TEETH IMPACTION: CHALLENGES AND SOLUTIONS.

The aim of the study was investigation of statistics of impaction and semi-impaction in permanent dentition in the population of Georgia, revealing the correlation and feedback of expressed adentia and retention in different groups of teeth. Study was also aimed to determine any regularity in reduction of tooth number of the skeleto-dental system. To comply with this goal, 1000 panoramic images of patients, from 12 to 35 years of age 651 women and 349 men have been examined. In our study cases 1 and 3 were similar. In both situations possible cause of impaction was dental crowding and space deficiency. Similarities were found in facial features as well. Case 1 (N. J.) - NLA (nasolabial angle) was obtuse and patient had prominent chin. E-Line to lower lip was (-5) mm. Therefore tooth extraction could cause adverse esthetic outcome. Case 2 (N.G.) - patient had class I dental and skeletal malocclusion and tendency towards vertical growth (Sn-GoGn- 34 degrees , FMA- 31 degrees ). Maxillary right canine was horizontally impacted and was located close to the nasal cavity. Technically it was very difficult to expose canine surgically and put it orthodontically into the dental arch. Deciduous canine was extracted, space was closed and missing canine was substituted with first bicuspid. We ended treatment with right side in functional class II malocclusion and left side in class I molar and canine relationship. Case 3 (N.S.) - Sn-GoGn angle was 28 degrees and FMA -22 degrees -patient had Low Mandibular Plane angle, square Gonial angle and tendency towards "horizontal facial growth". In both cases treatment was without tooth extraction. Spaces were created for retained teeth and facial esthetics was improved. In some cases, the restorative approach can be considered as an alternative to orthodontic treatment. Improvement of facial aesthetics, taking into consideration individual cases and approaches, can be achieved by aesthetic restoration. Despite the considerable number of cases reported in the literature, to find guideline of proper outcome of treatment therapy of abovementioned abnormalities is difficult. That's why, the aesthetic rehabilitation has been suggested, to depend upon the patient's desires, but at the same time, avoid treatment plans with aggressive management.