After the publication of previous articles, and especially , I received several comments with the question - “And if the 7th tooth was once removed, will the 8th one take its place?” or “Is it possible to pull out the 8th (horizontal) tooth and put it in the place of the 7th, which is missing?”
So, it is theoretically possible to do this the way you imagine it, but... difficult.
No, of course, there are “masters” who are actively involved 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 such an 8 and put it in a row with the rest of your teeth, you will be crowned with one hundred percent success. There are also methods for tooth replantation. Which I am extremely skeptical about. Especially in the case when, in place of the 6th or 7th tooth, which were removed long ago, an artificial “socket” (simply a “hole” in the bone) is cut out, into which a similarly cut horizontal wisdom tooth is placed. Which, in turn, needs to be treated endodontically (that is, remove the nerve from it). Don’t you think this is absurd?
In my opinion, this is just stupid, but! This kind of thing happens. Everyone “works” as he wants or knows how, if you like. As they say, “everything is according to indications.” I express my point of view, which may differ radically from the opinions of others.
So why not pull out your wisdom teeth?
After all, orthodontists install braces, move teeth, and pull “lying” impacted (unerupted) fangs, which are located horizontally in the jaw. Let's pull out 8k too! You say.
The problem is that the area of wisdom teeth, and especially lower 8-ok is quite specific. The bone tissue in this place is very dense, and the area itself is usually wide. This area is even a donor area for osteoplastic surgery.
That is, in this place, using special instruments, you can take a bone fragment (block) and transplant it to where there is not enough bone tissue to place an implant. And this zone (where the bone fragment was taken) will recover over time and, if necessary, the manipulation can be repeated.
But bone grafting is the topic of separate articles, which we will definitely consider later.
So here it is. The bone is dense and wide. If you try to pull out the 8th tooth, a deep bone pocket will form behind it, and any self-respecting tooth should be surrounded by bone tissue on all sides. A small example - take a stick and stick it in the sand, move it, what will happen? A “groove” will appear in the sand. There will also be a similar problem in dice. Pulling out a horizontal tooth so that it is surrounded by bone on all sides is extremely doubtful.
You say, “Okay, what about a vertical tooth rather than a horizontal one?”
My answer is that the situation with a vertically standing tooth is somewhat different; such serious movements, of course, will not be necessary. But the problem will be the same; it is quite difficult to move the “body” of the tooth. We all know that the older a person gets, the slower the healing processes in the body are compared to younger people. Be it, for example, a fracture. And all due to the fact that a child’s bones contain much more organic substances than those of adults. The shell covering the outside of the bone (periosteum) is thick and well supplied with blood. Etc. and so on. And the older a person gets, the longer and more difficult the recovery processes take. It's the same story with teeth. If you are 14 years old, then all the tooth movements that the orthodontist has outlined will go through much faster and easier for you than if you were 40 years old. The same story with the “pulling” of fangs, which I talked about above - if you do this at age 14 years old, then the success of this procedure is maximum.
If, at the age of 40, you first took a panoramic photograph of your teeth and the doctor discovered an impacted horizontally lying canine there, then the chances of success are much less. It’s the same with 8, if you were 14 years old, then theoretically such a manipulation is possible, I can even imagine that it would be successful. But there is a big BUT! At this age, the roots are not yet formed; in a panoramic image, we can only see the formed coronal part of the tooth, located in the follicle (capsule surrounding the tooth germ), what then should we “pull”?
In this case, the rudiment can be damaged and the tooth will still have to be removed. Yes, and if at the age of 14 you brought one of your teeth to the point of removal... This is, to put it mildly, sad. What then will happen to your teeth by the age of 40?
And one more point, not so important, but relevant. This is the anatomy of the shape and size of the crown part of the 7th and 8th teeth. They are different. It is possible to create a full-fledged contact in this case, but will it be correct?
“If the 6th tooth has been removed for a long time, can the 7th move to the place of the 6th, and the 8th to the place of the 7th?”
No... It will be something like this -
"A holy place is never empty". If a tooth is missing for a long time, neighboring teeth begin to gradually shift towards them. Such movements occur only forward. That is, if , then the 7th tooth will not tilt back like the one 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), it won’t bother you?”
Alas, but not either.
Below, however, is an example 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 missing one, “trying” to find contact.
Placing an implant in the area of the 7th tooth is not a problem, but it will be impossible to prosthetize (install a crown) such a tooth correctly. Why? Because in this case the crown will be two times lower in height. And the so-called “block” is formed when the lower jaw moves, which I mentioned .
The logical question is: “What then? What to do about this situation?
Here's what. We call on everyone’s favorite orthodontists for help and, with the help of special structures and rods, we try to put the teeth in the correct position, as nature intended. In general, I believe that orthodontists are the most important dentists. Why? If you think about it, what are all the problems with teeth? - From their position. If “teeth are crooked,” then food debris becomes more actively clogged between the teeth, hence hygiene suffers, hence caries, and all the complications associated with it. Plus overload of teeth due to improper closure. Hello to abrasion, chips on teeth and all sorts of wedge-shaped defects (non-carious lesions that are located in the area of the necks of teeth in the form of a wedge-shaped defect). The TMJ (temporomandibular joint) also suffers; crunching, clicking, pain, etc. may appear. And if there are no problems with your bite, just brush your teeth and you will be happy. But no matter how funny it may sound, it must be done correctly. You can brush your teeth for 20 minutes, but it won’t do any good.
We got distracted. Here is a small clinical case.
An implant was installed and at the same time treatment with an orthodontist began. As we can see, the lower right 7th tooth is tilted, and the upper right 6th tooth has moved down slightly.
Please note that it is not necessary to install a full-fledged braces system in order to eliminate this problem. It is enough to glue 3 braces on the 4th, 5th, and 7th teeth, and use a special spring to push the problem tooth into place. On the upper jaw the situation is somewhat different. To correct the problem, two orthodontic screws are installed. One from the side of the cheek, and the second from the side of the palate. Two buttons are glued to the teeth, and traction is given (special elastic bands). They “pull” the tooth into place.
And from a different angle -
And now my question is, why do you need this? I'm talking about pulling an 8.
A wisdom tooth is not a “spare tire.” They can’t just pick up and replace a lost tooth. In addition to the fact that the process of movement is very long, especially with age, it is also not guaranteed. That is, you spent about a year or two “pulling” the 8. No one will give you guarantees for this, and in the end, if it happens, you will delete it anyway. It's worth it?
But you can place a single implant in time in the area of the extracted tooth and after 3 months (if we are talking about the lower jaw) you are guaranteed to have a full-fledged, chewing tooth that will serve you for the rest of your life. And no additional “pull-pull”. All this is subject to compliance with all recommendations and visits to the dentist once every six months for a preventive examination. Nothing will just happen to the implant. Ask: “Then why come?” So that if problems begin with neighboring teeth, they can also affect the implant. Whether it's a problem with the gums or the bone tissue around it. Preventive examinations with mandatory dental x-rays will help avoid such a problem. And, of course, professional oral hygiene is ideal, also every six months. Especially for people with bad habits, such as smoking. I don’t think it’s worth explaining why. Everything is clear.
You say, “This is disproportionately expensive!” or “Your teeth are better!”
On the issue of cost. I don’t want to upset you, but the surgical stage, plus the installation of an orthodontic structure and replacement of rods, over a couple of years with an orthodontist, will ultimately be almost comparable in cost to installing an implant and making a crown. But in the first case there are no guarantees, and in the second there are lifelong guarantees. Do you feel the difference?
Your own teeth are, of course, better. From the word always. We must fight for them to the last. But only if these teeth are important. And these are not wisdom teeth, from which there is nothing to expect except problems.
That's all for today, thank you for your attention!
Stay tuned!
Sincerely, Andrey Dashkov.
Source: habr.com