Teeth of wisdom: pull-pull

After the publication of previous articles, and in particular “Wisdom teeth are impossible to leave” , I received several comments with the question - “And if the 7th tooth was once removed, 8 will be in its place?” Or “Can Is the 8th (horizontal) tooth pulled out and put in place of the 7th, which is not? ”

So, to do it the way you imagine it is theoretically possible, but ... difficult.

No, of course, there are “masters” who are actively engaged in and promote this technique. But none of them will give you guarantees that after a year, or even two years of trying to pull out a similar 8-ku and put it in line with the rest of your teeth will be crowned with one hundred percent success. There are methods of tooth replantation. To which I am extremely skeptical. Especially in the case when in place of the 6th or 7th tooth, which have been removed a long time ago, an artificial “hole” (just a “hole” in the bone) is cut out, into which the horizontal horizontal wisdom tooth is also placed. Which, in turn, needs to be treated endodontically (that is, to remove a nerve from it) Do you think this is absurd?

In my opinion - it's just stupid, but! This is the place to be. Everyone "works" as he wants or is able, if you like. As they say - "all according to the testimony." I express my point of view, which can be completely different from the opinions of others.
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So why not stretch a wisdom tooth?

Orthodontists, after all, put braces, move teeth, and pull “recumbent” retentive (impacted) canines, which are placed horizontally in the jaw. Let's get 8ku "pull out"! You say.

The problem is that the area of ​​wisdom teeth, especially the lower 8-ca, is quite specific. The bone tissue in this place is very dense, and the site itself is usually wide. This area is even donor when performing osteoplastic operations.



That is, in this place, with the help of special tools, you can take a bone fragment (block) and transplant it to where the bone tissue is not enough to implant. And this zone (where the bone fragment was taken) will recover with time and, if necessary, the manipulation can be repeated.



But bone grafting is the topic of individual articles, which we will definitely look at later.

So here. The bone is dense, wide. If you try to pull out the 8th tooth, a deep bone pocket is formed behind it, and any self-respecting tooth should be surrounded by bone tissue from all sides. A small example - take a stick and stick it in the sand, lead it, what will happen? A "groove" will appear in the sand. Also in the bone there will be a similar problem. To extend a horizontal tooth, so that it is surrounded by bone on all sides, is extremely doubtful.



You will say, “Well, what about not a horizontal tooth, but standing upright?”

I will answer, the situation with a vertically standing tooth is somewhat different, of course, it is not necessary to make such serious movements. But the problem will be the same; it is rather difficult to move a “body” tooth. We all know that the older a person becomes, the slower the healing process in the body, compared with young people. Be it, for example, a fracture. And all due to the fact that the bones of the child are much more organic matter than adults. The shell covering the bone outside (periosteum) is thick, it is well supplied with blood. Etc. etc. And the older a person becomes, the longer and more difficult are the recovery processes. With teeth the same story. If you are 14 years old, then all the movements of the teeth that the orthodontist has scheduled will be much faster and simpler than if you were 40. The same story with the “pulling out” of the canines, about which I spoke above - if you do it at the age 14 years, the success of this procedure is maximum.



If, at the age of 40, for the first time, you took a panoramic picture of your teeth and the doctor discovered a horizontally lying reeled canine there, then the chances of success are much less. Similarly with 8k, if you were 14 years old, then theoretically such a manipulation is possible, I can even assume that it would be successful. But there is a big BUT! At this age, the roots of the 8k are not yet formed, in the panoramic image, we can see only the formed coronal part of the tooth, located in the follicle (the capsule surrounding the rudiment of the tooth), what then “pull”?



In this case, you can damage the bud and the tooth will still have to be removed. Yes, and if at the age of 14 you brought some of the teeth to removal ... To put it mildly, it is sad. What then will be with teeth by 40 years?

And one more thing, not so important, but having a place to be. This is the anatomy of the shape and size of the crown of the 7th and 8th teeth. They are different. To create a full-fledged contact in this case is possible, but will it be correct?

“If the 6th tooth is removed long ago, can the 7th move to the place of the 6th and 8ka to the place of the 7th?”

No ... There will be something like that -

"A holy place is never empty". With the long absence of any tooth, neighboring teeth begin to gradually shift towards them. Such movements occur only forward. That is, if you remove 8k , then the 7th tooth will not bend backwards, similar to what is shown in the picture. If there are no problems with the bite. (closing teeth).

“Can I remove only the lower wisdom tooth, and leave the upper one (or vice versa), does it bother you?”

Alas, but also not.

Below, however, an example is presented not with the 8th tooth, but the meaning is the same. In the absence of any tooth, its antagonist (the tooth with which it closes) begins to gradually move towards the absent “trying” to find contact.



It is not a problem to place the implant in the area of ​​the 7th tooth, but it will not be possible to properly prostrate (install the crown). Why? Because the crown in this case will be two times lower in height. And the so-called "block" is formed when the movement of the lower jaw, which I mentioned in this article .

The logical question is “How then to be? What to do with this situation? ”

And that's what. We call on the help of all beloved orthodontists and with the help of special structures and we try to put the teeth in the correct position, as it was intended by nature. I generally believe that orthodontists are the most important dentists. Why? If you think about it, all the problems with teeth from what? - From their position. If the “teeth are crooked”, then food debris is more actively clogged between the teeth, hence hygiene suffers, hence caries, and all the complications associated with it. Plus overload of teeth due to abnormal closure. Hi erasability, chipping on the teeth and any wedge-shaped defects there (non-carious lesion, which are located in the area of ​​the necks of the teeth in the form of a wedge-shaped defect). Also, a temporomandibular joint (temporomandibular joint) suffers; a crunch, clicks, pain, etc. may appear. And if there is no problem with a bite, know yourself brush your teeth and you will be happy. But no matter how ridiculous it may sound - and this must be done correctly. You can brush your teeth for 20 minutes, but there will be no sense from it.

Distracted. Here is a small clinical case.



An implant was installed and, simultaneously, treatment started with an orthodontist. As we can see, the lower right 7th tooth is tilted, and the upper right 6th tooth has somewhat moved down.

Please note that it is not necessary to install a full bracket system in order to fix this problem. It is enough to glue 3 brackets on the 4th, 5th, and 7th teeth, and using a special spring to push the problematic tooth into its place. In the upper jaw, the situation is somewhat different. Two orthodontic screws are installed to fix the problem. One from the side of the cheek, and the second from the side of the sky. Two buttons are glued to the teeth, and thrust is given (special rubber bands). They also "pull" a tooth into place.



And from a different angle -

And now I have a question, why do you need it? I'm talking about pulling 8s.

The wisdom tooth is not a "spare tire." They can not just take and replace a lost tooth. In addition, the process of movement is very long, especially with age, it is also not guaranteed. That is - you spent about a year, two on “drawing out” 8s. Nobody will give you guarantees for this, but in the end, it will happen, you will delete it anyway. It's worth it?

But you can put a single implant in time in the region of the extracted tooth and after 3 months (if we are talking about the lower jaw) you have a full, chewing tooth that will serve you all your life. And no additional “pull-pull”. All this, subject to compliance with all recommendations and visits to the dentist every six months for the purpose of routine inspection. With the implant just nothing happens. Ask: - “Then why come?” In order that if problems begin with the neighboring teeth, they can also affect the implant. Be it a gum problem or bone around. Prophylactic examinations with a mandatory x-ray image of the teeth will help to avoid such a problem. And, of course, the ideal is professional oral hygiene, also every six months. Especially in people with bad habits, such as smoking. Explain why I think not worth it. Everything is clear.

You will say, “This is incomparably expensive!” Or “Your teeth are better!”

To the issue of value. I do not want to upset you, but the surgical stage, plus the installation of an orthodontic structure and the replacement of the rods, for a couple of years at the orthodontist, will ultimately be almost commensurate in value with implant installation and crown fabrication. But in the first case there are no guarantees, and in the second one there is a lifelong guarantee. Feel the difference?

Your teeth are certainly better. From the word always. We must fight for them to the last. But if these teeth are important. And these are not wisdom teeth, from which, apart from problems, there is nothing to expect.

That's all for today, thank you for your attention!

Stay tuned!

Sincerely, Andrei Dashkov.