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Factors that Lead to Additional Surgical Interventions after Initial Exposure of Impacted Teeth
thesisposted on 06.08.2019 by Jessica Finkielsztein
In order to distinguish essays and pre-prints from academic theses, we have a separate category. These are often much longer text based documents than a paper.
Hypothesis: We hypothesize that the leading factor leading to revision of an exposure of an impacted tooth is debonding. Objective: Our objective is to identify potential factors that lead to additional surgical interventions and problems after initial exposure of impacted teeth to reduce the number of revisions necessary. Methods: In order to find the records to do this retrospective study, we conducted a search of Axium records. We wanted to look at patients that had exposure of impacted teeth at the COD from January 1, 2003 to December 31, 2017. We sought the following combination of codes: duplicate of one of these codes with the same tooth site: D7281(old code used for exposures) ,D7283 (place device to aid eruption),D7280 (surgical exposure for orthodontic reasons), and then another search for one of those same codes but with the addition of either D4268 (surgical revision). In total we found 126 patient charts meeting the criteria. 14 of the charts were omitted due to either patient dismissal from the COD, coding errors or note inaccessibility. A total of 112 charts were included. Of the charts, 7 had two sites in which re-exposures were needed in two different sites. A total of 119 expose and bond revisions were evaluated. Results: The most common tooth that needed the revision was tooth #6 (35.3%), second most was #11 (23.5%). The most common noted reasons for the revisions were as follows: 31.9% debonding, 22.7% gingival overgrowth, 16% ankylosis, and 5.9% required positional change of the attachment on the tooth. Conclusion: The most common need for a revision of an orthodontic tooth exposure was debonding, followed by gingival overgrowth. Funding: Not applicable IRB/ACC protocol: IRB 2018-5066