Orthodontic Tooth Uncovery of Impacted Teeth (Surgical Tooth Exposure)

Sometimes while an adult tooth/teeth are erupting into the mouth they get stuck in the wrong position. This is called tooth impaction. Commonly people think of this occurring with third molars (wisdom teeth), but it can also occur with any tooth in the mouth. To help bring your tooth into the proper position, a surgical orthodontic uncovery (also called a surgical tooth exposure) procedure may be necessary.

Tooth impaction occurs from:

  1. Improper Sequence of Tooth Eruption – teeth erupting into place early may prevent other teeth from erupting into their correct position.
  2. Crossbites – incorrect position of teeth and/ or jaw bone.
  3. Ankylosis – is when the tooth root fuses with the bone. Normally there is a
    periodontal ligament between the tooth root and bone.
  4. Genetic Factors – tooth impaction tends to run in families.
  5. Crowding of teeth – this blocks teeth from erupting into their correct position.
  6. Extra Thick Gum Tissue and Bone – thick tissue prevents teeth from erupting.
Patient Exam

The major problem preventing teeth from erupting into their proper position are resistance factors. These factors include thick gum tissue, dense (hard) bone, or entrapment by other tooth roots.

Our goal in treating these situations is to remove or get around these resistance factors without damaging the teeth.

First we will perform a periodontal exam and take x-rays to determine the position of the tooth/ teeth. Once we determine the tooth position, we will proceed with one of two treatments.

Lip or Check Side Tooth Impactions

If the tooth is stuck on the lip or check side of the jaw bone, most dentists cut away all of the good keratinized gum tissue. This can create gum recession with bone loss around teeth and eventually require a soft tissue graft. Drs. Craddock and Godat use highly specialized periodontal cosmetic techniques to preserve this good keratinized gum tissue. Preservation of the gum tissue prevents gum recession and the need for a soft tissue graft in the future.

We accomplish the result by preserving the gum tissue and moving it up or down on the tooth so it is out of the way. With an orthodontic uncovery procedure, we will also use Wilckodontics techniques to help the tooth move into place quicker. Additionally, we will place a bracket and power chain the day we uncover the tooth to help the tooth begin to move in to the proper position. This moves the tooth around the roots of the other teeth.

Palatal Side Tooth Impactions

For teeth impacted in the roof of the mouth (palate), we remove extra bone in this area, to allow the tooth to move into place. After removing the bone, we create a window in the gum tissue to pull the tooth through. Removing the extra thick bone and gum removes part of the resistance forces keeping the tooth/teeth from coming into place. We also utilize Wilckodontics techniques to help move the tooth/ teeth into place quicker. Additionally, we will place a bracket and power chain the day we uncover the tooth to help the tooth begin to move in to the proper position. This moves the tooth around the roots of the other teeth.

 

 

 

 

If needed, sedation can be used to keep you comfortable and relaxed.