Facilitation of Orthodontic Treatment
In patients who require retraction of first and second molars by orthodontic techniques, the presence of impacted third molars may interfere vith the treatment. It is therefore recommended that impacted third molars be removed before orthodontic therapy is begun.
Another consideration is that, after orthodontic treatment has been concluded, there may be crowding of the mandibular incisor teeth. This has been attributed to the mesial force transmitted to the molar and premolar teeth by impacted third molars, especially mesially inclined impactions. 11,12 Several other factors influence crowding. Growth of the maxilla stops before growth of tile mandible, If the upper and lower incisors are in a proper overbite and overjet relationship,-and if tile mandible continues to grow’ after the maxilla stops growing, tile mandibular incisors then become crowded to 3rCOJllIl1Odate the constriction imposed on them by the maxillary incisors: This explanation appears sound, because CfOW.
Impacted tooth retained under denture. Tooth is now at surface and is causing infection.
FIG. 9-9 Impacted tooth under fixed bridge. Tooth must be removed and therefore may jeopardize bridge ..ing Occurs after the age at which the axilla stops .growing and the mandible continues forward growth. Many orthodontists still refer their patients to surgeons for removal of impacted third molars after orthodontic treatment is complete. Although the surgeon should explain the other reasons for surgery, the decision to emove impacted teeth to help prevent crowding should be supported.