《阻生牙的拔除》PPT课件.ppt

下颌阻生智慧牙拔除,下颌阻生智齿分类一,下颌阻生智齿分类Classification of impaction of mandibular third molars,第一种分类方法：1 近中倾斜 Mesioangular 2 远中倾斜 distoangular3 垂直 vertical4 水平 horizontal 5 颊向 buccoangular 6 舌向 linguoangular 7 倒置 inverted,下颌阻生智齿分类二,下颌阻生智齿分类二,第二种分类方法：,a1 高位 The occlusal surface of the impacted tooth is at the same level as,or a little below that of,the second molara2 中位The occlusal surface of the impacted tooth is at the middle of the crown of the secondmolar or at the same level as the cervical linea3 低位The occlusal surface of the impacted tooth is below the cervical line of the second molar,下颌阻生智齿分类二,第二种分类方法：,b1 间隙大于牙冠 The distance between the second molar and the anterior border of the ramus is greater than themesiodistal diameter of the crown of the impacted tooth,so that its extraction does not require bone removal from the region ofthe ramusb2间隙小于牙冠 The distance is less and the existing space is less than the mesiodistal diameter of the crown of the impacted toothb3 没有间隙There is no room between the second molar and the anterior border of the ramus,so that the entire impacted tooth or part of it is embedded in the ramus,我临床上的分类,二大类：水平阻生和垂直阻生所有的牙齿都可归为此二类再综合前面所讲到的二种分类方法和牙根的情况进行详细分类描叙，这样的分类更加有利于临床实践，有利于拔牙手术的难度评估,水平阻生,水平阻生 113068,水平高位、根粗大 109058,中位 骨覆盖 114077,水平低位粗根,水平远中骨阻生空间小根多个,水平邻牙远中骨吸收根细113504,水平 根粗大 邻牙远中骨吸收严重 龋损,水平根分叉大空间小,水平阻生根分叉大,水平根分叉大邻牙远中骨吸收,水平 极低位 37根尖区113074,垂直阻生,高位远中骨阻生牙龈覆盖,垂直牙巨大远中骨阻生,垂直远中骨阻生空间小,垂直低位弯根远中骨阻生牙根吸收远中骨阻生空间小较难,垂直远中骨阻生空间小较难,远中骨阻生偏颊侧远中牙挺难下去无间隙,垂直低位远中骨阻力近下颌神经管,难度大的牙,增加拔牙难度的因素,巨大牙牙根长、粗大、多根、弯曲、分叉大骨埋伏低位于邻牙，去骨难度大垂直低位骨埋伏邻牙的根分叉颊舌向象水平低位，挺不好使力颊部胖，暴露不充分牙根骨粘连,颊舌向水平低位挺不好使力水平低位阻生-,颊舌向垂直阻生于颊侧根尖区,少见的拔牙并发症,下颌骨骨折舌神经暴露牙齿进入口底、咽旁间隙牙挺折断注射针头折断牙根进入上颌窦、下颌管,下颌骨骨折,舌神经暴露,牙齿进入口底、咽旁间隙,Thank You,启航号,