ORTHODONTICS
IMPACTION OF TEETH - FREQUENCY AND MOST OFTEN USED TREATMENT PROTOCOLS
Greta Roussanova Jordanova-Kostova 1a* , Pavel Kirilov Stanimirov 2a
Department of Orthodontics, Faculty of Dental Medicine, Medical University - Sofia, BG-1431 Sofia, Bulgaria
Department of Maxillo-Facial Surgery, Faculty of Dental Medicine, Medical University - Sofia, BG-1431 Sofia, Bulgaria
1
2
DDS, PhD, Associate Professor
a
Received: July 21, 2017
Revised: August 16, 2017
Accepted: September 13, 2017
Published: September 14, 2017
Academic Editor: Mariana Păcurar, DDS, PhD, Professor, Head, University of Medicine and Pharmacy Târgu Mureş, Târgu Mureş, Romania
Cite this article:
Jordanova-Kostova GR, Stanimirov PK. Impaction of teeth - frequency and most often used treatment protocols. Stoma Edu J. 2017;4(4):264-269.
ABSTRACT
DOI: 10.25241/stomaeduj.2017.4(4).art.3
Introduction: Tooth impaction is a biological phenomenon that can affect every tooth group, but
most often third molars, canines and second premolars.
Methodology: The aim of our survey is to find out the prevalence of impacted teeth in different tooth
groups. Another aim is to prove the following hypothesis, namely that there is a relationship between
impaction teeth and treatment protocols using the method of distalization of the upper molars
with the Pendulum appliance and also releasing space in the arc by the extraction of permanent
teeth. The study analyzed 182 patients diagnosed with impacted teeth and excluded patients with
impacted third molars. The analysis used the statistics packet SPSS version 13.0.
Results: The most common impacted teeth are the upper canines - 137 teeth, followed by upper
second premolars - 50 teeth, the lower second premolars - 27 teeth, the lower canine - 20 teeth,
the lower second molar - 11 teeth, the upper central incisor - 8 teeth, the lower lateral incisor -
3. Significant statistical relations were found between tooth agenesis, odonthoma collections and
tooth transposition with impaction. Patients in the early growth period stand a better chance not to
undergo non-extraction treatment than those for whom the formation of the constant dentition has
been finalized and who have passed the peak of their puberty growth.
Conclusion: The early diagnosis of the problem is an important factor for a successful treatment. The
growth potential of the patient is the leading factor that supports the processes.
Keywords: impaction teeth, tooth agenesis, tooth transposition, odontoma.
1. Introduction
Tooth impaction is a biological phenomenon that
can affect every tooth group. Impaction is the
process of tooth retention in the bone after its period
of eruption and even a change in its position and
location. The space for the impacted teeth in the
dental arch is often small and even missing. This is
the reason why teeth move and what most often
occurs is mesial movement of the posterior teeth.
The incisive point is mismatched to the middle line.
There are also tooth discrepancies in the opposite
side of the impacted tooth. Tooth eruption itself is
a sequence of biological processes that are largely
genetically guided and changed by the action
of external factors. The reasons for impaction are
researched by many authors. Here are some of them:
genetic influence (enamel hypoplasia, aplasia of the
second premolars, peg-shaped lateral incisors or
their absence and others),¹ supernumerary teeth,
changed position or shape of the roots of adjacent
teeth (dilacerations), odonthoma collections, lack of
space, crowding of the adjacent teeth, persistent or
ankylosed primary teeth, cysts or bone formations
that are obstacles to the eruption path, clefts and
syndromes, bone or root resorption process,
childhood traumas and others. 2
Impaction diagnosis is based on clinical and x-ray
examination. Orthodontic examinations are usually
supported by 2D X-ray images. In case impaction is
observed, a CBCT is assigned. There are a lot of prognosis
methods 3,4,5,6 techniques and factors for the probability of
impactions of canines 7 which allow early prognosis and
assessment. One of the factors for a successful treatment is
the age of the patients. The management of the treatment 8,9
of an impacted tooth should go as follows: localization of
the impacted tooth according to the planes (vestibule-
oral, and central alveolar position of the germ), depth in
the bone, prognosis for surgical access and technique. In
case of cysts and other collections, what comes first is to
determine the urgency of the case and whether orthodontic
or surgical treatment is necessary. With respect to shaping
and space gaining for the impacted teeth, the following
solutions are possible: alignment of the teeth and space
distribution; space gaining due to transversal expansion,
distal movement, teeth proclination or slenderizing; space
gaining due to tooth extraction; surgical exposure and
orthodontic traction of the impacted tooth; finishing and
retention of the case.
The treatment plan often includes the extraction of the
impacted canine. This decision is taken after assessing
*Corresponding author:
Assoc. Prof. Greta Roussanova Jordanova-Kostova, DDS, PhD, Department of Orthodontics, Faculty of Dental Medicine, Medical University – Sofia, 1, St. Georgi Sofiiski, BG-1431 Sofia, Bulgaria
Tel. 00359877922665, Fax: 0035929524556, e-mail: [email protected]
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Stoma Edu J. 2017;4(4): 264-269
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