Partially impacted tooth 17

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This topic contains 6 replies, has 3 voices, and was last updated by  Dr. Jay Reznick Mon Aug 20, 2018 04:28 pm.

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  • #3165

    I have not a big experience in extraction of wisdom tooth but I am getting more and more confident about it, also thanks to this site. So I have a case, actually it’s a friend of mine, who comes to my office in few days. The tooth has to be extracted, but I am not sure what to expect. X-ray is poor quality, I’ll made pano before surgery, but maybe you can tell me what to expect, I would be very thankful 🙂 probably the tooth is partially impacted, about 2/3 of the crown visible, probably distoangular. What would be your strategy to remove it? Make a flap at the beginning and should I remove the bone first or should I try to elevate it first? What about those roots? Is it a one fused or two in buccal/lingual direction?
    Sorry if it is trivial question, but as I said, I am quite a beginner 🙂

    Thank you!

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  • #3168

    Dr. Jay Reznick

    One of the first rules we teach you is that you need adequate radiographs to assess the position, depth, angulation, and relationship to other teeth, mandibular canal (or sinus) for any tooth you will be removing. Until you have this information, you can’t know what you are getting yourself in to. Your strategy will depend on all those parameters I just mentioned. Rather than going through all the possible scenarios, it would be best if you could get your friend in to get a panoramic image that we can look at and then discuss the surgical approach and patient management in this case.

    On a side note, if you are unsure about how to do this case, maybe you should refer your friend to an oral surgeon for this one. You want him to remain your friend. But, let’s first look a a good panoramic image and then we can talk about it with the necessary data before us.


    Ok thank you Dr. Reznick. I will get panoramic X-ray and I will make a decision.

    I have one more case to discuss, actually it is my fiancee’s 16. I am gonna remove the tooth tomorrow. I expect some troubles, the apex directs towards mesial side, there is small amount of bone besides the tooth so I expect it will break, additionally the sinus, I think the tooth lays on the sinus. But fortunately the tooth directs into buccal side, probably there is no bone covering the crown, because I can feel it with the finger on the buccal side. Could you tell me your thoughts about this one? thank you very much doctor.

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    Dr. Jay Reznick

    Most likely, you will just need to lay a flap to expose the crown of the tooth. You might need to remove some bone overlying the crown with the sharp end of a periosteal elevator to give it a clear path of removal. Then, you should be able to elevate the tooth to the buccal and remove it.

    But, if you are unsure about what to do in this case, do you really want to do it on your fiancee?


    Thank you for your response. I have a dental surgeon in next office so if anything I will get some help. In my opinion I have to do surgical extractions to gain experience and confidence. Thank you dr Reznick for advices, your website is really valuable for me and my career patch. Greetings


    gary davies

    Dear Dr Reznick,

    I was wandering if you could provide a video for disto angular lower third molars please; criteria re sectioning and options for obtaining a good path for removal would be invaluable

    Many thanks for your ongoing expertise and inspiration for minor oral surgeons !
    Kindest Regards


    Dr. Jay Reznick


    We will look for a good case to video. Frequently, being able to see and get good camera angles is challenging for a case like that, but we will keep our eyes open.


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