What is a partially erupted/impacted tooth?

The term partially erupted tooth is used to describe a tooth that has not fully emerged through the gums, while the term impacted tooth refers to one that has not erupted at all into the oral cavity within the expected timeframe. This issue often involves the third molars (wisdom teeth), but it can also affect other teeth. Causes may include lack of space in the jaw, abnormal position or direction of the tooth, as well as genetic or developmental factors.

Why do teeth remain impacted?

There are several reasons why teeth may remain impacted:

• Lack of space: Limited space in the oral cavity can prevent the proper eruption of teeth. This is particularly common with wisdom teeth, as the jaw may not have enough room to accommodate them.

• Developmental anomalies: In the case of canines, there may be delayed development or improper guidance during eruption, resulting in the tooth remaining impacted or partially erupted.

• Genetic factors: Some individuals may be born with dental characteristics that favor impaction, such as smaller jaw sizes or altered tooth alignment.

What complications can an impacted

tooth cause if it is not removed?

Failure to extract an impacted tooth can lead to various complications, including:

• Crowding: The impacted tooth may exert pressure on adjacent teeth, causing them to shift or rotate. This disrupts the alignment of the dental arch, even in patients who have previously undergone orthodontic treatment.

• Odontogenic cysts: These cysts can form around impacted teeth, leading to jawbone destruction and often requiring surgical removal.

• Tumor development: Although rare, an impacted tooth can be associated with the formation of tumors in the area. These tumors are typically benign but may grow significantly and require surgical excision.

• Jaw fractures: Particularly with impacted wisdom teeth, the tooth may act as a wedge at the angle of the mandible, increasing the risk of fractures in that region if trauma occurs.

• Pericoronitis: Especially in the case of partially erupted wisdom teeth, inflammation can develop around the crown of the tooth. This condition, known as pericoronitis, causes pain, redness, and swelling, and may require medication or even extraction of the tooth.

What are the indications for extracting an impactedb

tooth?

The extraction of an impacted tooth may be necessary to prevent the aforementioned problems. Specifically, the most common indications for wisdom tooth extraction are the following:

• Pericoronitis: This is an inflammation characterized by swelling and pain of the gums surrounding the wisdom tooth. The long-term presence of food debris and bacteria, due to the inability to maintain adequate oral hygiene, is the main cause of this inflammation.

• Tooth decay (caries): The prolonged accumulation of food debris and bacteria can lead to the development of carious lesions, both on the wisdom tooth and on the adjacent teeth.

• Orthodontic reasons: The presence of a wisdom tooth may interfere with the planned movement of other teeth during orthodontic treatment. Additionally, wisdom tooth extraction may be required as part of the preparation for orthognathic surgery and is usually performed at least 6 months prior to the procedure.

Other, less common indications for extraction include:

• Periodontal disease

• Root resorption of the second molar

• Presence of odontogenic lesions around the wisdom tooth

• Unexplained pain in the head or jaw area

• Preventive removal to reduce the risk of mandibular fracture in individuals participating in contact sports