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1/5. A case for absolute anchorage.

    It would be an understatement to say that implant technology has changed the face of dentistry in the past 10 years or so. Both the surgical and restorative specialties have undergone dramatic transformation from treatment planning through all phases of rehabilitation. However, the same cannot necessarily be said for the specialty of orthodontics. Although it could be argued that implants have had an impact on the planning and setup of orthodontic cases (such as in congenitally missing teeth situations), the actual utilization of implants as an integral part of mechanotherapy has only begun to be realized. The ultimate extension of this application of using implants to enhance tooth movement would be to employ implants that are designed solely for the purpose of facilitating orthodontic therapy, with no intention to restore, but rather to explant such implants, after their purpose is fulfilled.
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2/5. Two- and three-dimensional orthodontic imaging using limited cone beam-computed tomography.

    Considerable progress has been made in diagnostic, medical imaging devices such as computed tomography (CT). However, these devices are not used routinely in dentistry and orthodontics because of high cost, large space requirements and the high amount of radiation involved. A device using computed tomography technology has been developed for dental use called a limited cone beam dental compact-CT (3DX). The aim of this article is to demonstrate the usefulness of 3DX imaging for orthodontic diagnosis and treatment planning. We present three cases: (1) one case shows delayed eruption of the upper left second premolar, (2) the second case shows severe impaction of a maxillary second bicuspid; and (3) the third case shows temporomandibular joint disorder (TMD). In the tooth impaction cases, the CT images provided more precise information than conventional radiographic images such as improved observation of the long axis of the tooth, root condition, and overlap with bone. In the TMD case, clear and detailed temporomandibular joint images were observed and pre- and posttreatment condylar positions were easily compared. We conclude that 3DX images provide useful information for orthodontic diagnosis and treatment planning.
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3/5. Case report SB: long-term follow-up on Class II treatment with first molar extractions.

    Widespread acceptance of water fluoridation has greatly reduced the need for molar extractions. When treating Class II malocclusions that require the removal of teeth in the maxillary arch only, consideration should be given to the first molars as well as the more commonly extracted first premolars. This report describes such a case. The patient's active treatment ended in 1979, shortly before he left for college. After one retention visit, he was not seen again until he turned up in the early 1990s' literally on our doorstep, to practice general dentistry across the hall!
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4/5. chiropractic/dental cotreatment of lumbosacral pain with temporomandibular joint involvement.

    OBJECTIVE: To demonstrate the concept of integrated dental orthopedic and cranio-chiropractic care for treating structural disorders of the jaw, neck and spine. CLINICAL FEATURES: A 33-yr-old woman sought chiropractic care for centralized lumbosacral pain that had persisted for 3 months. She exhibited pain on lumbopelvic extension and marked limitations on lumbopelvic flexion. In addition, cervical rotation and cranial sutural motion in the right malar maxillary suture were restricted. The left temporal mandibular joint also was limited in translation. Based on initial chiropractic sacro-occipital technique, she was diagnosed with Category III lumbopelvic dysfunction. X-ray examination revealed a lumbosacral angle of 39 degrees, with sacral displacement posterior to the weight-bearing line. In conjunction with the beginning of chiropractic care, she was encouraged to seek dental-orthodontic evaluation. After 30 months of chiropractic treatment, she was still experiencing some lower back pain and limited improvement. She finally agreed to see the orthodontist. Orthodontic evaluation revealed a Class I malocclusion with significant loss of vertical dimension, characteristic of bilateral posterior bite collapse. INTERVENTION AND OUTCOME: Initial orthodontic treatment began in September 1991 and was followed by restorative dentistry to replace the missing teeth. This cotreatment approach, which integrated dental orthopedic and craniochiropractic care, ameliorated the pain and improved head, jaw, neck and back function. CONCLUSION: The position of the jaw, head and vertebral column, including the lumbar region, are intricately linked. Orthodontic treatment improved the position of the mandible, which in turn enabled the body to respond to chiropractic care.
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5/5. Restoring function and esthetics in a patient with amelogenesis imperfecta.

    amelogenesis imperfecta is a rare dental disease and presents a major challenge to the dentist. With the tremendous advances in the field of esthetic dentistry, especially in bonding to dentin, it is today possible to restore function and esthetics to an acceptable level. The need for full crown preparation has been decreased to an absolute minimum. A case of amelogenesis imperfecta, complicated by a malocclusion, is presented. A combination of periodontal treatment and resin-bonded porcelain onlays and nobel alloys resulted in a highly successful outcome. The virtual absence of enamel was overcome with the aid of dentin bonding.
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