WordNet

press or wedge together; pack together
a forceful consequence; a strong effect; "the book had an important impact on my thinking"; "the book packs a wallop" (同)wallop
the striking of one body against another
a means of enforcement; "the treaty had no teeth in it"
one of a number of uniform projections on a gear
something resembling the tooth of an animal
toothlike structure in invertebrates found in the mouth or alimentary canal or on a shell
hard bonelike structures in the jaws of vertebrates; used for biting and chewing or for attack and defense
a blast of a horn
having teeth especially of a certain number or type; often used in combination; "saw-toothed"

PrepTutorEJDIC

〈U〉〈C〉(…の…に対する)衝突,衝撃《+『of』+『名』+『against』(『on』,『upon』,『with』)+『名』》 / 〈C〉(…の…に対する)影響(influence)影響力《+『of』+『名』+『on』(『upon, against』)+『名』》
『歯』 / 『歯状の物』,(くし・のこぎり・歯車・フォークなど)歯の働きをする物 / …に歯を付ける;…‘を'歯状(ぎざぎざ)にする
…もまた,その上 / 『あまりにも』,過度に,必要以上に / 『非常に』,大変,はなはだ(very, extremely) / 《話》《相手の否定の言葉に,肯定で応じて》ところがどうして
(笛・らっぱなどの)プープー鳴る音;(笛・らっぱなどを)プープー鳴らすこと / 〈笛・らっぱなど〉‘を'鳴らす / 〈笛・らっぱなどが〉鳴る
歯のある / V字型の突起がある,ぎざぎざの

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/12/17 14:13:21」(JST)

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Mandibular canine impacted in the chin

3D CT of mandibular canine impacted in the chin

An impacted tooth is one that fails to erupt into the dental arch within the specific time. Because impacted teeth do not erupt, they are retained throughout the individual's lifetime unless extracted or exposed surgically. Teeth may become impacted because of adjacent teeth, dense overlying bone, excessive soft tissue or a genetic abnormality. Most often, the cause of impaction is inadequate arch length and space in which to erupt. That is the total length of the alveolar arch is smaller than the tooth arch (the combined mesiodistal width of each tooth). The third molars are frequently impacted because they are the last teeth to erupt in the oral cavity. Mandibular third molars are more commonly impacted than their maxillary counterparts. As a general rule, all impacted teeth must be removed unless otherwise contraindicated.^[1]

Classification

Classifications enable the oral surgeon to determine the difficulty in removal of the impacted tooth.^[2] The primary factor determining the difficulty is accessibility, which is determined by adjacent teeth or other structures that impair access or delivery pathway. The majority of classification schemes are based on analysis on a radiograph. The most frequently considered factors are discussed below.

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

Relationship of tooth to anterior border of ramus

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]

Relationship of tooth to occlusal plane

The depth of the impacted tooth compared with the adjacent second molar gives the basis for this type of classification. This was also given by Pell and Gregory and is called as Pell and Gregory A,B and C classification.

Complications

Erupted teeth that are adjacent to impacted teeth are predisposed to periodontal disease. Since the most difficult tooth surface to be cleaned is the distal surface of the last tooth, in the presence of an impacted tooth there is always gingival inflammation around the second molar that is invariably present. Even this minor amount of inflammation can provide bacteria access to a larger portion of the root surface that results in early formation of periodontitis compromising the tooth. Even in situations in which no obvious communication exists between the mouth and the impacted third molar there may be enough communication to initiate dental caries (tooth decay).

Pericoronitis

Pericoronitis is an infection of the soft tissue that covers the crown of an impacted tooth and is usually caused by the normal oral micriobiota. For most people there exists a balance between the host defenses and the oral micriobiota but if the host defenses are compromised like during minor illness such as influenza or an upper respiratory tract infection, pericoronitis results. Another common cause is entrapment of food beneath the gum flap (also called an operculum). Pericoronitis can present as a mild infection or severe infection. In its mildest form it is just a localized tissue swelling and soreness whereas in severe forms the swelling is slightly larger even sometimes creating trismus (difficulty opening the mouth ).

Occasionally, an impacted tooth causes sufficient pressure on the roots of adjacent teeth causing it to resorb.

An impacted tooth occupies space that is usually filled with bone. This weakens that area of bone and renders the jaw more susceptible to fracture.

When impacted teeth are retained completely within the alveolar process, the associated follicular sac is also retained along with it. Though in most persons the dental follicle maintains its original size sometimes it may undergo cystic degeneration and become a dentigerous cyst or a keratocyst.

Symptoms

Most commonly the individual complains of food getting lodged beneath the gums and a soreness that is usually confused with throat infections. In slightly milder forms a swelling is visible and mouth opening becomes difficult in severe cases. Pain is invariably present.

Management

All impacted teeth, unless and otherwise contraindicated, are considered for surgical removal.

References

^ http://books.google.co.in/books/about/Peterson_s_Principles_of_Oral_and_Maxill.html?id=Jf9WZltV1BAC&redir_esc=y
^ http://books.google.co.in/books?id=Xqw5_Uv9EOcC&pg=PT152&dq=impacted+teeth+classification&hl=en&sa=X&ei=ghlfUfqAIoXJrQe9wYDACA&ved=0CFMQ6AEwBg
^ http://books.google.co.in/books?id=wJHV_TqpL_sC&pg=PA126&dq=pell+and+gregory&hl=en&sa=X&ei=RxpfUcSiPMyXrgfAmIDIDg&sqi=2&ved=0CC8Q6AEwAA#v=onepage&q=pe

UpToDate Contents

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1. 小児における歯の損傷の評価およびマネージメント evaluation and management of dental injuries in children
2. 歯性感染症の合併症、診断、および治療 complications diagnosis and treatment of odontogenic infections
3. 経膣メッシュ曝露と骨盤手術後の疼痛のマネージメント management of transvaginal mesh exposure and pain following pelvic surgery
4. 頸動脈内膜剥離術および頸動脈ステント留置術の麻酔 anesthesia for carotid endarterectomy and carotid stenting
5. Hereditary angioedema: Prophylaxis prior to procedures (short-term prophylaxis)

English Journal

Transalveolar repositioning of an impacted immature permanent mandibular canine.

Ozdemir-Ozenen D1, Guler N2, Sungurtekin-Ekci E3, Sandalli N1.
Journal of dentistry for children (Chicago, Ill.).J Dent Child (Chic).2015 Sep-Dec;81(3):156-60.
The purpose of this case report is to discuss the four-year follow-up of a transalveolar transplantation of an impacted immature permanent mandibular left canine. A nine year-old-boy was referred to the dental school because of a mandibular swelling associated with the impacted canine. Under local a
PMID 25514261

An experimental and computational study of the hydrodynamics of high-velocity water microdrops for interproximal tooth cleaning.

Rmaile A1, Carugo D2, Capretto L2, Wharton JA3, Thurner PJ2, Aspiras M4, Ward M4, De Jager M5, Stoodley P6.
Journal of the mechanical behavior of biomedical materials.J Mech Behav Biomed Mater.2015 Jun;46:148-57. doi: 10.1016/j.jmbbm.2015.02.010. Epub 2015 Feb 21.
The flow field and local hydrodynamics of high-velocity water microdrops impacting the interproximal (IP) space of typodont teeth were studied experimentally and computationally. Fourteen-day old Streptococcus mutans biofilms in the IP space were treated by a prototype AirFloss delivering 115µL of
PMID 25792412

Japanese Journal

下顎水平埋伏智歯抜歯に対しロピバカインを用いて下顎孔伝達麻酔を施行した不整脈原性右室心筋症の1症例

佐野浩司,蔡豪倫,健石英夫,中里茜,播岡徳也
日本歯科麻酔学会雑誌 39(2), 184-185, 2011-04-15
NAID 10028179363

上顎前歯部に双生歯を伴う不正咬合2症例の矯正治療

佐藤和朗,小田島晶子,三條晃,桑島幸紀,山田裕之,三浦廣行
岩手医科大学歯学雑誌 35(2), 67-75, 2010-10-20
… We treated the malocclusion of two boys having a germinated tooth in the incisor region of maxilla. … In case 1, the germinated tooth was located at the right lateral incisor, in case 2, at the left central incisor region of maxilla. … The X-ray and CT examinations revealed that the germinated tooth was united by enamel and dentin and the dental pulp cavity was joined in both cases. …
NAID 110007880445