PubMed · 4943818
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J F Bates, G D Stafford. 1971-11-16. Immediate complete dentures. 4. Techniques in construction.. https://doi.org/10.1038/sj.bdj.4802767
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Impacted teeth present many problems for the orthodontist. They can compromise tooth movement, esthetics, and functional outcomes. The second most commonly impacted tooth, after the maxillary third molar, is the maxillary canine, with an incidence from 1% to 2.5%. Maxillary canines can be impacted facially or palatally and are more common in female patients than in male patients. Therefore, the purpose of this paper is to address the incidence and etiology associated with impacted maxillary canines, the clinical and radiographic evaluation of the situation, and the techniques for managing this problem. Papers related to this topic were identified and reviewed thoroughly. A decision tree involving the various techniques employed to expose impacted canines is presented, together with methods used to identify the location of impacted canines. The impacted canine can be properly managed with proper diagnosis and technique.
PURPOSE: Lingual nerve damage following lower third molar surgery remains a clinical problem. The traditional approach in the United States has been a buccal approach avoiding exposure or surgery on the lingual side of the crest of the ridge. An alternative technique is to deliberately expose the lingual tissues and retract the lingual nerve lingually before tooth removal. This study reports a trial of this technique. MATERIALS AND METHODS: Patients had removal of their lower third molars carried out using a technique that raises a lingual flap in addition to a buccal flap and places a specially designed lingual retractor to ensure that the lingual nerve is held out of the surgical field. This technique was used in cases where the crown of the tooth had to be sectioned or when distal bone needed to be removed. RESULTS: Two hundred fifty patients were treated by this method. There were 4 cases of transient lingual paresthesia, presumably caused by traction pressure from the retractor. Three of these cases were mild and resolved within 3 weeks. The fourth case had more profound paresthesia, but still resolved within 2 months. There were no cases of permanent nerve damage, and in many cases removal of the third molar was simplified by the superior access. CONCLUSION: Lingual retraction for third molar removal improves access to the surgical site and can simplify third molar removal. In this prospective study there were no cases of permanent lingual nerve injury.
A 45-year-old woman needing a Class V restoration in a mandibular molar without attached gingiva is presented. In an interdisciplinary intervention, transurgical restoration was accomplished, including flap surgery with a slight ostectomy and restoration with a bonding system and a resin composite. A 1-year clinical evaluation showed satisfactory marginal adaptation and restoration contour associated to gingival tissue health.