Impacted Tooth Extraction
Impacted Teeth Other Than Wisdom Teeth
On this page, impacted tooth extraction covers unerupted teeth other than wisdom teeth (20): impacted canine, supernumerary tooth, impacted premolar or central tooth. Not every impacted tooth follows the same surgical protocol; location and treatment goal determine the plan. Impacted wisdom tooth (20) surgery is addressed on a separate page.
Impacted wisdom tooth (20) surgery is addressed on a separate page; anatomical region, risk profile and surgical technique differ. This distinction is important for planning and patient information. Orthodontic coordination is often required in supernumerary and impacted canine cases.
Impacted Canine in an Orthodontic Context
For impacted upper canines, the orthodontist and surgeon decide together. If the tooth has eruption potential, surgical exposure and traction may be preferred; this approach is generally not relevant for impacted wisdom teeth (20). Palatal or buccal position is clarified with CBCT.
After surgical exposure, orthodontic traction may take several months. If the tooth cannot be erupted, extraction is planned; the space is assessed orthodontically or prosthetically.
Supernumerary and Other Regional Conditions
Mesiodens in the upper jaw midline may cause crowding or diastema. Supernumerary teeth may lead to cyst formation or interfere with an implant plan. Impacted premolar cases are rarer; root development and relation to neighbouring teeth are examined in detail.
Panoramic imaging may be sufficient for initial screening; CBCT can be considered in complex cases. Orthodontic exposure and traction may be assessed as an alternative to extraction for impacted canines. Asymptomatic supernumerary teeth may be monitored.
Surgery and Healing
Surgical access is designed according to tooth position; in canine surgery, the bracket and elastic traction protocol proceeds in coordination with orthodontics. Supernumerary removal is usually performed in a more localised area. In paediatric cases, eruption age and bone maturity are considered; assessment with orthodontist follow-up between ages 10-13 may be recommended.
If an orthodontic activation plan is present after healing, it may start within a few weeks. Soft diet and oral hygiene recommendations are shared in the first weeks. Swelling and sensitivity may last a few days after surgery; the clinic should be contacted if there is a marked increase beyond expectations. Orthodontic coordination is an inseparable part of impacted canine surgery. In paediatric cases, eruption age and bone maturity are considered.