The stages and indications for prophylactic wisdom tooth extraction

For preventive wisdom tooth removal, we should fully grasp the capacity of its removal. The intellectual tooth with potential harm should be removed as soon as possible, and the intellectual teeth that may exert their functions still need to be retained as much as possible. Choosing preventive removal can avoid the potential harm of Zhito tooth, and the intellectual teeth are in the period when the roots and periodontal membranes have not been fully developed. Therefore, it is difficult and small in damage.

1. The clinical staging of preventive extraction

Phase I -Crown formation period: The shape of the wisdom tooth crown has been formed, the long axis of the crown and the second grinding teeth long shaft tilt angle is greater than 35 °, or the distance between the secondary and high point of the teeth is far from the front edge of the mandible The distance that is less than the high tooth crown is near a high and high, and the heights of the middle shape (about 10 ~ 12 years old);

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Phase II -Crown neck formation period: On the basis of the stage I, the tooth neck of the wisdom tooth has been formed, and the tilt angle of the long axis of the tooth crowns is still greater than 35 °, or the near -medium crown edge is connected with the second molar to the long champion neck. (About 11 ~ 14 years old);

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Phase III -Early formation: The pulp cavity and roots of Zhiya have gradually formed, and the near -medium crowns are connected to the chart and neck of the second grinding teeth in the lower jaw. The secondary molar and the dental teeth are not absorbed or only lightly absorbed (about 13 ~ 15 years);

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Phase IV -Threat of Zhito Damage: Smart Ya has been determined that it cannot be sprouting normally and constitutes a threat to damage to the surrounding tissues. Below the high shape, or the bone tissue coverage of the distant and medium -sized wisdom teeth, the alveolar ravioli between the second molar and the wise teeth has been mostly absorbed or severely absorbed (about 13 ~ 16);

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Phase V -Zhizhi Darge Demonstration: Although the patient himself does not feel a little uncomfortable after molars, the wisdom tooth crowns have been embedded in the neck or root of the front teeth, and the root of the second grinding neck has been slightly damaged; Abnormalities, such as the crown towards the distant middle or lower mandibular or lower mandibular, or upper mandibular sinus, wise teeth ambush or deep or deep, the intellectual crown ditoral bone has inflammatory or pathological absorption (about 15 ~ 18 years old).

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2. Preventive certificate of prevention

1. Although the Zhiya has not sprung up, the crown has been formed, and there is insufficient gap that cannot be sprung up;

2. Smart teeth have not sprung up, but it may cause harm or threat to neighboring alveolar bones or adjacent teeth;

3. Even though Zhiya can sprout, it does not have a jaw wisdom to teeth, and it cannot form a bite relationship with other teeth;

4. The crown of Zhiya or the coronary neck root of the neighboring teeth near the middle of the neighboring teeth is crowded or the molar region or the front teeth area is crowded;

5. Wisdom tooth cheeks and tongue -side resistance or upside down cannot be sprinkled normally, or may cause certain diseases in the future.

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The staging and indication of therapeutic removal

If the roots of Zhiya have formed and have caused harm to neighboring teeth, the treatment method should be selected to avoid further harm of Zhiya on adjacent teeth or surrounding tissues. Corresponding stages of treatment of treatment can guide clinical operations and make clinical removal of theoretical basis.

1. The clinical staging of therapeutic removal

Phase I -Zhiya has been harmful to the surrounding, but the patient himself has not felt symptoms: the wise teeth are partial or completely ambush, the second molar and the alveolar between the wise teeth; The neck or root of the teeth is close to the root; the wise teeth are small tooth deformity or the side of the cheeks and tongue (palate) are signs of oblique or misplaced; there is no right jaw tooth (about 13 ~ 30 years old).

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Phase II -Zhiya itself may be damaged to the surrounding and the patient has not yet sensible symptoms: Zhiya itself caries, wisdom teeth are blocked and covered with gums; wisdom teeth are completely ambushing The alveolar is absorbed, and the wisdom tooth crown is embedded in the second molars to distant middle neck or root; the wise teeth far and mid -mandarin mandibular bone on X -ray are absorbed by the shadow (about 15-35 years old).

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Phase III -Zhiya itself may be damaged to the surrounding and the patient has occasionally felt symptoms: Smart tooth itself is sensitive to hot and cold or painful pain in the back area of the teeth; There are not only alveolar rectification absorption between the two molars and wisdom teeth, but also the wisdom tooth crown is embedded in the second molar to the distant middle neck or roots, which can easily cause discomfort or mild pain in patients; Dental mandibular (about 17 ~ 45 years old).

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Phase IV -Zhiya has obvious damage to the surroundings and the patients themselves often have symptoms. If they are not removed, they cannot stop and repair the damage: the wise teeth are partially blocked or completely ambush, the second molar and the alveolar between the wisdom teeth are absorbed by absorption In severe, the second molar distant medium -sized crown neck or wisdom tooth maxillofacial caries are larger or even pulpitis, or the wise teeth crown inflammation repeatedly occurred; and due to the obstacles of the wisdom tooth Large or pulp lesions (about 25 ~ 55 years old).

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Phase V -The damage caused by wisdom teeth is greater than the existence of lesions, and the lesion must be removed at the same time: the root cause of the ingenuity, periodontitis, or marginal osteomyelitis, repeated swelling and pain; , Mild occlusal pain or clinical examination found that the second molar I or II degree is loose, and the second grinding teeth can not be retained without removing wisdom teeth (about 40 years old).

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2. Application certificate for therapeutic removal

1. Smart teeth have occurred or loosened, and there is no bite with jaw tooth;

2. Inserting pulpitis, peripheral infection or maxillary lesions;

3. Occurrence or repeated period of wisdom crown inflammation, and should not be treated with gingival cutting;

4. Wisdom teeth are blocked at various angles, so that it cannot be sprouted normally;

5. Due to the obstruction of the wise teeth, the dental caries, the pulp lesion or the peculiar lesion of the neighboring teeth;

6. Smart teeth are germinated or partially sprouting often causes foods with neighboring teeth, or hinders neighboring tooth treatment;

7. Smart teeth cause crowded or mandibular malformations, or need to be removed due to orthodontic treatment;

8. Zhiya cannot sprout for its own lesions or periodontal lesions;

9. Blocking Smart tooth affects the repair of righteous dentures;

10. Blocking Zhiya may cause temporal mandibular joint disease

11. Other lesions caused by wisdom teeth, such as those with deeper infections in the ambush of Zhiya, neurological symptoms caused by wisdom teeth, and wise teeth enter the maxillary sinus infection.