EXTRACTION OF IMPACTED MAXILLARY CANINE WITH SIMULTANEOUS IMPLANT PLACEMENT
EXTRACTION OF IMPACTED MAXILLARY CANINE WITH SIMULTANEOUS IMPLANT PLACEMENT
Prof Dr Vinayak
Conventionally,Treatment of impacted upper canines in adults included
1.an orthodontic/braces procedure to bring the unerupted tooth to the dental arch or
2. prosthetic replacement of the missing tooth.
Nowdays a third alternative treatment that involves immediate placement of implant into extraction socket of the tooth is being done.
A patient with upper impacted canine can now chose to have the unerrupted tooth removed and replaced in the same sitting with immediate implant and crown.
WHY IT HAPPENS...
Epidemiological data shows that with the exception of third molars, the most frequently impacted teeth in adults are your upper canines (upto 3% people have this condition).
Disturbances in the eruption of permanent upper canines are common because
1. they develop deep within your upper jaw and
2. have the longest path to travel compared with any other tooth in the oral cavity.
WHY WE NEED IT.....
Canines play a vital role in
1. your facial appearance,
2. dental esthetics and arch development and
3.functional bitting/occlusion.
Abnormal eruption paths within the dentoalveolar process can have serious clinical ramifications.
It has been found that , impacted teeth may cause
1. migration of the neighboring teeth
2 loss of arch length.
3.unerupted canines may even increase the patient's risk of developing a cystic lesion and infection
4.may also cause root resorption of the nearby incisors .
WHEN TO DO......When impacted maxillary canines are not amenable to orthodontic traction or reimplantation, in some cases extraction is the only option available followed by immediate implant placement or prosthetic replacement of missing tooth.
THE CLINICAL PROCESS....We, at our SMILESSENCE SPECIALIST DENTAL CENTRE, have often followed new surgical technique that allows an immediate implant placement after the immediate extraction of the maxillary canine.
The implant screw threads and the bone defect around the dental implant are covered with the bone shavings collected during Extraction and ostectomy. The bone defects remaining around the implant were filled with the collected bone shavings.
ADVANTAGES....
The advantage of performing extraction and dental implant placement in the same procedure is that
1.the number of operations is minimized
2. waiting time are minimized.
3. avoids the need for conventional preparation of teeth as part of prosthetic reconstruction
4.prolonged orthodontic treatment aimed at bringing the impacted canine to the dental arch.
PREREQUISITES FOR CASE TO CASE SELECTION BASIS.....When possible, impacted upper canines are subjected to orthodontic / braces traction.However, If
1. traction by braces not possible
2. reimplantation of extracted tooth not feasible or
3.the patient is unwilling to accept orthodontic treatment,
In all these cases immediate extraction followed by dental implant placement is the best option.
SUCCESS RATE... More recently there has been an increase in the number of extractions of impacted teeth and the use of immediate dental implants.Several authors have reported success rates of more than 90 percent for implants placed into fresh extraction sites.
CONCLUSION..... The simultaneous placement of an implant into the extraction site of a palatally impacted canine in conjunction with bone grafting minimizes the number of surgical interventions and the waiting time. We need to emphasize, however, that a prerequisite for immediate placement of an implant into an extraction site is much dependent upon the expertise and increased surgical skill of the specialist dentist.