-
Advances in Clinical and Experimental... 2016A tooth normally erupts when half to three-quarters of its final root length has developed. Tooth impaction is usually diagnosed well after this period and is generally... (Review)
Review
A tooth normally erupts when half to three-quarters of its final root length has developed. Tooth impaction is usually diagnosed well after this period and is generally asymptomatic. It is principally for this reason that patients seek treatment later than optimal. Tooth impaction is a common problem in daily orthodontic practice and, in most cases, it is recognized by chance in a routine dental examination. Therefore, it is very important that dental practitioners are aware of this condition, since early detection and intervention may help to prevent many harmful complications. The treatment of impacted teeth requires multidisciplinary cooperation between orthodontists, oral surgeons and sometimes periodontists. Orthodontic treatment and surgical exposure of impacted teeth are performed in order to bring the impacted tooth into the line of the arch. The treatment is long, more complicated and challenging. This article presents an overview of the prevalence, etiology, diagnosis, treatment and complications associated with the management of impacted teeth.
Topics: Early Diagnosis; Humans; Interdisciplinary Communication; Orthodontics; Patient Care Planning; Periodontics; Surgery, Oral; Tooth, Impacted
PubMed: 27629748
DOI: 10.17219/acem/37451 -
BMJ Clinical Evidence Aug 2014The incidence of impacted wisdom teeth (third molars) is high, with some 72% of Swedish people aged 20 to 30 years having at least one impacted wisdom tooth. Impacted... (Review)
Review
INTRODUCTION
The incidence of impacted wisdom teeth (third molars) is high, with some 72% of Swedish people aged 20 to 30 years having at least one impacted wisdom tooth. Impacted wisdom teeth occur because of a lack of space, obstruction, or abnormal position. They can cause inflammatory dental disease manifested by pain and swelling of infected teeth and may destroy adjacent teeth and bone.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical questions: Should asymptomatic, disease-free impacted wisdom teeth be removed prophylactically? What are the effects of different operative (surgical) techniques for removing impacted wisdom teeth? We searched: Medline, Embase, The Cochrane Library, and other important databases up to October 2013 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We performed a GRADE evaluation of the quality of evidence for interventions.
RESULTS
We found 11 studies that met our inclusion criteria.
CONCLUSIONS
In this systematic review, we present information relating to the effectiveness and safety of the following interventions: prophylactic extraction, active surveillance, and different operative (surgical) techniques for extracting impacted wisdom teeth.
Topics: Humans; Molar, Third; Prophylactic Surgical Procedures; Tooth Extraction; Tooth, Impacted; United States
PubMed: 25170946
DOI: No ID Found -
Dental and Medical Problems 2021Extractions of third molars constitute about 90% of the scheduled surgical procedures performed by oral surgeons. Wisdom tooth surgery is associated with complications,...
BACKGROUND
Extractions of third molars constitute about 90% of the scheduled surgical procedures performed by oral surgeons. Wisdom tooth surgery is associated with complications, such as the lingual and inferior alveolar nerve damage, bleeding, tooth/jaw fractures, tooth displacement into the adjacent anatomical spaces, trismus, infections, and other.
OBJECTIVES
The aim of the study was to analyze complications after wisdom tooth extraction in patients treated at the Department of Oral Surgery of Jagiellonian University Medical College in Kraków, Poland, in the years 2016-2018.
MATERIAL AND METHODS
A retrospective analysis of the medical records of 339 patients treated in the outpatient setting was performed. The inclusion criterion comprised a single extraction of a third molar. The exclusion criteria were multiple extractions, comorbidities and pregnancy. No antibiotic prophylaxis was used. The incidence of post-extraction complications, such as oroantral communication, postoperative hematoma, acute inflammation of the surrounding tissues, trismus, and transient paresthesia in relation to patient gender and age, the developmental stage and location of the removed tooth as well as the type of surgery were studied.
RESULTS
Perioperative complications occurred in 51 (15.0%) cases, and comprised the acute inflammation of the surrounding tissues in 31 patients, trismus after the removal of 13 lower third molars, oroantral communication after the extraction of 5 upper wisdom teeth, and hematoma as well as a transient sensory alteration of the lingual nerve in 1 case each. Complications were more common in patients who had a surgical extraction of a wisdom tooth with root separation and in cases of lower third molar extractions. No statistically significant correlation was found between the patients' age or gender, the developmental stage of the extracted tooth and the number of observed complications.
CONCLUSIONS
Lower third molars and the necessity of surgical extraction with root separation are risk factors for postoperative complications in patients who require wisdom tooth removal. Complications after the removal of third molars are most often inflammatory.
Topics: Humans; Molar, Third; Poland; Retrospective Studies; Tooth Extraction; Tooth, Impacted
PubMed: 33789003
DOI: 10.17219/dmp/127028 -
Dental Press Journal of Orthodontics 2019Orthodontic traction of impacted canines stands as a major challenge for Orthodontics. It is a relatively frequent clinical complaint which management, more often than...
Orthodontic traction of impacted canines stands as a major challenge for Orthodontics. It is a relatively frequent clinical complaint which management, more often than not, requires a multidisciplinary approach. Surgical exposure of the impacted canine, and the complex orthodontic mechanics applied to align the tooth back into the arch, may frequently lead to complications involving supporting tissues, not to mention the long treatment time and high costs imposed to patients. In face of that, it is worth highlighting the relevance of early diagnosis as to intervene efficiently and as soon as possible. This paper presents a review of the main concepts involving prevalence, etiology and classification of impacted canines, and describes the different clinical management options that would help solve the problem. It illustrates the topic by presenting a treatment delivered to a 13 year 7 months old male patient, suffering from a Class II, division 2, left subdivision, malocclusion, associated to a deep bite and a prolonged retention of a primary upper canine caused by the impaction of the permanent tooth. Corrective orthodontic therapy was associated to a rapid maxillary expansion and to the use of a high pull headgear. Impacted canine was submitted to orthodontic traction and correctly positioned back into the arch. This approach proved to be efficient in meeting both functional and aesthetic goals.
Topics: Adolescent; Cuspid; Dentition, Permanent; Esthetics, Dental; Humans; Malocclusion; Orthodontic Extrusion; Tooth Movement Techniques; Tooth, Impacted
PubMed: 30916252
DOI: 10.1590/2177-6709.24.1.074-087.bbo -
Canadian Journal of Dental Hygiene :... Oct 2021Dentigerous cysts are one of the most common developmental types of odontogenic cysts occurring in the oral cavity and often manifest as incidental findings on dental... (Review)
Review
Dentigerous cysts are one of the most common developmental types of odontogenic cysts occurring in the oral cavity and often manifest as incidental findings on dental radiographs and/or as asymptomatic swellings. These cysts develop from remnants of reduced enamel epithelium around the crown of an unerupted or impacted tooth, attached at the level of the cementoenamel junction. Most are considered developmental. However, in young clients they may be inflammatory in origin, the result of caries in the primary dentition. This short communication highlights a case of an asymptomatic dentigerous cyst identified in a 4-year-old child and subsequent enucleation under general anesthesia. A thorough clinical and radiographic assessment of the oral cavity in pediatric clients merits a review of dentigerous cysts by the dental hygienist.
Topics: Child; Child, Preschool; Dental Caries; Dentigerous Cyst; Humans; Odontogenic Cysts; Tooth, Deciduous; Tooth, Impacted
PubMed: 34925518
DOI: No ID Found -
Archivos Argentinos de Pediatria Dec 2018Supernumerary teeth represent a common human dental anomaly, defined as presence of extra teeth-more than the normal number foreseen in primary or permanent dentition.... (Review)
Review
Supernumerary teeth represent a common human dental anomaly, defined as presence of extra teeth-more than the normal number foreseen in primary or permanent dentition. The prevalence has been reported between 0.2 to 3%, and is more frequent in males than females. The etiology is heterogeneous, highly variable and most of the cases are idiopathic. However, the presence of multiple impacted or erupted supernumerary teeth is rare and associated with some genetic syndromes: cleidocranial displasia, familial adenomatous polyposis, trichorhinophalangeal syndrome type I, Rubinstein-Taybi syndrome, Nance-Horan syndrome, Opitz G/BBB syndrome, oculofaciocardiodental syndrome and Robinow syndrome (autosomal dominant). The supernumerary teeth should be considered in order to possibly diagnose these entities with the aim of offering an interdisciplinary management and treatment, as well as offer adequate family genetic counseling.
Topics: Female; Genetic Counseling; Humans; Male; Prevalence; Syndrome; Tooth, Impacted; Tooth, Supernumerary
PubMed: 30457727
DOI: 10.5546/aap.2018.eng.437 -
Stomatologija 2019This study aims to review main diagnostic methods and different treatment strategies of impacted maxillary canines. (Review)
Review
OBJECTIVE
This study aims to review main diagnostic methods and different treatment strategies of impacted maxillary canines.
MATERIALS AND METHODS
A computerised systematic search of studies was conducted on PubMed and Cochrane databases. The systematic search was performed using inclusion and exclusion criteria.
RESULTS
23 publications were identified as relevant to the theme. Nine studies were about the treatment of impacted maxillary canines, and fourteen reviews were about the diagnostic methods of impacted maxillary canines. Seven of these studies analysed samples comprising combined surgical and orthodontic treatment. Two studies were based on a treatment method whereby deciduous maxillary canine was extracted, and maxilla was expanded to avoid the impaction of permanent maxillary canine. Seven studies compared which diagnostic way - a cone-beam computed tomography or conventional radiography - is more accurate. Four studies evaluated only the accuracy of dental panoramic radiograms. Two studies evaluated how accurate the cone-beam computed tomography method is in diagnosing impacted maxillary canines. One study analysed if cephalogram could be useful in early diagnosis of impacted maxillary canines.
CONCLUSIONS
Impacted maxillary canines are usually diagnosed by using panoramic imaging or cone-beam computed tomography. Cone-beam computed tomography is the most accurate diagnostic method to identify the localisation of impacted maxillary canines. Palatal expansion can help to avoid the impaction of maxillary canines. Combined surgical and orthodontic treatment is used to treat impacted maxillary canines in permanent dentition.
Topics: Cone-Beam Computed Tomography; Cuspid; Humans; Maxilla; Palatal Expansion Technique; Tooth, Impacted
PubMed: 31619657
DOI: No ID Found -
Science Progress 2021To evaluate the associations of impaction patterns of mandibular third molars (M3Ms) with pathologies caused by them. In this study, 262 patients with 432 impacted M3Ms...
To evaluate the associations of impaction patterns of mandibular third molars (M3Ms) with pathologies caused by them. In this study, 262 patients with 432 impacted M3Ms who referred in Shanghai Xuhui District Center were reviewed. The pathologies include pericoronitis, mandibular second molar (M2M) caries, and M2M distal periodontal pathology. The impaction patterns of M3Ms and the pathologies were examined, while the M2M outcomes after surgeries were evaluated. A χ test was used to analyze the data, with a value of <0.05 being considered statistically significant. Pericoronitis was the major symptom in all patients, whereas the propensities of M2M distal caries and periodontal pathologies increased in older patients. Soft tissue impacted and vertically angulated teeth were more associated with pericoronitis ( < 0.05); mesio-angular impacted teeth in less deep positions had greater risks of M2Ms distal caries ( < 0.05); mesio-angular and horizontal impacted teeth in relative deep positions were more likely to cause M2Ms distal periodontal pathologies ( < 0.05). Extractions of soft tissue impacted teeth in vertical angulations should be considered, while removals of mesially and horizontally angulated or bony impacted teeth could be delayed.
Topics: Aged; China; Humans; Mandible; Molar, Third; Pericoronitis; Tooth, Impacted
PubMed: 33913399
DOI: 10.1177/00368504211013247 -
Medicina Oral, Patologia Oral Y Cirugia... Jul 2016Coronectomy is an alternative to complete removal of an impacted mandibular third molar. Most authors have recommended coronectomy to prevent damage to the inferior... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Coronectomy is an alternative to complete removal of an impacted mandibular third molar. Most authors have recommended coronectomy to prevent damage to the inferior alveolar nerve during surgical extraction of lower third molars. The present study offers a systematic review and metaanalysis of the coronectomy technique.
MATERIAL AND METHODS
A systematic review and meta-analysis was performed based on a PubMed and Cochrane databases search for articles published from 2014 and involving coronectomy of mandibular third molars located near the inferior alveolar nerve canal, with a minimum of 10 cases and a minimum follow-up period of 6 months. After application of the inclusion and exclusion criteria, a total of 12 articles were included in the study.
RESULTS AND DISCUSSION
Coronectomy results in significantly lesser loss of sensitivity of the inferior alveolar nerve and prevents the occurrence of dry socket. No statistically significant differences were observed in the incidence of pain and infection between coronectomy and complete surgical extraction. After coronectomy, the remaining tooth fragment migrates an average of 2 mm within two years.
CONCLUSIONS
Coronectomy is indicated when the mandibular third molar is in contact with the inferior alveolar nerve and complete removal of the tooth may cause nerve damage.
Topics: Humans; Mandible; Mandibular Nerve; Molar, Third; Tooth Crown; Tooth Extraction; Tooth, Impacted; Trigeminal Nerve Injuries
PubMed: 27031064
DOI: 10.4317/medoral.21074 -
Sultan Qaboos University Medical Journal Aug 2019This retrospective study aimed to investigate complications associated with the extraction of third molars at a tertiary healthcare centre in Oman.
OBJECTIVES
This retrospective study aimed to investigate complications associated with the extraction of third molars at a tertiary healthcare centre in Oman.
METHODS
All consecutive patients who underwent extraction of one or more impacted third molars under general anaesthesia at Sultan Qaboos University Hospital, Muscat, Oman, between January 2007 and December 2017 were included. Age, gender, indication for extraction, teeth removed, procedure and complications were recorded.
RESULTS
A total of 1,116 third molars (56% mandibular and 44% maxillary) were extracted and the majority (67.7%) were from female patients. The mean age at extraction was 24 ± 5 years and most patients (77.7%) were 20-29 years old. The intraoperative and postoperative complication rates were 3.7% and 8.3%, respectively. The intraoperative complications included tuberosity fracture (1.2%), root fracture (1.1%), bleeding (0.7%), soft tissue injury (0.5%) and adjacent tooth damage (0.2%). Postoperative complications were sensory nerve injuries (7.2%), swelling/pain/ (0.6%) and dry socket (0.5%). Nerve injury was temporary in 41 patients and permanent in four cases. A statistically significant relationship was observed between those aged 30-39 years and dry socket ( = 0.010) as well as bone removal and all postoperative complications ( = 0.001).
CONCLUSION
Most complications resulting from third molar extractions were minor and within the reported ranges in the scientific literature. However, increased age and bone removal were associated with a higher risk of complications. These findings may help to guide treatment planning, informed consent and patient education.
Topics: Adult; Anesthesia, General; Female; Humans; Intraoperative Complications; Male; Molar, Third; Oman; Patient Education as Topic; Postoperative Complications; Retrospective Studies; Tertiary Healthcare; Tooth Extraction; Tooth, Impacted; Young Adult
PubMed: 31728221
DOI: 10.18295/squmj.2019.19.03.009