The extraction of impacted teeth is performed surgically and is typically done on an outpatient basis under local anesthesia. Long-lasting procedures are conducted under sedation or general anesthesia, particularly for anxious patients and deep impactions associated with jaw cysts.
The decision regarding the type of anesthesia is made in consultation with the doctor and the patient, considering numerous factors that may influence the course of the surgery: the type and complexity of the intervention, the age and psychological and physical condition of the patient, among others.
WHAT ARE IMPACTED TEETH?
Impacted teeth are those that have not erupted in the jaw, despite the passage of the usual eruption time.
The most common reason for impaction is an obstruction in the eruption path. This is often the case in jaws of insufficient width or where there is significant crowding among the teeth.
If a tooth has partially erupted, it is referred to as semi-impacted.
The most commonly impacted teeth are: lower and upper wisdom teeth, upper canines, upper incisors, and lower premolars.
Due to irregular root position, they occupy various positions: at certain angles (angled), towards the adjacent tooth, or towards the edge of the jaw.
WHAT ANALYSES DETERMINE TOOTH IMPACTION?
In cases where tooth eruption is absent, a detailed clinical examination and analysis of radiographs are conducted, most often using orthopantomography (panoramic X-ray), and sometimes CBCT (3D imaging of the jaws).
Deeply impacted teeth are often asymptomatic and are discovered through radiography. Their position is usually horizontal, angled, or vertical.
Semi-impacted teeth can be accompanied by infection, pericoronitis, pain, difficulty opening the mouth, bad breath, etc.
The risk of infections is reflected in the difficulty of cleaning these teeth. Food can become trapped between the tooth crown, the gum, and the adjacent tooth, leading to the formation of a periodontal pocket.
In this way, pathogenic microorganisms can penetrate deep below the gum line and cause various conditions, such as the aforementioned pericoronitis, dentoalveolar abscess, or maxillary sinusitis in the case of upper wisdom teeth.
WHEN IS TOOTH EXTRACTION INDICATED?
Impacted teeth are commonly asymptomatic and are often discovered incidentally through the analysis of orthopantomography or CBCT images made for other reasons.
In addition to this, certain signs and symptoms may indicate tooth impaction:
Based on evident symptoms and performed analyses, the oral surgeon will recommend the extraction of impacted teeth and/or other forms of therapy.