Cases reported "Diastema"

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1/38. The influence of transseptal fibers on incisor position and diastema formation.

    Transseptal fibers are a part of the gingival group of fibers of the periodontal membrane, and they are very tough and resistant. They form a chain from tooth to tooth which, provided that it remains intact and is sufficiently strong to resist displacing muscular pressures, will preserve the contacts between the teeth throughout the arch. If the continuity of the chain is interrupted, the balance of the forces acting upon the teeth on either side of the break is upset and considerable displacements can occur. Maxillary median diastemas are classified as "simple" or "persistent" according to their etiology, and an operation to clear the upper midline suture of transeptal fibers is described as an essential part of the treatment of persistent upper median diastema.
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2/38. Palatal radicular multigrooves associated with severe periodontal defects in maxillary central incisors.

    BACKGROUND: This case report describes a rare condition of palatal radicular multigrooves on teeth 11 and 21 with severe periodontal defects and the findings at 3-year follow-up. METHOD: Radiculoplasty using hand curettes and rotary burs were used to remove the multigrooves on the root surfaces and change the wrinkled root form to the relatively flat and smooth normal root morphology. Minor tooth movement and frenotomy were performed for a diastema between teeth 11 and 21. Supportive periodontal therapy started immediately after completion of the active treatment. RESULTS: Improved healthy periodontal tissues and adequate plaque control have been maintained.
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3/38. Operative dentistry: an alternative to orthodontics.

    The purpose of this paper is to describe a clinical case, which highlights the role of Operative dentistry in the treatment of Dento-alveolar Disproportion in an impoverished tropical environment. The patient had a diastema located between tooth 24 and tooth 25 due to an atypical position of his tongue while swallowing. The patient had been referred to because he could not afford orthodontics. We suggested a conservative bridge compounded of 2 resin veneers and pontic bounded by the composite tetric ceram. The 0.5 mm teeth reduction concern lingual and proximal faces with retention form, starting at 0.3 mm from the incisal edge to 0.5 mm from the gingiva was performed with diamond burs (shoulder and finishing). The result was satisfactory and leads us to conclude that Operative dentistry is a good alternative to orthodontics in a very specific social context.
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4/38. An unusual case of talon cusp on geminated tooth.

    A rare case of talon cusp on geminated permanent central incisor is described. These developmental anomalies cause clinical problems including unsightly dental appearance, occlusal interference, displacement of the affected tooth, attrition, periodontopathy, irritation of the tongue, loss of space and malocclusion. Clinical and radiographic characteristics of these anomalies and modes of treatment are presented. Recognition of this condition and early diagnosis are important to avoid complications.
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5/38. Aesthetic tooth alignment using etched porcelain restorations.

    In restorative dentistry, aesthetics often depends upon the creation of symmetry at the patient's midline. This concept can be taken further in that an aesthetic smile has symmetry and harmony between horizontal and vertical planes. This article demonstrates a prosthodontic alternative to orthodontic therapy for patients who require an immediate change to their smile rather than submitting to the latter's extended treatment period. While orthodontic treatment remains the standard for the majority of these cases, other modalities are required for patients who refuse it.
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6/38. Spaced dentition--open, close or redistribute?

    A spaced dentition can be due to various reasons such as hypodontia, tooth size discrepancy and impeded eruption. The dilemma for clinicians is whether to close, open or redistribute space. Closing space by orthodontics eliminates the need for prosthetic rehabilitation but it might compromise aesthetics and function. On the other hand, opening space is more complex and requires long-term maintenance. Based on these drawbacks, a careful occlusal analysis and an individualized treatment plan are mandatory for achieving the best result. The prognosis for closing space and substituting congenitally missing maxillary laterals with canines depends on factors such as overjet, lip support, crown colour, shape and root position. If these are unfavourable, opening space for prosthetic replacement is then preferred. Discrepancy between tooth and jaw size results either in spacing or crowding. The location of the spacing and the amount of overjet are important factors guiding the direction of treatment.
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7/38. Hypodontia: etiology, clinical features, and management.

    patients who are congenitally missing one tooth or more are frequently encountered in routine practice. The etiology, classification, and clinical features of hypodontia are reviewed, and treatment modalities are discussed. One case of mild-to-moderate hypodontia and one case of severe hypodontia are described. Osseointegrated implants have provided encouraging results, especially in patients who are missing anterior teeth or who have severe hypodontia.
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8/38. Multidisciplinary evaluation and clinical management of mesiodens.

    Supernumerary teeth are a disorder of odontogenesis relatively common in the oral cavity and characterized by an excess number of teeth. The term mesiodens is used to refer to an unerupted supernumerary tooth in the central region of the premaxilla between the two central incisors. The complications associated with mesiodens include: lack of eruption of permanent teeth, the deviation of the eruption path, rotations, retention, root re-absorption and pulp necrosis with loss of vitality, and diastema. Early detection of mesiodens is most important if such complications are to be avoided. This report describes the treatment of a maxillary central incisor impacted by a mesiodens. The case initially required only surgical treatment, to remove the supernumerary tooth. Successively, orthodontic therapy was done to bring into position the left permanent central incisor, which erupted physiologically, but rotated 90 degrees around along its long axis.
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9/38. Management of anterior spacing with orthodontics and prosthodontics.

    Closing maxillary and mandibular diastemas is facilitated by a multidisciplinary approach involving orthodontics and prosthodontics. This case study demonstrates the management of a discrepancy in maxillary and mandibular anterior tooth widths. The problem is resolved by limited orthodontic treatment followed by porcelain laminate veneers. Anterior spacing is one of the major reasons adults seek esthetic treatment. Multidisciplinary treatment (periodontics, orthodontics and/or prosthodontics) is often indicated for an optimal result.
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10/38. The use of orthodontic intrusive movement to reduce infrabony pockets in adult periodontal patients: a case report.

    Clinicians often encounter osseous defects that are best treated by conventional surgical techniques, including bone grafting and guided tissue regeneration, with a goal of establishing a new connective tissue attachment. On occasion, the recognition of an infrabony defect proximal to a tooth with a large diastema may present an opportunity to consider resolution by orthodontic tooth movement. Ideally, the tooth could be moved in the proximal direction until there was no further radiographic or clinical evidence of the predisposing defect. The authors decided to treat an advanced case of adult periodontitis, with extrusion and migration of a maxillary central incisor, using a multidisciplinary approach. Radiologically, a large infrabony defect was present on the mesial aspect of the incisor, with an initial probing depth of 9 mm. After the surgical periodontal therapy, the orthodontic movement started and the incisor was repositioned using an intrusive mechanism, also leading to the closure of the diastema. At the end of the treatment, there was a significant clinical decrease in the probing depth values, and radiographs showed a remarkable reduction of the infrabony defect volume.
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