Impacted tooth is the tooth that has been failed to erupt partially or completely in its correct position in the dental arch or its eruption potential has been lost All the details about this lecture in my channel https://www.youtube.com/watch?v=YZ66xpoQ5rc&t=28s

1. Impacted teeth
Done by:-
Dr .Sarah AL-khateeb
General dentist

2. contents
 Impacted tooth definition
 Etiology
 Commonly impacted teeth
 Diagnosis
 Treatment
 Indication and contraindication
 Step of surgical procedure
 Surgical Extraction of mandibular impacted teeth
 Surgical extractions of maxillary impacted teeth

3. Impacted tooth
It is the tooth that has failed to erupt completely or
partially to its correct position in the dental arch and its
eruption potential has been lost

4. Etiology of impaction
 Local factors
 Systemic factors
 Genetic factors

5. Local factors
 Failure of deciduous tooth resorption
 Premature loss of deciduous tooth
 Abnormal eruption path
 Dental crowding
 Dental trauma

6.  Enlarged dental follicle ( dentigerous cyst )
or other forms of soft tissue pathology
 Odontomas
 Anomaly in the position of the tooth

7.  Ankylosis of deciduous molars
 Root dilacerations
 Alveolar cleft

8. Systemic factor
 Endocrine deficiency (eg hypothyroid )
 Cleidocranial dystosis
 Amelogenesis imperfecta

9. Genetic factors
 Herediatary factors such as malposed tooth germ and
presence of an alveolar cleft

10. Commonly impacted teeth
 Mandibular third molar
 Maxillary third molar
 Maxillary canine
 Mandibular premolar
 Maxillary premolar
 Mandibular canine
 Maxillary central incisors
 Maxillary lateral incisors

11. Diagnosis
 History

12.  Clinical examination

13.  Radiographic examination

16. Treatment
 Managing asymptomatic impacted teeth
• If the impacted tooth is asymptomatic
there are two opinions either to remove it
as a prophylactic line of treatment or don’t
remove it and follow up the case
periodically by x-ray for any problems or
cystic formation

17. • Several reasons are given for the early removal of
asymptomatic or pathology free impacted teeth
especially wisdom teeth all of which are not based on
reliable evidence:-
 They have no useful role in the mouth
 They may increase risk of pathological changes and
symptoms
 The procedure is more difficult and more likely to
cause complication later in life

18. Timing
Most suitable time is when the patient young due to :-
 Younger patient generally well tolerate the surgical procedure
and stress
 Faster surgical wound healing compared with older
 Bone removal is more easy in young than older

19.  Symptomatic impacted teeth
If the impacted teeth are causing pain or other dental
problems are usually surgically removed ( Extracted )

20. Indication for extraction
 Localized or generalized neuralgia of the head

21.  Pericoronitis

23.  Production of caries

24.  Decreased bone support of second molar

25.  Obstruction of placement of partial or complete denture

26.  Provoking or aggravating orthodontic problem

27.  Development of various pathological condition

28.  Destruction of adjacent teeth due to resorption of roots

29. Contraindication
 Extreme of age
 Compromised medical status
 Excessive risk of damage to adjacent structure

30. Step of surgical procedure

32. Extraction of impacted mandibular
teeth
 Impacted third molar
Classification:-
 According to the angulation
 According to the depth in the bone
 According to the distance to the anterior border of the
ramus

36. Types of the flaps

38. Extraction of impacted third molar in
horizontal position

41. Extraction of third molar with
mesioangular impaction

45. Extraction of third molar with
distoangular impaction

48. Extraction of third molar in
edentulous patient

51. Impacted canine

54. Impacted premolars

57. Premolar with deep impaction

59. Extraction of impacted maxillary teeth
 Impacted third molar
Classification:-
 According to the angulation
 According to the depth of impaction

64. Extraction of impacted third molar

66. Impacted maxillary canine

69. Extraction using labial approach

71. Extraction using palatal approach

74. Ectopic impacted canine

76. Impacted premolar

83.  Consider removing erupted and
impacted 3M when they cause pain ,
are infected , are associated with
bone destroying pathology , are
carious or affect the health of
adjacent teeth
Active surveillance
 Regular follow up and reassessment
at regular intervals are recommended
for retained 3M rather than waiting
for the onset of symptoms to initiate
follow up

84. Thank you