IMPACTED TEETH
Certain
people suggest that the removal of impacted teeth is necessary as soon as their
presence is confirmed, which is usually by chance. They even believe that it must
be done as soon as possible, as long as there is no possibility that the
impacted tooth may be brought into alignment in the dental arch using a combination
of orthodontic and surgical techniques.
As
far as impacted teeth that have already caused problems are concerned, everyone
agrees that they should be removed, regardless of the degree of difficulty of
the surgical procedure. The symptoms of impacted teeth, such as:
a.
Localized or Generalized Neuralgias of the Head.
Impacted
teeth may be responsible for a variety of symptoms related to headaches and
various types of neuralgias. If this is the case, the pain may be due to pressure
exerted by the impacted tooth where it comes into contact with many nerve
endings. Many people suggest that the symptoms may subside after the removal of
the offending tooth, which basically involves ectopic impacted teeth.
b.
Pericoronitis.
This
is an acute infection of the soft tissues covering the semi-impacted tooth and
the associated follicle
c.
Production of Caries
Entrapment
of food particles and bad hygiene, due to the presence of the semi-impacted tooth,
may cause caries at the distal surface of the second molar, as well as on the
crown of the impacted tooth itself.
d.
Decreased Bone Support of Second Molar.
The
well-timed extraction of a semi-impacted tooth presenting a periodontal pocket
ensures the avoidance of resorption of the distal bone aspect of the
secondmolar, which would result in a decrease of its support.
e.
Obstruction of Placement of a Partial or Complete Denture.
The
impacted teeth of edentulous patients can erupt towards the residual alveolar
ridge, creating problems when applying a prosthesis. The localization of the tooth
is often observed after its communication with the oral cavity and the presence
of pain and edema.
f.
Obstruction of the Normal Eruption of Permanent Teeth.
Impacted
teeth and supernumerary teeth often hinder the normal eruption of permanent
teeth, creating functional and esthetic problems.
g.
Provoking or Aggravating Orthodontic Problems.
Lack
of room in the arch is possibly themost common indication for extraction,
primarily of impacted and semi-impacted third molars of the maxilla and
mandible.
h.
Participation in the Development of Various Pathologic Conditions.
The
coexistence of an impacted tooth and various pathologic conditions is not an uncommon
phenomenon. Often cystic lesions develop around the crown of the tooth and are
depicted on the radiograph as different-sized radiolucencies. These cysts may
be large and may displace the impacted tooth to any position in the jaw. When
the presence of such osteolytic lesions is verified radiographically, they must
be removed together with the associated impacted tooth.
e.
Destruction of Adjacent Teeth Due to Resorption of Roots.
Resorption
of the roots of adjacent teeth is another undesirable situation that may be
caused by the impacted tooth; the effect is brought about through pressure.
This case primarily involves the posterior teeth of the maxilla and mandible.
It begins with resorption of the distal root and, eventually, may totally
destroy the tooth. The resorption of roots
may also be observed in other areas of the dental arch and may involve dental
surfaces other than those mentioned above. Having mentioned the undesirable
situations that are associated with impacted teeth, and given the fact that
no one can guarantee that an asymptomatic impacted tooth will not create
problems in the future, the choice of removing or preserving the impacted tooth must
be made after considering all the possibilities.
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