Impacted Teeth
The most commonly impacted teeth are the wisdom teeth, which normally does not affect orthodontic treatment in children and
adolescents. The impaction of upper cuspid teeth is the next most common and it does affect orthodontic treatment directly. When detected at an early age (age 7-10), early
removal of baby teeth may sometimes allow the impacted teeth to spontaneously upright and erupt on their own. Adolescents will require surgical exposure of the impacted teeth
by an oral surgeon, who will attach a gold chain to the exposed teeth that will allow the orthodontist to apply a force to bring the impacted teeth into the mouth. If dental
crowding is present and teeth need to be extracted, sometimes the impacted teeth may be removed instead of the usual bicuspid teeth, since the bicuspid teeth looks very much
like the cuspid teeth from the side when one smiles. 12 year molars are commonly impacted as well, and their treatment may also involve surgical exposure.
Problem:
Class I crowding with impaction of both upper cuspid teeth touching each other in the midline in a 16 year old girl. The baby teeth were still present.
Treatment:
Full braces for 3 months followed by extraction of the retained baby teeth and surgical exposure of the
impacted teeth. Treatment was completed in a total of 23 months.
Problem:
Class II malocclusion with the impaction of both upper cuspid teeth and both lower second molars in a 14 year old teenage girl. The teeth on her right side are
in crossbite.
Treatment:
Phase II treatment involving palatal Hyrax expander to
correct the crossbite. Patient then had all four impacted teeth exposed by the oral surgeon. Full braces were worn for 27 months.
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At age 10, the impacted cuspids were discovered on the panoramic x-ray, but the positions were too high for direct
intervention. Patient had a 12 month Phase I treatment to correct her anterior and posterior crossbite.
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The retained primary cuspids were removed at age 12y 8m with surgical channeling up to the impacted teeth in the hope of
'redirecting' the impacted teeth into the extraction areas.
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Final result after Phase II treatment which involved surgical exposure of both the upper cuspid teeth and the lower second
molars. |
Problem: Class I malocclusion with impacted lower
12 year molars and dental crowding in both arches in a 13y 2m old teenage girl.
Treatment: Non-extraction treatment with full braces for 14 months. No surgical exposure was needed. The teeth were disimpacted by moving
them distally and subsequently up righting them with braces.
Problem:
Class I malocclusion with the presence of impacted upper right and left cuspid teeth in a 13y 7m old adolescent boy.
Treatment:
Non-extraction treatment with full braces for 25 months. After 4 months of increasing the space for the cuspid
teeth, the left one erupted on its own. However, the right impacted cuspid has to be surgically exposed by an oral surgeon. Once it was exposed, the tooth was moved into
position with braces.
Problem:
Class I crowding with the presence of an impacted upper right cuspid and a retained primary cuspid in a 12y 7m old girl.
Treatment:
Full braces for 6 months followed by extraction of the retained primary cuspid and surgical exposure of the
impacted teeth. Treatment completed in a total of 22 months.
Problem:
Class I malocclusion with the presence of an impacted upper right cuspid and a retained baby tooth in a 14y 2m old teenage girl.
Treatment:
Full braces for 26 months involving surgical exposure of the impacted cuspid tooth. No lower braces were
needed as the lower teeth were well aligned and the bite remained Class I.
Click on a Smile
Gallery link above
to view more before and after cases. |
