Apr 02, 2021

An impacted tooth is caused by the failure of the tooth to develop or emerge from the gum. Tooth impaction can be managed by either exposing or extracting the teeth through surgical means.

The method to be used for this process is dependent on different factors. The patient needs to be evaluated using the clinical method before a dental treatment plan is generated. The following is assessed during clinical testing:

  • The extent of impaction of the tooth
  • The usefulness of the tooth
  • The oral health and dental cavities.
  • The duration and affordability of the treatment
  • Treatment options available for the impaction
  • The possibility of carrying out a surgical exposure and orthodontic alignment
  • The patient’s age.

The extent of the impact of Orthodontic and Surgical Therapy

Deep impaction may be impossible to solve with surgical exposure and dental treatment. Even surgical removal of the impacted tooth might be contraindicated as this might lead to harming essential tissues and organs during the process.

It might be best to leave such cases alone and follow up with a radiograph for 6 to 12 months for changes in the follicle of impaction. Tooth Extraction of the crown is also another alternative.

The usefulness of the impacted tooth

If the impacted tooth is badly deformed or short-rooted, it might be better to remove the tooth than carry out surgical exposure and alignment.

Oral hygiene and dental cavities

Orthodontic exposure, tooth exposure, and forced eruption of the tooth impaction may not be indicated if the patient has regular cavities, bad teeth hygiene, and lacks the proper motivation to cooperate with the medical practitioner.

If the impacted tooth was observed to be broken, it might indicate that the impacted tooth needs to be removed.

The Length and Cost of Surgical Treatment

The duration of the orthodontic services and surgical treatment and the treatment cost are issues worthy of being considered. This should be talked about with the patient or guardian before a treatment plan is made.

It may take 1 to 3 years for the orthodontic treatment to direct the impaction to the dental arch and into the block. This also depends on the patient’s age, bone density, root formation level, and extent of the impaction.

The expenses are calculated using the parameters mentioned above. The longer it takes to bring the impacted tooth to the right position, the more expensive it will be.

Treatment options available for the impaction

There is various dental treatment available for someone with an impacted canine which includes;

Surgical removal: Removing the impacted canine through surgical means and replacing the tooth with a prosthetic done when the tooth cannot be salvaged.

Surgical exposure: This can be carried out if the impacted canine can be salvaged through orthodontic alignment and surgical exposure.

No treatment: No treatment might be the best option when it is impossible to remove the impacted teeth, except for periodic radiographic evaluation of disease condition.
Sex and age, alignment space, movement of the first premolar away from the canine site, and other important data should be collected, documented, and used to determine the most suitable treatment for the patient.

The possibility of carrying out a surgical exposure and orthodontic alignment

Saving the impacted teeth will require combining surgical and orthodontic management. To determine if exposure and orthodontic services are possible, first assess arch space, then the radiographic evaluation is important.

Age of patient

The most appropriate age for teeth exposure, eruption, or surgical extraction is during childhood and adolescence; due to the fusion of the impacted tooth with the surrounding bones (ankylosis) as the age increases, reducing the possibility to move the tooth to the dental arch.

This can be easily diagnosed without operation and may become obvious as the tooth fails to emerge even after orthodontic traction has been applied for several weeks. Ankylosis can also occur as a result of trauma to the primary dentition in childhood or adolescence.

Trauma to the primary dentition during childhood may precede damage to the dental germ resulting in displacement. Delayed eruption of the permanent tooth may also result from the premature loss of a primary tooth.

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