1/28. A comparison of autotransplantation and orthodontics in a case exhibiting two ectopic upper cuspids. Bilateral severely ectopic maxillary cuspids were treated differently on each side. On one side the ectopic cuspid was moved into position orthodontically, and on the other, the ectopic cuspid was positioned by autotransplantation. The orthodontic positioning took a long time and the tooth exhibited root resorption. Treatment time for the autotransplantation positioning was far quicker, and there was no resorption nor were there any other side effects. ( info) |
2/28. The management of traumatic ankylosis during orthodontics: a case report. Dental ankylosis may be a significant complication in orthodontic clinical practice. This case report describes the management of a malocclusion, complicated by an ankylosed maxillary central incisor, which arose during orthodontic treatment, following an acute traumatic injury. The use of the ankylosed incisor in successfully managing the significant Class II division 1 malocclusion is described. ( info) |
3/28. The complex case--unforeseeable findings and interdisciplinary treatment. Orthodontic treatment is described in a case requiring an early treatment start due to disturbed eruption in the upper front, with displacement of an upper central incisor, tongue dysfunction and Class III tendency. The further course revealed additional problems which had been unforeseeable at treatment onset: ankylosis of the lower left first molar and dehiscences in the lower front. Treatment duration was very long due to treatment measures overlapping. The interdisciplinary treatment measures are outlined and the difficulties posed by contractual guidelines are pointed out. ( info) |
| The purpose of this prospective study was to determine if there is a difference between the amount of cellular and acellular cementum on the roots of 2 teeth extracted from a subject with cleidocranial dysplasia (CCD) compared to 10 teeth extracted from 10 subjects unaffected by CCD. The cementum of 2 permanent teeth, which had been extracted from the CCD subject, was examined and histomorphometrically analyzed for comparison to the cementum of 10 anterior teeth that had been extracted from individuals who were unaffected by CCD. The percentage of the root covered by cellular or acellular cementum was quantified to determine if patients affected by CCD typically lack cellular cementum. In the roots of the 2 permanent teeth of the subject with CCD, a mean of 18.05 /- 10.67% was covered by cellular cementum and 76.90 /- 3.53% was covered by acellular cementum. In the 10 permanent teeth from subjects without CCD, a mean of 19.12 /- 15.60% of the root was covered by cellular cementum and 80.34 /- 15.71% was covered by acellular cementum. The findings indicate that there is no statistically significant difference between the amount of either cellular or acellular cementum covering the roots of the study subject with CCD and the roots of the 10 control teeth. The presumption that a lack of cellular cementum causes the increased number of unerupted teeth in patients with CCD is not supported by the findings of this study. ( info) |
5/28. Splinting of traumatized teeth with a new device: TTS (titanium Trauma Splint). Displacement injuries of permanent teeth are an increasing emergency in the dental office. Children and adolescents are particularly prone to dental trauma due to participation in risky activities. Repositioning or replantation with subsequent stabilization by a dental splint is the standard of care for most displaced or avulsed permanent teeth. Non-rigid fixation allowing physiologic tooth mobility has been shown to be desirable for periodontal healing. A flexible splint of short duration appears to reduce the risk of dentoalveolar ankylosis or external replacement resorption. Different splinting techniques are currently recommended for stabilization of repositioned or replanted teeth, including a wire-composite splint, an orthodontic bracket splint or a resin splint. Each splinting option has its specific advantages and shortcomings. This paper describes a new splinting technique which offers improved comfort and handling to the patient and dentist alike. ( info) |
6/28. Moving an ankylosed central incisor using orthodontics, surgery and distraction osteogenesis. When a dentist replants an avulsed tooth, the repair process sometimes results in the cementum of the root and the alveolar bone fusing together, with the replanted tooth becoming ankylosed. When this occurs, the usual process of tooth movement with bone deposition and bone resorption at the periodontium cannot function. If dental ankylosis occurs in the maxillary incisor of a growing child, the ankylosed tooth also cannot move vertically with the subsequent vertical growth of the alveolar process. This results in the ankylosed tooth leaving the plane of occlusion and often becoming esthetically objectionable. This report describes a 12-year-old female with a central incisor that was replanted 5 years earlier, became ankylosed, and left the occlusal plane following subsequent normal vertical growth of the alveolar process. When growth was judged near completion, the tooth was moved back to the occlusal plane using a combination of orthodontics, surgical block osteotomy, and distraction osteogenesis to reposition the tooth at the proper vertical position in the arch. This approach had the advantage of bringing both the incisal edge and the gingival margin of the clinical crown to the proper height in the arch relative to their antimeres. Previous treatment procedures for ankylosed teeth have often involved the extraction of the affected tooth. When this is done, a vertical defect in the alveolar process results that often requires additional bone surgery to reconstruct the vertical height of the alveolar process. If the tooth is then replaced, the replacement tooth must reach from the final occlusal plane to the deficient ridge. This results in an excessively long clinical crown with a gingival height that does not match the adjacent teeth. ( info) |
7/28. Hypodontia, ankylosis and infraocclusion: report of a case restored with a fibre-reinforced ceromeric bridge. Retained primary molars without permanent successors often undergo progressive infra-occlusion, without predictable exfoliation. Early prophylactic removal, after assessment of root resorption and adjacent periodontal support loss as well as age of onset, is often indicated. This article describes the joint orthodontic-restorative care of such a case and describes an alternative method of restoration using a fibre-reinforced ceromeric bridge. As well as a conservative preparation and good aesthetics, an overlay restoration provided a fully functional occlusion. ( info) |
| Masticatory function challenges the strength and adaptive capability of supporting bone. When osseous tissue is loaded, it accumulates fatigue damage which must be repaired by bone modeling and remodeling. The three principal masticatory abutments (normal teeth, ankylosed teeth and osseointegrated implants) are a dynamic physiologic continuum relative to bone biomechanics. Implants are rigidly integrated units that can only be moved by fracturing the interface. Normal teeth and some ankylosed teeth can be moved using implants for orthodontic and orthopedic anchorage. Because orthodontic translation generates new bone and attached gingiva, it is a form of tissue engineering. Modern interdisciplinary practice requires a thorough knowledge of the principles of bone physiology and biomechanics. ( info) |
9/28. Submerged permanent teeth: literature review and case report. Submerged permanent teeth pose a diagnostic as well as a treatment planning dilemma. Teeth with delayed eruption, arrested eruption, and paradoxical movement all can appear to be submerged teeth. While orthodontics may seem like the simplest solution, it often has the most frustrating results. A multidisciplinary approach often is required, utilizing surgical, orthodontic, and prosthetic components. ( info) |
10/28. Alveolar distraction osteogenesis: a case report involving ankylosed maxillary central incisors. Restorative dentistry, for the optimal esthetic and functional result, at times requires innovation, exacting techniques, and employment of various treatment modalities. A case has been presented here involving a large esthetic defect in the maxillary anterior. Traditional methods of restoration may have been successful but alveolar distraction osteogenesis was determined to be the treatment of choice due to time, predictability, lack of invasiveness, and cost. It is a relatively new surgical procedure that has many applications to restore esthetic defects, ridge augmentation, and large craniofacial abnormalities. Movement of osseous sections can be made in a vertical, labial, or lingual direction. When treatment planning restorative dentistry with vertical hard and soft tissue deficiencies, alveolar distraction osteogenesis can be considered to achieve optimal esthetics and a more ideal crown-to-root ratio. Further information can be obtained from any oral surgeon, orthodontist, or from the internet. Dr. Martin chin, a maxillofacial surgeon from san francisco, has done much of the clinical work regarding distraction procedures on humans and continues to be an innovator in craniofacial distraction osteogenesis. His work can be found on the internet at www.distraction.net; other interesting Web sites include www.klsmartin.com/distract.dir/indexdistract.html and www.seattle-implants.com/articles/distost.htm. ( info) |