Dental Tribune USA

Safe and effective management of impacted teeth in general dental practice: Facing the challenges.

Impacted teeth and teeth-like structures (supernumerary teeth and compound odontomas) are developmental deformities encountered in general dental practice. They may cause damage to adjacent anatomical structures in the jawbone and on dental arch. Treatment options include observation, surgical extraction, and surgical-orthodontic repositioning.

Impacted teeth and teeth-like structures (mesiodens, distomolars, compound odontomas) are considered to be developmental, pathological, medical deformities characteristic of a modern civilization (C.C Alling, III and R.D. Alling, 1993). Third molars are frequently impacted due to skeletal insufficiency in the anatomical area where they normally erupt. Canines and other teeth (incisors and premolars) may also be impacted due to a lack of coordination between shedding of deciduous tooth and maturation of the permanent tooth. When impacted, teeth-like structures, such as supernumerary teeth (mesiodens and distomolars) and compound odontomas, delay or preclude the normal eruption of underlying permanent tooth. Impaction of teeth and teeth-like structures may lead to mild to extensive damage to adjacent, normal anatomical structures (teeth, periodontium, maxillary sinus, nasal fossa, inferior alveolar and mental nerves) and the dental arch. Our 35-year clinical experience taught us that most of impacted teeth will erupt if hard-or soft tissue obstructions are removed from their eruption paths. Treatment options for the management of impacted teeth and teeth-like structures include long-term observation (if impaction is asymptomatic), and intervention, which includes surgical extraction (for orthodontic reasons or in presence of a pathology) or surgical-orthodontic repositioning (relocation). For impacted teeth and teeth-like structures, general and surgical dentists should consider only those treatment goals and options that minimize injury to the dentition and periodontium. Learning objectives:
  • Learning objective 1: A quick reminder of applied anatomy and local analgesia
  • Learning objective 2: Understand the indications, contra-indications, and complications of impacted teeth and teeth-like structures
  • Learning objective 3: Understand contemporary techniques used for the surgical extraction and surgical-orthodontic relocation of impacted teeth.

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