What does it mean to remove an impacted tooth. Surgery to remove an impacted tooth. Impacted tooth extraction specialists

It happens that under the influence of some factors, the tooth may grow in the wrong place for it, at the wrong angle, or remain under the gum, rendering Negative influence to adjacent teeth. Sometimes such an anomaly can be corrected with orthodontic treatment, but most often it is necessary to remove the impacted dystopic tooth.

Impacted dystopic tooth

An impacted tooth is a tooth that is incorrectly positioned in oral cavity. It either grows in the wrong place, or cuts through at the wrong angle or rotates around its axis. An impacted tooth presses on adjacent teeth, shifting the entire row, resulting in an abnormal bite.

You can learn about how you can correct an overbite without braces.

In dentistry, there is a concept of retention - this is a delay in eruption permanent teeth. Retention is of 2 types:

Partial: when the tooth erupted partially, and only its crown part appeared above the gum.
Complete: it is hidden under the mucous membrane of the gums or is located in the bone tissue.

In addition, there are several types of impacted teeth: vertical, medial, horizontal and distal. Most common medial view, which is located at an angle to the front row. Less common are teeth that are located vertically or horizontally.

In dentistry, there is the concept of "bone immersion" - the tooth is located in the thickness of the bone tissue and does not come out of it. A dystopic tooth is one that has not completely erupted, as a result of which it is not able to take its place in the oral cavity.

Causes

The reasons for the development of retention can be different:

hereditary factor,
stress,
infectious diseases,
too dense gum tissue structure,
unnatural arrangement of the rudiments of the teeth,
growth retardation,
improper feeding of the child.

Disorders caused by dystopia

An incorrectly positioned tooth often provokes difficulties in eruption of the rest. The result is various violations bite, which causes functional and aesthetic defects.

Often, an incorrectly erupted tooth provokes regular injury to the mucous membrane of the oral cavity, tongue, and cheeks. As a result, a chronic injury occurs, which gradually transforms into a decubital ulcer.

Very often, the dystopia of the eights of the bottom row is combined with retention. In this case, the tooth is called impacted dystopic. Often such figure eights rest with the crown part on the second molar. In addition, they can grow in branches mandible, towards the tongue or cheek.

Diagnosis and treatment

In most cases, the diagnosis consists in examining the oral cavity. In some cases, the patient is referred to x-ray examination, which makes it possible to determine the location of the tooth in relation to the rest, the presence of neoplasms and the state of the rudiments of permanent teeth.

Sometimes malocclusion caused by malpositioning of an impacted dystonated tooth can be corrected with orthodontic treatment. If the use of orthodontic appliances does not desired results, the only way out is to delete.

Indications for the removal of an impacted dystopic tooth

Often, the removal of an impacted dystopic tooth is the only way to avoid the development of complications. The main indications for surgical intervention are:

Contraindications

In some cases, removal is contraindicated:

hypertensive crisis,
blood diseases,
a few days before the onset of menstruation,
the first few weeks after the termination of pregnancy,
exacerbation of diseases of the central nervous system,
serious heart disease
severe form of the course of viral diseases,
heavy general state patient.

Pregnant women to carry out this operation need with extreme caution and better in the last trimester.

How is an impacted dystopic tooth removed?

This is a rather complicated surgical intervention, since the doctor needs one that has not erupted and is located in the gum. Removal is carried out only after all inflammatory processes in the retention area have been treated. The operation takes a long time - an average of about three hours and takes place in several stages:

An incision is made on the gum.
A hole is drilled in the bone tissue.
The tooth is removed.
Bone fragments are removed.
The wound is treated with antiseptic agents.
The incision is sutured.

If the tooth is large, it is first crushed into pieces, after which it is removed piece by piece. Recovery period lasts about a week - then the stitches are removed. If an impacted tooth provoked a purulent inflammatory process, it must be removed in urgently in a hospital setting.

In particularly difficult cases, the gouging method is used for removal. This is a time-consuming operation, before which it is necessary to provide access to the diseased tooth.

There is also the “Tom method”: the gum is drilled from the side of the cheek, the tooth is tilted in the right direction, and then hollowed out.

FAQ

First of all, one that does not hurt the gums during use. At the same time, the quality of oral hygiene depends more on whether the teeth are brushed correctly than on the shape or type of toothbrush. Concerning electric brushes, then for ignorant people they are a more preferable option; although you can brush your teeth with a simple (manual) brush. In addition, a toothbrush alone is often not enough - flosses (special dental floss) should be used to clean between the teeth.

Rinses are optional hygiene products which effectively clean the entire oral cavity from harmful bacteria. All these tools can be divided into two large groups– treatment-and-prophylactic and hygienic.

The latter include rinsing agents that eliminate bad smell and promote fresh breath.

As for therapeutic and prophylactic, these include rinses that have anti-plaque / anti-inflammatory / anti-carious effects and help reduce the sensitivity of hard dental tissues. This is achieved due to the presence of different kind biologically active components. Therefore, the rinse aid must be selected for each specific person on an individual basis, as well as toothpaste. And since the product is not washed off with water, it only fixes the effect. active components pastes.

Such cleaning is completely safe for dental tissues and less traumatic. soft tissues oral cavity. The point is that in dental clinics a special level of ultrasonic vibrations is selected, which affects the density of the stone, disrupts its structure and separates it from the enamel. In addition, in places where tissues are treated with an ultrasonic scaler (this is the name of the device for cleaning teeth), a special cavitation effect occurs (after all, oxygen molecules are released from water droplets, which enter the treatment zone and cool the tip of the instrument). Cell membranes pathogenic microorganisms are torn apart by these molecules, causing microbes to die.

It turns out that ultrasonic cleaning has a complex effect (provided that really high-quality equipment is used) both on the stone and on the microflora as a whole, cleaning it. Oh oh mechanical cleaning you won't say it. Furthermore, ultrasonic cleaning more pleasant for the patient and takes less time.

According to dentists, dental treatment should be carried out regardless of your position. Moreover, a pregnant woman is recommended to visit a dentist every one or two months, because, as you know, when carrying a baby, the teeth are significantly weakened, they suffer from a deficiency of phosphorus and calcium, and therefore the risk of caries or even tooth loss increases significantly. For the treatment of pregnant women, it is necessary to use harmless means anesthesia. The most suitable course of treatment should be selected exclusively by a qualified dentist, who will also prescribe the required preparations that strengthen tooth enamel.

Treating wisdom teeth is quite difficult due to their anatomical structure. However, qualified specialists successfully treat them. Prosthetics of wisdom teeth is recommended when one (or several) neighboring teeth are missing or need to be removed (if you also remove a wisdom tooth, then there will simply be nothing to chew on). In addition, the removal of a wisdom tooth is undesirable if it is located on the jaw in right place, has its own antagonist tooth and takes part in the chewing process. Also, one should take into account the fact that poor quality treatment can lead to serious complications.

Here, of course, much depends on the taste of the person. So, there are absolutely imperceptible systems attached to inside teeth (known as lingual), but there are also transparent ones. But the most popular are still metal braces having colored metal / elastic ligatures. It's really trendy!

Let's start with the fact that it's just unattractive. If this is not enough for you, we give the following argument - the stone and plaque on the teeth often provoke bad breath. And that's not enough for you? In this case, we move on: if the tartar "grows", this will inevitably lead to irritation and inflammation of the gums, that is, it will create favorable conditions for periodontitis (a disease in which periodontal pockets are formed, pus constantly flows out of them, and the teeth themselves become mobile). And this is already a direct path to loss healthy teeth. Moreover, the number of harmful bacteria at the same time increases, due to which there is an increased cariousness of the teeth.

The service life of an accustomed implant will be tens of years. According to statistics, at least 90 percent of implants function perfectly 10 years after installation, while the service life is on average 40 years. Tellingly, this period will depend both on the design of the product and on how carefully the patient takes care of it. That is why when cleaning without fail you need to use an irrigator. In addition, it is necessary to visit the dentist at least once a year. All these measures will significantly reduce the risk of implant loss.

Removal of a tooth cyst can be performed therapeutically either surgical method. In the second case we are talking about tooth extraction with further cleaning of the gums. In addition, there are those modern methods to save the tooth. This is, first of all, a cystectomy - quite complicated operation, which consists in removing the cyst and the affected root tip. Another method is hemisection, in which the root and a fragment of the tooth above it are removed, after which it (part) is restored with a crown.

As for therapeutic treatment, then it consists in cleaning the cyst by means of root canal. It is also a difficult option, especially not always effective. Which method to choose? This will be decided by the doctor together with the patient.

In the first case, teeth are used to change the color professional systems, which are based on carbamide peroxide or hydrogen peroxide. Obviously, it is better to give preference to professional bleaching.

A dystopian tooth is a tooth that is incorrectly located or displaced in the dentition.

Such a tooth is dangerous because it can put pressure on the dentition, which will eventually lead to the inclination of all teeth and malocclusion. It is difficult to imagine, but it happens that the teeth are even perpendicular to the normal direction of tooth growth.

An impacted tooth is a tooth that has not erupted, which, due to some circumstances, it did not come out and remained completely or partially hidden by the gum or bone.

Impacted teeth not only deform the gums and spoil appearance of the dentition, but also affect the chewing function, preventing the normal chewing of food. Most often these are the so-called "wisdom teeth". Many patients have already had to remove their wisdom teeth, including for this reason.

Retention that slows down teething can be:

partial in which the tooth appears above the surface of the gums only partially. Most often, only visible top part;
complete, in which the tooth is completely hidden by bone tissue or mucous membrane.

A dystopian tooth is a tooth that is placed incorrectly in the dentition. He may grow up in the wrong place where he should have been. It grows at the wrong angle, perhaps even turned around its own axis. It affects the condition of the others, affecting their inclination and breaking the bite, which greatly spoils the smile. Very often there are people whose teeth have both of these flaws.

Why "wisdom teeth" do not grow correctly

Wisdom teeth, or the outermost teeth in a row, usually erupt between the ages of 18 and 25. And they grow, as a rule, with serious violations.

Only the lucky ones can boast of even and straight grown “eights”. Frequent problems wisdom teeth become retention and dystopia, in most cases even both ailments at once.

wrong growth wisdom teeth is explained by the fact that, firstly, they grow in adulthood, when bone fully formed, it is very dense and hard - naturally, it is incredibly difficult to “break through” it. Secondly, modern man eighth teeth are not needed - our ancestors used them for chewing raw meat. Wisdom teeth do not even have guides - milk teeth, so they have to make their own path in hard bone.

To identify the pathology of the development of the "eighth" tooth, it is necessary to take an x-ray or computed tomography. After detecting retention or dystopia, you should immediately consult a doctor. He will decide whether something can be done to save the tooth, or whether it is necessary to perform an extraction. impacted tooth wisdom, because the consequences, if nothing is done, may not be the most pleasant.

Pathologies of tooth development can cause:

malocclusion;
inflammation of the gums;
injury to the mucosa, cheeks and tongue;
infection maxillary sinus;
swelling of muscle tissue.

Indications and contraindications for the removal operation

In most cases, the removal of an impacted or dystopic tooth is the only way avoid further complications.

In particular, among the indications for surgical intervention:

pain in the area of the tooth, swelling of the gums;
facial numbness due to pressure exerted by an impacted tooth on nerve endings;
high risk changes in the position of the teeth adjacent to the dystopian;
the need for a prosthetic procedure that interferes with problem tooth;
retention-induced osteomyelitis or periostitis,
chronic pulpitis or periodontitis;
orthodontic treatment, requiring the creation of additional space on the jaw.

Even a healthy impacted wisdom tooth can be removed if the "seven" next to it is affected. carious process. This is done so that the dentist can fully process the carious cavity.

Contraindications for the removal of impacted and dystopic teeth include:

severe general condition;
hypertensive crisis;
exacerbation of nervous diseases;
sharp forms heart disease;
advanced stage viral diseases or infectious nature;
blood diseases;
last days before the start of menstruation;
the first 2 weeks after the abortion.

Pregnant women should be careful dental procedures. It is recommended to remove an impacted wisdom tooth in the second trimester or at the very beginning of the third.

Removal of an impacted tooth

Extraction of an impacted tooth is quite common surgery.

An impacted tooth is a tooth that cannot erupt on its own, and therefore cannot be placed in the right place, therefore it remains inside the bone or is located under the mucous membrane. Most often, the removal of an impacted tooth is the removal of a wisdom tooth.

The cause of such a tooth may be early removal milk teeth or incorrect position of the molars, which shift the entire row and leave no room for the growth of a new tooth. In all cases, the extraction of an impacted tooth is the most effective way restore beauty and health to your smile.

Since the impacted tooth is located incorrectly, its removal is a complex procedure that requires high qualifications. To remove an impacted tooth, the doctor cuts the mucous membrane, and then drills through the bone tissue with a burr so that the tooth itself can be removed. Sometimes it is necessary to divide the tooth into parts if it reaches a large size.

After the operation, the doctor places a medicine in the hole that has formed, which speeds up healing and relieves pain. AT rare cases the doctor sews up the resulting hole, this is done if it was large enough.

The extraction of an impacted tooth sometimes takes up to three hours - it depends on the size and location of the tooth being removed. Sometimes patients develop swelling in the place that the doctor drilled with a burr, this lasts from 1 to 5 days. Also, patients may experience pain after surgery to remove an impacted tooth, but in this case, the doctor prescribes local anesthetics. The next day after the procedure, the patient needs to visit a doctor.

There is an opinion that an operation to remove an impacted tooth is not necessary if it does not cause concern.

But such a tooth is often the cause of infection, which eventually leads to caries, periodontitis, pericoronitis and other more dangerous diseases.

Extraction of a dystopic tooth

A dystopian is a tooth that is incorrectly located or displaced in a row.

Extraction of a dystopic tooth is necessary procedure, which avoids pressure on the rest of the teeth, and therefore prevents the tilt of all teeth or the formation of a malocclusion. Also, an operation to remove a dystopic tooth helps to avoid such complications as soft tissue injury. Canines, incisors and wisdom teeth can be dystopian.

The reason for this anomaly is wrong position tooth germ, which has a genetic or embryonic origin, as well as the influence of external factors.

The removal of a dystopic tooth is not addressed immediately, most often dentists try to avoid surgery with the help of orthodontic treatment. But if the patient is over 15 years old, then usually it does not give results, so you have to resort to removal.

The removal of a dystopic tooth is a very complicated surgical operation, since the location of such a tooth is atypical. To be sure of the quality of the procedure, you should contact qualified specialists working with new equipment.

Turning to the dentist with complaints of discomfort and toothache, many patients receive a referral for the extraction of an impacted or dystopic tooth. A person who is ignorant of dentistry, such a recommendation can be confusing and make you panic. However, it is often a radical solution to the problem may be the only correct one.

Concept, types of dystopia

Dystopic teeth are those whose eruption and growth develop with deviations. Typically, such a pathology entails the incorrect location of all other teeth, discomfort the patient, as well as the need for dental treatment.

The photo shows examples of vestibular and medial tooth dystopia

There are many types of dystopia. For example, the tooth itself can be correct form, but grow in the wrong place, or occupy the right place relative to adjacent teeth, but have pathological form, the wrong angle of growth, be located on the wrong side.

In medicine, the following types of pathology are distinguished:

Vestibular dystopia. Means the growth of the tooth at an inclination in one direction or another.
Torposition. The tooth is turned in the opposite direction.
medial dystopia. The tooth protrudes beyond the dentition.
Distal. The tooth seems to be pressed into the jaw.

The essence and types of retention

retention also means pathological development teeth, but somewhat different from dystopia. An impacted tooth is a tooth that is fully formed in the gum tissue and periosteum, but not cut outward, or cut through only partially. Sometimes this pathology is asymptomatic, but more often there is an infection, discomfort in the form pain, phlegmon, abscesses.

What is an impacted tooth, you can see in this photo:

Science knows 2 types of retention:

complete;
partial.

With full retention, the tooth is hidden under the gum and bone tissue, it cannot be seen when examining the jaw. And with a partial degree of development of the pathology, the crown can be seen when examining the oral cavity, but its main part is still hidden under the gum.

Reasons for the appearance

The main factor in the appearance of impacted and dystopic teeth is detrimental heredity. All people have a genetic program for the formation of the dentition, and for some teeth there is not enough space for growth.

Specialists in the field of dentistry note several more reasons for the development of such a pathology:

If a single tooth grows before all the following, which could play the role of landmarks.
Sometimes one extra tooth appears in the row, and there is not enough room for all the rest to develop properly.
unnecessarily dense fabric tooth socket.
Loose periodontal structure.
Dense arrangement of crowns.
Traumatic injuries also often lead to bite deformation.
Ultra-early loss of milk teeth often leads to incorrect formation of the entire row.

Types of teeth prone to pathology

The most commonly observed dystopia or retention of the following types of teeth:

A displaced wisdom tooth is a common pathology. The cause of this phenomenon may be heredity or trauma to the jaw. In addition, the molars of the third row are considered a sign of atavism, which may gradually disappear in the course of evolutionary development.
Fangs. This pathology occurs at 10–12 years of age due to improper development molar teeth. A dystopic or impacted canine usually means not only a violation of the aesthetics of the oral cavity, but also persistent problems when chewing solid food. Besides canine with medial dystopia can permanently injure the soft tissues of the cheeks and tongue, causing discomfort to the patient, provoking the danger of an inflammatory process.

Possible consequences of pathology

Often patients become accustomed to malocclusion without going to the dentist. Especially often this happens when the patient does not experience pain and other discomfort. However, in the absence timely treatment the presence of an impacted or dystopic tooth can lead to other violations of the state of the body.

Possible complications:

Incorrect bite does not allow you to completely chew food, which is fraught with incomplete digestion, and subsequently - diseases of the stomach and intestines.
With an incorrect location or the presence of extra dystopic teeth, there are frequent cases of loss of an absolutely healthy neighboring one.
If the dentition is formed incorrectly, there may be violations of diction, problems with the pronunciation of certain sounds.
Cases are not uncommon traumatic injuries inside of the cheek and tongue.

Removal of impacted and dystopic teeth

Indications for the extraction of an impacted tooth are:

pathological location, lack of space in the dentition;
delay in the loss of retrograde teeth;
destruction of the tooth neck;
if the impacted tooth is superfluous and interferes normal growth the rest;
dentists advise removing such teeth in the presence of complications.

Removal of an impacted and dystopic tooth implies a high invasiveness of the intervention, since it is necessary to exfoliate the mucous membrane and periosteum, extract the tooth from the bone with the help of a bur, extract it from the bone tissue using forceps, and suture. If the roots of neighboring teeth are exposed, the doctor resects them, and then performs a retrograde filling procedure.

When there are no indications for the removal of an impacted or dystopic tooth, doctors perform an intervention to excise the gums or periosteum. The next stage of therapy will be orthodontic treatment in the form of braces or special buttons.

With regular injury to the cheeks and tongue due to dystopia or retention, dentists can perform a grinding procedure for dental tubercles. However, most often with such pathologies, a radical solution to the problem is recommended. Sometimes, after such a procedure, prosthetics may be required.

Impacted wisdom tooth removal procedure:

Anesthesia of the gum surface with a special gel or spray.
Administration of an anesthetic injection.
Incision of the gums with a scalpel, exposure of the wall of the bed.
Hole drilling for access to the wisdom tooth.
Cutting and extraction of the dental crown.
Separation and extraction of dental roots.
Cleaning and disinfection of the wound, sometimes - the imposition of turunda with iodine.
If the turunda was not installed, after antiseptic treatment a seam is applied.

The removal of a dystopian wisdom tooth occurs in a similar way.

Postoperative period

After the operation, the patient's teeth need enhanced care and medical supervision.

If turunda was applied, during the first three days from the moment of intervention, you need to visit the dentist to monitor the condition of the wound, and perform disinfection procedures. After this time, the dentist will remove the swab and stitch it up.
Daily brushing of teeth should be carried out in a gentle manner, avoiding injury to the operated area.
For 3 days after the operation, the use of rinses for the oral cavity is prohibited..
All food should be pureed, chewing on the operated side is prohibited.
In the first few hours after the intervention, it is not recommended to drink, eat, or use tobacco products.
If the patient is concerned severe pain, which means that it is not forbidden to take an analgesic pill.
For 2-3 days after the operation, you should not get involved in physical exercises.

Impacted- This is a tooth that has not erupted and is located in the bone tissue, covered by the gum. dystopian called teeth that have an abnormal position - that is, they are shifted towards the cheek or tongue, rotated around their axis or tilted to the side. At the same time, some teeth can be both impacted and dystopic - that is, they are in the bone, while they are turned to the side relative to the correct vertical position. This mainly concerns the “wisdom teeth” or root eights, which are located at the very end of the dentition.

Why do "wisdom teeth" grow incorrectly?

Wisdom teeth, or the outermost teeth in a row, usually erupt between the ages of 18 and 25. And they grow, as a rule, with serious violations. Only the lucky ones can boast of even and straight grown “eights”. Retention and dystopia become frequent problems of wisdom teeth, in most cases even both ailments at once.

The incorrect growth of wisdom teeth is explained by the fact that, firstly, they grow in adulthood, when the bone tissue is fully formed, it is very dense and hard - naturally, it is incredibly difficult to “break through” it. Secondly, modern man does not need eighth teeth - our ancestors used them to chew raw meat. Wisdom teeth do not even have guides - milk teeth, so they have to make their own path in hard bone.

Wisdom teeth in most cases are subject to removal, especially if they do not appear above the gum and interfere neighboring teeth(press on the roots of their neighbors from the side). Check Status impacted teeth wisdom is also very important when appearing discomfort when opening and closing the jaw, pain in the ear, or when the body temperature rises.

Removal of an impacted and dystopic tooth

An impacted wisdom tooth can be in a straight or rotated position (dystopia) - in this case, it will put pressure on the roots of its neighbor. In order to avoid complications, such ungrown teeth must be removed. How is the operation carried out? In several stages:

The operation to remove an impacted / dystopic tooth lasts about 30 minutes - an hour. This is a fairly ordinary operation, which, when performing professional actions, will not lead to any complications. In some cases, if there is a large number uneven roots may take longer. The doctor can determine the approximate time of the operation based on the results of the examination of the image.

Complications after the removal of "wisdom teeth"

Unerupted teeth are sometimes deep enough in the bone, so their extraction can be quite a difficult procedure - this can lead to certain complications. For example, a nerve injury in the lower jaw, resulting in numbness of the lips, tongue and part of the cheek (passes on its own after a few weeks or months), rupture of the nasal sinus (a runny nose or sinusitis is formed). At difficult removal wisdom teeth, there is a high probability of a fracture of the jaw, adjacent teeth or prostheses. In order to avoid such complications, it is best to remove wisdom teeth from an maxillofacial surgeon who has a large practical experience in this region.

Care after the removal of "wisdom teeth"

After the removal of impacted wisdom teeth, there may be minor pain, bleeding from the wound, and rarely, suture separation. There are also swelling of the tissues, pain when chewing food and opening the jaw. If the pain does not go away for 2-3 days (at this time it is necessary to take painkillers - these can be Ketarol, Ketanov, Nise, etc., depending on the prescriptions after the operation), you should consult a doctor. In general, rehabilitation takes from 1 to 5 days. After a few days, you should definitely visit a doctor for a follow-up examination of the results of treatment and removal of sutures.

After the operation, it is very important to follow the precautions recommended by your doctor: within two hours after the extraction of the tooth, you must refrain from eating. For a couple of days, the foods consumed should be warm - not too hot and in no case cold. It is necessary to chew on the side opposite from the place of operation. It should also be temporarily excluded physical exercise. You can brush your teeth, but as carefully as possible so as not to damage the stitches. Remember to take antibiotics and medicines, restoring the state immune system body - they will be prescribed by your doctor.