After removal of the wisdom tooth doesn’t open his mouth
If, after the removal of wisdom teeth, don’t open your mouth, something to do with it something. In General, the implementation of the eighth tooth extraction procedure itself is complicated and time-consuming. This is due to the restriction of access to the implementation methodology. And if a tooth is rotated or not cut at all, the situation with the removal of complicated at times. Most people, even in the normal location of the wisdom tooth relative to the dental arch after the application of the extraction there is a restriction in opening. Let’s look at the causes of disturbed mobility of the lower jaw and talk about treatment in this situation.
Features extraction eights
The removal of wisdom teeth takes place in several stages and depends on the type of location in the bone. In the normal position in the bone, the doctor initially performs anaesthesia: conduction and infiltration if necessary. Next, the detachment of the circular ligament of the tooth. This structure is represented by connective tissue that connects the tooth located in the bone and gums. Then applied the forceps, and produce oscillating movement of small amplitude. By imbalance, slowly produce traction (withdrawal). Then check kuretani spoon hole, creating a clot for regeneration, and produce compression of the bone tissue of the alveolar process of the jaw in the vestibular-oral direction for the prevention of occurrence of exostosis (bony protrusions).
In the case of the location of the wisdom tooth in the position of polurethane and retention tactics of the intervention will be implemented differently.
Palletirovaniya eight visually determined in the oral cavity following parameters:
- The location is at an angle to the adjacent tooth;
- Partial 1_3 appearance of hillocks;
- Not prorezalsya part, and also partially the mounds may be covered with slimy hood;
- In the provision of long-term pressure on the right side the tooth is the latest change in the appearance of carious or complicated forms of caries on the surface;
- On the radiograph indicated the angular position in the bone, with a partial appearance on the surface.
Impacted eight in most cases is installed when you perform a panoramic study, which sets the direction in the bone defects of the tooth structure or nearby.
Extraction of wisdom teeth at the stage of retention and polurethane carried out in the following sequence:
- The production of anesthesia;
- An incision with a scalpel from the vestibular part of the eight, with the creation of a trapezoid area, base facing down. Detachment of the mucous flap;
- With the help of Bor drilling a hole in the cortical bone corresponding to the position of the wisdom tooth: in progress manipulations are guided not only by visual information of the mouth, but also on the result of the radiographic examination. Remove the drilled area;
- Make the cut with the cutter of the roots of eight, if necessary, complementing the dissection and crowns. Perform layer-by-layer removal of parts of the tooth;
- Curettage, antiseptic processing, application of material to prevent the development of inflammation;
- Reverse laying the mucous flap and fixation sutures on the wound.
Upon completion of any of the types of ongoing removal, the doctor gives recommendations for home care.
Etiological aspects contributing to the breach opening
After removal of the wisdom tooth to open mouth due to disorders in performing extractions, treatment. And if the doctor will not take into account the state of other organs and tissues of the mouth. To accompany the emergence of limitations in the opening after traction can microstoma (narrowing of the oral cleft genetic or acquired nature), and other pathology of the jaw, the defects of TMJ (temporomandibular joint). Disorders of the TMJ can be inflammatory and dystrophic character. And because this element of the maxillofacial region plays an important role in the process of opening of the mouth, it is impossible to dismiss. The fact that the joints connect the lower jaw head with a special cavity of the temporal bone. The joint is surrounded by a capsule, and the opening process and govern the special ligaments and muscles. In case of any change at this level, arising prior to or in the process of removing eights, limitation of mouth opening can designate itself too.
Now directly about the deletion. Generally before removing any of the group of eight is recommended to perform the original x-rays. Better sighting picture for a better view of the position of the object and assessment of the state of the adjacent teeth. Then proceed to delete.
Errors can cause of mouth opening limitation:
- Inadequate analgesia: a long and painful manipulations may provoke the development of inflammation in the removal area and soft tissues;
- The lack of detachment of the circular ligament of the tooth: sickle trowel should pass freely along koronkowa-root articulation on all tooth surfaces, except occlusal. In case there are restrictions for traction will have to make great efforts during the deletion of eight;
- Wrong forceps for the extraction tool should be imposed in the area koronkowa-root compounds, on the axis of the tooth. In violation of the location above or below relative to the connection or location is not parallel with the centre line of the tooth, irregular action of the shaking forces on the periodontium, which also leads to the need to apply excessive load;
- Violation in the performance of sway: in single rooted teeth it is possible to use simultaneously luxatie (rocking forwards / backwards) and rotation (movements performed in a circle). In multi you can perform only the luxation. In the implementation of the rotation, even once, it is likely to break off part of the root on the bend.
- The implementation of the removal of the tooth from the oral cavity with stress: it can damage the soft tissue and the jaw bone.
If the procedure is performed by your doctor, is a long time, the trigger restriction can muscle tension. When the mouth is open for a long time there is tension in the muscles and TMJ, which subsequently leads to the development of inflammation and lockjaw (tonic muscle spasm). If long to open the mouth, it is possible to create a series of conditions to obtain cracked corners of the mouth that, with the accession of the microbial flora (in most cases strepto-stafillokokkovye content) may lead to the development of Zayed, difficult-to-treat.
It is often the situation that after removing the eights, there is activation of infectious processes in other parts of the mouth. Especially fast are indicated by changes in the adjacent teeth and the presence of pathology of the tissues, especially if polurethane and retention, with emphasis to the neighboring tooth, defined in the picture.
Manifestations of the patient
The patient after the intervention notes that the jaw to open fully, he can not.
To open the mouth may be at different depth:
- Grade I: the mouth slit between the upper and lower Central incisors open 3_4 cm;
- Grade II: limitation in the opening to a depth of 1_1,5 cm;
- Grade III: opening diagnosed less than 1 cm.
Patients also report pain when opening, the heat in the area of intervention, swelling in the cheek, and enlargement and tenderness of lymph nodes, pain when swallowing. In the total state of change: low-grade temperature or above, the violation of sleep and appetite.
Execute the treatment
Pain that can occur after extraction of eights can normal continue for 7_10 days. For the correction of complications based on the clinical picture, the physician selects a medication for use at home: broad-spectrum antibiotics, antihistamines, analgesics if necessary, salt or herbal bath (only 2 days after execution of the traction).
If a patient came to a doctor appointment after the removal of the restriction opening, the doctor performs the following manipulations: inspection of the external and oral cavity, degree of obstruction, antiseptic treatment and other manipulation in the mouth (removal of residual tooth under control, radiography, removal of eksessov).
After that, the doctor gives treatment recommendations for limiting the opening:
- Elimination of inflammation in the mouth: in the field of intervention and other areas of the oral cavity in conjunction with the use of nonsteroidal anti-inflammatory drugs;
- Physiotherapy: laser, UHF, electrophoresis;
- Special exercises: overcoming the pain, the patient should try to open the jaw and carry out chewing movements slowly, gradually increasing the load on the teeth. At the initial stage in the diet must prevail foods the consistency of sour cream and cream, with a gradual replacement of the more solid.
The earlier you start treatment limit mouth opening after removal of the group of eight, the more likely you are to restore normal functioning of the elements in oral liceali region.