Optimization of surgical-orthodontic treatment tactics in patients with impacted teeth

Introduction: Impacted teeth is complex anomaly of teeth eruption that requires a balanced approach not only in the differential diagnosis of its forms, but choice of rational methods of treatment. The aim: Optimization of the tactics of orthodontic-surgical treatment of patients with impacted teeth based on the development and implementation of computed tomographic indices (KT) and photometric indices (FM) of opening of surgical access (OSA) to crowns of impacted teeth.

Materials and methods:The results of treatment of 48 patients with delay of permanent teeth eruption have been analyzed. For an objective assessment of treatment results, a group of 24 (aged from 9 to 19 years old ) was formed. All 24 patients had typical clinical situation.

Results: Orthodontic correction of patients envisaged, first of all, the elimination of obstacles in the way of teeth eruption, if necessary to provide space in dental arch and simultaneous treatment of associated bite malocclusions. Surgical exposure of impacted tooth crown was carried out and at the same time a triangular shaped guiding channel was formed, base of channel was at the impacted tooth and its angle finished into the dental arch. Precise dimensions and depth of the channel were preliminary planed on computed tomography slices with 3D reconstruction. Mean values of CT width (7,13±0,54mm), and length (6,42±0,78mm) of OSA and CT index (130,79±8,19%) of OSA to impacted teeth crowns were determined.

Conclusion: To improve the quality of diagnosis and optimization of methodological approaches to treatment of patients with teeth impaction, we have proposed CT and FM OSA indices to the crowns of impacted teeth. The developed indices serve as specific reference points for optimization of diagnostic process, for reducing of probability of repeated surgical interventions and choosing the optimal path for instrumental orthodontic treatment of patients with impacted teeth.