华西口腔课件-外科牙齿拔除术.pptVIP

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * Etiology Many pathologic conditions bring about retarded eruption, displacement and impaction of teeth. The growth of the jaws and the movement of the teeth are in a forward direction; consequently, anything which interferes with this forward movement or growth will cause impaction of the teeth. Acute infectious fevers of childhood, such as scarlet fever and measles, may interfere with the forward movement by producing a deposit of dense bone. Etiology Local increase in the density of the bone may also be brought about by inflammation of the peridental membrane, extending into the alveolar process. Severe traumatism to the jaws may cause a deposit of lime salts in the cancellated bone tissue and thus bring about impaction. Ankylosis of the mandibular joint in childhood, resulting in arrest of growth of the jaws, may leave insufficient space for the eruption of all teeth. Too early extraction of deciduous teeth may cause arrested development of the jaws and malpositions of the permanent teeth, this leading in turn to impaction of unerupted teeth. Disturbances caused by impacted teeth Impacted teeth may be present without giving rise to any symptoms whatever. Others cause many complications such as some of local and general effects. (I) Local effects An impacted third molar may press against the crown of the second molar and cause decay of the tooth, or itself becomes the seat of caries around the point of contact. It may also cause pressure absorption of the root of the second molar. Exposure and devitalization of the pulp from these causes may give rise to neuralgia. Neuralgia may be caused in another way by pressure of the impacted tooth on the inferior dental nerve or its branches. (I) Local effects -cont. Sometimes, especially in the case of the lower third molar, pericoronal infection, pericoronal abscess, cellulitis and osteomyelitis are set up, often accompanied by trismus. In any patient