FOOD IMPACTION It is defined as forceful wedging

FOOD IMPACTION It is defined as forceful wedging of food into the periodontium.

ETIOLOGY • Anatomy related • Inadequate Interproximal restoration • Prosthetic related • Implant related

ANATOMIC RELATED • Diastema • Tooth movement • Occlusion discrepancy • Inerdental papilla support/recession

INADEQUATE INTERPROXIMAL RESTORATION • Inappropriate design of marginal ridge&contact area

PROSHTHETIC RELATED Proximal filling related Fractured restoration Inadequate prosthetic crown Faulty design impression/laboratory procedure fabrication • Fractured of prosthesis at proximal contact • •

IMPLANT RELATED • Excessive distance between implant/implant &adjacent tooth • Inappropriate distance between contact point &alveolar bone crest(3 mm for adjacent implant&3 -5 mm for adjacent tooth -implant)

POSSIBLE ETIOLOGY OF PAIN • Pressure on periodontal tissue(propriorecepter in PDL) • Pulapal irritation through exposed dentinal tubules

SIGNS Proximal contact may be open Interdental papilla flattened/absent Plunger cusp apparent in opposing tooth In compatible marginal ridges of prosthetic crown of adjacent tooth • Food accumulation in proximal region • •

SYMPTOMES • Discomfort • Bad taste&Halitosis • Pain

INVESTIGATION • Inquire about the nature of pain • History of food impaction • Visual inspection/oral examination • Radiograph (IOPA&Bite wings)

DIAGNOSIS • Pts description of the problem&pain history • Clinical examination • Exclusion of pulpal involvement

D/D • Pulpitis (Acute) • Acute periodontitis

TREATMENT • Acute phase treatment • Creating proper proximal contact area • Special wedging techniques for direct restoration

ACUTE PHASE TREATMENT • Debride with/without local anesthesia • Motivate pts to clean the interdental area using any appropriate methods

CREATING PROPER PROXIMAL CONTACT AREA • Reproduce the anatomic proximal contact area and contours • Always creating a possible tight contact

SPECIAL WEDGING TECHNIQUES • Piggy back wedging • Double wedging • Wedge wedging

MCQ-1 • Which is the following a possible anatomic factor responsible for food impaction? (a)fractured restoration (b)proximal restoration (c)faulty design crown (d)occlusion discrepancy

MCQ-2 • How much distance between implant and adjacent tooth is ideal for fabrication of crown to prevent food impaction? (a)1 -2 mm (b)3 -4 mm (c)4 -5 mm (d)5 -6 mm

MCQ -3 • Which is best radiological methods to diagnose interproximal carious lesion? (a)intra oral peri apical (b)panaromic (c)occlussal (d)bitewing

MCQ-4 • Which is the following a sign of food impaction in proximal area? (a)plunger cusp (b)discomfort (c)halitosis (d)pain

MCQ-5 • Which is the following a symptoms of food impaction in proximal area? (a)plunger cusp (b)food accumulation (c)bad taste (d)open proximal contact