Three Cases Analysis Of Impacted Teeth In Different Positions

Objective: To investigate the possible pathogenesis,assistant diagnosis before treatment,treatment planning,process and effects through impacted teeth in different positions,including upper impacted canine,incisor and first molar.Materials and Methods: Three cases with impacted teeth in different positions during my postgraduate study period.Case 1: LJ,26-year-old female with chief complaint of unerupted upper anterior tooth.She had skeletal Class I with low mandibular plane angle.Right molars relationship was Class II,anterior teeth deep overbite(III),with impacted upper right canine and lingual ectopic erupted lower right first premolar,the corresponding deciduous teeth were retained,and the widths of posterior dental arch was slightly unmatched.Minor crowding was noted in both upper and lower arch.The patient got ideal occlusion and harmonious facial profile after pulling the impacted teeth by surgical exposure with orthodontic traction and aligning the dentitions.Case 2: SYH,18-year-old female with chief complaint of unerupted anterior teeth.She had skeletal Class I with low mandibular plane angle,the canines and molars relationship of both sides were Class II,and deep overbite(II)were observed.The upper right incisor and canine were impacted,and the lateral incisor was ectopic erupted,the upper right deciduous canine was retained,the lower right first premolar was residual crown.The Bolton index of dentition was small and slight crowding was noted in the lower arch.Aligning the upper and lower dentitions by orthodontic treatment after extraction of upper right impacted incisor,pulling the impacted lateral incisor and canine to the normal position,the spaces was closed.The upper incisor was aligned with the facial middle line after treatment,the restoration’s space of lower right first premolar was retained,and the facial profile was basically maintained,the frontal and smile views were improved,the patient was satisfied with the treatment consequence.Case 3: LJF,14-year-old male with chief complaint of crossbite.He had skeletal Class I and Class III malocclusion,negative anterior overbite and overjet.The upper left first molar was obliquely impacted toward the middle and the lower left second molar was excessively erupted.The widths of the upper and lower arches in the posterior region were unmatched.The patient was in the stage of pre-growth and development,aligning and leveling the dentitions by fixed aligner after the excessive erupted tooth extraction.Taking the forced eruption while adducting the lower dentition and refine the anterior overbite and overjet by using the MIA(Micro implant anchorage).Now the patient is about to complete the treatment and the occlusion is almost ideal.Result: After the treatments,all of the patients maintained skeletal Class I and obtained normal anterior overbite and overjet,the occlusion relationship are good with well cuspids and fossae relationships.The roots are parallel and the cortical bones of condyles are continuous,which have normal shapes.There is no obvious alveolar bone or root absorption and the patient is satisfied with the treatment effects.Conclusion: For impacted teeth in different positions,fully investigation of the possible pathomechanism,positions and directions of impacted teeth before treatment is well needed.Evaluating the eruption resistance,how to induce the teeth,difficulties of traction and other factors will make for best treatment planning.Most impacted teeth with normal shape and without root adhesion can be successfully pulled to the normal position by orthodontic treatment with multidisciplinary combined treatment.The impacted teeth,adjacent teeth and supporting tissues are totally healthy and the patients’ occlusion is well after treatments.