《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 distoangular 3 垂直 vertical 4 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 molar a2 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 line a3 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 ramus b2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 tooth b3 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