The wisdom teeth are special in many ways. The wisdom teeth usually appear much later in the mouth than the other teeth. The average fracture time of the wisdom tooth is the age of 18-20. Logically we should think that because of the late fracture they should start deteriorate later than the other tooth. In many cases it is true, but the wrong cleanability often alters the situation, and behind some patient’s intact teeth we often find decayed wisdom teeth.
The root structure of the wisdom teeth is completely irregular. If the wisdom teeth are damaged such an extent that the tooth may be inflamed or died, the accurate feasibility of root canal treatment is uncertain, in these cases the dentist often decide to remove the tooth.
Impacted wisdom tooth
The wisdom teeth must be removed often not because of the dental caries, but due to the abnormal position of the tooth. If the tooth lies in the bone or even hits the tooth before, than the whole part of the crown would be unable to get into the mouth.
The formed pockets around the completely unable fracture wisdom teeth are often inflamed. Then the first is the regular disinfection of the pockets, followed by the elimination of the triggering factor, so the tooth removal. If the tooth is so deep in the bone that we can’t access with our tools, we have to improve the access with incision and some bone removal; by this case we remove it under sterile conditions in surgical excavation without chiseling and drilling. We must be very careful, because the roots of the impacted wisdom teeth are very diverse, often embrace the underlying channel (image about the tooth) in which is the nerves and blood vessels located which provide the whole mandible up to the median line. It can be achieve serious permanent injury, if the doctor is not careful. That is why the accurate 3 dimension planning is essential based on X-ray (CT). Our surgery uses it uniquely in Baranya the ultramodern surgical appliance which you can see below, with which neither cannot be achieved nerve and other soft tissue injury deliberately.
If we don’t remove the impacted wisdom teeth, in long term it can be develop serious complications. The following picture shows a cyst which formed around the upper impacted wisdom teeth:
The impacted wisdom teeth may cause the above mentioned adverse processes:
- serious inflammatory or purulent processes (pericoronitis)
- endognathion (primarily in the incisor area, which can ruin the achieved result with the orthodontics)
- the absorption, decay of the second molar tooth’s root
- the formation of cyst from dental sac. Most cases the panoramic X-ray shows the several years growing painless cyst (which can cause the maxillary fracture)
- start of the tumor processes
- radiating pain into different areas of the head (ear, joint, nape)
- left pushed blood test (sedimentation rate)
- general joint complaints, pains
- hair loss
We carry out the intervention under local anesthesia in sterile conditions with the Piezotome II surgical ultrasound guided appliance without trauma, drilling and chiseling. In the case of the upper wisdom teeth the chance of the sinus opening is very minimal. Soft tissue, nerve, vascular can’t accidentally injure. Thanks to the ultracain anesthetic it is absolute painless. The removal of impacted wisdom tooth is about 10-15 minutes depends on its position.
The recovery time is approx. 2-3 days. We carry out the controls and the stitch removal for free.
Our Piezosurgery ultrasound guided appliance:
The following panoramic X-ray picture shows one possible complication, that the rear part of the tooth number 7 (second moral tooth) before the wisdom tooth (lies) decayed, because it is impossible to clean it. If it reaches the pulp with very strong pain, than it is not enough to remove the wisdom tooth in sterile excavation, but the root canal therapy is needed of the tooth number 7.
We usually suggest that preventive prepare panoramic X-ray in the age 12-14, where you can see the position of the wisdom teeth. If we remove the wisdom teeth in this age, the patient has much less discomfort, because the roots still not develop. The following X-ray demonstrates this in our 15 years old patient.
In such cases if the wisdom tooth located in the maxilla at the bottom of the sinus in resting situation, or it lies in the mandible immediate vicinity of the nerve ending, we remove the wisdom tooth only when having complaints. In this case the chance of the sinus opening and any violations of the maxilla’s nerve risk are higher. The exact planning (digital panoramic X-ray) is essential to avoid the serious complication.
There are situations where the bone doesn’t prevent the wisdom tooth in fracture, but the above located gingival. In this case to fracture we carry out the incision (circumcisio) of the gingival around the tooth in anesthetic diathermy.
After without bone preparation made wisdom tooth removal may occur minimal pain, but if the patient heeds the general instructions after the tooth removal, the pain goes away quickly. If there was bone removal too, the after surgery recovery may require two-three days. In this case it is essential to chilling after the surgery. With this we can greatly reduce the swelling after the intervention.
Important! Our advices posted on the tooth removal page are also relevant in case of removal of the wisdom teeth!
