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Surgical case histories—Impacted and unerupted teeth
SURGICAL CASE HIS'l'ORIES-BIPAC'l'Em AND UNERUPTlm TEETH By BENNETT
A. E'IEI"D, D.D.S.,
NEW YORK,
N.
Y.
ASE 1. Figs. 1 and 2. Female, eighty-three years of age, presented with extensive swelling of the left side of the face. Clinical examination revealed an intraoral fistula discharging pus in the left mandibular first molar region. The mandible was edentulous. A history of previous acute attacks was elicited. For a long time a marked rigidity of the submaxillary tissues had been observed,
C
Fig. 1.
Extraoral roentgenographic examination revealed presence of impacted and unerupted left mandibular first molar. About the crown of the unerupted tooth was evidence of a degenerated follicular sac. (A small cystic area in the premolar region may be observed in Fig. 1. This cyst is unrelated to the acute symptoms.) Note the complete disintegration of the crown of the tooth. After consultation with the family physician, it was decided to operate for the removal of this tooth as soon as the acute symptoms had subsided. On operating, the roots were found deeply embedded, fused, with a marked L-shaped curvature. 903
Bennett A. Field
904
Fig. 2 shows the immediate postoperative result. Note the thin layer of bone at the lower border of the mandible. Recovery was uneventful, the rigidity completely disappearing after the removal of the tooth.
Fig'. 2.
Fig. 3.
Fig. 4.
2. Figs. 3 and 4. Male, aged twenty-one years. Presented with extensive swelling of the face and edema of the tissues under the right eye. Roentgenographic examination revealed presence of impacted and unerupted right maxillary canine. There was a history of dizziness, nausea and vomiting, with temporary blindness at periodic intervals of ten days or two weeks ever since childhood. On operating, the tooth was found deeply embedded labially, extending from the apex of the right maxillary lateral upward and CASE
Surgical Case Histories
Fig. 5.-Impacted left maxillary and mandibular third molars and two premolars. premolar is completely inverted.
Fig. G.-Postoperative.
905
The secone!
906
Bennett
~L1.
F'ielcZ
Fig. 7.-Imp'lcted ri.;-ht mandibular third molar and first premolar.
Fig. 8.-Postoperative.
Surgical Case Histories
907
backward into the maxillary sinus. Although considerable time has elapsed since the operation was performed, there has been no recurrence of the symptoms described above. CASE 3.-Showing a series of six impacted and unerupted teeth. The foregoing cases are reported both for their general interest and for the object lesson they point. It is my contention that impacted teeth are at all times a source of potential disturbance both locally and constitutionally. They should be either brought into normal occlusion, if feasible, or operated upon for removal. 745 FIFTH AVENUE.
A. E'IEI"D, D.D.S.,
NEW YORK,
N.
Y.
ASE 1. Figs. 1 and 2. Female, eighty-three years of age, presented with extensive swelling of the left side of the face. Clinical examination revealed an intraoral fistula discharging pus in the left mandibular first molar region. The mandible was edentulous. A history of previous acute attacks was elicited. For a long time a marked rigidity of the submaxillary tissues had been observed,
C
Fig. 1.
Extraoral roentgenographic examination revealed presence of impacted and unerupted left mandibular first molar. About the crown of the unerupted tooth was evidence of a degenerated follicular sac. (A small cystic area in the premolar region may be observed in Fig. 1. This cyst is unrelated to the acute symptoms.) Note the complete disintegration of the crown of the tooth. After consultation with the family physician, it was decided to operate for the removal of this tooth as soon as the acute symptoms had subsided. On operating, the roots were found deeply embedded, fused, with a marked L-shaped curvature. 903
Bennett A. Field
904
Fig. 2 shows the immediate postoperative result. Note the thin layer of bone at the lower border of the mandible. Recovery was uneventful, the rigidity completely disappearing after the removal of the tooth.
Fig'. 2.
Fig. 3.
Fig. 4.
2. Figs. 3 and 4. Male, aged twenty-one years. Presented with extensive swelling of the face and edema of the tissues under the right eye. Roentgenographic examination revealed presence of impacted and unerupted right maxillary canine. There was a history of dizziness, nausea and vomiting, with temporary blindness at periodic intervals of ten days or two weeks ever since childhood. On operating, the tooth was found deeply embedded labially, extending from the apex of the right maxillary lateral upward and CASE
Surgical Case Histories
Fig. 5.-Impacted left maxillary and mandibular third molars and two premolars. premolar is completely inverted.
Fig. G.-Postoperative.
905
The secone!
906
Bennett
~L1.
F'ielcZ
Fig. 7.-Imp'lcted ri.;-ht mandibular third molar and first premolar.
Fig. 8.-Postoperative.
Surgical Case Histories
907
backward into the maxillary sinus. Although considerable time has elapsed since the operation was performed, there has been no recurrence of the symptoms described above. CASE 3.-Showing a series of six impacted and unerupted teeth. The foregoing cases are reported both for their general interest and for the object lesson they point. It is my contention that impacted teeth are at all times a source of potential disturbance both locally and constitutionally. They should be either brought into normal occlusion, if feasible, or operated upon for removal. 745 FIFTH AVENUE.