Orthodontic treatment of severe anterior open bite and alveolar bone defect complicated by an ankylosed maxillary central incisor: a case report

Orthodontic alignment of ankylosed teeth with aid of surgical luxation: Case series

BACKGROUND

Identification of tooth ankylosis before comprehensive orthodontic treatment can be challenging. This case series illustrates different presentations of tooth ankylosis, the importance of early diagnosis, the use of surgical luxation to aid orthodontic alignment of ankylosed teeth and its sequelae.

CASE PRESENTATION

All three cases were adolescents: a 14-year-old girl with a highly placed upper left lateral incisor and history of general anaesthesia; a 14-year-old boy with an impacted upper right first premolar and history of dental trauma; and a 13-year-old girl with an infraoccluded upper left central incisor with history of replantation due to avulsion. Iatrogenic malocclusion developed from attempts to align these ankylosed teeth. Subsequently, surgical luxation was performed, and the ankylosed teeth were successfully aligned. However, it was associated with pulp calcification, root resorption and recurrence of ankylosis.

CONCLUSION

Surgical luxation and orthodontic alignment of ankylosed teeth can be considered a useful short-term solution to delay the need of surgical removal and teeth replacement.

Camouflage Correction of Skeletal Class III Severe Open Bite with Tooth Ankylosis Treated by Temporary Anchorage Devices: A Case Report

Tooth ankylosis is a disorder characterized by the fusion of tooth and alveolar bone. This case report describes the treatment of a severe open bite due to tooth ankylosis. A 14-year-old female patient with a chief complaint of masticatory dysfunction was diagnosed with skeletal Class III severe anterior open bite and tooth ankylosis. She visited our university hospital with a chief complaint of an anterior open bite. After the surgical luxation of the ankylosed maxillary right central incisor, the tooth was orthodontically retracted using a nickel-titanium wire. The right mandibular lateral incisor and canine were luxated and retracted using intermaxillary elastics from a temporary anchorage device (TAD), which was inserted in the opposite jaw. During the treatment, skeletal Class III malocclusion deteriorated due to anterior growth of the mandible. Therefore, TADs were inserted into the retromolar pad on both sides of the mandible and retracted into the mandibular dental arch. Although the mandibular right canine was luxated several times, it could not be brought to the occlusal line, and was thus extracted; the extraction space was replaced with a prosthesis. Consequently, a normal overjet and overbite with a straight profile were achieved. Extrusion of ankylosed teeth by intermaxillary elastics from a TAD is a valid treatment option for patients with severe open bites.

Electroactive barium titanate coated titanium scaffold improves osteogenesis and osseointegration with low-intensity pulsed ultrasound for large segmental bone defects

For large segmental bone defects, porous titanium scaffolds have some advantages, however, they lack electrical activity which hinders their further use. In this study, a barium titanate (BaTiO3) piezoelectric ceramic was used to modify the surface of a porous Ti6Al4V scaffold (pTi), which was characterized by scanning electron microscopy, energy dispersive spectroscopy, X-ray photoelectron spectroscopy, and roughness and water contact angle analyses. Low intensity pulsed ultrasound (LIPUS) was applied in vitro and in vivo study. The activity of bone marrow mesenchymal stem cells, including adhesion, proliferation, and gene expression, was significantly superior in the BaTiO3/pTi, pTi + LIPUS, and BaTiO3/pTi + LIPUS groups than in the pTi group. The activity was also higher in the BaTiO3/pTi + LIPUS group than in the BaTiO3/pTi and pTi + LIPUS groups. Additionally, micro-computed tomography, the mineral apposition rate, histomorphology, and the peak pull-out load showed that these scaffold conditions significantly enhanced osteogenesis and osseointegration 6 and 12 weeks after implantation in large segmental bone defects in the radius of rabbits compared with those resulting from the pTi condition. Consequently, the improved osteogenesis and osseointegration make the BaTiO3/pTi + LIPUS a promising method to promote bone regeneration in large segmental bone defects for clinical application.

Lower incisor extraction therapy in a complex case with an ankylosed tooth in an adult patient: A case report

This case report describes a successful orthodontic therapy of an adult female treated by mandibular central incisor extraction and vestibular fixed appliances. The patient presented a skeletal Class I with normodivergent facial pattern, Class II subdivision dental relationship, extremely deep Curve of Spee and severe overbite. Moreover, during the treatment, the upper left first molar does not respond to orthodontic forces due to tooth ankylosis, augmenting the difficulty of this case. Despite this, a good occlusal relationship on both sites and an optimal extraoral outcome have been achieved after a 26-months therapy. To our knowledge no case report with such entity of Curve of Spee with contemporary tooth ankylosis has been presented.