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FAQ:  Impacted Teeth

Impacted Teeth Ask The Periodontist Marie Schwienebraten Question:
Impacted upper eye canine extraction: After unsuccessful orthodontic treatment to erupt it in its proper place I now have the unpleasant option of extracting the impacted canine and placing an implant.

The orthodontist said that the canine cannot be extracted all of it because it is severely impacted (the obvious question is why she said it could erupt when I first consulted her). She said that it has to be cut into pieces and much of the root will remain in the pallatal area.

My question is this: what happens with the nerve of the remaining tooth? Will there be any trouble with the implant and will it (the remaining root) continue to do whatever it does? ...Visitor from Athens Greece

It is difficult to determine the options you have for treating this canine without seeing an X-ray.

It sometimes happens that a tooth cannot be "drawn down" into the proper position because of its position, the amount of bone that covers it, or other reasons.

An upper canine can be close to your sinus and when extracting it, a high risk of complications with your sinus may be possible. It is rare that part of a tooth is left behind intentionally, but it does occur.

My recommendation to you is to have a consultation with an oral surgeon, if you have not already done so. If you need a second opinion, I would get one. This is too important to not make a knowledgeable decision.

I would also strongly recommend having a three dimensional image done. This will tell the surgeon exactly where the tooth is positioned and how much bone there is around it. I would not have the procedure until such an image is done and an oral surgeon looks at it. It will make choosing your treatment much clearer.

You are also correct that if not handled properly, if any of the tooth is retained, problems with an implant, if too close to the remaining tooth, can cause the implant to become infected or fail in the future. Again, a three dimensional image will help avoid this.

Good luck with a tough situation.

Marie C. Schweinebraten, DMD
Atlanta Periodontist
2925 Premiere Parkway
Duluth, GA 30097
(770) 623-0930

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