Sometimes some of the permanent teeth remain impacted in the bone, resulting in a delay of their eruption. This is often a cause for orthodontic problems. The delayed eruption can be a result of many factors (local and general) – endocrine problems like hypothyroidism, extra teeth, odontoma, crowding of teeth, sclerosis of the soft tissues that cover the teeth and many more. In order to facilitate eruption the dentist should use orthodontic and surgical techniques. That may include creating a flap and removing the bone over the tooth in order to expose the impacted or supernumerary tooth. In this way it will be easy for the dentist to execute the dental procedure.
If there are extra teeth, deciduous teeth or odontoma they need to be removed. When a big part of the crown is exposed orthodontic brackets can be bonded to the crown, and thetooth can be gradually aligned in its correct position in the dental arch. When the teeth are not erupted and are covered by soft tissue scalpel or electrosurgical blade is used for exposing the crown. This “window” helps it to erupt naturally. If that does not happen soon orthodontic treatment is needed.
Sometimes people believe they have supernumerary teeth but the problem actually consists of late eruption of the permanent teeth. In order to help the permanent teeth to erupt a palatal flap is created and a round bur is used to remove the bone covering the impacted teeth. Brackets are placed – they will help the traction of the teeth in their right position in the dental arch.
The presence of ectopic impacted teeth is not often observed. They can be at several places – near the mandibular angle, under the permanent teeth, in the mandibular ramus, in the coronoid process, in the maxillary tuberosity, in the walls of the maxillary sinus, nasal cavity and orbit. The treatment of these teeth is often complicated, especially when it comes to extraction and orthodontic treatment of supernumerary wisdom teeth. They are usually spotted on the x-rays but sometimes can cause a slight protuberance on the vestibular, lingual or palatal surface.