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Jumat, 01 Juli 2016

IMPACTED TEETH, GIGI IMPAKSI



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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