• Dr Changjie Guo

Surgical exposure of two impacted teeth.

An impacted tooth is one that fails to erupt or erupts only partially. After third molars (wisdom teeth), canines (eye teeth) are the most commonly impacted teeth. Upper canine teeth are some of the last to come through and therefore have more potential to become impacted and fail to reach their correct position within the upper jaw. The incidence of maxillary canine impaction has been estimated at 2%.

The causes for retarded eruption of teeth may be generalized or localized. Commonly, there may already be a degree of teeth crowding in the upper jaw due to a shortage of space. In some cases, there is a family history of canines being impacted.

If left untreated, canine impactions can lead to labial or lingual eruption of the nearby teeth, as well as loss of arch length, internal or external root resorption, dentigerous cyst formation and possible infection, or referred pain. In many instances, impacted teeth are totally asymptomatic apart from their potentially negative effects on orthodontic positioning and/or treatment.

Treatment for an impacted canine is usually part of a course of orthodontic therapy. Normally the best option is surgical exposure followed by orthodontics to bring the previously impacted tooth into the plane of occlusion. Extraction is usually contraindicated except when the impacted tooth is ankylosed, dilacerated, shows signs of resorption, the impaction is severe, the presence of a cyst is diagnosed, or the patient is not interested in undergoing orthodontic treatment.

In this case, it was not a single impacted tooth - we had two impacted teeth! One was buccally impacted canine and the other was completely horizontally impacted upper middle front tooth. The tooth's axis was perpendicular to the other normal teeth's. It took a long way to drag the tooth to the right position.



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