Abstract
This report suggests a classification of the various lesions of soft tissues produced by the difficult eruption of mandibular third molars. In addition it presents a bacteriological study of dental pulps dissected from embedded teeth which were extracted.
Unerupted teeth are classified as either impacted or embedded depending upon their relation to adjacent teeth and overlying bone. Both types may produce neuralgia and other lesions of nerve, muscle or organs of special sense. The local inflammatory reactions are classified under 4 general heads: (1) Simple pericoronitis; (2) Supurative pericoronitis (acute and chronic); (3) Diffuse pericoronitis; (4) Hypertrophic or hyperplastic pericoronitis. These several conditions require certain precautions in preliminary treatment but call ultimately for the removal of the tooth.
The bacteriological study of the vital pulps of unerupted third molars is a virgin field. The organisms of dental caries and pyorrhea have been extensively studied but no report has been published so far as we have been able to discover, of a bacteriological research upon dental pulps of embedded teeth. Only teeth with unbroken or non-mutilated crowns and roots were utilized. The technic of sterilization of tissues and instruments before and after extraction was carefully checked against accidental contamination from bacteria.
From an examination of embedded and impacted teeth where pericoronitis had developed it was found that over three-fourths gave cultures of non-hemolytic green producing streptococcus. This relative frequency is probably due, first, to the fact that unerupted third molars have larger apical foramina than erupted teeth. Thus, there is greater opportunity for organisms to gain access to the pulp.
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