Professional Documents
Culture Documents
Bayoumi's lecture
Lec #3 Impaction
Frequency :
Clinical examination:
By palpation:
a) Presence of distinct bulge
b) Deflection of crowns: mostly of lateral incisors pr premolars.
Radiological examination:
a) Intra-oral periapical films
d) Stereoscopic technique:
It is old fashion technique m the film is translated into 3-D image by special device.
e) Tomograms:
Sections are taken, if the canine is impacted buccally , it's tip will appear first , while if
impacted palatally, the apex will appear first.
f) Extra-oral oblique or true lateral:
g) Panoramic films:
To determine relation to maxillary sinus.
2- If bilateral:
- The flap will result in cutting of nasopalatine vessels & nerves leading to hemorrhage &
numbness in order.
- However, regeneration of the nerve fibers will occur later so if you don't have anyother
option, do it.
- Anther solution is to make the flap crossing around the incisive papilla to avoid injury to
the neurovasculature.
- Upon suturing a palatal flap always place the knots buccally to prevent irritation of the
tongue.
The problem here is the pneumatization of the maxillary sinus & should be in
mind while doing such impaction.
If the tooth need the buccal side, do buccal flap.
If the tooth need the palatal side do palatal flap.
Treatment Options:
1. Extraction.
2. Reposition.
3. Surgical exposure & orthodontics.
4. Replantation.