Teeth of Wisdom: Pull-Pull
After the publication of previous articles, and in particular, “Wisdom teeth cannot be left,” I received several comments asking: “And if the 7th tooth was once removed, will the 8th replace it?” Or “Can I Is the 8th (horizontal) tooth pulled out and put in place of the 7th, which is not there? ”
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 extend a similar 8-ku and put it in a row with the rest of the teeth will be crowned with one hundred percent success. There are also methods of tooth replantation. To which I am extremely skeptical. Especially in the case when in place of the 6th or 7th tooth, which has long been removed, an artificial “hole” (just a “hole” in the bone) is cut, into which a horizontal sawn-off wisdom tooth is also placed. Which, in turn, needs to be treated endodontically (that is, to remove the nerve from it). Do not you consider this an absurdity?
In my opinion - this is just stupid, but! This is the place to be. Everyone "works" as he wants or knows how, if you like. As they say - "all according to indications." I express my point of view, which can radically differ from the opinions of others.
So why not stretch out a wisdom tooth?
After all, orthodontists put braces, move their teeth, and pull the “lying” retinated (uncut) fangs, which are located horizontally in the jaw. Let's "pull" 8k! You say.
The problem is that the area of wisdom teeth, and especially the lower 8-ok, is quite specific. The bone tissue in this place is very dense, and the site itself is usually wide. This area is even a donor for bone plastic surgery.
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 place the implant. And this area (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 individual articles, which we will definitely consider later.
So here. The bone is dense, wide. If you try to extend the 8th tooth, a deep bone pocket forms 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, drive it, what will happen? A “groove” will appear in the sand. There will also be a similar problem in the bone. To extend a horizontal tooth, so that it is surrounded by bone on all sides, is extremely doubtful.
You say, “Well, what about not a horizontal tooth, but an upright tooth?”
I’ll answer, the situation with a vertically standing tooth is somewhat different, of course, you won’t have to make such serious movements. But the problem will be the same; moving the “body” tooth is rather difficult. We all know that the older a person becomes, the slower the healing processes in the body go, compared to young people. For example, a fracture. And all due to the fact that in the bones of a child there are much more organic substances than in adults. The membrane covering the bone outside (periosteum) is thick, well supplied with blood. Etc. etc. And the older a person becomes, the longer and more difficult are the recovery processes. The same story with teeth. If you are 14 years old, then all the tooth movements that the orthodontist has outlined will be much faster and easier for you than if you were 40 years old. The same story with “pulling out” fangs,
If, at the age of 40, you first took a panoramic picture of your teeth and the doctor found there a retarded horizontally lying fang, then the chances of success are much less. So it is with 8, if you were 14 years old, then theoretically such manipulation is possible, I can even assume that it would be successful. But there is a big BUT! At this age, the roots of 8oc are not yet formed, in a panoramic picture, we can only see the formed coronal part of the tooth located in the follicle (capsule surrounding the tooth primordium), what then is to “pull”?
In this case, the embryo can be damaged and the tooth will still have to be removed. Yes, and if at the age of 14 you brought one of the teeth to the extraction ... It is sad to say the least. What will happen to teeth by the age of 40?
And one more point, 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. It is possible to create a full contact in this case, but will it be right?
“If the 6th tooth has been removed long ago, can the 7th move to the 6th place, and the 8th to the 7th place?”
No ... There will be something like that -
“A holy place is never empty.” With a prolonged absence of any tooth, adjacent teeth begin to gradually shift in their direction. Such movements occur only forward. That is, if 8k is removed , then the 7th tooth does not lean back like that shown in the picture. If there is no problem with a bite. (closing teeth).
“Can I remove only the lower tooth of wisdom, and leave the upper one (or vice versa), doesn’t it bother me?”
Alas, but not too.
Below, however, an example is not presented 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 advance toward the absent one, “trying” to find contact with itself.
It is not a problem to place an implant in the area of the 7th tooth, but it will not be possible to prosthetically (install a crown) such a tooth. Why? Because the crown in this case will be two times lower in height. And the so-called “block” is formed, with 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 here is what. We call for help from our beloved orthodontists, and with the help of special designs and rods we try to put our teeth in the correct position, as nature intended. I generally believe that orthodontists are the most important dentists. Why? If you think about it, all problems with teeth from what? - From their position. If the “teeth are crooked”, then the remnants of food are more actively clogged between the teeth, hence hygiene suffers, hence caries, and all the complications associated with it. Plus tooth overload due to improper closure. Hi abrasion, chips on the teeth and all kinds of wedge-shaped defects there (non-carious lesions, which are located in the neck of the teeth in the form of a wedge-shaped defect). TMJ (temporomandibular joint) also suffers, crunching, 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 clean your teeth for 20 minutes, but there will be no sense from this.
Distracted. Here is a small clinical case.
An implant was installed and treatment at the orthodontist started in parallel. As we can see, the lower right 7th tooth is tilted, and the upper right 6th has moved slightly down.
Please note that it is not necessary to install a full-fledged bracket system in order to fix this problem. It is enough to glue 3 braces on the 4th, 5th, and 7th teeth, and using a special spring to push the problem tooth into place. On the upper jaw, the situation is somewhat different. To fix the problem, two orthodontic screws are installed. One from the side of the cheek, and the second from the side of the sky. Two buttons are glued to the teeth, and traction is given (special rubber bands). They "pull" the tooth in place.
And from a different angle -
And now I have a question, why do you need this? I'm talking about pulling 8s.
A wisdom tooth is not a "spare tire." They can’t just take and replace a lost tooth. In addition, the process of movement is very long, especially with age, it is still not guaranteed. That is - you spent about a year, two on “pulling" 8-ki. Nobody will give 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 on time in the area of the extracted tooth and after 3 months (if we are talking about the lower jaw) you are guaranteed a full, chewing tooth that will serve you all your life. And no additional pull-pull. All this, subject to all recommendations and visits to the dentist once every six months for the purpose of preventive examination. With an implant, nothing will happen just like that. Ask: - “Then why come?” So that if problems begin with neighboring teeth, they can also affect the implant. Be it a gum problem or bone around. Preventive examinations with a mandatory x-ray of the teeth will help to avoid such a problem. And, of course, professional oral hygiene is ideal, also every six months. Especially in people with bad habits, such as smoking. Explain why I think it’s not worth it. Everything is clear.
You say, “This is disproportionately expensive!” Or “Your teeth are better!”
To the question of cost. I don’t want to upset you, but the surgical stage, plus the installation of the orthodontic design and replacement of the rods, for a couple of years at the orthodontist, in the end, will be practically comparable in cost with the installation of the implant and the manufacture of the crown. But in the first case there are no guarantees, and in the second, lifetime. Feel the difference?
Your teeth are certainly better. From the word always. We need to fight for them to the last. But in the event that 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!
Sincerely, Andrey Dashkov.
What else to read about wisdom teeth and their removal?
-Wisdom teeth: cannot be removed
- Removal of wisdom teeth: how is this done?
- Consequences of untimely removal of wisdom teeth
- Maxillofacial surgery or not? That's the question