Mand 3 rd molar


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Mand 3 rd molar

  1. 1. INDIAN DENTAL ACADEMY Leader in continuing dental education
  3. 3. AIM • To study the relationship b/w the presence and influence of Unerupted Mandibular 3rd Molar and #’s of the Mandibular Condyle.
  4. 4. INTRODUCTION • It’s reported that Pts with unerupted Mand molar were likely to have an angle # than those Pts without unerupted Mand 3rd molar’s. • Reason for this is, Angle region that contains the unerupted 3rd molars has a decreased cross sectional area of bone, and this weakens the Mand because the tooth occupies more of Osseous space ,so its an area of lowered resistance to External forces
  5. 5. • Based on this evidence, some authors advocated removing unerupted Mand 3rd molar to prevent Mand angle #, however its been observed that Pts without unerupted Mand 3rd molar were more likely to have a Condyle # than those with unerupted mand 3rd molars. • If the Mand #’s more often at the Condyle, rather than at the angle in the absence of Unerupted 3rd molar,it may not be beneficial to remove the unerupted 3 rd molar as a means of preventing Mand angle #, because the treatment of Condyle # is more challenging than that of Angle #.
  6. 6. MATERIALS & METHODS • It’s a retrospective study of all Mand #’s treated at the Univ from January 1999 to April 2004. • During this period 439 Pts sustained Mand #’s, data’s were collected from the Pts records and X-rays for the following Information: Age, Sex, causes of #’s presence and state of Lower 3rd molars and the number and locations of Mand #’s.
  7. 7. • From the obtained information, the Pts were divided into 2 groups according to whether or not, there were the unerupted 3rd molar teeth. • {Any 3rd molar partially or completely covered by bone tissue was regarded as unerupted} • Data were analysed by calculating the means and standard deviation, and the Cohart comparison were made by the Chi square test and Standard t test.
  8. 8. RESULTS • A total 439 Pts were divided into unerupted 3rd molar present group and the unerupted 3rd molar absent group. • 439 Pts had a total of 624 #’s of the mandible. The unerupted 3rd molar present group of 226 Pts had 328 #’s. The unerupted 3rd molar absent group of 213 Pts had 296 #’s. • Unerupted 3rd molar present group had a higher proportion of Angle # than those pts in the unerupted 3rd molar absent group.
  9. 9. • On the other hand, Condyle #’s were common in the unerupted 3rd molar absent group than in the uneruprted 3rd molar present group. • With regard to Symphysis and Angle combination #, there were more Symphysis and Angle combination #’s in the unerupted 3 rd molar present group than in the unerupted 3 rd molar absent group. • In contrast there were more Symphysis and Condyle # in the unerupted 3rd molar absent group than in unerupted 3rd molar present group.
  10. 10. DISCUSSION • Due to the reasons said earlier Angle #’s are more common in Pts with unerupted 3rd molars • At the same time Pts without unerupted 3rd molar are more prone to have condylar #’s. • Though Condylar #’s are considered to be a safety valve mechanism to protect the Middle cranial fossa in traumatic situations, precise reduction and fixation of Condyle is always challenging to Oral surgeons, due to risk of involvement of facial nerve injury.
  11. 11. • On the other hand reduction and fixation of of Angle #’s are easily performed due to easy access and visibility during plating. • This should not be the criteria for prophylactic removal of symptom free unerupted 3rd molar to strenghten the Angle. • At the same time the Pt is at high risk for Condylar #’s.
  12. 12. • More over, when large force are applied to a small area of the mandible, the # will occur at the point of Impact, regardless of the architecture of the mand at that site. Therefore the majority of the Pts who had a high force of Impact on their chins as a result of a fall suffered # of the Symphysis inspite of the fact Symphysis has the largest cross section area of the Mand. • So irrespective of the unerupted 3rd molar being removed or retained, #’s of Mand do occur (At Condyl or at othe regions).
  13. 13. CONCLUSION • The findings in these cases emphasize that #’S of the Condyle region showed a significantly higher incidence In Pts without unerupted 3rd molar than in Pts with unerupted 3rd Molars….
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