SEARCH · PubMed Health
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
This case illustrates a restorative approach using adhesive techniques to overcome the aesthetic and functional problems associated with infraclusion of a mandibular canine tooth resulting from ankylosis. In this case a diagnosis of ankylosis was confirmed after 3 months of fixed appliance orthodontic therapy failed to extrude the tooth.
There are several techniques available to the practitioner for the treatment of impacted, fully developed teeth. These techniques often involve surgical and/or orthodontic manipulation of the affected tooth. A more conservative approach was used in the case presented here, involving a boy who was 12 years 5 months old. An odontoma was surgically removed and the impacted tooth was allowed to erupt without the aid of external forces.
INTRODUCTION: The purpose of this study was to investigate a simple method for correcting upper dental midline shift, by physiologic movement of the incisors during the retention period of rapid maxillary expansion. METHODS: Thirty-two patients with upper midline shifts due to constricted maxillae and anterior crowding were selected. All had undergone radiological and clinical examinations to be sure that the midline shift was not functional and was caused only by crowding. The patients were randomly divided into 2 groups. In both groups, acrylic cap splint type expansion appliances were used. In group 1, the acrylic cap covered all the dentition except the incisors and the canine on the shifted side. After expansion, the incisors on the shifted side were allowed to move toward the midline, and the incisors of the other side were held by the acrylic cap. In group 2, the acrylic cap covered only the posterior teeth, from the first premolars on both sides. After expansion, the incisors on the shifted side were allowed to move toward the midline diastema, whereas those on the other side were held in place by ligation of the brackets, which had been placed immediately after expansion. RESULTS: In both groups, the midline shift was corrected by the movement of the shifted incisors toward the midline diastema, without orthodontic force. CONCLUSIONS: Residual or unwanted forces produced during rapid maxillary expansion can be used to correct an upper dental midline shift.
A case report of a two-stage canine transplant is presented in which circumstances appeared ideal for success. Storage of the tooth in a buccal pouch for six months precipitated extensive crown and root resorption. The prognosis for this approach to treatment of impacted canines indicates caution in its use.
Surgical separation of supernumerary teeth fused to permanent incisor teethhas typically given rise to residual post surgical periodontal defects, induding loss of attachment and deep periodontal pocketing with persistent inflammation. Other complications include devitalisation of the retained tooth section, ankylosis, external and replacement resorption. A unique technique of using guided tissue regeneration has been successfully employed to promote periodontal healing, after 2 cases of surgical removal of a supernumerary tooth fused to a permanent maxillary lateral incisor tooth. In the first case, a 2-stage guided tissue regeneration technique was completed with a nonresorbable Gor-Tex membrane, and was followed up after 9 years. The second case was completed using a resorbable Vicryl membrane, in a single-stage guided tissue regenerative technique; and was followed up after 5 years.
Orthodontic tooth extrusion is used at crown lengthening procedures or in conjunction with periodontal therapy aimed at eliminating or reducing angular bone defects. A technique for orthodontic extrusion combined with resection of the supracrestal attachment fibers (fiberotomy) was recently proposed as an adjunct to certain restorative procedures. The aim of the present investigation was to analyze reactions of the periodontal tissues to orthodontic extrusion when combined with fiberotomy. In 5 beagle dogs, the mesial roots of the 2nd, 3rd and 4th hemisected mandibular premolar were used as target roots while the distal roots served as reference units. After a baseline examination, an orthodontic extrusion device (stent) was installed and reactivated at 2-week intervals during an 8-week period of active tooth movement. Immediately following the installation of the stent and once every 2nd week, the target roots were exposed to fiberotomy. After the active period, the teeth were retained in their new position for a period of 8 weeks. Clinical, radiographical and histological measurements were performed. The results from the investigation demonstrated that orthodontic extrusion combined with supracrestal fiberotomy resulted in a coronal displacement of the tooth and was associated with pronounced recession of the gingival margin and extensive loss of connective tissue attachment. The degree of gingival recession and the amount of loss of connective tissue attachment were, however, less extensive than the amount of tooth extrusion. Thus, repeated fiberotomy obviously failed to entirely prevent coronal migration of the attachment apparatus. It was also observed that undesired attachment loss had occurred at the reference roots.
A patient with a unilateral horizontally impacted upper left canine and first premolar was treated orthodontically. The use of a double archwire technique achieved the desired treatment goals. We discuss the problems associated with impacted maxillary canines and first premolars and the biomechanical interventions used for this patient.
This article describes a combined surgical-orthodontic method to manage impacted teeth, primarily maxillary canines. The method uses a modified type of ligation chain that enables the oral surgeon to lasso the tooth with ease and affords the orthodontist large, successively placed eyelets to which he can easily tie elastic thread in order to keep continuous heavy force pulling the tooth toward the oral cavity.
(1) A significant percentage of orthodontic practice involves impacted teeth that require surgical procedures to aid in their successful realignment. (2) A technique for direct bonding to the crown is a simple, one operation procedure which dies not damage the tooth or adjacent tissues. (3) The most beneficial application of force to any preselected aspect of the crown to help reduce traction time can be used. (4) If carried out correctly, there is little likelihood of failure.
Apical root shortening is one of the most common complications of orthodontic treatment. Force magnitude has been suggested as an important factor. Studies on the occurrence of root resorption show equivocal results. The aim of the present study was to evaluate the relationship between intrusion with low forces (25 gm) using utility arches in the bioprogressive technique and root shortening. Age, sex, facial type, treatment time, extraction versus nonextraction therapy, width of the symphysis, and the angle of the incisors to skeletal reference planes also were studied for their relationship to intrusion and root shortening. Root shortening was found to average 1.84 mm for maxillary incisors and 0.61 mm for mandibular incisors subjected to intrusive force. Intrusion of incisors in a population exhibiting growth was found to be one of "holding against growth" and in the upper arch to a change in angulation of the maxillary incisors. Furthermore, when extraction was a part of the orthodontic treatment, it was related to intrusion of maxillary incisors but not to intrusion of mandibular incisors. No relationship was found between the amount of root shortening and degree of intrusion achieved. However, a long treatment time was significantly correlated to root shortening. None of the other characteristics studied were related to either intrusion or root shortening. In the present study, it was found that intrusion with the utility arch type of technique is not related to amount of root shortening. The degree of root shortening was markedly higher in the maxilla than the mandible. In general, treatment time was the most significant factor for occurrence of root shortening.(ABSTRACT TRUNCATED AT 250 WORDS)
The impacted maxillary central incisor in a child poses a disturbing esthetic dilemma to parents, by virtue of its location. Neither the orthodontist nor the parents prefer to wait for the fully erupted permanent dentition and comprehensive orthodontics to resolve this problem. This challenge can be met in the early mixed dentition stage, as described with these two cases. The response to the technique was excellent. The patients now possess confidence to smile and have enhanced self-esteem, which is critical even in early life. Just as important is that the newly positioned maxillary central incisor is the natural tooth, not a temporary prosthesis that can loosen or break. Gingival contour is a consideration, however.
The importance of the mucogingival complex in any restorative procedure has long been recognized, and various surgical and nonsurgical procedures have been developed to restore the compromised gingiva to its original health. The learning objective of this article is to review nonsurgical restorative techniques to manipulate the soft tissue surrounding the cervical aspect of the restored tooth into a more favorable contour. The techniques presented are applicable to direct and indirect restorations. Six case reports are used to illustrate the various clinical procedures. The techniques include: Supragingival direct restorative techniques, such as recontouring intact dentition; and intracrevicular indirect techniques, such as recapturing the soft tissue of deficient crown restorations, re-engineering recessed injured tissue, re-creation of hyperplastic injured tissue, re-engineering hyperplastic recessed posttrauma tissue, and re-engineering the periprosthetic envelope.
This article describes the background, technique, and benefits of forced eruption vs conventional osseous surgery in maintaining anterior esthetics. Four case reports will demonstrate the benefits of the procedure for maintaining esthetics and phonetics and preventing open interproximal spaces, which are seen frequently after conventional surgical procedures.
Maxillary canine is one of the most common teeth that are impacted. This accounts for 1-2% of all patients who attend orthodontic treatment. The key to achieve maximal eruption of these teeth is their surgical exposure and the role of periodontist in such situations is to provide a functional and satisfactory width of attached gingiva on the labial surface. There are different techniques to surgically expose the impacted teeth, namely--gingivectomy technique, apically positioned flap, closed eruption technique, modified apically positioned flap, double pedicle flap and free gingival graft. Selection of the procedure is dependent on the positioning of the tooth in relation to mucogingival junction and attached gingiva. In the present case series we describe three different techniques for uncovering of impacted teeth, which are apically positioned flap, closed eruption technique and a modified double pedicle graft specially planned for the situation. These procedures when selected diligently using sound selection criteria will create adequate width of attached gingiva which minimizes or eliminates the future mucogingival problems.
This article provides a brief overview of the history of orthodontic practice and comments on the "era of limitations" that exemplified orthodontic thinking in the 1930s. In contrast, the Bioprogressive philosophy of orthodontic treatment which developed 2 decades later resulted from an attitude of academic and clinical freedom. The Bioprogressive philosophy brought many aspects of biology and function into the arena of orthodontic therapy. This technique does not follow a series of rigidly fixed treatment steps, but rather stresses a number of orthodontic principles that have stood the test of time. This article revisits and updates the Bioprogressive principles in line with the latest developments in biology and orthodontic materials.
A case report illustrates an esthetic temporary restorative technique for use during the stabilization period after vertical root extrusion. A polycarbonate crown was adapted to the stabilized root and anchor system with acid-etch composite resin material. This restoration withstood a five-month stabilization period and provided both function and a good esthetic appearance.
Several factors may affect the outcome of the orthodontic/surgical modality for the resolution of impacted central incisors, but particularly the manner in which the impacted tooth is exposed. The present study aimed to evaluate the post-retention clinical appearance and periodontal status of impacted maxillary central incisors which were exposed and aligned with an open-eruption surgical-orthodontic technique. Twelve subjects (four males, eight females), aged 22 years (range 15-38 years), previously treated for a unilateral impacted central incisor (ICI), were examined 10 years (range 3-25 years) post-retention. A split-mouth method was used for the comparison with the unaffected side. One treated central incisor exfoliated 10 years post-retention, thus the results were based on the remaining 11 patients. Statistically significant differences were found between the affected and control incisors in most of the periodontal parameters measured, although some were small and of minimal clinical importance. The increase in the mesio-labial pocket depth was associated with a highly significant 10 per cent reduction in bone level at this site (P = 0.007). A highly statistically significant increase in crown length (P < 0.001) and a reduction in the width of the attached gingiva (P = 0.005) were seen in these previously impacted teeth. An abnormal gingival contour was present in eight treated incisors and positional relapse in five cases. It is concluded that the convenience of the open-eruption technique must be weighed against the long-term negative aesthetic and periodontal effects on the treated tooth, although the findings of this study should be viewed with caution due to the limited sample size.
The records of 96 consecutively treated patients, with a total of 110 exposed maxillary canines, were reviewed after orthodontic alignment of the exposed teeth. In view of the high degree of clinical and patient satisfaction with the results, a random sample of 25 patients, with a total of 30 exposed canines, were critically assessed. The assessment involved scoring for clinical impression, mobility, gingival condition and pocketing, oral hygiene, vitality, and radiographic appearances. The results indicate that the technique of surgical exposure and orthodontic alignment of ectopic maxillary canines provides a satisfactory method of treatment.