Ectopic Eruptions and Impactions | Orthodontic Matters 23 скачать в хорошем качестве

Ectopic Eruptions and Impactions | Orthodontic Matters 23

Hi. Welcome to a new episode of Orthodontic Matters. Today we are going to talk about ectopic eruption and impacted teeth. This is a topic that oftentimes I get questions about and several of you have asked if I could put together a short video with some examples. Let's get started here. Okay? First, when we talk about ectopic eruption, what do we mean by that and what is ectopic eruption really is? Really if you want to define what ectopic eruption is, it's a disturbance where the tooth does not follow its usual course. That just means you know the way a tooth should erupt, it's not following that path. For example, you can see here the uppers threes, in orthodontics we number the teeth starting from the middle, so the uppers threes would be the canines. These canines should be coming down very nicely by this age, but as you can tell there's just really no room in this patient for the eruption of the upper canines and so what you see is these teeth are ectopically erupting. They're just not simply following the normal path as the canines should erupt. As opposed to impacted teeth, tooth impaction is different. Tooth impaction is when a tooth fails to erupt into the dental arch within the expected accepted developmental window. If a 12-year molar should erupt let's say by age 12, 13, and by age 16, 17 it still has not erupted, that molar would be classified as impacted. Like for example here, you can see the lower left wisdom tooth it should have been erupted by now into the arch, but obviously this tooth is impacted and it's not going to erupt into the arch by the timeline that it should have reached that developmental point. This tooth is impacted and like we said earlier, ectopic eruption is just the process where a tooth is just simply not following the course of the path that it should erupt. It's important to make those distinctions. Sometimes I hear doctors talking about a tooth is impacted so they're talking about, you know, let's see, an eight-year-old or a nine-year-old who's got a canine that just looks like there's just not enough room for a canine to come down, for example like in this case, well that tooth is really not impacted yet, because it's not in a timeframe that it should have been erupted into the arch. It's just simply following an ectopic eruption path. Later on if the patient is let's say, 16 years old and the canines are still at this position, then you would call this an impacted tooth. Anyways, it's an important distinction to make. The most common areas for ectopic eruption, impacted teeth, are the third molars. That would be one of the most common areas where you'll see this. The next one would be the upper canines, which we already saw an example for, and also second premolars. Those are some of the common areas where you see this. Now during the transitional dentitional stage, it's important that we take panoramic x-rays. Now why do we do that? Well, for one thing we look for any pathologies, but the most important thing is that we look for the location of the upper canines. If the canines are beginning to cross into the lateral incisor root, oftentimes some intervention is necessary. It's like for example you can see in this case, this patient the canines are erupting in an ectopic manner. They're just really pushing on the roots of those laterals. It's important to take a panorex to simply discover that this is going on and to recognize this and oftentimes in these cases we have to take some interventions. Not always, but depending on the severity of the ectopic eruptions or later to try to prevent it becoming an impaction. Here we'll see some examples for this. Now some of you, you would ask what type of interventions we have to do? Well it really depends. There's two common ones that we have to take into consideration. One would be a lot of times if you see these ectopic erupting canines, some times we do an arch expansion. We have to keep in mind the lower arch because remember the lower arch is our diagnostic arch, so we can't just indiscriminately expand the upper arch not paying attention to what's going on with the lower arch. We have to coordinate the two. Nevertheless sometimes if, for example, the patient has some large tonsils or airway issues or they just have a lower and forward tongue position, a lot of times these patients have a narrow upper arch. The lower arch is actually often time wider than the upper arch.