Académique Documents
Professionnel Documents
Culture Documents
MAXILLOFACIAL SURGERY
CANINE IMPACTION
CANINE IMPACTION
INTRODUCTION:
The word IMPACTION is derived from
latin word “impactus”.
DEFINITION:
Impacted tooth 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.
Maxillary canines are usually more
commonly impacted than mandibular
canines.
FACTORS RESPONSIBLE
FOR CANINE IMPACTION
1. Delayed resorption of the primary canines may
lead to impaction of permanent canine.
side.
c. mental
protuberance
CLINICAL FINDINGS FOR
IMPACTED TOOTH
RADIOLOGICAL EXAMINATION:
1 Intraoral x-ray:
These are possible if the tooth is in
the alveolus and not in the ramus.
Possible if oral opening is adequate.
If there is no gagging.
Useful to study the relation with adjoining tooth.
Useful to study the configuration of the roots and
status of crown.
Useful to record the relationship with inferior
alveolar canal.
TUBE SHIFT TECHNIQUE:
1. PALATAL INCISION:
Incision
is started from first
molar region around
the neck of the teeth
upon the central
incisor.
COMPLETE PALATAL INCISION:
Remove the tooth follicle and bone chips, flush with normal
saline.
1.HEMORRHAGE:
When there is bleeding from soft tissue,blood vessel can be caught with a
hemostat and ligated or a stick tie may be applied.
The bleeding from the bone can be controlled by crushing the bone on the
bleeding point.
Adrenaline pack kept for sometime in the socket will also stop the hemorrhage.
2.FRACTURE OF ROOT:
It may take place either due to wrong technique or due to injudicious use of
elevators.
Fractured root have to be removed surgically.
3. INJURY TO ADJACENT TOOTH:
It may occur due to injudicious use of
elevators.
Proper precautions should be taken while cutting the bone
and elevating the third molar during removal.
4. BREAKING OF INSTRUMENTS:
Use of old and rusty elevators should be
avoided as these may beak during elevation of tooth.
5. ASPIRATION OF TOOTH:
It is a serious complication unless tooth is
coughed out by the patient with a forceful reflex cough.
6. FRACTURE OF MANDIBLE:
It is a rare complication that occur due to excessive
force during elevation of the tooth .
It can occur because of fragility of the bone and ankylosis of the tooth to
the bone.
1. OEDEMA:
Swelling of face after every surgical procedure is a common
observation and disappears mostly within 5-7 days.
2. SECONDARY HEMORRHAGE:
Hemorrhage seen after 24-48 hours of operation is mostly due
to incomplete hemostasis during surgery.
When there is bleeding from soft tissue,blood vessel can be caught with a
hemostat and ligated or a stick tie may be applied.
The bleeding from the bone can be controlled by crushing the bone
on the bleeding point.
Adrenaline pack kept for sometime in the socket will also stop the
hemorrhage.
3.PAIN:
The pain of surgical trauma which is normally experienced in the
post operative period disappears within 24 hrs.
Proper antibiotic and analgesic therapy should be given.
4.DRY SOCKET:
It is also called localised alveolar osteitis and is one of the most
common post operative complication.
there is severe neuralgic pain sensitive to any food and foul smell
from the socket.
Treatment consist of sedative and analgesics dressings locally.
5. OSTEOMYELITIS:
It may follow localized alveolitis.
There may be pus discharge or granulation tissue extruding from
the bone
6. TRISMUS:
Acute trismus is seen following the removal
of a difficult impaction.
8. ECCHYMOSIS:
Discoloration of the soft tissues beneath the eye , in
the cheek, under the mandible and floor of the mouth is
seen as a result of post operative bleeding.
References
COLIN YATES : a manual of oral and maxillofacil
surgery.
KABAN TOULIS: pediatric oral and maxillofacial surgery.
PETERSON: textbook of oral and maxillofacial surgery.
KRUGER: textbook of oral and maxillofacial surgery.
NEELIMA ANIL
MALIK: textbook of oral and maxillofacial surgery.