18 May WISDOM TOOTH RESISTANCE FROM TISSUES AND CLASSIFICATION OF GROWTH STATUS
Wisdom teeth are blocked by the surrounding tissues and dwell in the jaw during the process of growth and eruption. It is crucial knowledge to understand the resistance from the surroundings of the wisdom teeth for wisdom tooth extraction. Moreover, it’s necessary to be aware of the size of the crown, the length and the degree of bending of the roots, and the relationship with the surrounding soft and hard tissues.
Soft tissues and hard tissues are the surrounding tissues that resist the eruption of the wisdom tooth.
Resistance from Soft Tissue
The normal eruption of wisdom teeth is without impaction, positioned at the right angle, and with no impediment from the bone and the gingiva. In the event that the wisdom teeth encounter resistance, the eruption will be disrupted and the wisdom teeth might not erupt from the alveolar ridge. The soft tissue in the retromolar pad cannot retreat to the neck of the wisdom teeth. The gingiva, attached gingiva or oral mucosa, covers the crown of the wisdom teeth around the occlusal surface or the lingual/palatal and buccal side. The gingival flap covering the crown obstructs the removal of the wisdom teeth.
Resistance Partially from Gingival Flap
A portion of the wisdom tooth crown is shrouded by the gingival flap tissue; the other part of the crown is visible. The gingival flap tissue causes resistance to hinder the eruption of the wisdom teeth, thus dislocating the teeth.
Resistance Wholly from Gingival Flap
The crown of the wisdom tooth is fully enclosed by gingival tissue forming resistance from the gingival flap.
Resistance from Hard Tissue
When the wisdom teeth cannot completely erupt or are fully impacted in the jaw, they experience resistance from the surrounding teeth, bone, crown, neck, and root of the wisdom teeth themselves during extraction.
Resistance from Bone
The jaw bone around the wisdom tooth resisting the dislocation of the tooth called bone resistance
Resistance from Bone and Teeth
Double resistance of dislocation and extraction of wisdom tooth comes from the jaw bone around the wisdom tooth and the resistance from the second molar
Resistance from Teeth
The resistance from the tooth mainly comes from the second molar which resists the growth of wisdom tooth or the extraction
Resistance from Roots
The resistance from the bending or fat root of wisdom tooth hinders the extraction and dislocation of the toot
Resistance from Both Bone and Roots
Two resistances for the extraction or dislocation of wisdom tooth are from the jaw bone and abnormal roots
Resistance from both Teeth and Roots
Two resistances for the extraction or dislocation of wisdom tooth are from the second molar and abnormal roots
Resistance from Bone, Teeth, and Roots
Three resistances for the extraction or dislocation of wisdom tooth are from the jaw bone, the second molar, and abnormal roots
Classification of Wisdom Teeth Growing Status
High, Middle, and Low Site
The high, middle, and low sites of wisdom teeth are determined by their relative position to the second molar.
Tilting, Vertical, and Horizontal
- “Tilting” means that the angle of the long axis between the wisdom tooth and second molar is less than 90°.
- “Vertical” means that the long axis between the wisdom tooth and second molar is parallel with each other.
- “Horizontal” means that the angle of the long axis between the wisdom tooth and second molar equals 90°.
Malposition: Buccal and Lingual (Palatal)
Crowding is a dental malposition where teeth are not aligned correctly.
Embedding, Inversion, and Reverse
- “Embedding” means that the crown of the wisdom tooth embeds into the distal crown, neck, and root of the second molar (1/4 embedded).
- “Inversion” means that the angle of the long axis between the wisdom tooth and second molar is more than 90°.
- “Reverse” means that the crowns of the wisdom tooth and the second molar are in the opposite direction.
Upward, Underneath, Forward, and Backward
- The occlusal surface of the wisdom tooth is even above the root apex of the second molar. The occlusal surface of the wisdom tooth is in front of the root apex of the second molar. The occlusal surface of the wisdom tooth is behind the root apex of the second molar, with a distance of at least the mesiodistal crown of the wisdom tooth.
Conclusion
The resistance coming from the tissues surrounding the wisdom teeth affected the teeth’s eruption and extraction. The resistance also influenced the growth direction and position of the wisdom teeth.
