Impacted Teeth and Dental Implants

Impacted Teeth and Dental Implants

Q: My doctor said I can’t have an implant to replace my missing tooth because there is an old impacted canine tooth up in the bone. I really don’t want a bridge which means grinding down the two adjacent teeth and I don’t want a denture the rest of my life for one tooth.

Man, is it hot out! This morning I was walking my 11 pound Chihuahua-mix, Casey. His mouth was frozen open, snout pointing straight ahead, body stiff and horizontal sucking in as much air as he could to cool his kishka’s off. He looked like one of those souvenir stuffed baby alligators my grandparents would bring back from Florida in the early 70’s. What were they thinking?! How about a cocoanut patty?!

A: A common condition is impacted canines and premolars; un-erupted teeth, leaving you with a space in the dentition. During childhood, some oral surgeons and orthodontist have successfully brought them down alongside the rest of the teeth with surgery and attaching brackets and wires.

These are stuck, lying horizontally way up in the maxilla (upper jaw) or mandible (lower jaw) sometimes close to the nasal cavity, the inferior border of the orbit (eye socket), mental nerve (lip nerve) and just in front of the zygoma (cheek bone). Due to their proximity to these vital structures it is best to leave these alone.

Very often the tooth is in the way of placing an implant, as the implant will penetrate the impacted tooth. I have had success in placing implants even in this situation. Now I know why it has always worked:

In the May/June 2019 edition of The International Journal of Periodontics and Restorative Dentistry, a study was done out of Columbia University in New York on combination with the University of Catalunya and The University of Ferrara, Italy. In this study, eleven implants were placed in sites with impacted teeth, penetrating into the tooth’s dentin and enamel. The implants were immediately loaded with temporary crowns. Seven years later, ALL the implants were still intact. Pretty “cool”.

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