Transposition of a canine to the extraction site of a dilacerated maxillary central incisor

Prosthetic and orthodontic rehabilitation of a patient with severe maxillary central incisor root resorption associated with impacted maxillary canines

OBJECTIVE

This case report describes the orthodontic and prosthetic rehabilitation of a patient with resorption of the roots of the maxillary central incisors due to the ectopic maxillary canines.

CLINICAL CONSIDERATIONS

A 16-year-old woman presented with severe resorption of the roots of the maxillary central incisors due to the ectopic maxillary canines. The impacted canines were orthodontically tracted with a lingual arch-supporting temporary central incisors and vertical elastics, and, undesirable root proximity was later corrected by moving the canines distally 1.5 mm apart. Gingival replacement cords were placed into the gingival sulcus of the canines, and tooth preparation was performed along with rotary gingival curettage of the interdental papilla. Convex form was provided for the mesial and labio-distal subgingival contour of the restorations.

CONCLUSIONS

The creeping attachment of the interdental papilla was successfully achieved by the orthodontic arrangement of interdental distance and the prosthetic stimulus via the retraction cord, rotary curettage, and convex mesial subgingival contours. In addition, selective retraction of the labio-distal gingiva by overcontoured restorations moved the gingival zenith position (GZP) distally. Finally, the canine crown morphology and gingival level mimicked the central incisors.

CLINICAL SIGNIFICANCE

This clinical report introduces a treatment workflow of to recover the esthetic disturbance due to severe root resorption of the maxillary central incisors associated with impacted maxillary canines. The present orthodontic and prosthetic procedure can improve both hard and soft tissue esthetics and could be used in similar cases, such as malformed teeth and tooth autotransplantation or transposition with disturbances in the interdental papilla height or the GZP.

Solutions for atypical problems in the incisors area: a transdisciplinary challenge

Introduction:

A significant increase in the number of adults in search of orthodontic treatment has raised a new challenge for orthodontists: the need to interact with other specialties to achieve excellent results, particularly when dealing with smile aesthetics and facial balance. Several factors should be considered to respond to their demand: adequate tooth leveling and alignment, individual tooth proportions between adjacent teeth and their contralateral teeth, shape and natural appearance of each tooth and gingival architecture, which should all be in agreement with facial harmony. Maxillary or mandibular incisors congenitally missing or lost due to caries or trauma and tooth-size discrepancies (Bolton) are some of the important aesthetic challenges for an integrated orthodontic treatment.

Objectives:

This study describes cases that illustrate the clinical challenges of treating the anterior area, as well as the multidisciplinary strategies required for their resolution.

Conclusion:

The increasingly frequent multidisciplinary orthodontic treatments of complex cases seem to effectively maximize aesthetic and functional results using a combination of procedures conducted by specialists in related areas, such as Surgery, Prosthetics, Implantology, Restorative Dentistry and Periodontics.

Early treatment of an ectopic premolar to prevent molar-premolar transposition

Orthodontic treatment is planned on an individual, case-by-case basis after thoroughly considering the patient's overall facial and dental characteristics, the expected duration of treatment, costs, patient preferences, and the orthodontist's experience. This article reports the treatment of a patient with a maxillary premolar-molar transposition in the permanent dentition that was successfully managed with orthodontic treatment. A girl, aged 10 years 2 months, came for treatment with an ectopic maxillary left premolar. Radiographic analysis indicated a developing complete transposition of the maxillary left premolar. The patient was treated with extraction of the deciduous molar and surgical exposure and ligation of the premolar. Eruption was properly guided, and the correct order of the 2 teeth was restored in the arch. This challenging treatment approach is described in detail, including the mechanics used to align the ectopic premolar. Early treatment can, in many cases, prevent a molar-premolar transposition.

Unusual orthodontic approach to a maxillary canine-premolar transposition and a missing lateral incisor with long-term follow-up

In this case report, we present an unusual approach that was used to treat a 14-year-old patient with a bilateral canine-premolar transposition and a missing maxillary lateral incisor. The orthodontic treatment involved maintaining the transposition and creating a space for lateral incisor replacement. Toward the end of the treatment, accentuated buccal root torque was performed, and lateral group function was established to improve the treatment outcome. Finally, an ideal esthetic and functional occlusion was achieved. The 8-year posttreatment follow-up records show the stability of this treatment.

Effect of different methods for decontaminating tooth enamel after contact with blood before bonding orthodontic buttons

PURPOSE

To evaluate the best method for decontaminating tooth enamel contaminated by contact with blood before bonding orthodontic buttons.

MATERIALS AND METHODS

The labial surfaces of 195 bovine incisors initially received prophylaxis, followed by 37% phosphoric acid etching, adhesive application, and light polymerization. After this, the labial surfaces of all teeth were contaminated with blood. The teeth were then randomly divided into 13 groups (n = 15), comprising the control group (treated according to the manufacturer's recommendations) and 12 experimental groups treated by the following decontamination methods: group 1, no decontamination; group 2, washing with distilled water; group 3, washing with physiologic solution; group 4, jets of air; group 5, gauze; group 6, cotton wool; group 7, distilled water plus jets of air; group 8, distilled water plus gauze; group 9, distilled water plus cotton wool; group 10, physiologic solution plus jets of air; group 11, physiologic solution plus gauze; and group 12, physiologic solution plus cotton wool.

RESULTS

No statistical differences were shown between the control group and groups 4, 7, 10, and 11 (P > .05). The lowest bond strength values were shown in group 1, in which no decontamination was performed, and groups 6 and 12, which were decontaminated with cotton wool and physiologic solution plus cotton wool, respectively.

CONCLUSIONS

The best method of decontaminating enamel contaminated with blood is washing with physiologic solution, followed by drying with jets of air and gauze or drying with jets of air only.