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Giachetti L, Scaminaci Russo D, Cinelli F. Agenesis of the maxillary permanent lateral incisors with the deciduous retained: Conservative and biomimetic approach using the BAIR technique. J ESTHET RESTOR DENT 2024; 36:1093-1099. [PMID: 38291733 DOI: 10.1111/jerd.13201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/18/2024] [Accepted: 01/18/2024] [Indexed: 02/01/2024]
Abstract
OBJECTIVE Agenesis of the maxillary permanent lateral incisors is a condition that requires treatment aimed at improving the esthetics, even at an early age. However, traditional therapeutic protocols are long, invasive and have limitations and contraindications imposed by the age of the patient. CLINICAL CONSIDERATIONS Recent developments in restorative dentistry have provided a new approach to this clinical situation, in particular when the deciduous laterals are retained. We report two cases regarding the management of missing lateral incisors using Biologically Active Intrasulcular Restoration (BAIR) technique. The BAIR technique allows us to transform the shape of the deciduous lateral incisor into the permanent, acting both on the dental morphology and proportions, and on the appearance of the soft tissues and the gingival parables. CONCLUSIONS The BAIR technique is a valid approach to cases of agenesis of the maxillary permanent lateral incisors, when the deciduous are retained. It does not require any preparation of the dental tissues, is reversible and minimally invasive. It is applicable to patients of all ages, and results are obtained in a single appointment. CLINICAL SIGNIFICANCE The BAIR technique allows a biomimetic conservative approach for the rehabilitation of congenitally missing permanent lateral incisors, when the deciduous are retained. It is a non-invasive protocol and effective in successfully restoring esthetics.
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Affiliation(s)
- Luca Giachetti
- Unit of Dentistry, Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy
| | - Daniele Scaminaci Russo
- Unit of Dentistry, Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy
| | - Francesca Cinelli
- Unit of Dentistry, Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy
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Sánchez-Beltran JM, Rodríguez-Cárdenas YA, Ruíz-Mora GA, Aliaga-Del Castillo A, Arriola-Guillén LE. Alveolar morphometry in young adults with and without agenesis of the upper lateral incisor: A retrospective study. Int Orthod 2024; 22:100864. [PMID: 38417225 DOI: 10.1016/j.ortho.2024.100864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 02/06/2024] [Accepted: 02/08/2024] [Indexed: 03/01/2024]
Abstract
INTRODUCTION We aimed to compare alveolar morphometry in young adults with agenesis of the upper lateral incisor versus the side without agenesis and versus matched controls. MATERIAL AND METHODS In this observational retrospective study, cone beam computed tomography scans were obtained of 36 upper hemiarches from young adults aged 15 to 30 years. The hemiarches were distributed into three groups: group 1: 12 upper hemiarches presenting agenesis of the upper lateral incisor; group 2: 12 upper hemiarches from the opposite side without agenesis of the upper lateral incisor (control group 1); and group 3: 12 upper hemiarches without agenesis of the upper lateral incisor matched for age and sex with respect to the affected group (control group 2). A trained and calibrated investigator performed all the alveolar measurements at two different times, including sagittal, coronal and axial slices of each hemiarch. Paired Student's t-tests, Chi-square and repeated measures ANOVA with Bonferroni correction were used, (P<0.05). RESULTS Apical mesial evaluation of group 1 (4.22±1.19mm) was significantly lower (P<0.001) than that of groups 2 (6.72±1.17mm) and 3 (7.58±1.67mm). Apical distal evaluation also showed differences (P<0.001) among the three groups, with the dimension being smaller in group 1 with agenesis (4.53±1.14mm), followed by group 2 without agenesis (6.23±1.55mm) and the healthy control group 3 (7.73±1.71mm). CONCLUSIONS Lateral incisor agenesis significantly reduces the alveolar dimensions of the affected area. In cases of unilateral agenesis, the unaffected side also shows sequelae, with decreased dimensions compared to cases without agenesis. This condition should be taken into account when making therapeutic decisions regarding rehabilitation with implants or canine replacement.
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Affiliation(s)
| | | | | | - Aron Aliaga-Del Castillo
- Department of Orthodontics and Pediatric, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Luis Ernesto Arriola-Guillén
- Division of Orthodontics and Division of Oral and Maxillofacial Radiology, School of Dentistry, Universidad Científica del Sur, Lima, Peru.
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García AK, Crespo Reinoso P, Ruiz Delgado E. Interdisciplinary management of maxillary incisors with root resorption caused by impacted canines: A case report. J Orthod 2024; 51:53-59. [PMID: 37081821 DOI: 10.1177/14653125231169797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
The aetiology of impacted canines is multi-factorial. Several theories have been proposed, such as lack of space, genetic predisposition, physical barriers like supernumerary teeth, odontomas and other conditions that interfere with the eruption pathway. One of the main complications that can be generated by impacted canines is the resorption of the root of the adjacent teeth. This case report examines the importance of interdisciplinary management of maxillary incisors with root resorption caused by impacted canines in a 13-year-old male patient. Careful traction of impacted canines and proper tissue management followed by space closure and retroclination of anterior incisors with orthodontic treatment. Finally, functional and aesthetic results using dental veneers for oral rehabilitation allowed the patient to obtain favourable results.
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Affiliation(s)
- Ana Karina García
- Dental School, Universidad de Cuenca, Cuenca, Ecuador
- Department of Orthodontics, Universidad Nacional Autónoma de México, Mexico City, Mexico
- Department of Orthodontics, Universidad Católica de Cuenca, Cuenca, Ecuador
- Private practice, VanguardiaDENTAL, Cuenca, Ecuador
| | - Pablo Crespo Reinoso
- Dental School, Universidad de Cuenca, Cuenca, Ecuador
- Private practice, VanguardiaDENTAL, Cuenca, Ecuador
- Department of Oral and Maxillofacial surgery, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Emilio Ruiz Delgado
- Dental School, Universidad de Cuenca, Cuenca, Ecuador
- Department of prosthodontics, Universidad Intercontinental, Mexico City, Mexico
- Department of prosthodontics, Universidad estatal de Cuenca, Cuenca, Ecuador
- Private practice, Emilio Ruiz Delgado Dental Group, Cuenca, Ecuador
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Katanaki N, Makrygiannakis MA, Kaklamanos EG. The Prevalence of Congenitally Missing Permanent Teeth in a Sample of Orthodontic and Non-Orthodontic Caucasian Patients. Healthcare (Basel) 2024; 12:541. [PMID: 38470652 PMCID: PMC10931087 DOI: 10.3390/healthcare12050541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/11/2024] [Accepted: 02/20/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Hypodontia represents a notable clinical and public health concern. OBJECTIVE To assess the prevalence of congenitally missing permanent teeth in a sample of orthodontic/dental patients of Caucasian origin originating from the Greek island of Lesvos. MATERIALS AND METHODS Panoramic X-rays from 621 children and adolescents, aged 9 to 16 years (average age 12.5 years), 521 seeking orthodontic care (orthodontic group) and 100 seeking dental care (non-orthodontic group) were examined to identify congenitally missing permanent teeth. RESULTS The orthodontic group exhibited a 5.5% prevalence of congenitally missing permanent teeth (2.8% females; 2.7% males), while the non-orthodontic group showed a prevalence of 4% (3% females; 1% males). The descending order of prevalence for missing tooth types was as follows: lower second premolars, upper laterals, lower central incisors, lower canines, upper second premolars, and lower second molars. Among orthodontic patients with missing teeth, 62% presented with an Angle's Class II malocclusion. Hypodontia was most frequently observed in the mandible. No statistically significant differences were observed between the orthodontic and non-orthodontic groups in terms of the percentage of children and types of congenitally missing teeth. CONCLUSIONS Congenitally missing teeth were observed in about 4-5% of the studied population with a female predilection. The lower second premolar was the most commonly absent tooth, followed by the maxillary lateral incisors. An Angle's Class II malocclusion was present in the majority of orthodontic patients with hypodontia, mostly in the mandible.
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Affiliation(s)
| | | | - Eleftherios G. Kaklamanos
- School of Dentistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
- School of Dentistry, European University Cyprus, Nicosia 2404, Cyprus
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai P.O. Box 505055, United Arab Emirates
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Lee MY, Park JH, Chang NY, Chae JM. Interdisciplinary treatment of mutilated dentition and transverse maxillary deficiency with microimplant-assisted rapid palatal expansion, microimplants, and dental implants. J ESTHET RESTOR DENT 2024; 36:239-249. [PMID: 37766643 DOI: 10.1111/jerd.13139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 09/08/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023]
Abstract
OBJECTIVE This case report demonstrates an interdisciplinary approach to treat a 26-year-old male patient with hyperdivergent Class II skeletal pattern, maxillary transverse deficiency, slight anterior open bite, and multiple hopeless teeth with root rests. CLINICAL CONSIDERATIONS An interdisciplinary treatment was required for oral hygiene improvement, caries treatment, extraction of residual roots and hopeless teeth, maxillary expansion using microimplant-assisted rapid palatal expansion, improvement of skeletal and dental relationship using orthodontic microimplants, and prosthetic restorations with the aid of dental implants. CONCLUSION Consequently, esthetic and functional occlusal rehabilitation was achieved. CLINICAL SIGNIFICANCE Hyperdivergent Class II facial and skeletal patterns with multiple missing teeth can be effectively treated using orthodontic skeletal anchorage. In young adults, the transverse discrepancy can be resolved using MARPE, which is also useful for improving the sagittal and vertical relationships. In the case of multiple missing teeth, orthodontic treatment can provide the proper space to facilitate dental implants to achieve optimal esthetics and function.
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Affiliation(s)
- Mi-Young Lee
- Department of Orthodontics, Seoul National University Gwan-ak Dental Hospital, Seoul, South Korea
| | - Jae Hyun Park
- Postgraduate Orthodontic Program, Arizona School of Dentistry and Oral Health, A.T. Still University, Mesa, Arizona, USA
- Graduate School of Dentistry, Kyung Hee University, Seoul, South Korea
| | - Na-Young Chang
- Department of Orthodontics, School of Dentistry, University of Wonkwang, Wonkwang Dental Research Institute, Iksan, South Korea
| | - Jong-Moon Chae
- Postgraduate Orthodontic Program, Arizona School of Dentistry and Oral Health, A.T. Still University, Mesa, Arizona, USA
- Department of Orthodontics, School of Dentistry, University of Wonkwang, Wonkwang Dental Research Institute, Iksan, South Korea
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Gresnigt MMM, Jonker JA, van der Made SAM. The cantilever contact-point resin bonded bridge; adhesion 2.0. J ESTHET RESTOR DENT 2024; 36:37-46. [PMID: 38084818 DOI: 10.1111/jerd.13179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 11/26/2023] [Accepted: 11/27/2023] [Indexed: 01/23/2024]
Abstract
AIM When young patients are congenitally missing anterior teeth, different treatment modalities can be used to complement the dental arch. This article proposes a new treatment modality for the replacement of anterior teeth, the cantilever contact-point resin bonded bridge (CCP-RBB). MATERIALS AND METHODS In this proof of principle study, CCP-RBB's delivered by one operator were clinically assessed. Patients who were missing maxillary incisors and had suitable intra-oral conditions for a contact-point cantilever RBB were included. Three cases are presented to describe all adhesive steps. This proof of principle clinical study is presented with up to 60 months follow-up of the cantilever contact resin bonded bridges. RESULTS A total of 19 CCP-RBB's were evaluated after a mean period of 29.8 months. None of the restorations exhibited failure, carious lesions or fractures during the follow-up periods, demonstrating an absence of restoration debonding or the need for repair. CONCLUSION The new cantilever contact-point resin bonded bridge exhibited an excellent treatment modality without failure or debonding up to 5 years. More and extended duration in vivo studies are needed to evaluate this new treatment modality. CLINICAL SIGNIFICANCE In this proof of principle the new cantilever contact-point resin bonded bridge obtained excellent results up to 5 years of clinical follow-up.
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Affiliation(s)
- Marco M M Gresnigt
- Department of Restorative Dentistry and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- Department of Special Dental Care, Martini Hospital, Groningen, the Netherlands
| | - Joyce A Jonker
- Department of Restorative Dentistry and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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Sanatnama E, Frantz L, Ahlin E, Naoumova J. Implant-supported crowns on maxillary laterals and canines-a long-term follow-up of aesthetics and function. Clin Oral Investig 2023; 27:7545-7555. [PMID: 37940682 PMCID: PMC10713674 DOI: 10.1007/s00784-023-05344-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/14/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVES To assess the long-term aesthetic and functional aspects of implant-supported crowns in lateral (ISC-L) and canine positions (ISC-C). MATERIALS AND METHODS Thirty-two patients (14 males, 18 females, mean age: 23.1, SD:2.0) with an ISC-L or ISC-C participated in this prospective cohort study at baseline (T0) and in the long-term follow-up (T1, mean years: 11.1, SD: 1.0). Twenty-four patients (11 males, 13 females) participated in T1. Patient-reported outcomes (PROM) were rated using surveys with questions related to aesthetics and function. The colour of the implant crown and the buccal gingiva, the appearance of the papilla, periodontal health and temporomandibular disorder (TMD) outcomes were assessed in a clinical examination. The Mann-Whitney, Chi-square and Signed Rank tests were performed. RESULTS Patients with an ISC-L and ISC-C were equally satisfied with the crown shape and colour at T0 and T1. No differences in TMD outcomes were reported by the patients and no clinical signs of TMD were observed. At T1, ISC-C had more bleeding on probing and a three mm greater pocket depth than ISC-L (p = 0.03, p = 0.01, respectively). At T0, operators graded the crown colour of ISC-L as being too dark (35%) and ISC-C as being too light (40%). At T1, no difference was seen between the two groups regarding crown colour, gingiva colour and the papilla (p = 0.2749, p = 0.2099, p = 0.8053, respectively). CONCLUSIONS The PROM and clinical examination show that ISC-L and ISC-C are equivalent with regard to aesthetics and function in the long term. CLINICAL RELEVANCE Although ISC-L and ISC-C are aesthetically and functionally comparable in the long term, ISC-Cs are more likely to impact periodontal health.
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Affiliation(s)
- Elnaz Sanatnama
- Public Dental Service, Region Västra Götaland, Gothenburg, Sweden
| | - Lena Frantz
- Specialist Clinic for Orthodontics, Gothenburg, Public Dental Service, Region Västra Götaland, Gothenburg, Sweden
| | - Erik Ahlin
- Specialist Clinic for Orthodontics, Borås, Public Dental Service, Region Västra Götaland, Gothenburg, Sweden
| | - Julia Naoumova
- Specialist Clinic for Orthodontics, Gothenburg, Public Dental Service, Region Västra Götaland, Gothenburg, Sweden.
- Department of Orthodontics, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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Bocchino T, Martina S, Sangiuolo C, Galdi M, Valletta A, D’Antò V. Maxillary Impacted Canine and Upper Lateral Incisor Agenesis Treatment with "Canine First Technique" and Clear Aligners: A Case Report. Healthcare (Basel) 2023; 11:2345. [PMID: 37628542 PMCID: PMC10454623 DOI: 10.3390/healthcare11162345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/16/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023] Open
Abstract
The aim of this study was to show a case of an impacted canine in an adult patient with agenesis of the maxillary lateral incisor treated with clear aligners (CA). A 19-year-old male with a persistence of 5.3 and absence of 1.2 came to our department of the School of Orthodontics at the University of Federico II in Naples and asked for an aesthetic treatment. The Canine First approach was used to surgically expose the canine and pull it into the dental arch. In order to ensure long-term aesthetic, periodontal, and occlusal results, a treatment with CAs to close the space through the mesial placement of the canine and the enameloplasty of the tooth crown was performed. At the end of the treatment, the occlusal objectives were achieved.
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Affiliation(s)
- Tecla Bocchino
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy; (T.B.); (C.S.); (M.G.); (A.V.); (V.D.)
| | - Stefano Martina
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Allende, 84081 Baronissi, Italy
| | - Carolina Sangiuolo
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy; (T.B.); (C.S.); (M.G.); (A.V.); (V.D.)
| | - Marzio Galdi
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy; (T.B.); (C.S.); (M.G.); (A.V.); (V.D.)
| | - Alessandra Valletta
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy; (T.B.); (C.S.); (M.G.); (A.V.); (V.D.)
| | - Vincenzo D’Antò
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy; (T.B.); (C.S.); (M.G.); (A.V.); (V.D.)
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Yu X, Duan X, Zhi C, Jiang Y, Chen Z, Zhang C. Orthodontic treatment of traumatically avulsed maxillary central incisors with bimaxillary dentoalveolar protrusion in an adult female: a case report. BMC Oral Health 2023; 23:468. [PMID: 37422648 PMCID: PMC10329787 DOI: 10.1186/s12903-023-03123-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 06/08/2023] [Indexed: 07/10/2023] Open
Abstract
BACKGROUND Clinicians agree that obtaining and retaining good treatment results for missing maxillary central incisors owing to trauma is not easy. Management of adult patients with permanent maxillary central incisor loss who visit the clinic with high expectations for aesthetics and function pose a significant diagnostic dilemma. Therefore, esthetic and functional outcomes should be taken into consideration when deciding the proper treatment method. The treatment described in this study aimed to reestablish smile esthetics by proposing an effective multidisciplinary clinical approach that includes orthodontic-prosthetic-periodontal procedures, optimally reduced lip protrusion, center dental midlines, and establishment of stable occlusion. CASE PRESENTATION The patient was a 19-year-old adult female with bimaxillary arch protrusion who had been wearing removable dentures for several years since the loss of her maxillary central permanent incisors. A multidisciplinary treatment including the extraction of two mandibular primary premolars was adopted. The treatment plan consisted of orthodontic space closure by shifting the adjacent teeth towards the central incisor spaces combined with appropriate morphologic remodeling and gingival reshaping to obtain good aesthetic and functional results. The duration to complete the orthodontic treatment was 35 months. Clinical and radiographic results after treatment suggested smile harmony with an improvement in the facial profile, good function of the occlusion, and a positive effect on bone remodeling in the area of the missing incisors during orthodontic tooth movement. CONCLUSIONS This clinical case illustrated the necessity for using multidisciplinary methods involving orthodontic, prosthodontic, and periodontic procedures to treat an adult female patient with bimaxillary arch protrusion and long-term absence of anterior teeth due to severe trauma.
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Affiliation(s)
- Xiaotong Yu
- Department of Orthodontics, Tianjin Stomatological Hospital, School of Medicine Nankai University, Tianjin, 300041, China
- Tianjin Key Laboratory of Oral and Maxillofacial Fuction Reconstruction, Tianjin Stomatological Hospital, Tianjin, 300041, China
| | - Xiaoni Duan
- Department of Orthodontics, Tianjin Stomatological Hospital, School of Medicine Nankai University, Tianjin, 300041, China
- Department of Orthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, 310006, China
| | - Cheng Zhi
- Department of Orthodontics, Tianjin Stomatological Hospital, School of Medicine Nankai University, Tianjin, 300041, China
- School and Hospital of Stomatology, Tianjin Medical University, Tianjin, 300070, China
| | - Yilin Jiang
- Department of Orthodontics, Tianjin Stomatological Hospital, School of Medicine Nankai University, Tianjin, 300041, China
- Tianjin Key Laboratory of Oral and Maxillofacial Fuction Reconstruction, Tianjin Stomatological Hospital, Tianjin, 300041, China
| | - Ziyi Chen
- Department of Orthodontics, Tianjin Stomatological Hospital, School of Medicine Nankai University, Tianjin, 300041, China
- School and Hospital of Stomatology, China Medical University, Shenyang, 110001, China
| | - Chunxiang Zhang
- Department of Orthodontics, Tianjin Stomatological Hospital, School of Medicine Nankai University, Tianjin, 300041, China.
- Tianjin Key Laboratory of Oral and Maxillofacial Fuction Reconstruction, Tianjin Stomatological Hospital, Tianjin, 300041, China.
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Gillgrass T. The orthodontic management of patients with cleft lip and palate: from the permanent dentition and the adult returning to the service. Br Dent J 2023; 234:892-898. [PMID: 37349437 DOI: 10.1038/s41415-023-5956-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 03/09/2023] [Accepted: 03/18/2023] [Indexed: 06/24/2023]
Abstract
This is the second of two papers outlining the orthodontic management of patients with cleft lip and palate. The first paper reviewed orthodontic input into children with cleft lip and palate from birth to the late mixed dentition before definitive orthodontics. In this second paper, I will discuss tooth management across the grafted cleft site and its impact on the bone graft itself. I will also discuss the some of the challenges of the adult patient returning to the service.
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Affiliation(s)
- Toby Gillgrass
- Cleft Surgical Service for Scotland & Glasgow Dental Hospital and School, Glasgow, United Kingdom.
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Calheiros-Lobo MJ, Calheiros-Lobo M, Pinho T. Esthetic Perception of Different Clinical Situations of Maxillary Lateral Incisor Agenesis According to Populations with Dental and Non-Dental Backgrounds: A Systematic Review and Meta-Analysis. Dent J (Basel) 2023; 11:dj11040105. [PMID: 37185483 PMCID: PMC10137431 DOI: 10.3390/dj11040105] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/04/2023] [Accepted: 04/10/2023] [Indexed: 05/17/2023] Open
Abstract
Treatment of unilateral or bilateral maxillary lateral incisor agenesis is challenging, time-consuming, expensive, and requires careful treatment planning, predictability, and esthetics. This review aimed to identify differences in esthetic perception among orthodontists, general dentists, differentiated dentists, and laypersons, which may interfere with treatment options. EBSCO, PubMed, ScienceDirect, Cochrane Library databases, and Google Scholar were searched using keyword pairing and a Boolean expression, "(congenitally missing OR agenesis OR hypodontia) AND (maxillary lateral incisors) AND (esthetic perception OR smile) AND (laypersons OR dental professional OR general dentist OR orthodontists)." Reviews and case studies were excluded. A total of 13 studies were selected for qualitative analysis (adapted ROBINS-I) and 11 were selected for meta-analysis (p < 0.05) after being sub-grouped into "Opening vs. Closure" and "No remodeling vs. Dental remodeling vs. Dental and gingival remodeling" groups. A meta-analysis evaluated the magnitude of the difference between groups based on differences in means and effect sizes (α = 0.05; 95% CI; Z-value 1.96), revealing that the esthetic perception of maxillary lateral incisor agenesis treatment remains controversial even among professionals. Gingival remodeling was not valued compared to isolated dental remodeling. Studies lack rigorously comparable methodologies. Discussion with the patient is pertinent in doubtful situations, as the best treatment option remains unclear, and overtreatment should be avoided.
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Affiliation(s)
- Maria João Calheiros-Lobo
- UNIPRO-Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), Cooperativa de Ensino Superior Politécnico e Universitário (CESPU), Rua Central de Gandra 1317, 4585-116 Gandra, Portugal
- Conservative Dentistry, Department of Dental Sciences, University Institute of Health Sciences (IUCS), Cooperativa de Ensino Superior Politécnico e Universitário (CESPU), Rua Central de Gandra 1317, 4585-116 Gandra, Portugal
| | - Mafalda Calheiros-Lobo
- UNIPRO-Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), Cooperativa de Ensino Superior Politécnico e Universitário (CESPU), Rua Central de Gandra 1317, 4585-116 Gandra, Portugal
- Conservative Dentistry, Department of Dental Sciences, University Institute of Health Sciences (IUCS), Cooperativa de Ensino Superior Politécnico e Universitário (CESPU), Rua Central de Gandra 1317, 4585-116 Gandra, Portugal
| | - Teresa Pinho
- UNIPRO-Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), Cooperativa de Ensino Superior Politécnico e Universitário (CESPU), Rua Central de Gandra 1317, 4585-116 Gandra, Portugal
- Pediatrics Dentistry and Orthodontics, Department of Dental Sciences, University Institute of Health Sciences (IUCS), Cooperativa de Ensino Superior Politécnico e Universitário (CESPU), Rua Central de Gandra 1317, 4585-116 Gandra, Portugal
- IBMC-Institute for Molecular and Cell Biology (IBMC), Institute of Innovation and Investigation in Health (i3S), University of Porto, R. Alfredo Allen, 4200-135 Porto, Portugal
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Reconstruction of Oronasal Fistula with Tongue Flap: A Cleft Palate Report. Bioengineering (Basel) 2022; 9:bioengineering9090455. [PMID: 36135001 PMCID: PMC9495852 DOI: 10.3390/bioengineering9090455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/14/2022] [Accepted: 09/05/2022] [Indexed: 11/17/2022] Open
Abstract
Oronasal fistula can persist after conventional secondary alveolar bone graft surgery, which may lead to functional issues, such as regurgitation of fluids from the oral to the nasal cavity. This manuscript describes a clinical case of a patient with a bilateral cleft lip and palate that underwent tongue graft surgery for closure of an oronasal fistula after three failed local mucosa flap surgeries. The multidisciplinary treatment was comprised of orthodontic treatment, mucosa and alveolar grafts for palate closure and aesthetic rehabilitation of the anterior maxillary teeth. Smile aesthetics were noticeably improved, enhancing the patient’s self-perception and confidence.
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Papalexopoulos D, Samartzi TK, Tsirogiannis P, Sykaras N, Sarafianou A, Kourtis S, Mikeli A. Impact of maxillofacial growth on implants placed in adults: A narrative review. J ESTHET RESTOR DENT 2022; 35:467-478. [PMID: 35929493 DOI: 10.1111/jerd.12950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 07/15/2022] [Accepted: 07/19/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine the effect of lifetime maxillofacial changes on dental implants placed in adults, analyze the clinical implications of these changes, identify prognostic factors, and offer possible solutions. OVERVIEW The relationship between implant placement and maxillofacial changes, occurring during not only the active growth period but also the entire span of adulthood, has not been extensively examined. Vertical differences between implants and adjacent teeth due to the ankylotic behavior of the former might be observed at any age and endanger restoration biologically, functionally, and esthetically. Regarding interproximal contacts, firm contact loss may occur within a few months after restoration, resulting in food impaction. Many prognostic factors have been reported, but most do not exhibit a statistically significant association with implant infraocclusion and interproximal contact loss. Incorporation of alternative solutions, accurate treatment planning, strict recall protocols, and retrievability of implant-supported restorations can facilitate efficient management of complications. CONCLUSION Maxillomandibular changes throughout adulthood may lead to complications such as implant infraocclusion and interproximal contact loss. Rehabilitation of edentulism should be characterized by well-designed and flexible treatment plans to resolve long-term complications efficiently. Further long-term clinical studies are needed to identify other risk factors. CLINICAL SIGNIFICANCE Treatment plans for implant therapy should be reconsidered for adults. Careful patient monitoring and early intervention are essential for securing treatment outcomes.
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Affiliation(s)
- Dimokritos Papalexopoulos
- Department of Prosthodontics, School of Dentistry, National and Kapodistrian University of Athens, Zografou, Greece
| | | | - Panagiotis Tsirogiannis
- Department of Prosthodontics, School of Dentistry, National and Kapodistrian University of Athens, Zografou, Greece
| | - Nikitas Sykaras
- Department of Prosthodontics, School of Dentistry, National and Kapodistrian University of Athens, Zografou, Greece
| | - Aspasia Sarafianou
- Department of Prosthodontics, School of Dentistry, National and Kapodistrian University of Athens, Zografou, Greece
| | - Stefanos Kourtis
- Department of Prosthodontics, School of Dentistry, National and Kapodistrian University of Athens, Zografou, Greece
| | - Aikaterini Mikeli
- Department of Prosthodontics, School of Dentistry, National and Kapodistrian University of Athens, Zografou, Greece
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Lopes-Rocha L, Rocha D, Pinho T. A Multidisciplinary Approach to Maxillary Lateral Incisor Agenesis (MLIA): A Case Report. Oper Dent 2022; 47:367b-374. [PMID: 36001812 DOI: 10.2341/21-069-s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2021] [Indexed: 11/23/2022]
Abstract
Maxillary lateral incisor agenesis (MLIA) is a condition that significantly compromises smile esthetics and is a particular concern in younger patients. The treatment options include orthodontics for space opening with rehabilitation or space closure with canine camouflage. Currently, there is some controversy regarding the most appropriate treatment. In this case report, we propose a multidisciplinary approach through the combination of orthodontic treatment, frenectomy, and a restorative finishing stage with composite resin and dental implants. More specifically, this treatment was planned to orthodontically close the anterior space by opening the premolar area for subsequent placement of implants and enameloplasty with a composite resin. The replacement of a missing lateral incisor by an implant is a predictable treatment approach, but it might best be deferred until dental maturity and then accurately placed in a well-developed site through a multidisciplinary approach. Precluding the closure of the anterior spaces and the opening of the posterior zone for implant placement, allows for a more stable and appealing esthetic and functional rehabilitation for young patients, in whom esthetic appearance and self-esteem play a primary role.
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Affiliation(s)
- L Lopes-Rocha
- Lígia Lopes-Rocha, DDS, UNIPRO, Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, Gandra Campus, Paredes, Portugal
| | - D Rocha
- Duarte Rocha, DDS, UNIPRO, Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, Gandra Campus, Paredes, Portugal
| | - T Pinho
- *Teresa Pinho, DDS, PhD, UNIPRO, Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, Gandra Campus, Paredes, Portugal. IBMC - Institute of Molecular and Cellular Biology, i3S - Institute of Innovation and Research in Health, Oporto University, Portugal
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15
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Schroeder DK, Schroeder MA, Vasconcelos V. Agenesis of maxillary lateral incisors: diagnosis and treatment options. Dental Press J Orthod 2022; 27:e22spe1. [PMID: 35674572 PMCID: PMC9172892 DOI: 10.1590/2177-6709.27.1.e22spe1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 01/06/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction: There are different possibilities of orthodontic planning for cases with congenital absence of maxillary lateral incisors. This subject divides the opinion of orthodontists and oral rehabilitation clinicians, due to the advantages and disadvantages of each treatment option, which may involve opening spaces for future implants and/or prosthetic restorations, or closing the spaces by positioning the maxillary canines in the place of lateral incisors. The correct diagnosis and careful evaluation of each patient allow to determine the best therapeutic approach. This paper discusses the main topics to be considered when planning these cases. Objectives: To evaluate the main aspects related to orthodontic treatment planning in cases of congenital absence of maxillary lateral incisors, to aid the decision-making, with clinical and scientific basis.
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16
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Palone M, Casella S, De Sbrocchi A, Siciliani G, Lombardo L. Space closure by miniscrew-assisted mesialization of an upper third molar and partial vestibular fixed appliance: A case report. Int Orthod 2022; 20:100602. [PMID: 35012896 DOI: 10.1016/j.ortho.2021.100602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/22/2021] [Accepted: 11/24/2021] [Indexed: 11/26/2022]
Abstract
This case report demonstrates how the use of skeletal anchorage and appropriate orthodontic biomechanics can be used to resolve even complex cases, reducing unwanted dental movements and allowing the use of a partial vestibular appliance. It describes the complete mesialization of the left upper third molar and space closure following extraction of tooth UR7, due to vertical fracture one year after previous endodontic therapy for caries. This therapeutic choice was conditioned by the need not to alter the good pre-existing interarch relationships, and above all by the patient's request to be treated conservatively, and therefore not to undergo prosthetic implant rehabilitation. The use of orthodontic miniscrews and the careful application of orthodontic biomechanics, based on both direct and indirect anchorage, enabled the treatment objectives to be achieved in a reasonable period of time with reduced treatment costs.
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Affiliation(s)
- Mario Palone
- Postgraduate School of Orthodontics, University of Ferrara, Via Luigi-Borsari, 46, 44121 Ferrara, Italy
| | - Sofia Casella
- Postgraduate School of Orthodontics, University of Ferrara, Via Luigi-Borsari, 46, 44121 Ferrara, Italy.
| | | | - Giuseppe Siciliani
- Postgraduate School of Orthodontics, University of Ferrara, Via Luigi-Borsari, 46, 44121 Ferrara, Italy
| | - Luca Lombardo
- Postgraduate School of Orthodontics, University of Ferrara, Via Luigi-Borsari, 46, 44121 Ferrara, Italy
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17
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Bahamid AA, AlHudaithi FS, Aldawsari AN, Eyyd AK, Alsadhan NY, Alshahrani FAM. Success of Orthodontic Space Closure Vs. Implant in The Management of Missing First Molar: Systematic Review. ANNALS OF DENTAL SPECIALTY 2022. [DOI: 10.51847/jdpeo7jlvg] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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18
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Elsherif N, Rodriguez J, Ahmed F. The prevalence and management of patients with hypodontia: A cross -sectional study. J Orthod 2021; 49:332-337. [PMID: 34903073 DOI: 10.1177/14653125211065457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Hypodontia is one of the most common anomalies in dentistry. Hypodontia has a negative impact on oral health-related quality of life with patients best seen in a multidisciplinary clinic to improve treatment outcomes. AIM To investigate the prevalence of hypodontia and its association with other dental anomalies, as well as malocclusion, and to investigate the treatment planned for patients attending the clinic and whether the type of missing teeth affected the proposed treatment. MATERIALS AND METHODS Analysis of consecutive patients attending the hypodontia clinic at a dental hospital between February and November 2020. A total of 100 patients who met the inclusion criteria were identified. Data collected included the following: age/sex; number and type of missing teeth; pre-treatment occlusion; presence of other dental anomalies; and planned treatment. RESULTS A total of 100 patients (55% female; age range = 7-41 years; mean age = 18 years) were included. Of the cohort, 47% had a class I skeletal relationship and participants were significantly less likely to have a class III skeletal or incisor relationship; 45% had another dental anomaly with the most common being microdontia. Space opening was the preferred treatment option for those managed by orthodontic treatment with resin-bonded bridges most likely to be used for restoration of spaces, 86%. CONCLUSION Lower second premolars were the most commonly missing teeth. Participants were significantly less likely to have a class III incisor or skeletal relationship than class I or II. Space opening was the favoured approach for orthodontic treatment, particularly for maxillary lateral incisors.
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Affiliation(s)
- Nusaybah Elsherif
- Department of Oral Medicine, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Jose Rodriguez
- Department of Restorative Dentistry, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Farooq Ahmed
- Department of Orthodontics, Guy's and St Thomas' NHS Foundation Trust, London, UK
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19
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Lacarbonara M, Cazzolla AP, Lacarbonara V, Lo Muzio L, Ciavarella D, Testa NF, Crincoli V, Di Venere D, De Franco A, Tripodi D, Grassi FR, Capogreco M. Prosthetic rehabilitation of maxillary lateral incisors agenesis using dental mini-implants: a multicenter 10-year follow-up. Clin Oral Investig 2021; 26:1963-1974. [PMID: 34564740 PMCID: PMC8816522 DOI: 10.1007/s00784-021-04176-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 09/01/2021] [Indexed: 11/28/2022]
Abstract
Objectives Implants are used to replace congenitally missing lateral incisors but often the space across the alveolar crest is too narrow to permit their use. This multicenter study (Dental Clinic of the University of Foggia, Odontostomatology Clinic of the University of L’Aquila) evaluated the efficacy of mini-implants in cases of maxillary lateral incisor agenesis with severe osseous atrophy in 10-year follow-up. Materials and methods Forty-seven mini-implants have been inserted in 35 patients affected by lateral incisors agenesis (23 single and 12 bilateral ageneses). All patients underwent orthodontic opening of the space of the upper lateral incisors. After the insertion of the implants, the immediate, non-functional loading, positioning of crowns, presence of pain during percussion and mini-implant function, horizontal and vertical movement when a force of 5 N was applied, ridge loss, and plaque index have been evaluated 1 month after loading, 1 year after loading, and then every 5 years in the following 10 years. Little’s test was used to evaluate the assumption that data of loss to follow-up implants are missing completely at random (MCAR) and that a complete-case scenario could be adopted. Wilcoxon test was carried out to look statistically significant differences between the various parameters resulting in the complete-case scenario and those assumed for the worst scenario. The software R (v. 3.6.1, 2019) was employed to perform the statistical analysis. Results The results obtained over 10 years range from 89% of success rate in a worst-case scenario to the 100% using a complete-case analysis with satisfactory values of marginal bone resorption and good conditions of the peri-implant tissue. Ten-year follow-up using complete-case analysis shows survival rates of 100% for implants with no signs of peri-implantitis, stability of the marginal bone levels and soft tissue around the dental implants. Conclusions The data collected show very good implant stability, absence of progressive peri-implantitis, and satisfactory aesthetical results in time (no signs of infraocclusion). Clinical relevance Mini-implants can be considered a valid and stable over time solution in the restorative treatment of maxillary lateral incisors agenesis.
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Affiliation(s)
- M Lacarbonara
- Department of Life, Health and Environmental Sciences, Dental Clinic, University of L'Aquila, L'Aquila, Italy
| | - A P Cazzolla
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - V Lacarbonara
- Interdisciplinary Department of Medicine, University of Bari, Bari, Italy
| | - L Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - D Ciavarella
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.
| | - N F Testa
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - V Crincoli
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari, Bari, Italy
| | - D Di Venere
- Interdisciplinary Department of Medicine, University of Bari, Bari, Italy
| | - A De Franco
- Interdisciplinary Department of Medicine, University of Bari, Bari, Italy
| | - D Tripodi
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
| | - F R Grassi
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari, Bari, Italy
| | - M Capogreco
- Department of Life, Health and Environmental Sciences, Dental Clinic, University of L'Aquila, L'Aquila, Italy
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20
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Beltrami F, Antonarakis GS, Kiliaridis S. Prevalence, distribution, and age at clinical detection of missing permanent incisors. Eur J Orthod 2021; 43:25-28. [PMID: 32006441 DOI: 10.1093/ejo/cjaa006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To determine the prevalence and distribution of clinically missing permanent incisors, and the age at which they are detected, in school-aged children. METHODS A total of 2573 children aged 4-13 underwent oral health screening on at least one occasion between 2001 and 2017. In order to define a threshold age, after which permanent incisor agenesis could be suspected clinically with reasonable certainty, children who had been seen for at least three consecutive years, with any clinically missing permanent incisor were selected (n = 19). The maximum age of detection among these children was chosen as the threshold age. Based on this, a total of 766 children at or above the threshold age were screened for a cross-sectional epidemiological survey. Chi-squared tests were used to compare the prevalence of clinically missing permanent incisors among boys and girls, comparing unilateral versus bilateral, and right- versus left-sided missing teeth. RESULTS Roughly 2% of the sample presented with at least one clinically missing maxillary lateral incisor. This was bilateral in half of cases. Clinically missing mandibular incisors were found in 0.5% of children. Finally, the threshold age for clinical suspicion of maxillary lateral incisor agenesis was set at 11.5 years. Agenesis was confirmed in all of the children attending a follow-up radiographic visit. CONCLUSIONS Approximately 1 in 50 children present with a clinically missing maxillary lateral incisor. The age at suspicion of maxillary lateral incisor agenesis can sometimes be several years after its expected eruption, perhaps due to significant variation in eruption times.
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Affiliation(s)
- Fara Beltrami
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, Switzerland
| | - Gregory S Antonarakis
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, Switzerland
| | - Stavros Kiliaridis
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, Switzerland
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21
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Ben Gassem A, Hashem D. Multidisciplinary management of congenitally missing lateral incisors: A minimally invasive approach. Clin Case Rep 2021; 9:e04521. [PMID: 34336211 PMCID: PMC8311912 DOI: 10.1002/ccr3.4521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 05/27/2021] [Accepted: 06/04/2021] [Indexed: 11/07/2022] Open
Abstract
The following case report demonstrates how a multidisciplinary team approach can be utilized successfully for the minimally invasive esthetic treatment of congenitally missing maxillary lateral incisors through space closure and canine re-anatomization.
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Affiliation(s)
- Afnan Ben Gassem
- Department of Pediatric Dentistry and OrthodonticsCollege of DentistryTaibah UniversityAlMadinah AlMunawwarahSaudi Arabia
| | - Danya Hashem
- Department of Restorative Dental ScienceCollege of DentistryTaibah UniversityAlMadinah AlMunawwaraSaudi Arabia
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22
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Naoum S, Allan Z, Yeap CK, Razza JM, Murray K, Turlach B, Goonewardene MS. Trends in orthodontic management strategies for patients with congenitally missing lateral incisors and premolars. Angle Orthod 2021; 91:477-483. [PMID: 33657211 DOI: 10.2319/092320-809.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 12/01/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To identify changes in orthodontic management strategies in patients with hypodontia seen in 2000, 2010, and 2017/2018 (during a 1-year period). MATERIALS AND METHODS An assessment of the panoramic radiographs of 3701 patients from a Western Australian private practice identified 276 individuals demonstrating hypodontia. The location of missing teeth, age, sex, type of malocclusion, and the management strategies (space closure or opening) for each patient were noted. RESULTS Most hypodontia involved agenesis of three or fewer teeth (90%). Maxillary lateral incisors and mandibular second premolars were the most commonly missing teeth. Female preponderance was noted. When considering treatment, the odds ratio for orthodontic space opening and prosthetic replacement in 2000 was 3.266 (P value = 7e-04; 95% confidence interval [CI], 1.464-4.633) compared with patients seen in 2010 and 1.632 (P value = 7e-04; 95% CI, 0.811-2.434) compared with patients in 2017/2018. For patients demonstrating bilateral absence of maxillary lateral incisors, the odds ratio for orthodontic space opening was 3.185 (P value = 0.0215; 95% CI, 1.182-9.243) compared with counterparts with unilateral agenesis. None of the factors investigated were significantly associated with the types of treatment planned/provided for the patients with missing mandibular second premolars. CONCLUSIONS Maxillary lateral incisors and mandibular second premolars were the most commonly missing teeth. A trend away from space opening and prosthetic replacement toward orthodontic space closure was observed from 2000 to 2017/2018. This may reflect a change in attitude toward prosthetic replacement options and/or greater optimism with biomechanical strategies since the implementation of temporary anchorage devices to assist in space closure.
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23
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Pithon MM, Vargas EOA, da Silva Coqueiro R, Lacerda-Santos R, Tanaka OM, Maia LC. Impact of oral-health-related quality of life and self-esteem on patients with missing maxillary lateral incisor after orthodontic space closure: a single-blinded, randomized, controlled trial. Eur J Orthod 2021; 43:208-214. [PMID: 33367539 DOI: 10.1093/ejo/cjaa075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND The maxillary lateral incisor is one of the teeth most likely to suffer agenesis, resulting in spacing between the central incisor and the canine. OBJECTIVE To compare maxillary lateral incisor agenesis with space closure treatment versus non-treatment based on measurements of the self-perceived oral-health-related quality of life (OHRQoL) and self-esteem of the participants. SUBJECTS AND METHODS A total of 44 people, aged 17-49 years, with missing lateral incisors were randomly assigned to two groups (n = 22 in each)-a treated group in which the space was orthodontically closed (TG) and a control group that remained untreated (CG). Randomization was performed by a researcher who was not involved in the clinical part of the study. The outcomes were assessed using the Oral Health Impact Profile and Rosenberg's Self-Esteem Scale, which were applied before (phase 1) and after (phase 2) the orthodontic treatment in the TG, and at baseline (phase 1) and 12 months after (phase 2) in the CG. All the data were blindly evaluated, supporting the single-blinded design of the study. RESULTS All participants finished the randomized controlled trial, and the demographic characteristics were similar between the groups. In phase 1, the levels of self-esteem and OHRQoL at baseline were similar (P = 0.079, P = 0.693, respectively). In phase 2, the self-esteem scores of the CG decreased and the OHRQoL increased (P = 0.005, P < 0.001, respectively), while self-esteem increased in the TG and the OHRQoL decreased (P < 0.001). The CG had lower scores than the TG for self-esteem, but the opposite was observed for OHRQoL (P < 0.001). LIMITATIONS Information bias may have occurred. Since the questionnaires could not have been applied at the same time in both groups, the time difference between the two assessments may have led to random and systematic error. CONCLUSIONS The spacing resulting from missing maxillary lateral incisors had a negative impact on the OHRQoL and self-esteem of the participants, while orthodontically closing those spaces had a positive impact on those aspects. CLINICAL TRIAL REGISTRATION This study was not registered. PROTOCOL The protocol was not published before trial commencement.
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Affiliation(s)
- Matheus Melo Pithon
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro-UFRJ, Rio de Janeiro, Brazil.,Department of Health I, Southwest Bahia State University, Jequié, Bahia, Brazil
| | - Eduardo Otero Amaral Vargas
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro-UFRJ, Rio de Janeiro, Brazil
| | - Raildo da Silva Coqueiro
- Department of Health I, Southwest Bahia State University, Jequié, Bahia, Brazil.,Center for Studies in Aging, Southwest Bahia State University, Jequiée, Bahia, Brazil
| | - Rogério Lacerda-Santos
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, Federal University of Juiz de For a-UFJF, Governador Valadares, Brazil
| | - Orlando Motohiro Tanaka
- Graduate Dentistry Program, School of Life Sciences, Orthodontics Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro-UFRJ, Rio de Janeiro, Brazil
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Liu C, Wong L, Hameed O, Pandis N, Seehra J. Predictors of treatment decisions made by adult orthodontic patients presenting with unerupted permanent teeth. Int Orthod 2020; 19:76-81. [PMID: 33248909 DOI: 10.1016/j.ortho.2020.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 10/28/2020] [Accepted: 10/30/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Unerupted permanent teeth are amongst the most commonly occurring dental anomalies in adults and present unique treatment challenges. The aim of this retrospective study was to (1) identify the prevalence of adult patients with unerupted teeth attending a multidisciplinary clinic and (2) to identify predictors (age, gender, incisor and skeletal classification) which influence the patients treatment decision. MATERIAL AND METHODS Consecutive adult patients with unerupted permanent teeth attending the Joint Orthodontic-Restorative clinic were identified. Study variables were collected using a prespecified data collection form. Descriptive statistics were employed; Fisher's exact test was used to detect associations between variables and treatment decision outcome. Ordinal logistic regression derived multinomial regression relative risk ratios (RRR) and 95% confidence intervals (CI) were calculated for the effect of age, gender, incisor and skeletal classification on treatment decision/outcome. RESULTS Sixty-six patients with impacted teeth were identified from a sample of 483. The prevalence of adults with unerupted teeth was 13.7%. The mean age was 30.7 years (SD 11.2). The majority of the sample had a Class I incisor relationship (54.6%) or Class I skeletal base relationship (54.6%), and the most common distribution of impacted teeth was a single unerupted upper right canine (34.9%). Orthodontic treatment (non-extraction or extraction basis incorporating the alignment or removal of impacted teeth) and restorative treatment only were equally favoured. Factors including age, gender, incisor and skeletal classification did not appear to influence or predict the final treatment decision. CONCLUSIONS In this sample, adults presenting with impacted teeth favoured certain treatment modalities: orthodontic treatment only and restorative treatment only. Factors such as age, gender, incisor and skeletal classification did not influence the outcome.
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Affiliation(s)
- Catherine Liu
- Queen's hospital, barking, havering and redbridge university hospitals trust, department of oral and maxillofacial surgery, RM7 0AG Romford, United Kingdom
| | - Lilia Wong
- Kings college hospital NHS Foundation Trust, King's college London, department of orthodontics, faculty of dentistry, oral and craniofacial sciences, Bessemer road, SE5 9RS London, United Kingdom
| | - Othman Hameed
- Kings college hospital NHS Foundation Trust, King's college London, department of orthodontics, faculty of dentistry, oral and craniofacial sciences, Bessemer road, SE5 9RS London, United Kingdom
| | - Nikolaos Pandis
- University of Bern, dental school/medical faculty, department of orthodontics and dentofacial orthopaedics, Bern, Switzerland
| | - Jadbinder Seehra
- Guy's hospital, Guy's and Saint-Thomas NHS Foundation Trust, King's college London, faculty of dentistry, oral and craniofacial sciences, department of orthodontics, floor 25, SE1 9RT London, United Kingdom.
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25
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Barros SE, Janson G, Chiqueto K, Lemanski M. Dissipating tooth-mass discrepancy caused by a set of mandibular incisor anomalies. Am J Orthod Dentofacial Orthop 2020; 158:738-751. [PMID: 32736850 DOI: 10.1016/j.ajodo.2019.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 06/01/2019] [Accepted: 06/01/2019] [Indexed: 10/23/2022]
Abstract
Dental anomalies are complicating factors of orthodontic treatment, especially when 1 or more anterior teeth are affected. In this case report, a girl, aged 12.5 years with a retrognathic chin; number, size, and position anomalies of the mandibular incisors; and bilateral Class I molar relationship sought orthodontic treatment. Tooth-size ratio discrepancy was dissipated without extraction or prosthetic rehabilitation, and the initial molar relationship was maintained, as well as the straight soft tissue profile. Tipping of maxillary and mandibular incisors, crown torque of canines, restoration of anomalous incisor, and maxillary interproximal enamel reduction were key points for successful treatment. After 18 months, the orthodontic records showed stable results, excellent static and functional occlusion, and good smile esthetics and facial appearance, in addition to a high degree of patient satisfaction with the achieved results.
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Affiliation(s)
- Sérgio Estelita Barros
- Department of Orthodontics, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Guilherme Janson
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil
| | - Kelly Chiqueto
- Department of Orthodontics, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Maitê Lemanski
- Department of Orthodontics, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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26
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Malgaj T, Plut A, Eberlinc A, Drevenšek M, Jevnikar P. Anterior Esthetic Rehabilitation of an Alveolar Cleft Using Novel Minimally Invasive Prosthodontic Techniques: A Case Report. Cleft Palate Craniofac J 2020; 58:912-918. [PMID: 33063533 DOI: 10.1177/1055665620964709] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Missing lateral incisors are the most frequent dental disorder associated with cleft alveolus. When orthodontic closure of the edentulous space is not possible, more aggressive prosthodontic treatments are required. Contemporary resin-bonded fixed dental prostheses (RBFDPs) represent a promising, time-efficient alternative treatment with fewer biological complications. This clinical report proposes a modified approach to the esthetic rehabilitation of a patient with a complete unilateral cleft lip and palate on the left side and an incomplete cleft lip and alveolar cleft on the right side. Digital diagnostics, treatment planning, and clinical procedures involved in the fabrication of facially bonded RBFDPs are presented. This modified technique enables the concurrent replacement of lateral incisors and correction of the malformed central incisors as well as increasing the retention of the restorations.
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Affiliation(s)
- Tine Malgaj
- Department of Prosthodontics, 37664Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Alja Plut
- Department of Orthodontics and Dentofacial Orthopaedics, 37667University Medical Centre Ljubljana, Slovenia
| | - Andreja Eberlinc
- Department of Maxillofacial and Oral Surgery, 37667University Medical Centre Ljubljana, Slovenia
| | - Martina Drevenšek
- Department of Orthodontics and Dentofacial Orthopaedics, 37667University Medical Centre Ljubljana, Slovenia.,Department of Orthodontics and Dentofacial Orthopaedics, 37664Faculty of Medicine, University of Ljubljana, Slovenia
| | - Peter Jevnikar
- Department of Prosthodontics, 37664Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.,Department of Prosthodontics, 37667University Medical Centre Ljubljana, Slovenia
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Rosa M. Missing teeth in the smile area: space closure in all malocclusions looking for long term health, esthetics and function. Semin Orthod 2020. [DOI: 10.1053/j.sodo.2020.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Vásquez-Cárdenas J, Zapata-Noreña Ó, Carvajal-Flórez Á, Barbosa-Liz DM, Giannakopoulos NN, Faggion CM. Systematic reviews in orthodontics: Impact of the PRISMA for Abstracts checklist on completeness of reporting. Am J Orthod Dentofacial Orthop 2019; 156:442-452.e12. [PMID: 31582116 DOI: 10.1016/j.ajodo.2019.05.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 05/01/2019] [Accepted: 05/01/2019] [Indexed: 12/13/2022]
Abstract
INTRODUCTION This study evaluated and compared the completeness of reporting of abstracts of orthodontics systematic reviews before and after the publication of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Abstracts Checklist (PRISMA-A). METHODS Abstracts of systematic reviews and meta-analyses in orthodontics published in PubMed, Latin American and Caribbean Health Sciences Literature, and the Cochrane Database of Systematic Reviews databases before March 23, 2018, that met the predefined inclusion and exclusion criteria, were evaluated using the 12 items of PRISMA-A, scoring each item from 0 to 2. Abstracts were classified into 2 groups: before and after publication of the PRISMA-A checklist. Three calibrated evaluators (intraclass correlation coefficient and kappa > 0.8) assessed the scores for compliance with the checklist. The number of authors, country of affiliation of the first author, performance of meta-analysis, and topic of the article were recorded. A regression analysis was performed to assess the associations between abstract characteristics and the PRISMA-A scores. RESULTS Of 1034 abstracts evaluated, 389 were included in the analysis. The mean PRISMA-A score was 53.39 (95% CI, 51.83-54.96). The overall score for studies published after the publication of the checklist was significantly higher than for studies published before (P ≤ 0.0001). The components returning significantly higher scores after publication of PRISMA-A were title (P = 0.024), information from databases (P = 0.026), risk of bias (P ≤ 0.0001), included studies (P ≤ 0.0001), synthesis of results (P ≤ 0.0001), interpretation of results (P = 0.035), financing and conflict of interest (P ≤ 0.0001), and registration (P ≤ 0.0001). These results showed the positive effect of PRISMA-A had on the quality of reporting of orthodontics systematic reviews. Nevertheless, the poor adherence revealed that there is still need for improvement in the quality of abstract reporting. CONCLUSIONS The quality of reporting of abstracts of orthodontic systematic reviews and meta-analyses increased after the introduction of PRISMA-A.
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Affiliation(s)
- Jenny Vásquez-Cárdenas
- Orthodontic Postgraduate Program, Gionorto Research Group, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - Óscar Zapata-Noreña
- Orthodontic Postgraduate Program, Gionorto Research Group, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - Álvaro Carvajal-Flórez
- Orthodontic Postgraduate Program, Gionorto Research Group, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - Diana María Barbosa-Liz
- Orthodontic Postgraduate Program, Gionorto Research Group, Faculty of Dentistry, University of Antioquia, Medellín, Colombia.
| | | | - Clovis Mariano Faggion
- Department of Periodontology and Operative Dentistry, Faculty of Dentistry, University of Münster, Münster, Germany
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Canine substitution of congenitally missing maxillary lateral incisors in Class I and Class III malocclusions by using skeletal anchorage. Am J Orthod Dentofacial Orthop 2019; 156:512-521.e6. [PMID: 31582123 DOI: 10.1016/j.ajodo.2018.10.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 10/01/2018] [Accepted: 10/01/2018] [Indexed: 11/22/2022]
Abstract
INTRODUCTION This prospective cohort study aimed to evaluate canine substitution supported by skeletal anchorage as a viable treatment protocol for patients with maxillary lateral incisor agenesis (MLIA) and skeletal Class I or Class III. METHODS Patients (n = 30) who met the following criteria were recruited: (1) bilateral MLIA or unilateral MLIA with a riziform contralateral incisor with a planned extraction; (2) skeletal Class I or Class III; and (3) dentoalveolar discrepancy in the mandible <5 mm. The archwire sequence routine was administered, combined with a rapid palatal expander, temporary intraoral skeletal anchorage device, and intermaxillary traction with Class III elastics. The results of the cephalometric analyses, peer assessment rating indexes, and the patient's smile self-evaluation using the visual analog scale were compared between initial and final treatments. RESULTS This study indicated that closing the space in patients with Class I or Class III malocclusion by using temporary intraoral skeletal anchorage devices in the mandible, along with Class III elastics, yielded satisfactory outcomes. Proper occlusion was established by mesialization of the maxillary teeth and correction of the intermaxillary discrepancy, thereby yielding beneficial and significant cephalometric changes after the treatment. The soft tissue profile was maintained when it was harmonious before the treatment and improved posttreatment in patients in whom the profile was initially inharmonious. All occlusions improved, as evidenced by the peer assessment rating index. Smile esthetics were also enhanced after orthodontic treatment for all patients. CONCLUSIONS Canine substitution may be safely offered to patients with Class I and Class III skeletal pattern and MLIA.
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Alshatti H, Chen PJ, Feldman JA, Upadhyay M, Yadav S. Mini-Implant-Assisted En Masse Protraction of Maxillary Posterior Segment. Turk J Orthod 2019; 32:182-189. [PMID: 31565695 DOI: 10.5152/turkjorthod.2019.18058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 10/09/2018] [Indexed: 11/22/2022]
Abstract
Protraction of posterior teeth to close the spaces in patients with congenitally missing maxillary lateral incisors is challenging. Mini-implants are a reliable source of anchorage for this purpose. This case report demonstrates the application of a T-bar protraction appliance with a palatal mini-implant for en masse protraction of posterior teeth into the lateral incisor space in an adolescent patient. The patient's occlusion and esthetics were significantly improved, and ideal overjet and overbite were obtained after 30 months of treatment. Follow-up records six months after the completion of the treatment displayed stable results.
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Affiliation(s)
- Hussain Alshatti
- Attending Orthodontist, Amiri Hospital, Ministry of Health, Kuwait
| | - Po-Jung Chen
- Division of Orthodontics, Department of Craniofacial Sciences, University of Connecticut School of Dentistry, Farmington, CT
| | - Jonathan A Feldman
- Division of Orthodontics, Department of Craniofacial Sciences, University of Connecticut School of Dentistry, Farmington, CT
| | - Madhur Upadhyay
- Division of Orthodontics, Department of Craniofacial Sciences, University of Connecticut School of Dentistry, Farmington, CT
| | - Sumit Yadav
- Division of Orthodontics, Department of Craniofacial Sciences, University of Connecticut School of Dentistry, Farmington, CT
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Harrison J. Management of patients with hypodontia: What has changed? J Orthod 2019; 46:60-64. [DOI: 10.1177/1465312519840043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This review will consider changes in clinical practice associated with the management of patients with missing teeth and briefly review the evidence base that underpins what we do for them.
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Affiliation(s)
- Jayne Harrison
- Consultant Orthodontist, Liverpool University Dental Hospital, Liverpool, UK
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Priest G. The treatment dilemma of missing maxillary lateral incisors‐Part I: Canine substitution and resin‐bonded fixed dental prostheses. J ESTHET RESTOR DENT 2019; 31:311-318. [DOI: 10.1111/jerd.12484] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 03/05/2019] [Accepted: 04/14/2019] [Indexed: 11/29/2022]
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Li R, Mei L, Wang P, He J, Meng Q, Zhong L, Zheng W, Li Y. Canine edge width and height affect dental esthetics in maxillary canine substitution treatment. Prog Orthod 2019; 20:16. [PMID: 30957211 PMCID: PMC6451936 DOI: 10.1186/s40510-019-0268-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 10/19/2018] [Indexed: 02/05/2023] Open
Abstract
Background To investigate the effect of canine edge width and height on dental esthetics in maxillary canine substitution treatment. Methods A total of 127 canine substitution treatment cases were screened and evaluated by a panel of orthodontic experts and laypersons in the pilot study. The top five subjects with the esthetically most pleasant canine substitution were included in the study, resulting in 140 computerized images displaying only the upper dentition, with different canine edge widths (0%, 12.5%, 25%, 37.5%, 50%, 62.5%, and 75% of the central clinical width) and heights (− 0.5 mm, 0 mm, 0.5 mm, and 1.0 mm vertically relative to the central incisor edge) finally used for the esthetic evaluation by 101 observers (41 orthodontists and 60 laypersons). The ordered logistic regression analysis, the univariate analysis of variance, the chi-square, and Fisher’s exact tests were used for statistical analyses. Results The most esthetic canine shape for canine substitution was found to be a shape with the edge width of 62.5% of the central incisor width and the edge height of 0.5 mm gingival to the central incisor edge (P < 0.05). The canine edge width of 50–75% and height of 0.5–0 mm gingival to the central incisor edge were generally considered to be esthetic by all observers. Orthodontists and laypersons had the same ranking on the top two most esthetic canine shapes (edge width and height 62.5% and 0.5 mm gingival; 50% and 0 mm incisal) as well as the bottom two most unesthetic canine shape (0% and 0.5 mm gingival; 75% and 1 mm incisal). Male and female observers generally had similar esthetic grades and rankings on the canine shapes (P > 0.05). Conclusions The most esthetic canine shape for canine substitution is a shape with the canine edge width of 62.5% of the central incisor width and the edge height of 0.5 mm gingival to the central incisor edge. The different collocations of the canine edge width and height affect dental esthetics of the canine during canine substitution treatment.
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Affiliation(s)
- Ruomei Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Orthodontics, Ninth People's Hospital, School of Stomatology, Shanghai key Laboratory of Stomatology, Shanghai Jiao Tong University, Shanghai, China
| | - Li Mei
- Discipline of Orthodontics, Department of Oral Sciences, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Pengfei Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jiarong He
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Qingyan Meng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Linna Zhong
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wei Zheng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No.14, South Renmin Road section 3, Chengdu, 610041, China.
| | - Yu Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Konstantonis D, Brenner R, Karamolegkou M, Vasileiou D. Torturous path of an elastic gap band: Interdisciplinary approach to orthodontic treatment for a young patient who lost both maxillary central incisors after do-it-yourself treatment. Am J Orthod Dentofacial Orthop 2018; 154:835-847. [PMID: 30477782 DOI: 10.1016/j.ajodo.2018.08.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 08/01/2018] [Accepted: 08/01/2018] [Indexed: 12/12/2022]
Abstract
Spacing between the maxillary anterior teeth is a common concern for young patients and their parents. Patients often consider a diastema to be an annoying but minor problem; they might consult their general dentists for help, or try to address the issue themselves by applying elastic "gap bands." Moreover, parents, without any informed consent, sometimes accept this erroneous method as an easy and inexpensive treatment approach. A 9-year-old boy had severe acute periodontitis involving the maxillary central incisors caused by the placement of an elastic band and its apical migration. Despite periodontal and surgical interventions, the maxillary central incisors were finally extracted, and the patient started orthodontic treatment. The orthodontic treatment plan included maxillary lateral incisor substitution to replace the lost central incisors and mesialization of the maxillary posterior dentition. An interdisciplinary approach with excellent cooperation among the orthodontist, general dentist, and other dental specialists obtained an esthetically pleasing and optimized functional result. Treating the diastema between the anterior teeth with elastic gap bands and without fixed orthodontic appliances should be avoided. Patients should seek proper orthodontic advice for even small-scale orthodontic problems to prevent catastrophic outcomes, as exhibited in this case report.
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Affiliation(s)
- Dimitrios Konstantonis
- Department of Orthodontics, National and Kapodistrian University of Athens, Athens, Greece; Clinic for Orthodontics and Paediatric Dentistry, Center of Dental Medicine, Faculty of Medicine, University of Zurich, Zurich, Switzerland.
| | - Ross Brenner
- Center for Advanced Dental Education, Department of Orthodontics, Saint Louis University, Saint Louis, Mo
| | - Marina Karamolegkou
- Department of Orthodontics, National and Kapodistrian University of Athens, Athens, Greece
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Thierens LAM, Verhoeven B, Temmerman L, De Pauw GAM. An esthetic evaluation of unilateral canine substitution for a missing maxillary lateral incisor. J ESTHET RESTOR DENT 2017; 29:442-449. [PMID: 28858425 DOI: 10.1111/jerd.12324] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of this study is to determine whether variation in size, morphology, and color of a unilateral substituted maxillary canine has influence on the dentogingival attractiveness perceived by dental professionals and laypeople. MATERIALS AND METHODS A frontal clinical photograph of a patient with unilateral canine substitution was used as standard picture. Five different series were created by modification of following parameters with a raster graphics editor (Photoshop CS 6): (1) width, (2) color, (3) gingival margin height, and (4) crown tip morphology of the substituted canine and (5) the gingival margin height of the neighboring first premolar. For each parameter, the photograph deviating the most from the standard photograph, was combined into a final series. Four groups of examiners (orthodontists, periodontists, dentists, and laypeople) were asked to rank the photographs from most to least attractive. RESULTS One hundred seventy-four examiners ranked the photographs in order of attractiveness. Overall, a darker canine color (mean rank 4.36 ± 1.03) and a more pronounced canine tip morphology (mean rank 3.47 ± 1.11) were significantly ranked as most unattractive (P < .05). The gingival height of the neighboring premolar was ranked as least unattractive by all groups of examiners (mean rank 1.30 ± 0.74). CONCLUSIONS Darker canine color and a pronounced tip morphology of a substituted canine are rated as the most unattractive by dental professionals and laypeople. CLINICAL SIGNIFICANCE The present study showed that the canine color and crown tip morphology are important parameters when considering unilateral canine substitution, both for professionals and laypeople. There is a general preference in favor of canines with a light color and a reduced incisal tip.
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Affiliation(s)
| | | | | | - Guy A M De Pauw
- Department of Orthodontics, Ghent University, Ghent, Belgium
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Annual review of selected scientific literature: Report of the committee on scientific investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2017; 118:281-346. [DOI: 10.1016/j.prosdent.2017.04.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 04/27/2017] [Accepted: 04/27/2017] [Indexed: 01/19/2023]
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