Impacted Teeth

impacted canineIn some orthodontic cases, a complicating factor is that a tooth or several teeth are "impacted". This means that the teeth are trapped under the gum and will not erupt or grow into place on their own. The cause of this problem is not always known, but crowding, trauma, genetics, and size and shape of the teeth may all be contributing factors. In many cases, development of space for the impacted tooth will allow the passive eruption of the tooth into the mouth. In some cases, development of room for the tooth is not enough and surgical intervention is required.
During this surgical intervention, a small incision is made in the gum and a small amount of bone is removed to uncover the tooth. After exposure of the tooth, a bracket or gold chain may be bonded to the tooth to allow traction to be placed on the tooth to bring the tooth into the mouth. As the tooth erupts into the mouth, a conventional bracket can be placed on the tooth and the tooth can be moved into its final position.
The following are some possible complications and undesirable side effects that may occur during this process:
1. The impacted tooth may not fully erupt or may be impossible to bring into the mouth. This may necessitate the extraction of the tooth and implant replacement of the tooth.
2. There may be damage to the impacted tooth or the adjacent teeth in the arch. This may include resorption or shortening of the roots of the teeth. In rare instances, this may also lead to the loss of the teeth and necessitate implant replacement of the tooth or teeth.
3. The bracket or gold chain attached to the tooth may break away from the tooth and need to be rebonded during another surgical procedure. An additional surgical procedure may also be needed to luxate or loosen the impacted tooth or to place the bracket onto a different portion of the tooth to aid eruption.
4. It may not be possible to bring the impacted tooth into a perfect position and the tooth may be rotated 180 degrees. There may also be gum recession that would require a grafting procedure for correction.
5. As an adjunct to conventional orthodontic treatment, jaw surgery may be necessary to compensate for changes to the occlusal or biting plane that may occur as the impacted tooth is brought into place.
6. Temporary anchorage devices (TADs) may need to be placed by the oral surgeon, at an additional expense, to aid in bringing the impacted tooth into the mouth.
7. Treatment time can be significantly longer in cases involving impacted teeth.
Dr. Durbin would be happy to discuss these or any other orthodontic concerns that you may have.


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