Removal of impacted wisdom teeth: the dystopia on the lower jaw
Removal of impacted wisdom teeth is important when delayed eruption or violation of the appearance of eight. Retention note when the tooth is fully formed, but it is in the bone, appearing with the crown through the gum. There are cases where partially still is indicated on the surface one or two mounds. This situation is denoted by polurethane. A delay in the eruption mainly affects wisdom teeth, the upper canines and lower premolars. But increasingly common in end segment of the jaw with the eights. Let’s look at the necessity of extraction of wisdom teeth, talk about technique, care and possible complications after the extraction.
Classification delay the eruption of eight and indications for extraction
What are impacted wisdom teeth? Distopian wisdom tooth klassificeret in correlation, the direction of shear and the degree of absorption in the alveolar bone in the upper or lower jaw.
Shift wisdom teeth with delayed eruption may occur in the following variants:
- Inclined: the axis passing through the middle of the tooth forms occlusal plane angle. There are slopes in the distal, medial, cervical and lingual.
Dystopia wisdom teeth in correlation to the degree of coating of the gum:
- Full: the crown is completely hidden in the gums. On the background of this pathology is difficult to diagnose incipient inflammation;
- Partial: the tooth is indicated on the surface of the upper or lower jaw 1_3 bumps. This forms a fold of the gum covering the dental crown, which is called a hood. The presence of mucosal hood is a predisposing factor to delayed food residue, the addition of microbes and later development of inflammation.
The degree of immersion:
- The presence of eight dice: is a predisposing factor in the development of inflammation of the alveolar bone of the jaw. The removal of wisdom teeth is performed with a special technique;
- Dip part of the wisdom tooth into soft tissue: a normal variant in the process of ontogenesis. The method of removal depends on the inclination of the tooth relative to the midline axis and occlusal plane.
Indications for removal
- No eruption in term or partial appearance;
- Incorrect position;
- There is insufficient space in the bone for the emergence of eight;
- Perikoronit is an inflammation of the gums, partially covering the crown.
Why do I need to remove incorrectly standing wisdom tooth
Impacted wisdom teeth is recommended to withdraw from dice on the background of the fact that they can cause a number of complications:
- The development of caries and carious dental tissue complications:
- Due to the difficulty of access to the therapeutic intervention, there is a rapid spread of caries;
- On the background of infection from the carious cavity or by prolonged pressure gistaminovogo crown of the wisdom tooth on the crown adjacent is the development of pulpitis and periodontitis. Periodontitis may develop with the formation of granulomas, which prolonged chronic course has a tendency to progressive growth. This growth may be complicated by subsequent fracture of the jaw;
- On the background of retention of eight is delayed eruption of the adjacent teeth and the appearance of them later in an improper location of the alveolar bone, which causes defective operation and the probability of subsequent removal;
- When the wisdom tooth at the buccal side, forming a contact with the buccal mucosa, gradual rubbing at the join point. With a slight wound that bleeds and can gradually transform into malignant direction;
- The partial closing of the tooth mucous hooded, over time, produces inflammation in the immediate radius of the tooth. Depending on the clinical situation may be limitation of mouth opening, facial asymmetry, and other changes.
The development of each complication is individually and not always impacted wisdom teeth can trigger complications.
The final decision about the removal
The need to delete gistaminovogo tooth takes dentist after patient interviews and the main and additional surveys. A survey of the patient consists of a collection of patient complaints, medical history of the disease, as well as clarifying information about the development of the body during life.
By clinical examination the dentist General condition of the patient, the configuration of the face, the presence of pathological elements on the skin, the condition of the lymph nodes, the degree of opening of the mouth. In the mouth note a partial or complete cure eight, the presence of mucosal hood, inflammation and swelling of the gums and surrounding tissues, the presence of defects on partially the crown. The detection of irregularities in the tooth structure, you need to perform temperature diagnostics. In celebration of the tooth surface is also required tapping on the tooth tissue to evaluate the inflammatory changes in the periodontium.
The main method of diagnosis in ascertaining retention is diagnostic radiology. Used for panoramic imaging: preferably ortopantomografy. OPG – reflects the deployed state of the upper and lower jaw, with the capture of joint is the temporomandibular joint. The estimated position of the impacted teeth: direction, deeper into the bone. But it is also possible to use computed tomography for layered examination of bone and tooth tissues. According radioviziografichesky survey used the decision how to perform the removal of wisdom teeth.
The method of extraction
The removal of wisdom teeth is performed in several stages. Before surgery prepares.
Preparing for operation is to test for allergies to commonly used fluids and materials in the removal process. If the patient when filling out the questionnaire about the General health notes chronic pathology of other systems, it is necessary to direct it to the intervention of the specialist of this profile. This preparation will reduce the risk of birth complications, during surgery and after. This is especially true in the operation of removal of wisdom teeth under General anesthesia. If the patient is in severe anxiety before the intervention, produce an implementation of premedikatia.
Removal of impacted tooth gistaminovogo perform specialized studies of surgery. All the tools used during extraction should be prosterilizovat and Packed in disposable packaging.
The sequence of removal
Perform impacted wisdom tooth removal in the following order:
- Formulation for pain relief: initially, the injection site is treated with an analgesic gel or spray. Then perform conduction anesthesia: tuberling on the top, trusolino and mandibular in the lower jaw;
- Perform a trapezoidal cross-section of the mucosa with a scalpel with the retreat of the mucosa, exposing the cortical plate of the alveolar process;
- Using hog produce drilling required for the extraction of access;
- With the help of a cutter make the cut the tooth into pieces, thereby facilitating the removal process. Removed with forceps and elevators. In the upper jaw is used tongs binitie. In the mandible coracoid.
- After removing all remnants of the root, making sure that, given the anatomical configuration and data of x-rays, perform curettage wells with kuretani spoons;
- Spend antiseptic treatment of the wells with 3% hydrogen peroxide solution, _2 0,05% solution of chlorhexidine bigluconate. The treatment is done without effort, so as not to wash out the blood clot, which is predisposing factors for healing wounds formed;
- In a remote hole is placed iodoform turundas. If operative intervention was carried out in a small area, then you can do without overlap;
- Mucoperiosteal flap is laid into place, sutured.
Features of postoperative care
After performing the extraction can not eat for at least 2 hours and it 5_6. It is advisable to eat foods the consistency of sour cream and cream. If the cavity holes were laid iodoformi turunda, then every 3 days you need to come to the dressing and replace with a new one. The installation process is done in the healing of wounds. Iodoformi turunda used for local bactericidal action in the extraction socket.
In the presence of pain prescribed analgesics (ketorol, Nise). If the dystopia of the group of eight noted severe inflammatory manifestations, add to the treatment antihistamines (claritin, diazolin), broad-spectrum antibiotics (tsiprolet). Recommended salt baths the day after removal.
It is prohibited to:
- Visit bath and sauna;
- Physical activity;
- Overwork and long-term nervous;
- When sewing the wound to actively chew and articulate;
- Touch the tip of the tongue, hands to the hole;
- Brush teeth in the area of the hole;
- Take alcohol and to smoke for 1_3 days.
If the removal of the eight were conducted in the beginning or in the middle of the healthy oral cavity, subsequent intervention is recommended not earlier than in 1_2 weeks after the extraction.
Complications after surgery
Meet at norm and as a variant of the deterioration of the body:
- Two hours later in the area of the hole will be marked pain aching. Place of intervention can vspyhnut. It is recommended to apply cold;
- Limited swelling place of removal referred to after 3 days. There may be bruising, blue in the face. These phenomena disappear after a couple of days;
- The pain of the hole. Appears as a consequence of intervention. Prescribed analgesics. The pain should resolve itself in a few days;
- Bleeding from the hole. Should also gradually take place. The severity of bleeding depends on blood coagulation system;
- Desiccation or and crack on the lips and in the corners of the lips, especially during prolonged invasive treatment. It is necessary to smear cream or gel solkoserilom. The possible exacerbation of herpes infection;
- General changes: a slight rise of temperature, weakness, sleep disturbance and appetite, pain in the head;
- Limitation of mouth opening within 2_3 days.
The severity of symptoms of complications depends on the individual characteristics of the organism, the morbidity of the intervention.
In any case if the symptoms are severe you must consult a doctor to prevent the development of alveolitis (inflammation of the tooth) or other pathologies.