Treatment of a Class II Division 1 malocclusion with macrodontia of the maxillary central incisors

Management of Fused Anterior Teeth: Review and Clinical Report

The phenomenon of fusion is a type of tooth dysplasia, but few studies have systematically described the treatment of this kind of abnormality. This paper summarizes the treatment methods for fused teeth and classifies the management schemes according to whether the pulp is fused. Then, the treatment for a patient with bilateral anterior tooth fusion is reported. After orthodontic treatment, porcelain veneers were used to restore the normal shape and aesthetic appearance of the anterior teeth. This article is protected by copyright. All rights reserved.

The Management of the Dilacerated Impacted Maxillary Central Incisor

The clinical problem of how best to manage a dilacerated, impacted maxillary central incisor will only be encountered rarely. The treatment aim should be to achieve results that are indistinguishable from normal appearance in a way that is appropriate for the patient. This article discusses the incidence of dilacerations in maxillary incisors and describes the treatment approaches available − orthodontic alignment or surgical removal and management of the resulting space, considering orthodontic repositioning, autotransplantation and various prosthetic replacements. Treatment indications, advantages and disadvantages, restorative and surgical implications, as well as the evidence-base relating to the various treatment modalities will be presented, along with clinical case examples. Clinical relevance: This paper discusses a problem that, if not managed appropriately, can lead to poor results for the patient. Even for practitioners who may not undertake the treatment mentioned, it will enable them to have more in-depth discussion with their patients should the situation arise.

Conservative Management of Macrodontia in the Mixed Dentition Stage--A Case Report

Macrodontia is a rare dental abnormality, which can cause cosmetic concerns. Various management techniques for this condition have been documented in the literature. This case describes the initial management of macrodontia in the mixed dentition stage with the use of a minimally invasive approach to treatment. CPD/Clinical Relevance: The importance of early referral of dental abnormities is highlighted. Short- and long-term treatment options for macrodontia are described, including the impact such anomalies can have on the developing dentition.

[Early orthodontic treatment of children with dentofacial anomalies in the mixed dentition with the use of fixed appliances]

The article summarizes the authors experience in the treatment of patients with dentofacial anomalies in mixed dentition with fixed orthodontic appliances ("system 2×4") and combined treatment type with the use of extraoral device. Indications and contraindications, advantages and disadvantages, special conditions of the treatment, the mechanism of a face-bow action with extraoral traction, the sequence of events during the treatment are described in the article. Clinical cases of early treatment with "system 2×4" and in combination with the face-bow and extraoral traction demonstrate the effectiveness of the methods.

Macrodontic maxillary incisor in alagille syndrome

This case report describes the surgical-orthodontic guided-eruption of a deeply impacted macrodontic maxillary central incisor in a 10-year-old patient with Alagille syndrome (ALGS). In the first stage, orthodontic treatment with fixed appliance on deciduous teeth allowed to create enough space for the eruption of the maxillary right central incisor. The second stage included closed surgical exposure and vertical traction. After impacted tooth erupted in the proper position, accessory periodontal treatment and dental reshaping procedures may be indicated to camouflage macrodontic incisor with the adjacent teeth. This is the first report that presents a patient with ALGS undergoing orthodontic and surgical treatment.

Macrodont management

Macrodontia is an uncommon dental anomaly that can present in both primary and permanent dentition. It has often been reported to occur concomitantly with other dental anomalies and has also been an established clinical characteristic of numerous systemic conditions and syndromes. The following case reports illustrate the challenges of managing macrodont teeth in view of the various treatment options available, as well as the multiple factors that tend to influence each case individually.

CLINICAL RELEVANCE

This article highlights the importance of early referral and a multidisciplinary approach to treating patients with dental anomalies.

Management of 'double teeth' in children and adolescents

BACKGROUND

Abnormally, large teeth are often referred to as 'double teeth'. These can pose numerous challenges for the clinician. There is no published protocol on the management of double teeth.

AIM

To review the published literature and also patients managed at the Eastman Dental Hospital (EDH) and to develop a clinical protocol for the management of double teeth in children and adolescents.

DESIGN

Literature was searched (Medline and Embase) and data collated. Patient notes of cases managed at the EDH were reviewed.

RESULTS

Eighty-one teeth from 53 papers and 22 patients were included in the review. Success criteria were only reported in 32 papers and were variable. Twenty-three papers had no follow-up period. The main factor in determining the management of a double tooth was root and root canal system morphology. The treatment of choice in teeth with separate roots was hemisection and in those with a single root was crown modification or extraction.

CONCLUSION

It was not possible to determine the best management strategies because of the variable reporting in the literature. The authors have proposed a protocol for management and a data collection sheet for essential information needed when reporting on double teeth cases.

2 '2' 1: Orthodontic repositioning of lateral incisors into central incisors

The clinical problem of how best to manage an anterior space resulting from a missing central incisor will only be encountered rarely. The goal should be to deliver treatment results that are indistinguishable from normal appearance. This article describes one treatment approach - orthodontic space closure with substitution of the maxillary central incisor by the lateral incisor. Treatment indications, orthodontic and restorative considerations, advantages and disadvantages, as well as the evidence base relating to this treatment modality will be presented and supported by two clinical case examples.