Treatment of impacted teeth in orthodontic practice

  • Mohamad Azhar Ibrahim Kharsa DDS. PhD. Orth. Consultant Orthodontist, King Fahad Hospital- Madinah. Saudi Arabia.
Keywords: Impacted teeth, orthodontic forced eruption, open eruption, closed eruption, traction attachments

Abstract

Treatment of impacted teeth in orthodontics is crucially important, as clinician is supposed to manage such cases in his / her daily practice. However, impaction cases can be so complicated especially when other factors interfere within their treatments such as anatomical locations of the impacted teeth, surgical considerations and Orthodontic Traction difficulties. The management of impacted teeth in orthodontic practice varies widely from extraction of the impacted tooth to forced orthodontic eruption. Orthodontic eruption varies between closed or open techniques that must be determined for each case, per se. One hundred and fifty-one impacted teeth cases were followed up, classified by their techniques as to register the results statistically. The approaches for handling the impacted teeth were open forced eruption "as window or Apically Positioned Flap (APF)", closed forced eruption, negligence and extraction when indicated. Bonding with Light Cure orthodontic composite was used for all cases of forced eruption.The light cure device that was used for bonding was Mini LED,  Acteron, Li-ION 3.7V, 2500mAh. Time of exposure being 20 second. The traction attachments had been either Titanium Button and Chain (Watted) Dentaurum, or conventional Buttons (with ligature wires or elastics). The clinical audit and outcome is presented here with recommendations. It is recommended that the decision regarding orthodontic forced eruption (closed  or open), or extraction should be based on evaluation of each independent case on its own merit. 126 cases out of the 151 screened cases had been treated successfully by orthodontic forced eruption, but complications such ankylosis, resorption, eruption failure and periodontal pockets need to be taken into account. Another complication can often be encountered that is bonding failure, especially in closed force eruption. However, the new bonding materials and the improved techniques have helped overcome such a problem. Finally, the more precise the location and position of the impacted tooth is known, the easier the procedure becomes. This research discusses the prognosis of impacted teeth, the approaches of the orthodontic forced eruption and when to expose, extract or even "neglect". The article does not recommend one treatment plan for all cases, in contrary, it urges the reader to search more for innovative solutions whenever such cases come across.

Published
2018-08-31
How to Cite
Kharsa, M. A. (2018). Treatment of impacted teeth in orthodontic practice. Pakistan Orthodontic Journal, 10(1), 56-67. Retrieved from https://poj.org.pk/index.php/poj/article/view/213
Section
Case Series