Biomedical subjects
Publications and source records attributed to G A Thurnwald.
A case of an infected mandibular fracture is presented. A submandibular abscess appeared to arise from chronic pericoronal infection associated with a third molar tooth in the line of fracture. Treatment of the case is described followed by a short discussion on the aetiology and management of infected mandibular fractures. The importance of adequate first aid and prompt referral is stressed.
The mandibular infected buccal cyst was first described over ten years ago as a discrete pathological entity found only in children. The features of this lesion have been consistently described as a buccal location adjacent to erupting first molar teeth, a thick, hyperplastic non-keratinized epithelial lining, expansion of buccal cortex and associated infection. The paradental cyst had been described some years previously. This lesion was noted to have a similar non-specific hyperplastic non-keratinized epithelial lining but was described as being associated predominantly with third molar teeth in young adults. Recently investigators have called for the mandibular infected buccal cyst to be reclassified as a variant of the paradental cyst. In this paper, ten previously unreported cases of mandibular infected buccal cysts are presented and the evidence for their reclassification as paradental cysts is advanced.
The mandibular dental arches of 45 young adults (mean age = 24.3 years) were analyzed by measuring study casts taken immediately before and twelve weeks after the removal of impacted third molar teeth. Arch length and width were measured at predetermined points on the study casts. The results showed significant buccal movement of mandibular second molar teeth following surgery (p < 0.01). Bilateral mesioangular impactions were associated with larger increases in mandibular arch width following surgery than unilateral mesioangular impactions or other classes of impaction (p < 0.05). The greatest amount of tooth movement was observed in cases where mandibular second molars had a pre-operative lingual inclination. It is hypothesised that mesioangularly impacted mandibular third molars can produce sufficient force to displace the adjacent second molar teeth in a lingual direction and when the adjacent third molar is removed this movement is reversed by functional forces.