Cases reported "Diastema"

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11/40. 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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12/40. An interdisciplinary approach for improved esthetic results in the anterior maxilla.

    This clinical report describes an interdisciplinary (orthodontic, periodontic, and prosthodontic) approach for the coordinated treatment of a patient diagnosed with peg-shaped maxillary lateral incisors, diastemata, short clinical crowns, excessive gingival display, and orthodontic malocclusion. The patient's specific esthetic expectations for the anterior maxilla were successfully met through phased treatment, including orthodontic tooth movement, provisional restorations, periodontal surgery for lengthening of the clinical crown, porcelain laminate veneers, and direct composite restorations. Such coordinated interdisciplinary evaluation and treatment are necessary for improved esthetic results in maxillary anterior areas esthetically compromised in several aspects.
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13/40. Hypohydrotic ectodermal dysplasia: an unusual presentation and management in an 11-year-old Xhosa boy.

    ectodermal dysplasia (ED) is an inherited disorder in which two or more ectodermally derived structures fail to develop, or are abnormal in development. Hypohydrotic ectodermal dysplasia (HED) or Christ-Siemens-Touraine syndrome, is an X-linked recessive syndrome with an incidence of 1/10,000 to 1/100,000 births. Because of its X-linked inheritance pattern, it is more common in males. HED is characterised by hypohydrosis (diminished perspiration), hypotrichosis (decreased amount of hair) and microdontia (small teeth), hypodontia (lack of development of one or more teeth) or adontia (total lack of tooth development). These patients present diagnostic and treatment challenges because of variable oral manifestations. This report describes an 11-year-old Xhosa boy, who was referred to the University Dental faculty by his general medical practitioner because of hypodontia. General facial features included: frontal bossing, a depressed nasal bridge, 'butterfly' pattern of eczema over the nasal bridge to the malar process of each cheek, thinned out hair, loss of vertical dimension of face and dry skin. Intra-oral examination revealed hypodontia with peg-shaped anterior teeth and diastemas. Radiological examination revealed no developing permanent teeth or tooth buds. diagnosis was confirmed by doing a sweat gland count. Management included oral hygiene instruction, fluoride treatments, construction of a partial lower denture and counselling about his condition with particular reference to the danger of hyperthermia and control of allergies.
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14/40. diastema preservation in resin-bonded fixed partial dentures.

    The etched-metal, resin-bonded fixed partial denture has evolved rapidly from its origination as an extracoronal splint. Technologic advancements in both resin chemistry and retentive surface etching techniques have markedly improved the quality of the prosthesis. Today, resin-bonded fixed partial dentures are an effective, conservative means of replacing missing teeth when specific contra-indications--long spans, insufficient sound enamel, malocclusion, pathologic occlusal habits--are identified and avoided. A universally-accepted standard preparation does not exist for resin-bonded fixed partial dentures; rather, common principles of tooth reduction are agreed upon by most authors. This case report details necessary modifications in typical preparation and framework design that must be included to maintain a midline diastema when such spacing is required or preferred by the patient.
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15/40. Ceramic restorations of anterior teeth without proximal reduction: a case report.

    The primary advantage of using all-ceramic restorations is to reproduce a color and translucency close to those of the natural tooth. Additionally, it is anticipated that the use of an adhesion technique will allow a ceramic restoration without removing tooth structure in some patients. This case report describes the use of proximally bonded ceramic restorations for the closure of an anterior diastema without proximal tooth reduction. A silane coupling agent and a resin cement were used for bonding. The diastema was close with the ceramic restorations, which provided a natural appearance of the teeth. It was concluded that ceramic restorations without proximal tooth reduction was effective in improving esthetics, if the case was properly selected.
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16/40. Orthosurgical treatment with lingual orthodontics of an infraoccluded maxillary first molar in an adult.

    The biological mechanism that leads to a cessation in the normal passive eruption of a tooth is unclear, and there are differing views as to whether ankylosis is involved. When infraocclusion of a permanent molar occurs in the permanent dentition, its effects are seen (1) locally, with exaggerated tipping and relative under-eruption of the adjacent teeth; (2) regionally, with overeruption of the opposing tooth or teeth; and (3) farther afield, with deviation of the dental midline to the affected side. Treatment aimed at eliminating these adverse conditions is warranted, and this might involve the skills of both an orthodontist and an oral surgeon. When the condition occurs in an adult, the changes in facial appearance that will be caused by traditional fixed orthodontic appliances might undermine the patient's willingness to accept treatment. This report describes the successful orthosurgical treatment with lingual orthodontics of an infraoccluded maxillary first molar in an adult. The challenges, treatment alternatives, and technical refinements are emphasized.
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17/40. Management of congenitally missing second premolars with orthodontics and single-tooth implants.

    This article describes the treatment of an adolescent girl who was congenitally missing all 4 second premolars and had a retained mandibular second primary molar. Various treatment alternatives are discussed, and the final treatment plan of space opening for 3 implants and space closure of the maxillary left second premolar site is presented.
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18/40. Spontaneous correction of pathologic tooth migration and reduced infrabony pockets following nonsurgical periodontal therapy: a case report.

    This case report describes the spontaneous correction of pathologic tooth migration and reduced infrabony pockets after nonsurgical periodontal therapy. A 3-mm diastema between the maxillary incisors was closed completely, and the mandibular teeth, which had migrated pathologically, returned to the optimal position. Clinical evaluation showed a significant reduction in probing depth, with increased clinical attachment and bone deposition demonstrated radiologically.
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19/40. Lower mesiodens: report of an unusual case.

    This report describes a case of an 11 years old girl presenting a supernumerary tooth between lower central incisors. The case initially required only surgical treatment to remove the lower mesiodens. Sequentially, the patient was referred to an orthodontic therapy due to a presence of diastema.
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20/40. The use of a resin-bonded prosthesis while maintaining the diastemata: a clinical report.

    A dental arch with diastemata and missing lateral incisors represents a challenge because of discrepancies in tooth size. If an implant-supported prosthesis is not possible or not selected as a treatment option, a modified resin-bonded fixed partial denture may be a treatment option to eliminate the esthetic problems of conventional fixed partial dentures. This clinical report describes the procedures to replace congenitally missing lateral incisors with a resin-bonded prosthesis, while maintaining diastemata.
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