Orthodontic mechanics, Part 4: Brakes and space management.
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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.
Implant-supported restorations have become an established treatment modality, well accepted by patients and clinicians. Regaining function is now routinely expected, and the focus of patient demand has shifted to aesthetics. Aesthetic restoration of the partially edentulous anterior maxilla can be particularly challenging. The learning objective of this article is to present a comprehensive multidisciplinary treatment protocol, developed to establish a foundation for optimal aesthetics in implant therapy, with emphasis on the role of orthodontics in the enhancement of deficient components. Periodontal orthodontics is used to increase the vertical osseous dimension and preserve papillae; restorative orthodontics optimizes the site through manipulation of supragingival restorative space. Two clinical cases are utilized to illustrate the principles and implementation of this protocol.
A severe Class III malocclusion with asymmetric mandibular prognathism, maxillary A-P deficiency, and excessive vertical facial height is presented. The malocclusion was treated with a combination of orthodontics and orthognathic surgery.
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The use of orthodontics to correct dental malocclusions and enhance the cosmetic appearance in the adult patient is evaluated. A review of the current literature highlights the latest materials and techniques in adult orthodontics. A categorization of the diagnostic variables involved and the therapeutic options available is presented. Alignment, sagittal, vertical, transverse, and soft-tissue discrepancies, as well as future considerations, are discussed.
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