Tooth impaction

An impacted tooth is one that fails to erupt into the dental arch within the expected developmental window. Because impacted teeth do not erupt, they are retained throughout the individual's lifetime unless extracted or exposed surgically. Teeth may become impacted because of adjacent teeth, dense overlying bone, excessive soft tissue or a genetic abnormality. Most often, the cause of impaction is inadequate arch length and space in which to erupt. That is the total length of the alveolar arch is smaller than the tooth arch (the combined mesiodistal width of each tooth). The wisdom teeth (third molars) are frequently impacted because they are the last teeth to erupt in the oral cavity. Mandibular third molars are more commonly impacted than their maxillary counterparts.

Mandibular canine impacted in the chin
3D CT of mandibular canine impacted in the chin

Some dentists believe that impacted teeth should be removed except, in certain cases, canine teeth: canines may just remain buried and give no further problems, thus not requiring surgical intervention. However, removal of asymptomatic, pathology-free, impacted teeth is not a medical consensus: watchful monitoring may be a more prudent and cost-effective strategy and make the future placement of a dental implant through such impacted tooth a feasible approach.

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