Adult dental impaction treatment prognosis and therapeutical indications

AIM: Evaluate all prognostic factors that could lead to failure of conservative-orthodontic-surgical therapy in adult patient. METHODS AND MATERIALS: Were considered 45 patients, 38 years mean age, 21 males and 24 females, 82 permanent dental impactions with total bone inclusion. All of them have undergone to surgical intervention of mucosal-bone disimpaction, elastic force application through fixed orthodontics. Only in 5 cases the treatment has been stopped preferring a prosthetical solution. RESULTS: In base of clinical experience has been reached a success average of 81%. In 19% the failures are caused by poor collaboration of the patients for the necessity of a new surgical intervention, by local complication, ankylosis, tooth impaction position. CONCLUSION: Disimpaction in adult patients is different in comparison with growing patients, for: total or partial primitive ankylosis, space reduction after spontaneous migration of adjacent teeth, for deciduous absence and occlusal relationship alteration, local complications as cyst, root resorption or rhizolysis, iatrogenic periodontal damages, alveolar ridge resorption, poor adherent gingiva. A successfull disimpaction in adults depends on a correct evaluation of these factors: age, apex and crown morphology, position, bone type, surgical procedure patient compliance. If there are unfavorable conditions is better propose extraction, prosthetic solution, or orthodontic space closure.