The patients who have impacted tooth are common in orthodontic practice. It is difficult to determine the causes of impacted teeth, but most common causes are supernumerary teeth, cysts, odontomas, and lack of space. Until up to now, many
treatment
methods for impacted tooth have been developed, but now most commonly used methods are this : After surgically uncovering of the impacted teeth, a bond of orthodontic appliance is established, and orthodontic traction is starting with a removable
and
fixed appliance.
Surgical uncovering is very important for gingival health of the impacted tooth. We should provide at least 2mm of keratinized gingiva arround the teeth. for this, we seriously select one of these surgical methods: Gingivectomy, Apically
positioned
flap
technique, Flap/closed eruption technique. For proper bracketing, at least one half to two thirds of the crown should be uncovered. If this can be achived by simple excision of tissue, leaving at least a 3 mm gingival collar, then gingivectomy is
the
treatment of choice. If a gingivectomy will not leave enough attached gingiva, then an apically positioned flap technique may be the treatment of choice. This is most often seen when the tip of the labially impacted canine is apical to the
adjacent
CEJ.
If the tooth is impacted in the middle of the alveolus or high in the vestibule near the nasal spine, the closed eruption technique may be the treatment of choice.
We used apically positioned flap technique and flap/closed eruption technique for bonding. After that traction was done with removable and fixed appliance. With these technique we achieved following good result s:
1. We made a proper alignment, so we have now created a good esthetic and functional relationship.
2. We gave a proper keratinized gingiva, so it is possible to maintain a good gingival health.
|