Management of selected occlusal discrepancies of the mixed dentition.
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Retaining tooth positions after orthodontic space closure in cases with multiple spacing of anterior teeth are illustrated by selected cases with varying degrees of bimaxillary spacing initially (Figs. 1-6). In each case, bonded lingual retainers which allowed physiologic tooth movements were used with encouraging results. A meticulous technique for fabrication and bonding of flexible spiral wire retainers is mandatory for clinical success. Detailed recommendations are presented. If similar trials by others confirm the durability and effectiveness of acid-etched lingual retainers, it is expected that the technique can be recommended for routine clinical application.
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During the last century orthodontic treatment philosophies changed continuously. The necessity to extract teeth in order to correct a lack of space has many times been the subject of discussion. In fact there exists several techniques which make it possible to avoid extractions in many cases. A number of criteria which influence the decision to extract or not, as well as some techniques to regain space in upper and lower arch are discussed.
Early recognition of malocclusions is in the hands of the primary care providers. Pediatric and general dentists should be familiar with conditions that are known to interfere with growth and development of a child. Conditions such as early loss of primary teeth, anterior and posterior crossbites, and some Class III skeletal problems can be treated in the primary dentition to facilitate normal growth and development and offered some benefit to the patients. On the other hand, aggressive arch length modulation, Class II correction and intervention for vertical problems, including non-nutritive sucking habits, is largely unwarranted.
Space maintaining extraction on one side is a controversial point in orthodontics, yet relevant references in literature are only few and far between. The author has summed up the attitudes towards the unilateral Space maintaining extraction by levelling. Among other things, he emphasizes the importance of avoiding extraction on one side, however when in one quadrant there is smaller room than that of a pre-molar would occupy, an extraction as a concession might be made. When making extraction distal removal is indicated (in such cases the extraction of a molar is also possible) and to avoid non-preferable deformities very soon a strong and rigid are needs to be applied. Teeth in situations which are not meant to be changed, should be fixed. Care should be taken that the central line will not be displace to the direction of extracting. Generally speaking, it is not possible to establish an excellent occlusion in the case of unilateral extraction. After the treatment, the wisdom tooth which pushes forward might cause the displacement of the central line. In the case of unilateral extractions, the patient should be reported on the visible consequences that might occur.
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A method for treating a minimum vertical clearance maxillary overdenture patient is detailed. A low-profile, cemented, Hader bar with parallel guiding planes is used to stabilize a maxillary implant-supported overdenture. This system maximizes implant support while maintaining simple construction, ease of oral hygiene maintenance, good space for excellent esthetics, and allows enough acrylic bulk for long-term service.
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The natal, neonatal and early infancy teeth predominantly being of the normal series of primary dentition, the management should aim at preservation of these teeth for esthetics and maintenance of space for eruption of permanent successor. The treatment method should take into consideration (a) trauma to child's oral tissue or mother's breast (b) mobility and (c) danger of inhalation. Trauma was noted in 10 percent, mobility and danger of inhalation in 94 percent. Extraction carried out in 97 percent of 50 children with natal/neonatal/early infancy teeth showed that the neighbouring primary teeth tended to move into the extraction space. Eruption of the permanent successors to natal/neonatal teeth was not delayed, rather in some instances the eruption was found to be enhanced as compared to contralateral incisor as noted in unilaterally occurring natal/neonatal teeth. The mandibular anterior arch collapse was not permanent as the successors erupted uncrowded. The paper discusses the method and timing of extraction. From the immunological and hematological point of view the best time for extraction was calculated to be 7-25 days of birth.
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The aim of this study was to evaluate clinically a bonded space maintainer, which would reduce chair-side time and cost. Sixty appliances were fabricated from 0.7 mm stainless steel round wire and bonded using light-cured composite to the two teeth adjacent to the site of extraction of a posterior primary tooth. Twenty males and sixteen females (age range 5-9-years-old) were selected from the Pedodontic clinic of the State University of Rio de Janeiro. The sixty space maintainers were divided into two groups according to the site in which they were placed: a) absent first primary molar and b) absent second primary molar. Impressions and study models were obtained prior to and 6 months after bonding the appliances. During this period only 8.3% of failures were observed, most of them from occlusal or facial trauma. Student t-test did not show statistically significant alterations in the sizes of the maintained spaces during the trial period.