Teeth Super-eruption - Please help!

[Gaby2006]

Hi everyone,

I hope someone will be able (and willing) to answer my question. For one of my exams I had to do a discourse on tooth super-eruption and possible treatments. My answer was that a tooth can be pushed back into its place without the need for braces. My lecturer, however, decided that the answer was wrong. Now, I'd like to have the exam looked into but I was hoping for some answers from you, clever guys, first.
Can a tooth be pushed back if the opposite one is missing? Or are braces really needed?
Thanks everyone. Much appreciated.

---

Members don't see this ad.

 

[diagnodent]

First explain how you would fix the supraeruption.

 

[Gaby2006]

First explain how you would fix the supraeruption.

Well, I'd use the same procedure as with missing teeth through trauma such as sports accidents. Push them slowly back in and keep them in place until the gum and bone have covered the missing enamel, maybe for one or two weeks longer but not more. I figured it should be even easier since the nerve is in its place and there is no receeding gum, trauma, etc.

 

[aphistis]

Hi everyone,

I hope someone will be able (and willing) to answer my question. For one of my exams I had to do a discourse on tooth super-eruption and possible treatments. My answer was that a tooth can be pushed back into its place without the need for braces. My lecturer, however, decided that the answer was wrong. Now, I'd like to have the exam looked into but I was hoping for some answers from you, clever guys, first.
Can a tooth be pushed back if the opposite one is missing? Or are braces really needed?
Thanks everyone. Much appreciated.

Long version: Pushing a supraerupted tooth back into the bone (a process called "intrusion") is a difficult and time-consuming process. You can replace avulsed teeth after sports trauma because the socket is already empty and ready to accept the tooth back into its previous location, but in a supraerupted tooth you're talking about literally pushing the tooth back through fully-developed bone, over a span of several months, to reach its new position. I can't even imagine a practical mechanism other than braces.

Short version: Sorry, ain't no way. 🙂

 

[crazy_sherm]

Well, I'd use the same procedure as with missing teeth through trauma such as sports accidents. Push them slowly back in and keep them in place until the gum and bone have covered the missing enamel, maybe for one or two weeks longer but not more. I figured it should be even easier since the nerve is in its place and there is no receeding gum, trauma, etc.

How do you plan to "push it back in" without orthodontics? Just push on it with your finger 23 hours/day until the bone remodels?

 

[endoking]

Long version: Pushing a supraerupted tooth back into the bone (a process called "intrusion") is a difficult and time-consuming process. You can replace avulsed teeth after sports trauma because the socket is already empty and ready to accept the tooth back into its previous location, but in a supraerupted tooth you're talking about literally pushing the tooth back through fully-developed bone, over a span of several months, to reach its new position. I can't even imagine a practical mechanism other than braces.

Short version: Sorry, ain't no way. 🙂

Depending on the amount of supraeruption: enameloplasty, but if its significant you could always cut it down and crown it (need to make sure the original cause of the supraeruption is corrected) Aphistis nailed it, intrusion is a no go

 

[docj1]

You could possibly use TADs and elastics (this is an orthodontic tooth movement, but doesn't necessarily require brackets and archwires). It will cost more and be alot more time consuming than a crown, but is possible(sometimes).

Good Luck

 

[doc toothache]

Hi everyone,

I hope someone will be able (and willing) to answer my question. For one of my exams I had to do a discourse on tooth super-eruption and possible treatments. My answer was that a tooth can be pushed back into its place without the need for braces. My lecturer, however, decided that the answer was wrong. Now, I'd like to have the exam looked into but I was hoping for some answers from you, clever guys, first.
Can a tooth be pushed back if the opposite one is missing? Or are braces really needed?
Thanks everyone. Much appreciated.

Assuming for the moment that you are a dental student, your lecturer must have been equally impressed with your command of contemporary dental terminology.

The treatment modality is going to be dependent on the particular situation. For example, if there are no teeth left distal to the supraerupted tooth, there would not be much point in keeping the offending tooth unless we are also contemplating restoring the opposing arch. Clinically, usually one will see a supraerupted either upper or lower 3rd or 2nd molar. In the presence of teeth distal to the offending supraerupted tooth, it is a different story. Here we may contemplate a treatment plan for the supraerupted tooth. In this case, however, one is committed to restoring the opposing arch as well. Intruding the supraerupted tooth is probably the ideal tx plan. Enameloplasty can be done, but will be dependent on the amount of reduction that will be necessary to bring the occlusal plane and marginal ridges to an acceptable level. As the amount of reduction increases we may see an increase in the sensitivity of the tooth to thermal changes. If we push the limit and decide to restore the tooth with full coverage, we may be looking at endo, thereby increase the cost to 2-3K. One disadvantage of supraerupted molars is that it increases the likehood of furcation involvement. A clinical finding something encountered is the appearance of supraeruption of the upper centrals. These are usually not a result of a lack of occlusion from the opposing arch. More often than not, these are periodontally involved teeth and the treatment plan would not involve orthodontic intrusion.

 

[Gaby2006]

Assuming for the moment that you are a dental student, your lecturer must have been equally impressed with your command of contemporary dental terminology.

The treatment modality is going to be dependent on the particular situation. For example, if there are no teeth left distal to the supraerupted tooth, there would not be much point in keeping the offending tooth unless we are also contemplating restoring the opposing arch. Clinically, usually one will see a supraerupted either upper or lower 3rd or 2nd molar. In the presence of teeth distal to the offending supraerupted tooth, it is a different story. Here we may contemplate a treatment plan for the supraerupted tooth. In this case, however, one is committed to restoring the opposing arch as well. Intruding the supraerupted tooth is probably the ideal tx plan. Enameloplasty can be done, but will be dependent on the amount of reduction that will be necessary to bring the occlusal plane and marginal ridges to an acceptable level. As the amount of reduction increases we may see an increase in the sensitivity of the tooth to thermal changes. If we push the limit and decide to restore the tooth with full coverage, we may be looking at endo, thereby increase the cost to 2-3K. One disadvantage of supraerupted molars is that it increases the likehood of furcation involvement. A clinical finding something encountered is the appearance of supraeruption of the upper centrals. These are usually not a result of a lack of occlusion from the opposing arch. More often than not, these are periodontally involved teeth and the treatment plan would not involve orthodontic intrusion.

Actually, I'm a medical student and the question I asked here (in simple words) was part of my histology exam, which focused on bone structure, density and the difficulties in healing procedures rather than costs of treatment etc. I guess not everyone likes boasting with terminology since it was meant as a short question of whether or not orthodontics was necessary. Sorry, mate, you do come across very arrogant. Not sure I'd want you as my dentist, lecturer, etc.
Thanks everyone for your help.

 

[aphistis]

Assuming

Mistake #1.

for the moment that you are a dental student

#2.

your lecturer must have been equally impressed with your command of contemporary dental terminology.

"With an order of sneering contempt on the side, drizzled in wrong assumptions. Thanks."

🙄

 

[doc toothache]

Actually, I'm a medical student and the question I asked here (in simple words) was part of my histology exam, which focused on bone structure, density and the difficulties in healing procedures rather than costs of treatment etc. I guess not everyone likes boasting with terminology since it was meant as a short question of whether or not orthodontics was necessary. Sorry, mate, you do come across very arrogant. Not sure I'd want you as my dentist, lecturer, etc.
Thanks everyone for your help.

Well, I'd use the same procedure as with missing teeth through trauma such as sports accidents. Push them slowly back in and keep them in place until the gum and bone have covered the missing enamel, maybe for one or two weeks longer but not more. I figured it should be even easier since the nerve is in its place and there is no receeding gum, trauma, etc.

Well that certainly explains it. Pushing back and gums must be histology terms. One might have been worried about the information given in dental schools, what with "sports accidents trauma, pushing them back, gum and bone covering the missing enamel, for one or two weeks longer but not more, no receding gum."

Arrogance is thinking that you are smarter than your instructor, trying to appeal to SDN "clever guys", being unable to resort to your own resources, and failing to achieve the desired response. Nothing could be more devastating than being left out of your circle of friends.

 

[doc toothache]

Mistake #1.
#2.
"With an order of sneering contempt on the side, drizzled in wrong assumptions. Thanks."
🙄

Just fodder for posts to repond to; helping a friend meet the 3.72 posts/day quota. Number 6166 coming up?

 

[aphistis]

Meanwhile, back to the OP, hopefully you've had your questions answered. If you have any others, all but one person here will be glad to help.

 

[armorshell]

They teach this in medical schools now? I thought the only entry for "mouth" on a standard physical exam form was "Present/Not present."

 

[Supernumerary]

In big fancy technical language the reason you can push an avulsed tooth back in is because there is already a hole in the bone to push the tooth back into. For a supra-erupted tooth there is only solid bone behind the tooth. You aren't going to "push" a tooth through solid bone.

Sorry you missed the question. Hope it wasn't an important test.

 

[doc toothache]

Meanwhile, back to the OP, hopefully you've had your questions answered. If you have any others, all but one person here will be glad to help.

Very magnanimous, although you appear to be very selective in dispensing the gesture (http://forums.studentdoctor.net/showpost.php?p=5527638postcount=3)

What your mate needs is a reality check. Although there are occasional exceptions, the instructors have, however slight, more extensive knowledge of the subject matter they are teaching than the student (dental, medical, undergrad, grad, etc.). In this case, he is confusing his role with that of the other.

 

[endoking]

Very magnanimous, although you appear to be very selective in dispensing the gesture (http://forums.studentdoctor.net/showpost.php?p=5527638postcount=3)QUOTE]

Zing!

 

[EuroOMFS]

They teach this in medical schools now? I thought the only entry for "mouth" on a standard physical exam form was "Present/Not present."

One of my best friends, who is a doctor, once told me that in med school, the oral cavity was covered in one minute in a lecture that basically went:

"This is the mouth and the teeth. Diseases in this area are treated by dentists. And now to the pharynx."

 

[Gaby2006]

Well that certainly explains it. Pushing back and gums must be histology terms. One might have been worried about the information given in dental schools, what with "sports accidents trauma, pushing them back, gum and bone covering the missing enamel, for one or two weeks longer but not more, no receding gum."

Arrogance is thinking that you are smarter than your instructor, trying to appeal to SDN "clever guys", being unable to resort to your own resources, and failing to achieve the desired response. Nothing could be more devastating than being left out of your circle of friends.

Jeez, you must have had a hell of a time during your education that you're so completely full of yourself. I bet you had a lecturer who asked you to get the Oxford Dictionary of Dentistry and you found it such a good read that you decided to learn it by heart and incorporate it in your everyday conversations. I guess your patients will have to attend a short course in Dentistry before seeing you otherwise you'll get their behinds kicked out the door for not speaking the same 'language'.
If you weren't so ridiculous I might be offended but it's just plain funny how much Freud's theory of stagnation in the phallic period nails your case. You must have felt plenty of p....-envy during your childhood and adolescence that you need to prove yourself like crazy.
Oh, by the way, you'd be surprised how much crap some lecturers teach you. I must know since, at 33, I've spent almost my entire life in education, getting a Bachelor in Psychology and then a PhD in Clinical Psy before deciding to go to Med School. Guess I'll have to get a copy of that Oxford Dictionary before addressing you again since I don't "wanna sound - like - stupid or somethin'."


EuroOMFS, that's about all I heard about the oral cavity in my lectures and seminars before sitting my exam. In my oral anatomy exam, I had to answer a question about the digestive system of the cow, which was very entertaining since it's not something you read in your ordinary med books.

Thanks for your help, everyone. I really appreciate it.

 

[doc toothache]

If you weren't so ridiculous I might be offended but it's just plain funny how much Freud's theory of stagnation in the phallic period nails your case. You must have felt plenty of p....-envy during your childhood and adolescence that you need to prove yourself like crazy.
Oh, by the way, you'd be surprised how much crap some lecturers teach you. I must know since, at 33, I've spent almost my entire life in education, getting a Bachelor in Psychology and then a PhD in Clinical Psy before deciding to go to Med School. Guess I'll have to get a copy of that Oxford Dictionary before addressing you again since I don't "wanna sound - like - stupid or somethin'."

It looks like your PhD. in Clinical Psy is finally paying dividends. And to think all of that from, what, five sentences. Think what you could do, with say five paragraphs! Oh, your English ain't too bad.