1/23. The surgical uncovering and orthodontic positioning of unerupted maxillary canines.1. The presence of the maxillary canine is vital to the function and esthetics of the dental complex. The availability of this tooth must be carefully considered during an orthodontic diagnosis. Lack of space is the most common cause of canine impaction. Other contributing factors are that this tooth has the longest period of developmenent and that it is bigger longer, and travels farther while erupting than any other tooth. 2. Proper management of unerupted canines is a challenge to the dental practitioner. Maxillary canines are found impacted to both the buccal and the lingual. Palatal impactions are much more common than labial impactions, but, of the two, labial impactions are more difficult to manage. 3. An appropriate surgical procedure which opens to the crowns of unerupted teeth is a key to uneventful orthodontic positioning of these teeth. Packing the follicular space with baseplate gutta-percha and keeping the crown open to the oral cavity with surgical WondrPak is an effective method of making the tooth erupt into the oral cavity. 4. Modern preformed bands and improved cements make the placement of attachment on malposed teeth relatively easy. Direct bonding techniques are also of value in the management of unerupted teeth. 5. It is practical to move teeth orthodontically from seemingly impossible positions into ideal alignment. Such teeth will function normally, and no evidence will be left of their original position or of their having been moved over long distances.- - - - - - - - - - ranking = 1keywords = labial (Clic here for more details about this article) |
2/23. Non-extraction treatment of a thirteen-year-old boy with a Class III skeletal discrepancy and severe crowding in both the upper and lower dentitions.A thirteen-year-old boy presented with a Class III skeletal tendency in association with severe crowding in both the upper and lower arches. Whilst there was not a frank posterior crossbite, it was felt that the upper arch was narrow and that the lower arch was similarly constricted. Taking this into account along with the fact that his upper lip was flat and the nasolabial angle obtuse, it was decided to pursue a non-extraction treatment, with the aim of providing by expansion an extra 16 mm of space in the upper arch and 8 mm in the lower arch to accommodate the full dentition, and with a view to extracting third molar teeth later. This proved to be successful, albeit over an extended period of time, with active treatment taking nearly three and a half years. A realistic alternative would have been to remove four bicuspid teeth and pursue an orthodontic/surgical approach to treatment. In retrospect, and with the benefit of reviewing his records without surgical intervention, the treatment plan decided upon has been well justified.- - - - - - - - - - ranking = 0.5keywords = labial (Clic here for more details about this article) |
3/23. A case of anterior open bite developing during adolescence.Imaging studies have reported on the relationship between temporomandibular joint (TMJ) degeneration and facial deformity. These studies have suggested that mandibular growth is affected by TMJ degeneration, resulting in altered skeletal structure as mandibular retrusion. However, there are very few longitudinal case reports on TMJ osteoarthrosis (OA). Progressive open bite occurred in an adolescent patient with TMJ OA. Cephalometric analysis showed a downward and backward rotated mandible, and a labial inclination of the upper incisor. magnetic resonance imaging showed internal derangement without reduction and erosion in the right and the left condyles. Although the cause of open bite is unclear in this case, tongue thrusting, and internal derangements in the temporomandibular joint were suspected as causes of the open bite.- - - - - - - - - - ranking = 0.5keywords = labial (Clic here for more details about this article) |
4/23. Simultaneous presence of a congenitally missing premolar and supernumerary incisor in the same jaw: report of case.Supernumerary teeth and hypodontia can be regarded as opposite developmental phenomena. An eight-year-old girl presented a concomitant occurrence of a supernumerary tooth and two congenitally missing teeth. The supernumerary tooth was found in the left maxillary incisor region, while the left second premolar in the maxilla and the left lateral incisor in the mandible were congenitally missing. The supernumerary tooth showed a similar color and morphology to those of the maxilla lateral incisor, and the lateral incisor on the mesial side was diagnosed as a supernumerary tooth from dental age, eruption time, and mesiodistal crown dimension. The supernumerary incisor was guided labially to cure an anterior cross-bite, and the lateral incisor, canine, and first premolar were guided distally to compensate for the space left by the congenitally missing left second premolar.- - - - - - - - - - ranking = 0.5keywords = labial (Clic here for more details about this article) |
5/23. A newer approach in positioning teeth for dental prosthetics using lateral cephalometric, trans-cranial radiographs, and the Denar-Witzig articulator: a case of hypodontia in an adolescent patient.Traditionally in full denture prosthetics, anterior teeth are set on the models, independent of the effects on the face. More enlightened dentists, will then adjust the wax-up for speech, and some effects on the lips. Consideration is infrequently given to restoring the face by repositioning the teeth and mandible. Rarely is thought given to the effects of occlusion on the posture of the body. This report uses several techniques to restore facial esthetics and body posture. The techniques used include a cephalometric radiograph, transcranial radiographs, an articulator that has an adjustable "TMJ" (Denar-Witzig), and Symmetrigraf posture Chart. This clinical report describes a newer approach in the positioning of maxillary anterior teeth for a patient with hypodontia and nail dysplasia syndrome, and the overall effect of this approach on the face and posture of the patient. Conventionally the precise form of the maxillary wax rim is fabricated with considerable variation from technician to another, based on the technicians training. This variation is evident on the position of the labial aspect of the rim horizontally and vertically. The wax rim is then further adjusted chair side based on subjective evaluation of the face. The maxillary anterior teeth position is established without considering that the lip position is not yet accustomed to the wax rim.- - - - - - - - - - ranking = 0.5keywords = labial (Clic here for more details about this article) |
6/23. Rigid external distraction osteogenesis for a patient with maxillary hypoplasia and oligodontia.OBJECTIVE: In this report, the orthodontic treatment combined with rigid external distraction osteogenesis in a 5.5-year-old girl with midfacial hypoplasia and oligodontia is described. PATIENT: The child presented with a reduced maxilla, protruding lower lip, skeletal Class III jaw relationship with a low mandibular plane angle, a short and flattened nose, anterior crossbite, and aplasia of 16 permanent teeth. The patient was treated with rigid external maxillary distraction osteogenesis, maxillary protraction headgear, and Class III elastics. Following treatment, the maxilla was displaced in a forward direction with new bone formation at the tuberosities and the mandible rotated backward in relation to the anterior cranial base. The anterior crossbite was corrected, and the skeletal jaw relationship changed from a Class III to a Class I skeletal pattern. The soft tissue facial profile showed that the nasal projection had been increased, the nasolabial angle increased, and the lower lip protrusion was reduced. Postoperative treatment results were acceptable. CONCLUSION: This report documents that early maxillary advancement with rigid external osteogenesis offers a promising treatment alternative for a very young patient with maxillary hypoplasia and oligodontia.- - - - - - - - - - ranking = 0.5keywords = labial (Clic here for more details about this article) |
7/23. Orthodontic treatment for jaw deformities in cleft lip and palate patients with the combined use of an external-expansion arch and a facial mask.patients with cleft lip and palate can suffer from contraction of the maxillary arch and anterior cross-bite accompanied by skeletal growth retardation. We use an appliance called an external-expansion arch and induce maxillary protraction using a facial mask in order to correct the anterior cross-bite and maxillary retrusion. In this paper, the method of application of these appliances and the effects of this therapy are reported here. The external-expansion arch consists of a labial wire, bands and a sectional arch. The 0.045-inch stainless steel wire extends along the maxillary dental arch. Hooks are soldered immediately distal to the lateral incisor and the distal leg of the vertical loop. The brackets are bonded to the maxillary anterior teeth, and a 0.016 x 0.016 inch sectional arch is set. The external-expansion arch is inserted into the headgear tube and ligated with the sectional arch using elastic thread. The maxillary bone is pulled by use of the facial mask and the elastic band. For traction, the force is about 300 g on each side, applied parallel to the occlusal plane or slightly downward. The duration of use is 8 to 12 hours per day. The external-expansion arch has several advantages: it can be applied from the early period of Hellman's dental age IIIA or IIC to improve anterior cross-bite. As it is easy to expand the anterior teeth and move individual teeth to the labial and buccal sides, establishment of a dental arch from severe collapse is not difficult. When an expanding device such as the Quad-helix is incorporated, lateral expansion becomes easier. Furthermore, it is easy to control the teeth vertically, and patient compliance is not necessary. Hence, this method is effective as a phase 1 treatment for orthodontic patients with cleft lip and palate characterized by maxillary retardation.- - - - - - - - - - ranking = 1keywords = labial (Clic here for more details about this article) |
8/23. Mandibular symphyseal distraction and its geometrical evaluation: report of a case.In this report, the case of a patient who has been treated with a different use of a tooth-borne custom-made mandibular symphyseal distraction device is presented. The difference in the application is that the distal arm of the device was sectioned during the retention phase to allow the possible relapse of displaced condyles to their original positions while the labial segment expansion is being maintained. The effect of this procedure was also evaluated on a geometrical model using measurements from the patient's cast. We conclude that symphyseal distraction is an effective and fast method of correcting orthodontic anomalies. The effect of the procedure on the condyle was only 3 degrees of distolateral rotation as calculated using the geometrical model.- - - - - - - - - - ranking = 0.5keywords = labial (Clic here for more details about this article) |
9/23. A case of oculo-facio-cardio-dental syndrome with integrated orthodontic-prosthodontic treatment.OBJECTIVE: Oculo-facio-cardio-dental (OFCD) syndrome is a very rare condition that requires comprehensive dental management because of associated multiple dental anomalies such as canine radiculomegaly, delayed dentition, oligodontia, persistent primary teeth, microdontia, and macrodontia. This report presents a case of OFCD in a Japanese girl (13 years 1 month old). We analyzed cephalograms, panoramic roentgenograms, and dental casts and discuss our integrated orthodontic-prosthodontic treatment. DESIGN: The sizes of the tooth crown and root as well as lateral cephalograms were compared with those from a Japanese control group. The outcome of orthodontic treatment was evaluated by comparing cephalograms taken before and after treatment. RESULTS: Radiculomegaly was found not only in the upper and lower canines but also the upper central incisors and lower first premolars. Macrodontia was found in the upper central incisors, upper canines, lower canines, and lower first premolars. Microdontia was found in the upper lateral incisor. Lateral cephalometric analysis showed a remarkable hypoplastic midface in both the sagittal and vertical dimensions, coupled with a significantly decreased cranial base length and an increased gonial angle. Serial lateral cephalograms during orthodontic treatment from 13 to 23 years of age demonstrated only slight maxillary growth and significant downward mandibular growth with clockwise rotation in addition to pronounced labial tipping of the upper central incisors. CONCLUSIONS: Characteristic dental anomalies together with a unique craniofacial dysmorphology were clarified. Successful oral rehabilitation was achieved by integrated orthodontic-prosthodontic treatment.- - - - - - - - - - ranking = 0.5keywords = labial (Clic here for more details about this article) |
10/23. Screw-type implants used as anchorage for lingual orthodontic mechanics: a case of bimaxillary protrusion with second premolar extraction.We present a case of bialveolar protrusion treated with second premolar extraction. The patient did not agree to placement of a visible labial appliance or to the use of a headgear. Therefore, a lingual orthodontic appliance was used, and titanium screws were placed into the buccal alveolar bone for orthodontic absolute anchorage and support of en masse retraction of the anterior teeth. Cephalometric superimposition and panoramic radiographs showed little anchorage loss and good occlusion at the end of treatment. Our results suggest that lingual treatment combined with a screw-type implant anchorage provides reliable and comfortable results for those seeking invisible treatment.- - - - - - - - - - ranking = 0.5keywords = labial (Clic here for more details about this article) |
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