Orthodontic Surgical Bonding/Bracketing
Altered eruption and impaction of teeth is a frequently encountered problem with orthodontic treatment. There are a number of possible reasons to the impaction of such teeth, such as canines and premolars, ranging from loss of space in the arch to resorption of the roots of the adjacent teeth. The management of the altered erupting teeth necessitates the combined efforts of a number of clinicians, including the orthodontist who provides the patient with the optimal treatment options and the most favorable outcome.
Issues from Impacted Teeth
Many of these impacted teeth, such as canines and premolars, cannot erupt into the dental arch and may need assistance by performing a surgical procedure to adapt a orthodontic button/bracket for the orthodontist to use to further assist the impacted tooth into the correct dental position. This involves both the surgical and orthodontic management using an orthodontic button/bracket and ligation chain attached to the tooth. First, an incision is made in the gums to expose the impacted tooth, next bonding material is used to maintain the button/bracket to the impacted tooth and then the area is allowed to heal. Your orthodontist will then make an appointment to begin management of positioning the tooth. Our office works closely with the referring clinician to make sure the patient is well informed of their surgical and orthodontic treatment plan.
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What To Expect From Surgery To Expose & Bracket An Impacted Tooth
The surgery to expose and bracket an impacted tooth is a very straightforward surgical procedure that is performed in the oral surgeon’s office. For most patients, it is performed using laughing gas and local anesthesia. In selected cases it will be performed under IV sedation if the patient desires to be asleep, but this is generally not necessary for this procedure. The procedure is scheduled for approximately 75 minutes if one tooth is being exposed and bracketed, and 105 minutes if both sides require treatment. If the procedure only requires exposing the tooth with no bracketing, the time required will be shortened by about one half. These issues will be discussed in detail at your preoperative consultation with your doctor. (You can also refer to Preoperative Instructions under Surgical Instructions on this website for a review of any details).
You can expect a limited amount of bleeding from the surgical sites after surgery. Although there will be some discomfort after surgery at the surgical sites, most patients find Tylenol or Advil to be more than adequate to manage any pain they may have. Within two to three days after surgery there is usually little need for any medication at all. There may be some swelling from holding the lip up to visualize the surgical site; it can be minimized by applying ice packs to the lip for the afternoon after surgery. A soft, bland diet is recommended at first, but you may resume your normal diet as soon as you feel comfortable chewing. It is advised that you avoid sharp food items, like crackers and chips, as they will irritate the surgical site if they jab the wound during initial healing. Your doctor will see you seven to ten days after surgery to evaluate the healing process and make sure you are maintaining good oral hygiene. You should plan to see your orthodontist within 1-14 days to activate the eruption process (applying the proper rubber band to the chain on your tooth). As always, your doctor is available at the office and can be contacted after hours if any problems should arise after surgery.