Removal of impacted teeth

Removal of impacted teeth and wisdom teeth in Kyiv

In dental practice, the term “complex extraction” is applied to clinical cases that require increased attention, additional time, and special surgical skills. First of all, this concerns the removal of impacted teeth — units that are completely or partially hidden under the gum or within the bone tissue. The service of complex wisdom tooth removal in Kyiv is especially in demand, since it is the “eights” that more often than others have an abnormal position and erupt late.

The need to consult a surgeon arises with horizontal growth, lack of space in the dental arch, curved or fused roots. At Crystal Dent, we emphasize painlessness: multi-level anesthesia, sedation, and precise diagnostics completely eliminate discomfort during the intervention.

An impacted tooth is a tooth that, for various reasons, did not erupt at the proper time and remained inside the jawbone or under the soft tissues of the gum. Most often, this feature concerns third molars — wisdom teeth. Canines and premolars are also subject to impaction.

Key characteristics:

• absence of the crown part in the oral cavity;
• location in the bone alveolus or under the mucosa;
• possible pressure on the roots of neighboring teeth.

Removal of an impacted wisdom tooth requires a preliminary CT examination, since without an accurate understanding of the depth of occurrence and orientation of the roots, the operation is associated with the risk of damage to the inferior alveolar nerve or neighboring units.

The classification is based on the degree of immersion in the bone/gum and spatial orientation.

• Fully impacted — the tooth is hidden under soft and bone tissues, not visible during visual examination. Detected only on an X-ray or CT scan.
• Partially impacted (semi-impacted) — part of the crown has appeared above the gum, but the main volume of the tooth remains in the bone. Often forms a “hood” — an overhanging mucosa where food debris accumulates, leading to chronic inflammation.
• Dystopic — the tooth has the correct degree of eruption, but an incorrect position in the row (shifted, rotated). Removal of a dystopic wisdom tooth is necessary if it injures the cheek, tongue, or interferes with jaw closure.
• Horizontally positioned — the most complex clinical case. Such a tooth lies across the jaw, resting its crown against the root of the neighboring molar. If a wisdom tooth grows horizontally, removal is performed in parts with gum incision and creation of bone access.

Surgical intervention is indicated in the following conditions:

• Pain — constant aching or sharp when pressed, indicating pressure on nerve endings.
• Inflammation — pericoronitis (inflammation of the hood), swelling, purulent discharge, abscess.
• Pressure on neighboring teeth — leads to resorption (dissolution) of the roots of the second molar, crowding of the front teeth.
• Preparation for braces — even asymptomatic impacted wisdom teeth can shift the frontal units after orthodontic treatment.

Removal is also recommended for cysts, follicular tumors, inability of endodontic treatment due to curved canals.

The procedure belongs to the category of high-complexity surgical interventions and includes the following stages:

1. Diagnostics (CT) — a mandatory condition. Computed tomography shows the exact location of the tooth in three planes, the relationship with the mandibular canal, the number and shape of the roots.
2. Anesthesia — local (infiltration, conduction) using articaine. For anxious patients or a large volume of work — sedation or general anesthesia.
3. Gum incision — the surgeon detaches a mucoperiosteal flap, opening access to the bone tissue.
4. Tooth removal in parts — using a drill and special handpieces, the crown and roots are divided into fragments. Each is removed separately. This is a key feature of the operation to remove an impacted wisdom tooth.
5. Suturing — after санация of the socket and hemostasis, the flap is returned to its place, fixed with interrupted or continuous sutures. The sutures are removed on day 7–10.

The entire procedure takes from 30 to 90 minutes depending on complexity. Complex removal of an impacted wisdom tooth requires the surgeon to have experience in bone grafting and micropreparation.

Third molars are an evolutionary rudiment that has lost its functional significance. It is the rudimentary nature and growth specifics that explain why dentists so often recommend their removal.

• Late eruption — begins at 18–25 years, when the jaw is already formed, and there is not enough space in the dental arch.
• Frequent complications — pericoronitis, crown caries (due to difficult hygiene), cysts, retrograde pulpitis.
• Complex anatomy — roots often fuse, curve, pass near the inferior alveolar nerve. Removal of a wisdom tooth under the gum requires precise work so as not to affect the nerve bundles.

For these reasons, many dentists recommend preventive removal of “eights” at the age of 18–22, when the bone is more plastic and healing is faster.

The classification is based on the degree of destruction and position of the tooth:

Simple removal

Performed with forceps and elevators. Possible if the crown has fully erupted, the roots are straight, there is no bone inflammation.

Complex removal

Requires gum incision, flap detachment, cutting of bone tissue. Used for impacted, semi-impacted, dystopic units.

Atypical removal

Performed in case of abnormal anatomy (supernumerary teeth, inversion of roots, fusion with a neighboring tooth). Atypical wisdom tooth removal in Kyiv is offered by clinics with maxillofacial surgeons, since the procedure may include sinus lifting or resection of the root of a neighboring tooth.

Removal of the hood

Excision of the overhanging mucosa above a partially erupted tooth. This is not extraction of the tooth itself, but an operation that eliminates a pocket for infection. Removal of the hood of a wisdom tooth is often a temporary measure if complete removal is contraindicated (for example, due to proximity of the nerve).

Technologies of recent years minimize trauma and accelerate healing.

• Ultrasound (piezosurgery) — instead of a drill, a piezoelectric scalpel is used, which cuts only hard tissues (bone, tooth) and does not damage soft tissues (nerve, vessels, gum). Removal of a wisdom tooth with ultrasound gives minimal swelling and practically eliminates postoperative neuralgia.
• Laser — used for gum incision and coagulation of vessels. Advantages: bloodlessness, sterility, absence of vibration. The laser beam also has a bactericidal effect.
• Microsurgery — work under an operating microscope with magnification up to 20 times. Allows the surgeon to see the smallest structures and perform root separation with accuracy to fractions of a millimeter.

Modern wisdom tooth removal in Kyiv is increasingly performed with a combination of these methods: piezotome for bone, microsurgical instruments for roots, laser for soft tissues.

Pain control is a priority at the Crystal Dent clinic. Local anesthesia is the standard method. We use articaine-based preparations (Ubistesin, Septanest) with vasoconstrictors, which provides anesthesia for 2–3 hours. This is sufficient for any complex removal.

Sedation — medical calming in which the patient remains conscious, but relaxed and does not experience anxiety. Sedation with nitrous oxide or intravenous drugs (midazolam) reduces the gag reflex and fear of surgery. Sedation during wisdom tooth removal is especially recommended for patients with dentophobia.

General anesthesia — complete shutdown of consciousness with artificial lung ventilation. Used for total destruction of the tooth, purulent complications (phlegmon, osteomyelitis), simultaneous removal of 3–4 wisdom teeth, allergy to local anesthetics. Removal of a wisdom tooth under general anesthesia in Kyiv is performed in our clinic where an experienced anesthesiologist-resuscitator works.

The choice of anesthesia method is carried out after consultation with the surgeon and anesthesiologist, taking into account concomitant diseases (cardiovascular, endocrine).

The postoperative period when removing impacted wisdom teeth lasts longer than after simple extraction.

Swelling — reaches its maximum by the end of the third day, subsides on days 4–7. Cold compresses in the first 6–8 hours reduce swelling.

Recommendations:

• do not eat or drink for 2–3 hours after surgery;
• during the first day only soft, warm food;
• exclude chewing on the side of removal;
• do not rinse the mouth (so as not to wash out the blood clot);
• take prescribed antibiotics (in complex cases);
• sleep with an elevated headboard.

Healing time — primary healing occurs on days 7–10 after suture removal. Complete bone remodeling takes 4–6 months. Complications after wisdom tooth removal (alveolitis, paresthesia, suppuration) occur when hygiene is not followed, smoking, and violation of recommendations. If pain increases, putrid odor from the mouth, fever — immediately see a doctor.

The cost is formed individually and depends on a number of factors.

What the price depends on:

• complexity of the clinical case (simple / complex / atypical removal);
• type of anesthesia (local / sedation / general anesthesia);
• necessity of CT (from 500 to 1200 UAH);
• additional services (suturing, bone graft material);
• clinic status and surgeon qualification (a maxillofacial surgeon is higher in price than a general dental surgeon).

Approximate prices for wisdom tooth extraction in Kyiv for 2026:

• Simple removal — from 800 to 1500 UAH.
• Complex removal (impacted, horizontal) — from 2500 to 5500 UAH
• Atypical removal — from 6000 UAH
• Sedation — +1500 – 3000 UAH
• General anesthesia — +4000 – 7000 UAH

You can find out the exact cost of wisdom tooth removal after examination and diagnostics using CT in our clinic.

The Crystal Dent clinic in Kyiv specializes in complex surgical dentistry, including removal of impacted and dystopic wisdom teeth.

• Experienced surgeons — doctors with 10+ years of experience, including maxillofacial surgeons who have completed internships in Europe.
• Modern equipment — piezosurgical device, operating microscope, 3D CT with low radiation exposure.
• Painless — multi-stage anesthesia (application + injection) and sedation according to indications.
• Fast recovery — the use of atraumatic techniques reduces swelling and the risk of alveolitis.

Sign up for wisdom tooth removal at the Crystal Dent dental clinic. We will carry out the procedure as comfortably, safely, and painlessly as possible even in complex cases.