Semipermanent replacement of missing maxillary lateral incisors by mini-implant retained pontics: A follow-up study

FEM Analysis of Individualized Polymeric 3D Printed Guide for Orthodontic Mini-Implant Insertion as Temporary Crown Support in the Anterior Maxillary Area

Either due to trauma, extraction or congenital factors, the absence of teeth has aesthetic, functional, financial and psychological consequences. The aim of the current study is to assess an individualized polymeric 3D printed digitally planned surgical guide designed to achieve precision and predictability in non-standard mini-implant orthodontic cases. Twenty-seven patient records with missing anterior teeth were selected from the database of a private clinic in Timisoara, Romania. Based on the analysis of the cases included in the research, a surgical guide for the insertion of mini-implants as provisional crown support was designed. An FEM simulation was performed using the Abaqus numerical analysis software. Finite element simulation revealed the maximum displacements and stresses that occur in the surgical guide. Mini-implant supported provisional crowns can be a simple and low-cost method to increase patient self-esteem and compliance with the orthodontic treatment. Computer aided mechanical simulation is a useful tool in analyzing different polymeric surgical guide designs before being used in clinical situations in order to avoid failure.

Management of a prosthetic complication on an implant restoration placed when the patient was 10 years old: A case report

The use of dental implants in pediatric patients may create unique complications. A 38-year-old patient presented with a mobile, cement-retained implant crown due to an abutment screw loosening. The maxillary right central incisor implant was placed when the patient was 10 years old. Pus discharge from the peri-implant sulcus was observed. The mucosal margin of the implant was at the level of the mucogingival junction of neighboring teeth. Radiographically, the platform of the implant appeared to be at the level of the apical third of the adjacent roots. After removing the existing implant-retained crown, the inflamed peri-implant tissue covering the implant platform was removed and the stability of the implant was confirmed. A new screw-retained implant crown was made using an angulated screw channel to correct the labiopalatal angulation of the implant and allow for retrievability. Pink porcelain was used to match the mucosal margin of the implant crown to that of the maxillary left central incisor. This case report highlights the risk of implant placement in pediatric patients and agrees with previous reports that implants should be delayed until growth is complete.

Use of transcortical miniscrews for alveolar ridge preservation following tooth extraction: A pilot study

OBJECTIVES

The purpose of this split-mouth pilot study was to investigate the effects of a transcortical miniscrew placed over the buccal plate of an extraction socket for alveolar ridge preservation in humans.

METHODS

One week after the extraction of bilateral maxillary premolars, cone-beam computed tomography (CBCT) and intraoral digital imaging were performed (T0). A transcortical miniscrew was placed over the buccal plate of the extraction socket on one side (experiment), and the extraction socket on the contralateral side was left untreated (control). Follow-up CBCT and intraoral digital imaging were performed at 8 months immediately after miniscrew removal (T8). Changes in the width of the alveolar bone and ridge were measure by superimposing T0 and T8 of CBCTs and intraoral digital scans.

RESULTS

Six participants completed the study protocol. Overall, the experimental side with the miniscrew demonstrated less bone loss and less alveolar ridge reduction than the control side. Bone loss on the experimental side (0.7 ± 0.2 mm) was significantly less than that on the control side (1.3 ± 0.7 mm) at the apical level of the socket on axial CBCT imaging (Wilcoxon signed rank test, p = .031). The experimental side (-18 ± 8%) exhibited less reduction in the alveolar ridge width than the control side (-21 ± 12%) at the crestal level on coronal superimposition of the intraoral digital scans.

CONCLUSIONS

Transcortical miniscrew placement over the buccal plate of the extraction socket resulted in less resorption of the alveolar ridge and bone 8 months after tooth extraction.

CLINICAL TRIAL REGISTRATION

NCT03205800: Temporary Anchorage Devices for Ridge Preservation (TAD).

Association between hypodontia of permanent maxillary lateral incisors and other dental anomalies

Introduction:

Tooth agenesis is often associated with other tooth anomalies, such as microdontia, delayed eruption and ectopic eruption. Moreover, they may be found all in the same individual, as certain genetic mutations may have a variable phenotypic expression. Treatment of cases of hypodontia of anterior teeth should not involve only opening or closing space for prosthetic rehabilitation. Individuals with hypodontia of permanent maxillary lateral incisors may have teeth with a mesiodistal width smaller than that of patients with a normal dentition, and which may need reshaping to achieve an esthetic and functional occlusion.

Objective:

This clinical case report discusses the association of hypodontia of permanent maxillary lateral incisors with other tooth anomalies and their treatment alternatives.

The Maryland bridge retainer: A modification of a Maryland bridge

Preservation of the maxillary lateral incisor space after orthodontic treatment in an adolescent patient traditionally requires the use of a retainer with a lateral pontic, commonly referred to as a "flipper," which is minimally effective in the long term. This article illustrates a technique for chairside fabrication of a Maryland bridge retainer for semi-permanent retention. A stainless steel braided palatal wire is bonded to the anterior teeth. A pontic is then built intraorally with flowable composite, using the palatal wire as scaffolding. The retainer is maintained until the patient is of age for a more permanent restoration.

Development of a calcified odontogenic hamartoma following avulsion of a permanent central incisor

The avulsion of a permanent immature tooth is a serious condition and a real emergency in dentistry. The management of a traumatized avulsed tooth is always a challenge to the clinician. This case report concerns the development of a calcified odontogenic hamartoma after the avulsion of an immature central incisor in an eight-year-old female. The patient presented for the treatment four months after the avulsion. Her intraoral examination showed complete healing of the area but an atypical appearance of the alveolar area of the missing tooth was observed in the periapical radiograph. A new radiographic scan performed six months later revealed the formation of a radiopaque irregular structure at the cervical level of the alveolar ridge at the site of the missing tooth. Surgical removal was performed, and the histopathological examination revealed a hamartomatous proliferation of odontogenic tissue with calcification. After healing, the lateral incisor was orthodontically moved mesially and restored to resemble the central incisor. An orthodontic device was installed to improve function and aesthetics of the patient.

Can forces be applied directly to the root for correction of a palatally displaced central incisor with a dilacerated root?

This case report describes the interdisciplinary treatment of an ectopic horizontally placed maxillary right central incisor with severe root dilaceration. The root was distally angulated and entrapped by the root of the maxillary right lateral incisor. The initial force system was aimed at an occlusal displacement and applied to the crown. During the second phase, a button was cemented onto the apex of the impacted tooth. A force from the apex to a temporary anchorage device in the palate moved the root toward the midline. Finally, a root canal and an apectomy were performed and the central incisor could be moved to its ideal position. The treatment generated a normal height of the alveolar bone and an ideal occlusion with a healthy periodontium.

Semi-permanent Substitution of Maxillary Anterior Teeth: TADs Supported Approach

The present paper describes a technique for intermittent replacement of missing anterior edentulous spans which in simple, logical, less time consuming and cost-effective. The objective was to incorporate a rigid framework as a long edentulous span had to be replaced, along with miniscrews at two different angulations, thus restricting the effect of perioral and masticatory forces in an effective manner