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Cai J, Chen S, Chen L, Yang X, Dai X, Dai Z, Xu L. Digital-assisted diagnosis and orthodontic management of an impacted mandibular lateral incisor: a case report. BMC Oral Health 2024; 24:1210. [PMID: 39396952 PMCID: PMC11479465 DOI: 10.1186/s12903-024-04902-6] [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: 04/06/2024] [Accepted: 09/12/2024] [Indexed: 10/15/2024] Open
Abstract
BACKGROUND The impaction of mandibular lateral incisors presents significant aesthetic and functional challenges in orthodontics, including Bolton ratio discrepancies and anterior occlusal anomalies. The increasing preference for nonextraction treatment further complicates space management within the dental arch. However, the advent of digital-assisted orthodontic technologies, particularly advanced digital simulations, has revolutionized the precision and effectiveness of diagnosis and treatment planning. These technologies enable clinicians to strategically leverage natural jaw development and create the necessary space for the alignment of impacted teeth without resorting to extraction. CASE PRESENTATION This case report details the treatment of a 12-year-old male with an impacted mandibular lateral incisor, which resulted in both aesthetic concerns and functional impairments, alongside Class II malocclusion. By employing a digital-assisted diagnostic approach, including comprehensive digital simulations, we meticulously evaluated the feasibility of a nonextraction treatment plan. The strategy centred on harnessing the patient's mandibular growth potential to expand the available space naturally. The treatment involved surgical exposure of the impacted tooth, followed by precise orthodontic traction guided by continuous digital monitoring. The integration of digital tools throughout the treatment process was crucial in achieving successful eruption and alignment of the impacted tooth, thus restoring optimal aesthetics and function without the need for extraction. CONCLUSION This case highlights the transformative impact of digital-assisted technologies in the management of complex orthodontic cases, such as impacted mandibular lateral incisors. The successful integration of these advanced tools with a nonextraction treatment approach underscores their potential to significantly enhance clinical outcomes. Digital technologies not only improve the accuracy and effectiveness of treatment but also facilitate a multidisciplinary approach that elevates the standard of patient care in addressing complex orthodontic challenges.
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Affiliation(s)
- Jingwen Cai
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, Jiaotong Road No 88, Fuzhou City, Fujian Province, People's Republic of China
- Orthodontics Department, School and Hospital of Stomatology, Fujian Medical University, Yangqiao Zhong Road No 246, Fuzhou City, Fujian Province, People's Republic of China
| | - Sihang Chen
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, Jiaotong Road No 88, Fuzhou City, Fujian Province, People's Republic of China
- Orthodontics Department, School and Hospital of Stomatology, Fujian Medical University, Yangqiao Zhong Road No 246, Fuzhou City, Fujian Province, People's Republic of China
| | - Linxin Chen
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, Jiaotong Road No 88, Fuzhou City, Fujian Province, People's Republic of China
- Orthodontics Department, School and Hospital of Stomatology, Fujian Medical University, Yangqiao Zhong Road No 246, Fuzhou City, Fujian Province, People's Republic of China
| | - Xinhan Yang
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, Jiaotong Road No 88, Fuzhou City, Fujian Province, People's Republic of China
- Orthodontics Department, School and Hospital of Stomatology, Fujian Medical University, Yangqiao Zhong Road No 246, Fuzhou City, Fujian Province, People's Republic of China
| | - Xiran Dai
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, Jiaotong Road No 88, Fuzhou City, Fujian Province, People's Republic of China
- Orthodontics Department, School and Hospital of Stomatology, Fujian Medical University, Yangqiao Zhong Road No 246, Fuzhou City, Fujian Province, People's Republic of China
| | - Zhenzhen Dai
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, Jiaotong Road No 88, Fuzhou City, Fujian Province, People's Republic of China
- Orthodontics Department, School and Hospital of Stomatology, Fujian Medical University, Yangqiao Zhong Road No 246, Fuzhou City, Fujian Province, People's Republic of China
| | - Linyu Xu
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, Jiaotong Road No 88, Fuzhou City, Fujian Province, People's Republic of China.
- Orthodontics Department, School and Hospital of Stomatology, Fujian Medical University, Yangqiao Zhong Road No 246, Fuzhou City, Fujian Province, People's Republic of China.
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Alhasyimi AA, Indra P, Setijanto RD, Tajudin AM, Noviasari P, Rosanto YB. Open surgical exposure of two horizontally impacted maxillary incisors combined with orthodontic treatment: A case report. Int J Surg Case Rep 2024; 118:109620. [PMID: 38615467 PMCID: PMC11033169 DOI: 10.1016/j.ijscr.2024.109620] [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: 02/27/2024] [Revised: 03/30/2024] [Accepted: 04/03/2024] [Indexed: 04/16/2024] Open
Abstract
INTRODUCTION Maxillary anterior teeth that have not erupted may substantially alter the appearance of the teeth and face. Orthodontists often encounter a clinical challenge while dealing with an impacted maxillary incisor, which creates space problems in the anterior region. The purpose of this paper is to describe the well-synchronized orthodontic and surgical treatment of a horizontally impacted maxillary central incisors. CASE PRESENTATION A male patient, aged 27, presented with a complaint of unerupted two maxillary front teeth. This resulted in the displacement of adjacent teeth into the vacant region. An intraoral examination revealed a Class II molars on both sides, a deep curve of the space with a 2.3 mm overjet, and an edge-to-edge bite of 0.1 mm. The 3D cone beam computed tomography (CBCT) imaging unveiled a labial impacted and a rotation of approximately 90 degrees (horizontal impacted) on both central maxillary incisors. DISCUSSION The self-ligating bracket was installed and orthodontic traction aligned the affected tooth in the dental arch. To reach the labial surface of the impacted incisor, open surgical exposure by window excision of soft tissues with a laser was preferable due to the large bulge in the sulcus. Because self-ligating bracket systems employed modest pressures to position the maxillary right central incisor in the arch, the window surgical technique did not produce gingival scarring or increased clinical crown length. CONCLUSION The impacted upper central incisor was successfully treated using a collaborative interdisciplinary (surgical-orthodontic) approach, which resulted in a favorable aesthetic and functional outcome.
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Affiliation(s)
- Ananto Ali Alhasyimi
- Department of Orthodontics, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia.
| | - Putu Indra
- Orthodontist, Smile Cloud Clinic, Indonesia
| | - R Darmawan Setijanto
- Department of Dental Public Health, Faculty of Dental Medicine, Universitas Airlangga, Indonesia
| | | | - Paramita Noviasari
- Department of Orthodontics, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Yosaphat Bayu Rosanto
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universitas Gadjah Mada, Indonesia
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Pendem S, Bharadwaj S, Selvarasu K, Sridharan G, Krishnan M, Mr M. A comprehensive classification for impacted cuspids and bicuspids with a proposal for Difficulty Index Categorization: a single center evaluation of 4165 cases. Minerva Dent Oral Sci 2024; 73:81-87. [PMID: 36786682 DOI: 10.23736/s2724-6329.22.04757-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
BACKGROUND The aim of the current study was to propose a classification of impacted cuspids, and bicuspids based on their spatial position in the maxillary and mandibular arches and their radiological appearance. METHODS This prospective study was conducted including all the patients who reported to our center for extractions, orthodontic treatment, missing permanent cuspids/bicuspids, removal of third molar teeth. All patients who reported within a time frame of 6 months were enrolled in the study. Orthopantomogram was advised for all the patients as a part of diagnostic work up. The panoramic radiographs and clinical data were reviewed and patients with evidence of impacted bicuspids and cuspids were included in the study and were advised to undergo a cone beam computed tomography to evaluate the 3-dimensional position of the impacted teeth. Treatment plan was decided based on the position of the impacted teeth and feasibility for orthodontic movement. Standard surgical protocol was followed for all the patients. The duration of the procedure from the time of incision till the suturing were tabulated and the difficulty of extraction was correlated with the current Difficulty Index to validate the same. RESULTS A total number of 4165 patients were enrolled in the study and based on the inclusion and exclusion criteria, 3680 patients were excluded and 487 patients with impacted cuspids/bicuspids were included in the study. A total number of 231 patients had impacted maxillary cuspids and bicuspids and 256 cases had impacted mandibular cuspids/bicuspids. Amongst the 256 mandibular cuspid and bicuspid that were impacted, 62% were in position C while the rest of 38% were in position B. More than ⅓ of the teeth which were in position C had transmigrated (35%). Seventy-three percent of the maxillary teeth were in position C and 69% of these teeth were either transmigrated (29%), or were horizontally (38%) placed in the alveolus or inverted (2%). The rest of the 31% were found to be either mesially inclined or vertical. The average Difficulty Index for maxillary teeth was 8 and mandibular teeth was 9. Mandibular cuspids and bicuspids in position B and C took longer time for surgical removal compared to the maxillary teeth and this was statistically significant. CONCLUSIONS The proposed clinical classification on impacted mandibular cuspids and bicuspids provides a structured approach to plan the treatment based on the 3-dimensional position of the teeth in the arch.
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Affiliation(s)
- Sneha Pendem
- Saveetha Dental College, Department of Oral and Maxillofacial Surgery, Chennai, India -
| | - Srishty Bharadwaj
- Saveetha Dental College, Department of Oral and Maxillofacial Surgery, Chennai, India
| | - Kathiravan Selvarasu
- Saveetha Dental College, Department of Oral and Maxillofacial Surgery, Chennai, India
| | - Geetha Sridharan
- Saveetha Dental College, Department of Oral and Maxillofacial Surgery, Chennai, India
| | - Murugesan Krishnan
- Saveetha Dental College, Department of Oral and Maxillofacial Surgery, Chennai, India
| | - Muthusekhar Mr
- Saveetha Dental College, Department of Oral and Maxillofacial Surgery, Chennai, India
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Attogbain KP, Daniel A, Patrice G, Vazoumana K, Sylvie NAK. Treatment approaches of the retention of the 2nd molar by the germ of the mandibular wisdom tooth. ORAL AND MAXILLOFACIAL SURGERY CASES 2022. [DOI: 10.1016/j.omsc.2022.100285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Frequency and Local Etiological Factors of Impaction of Permanent Teeth among 1400 Patients in a Greek Population. Dent J (Basel) 2022; 10:dj10080150. [PMID: 36005248 PMCID: PMC9406841 DOI: 10.3390/dj10080150] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 07/25/2022] [Accepted: 08/09/2022] [Indexed: 11/19/2022] Open
Abstract
Background: The purpose of this study is to analyze the frequency of impaction of permanent teeth, beyond the third molars, and to highlight the factors causing this condition. Methods: Panoramic radiographs of 1400 patients that sought orthodontic treatment in private practice were retrieved and examined. All teeth that had not been erupted at the time of the examination while their root formation was completed were considered impacted. Results: In total, 212 out of 1400 patients had at least one impacted tooth (15.14%). The highest incidence of tooth impaction was in the canines of the maxilla, followed by the central incisors of the maxilla, the second molars of the mandible and the second premolars of the mandible. The most common etiological factors responsible for the impaction were the ectopic eruption pathway, loss of space in the arch, the ankylosis of the deciduous teeth and the presence of supernumerary teeth. Conclusions: Tooth impaction is frequently seen in everyday orthodontic practice. The upper canines are the teeth most frequently associated with impaction and failure of eruption. It is important to diagnose cases of impaction early on and identify the etiological factors in order to achieve immediate and effective treatment per patient.
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Mandibular Molar Uprighting Using Skeletal Anchorage: A Novel Approach. J Clin Med 2022; 11:jcm11133565. [PMID: 35806851 PMCID: PMC9267505 DOI: 10.3390/jcm11133565] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 02/05/2023] Open
Abstract
Background: The management of eruption anomalies affecting second molars, although quite uncommon, may represent a real challenge for the clinician. The aim of this study is to present a novel technique that combines the surgical and orthodontic approach in order to obtain the retrieval of impacted second molars through a complex distalizing movement and skeletal anchorage. Methods: Nineteen consecutive patients with impacted second molars were treated according to this technique, which involved extraction of the third molar followed by the placement of a distally positioned screw, and the subsequent use of a coil spring to connect the screw to an eyelet directly bonded on the second molar. In selected cases, it proved to be necessary to reposition the second molar through traditional orthodontics. All of the parameters were recorded: the time required for completing the treatment, the initial angle between the second molar and the adjacent tooth, and treatment related-complications. Results: Twenty impacted second molars were correctly repositioned. The mean initial angle of the second molar was 55.7° (SD 22.6°, min 13.3°, max 104.8°). The mean treatment time was 10 months. There were no major complications. Conclusions: Given that periodontal tissues were minimally affected, the temporary anchorage device was fully controlled, and there was no unwanted movement of adjacent teeth, the presented technique not only proved effective but also minimally invasive.
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Lana Mattiello FD, Deon Rizzatto SM, Macedo de Menezes L, Araújo EA, Kim KB, Martinelli de Lima E. Dimensional and morphologic characteristics of unilateral impacted maxillary central incisors. Am J Orthod Dentofacial Orthop 2022; 162:340-347. [PMID: 35568599 DOI: 10.1016/j.ajodo.2021.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 03/01/2021] [Accepted: 03/01/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION This cross-sectional study aimed to investigate the crown and root characteristics of impacted central incisors compared with spontaneously erupted contralateral incisors and the influence of etiologic and local factors on their dimensions. METHODS Forty-five patients (22 boys, 23 girls) who underwent orthodontic treatment for unilateral impaction of maxillary central incisors were referred for cone-beam imaging. Dimensions of the impacted and contralateral incisors were assessed using Dolphin 3D software (Dolphin Imaging & Management Solutions, Chatsworth, Calif). Paired t test and linear regression were used to compare the characteristics of the impacted and contralateral teeth. RESULTS Contralateral and impacted central incisors showed statistically significant differences for root length (95% confidence interval [CI], 2.32-3.46; P <0.001), mesiodistal crown-root angulation (95% CI, 4.09-15.95; P = 0.001), and labiolingual crown-root angulation (95% CI, -18.69 to -4.70; P = 0.002). Etiologic factors did not alter the dimensions of incisors (95% CI, -1.17 to 0.76; P = 0.672). According to the multiple linear regression the independent variables associated with root length of contralateral and impacted incisors were sex (β = -0.904; 95% CI, -1.62 to - 0.19; P = 0.014) and the presence of impaction (β = -2.87; 95% CI, -3.67 to -2.07; P <0.001). CONCLUSIONS Regardless of their etiology, the impacted incisors showed roots that were 2.89 mm shorter than the contralateral incisors and had greater angulation in the mesiodistal and labiolingual directions. Girls showed a reduction of 0.904 mm (7.6%) on the lengths of roots of both impacted and contralateral central incisors. The presence of impaction led to a reduction of 25% in incisor root lengths. Approximately 30% of the impacted teeth showed crown-root angulations >20° resulting in an increased distal and labial angulation of the root apical portion.
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Affiliation(s)
- Fabiano Dalla Lana Mattiello
- Department of Orthodontics, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Susana Maria Deon Rizzatto
- Department of Orthodontics, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Luciane Macedo de Menezes
- Department of Orthodontics, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Eustáquio Afonso Araújo
- Department of Orthodontics, School of Dentistry, Saint Louis University, St Louis, Mo, Brazil
| | - Kim Beom Kim
- Department of Orthodontics, School of Dentistry, Saint Louis University, St Louis, Mo, Brazil
| | - Eduardo Martinelli de Lima
- Department of Orthodontics, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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Meade MJ, Dreyer CW. Eruption disturbances in the mixed dentition: orthodontic considerations for primary dental care. Aust Dent J 2022; 67 Suppl 1:S14-S23. [PMID: 35916055 DOI: 10.1111/adj.12931] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2022] [Indexed: 01/07/2023]
Abstract
The primary dental care clinician is in a prime position to identify deviations from normal dental development. Disturbances can affect any new erupting tooth. The objective of this narrative review is to describe several situations in which eruption disturbances can arise during the mixed dentition. It will provide an overview of the orthodontic considerations of these disturbances in addition to key summary points on interceptive management, based on the best available evidence.
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Affiliation(s)
- M J Meade
- Orthodontic Unit, Adelaide Dental School, The University of Adelaide, South Australia, Australia
| | - C W Dreyer
- Orthodontic Unit, Adelaide Dental School, The University of Adelaide, South Australia, Australia
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Selvido DI, Wongsirichat N, Arirachakaran P, Rokaya D, Wongsirichat N. Surgical Management of Impacted Lower Second Molars: A Comprehensive Review. Eur J Dent 2022; 16:465-477. [PMID: 35016240 PMCID: PMC9507580 DOI: 10.1055/s-0041-1739443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Impacted lower second molars (ILM2) are rarely reported in the literature, but various studies have been done for its treatment. Apart from solely orthodontic approaches, different surgical management techniques were reported to have successful outcomes. Surgical intervention of ILM2 can help expose the tooth for further orthodontic purposes, simplifying complex treatment methods, and reducing treatment time. This review illustrates the comprehensive evaluation and updated methods of surgical uprighting, repositioning, and transplantation of ILM2 with future directions for better understanding and treatment planning in the clinical setting. The successful outcome of surgical intervention depends on case selection, root development of ILM2, careful surgical manipulation, and adherence to sound biological principles.
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Affiliation(s)
- Diane Isabel Selvido
- Clinical Science Department, International College of Dentistry, Walailak University, Bangkok, Thailand
| | - Nattharin Wongsirichat
- Department of Preventive Dentistry, Division of Orthodontics, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Pratanporn Arirachakaran
- Clinical Science Department, International College of Dentistry, Walailak University, Bangkok, Thailand
| | - Dinesh Rokaya
- Clinical Science Department, International College of Dentistry, Walailak University, Bangkok, Thailand
| | - Natthamet Wongsirichat
- Clinical Science Department, International College of Dentistry, Walailak University, Bangkok, Thailand
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Parihar A, Singh S, Chaturvedi T, Shukla N. A case series of orthodontic traction of maxillary impacted canine. Natl J Maxillofac Surg 2022; 13:147-152. [PMID: 35911814 PMCID: PMC9326190 DOI: 10.4103/njms.njms_235_20] [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: 10/24/2020] [Revised: 01/29/2021] [Accepted: 04/08/2021] [Indexed: 11/26/2022] Open
Abstract
Impacted maxillary canine is frequently encountered in clinical practice. Being the cornerstone of the dentition, orthodontic traction of impacted canine is always desirable in order to achieve successful functional occlusion. The aim of this case series is to illustrate different methods employed for orthodontic traction of maxillary impacted canine.
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The Correlation between Impacted Third Molar and Blood Group. Int J Dent 2021; 2021:2775913. [PMID: 34777499 PMCID: PMC8589526 DOI: 10.1155/2021/2775913] [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: 06/18/2021] [Revised: 09/24/2021] [Accepted: 10/19/2021] [Indexed: 12/03/2022] Open
Abstract
Background Blood type is among the most important genetical characteristics of any individual and is shown to be correlated with the development of a variety of illnesses including dental diseases. Finding the association of ABO and Rh blood groups and impacted tooth is important in order to predict which population is more vulnerable to grow impacted third molars that could lead to making better intervention. The present investigation tried to take a small step in that regard, by evaluating the correlation between ABO and Rh blood groups and the most commonly impacted tooth, bony impacted third molars among Iranian individuals. Methods The investigation was done retrospectively on patients who were referred to the Department of Oral Radiology, Shiraz University of Medical Science, Shiraz, Iran. The patients were classified according to their blood groups, and 40 patients were randomly selected for each blood type. Therefore, the impaction of their third molars was evaluated, and statistical analyses were done in order to find any association. Results A total of 320 participants contributed to the study; 136 (42%) were males and 184 (57%) were females. The mean age was 29 ± 6 years. Among all participants, 205 (64%) had no impacted third molar, 26 (8%) had one impacted third molar, 43 (13%) had 2 impacted third molars, 5 (1%) had 3 impacted third molars, and 41 (12%) had 4 impacted molars. Conclusion According to the results of the present study, nearly one out of three individuals has at least an impacted third molar in the Iranian population, being more prevalent in individuals between 20 and 30 years old. The evaluation of the relationship between the blood group and impacted third molar revealed that blood groups have no association with the impacted third molars. However, more studies with higher and diversified participants should be done to find comprehensive results.
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Sangha TK, Sangha SK, Hanna B, Tayab T, Padala S. Surgical uprighting of impacted mandibular second molar: a narrative review. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2021. [DOI: 10.1051/mbcb/2020058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Early diagnosis of impacted mandibular second molar (MM2) is critical since treatment at a later stage can be complicated. It often requires a multidisciplinary approach. Surgical uprighting of impacted MM2 appears to be a safe, effective, and a reliable alternative to conventional orthodontic mechanics with minimal risk of morbidity or pulpo-periodontal problems. Timely diagnosis is critical and factors affecting treatment outcomes must be assessed for a successful outcome. Although surgical uprighting or repositioning is the most commonly prescribed option for MM2 management, there isn't a review of literature that discusses the etiology, assessment, and surgical management of impacted MM2 with an emphasis on surgical uprighting technique and comparing various factors that affect the outcome.
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Wong ASM, Virk JS, Magarey MJR. Endoscopic removal of ectopic dentition in ethmoid sinus. BMJ Case Rep 2021; 14:14/2/e237858. [PMID: 33619132 PMCID: PMC7903100 DOI: 10.1136/bcr-2020-237858] [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: 11/04/2022] Open
Abstract
A 66-year-old woman presented with a 6-month history of unilateral right nasal obstruction and rhinorrhoea not responding to medical therapy. She had a history of dental implantation for an unerupted tooth on the right side 3 years ago. Physical examination including flexible nasendoscopy demonstrated yellow debris in the right middle meatus. CT paranasal sinuses demonstrated a radiopaque lesion in the right anterior ethmoid sinus and resembled the unerupted tooth. The tooth was removed endoscopically from the right nasal cavity without complications. This case highlights the importance of eliciting an accurate dental history and considering ectopic dentition as a differential diagnosis in a patient with unilateral symptoms of sinusitis.
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Affiliation(s)
- Amy SM Wong
- Otolaryngology, Epworth Healthcare Richmond, Melbourne, Victoria, Australia,Otolaryngology, Northern Health, Melbourne, VIC, Australia
| | - Jagdeep S Virk
- Head and Neck, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Matthew J R Magarey
- Otolaryngology, Epworth Healthcare Richmond, Melbourne, Victoria, Australia,Head and Neck, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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Tamer İ, Öztaş E, Marşan G. Up-to-Date Approach in the Treatment of Impacted Mandibular Molars: A Literature Review. Turk J Orthod 2020; 33:183-191. [PMID: 32974065 DOI: 10.5152/turkjorthod.2020.19059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 11/10/2019] [Indexed: 11/22/2022]
Abstract
Eruption problems in the mandibular molars are rare, but they have to be diagnosed and treated early. Treatment of impacted molars is challenging due to a limited access and complexity of the mechanics that needs to be applied. Methods for managing impacted or tilted mandibular molars include orthodontic repositioning, surgical uprighting, and extraction with or without transplantation of the third molar into the extraction site. This review highlights the methods and clinical procedures of surgical and orthodontic uprighting procedures of mandibular molars with different degrees and levels of impaction. It further discusses the use of the ramus screw as a temporary anchorage device in the uprighting of horizontally impacted mandibular molars.
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Affiliation(s)
- İpek Tamer
- Department of Orthodontics, İstanbul University İstanbul School of Dentistry, İstanbul, Turkey
| | - Evren Öztaş
- Department of Orthodontics, İstanbul University İstanbul School of Dentistry, İstanbul, Turkey
| | - Gülnaz Marşan
- Department of Orthodontics, İstanbul University İstanbul School of Dentistry, İstanbul, Turkey
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Rédua RB, Nascimento DD, Minchio ES, Dos Santos LS. Interception and early treatment with rapid maxillary expansion for the impacted maxillary permanent central incisor in children: Two cases report with 5-years follow-up. Int Orthod 2020; 18:603-623. [PMID: 32493625 DOI: 10.1016/j.ortho.2020.04.007] [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: 04/14/2020] [Revised: 04/27/2020] [Accepted: 04/30/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The maxillary central incisor impaction represents a complex challenge in paediatric dentistry practice and may result in aesthetic and functional disharmony. The causes of this condition include physical barriers associated or not with a lack of space making eruption not possible, idiopathic ectopic positioning of the teeth or by trauma, non-coordination in rhizalysis and rhizogenesis between deciduous and successor or tooth shape abnormalities. The incidence of this involvement is quite rare, around 1% of the population. Opening of space through disjunction of the palatal suture is the main treatment proposed to solve this situation and, when necessary, the orthodontic traction assisted by surgery. DESCRIPTION Were presented two cases of maxillary central incisors impaction in children treated with rapid maxillary expansion, alignment and levelling, and a follow-up after 5 years of treatment. RESULTS AND CONCLUSIONS The challenge of these treatments were based on the early treatment in mixed dentition with expansion. The treatment of permanent maxillary central incisor impaction in children enabled excellent periodontal response and post-treatment occlusal stability.
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Ismail MQ, Lauridsen E, Andreasen JO, Hermann NV. Ectopic eruption of the second premolar: an analysis of four different treatment approaches. Eur Arch Paediatr Dent 2020; 21:119-127. [PMID: 31190243 DOI: 10.1007/s40368-019-00459-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 06/04/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Ectopic second premolars may lead to impaction and loss of space in the jaws, and in rare cases even to resorption of the first permanent molar. The aim of this study was to analyse different treatment strategies of ectopic second premolars and if possible give guidelines on when to favour different treatment approaches. MATERIALS AND METHODS The study was a retrospective, non-randomised, outcome analysis of treatment on 41 ectopic second premolars in 37 patients (24 females and 13 males). In all cases oral examination, radiographs (pre-, peri-, and post) and full medical history were obtained. The treatment options included: (a) spontaneous eruption, (b) spontaneous eruption + extraction of primary tooth, (c) surgical exposure, (d) surgical uprighting, and (e) surgical uprighting + orthodontic extrusion. For evaluation each tooth was scored according to: (1) stage of root development, (2) distance between edges of the premolar and first permanent molar, (3) depth of impaction, (4) inclination, (5) horizontal position of the tooth. The level of significance was set to 5%. RESULTS Only mild cases of ectopic second premolars are self-correcting. Based on the position of the tooth in the jaw different treatment options may be chosen, these may include: extraction of primary predecessor (impaction depth < 5 mm, inclination < 55°), surgical exposure of tooth germ (impaction depth < 5.5 mm, inclination < 95°) or surgical uprighting (impaction depth > 5.5 mm with no inclination limit). CONCLUSION If there is no sign of self-correction after a short observation period, it is important to consider active treatment to help guiding the tooth into the correct eruption pathway.
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Affiliation(s)
- M Q Ismail
- Department of Pediatric Dentistry and Clinical Genetics, School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Nørre Allé 20, 2200, Copenhagen N, Denmark
| | - E Lauridsen
- Resource Centre for Rare Oral Diseases, Copenhagen University Hospital Rigshospitalet, Inge Lehmanns Vej 7, 2100, Copenhagen Ø, Denmark
| | - J O Andreasen
- Resource Centre for Rare Oral Diseases, Copenhagen University Hospital Rigshospitalet, Inge Lehmanns Vej 7, 2100, Copenhagen Ø, Denmark
| | - N V Hermann
- Department of Pediatric Dentistry and Clinical Genetics, School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Nørre Allé 20, 2200, Copenhagen N, Denmark.
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Al-Jasser R, Al-Jewair T, Al-Rasheed A. One-year rotational relapse frequency following conventional circumferential supracrestal fiberotomy. World J Clin Cases 2020; 8:284-293. [PMID: 32047776 PMCID: PMC7000953 DOI: 10.12998/wjcc.v8.i2.284] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 12/17/2019] [Accepted: 12/21/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Relapse following orthodontic treatment has been a common problem that can occur due to several factors. It was suggested that surgical circumferential supracrestal fiberotomy (CSF) is an effective measure to reduce this relapse. However, very few studies have reported the amount of relapse that occurs afterward. AIM To assess the frequency of rotational relapse on anterior teeth 1 year following CSF. METHODS Eleven adults (six male and five female) with a mean age of 23 years (standard deviation = 5.2), who had a total of 90 rotated anterior teeth, were included in this study. CSF was performed after comprehensive orthodontic treatment involving the use of full-fixed preadjusted edgewise appliances (Victory Series APC, 3M, United States) with a 0.022-inch slot and Roth prescription brackets (Ovation; DENTSPLY GAC, Bohemia, New York, United States) and placement of a fixed lingual retainer from canine to canine in both arches using a 0.016 Australian wire (AJ Wilcock, Australia). Degrees of rotational correction and relapse were measured on three sets of casts [pretreatment, post-treatment (at the debond visit), and 1-year post-treatment]. Rotational relapse was categorized as follows: Unnoticeable relapse (0°), barely noticeable relapse (1°-3°), noticeable relapse (4°-9°), and clearly noticeable relapse (≥ 10°). The percent relapse that had occurred 1 year after teeth were aligned to their ideal position was calculated. Data were analyzed by dental arch type and tooth types. RESULTS Mean rotational correction was 14.05° during posttreatment. Mean relapse at 1-year follow-up was 1.1° (10.8%). More than half (n = 52, 57.8%) of teeth were categorized as having unnoticeable relapse (0°). Of the remaining teeth, 31 (34.5%) had barely noticeable relapse (1°-3°), 6 (6.6%) had noticeable relapse (4°-9°), and only one (1.1%) had clearly noticeable relapse (> 10°). When analyzed by arch, 54.5% (n = 6) of the relapsed maxillary teeth had barely noticeable relapse (1°-3°). While most of the mandibular teeth (3, 37.5%) fell into noticeable relapse category (4°-9°), only 1 (12.5%) tooth had clearly noticeable relapse (≥ 10°). CONCLUSION When relapse was measured following CSF, it was found to be more pronounced in maxillary than in mandibular arch. Most frequent relapse was found in maxillary lateral incisors and mandibular canines.
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Affiliation(s)
- Reham Al-Jasser
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Thikriat Al-Jewair
- Graduate Program Director in Orthodontics, School of Dental Medicine, State University of New York, Buffalo, NY 14214, United States
| | - Abdulaziz Al-Rasheed
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
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18
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Plakwicz P, Abramczyk J, Wojtaszek-Lis J, Sajkowska J, Warych B, Gawron K, Burzykowski T, Zadurska M, Czochrowska EM, Wojtowicz A, Górska R, Kukuła K. The retrospective study of 93 patients with transmigration of mandibular canine and a comparative analysis with a control group. Eur J Orthod 2019; 41:390-396. [PMID: 30295778 PMCID: PMC6686080 DOI: 10.1093/ejo/cjy067] [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] [Indexed: 12/04/2022]
Abstract
Objectives The aim of this study was to evaluate characteristics of patients with unilateral transmigration of a mandibular canine in the largest study group presented until now. Materials and methods The study group consisted of 93 patients with unilateral transmigration of mandibular canine; the control group included 85 non-affected patients. Type of transmigration, status of deciduous and permanent canines, prevalence of missing teeth, class of occlusion, and space conditions were assessed to draw comparisons between groups. Results In this study, 64.5 per cent patients presented type 1 of transmigration; types 2, 3, 4, and 5 were present in, respectively, 23.7, 5.4, 4.3, and 2.1 per cent patients. There was a clear, statistically significant difference (P < 0.0001) between the mean crown and apex migration and angulation for the three groups of canines (transmigrated, contralateral, and control), whereas no differences were observed for the total number of permanent teeth present. In the study group, 73.1 per cent patients retained their primary canine on the affected side and 18.3 per cent on the contralateral side; in the control group, 22.3 per cent subjects had at least one primary canine. There was a statistically significant difference in the distribution of types of malocclusion between the study and the control groups. Conclusions Transmigration of mandibular canine was associated with the presence of retained primary canine on the affected side, higher mesial tilting of contralateral mandibular canine when compared to the canines in the control group. Additionally, higher prevalence of Angle’s Class I occlusion in patients with canine transmigration was recorded.
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Affiliation(s)
- Paweł Plakwicz
- Department of Periodontology, Medical University of Warsaw, Warsaw
| | - Joanna Abramczyk
- Department of Orthodontics, Medical University of Warsaw, Warsaw
| | | | | | | | - Katarzyna Gawron
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
| | - Tomasz Burzykowski
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics (I-BioStat), Hasselt University, Belgium.,Department of Statistics and Medical Informatics, Faculty of Health Sciences, Medical University of Bialystok, Poland
| | | | | | | | - Renata Górska
- Department of Periodontology, Medical University of Warsaw, Warsaw
| | - Krzysztof Kukuła
- Department of Oral Surgery, Medical University of Warsaw, Poland
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19
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Kalabalık F, Tarım Ertaş E. Investigation of maxillary sinus volume relationships with nasal septal deviation, concha bullosa, and impacted or missing teeth using cone-beam computed tomography. Oral Radiol 2018; 35:287-295. [PMID: 30484216 DOI: 10.1007/s11282-018-0360-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 10/23/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVES The aim of this retrospective study was to investigate the correlations of maxillary sinus volume with nasal septal deviation, concha bullosa, impacted teeth, and missing teeth in the maxillary posterior region on maxillary sinus volume using cone-beam computed tomography (CBCT) images. METHODS The study cohort comprised 252 CBCT images of 252 patients retrospectively selected from the records in our CBCT archive. All CBCT images were exported to 3D modeling software for calculation of maxillary sinus volumes. Nasal septal deviation cases were grouped as mild, moderate, and severe. Concha bullosa was classified as lamellar, bulbous, and extensive. Maxillary sinus volume differences were evaluated by comparing the bilateral sinus volumes in patients with nasal septal deviation, unilateral concha bullosa, and unilateral impacted or missing maxillary posterior teeth. RESULTS The findings revealed that males had a significantly higher mean sinus volume than females (p < 0.01) and that sinus volume tended to decrease with age (p < 0.05). In moderate and severe nasal septal deviation cases, the maxillary sinus volume was significantly smaller on the same side as the deviation than on the contralateral side (p < 0.05). There were no significant correlations between maxillary sinus volume and concha bullosa, unilateral impacted teeth, or unilateral missing teeth (p > 0.05). CONCLUSIONS The present findings suggest that maxillary sinus volume is smaller on the same side as the deviation in moderate and severe septal deviation cases and that the maxillary sinus volume tends to decrease with increasing age.
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Affiliation(s)
- Fahrettin Kalabalık
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Izmir Katip Celebi University, Aydinlik Evler Mahallesi, Cemil Meric Caddesi, 6780 Sokak No: 48, 35640, Cigli, Izmir, Turkey.
| | - Elif Tarım Ertaş
- Dentistanbul Dental Hospital, Yildiz Caddesi No: 71, Besiktas, Istanbul, Turkey
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20
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Decompression for Unerupted Primary Mandibular Second Molars Associated with Physical Barriers: Case Reports. J Clin Pediatr Dent 2018; 42:150-154. [PMID: 29087801 DOI: 10.17796/1053-4628-42.2.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Primary impaction of primary teeth might be due to genetic predisposition or physical disturbance including odontoma, supernumerary tooth, and crowded tooth. Among them, calcific deposit or odontoma is commonly associated with primary dentition. Early diagnosis and treatment is the key to prevent complications. However, results of treatment may vary depending on the condition of unerupted tooth. Here we report two clinical cases of unerupted primary mandibular second molars with physical barriers such as compound odontoma and calcific deposit focusing on diagnostic means and the importance of early treatment of these lesions.
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21
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Hasanuddin S, Reddy ER. Erupted odontome associated with a primary molar: A unique clinical presentation, 4-year follow-up. J Oral Maxillofac Pathol 2017; 21:322. [PMID: 28932056 PMCID: PMC5596697 DOI: 10.4103/jomfp.jomfp_230_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Erupted odontomas occur very rarely in both the primary and permanent dentitions. The present case report discusses an unusual erupted odontome associated with a primary first mandibular molar. A 7-year-old female patient with an erupted odontome in the oral cavity was reported. The surgical extraction of odontome was performed under local anesthesia to allow eruption of underlying premolar tooth. After 4 years of follow-up, the first premolar had erupted with an unusual occlusal morphology, similar to that of a primary first molar. Orthopantomogram revealed no supplemental/supernumerary teeth in the vicinity of the erupted tooth. Early evaluation, precise diagnosis of odontogenic lesions interfering with erupting teeth, especially in the first decade of life is essential for prevention of malocclusion in young children. Erupted permanent successor should be differentiated from a primary first molar to avoid unnecessary extraction.
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Affiliation(s)
- Shaik Hasanuddin
- Department of Pedodontics and Preventive Dentistry, Government Dental College and Hospital, Hyderabad, Telangana, India
| | - E Rajendra Reddy
- Department of Pedodontics and Preventive Dentistry, Kamineni Institute of Dental Sciences, Nalgonda, Telangana, India
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22
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Padwa BL, Dang RR, Resnick CM. Surgical Uprighting Is a Successful Procedure for Management of Impacted Mandibular Second Molars. J Oral Maxillofac Surg 2017; 75:1581-1590. [DOI: 10.1016/j.joms.2017.02.027] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 01/28/2017] [Accepted: 02/21/2017] [Indexed: 11/16/2022]
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23
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Late-Developing Supernumerary Premolars: Analysis of Different Therapeutic Approaches. Case Rep Dent 2016; 2016:2020489. [PMID: 27761271 PMCID: PMC5059562 DOI: 10.1155/2016/2020489] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Accepted: 08/03/2016] [Indexed: 12/16/2022] Open
Abstract
This case series describes the different potential approaches to late-developing supernumerary premolars (LDSP). LDSP are supernumerary teeth (ST) formed after the eruption of the permanent dentition; usually they develop in the premolar region of the upper and lower jaw. The choice to extract or to monitor the LDSP depends on many factors and has to be carefully planned due to the several risks that either the monitoring or the extraction could provoke. These four cases of LDSP showed different treatment plan alternatives derived from a scrupulous assessment of the clinical and radiographic information.
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Shetty K, Kumar M, Amanna S, Sridharan S, Reddy S. Management of a rare case of idiopathic multiple unerupted impacted permanent teeth in an adult female patient. J Indian Prosthodont Soc 2016; 16:303-6. [PMID: 27621553 PMCID: PMC5000573 DOI: 10.4103/0972-4052.161572] [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] [Indexed: 11/18/2022] Open
Abstract
This clinical case report describes the multi-disciplinary approach in the management of an unusual presentation of idiopathic multiple unerupted impacted permanent teeth in a 20-year-old female patient. The case was unique in that, not only were there multiple missing permanent teeth, but also over retained deciduous teeth and attrited existing permanent teeth with loss of vertical dimension of occlusion. Since the patient was young, it was decided to retain all the erupted permanent teeth and extract the infected deciduous teeth with the objective of fabricating overlay complete dentures. This is a simple, reversible and an economical treatment modality, which satisfies both the esthetic and functional demands where the extraction of teeth is not generally indicated and, in addition, provides a stable occlusion.
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Affiliation(s)
- Karunakar Shetty
- Department of Prosthodontics, Bangalore Institute of Dental Sciences and Postgraduate Research Centre, Bengaluru, Karnataka, India
| | - Mahesh Kumar
- Department of Prosthodontics, Bangalore Institute of Dental Sciences and Postgraduate Research Centre, Bengaluru, Karnataka, India
| | - Susan Amanna
- Department of Prosthodontics, Bangalore Institute of Dental Sciences and Postgraduate Research Centre, Bengaluru, Karnataka, India
| | - Srirangarajan Sridharan
- Department of Periodontics, Bangalore Institute of Dental Sciences and Postgraduate Research Centre, Bengaluru, Karnataka, India
| | - Satyanarayan Reddy
- Department of Conservative Dentistry and Endodontics, Bangalore Institute of Dental Sciences and Postgraduate Research Centre, Bengaluru, Karnataka, India
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25
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Rescue therapy with orthodontic traction to manage severely impacted mandibular second molars and to restore an alveolar bone defect. Am J Orthod Dentofacial Orthop 2016; 150:352-63. [DOI: 10.1016/j.ajodo.2015.09.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 09/01/2015] [Accepted: 09/01/2015] [Indexed: 11/23/2022]
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26
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Dinoi MT, Marchetti E, Garagiola U, Caruso S, Mummolo S, Marzo G. Orthodontic treatment of an unerupted mandibular canine tooth in a patient with mixed dentition: a case report. J Med Case Rep 2016; 10:170. [PMID: 27286815 PMCID: PMC4902959 DOI: 10.1186/s13256-016-0923-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 05/03/2016] [Indexed: 12/02/2022] Open
Abstract
Background The aim of this case report was to describe the surgical–orthodontic treatment of an unerupted mandibular canine tooth in a 9-year-old girl. Case presentation A 9-year-old white girl presented with an unerupted right mandibular canine tooth. Combined surgical–orthodontic treatment was performed to correct dental impaction and to achieve good aesthetic and functional results. Conclusion Orthodontic treatment achieved all of the required objectives.
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Affiliation(s)
- Maria Teresa Dinoi
- Department MeSVA, School of Dentistry, University of L'Aquila, L'Aquila, Italy.
| | - Enrico Marchetti
- Department MeSVA, School of Dentistry, University of L'Aquila, L'Aquila, Italy
| | - Umberto Garagiola
- Biomedical Surgical and Dental Sciences Department, University of Milan, Milan, Italy
| | - Silvia Caruso
- Department MeSVA, School of Dentistry, University of L'Aquila, L'Aquila, Italy
| | - Stefano Mummolo
- Department MeSVA, School of Dentistry, University of L'Aquila, L'Aquila, Italy
| | - Giuseppe Marzo
- Department MeSVA, School of Dentistry, University of L'Aquila, L'Aquila, Italy
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Bhatia SK, Goyal A, Gauba K, Acharya S. Unusual root development following surgical repositioning of horizontally developing central incisor. Dent Traumatol 2015; 31:413-7. [PMID: 26040300 DOI: 10.1111/edt.12182] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2015] [Indexed: 12/17/2022]
Abstract
Dilaceration is one of the causes of maxillary central incisor eruption failure. If the dilacerated maxillary permanent central incisor is in a horizontal or vertical position and root formation is in early stages, surgical repositioning is frequently the treatment of choice. In this article, the case of a horizontally impacted and dilacerated maxillary central incisor is presented which was treated by surgical repositioning. The tooth developed an unusual form of the root with discontinuity at the middle third region with the coronal and apical parts growing separately. Radiographic and clinical monitoring of the case was regularly performed. The tooth completely erupted in 2 years after the repositioning and even after 6 years of surgery is currently successfully functional in the arch with the malformed root. This article highlights the ability of Hertwig's epithelial root sheath to withstand trauma and its ability to recover.
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Affiliation(s)
- Sarabjot Kaur Bhatia
- Department of Pediatric and Preventive Dentistry, Oral Health Sciences Center, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ashima Goyal
- Department of Pediatric and Preventive Dentistry, Oral Health Sciences Center, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Krishan Gauba
- Department of Pediatric and Preventive Dentistry, Oral Health Sciences Center, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Shivesh Acharya
- Department of Pediatric and Preventive Dentistry, Bhojia Dental College & Hospital, Baddi, Himachal Pradesh, India
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Kim SJ, Kim JW, Choi TH, Lee KJ. Restoration of a vertical alveolar bone defect by orthodontic relocation of a mesially impacted mandibular first molar. Am J Orthod Dentofacial Orthop 2015; 147:S122-32. [PMID: 25836343 DOI: 10.1016/j.ajodo.2014.04.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Revised: 04/01/2014] [Accepted: 04/01/2014] [Indexed: 11/16/2022]
Abstract
An impacted mandibular first molar tends to cause serious bone defects of the adjacent teeth. When choosing between the 2 typical treatment options-extraction or orthodontic relocation of the impacted tooth-the decision should be based on assessment of the prognosis. A 22-year-old man with severe mesioangulation and impaction of the mandibular first molar and a related vertical bone defect on the distal side of the second premolar was treated with extraction of the second molar and orthodontic relocation of the first molar with a retromolar miniscrew. Comprehensive orthodontic treatment involving premolar extraction was conducted. Strategic extraction of the molar and adequate orthodontic movement helped to restore the bone structure on the affected side. This case report suggests the effectiveness of restoration of bone defects by using viable periodontal tissues around the impacted tooth for the longevity of the periodontium.
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Affiliation(s)
- Sung-Jin Kim
- Lecturer, Department of Orthodontics, School of Dentistry, Yonsei University, Seoul, South Korea
| | - Jin-Wook Kim
- Postgraduate student, Department of Orthodontics, School of Dentistry, Yonsei University, Seoul, South Korea
| | - Tae-Hyun Choi
- Lecturer, Department of Orthodontics, School of Dentistry, Yonsei University, Seoul, South Korea
| | - Kee-Joon Lee
- Professor, Department of Orthodontics, School of Dentistry, Yonsei University, Seoul, South Korea.
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29
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Khan S. Orthosurgical Management of Odontome-Associated Maxillary Central Incisor Impaction. ACTA ACUST UNITED AC 2014. [DOI: 10.15406/jdhodt.2015.02.00034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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30
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Manjunatha BS, Chikkaramaiah S, Panja P, Koratagere N. Impacted maxillary second premolars: a report of four cases. BMJ Case Rep 2014. [PMID: 25320255 DOI: 10.1136/bcr-2014-205206.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Impacted teeth are commonly encountered in clinical practice. Apart from their symptomatic nature and the probable functional disruption they can cause, impacted teeth have the potential to cause more severe and serious problems such as development of dentigerous cysts and other complications due to their proximity to the nasal and oral cavity. In this report, we highlight a series of four cases involving maxillary second premolars, teeth that are not often impacted.
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Affiliation(s)
| | | | - Pritam Panja
- Basic Dental Sciences, College of Dentistry, University of Taif, Al-Hawaiah, Taif Kingdom of Saudi Arabia
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31
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Manjunatha BS, Chikkaramaiah S, Panja P, Koratagere N. Impacted maxillary second premolars: a report of four cases. BMJ Case Rep 2014; 2014:bcr2014205206. [PMID: 25320255 PMCID: PMC4202084 DOI: 10.1136/bcr-2014-205206] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2014] [Indexed: 11/03/2022] Open
Abstract
Impacted teeth are commonly encountered in clinical practice. Apart from their symptomatic nature and the probable functional disruption they can cause, impacted teeth have the potential to cause more severe and serious problems such as development of dentigerous cysts and other complications due to their proximity to the nasal and oral cavity. In this report, we highlight a series of four cases involving maxillary second premolars, teeth that are not often impacted.
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Affiliation(s)
| | | | - Pritam Panja
- Basic Dental Sciences, College of Dentistry, University of Taif, Al-Hawaiah, Taif Kingdom of Saudi Arabia
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32
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Tecco S, Lacarbonara M, Dinoi MT, Gallusi G, Marchetti E, Mummolo S, Campanella V, Marzo G. The retrieval of unerupted teeth in pedodontics: two case reports. J Med Case Rep 2014; 8:334. [PMID: 25301242 PMCID: PMC4206860 DOI: 10.1186/1752-1947-8-334] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Accepted: 07/31/2014] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The retrieval of unerupted teeth in pedodontics is always significant to preserve the trophism of adjacent tissues, establish the correct space, provide adequate function and maintain good esthetics for the patient. The treatment plan is based on radiographic examinations and measurements, and on an accurate clinical evaluation; it aims to achieve the best treatment possible depending on the complexity of the specific case.In the most difficult clinical cases it is very important to have an early diagnosis, which is essential to plan the treatment and achieve success. In these cases, the pediatrician is in a strategic position to give an early diagnosis through a child's medical history and by counting the child's teeth. CASE PRESENTATION This article presents two different difficult clinical cases of impacted teeth diagnosed during pediatric age, with a radiological analysis, and successfully treated with orthodontic devices designed for these specific cases. Clinical case 1 describes a 13-year-old Italian girl; clinical case 2 describes a 9-year-old Italian girl. The use of these devices achieved the desired treatment goals. The problems associated with impacted teeth and the biomechanical interventions used for these patients are discussed. CONCLUSIONS An early and careful diagnosis followed by an accurate treatment plan for the individual cases can lead to retrieval of the impacted teeth without affecting other anatomic structures and adjacent teeth. In these cases, the pediatrician is in a strategic position to give an early diagnosis through a child's medical history and by counting the child's teeth.
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Affiliation(s)
- Simona Tecco
- University Vita-Salute San Raffaele, Dental Clinic, via Olgettina, 58 20132 Milano, Italy.
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Abstract
Maxillary midline diastema is a common aesthetic complaint of patients. Treating the midline diastema is a matter of concern for practitioners, as many different aetiologies are reported to be associated with it. The appearance of midline diastema as part of the normal dental development makes it difficult for practitioners to decide whether to intervene or not at an early stage. The aim of this article is to review the possible aetiology and management options which will help the clinician to diagnose, intercept and to take effective action to correct the midline diastema. The available data shows that an early intervention is desirable in cases with large diastemas. Treatment modality, timing and retention protocol depends on the aetiology of the diastema. Therefore, priority needs to be given to diagnosing the aetiology before making any treatment decisions. Clinical Relevance: This article aims to determine and evaluate the aetiology and possible treatment options of midline diastema.
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Dinoi MT, Lacarbonara M, Dimartino S, Monaco A, Marzo G. Periodontal probing of an impacted tooth recovered through a surgical-orthodontic approach: a case report. J Med Case Rep 2014; 8:25. [PMID: 24468410 PMCID: PMC3917525 DOI: 10.1186/1752-1947-8-25] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 11/20/2013] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The aim of this work was to assess the periodontal support of a central upper incisor recovered through a surgical-orthodontic approach compared to the spontaneously erupted contralateral incisor. CASE PRESENTATION This case study describes an 8-year-old Caucasian female with an impacted upper right central incisor. Surgical-orthodontic treatment was performed to reset the impacted dental element in the arch. Periodontal probing was performed of all sites (mesio-buccal, central-buccal, disto-buccal, mesio-palatal, central-palatal and disto-palatal) of the recovered impacted tooth and the contralateral tooth. The results were compared to determine whether the treated element showed signs of periodontal injury. CONCLUSIONS Most of the probing results on both her right and left incisors gave values of approximately 3mm, which were not considered pathological. Both dental elements had adequate and physiological osseous attachments.
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Affiliation(s)
- Maria Teresa Dinoi
- Department MeSVA, School of Dentistry, University of L'Aquila, L'Aquila, Italy.
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Hashim HA, Al-Qahtani AA, Taha SM, Tharupeedikayil S, Ahmed MF. Management of complete impacted maxillary second deciduous molar with the aid of cone-beam computed tomography: Case report and a review of the literature. J Orthod Sci 2013; 2:130-5. [PMID: 24987655 PMCID: PMC4072386 DOI: 10.4103/2278-0203.123201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Complete impaction of primary teeth is a very rare condition and less seen at the dental office compared with permanent dentition. To report the use of cone-beam computed tomography in the management of a 7-year-old boy with completely impacted maxillary second deciduous molar due to the presence of odontoma and a cystic lesion.
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Affiliation(s)
- Hayder A Hashim
- Orthodontic Section, Department of Dentistry Hamad Medical Corporation, Doha, Qatar
| | | | - Samir M Taha
- Department of Oral and Maxillofacial Surgery, Department of Dentistry Hamad Medical Corporation, Doha, Qatar
| | | | - Mutaz F Ahmed
- Endodontics Section, Department of Dentistry Hamad Medical Corporation, Doha, Qatar
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Affiliation(s)
- Tyler Boynton
- Department of Oral and Maxillofacial Surgery, University of Connecticut School of Dental Medicine, 263 Farmington Avenue, Farmington, CT 06030, USA
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Seager L, Ponduri S, Robinson S. Mandibular second premolars – the wandering minstrel. ACTA ACUST UNITED AC 2013. [DOI: 10.12968/ortu.2013.6.2.38] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Leonie Seager
- Maxillofacial SHO, Queen Alexandra Hospital, Portsmouth, St Mary's Hospital, Isle of Wight and the Spires Cleft Centre, Salisbury, UK
| | - Sirisha Ponduri
- Consultant Orthodontist, Queen Alexandra Hospital, Portsmouth, St Mary's Hospital, Isle of Wight and the Spires Cleft Centre, Salisbury, UK
| | - Stephen Robinson
- Consultant Orthodontist, Queen Alexandra Hospital, Portsmouth, St Mary's Hospital, Isle of Wight and the Spires Cleft Centre, Salisbury, UK
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Agrawal B, Gharote H, Nair P, Shrivastav S. Infected complex odontoma: an unusual presentation. BMJ Case Rep 2012; 2012:bcr-2012-006493. [PMID: 22922919 DOI: 10.1136/bcr-2012-006493] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Odontomas represent a hamartomatous malformation. They are usually asymptomatic and are diagnosed on routine radiological examination .The eruption and infection of odontoma are uncommon. Till now, only 20 cases of erupted odontoma are reported in the literature. We report an unusual case of infected complex odontoma with eruption of odontoma in the oral cavity and perforation of the cheeks with a tooth impacted upon which makes the presentation unusual that has not been reported earlier. The dentist should be familiar with common and unusual appearance of odontoma for proper diagnosis and management.
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Affiliation(s)
- Bhavana Agrawal
- Department of Oral Medicine and Radiology, Jodhpur Dental College General Hospital, Jodhpur, Rajasthan, India
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A review of the oral health-related evidence that supports the orthodontic treatment need indices. Prog Orthod 2012; 13:314-25. [PMID: 23260543 DOI: 10.1016/j.pio.2012.03.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2011] [Revised: 03/02/2012] [Accepted: 03/06/2012] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND AND OBJECTIVES To date, there is no evidence-based method of quantification for malocclusion. Consequently, how deviant occlusal traits should be scored and weighted relative to one another is a matter of serious debate. Orthodontic Treatment Need Indices (OTNI) use the subjective opinion of the experts, as their foundation, to define the pathological boundaries (cut-offs) of occlusal traits. This paper reviews the evidence relating malocclusions or deviated occlusal traits to oral health problems, and investigates if this evidence supports the cut-off points and the rationale used for OTNI. MATERIALS AND METHODS The relevant cited studies and reviews from the MEDLINE, Web of Science, Scopus, Cochrane databases, and scientific textbooks were used. The citation rate was confirmed by using the Google Scholar. RESULTS So far, the evidence for harmful effects of deviated occlusal traits on oral health is either lacking or exists as cross-sectional (mostly) and longitudinal (a few and primarily short-term) studies. When an association was reported between a deviated occlusal trait and an oral health problem, either the strength of that association was weak, or due to methodological issues, findings were not conclusive. Consequently, establishing a cause and effect relationship is difficult. Further, commonly used OTNI do not record a full spectrum of occlusal traits, and relating their ranking or scoring systems to the available evidence is difficult. Therefore, there is little evidence to suggest that individuals with a high need (high score), as measured by OTNI, will necessarily put at risk their oral health if they turn down orthodontic therapy. CONCLUSION OTNI have a role in the epidemiology and can be used for resource planning, but their predictive value to detect the future objective functional deficits or oral health problems is questionable. OTNI will need revalidation over time with emerging research findings.
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The impacted maxillary canine: a proposed classification for surgical exposure. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 113:222-8. [DOI: 10.1016/j.tripleo.2011.02.025] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2010] [Revised: 02/09/2011] [Accepted: 02/14/2011] [Indexed: 11/19/2022]
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Abstract
Dentoalveolar surgery in children presents general dentists with unique challenges not encountered in adults. The long-term effects that treatments have on these children must always be taken into consideration. A clear understanding of the growth and development of pediatric patients is necessary to correctly identify dental abnormalities.
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Affiliation(s)
- Sean W Digman
- Department of Oral and Maxillofacial Surgery, David Grant USAF Medical Center, 101 Bodin Cir, Travis AFB, CA 94535, USA.
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Pinho T, Neves M, Alves C. Impacted maxillary central incisor: Surgical exposure and orthodontic treatment. Am J Orthod Dentofacial Orthop 2011; 140:256-65. [DOI: 10.1016/j.ajodo.2009.11.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2009] [Revised: 11/01/2009] [Accepted: 11/01/2009] [Indexed: 10/17/2022]
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Ferro F, Funiciello G, Perillo L, Chiodini P. Mandibular lip bumper treatment and second molar eruption disturbances. Am J Orthod Dentofacial Orthop 2011; 139:622-7. [PMID: 21536205 DOI: 10.1016/j.ajodo.2009.07.024] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2009] [Revised: 06/01/2009] [Accepted: 07/01/2009] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Mandibular lip-bumper (LB) nonextraction treatment, usually started before complete second molar (M2) eruption, inevitably interacts with the development of the dentition. Yet, its effects on M2 eruption are still unknown. The first aim of this study was to retrospectively investigate whether LB therapy (260 patients) enhances the risk for M2 ectopic eruptions and impactions in comparison with 135 untreated subjects. The second aim was to assess, among treated patients (n = 197), the main potential determinants of M2 impaction and ectopic eruption. METHODS M2 eruption and impaction were determined on panoramic radiographs. To assess the predictive role of M2 inclination in relation to the first molar, a panoramic radiograph suitable for this measurement before treatment was required. The data were analyzed by using software (version 8.2, SAS, Cary, NC). RESULTS LB treatment significantly enhanced M2 impaction and ectopic eruption. Negative prognostic factors were found. An initial inclination of the M2 greater than 30° was significantly associated with a higher impaction risk compared with an angulation less than 10°. LB treatment duration longer than 2 years increased the risk of ectopic eruptions. CONCLUSIONS While gaining space in the anterior arch, unwanted effects might be produced in the posterior arch. To be informed about these unplanned events is necessary to better optimize treatment.
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Karp JM. Delayed tooth emergence. Pediatr Rev 2011; 32:e4-17. [PMID: 21196499 DOI: 10.1542/pir.32-1-e4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Jeffrey M Karp
- Division of Pediatric Dentistry, Department of Dentistry, University of Rochester Medical Center, Rochester, NY, USA
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Xuan K, Zhang YF, Liu YL, Jun F, Jin F, Wei KW. Comprehensive and sequential management of an impacted maxillary central incisor with severe crown-root dilacerations. Dent Traumatol 2010; 26:516-20. [PMID: 21078077 DOI: 10.1111/j.1600-9657.2010.00931.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Tooth dilaceration refers to a dental anomaly characterized by an abrupt deviation in the longitudinal axis of tooth. Crown-root dilaceration is diagnosed in teeth with sharp angles at the cement-enamel junction. The greater the bending degree is, the less chance there is for successful teeth preservation and relocation. In this report, a clinical case of an impacted maxillary central incisor with severe crown-root dilacerations was described by means of an operative evaluation using three-dimensional dental computed tomography and a multidisciplinary approach that included surgical, orthodontic, endodontic, prosthetic and periodontal therapy.
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Affiliation(s)
- Kun Xuan
- Department of Pediatric Dentistry, School of Stomatology, Fourth Military Medical University, Xi'an, China.
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Barros SEC, Janson G, Torres FC, de Freitas MR, de Almeida RR. Class I malocclusion treatment: influence of a missing mandibular incisor on anterior guidance. Am J Orthod Dentofacial Orthop 2010; 138:109-17. [PMID: 20620841 DOI: 10.1016/j.ajodo.2008.02.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2007] [Revised: 02/01/2008] [Accepted: 02/01/2008] [Indexed: 11/16/2022]
Abstract
This case report describes the orthodontic treatment of a patient with a deep-overbite Angle Class I malocclusion, agenesis of a mandibular central incisor, and 2 supernumerary teeth, which caused impaction of the mandibular first premolars. The 15-year-old patient also had a convex profile, maxillary dentoalveolar protrusion, and deficiency of space for the correct alignment of teeth. Therefore, treatment consisted of fixed appliance therapy, cervical headgear, extraction of the supernumeraries and the mandibular and maxillary first premolars, and mesiodistal reduction of the maxillary incisors to solve the arch perimeter discrepancy as much as possible with interproximal stripping. This method of treatment significantly improved the patient's facial and dental esthetics and provided a good functional occlusion, despite the absence of a mandibular incisor, which generally impairs achieving adequate incisal guidance.
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L’ankylose dentaire : diagnostic par tomodensitométrie et reconstruction tridimensionnelle. ACTA ACUST UNITED AC 2010; 91:707-11. [DOI: 10.1016/s0221-0363(10)70101-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Mesotten K, Naert I, van Steenberghe D, Willems G. Bilaterally impacted maxillary canines and multiple missing teeth: a challenging adult case. Orthod Craniofac Res 2005; 8:29-40. [PMID: 15667643 DOI: 10.1111/j.1601-6343.2004.00313.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
UNLABELLED AUTHORS: Mesotten K, Naert I, van Steenberghe D, Willems G. OBJECTIVES Orthodontic correction of bilateral maxillary canine impaction with agenesis of the lower second premolars and extraction of the lower first molars in an adult patient. METHODS After surgical exposure, the canines were relocated in the arch by means of immediate orthodontic traction. Endosseous Branemark system implants were inserted in the lower jaw with a double purpose: stabilization of orthodontic anchorage and prosthetic tooth replacement. RESULTS Closure of the edentulous space in the lower arch was accomplished by a multidisciplinary approach while orthodontic correction of the initial malocclusion was achieved. CONCLUSION Implants provided anchorage control for tooth movement and created the possibility of prosthetic rehabilitation through a multidisciplinary treatment approach.
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Affiliation(s)
- K Mesotten
- Department of Orthodontics, School of Dentistry, Oral Pathology and Maxillo-Facial Surgery, Faculty of Medicine, Katholieke Universiteit Leuven, Kapucijnenvoer 7, B-3000 Leuven, Belgium
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Abstract
General dental practitioners frequently refer patients with unerupted premolars for specialist management. The frequency of unerupted lower second premolars in 15-year-old children has been cited as high as 9.7%. Two cases are discussed involving unilateral unerupted premolars, which initially appear to be in unfavourable positions. The first patient was referred at 16 years of age and presented with an unerupted lower left first premolar positioned along the lower border of the mandible. The second patient presented with an unerupted distally inclined, horizontally positioned second premolar impacting on the roots of the first permanent molar. Both cases were reviewed without any treatment, and both premolars erupted into excellent positions. This raises important questions concerning the possible treatment options for such teeth as well as the timing of any interceptive treatment. In cases where premolars are unerupted or impacted, a multidisciplinary approach is indicated involving orthodontics, paedodontics and oral surgery to establish the optimal treatment plan.
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Affiliation(s)
- P Murray
- Oral and Maxillofacial Surgery and Orthodontics, Southmead Hospital, Bristol, UK
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Abstract
The purpose of this study was to increase understanding of the factors initiating feline odontoclastic resorptive lesions (FORLs). Fifty-six teeth (clinically and radiographically unaffected by ORLs) were harvested. Of these, 43 were from cats that had ORLs in other teeth (group A) and 13 were from cats with no clinical or radiographic evidence of ORLs in any teeth (group B). Twenty-six teeth in group A and one tooth in group B showed histological evidence of external root resorption (surface resorption and replacement resorption resulting in ankylosis). Some teeth in group B showed healed cementum resorption. It has previously been assumed that FORLs were similar to lesions associated with peripheral inflammatory root resorption, and were associated with periodontal disease. These histological findings suggest instead that a FORL is a non-inflammatory replacement resorption, resulting in ankylosis. The periodontal ligament of resorbing teeth lacked normal fibrous architecture, but was not inflamed. Resorption was not identified in cervical cementum. However, the histological appearance of the cervical cementum differed between the two groups. Several aetiopathogenetic explanatory models which arise from these observations are discussed.
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Affiliation(s)
- C Gorrel
- Department of Oral Pathology, Centre for Oral Health Sciences, Malmö University, Sweden
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