Pre-prosthetic orthodontics

Interdisciplinary treatment of mutilated dentition and transverse maxillary deficiency with microimplant-assisted rapid palatal expansion, microimplants, and dental implants

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.

Impact of Bone-Grafting Materials on the Rate of Orthodontic Tooth Movement: A Systematic Review

Orthodontists may encounter patients with alveolar bony defects, which are often treated with various bone-grafting materials. The effects of different bone-grafting materials on orthodontic tooth movement (OTM) are of concern to orthodontists. Therefore, we aimed to evaluate the current status of the literature that reports on the effects of different bone-grafting materials on OTM in terms of the rate and side effects. An electronic search of the PubMed and Scopus databases and Google Scholar was performed. Two reviewers independently conducted the screening process using COVIDENCE™, and a third reviewer resolved any conflicts. SYRCLE's (Systematic Review Centre for Laboratory Animal Experimentation's) risk-of-bias tool for animal studies was utilized to assess the quality of the included studies. Out of 457 initial titles, 11 studies were finally included for data extraction. All of the included studies were animal experiments, and none of them were considered to have a low risk of bias. The included studies had varied results. However, a general tendency existed, whereby OTM in surgically treated areas with no bone grafting presented the highest OTM rate. In cases where a bone graft was used, xenografts revealed the highest OTM rate, followed by alloplasts. Lastly, the use of allografts resulted in the slowest OTM rates. The most common side effect was root resorption. In conclusion, there is a lack of high-quality evidence regarding the effects of bone-grafting materials on OTM rate. Due to the lack of human subjects, RCTs, and the heterogeneity of subjects in the current literature, the impact of bone-grafting materials on OTM deserves further investigations using more rigorous scientific methodologies.

Preorthodontic functional long-term trial restoration of a worn dentition for optimizing outcomes: A clinical report

Orthodontic tooth movement is often required before restorative treatment to maximize the esthetic and functional outcomes. Diagnostic waxing is a crucial step before active treatment to validate the optimal tooth position for future restorations. In this clinical report, a bonded prototype of the diagnostic waxing was used to guide and facilitate orthodontic treatment with the definitive restorations mind. The orthodontic treatment created the required space between the teeth for the ceramic restorations, improved dental and facial features, and restored appropriate incisal guidance.

Smile Design: Mechanical Considerations

Smile designing refers to the cosmetic and esthetic dental reconstruction that is visible during smiling. The use of modern digital tools requires adequate knowledge about the tooth shape and shade principles. Mechanical, biological, and psychological factors should be understood and tailor an individualized treatment accordingly to achieve pleasing esthetic outcomes. Dental therapy is becoming more appearance-driven, and thus, both patients and dental clinicians mainly emphasize on cosmetic dental and facial aspects of treatments.

The effect of orthodontic extrusion on alveolar bone - a prospective clinical study

Introduction/Objective. Orthodontic extrusion is the procedure for moving the teeth in a vertical, coronal direction. This movement induces changes in the periodontal ligament and the production of new alveolar bone. The objective of the study was to determine the changes on buccal, palatal and interdental alveolar bone as a result of orthodontic extrusion. Methods. Experimental group included 6 patients who received orthodontic treatment with the fixed appliances; the control group included 4 patients without orthodontic treatment. Two cone-beam computed tomography scans (initial and final) were obtained for each patient in both groups. Length of a tooth, shortest distance from tooth?s center of resistance to the referent plane, distance from buccal or palatal plate tip to the enamel-cement junction, the height of interdental septum, buccal and palatal plate vertical gain, buccal and palatal plate thicknesses were measured on initial and final scan in the experimental and control group. Results. The reduced length of the extruded tooth was observed in the experimental group. The distance from buccal and palatal plate tip to the enamel-cement junction, mesial interproximal bone septum and buccal plate gain significantly increased in the experimental group. No significant difference was found in the distal interproximal bone septum, palatal plate gain and buccal/palatal plate thickness between groups. Conclusion. Orthodontic extrusion affects alveolar bone level by gaining the hard tissue buccal and mesial of extruded teeth, while buccal and palatal plate thickness insignificantly changed.