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1. Tooth impaction Research Articles
Tooth impaction refers to the failure of teeth to erupt
into the mouth within the normal time, where the failure
of outburst appears to originate from mechanical
blocking. Tooth impaction may result from a number of
local causal factors. These include arch length
discrepancy, ectopic positioning of the teeth, presence
of supernumerary teeth, bony barriers, and retained
deciduous teeth
Angulation of tooth Most commonly used
classification system with respect to treatment
planning. Depending on the angulation the tooth
might be classified as
 Mesioangular
 Horizontal
 Vertical
 Distoangular
 Palatal
 Buccal
 Lingual
This type of classification is based on the amount of
impacted tooth that is covered with the mandibular ramus.
It is known as the Pell and Gregory classification, classes
1, 2, and 3.[3]
Impacted wisdom teeth don't always cause symptoms.
However, when an impacted wisdom tooth becomes
infected, damages other teeth or causes other dental
problems, you may experience some of these signs or
symptoms:
 Pain
 Red or swollen gums

2.  Tender or bleeding gums
 Swelling around the jaw
 Bad breath
 An unpleasant taste in your mouth
 Headache
Complications

 Damage to other teeth. If the wisdom tooth pushes
against the second molar, it may damage the second
molar or make it more vulnerable to infection. This
pressure can also cause problems with crowding of the
other teeth or orthodontic treatments to straighten other
teeth.
 Cysts. The wisdom tooth grows in a sac within the
jawbone. The sac can fill with fluid, forming a cyst that
can damage the jawbone, teeth and nerves. Rarely, a
tumor — usually a noncancerous tumor — develops.
This complication may require removal of tissue and
bone.
 Decay. Partially impacted wisdom teeth appear to be
more vulnerable to tooth decay (caries) than other teeth.
This probably occurs because wisdom teeth are harder
to clean and because food and bacteria get easily
trapped between the gum and a partially erupted tooth.
 Gum disease. The difficulty of cleaning impacted,
partially erupted wisdom teeth also makes them a
vulnerable site for the development of a painful,
inflammatory gum condition called pericoronitis (per-ih-
kor-o-NI-tis)
ClassificationWinter's
The classification is based on the inclination of the

3. ) to the long axis of the3rd molarimpacted wisdom tooth (
.2nd molar
The impacted tooth is tilted toward the.Angular-Mesio
directionmesial2nd molar in a
The long axis of the 3rd molar is.Angular-Disto

4. lawayfrom the 2nd moladistally / posteriorlyangle
horizontalThe long axis of the 3rd molar is.Horizontal
The long axis of the 3rd molar is parallel to the.Vertical
long axis of the 2nd molar.

5. the above,In combination with.Lingual Obliquity/Buccal
the tooth can be
(tiltedlingually(tilted towards the cheek) orbuccally
towards the tongue)

6. impacted.
This is where the tooth is in.Transverse
impacted but in ahorizontallyeffect
tongue direction.-cheek

7. ClassificationPell & Gregory's
This is based on the relationship between the impacted
lower wisdom tooth (3rd
(lower jaw) and theramus of the mandiblemolar) to the
molar (based on the2nd
to the 2nd molar).distalspace available
of the impacted tooth is atocclusal planeThe.Class A
the same level as the
(The highest portion ofof the 2nd molar.occlusal plane
impacted 3rd molar is on
).clusal planeoca level with or above the
of the impacted tooth isocclusal planeThe.Class B
occlusal planebetween the

8. (The highestof the 2nd molar.cervical margin& the
portion of impacted 3rd
cervicalbut above theocclusal planemolar is below the
ar).of the of 2nd molline
cervicalThe impacted tooth is below the.Class C
(Theof the 2nd molar.margin
cervicalhighest portion of impacted 3rd molar is below the
of the of 2ndline
molar).
There is sufficient space available between.Class 1
theanterior border ofthe
aspect of the 2nd molar fordistal& theascending ramus
the eruption of the 3rd
molar.
anterior borderThe space available between the.Class 2
& theof the ramus
aspect of the of the 2nd molar is less thandistal
of thedistal width-mesiothe
portion ofdistalIt denotes that thecrown of the 3rd molar.
the 3rd molar crown is
.ascending ramuscovered by bone of the
The 3rd molar is totally embedded in the bone of.Class 3
anterior border ofthe
ack ofbecause of the absolute lthe ascending ramus
It is obvious thatspace.
teeth present more difficulty in removal as aClass 3
relatively large amount of
damagingbone has to be removed and there is a risk of

9. fracturingorthe ID nerve
the mandible(or both).
Classification of Impacted Maxillary 3rd Molars
3rd molars ismaxillaryclassification of impactedThe
similar to those used for
3rd molars.mandibular
ClassificationGregory-Pell
of the impacted tooth is atocclusal planeThe.Class A
the same level as the
(The lowest portion ofof the 2nd molar.occlusal plane

10. impacted 3rd molar is on a
).occlusal planelevel with or above the
of the impacted tooth isocclusal planeThe.Class B
occlusal planebetween the
(The lowestof the 2nd molar.cervical margin& the
f impacted 3rd molarportion o
ofcervical linebut above theocclusal planeis below the
the of 2nd molar).
cervicalThe impacted tooth is below the.Class C
(Theof the 2nd molar.margin
cervicallowest portion of impacted 3rd molar is below the
of 2nd molar).of theline
Winter'sClassification
 Vertical
 Horizontal
 Mesio-Angular
 Disto-Angular
 Inverted
 Bucco-version
 Linguo-version
 Transverse
 These classifications have been revised / tweaked /
conflated by Archer (1975) &
Kruger (1984).

11. Relationship of the Maxillary 3rd Molar to the Maxillary
Sinus / Antrum
Sinus Approximation (SA):
No bone or thin partition of bone twixt the
impacted maxillary 3rd molar & the
maxillary sinus / antr
> 2mm of bone twixt the impacted maxillary 3rd molar &
the maxillary sinus /
antrum.

12. No Sinus Approximation (NSA):
> 2mm of bone twixt the impacted maxillary 3rd molar &
the maxillary sinus /
antrum.