Читать книгу Orthodontic Treatment of Impacted Teeth - Adrian Becker - Страница 95

The most obvious example is a superficially placed tooth, palpable beneath the bulging gum. This type of impaction may be found in relation to the maxillary canine (Figure 5.1), or in the mandibular premolar area (see Figure 1.8) or even the maxillary central incisor. The usual cause of this condition is where very early extraction of the deciduous predecessor was performed while the immature permanent tooth bud was still deep in the bone, with as yet inadequate eruption potential. Healing then took place, the gum closed over and the permanent tooth was unable to penetrate the thickened mucosa. Removing the fibrous mucosal covering or incising and re‐suturing it to leave the incisal edges exposed (Figure 5.2a–c) will generally lead to a fairly rapid eruption of the soft tissue impacted tooth, particularly in the maxillary incisor area. The more the tooth bulges the soft tissue, the less likely will be a re‐burial of the tooth during healing of the soft tissue, with the consequent rapid eruption of the tooth.

Fig. 5.1 (a) A 16‐year‐old female exhibits an unerupted maxillary left canine, which has been present in this position for two years and has not progressed. (b) The tooth was exposed and the flap, which consisted of attached gingiva, was apically repositioned. (c) At nine months post‐surgery, the tooth has erupted normally, without orthodontic treatment.

Courtesy of Professor L. Shapira.