3s removed who are at increased risk for periodontal defects after M3 re¬
moval, pre existing periodontal defects, and a horizontal or mesioangular impaction. In
the clinical setting of all three risk factors being present, there seems to be a predictable
benefit to treating the dentoalveolar defect at the time of extraction.
Nerve Injuries After Third Molar Removal 105
Vincent B. Ziccardi and John R. Zuniga
Trigeminal nerve injuries are a known complication of third molar surgery. This article
reviews the diagnosis, assessment, classification, microsurgical management, and out¬
come assessment of trigeminal nerve injuries that result from third molar removal.
Complications of Third Molar Surgery 117
Gary F. Bouloux, Martin B. Steed, and Vincent J. Perciaccante
This article addresses the incidence of specific complications and, where possible, offers
a preventive or management strategy. Injuries of the inferior alveolar and lingual nerves
are significant issues that are discussed separately in this text. Surgical removal of third
molars is often associated with postoperative pain, swelling, and trismus. Factors
thought to influence the incidence of complications after third molar removal include
age, gender, medical history, oral contraceptives, presence of pericoronitis, poor oral hy¬
giene, smoking, type of impaction, relationship of third molar to the inferior alveolar
nerve, surgical time, surgical technique, surgeon experience, use of perioperative antibio¬
tics, use of topical antiseptics, use of intra socket medications, and anesthetic technique.
Complications that are discussed further include alveolar osteitis, postoperative
infection, hemorrhage, oro antral communication, damage to adjacent teeth, displaced
teeth, and fractures.
CONTENTS vii
Legal Implications of Third Molar Removal 129
James R. Hupp
This article focuses on legal ramifications inherent in the management of impacted teeth.
The initial section explores the potential problems associated with the care of impacted
teeth that makes such treatment clinically challenging and legally risky. The next section
discusses means of preventing or mitigating the injuries that can occur during or after
impaction surgery. The final sections cover various strategies to consider should a pro¬
blem occur or legal action seem imminent.
Index 137
viii CONTENTS |
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| spelling | Management of impacted teeth Vincent J. Perciaccante, guest ed. Philadelphia [u.a.] Saunders 2007 VIII, 140 S. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Oral and maxillofacial surgery clinics of North America 19,1 Dentistry, Operative Perioperative Care Tooth, Impacted Retentio dentis (DE-588)4177895-9 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Retentio dentis (DE-588)4177895-9 s b DE-604 Perciaccante, Vincent J. Sonstige oth Oral and maxillofacial surgery clinics of North America 19,1 (DE-604)BV002758944 19,1 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=015606000&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Management of impacted teeth Oral and maxillofacial surgery clinics of North America Dentistry, Operative Perioperative Care Tooth, Impacted Retentio dentis (DE-588)4177895-9 gnd |
| subject_GND | (DE-588)4177895-9 (DE-588)4143413-4 |
| title | Management of impacted teeth |
| title_auth | Management of impacted teeth |
| title_exact_search | Management of impacted teeth |
| title_exact_search_txtP | Management of impacted teeth |
| title_full | Management of impacted teeth Vincent J. Perciaccante, guest ed. |
| title_fullStr | Management of impacted teeth Vincent J. Perciaccante, guest ed. |
| title_full_unstemmed | Management of impacted teeth Vincent J. Perciaccante, guest ed. |
| title_short | Management of impacted teeth |
| title_sort | management of impacted teeth |
| topic | Dentistry, Operative Perioperative Care Tooth, Impacted Retentio dentis (DE-588)4177895-9 gnd |
| topic_facet | Dentistry, Operative Perioperative Care Tooth, Impacted Retentio dentis Aufsatzsammlung |
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